When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.
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Back muscles development
With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:
Back muscles and core muscles increase in function and performance.
Muscles are strengthened.
Lean muscle mass increases.
The range of motion of the spine increases.
Body fat decreases.
Guidelines while using weights
When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:
Severe pain.
Back pain that originates from:
Previous spinal surgery
Tumor
Nerve root compression
Neurological symptoms
Sciatica
Spinal fracture/s
Spinal infection/s
Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.
Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
Trained physical/occupational therapists and sports chiropractors can educate an individual on:
Correct techniques
Frequency
Type of training that will help an individual’s condition.
Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.
Smaller weights build strength progressively
Effective ways to strengthen the spine.
Begin with small/light weights and exercise slowly.
Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
It is recommended to start with:
Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
Simple stretches
Exercise machines can be recommended instead of free weights.
Exercise machines can provide safe, effective, and progressive resistance to the exercises.
The machines can help reduce/prevent injury compared to free weights.
The machines can maintain proper support on the back and spine.
It is recommended to combine regular walking activity with a weight training program.
Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
This promotes healing and reduces stiffness.
Training program and benefits
Gaining the most benefits from strength training, tips to keep in mind:
Warm up for a few minutes using heat therapy and simple stretches.
Try for 2 or 3 times a week for 30 minutes.
Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
There is no need to join a gym or buy expensive equipment.
Work out at home with small hand weights, resistance bands, and body weight.
The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
If back pain presents with a sustained increase, take time off or modify the strength training exercises.
Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.
Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.
Body Composition
Carbohydrates and Muscle Growth
Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.
Carbs prevent muscle weakness.
Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.
Carbs help muscles recover after exercise.
Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.
References
Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.
Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325
Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.
Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050
Many individuals do not realize the importance of the type of pillow they use for sleep. Sleeping on the wrong pillow is the perfect set-up for neck, shoulder, and back pain. Here are a few chiropractic tips on what to know about picking the best pillow. Knowing which is the right pillow for you can be the key to proper sleep and waking up pain-free.
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Importance of Pillows
Neck and shoulder pain can be a nightmare, especially when the body cannot get decent rest. The right pillow/s can help with neck and back pain symptoms and recover from injuries quicker. When the head is in an awkward position for sleep duration, this causes neck, shoulder, and headache problems. The importance of finding the right pillow follows a set of guidelines.
Shape
The shape of the pillow has a definitive role in the cervical/neck’s curvature.
Posture
Sleep posture is important in preventing neck, shoulder, and back musculoskeletal pain.
Sleep quality
Craniocervical pressures and cervical spine alignment are height-specific. Any changes can affect an individual’s sleep quality.
Height
Cervical alignment can become significantly impacted by the shape and height of the pillow.
Pillow Comfort Importance
Trying to find the right pillow will require trial and error. The basics to consider include:
One sign that it’s time for a new pillow is waking up with pain.
Age of current pillows. The recommendation is they should be replaced every year or two. This depends on the stuffing/material used as different types wear down quicker.
If problems are getting comfortable and being able to fall asleep.
Constantly readjusting or fluffing the pillow/s.
The pillow has become lumpy or lost its shape.
It is flat with no cervical support or, too high placing the head in a forward tilt.
This is an online quiz along with a personalized process in their stores.
The process helps choose a pillow based on individual support preferences and sleep position for the best spinal alignment.
Customizable or adjustable pillows are another option. These pillows allow the individual to change the amount of filling to fit their needs.
Research, personal preference, and advice from a doctor and or chiropractor will help find the pillow that is right for you.
A third of an individual’s life is spent in bed. Make it as comfortable as possible.
Body Health
Sleep Body Composition Importance
Not getting enough sleep makes it difficult to gain muscle.
Not getting enough sleep means that the body experiences less short wave sleep, affecting the body’s ability to secrete Growth Hormone and develop muscle.
Testosterone is negatively affected by lack of sleep.
Not enough sleep increases cortisol levels, impairing muscle development.
Not getting enough sleep makes it difficult to lose fat.
Irregular sleep throws off the body’s ghrelin/leptin cycles, causing hunger.
Not getting enough sleep has been linked to eating more.
Not getting enough sleep can cause reductions in the body’s Basal Metabolic Rate, reducing total energy output.
Tiredness reduces spontaneous movements.
References
“Effect of sleep posture on neck muscle activity.” Journal of Physical Therapy. June 2017. https://pubmed.ncbi.nlm.nih.gov/28626314/
“Effect of pillow height on the biomechanics of the head-neck complex: investigation of the craniocervical pressure and cervical spine alignment.” PeerJ. August 2016. https://pubmed.ncbi.nlm.nih.gov/27635354/
“How Often Should You Replace Your Pillows?” Sleep Foundation, Seattle, WA. https://www.sleepfoundation.org/bedding-information/how-often-should-you-replace-your-pillows
“Improving the quality of sleep with an optimal pillow: a randomized, comparative study.” Tohoku Journal of Experimental Medicine. July 2014. https://pubmed.ncbi.nlm.nih.gov/25008402/
“The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis.” Clinical Biomechanics. May 2021. https://pubmed.ncbi.nlm.nih.gov/33895703/
Okamoto-Mizuno, Kazue, and Koh Mizuno. “Effects of thermal environment on sleep and circadian rhythm.” Journal of physiological anthropology vol. 31,1 14. 31 May. 2012, doi:10.1186/1880-6805-31-14
Low-back, neck, shoulder, hip, leg, and foot pain are all causes of everyday discomfort and a bad mood. Chronic pain exacerbates the discomfort and bad mood times 10. Chiropractic treatment can help realign the spine and alleviate the pain. However, to maintain pain relief, individuals need to make healthy lifestyle adjustments. One of the most important adjustments is eating habits. Those dealing with chronic pain may not realize their diet is contributing to the pain.
At Injury Medical Chiropractic and Functional Medicine Clinic, we have a combined team of chiropractors, physical therapists, a health coach, and a nutritionist to help educate, develop, and support a personalized treatment plan on spinal health, posture, physical activity/exercise, balance, and eating habits.
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Salt, Sugar, and Fat Affects the Body
A sedentary lifestyle is a significant contributor to chronic pain, but unhealthy eating habits also play a role. Poor diet adds weight to the body. This stresses the body’s biomechanical structure. It also aggravates inflammation. Too much salt, sugar, and fats ingested through processed foods, fast food, and unhealthy habits affect the body’s regulating systems. They can affect everything from the nervous system, nerves, proper circulation, even the limbic system. The inflammation and stress generate and exacerbate chronic pain symptoms.
Changing unhealthy eating habits is up to the individual.
Individuals can be advised to cut back or cut out unhealthy diet choices; however, it is easier said than done. A doctor, health coach, and nutritionist have no control over what individuals do when they leave the clinic. Individuals themselves can have little control over their own eating habits. Many have an addiction to unhealthy food, which is a disease in itself. To help change poor eating habits, individuals need to be educated on how their eating habits affect the total body and mental health.
Nutrition Discussion
Chronic pain associated with inflammation linked to a poor diet is the first step in the diagnosis and developing an optimal treatment plan. It could be as simple as informing an individual that eating cheeseburgers are causing the inflammation that is hurting their back. However, there is more to it, but individuals are more inclined to avoid the foods causing the inflammation upon hearing a full explanation. Targeting specific foods is the first step in alleviating pain.
The temptation is always there, especially when stress comes into the picture. This is why it is important to have ready-to-go adjustments/alternatives that keep the individual eating healthy, despite the chaos going on around them. A treatment plan will include quick alternatives that can happen instages. An example could be:
Having one cheeseburger and not two.
Having a burger without cheese.
Eating a burger without the buns.
Switching to a plant-based burger.
There are many options to be explored to improve eating habits in small steps.
Willpower also has to be addressed in a controlled and supportive setting. This is where the whole team comes in. Many individuals’ eating habits are part of who they and adjusting them can be an uphill challenge. To educate on:
Having the family or friends eat healthy with them
These are techniques and methods to increase willpower to make healthy changes.
Body Composition
Foods Can Support Body Detoxing
The proper foods can support the body in detoxifying toxins and counter the negative effects like brain fog, neurodegenerative disorders, and chronic pain. The foods help to:
Neutralize oxidative stress
Lower inflammation
Increase immunity
Strengthen the musculoskeletal system
Foods and nutrients that detoxify can be a part of a healthy lifestyle.
References
Bjørklund, Geir et al. “Insights on Nutrients as Analgesics in Chronic Pain.” Current medicinal chemistry vol. 27,37 (2020): 6407-6423. doi:10.2174/0929867326666190712172015
Elma, Ömer et al. “Chronic Musculoskeletal Pain, and Nutrition: Where Are We and Where Are We Heading?.” PM & R: the journal of injury, function, and rehabilitation vol. 12,12 (2020): 1268-1278. doi:10.1002/pmrj.12346
Gómez-Pinilla, Fernando. “Brain foods: the effects of nutrients on brain function.” Nature reviews. Neuroscience vol. 9,7 (2008): 568-78. doi:10.1038/nrn2421
More individuals are reporting extreme levels of stress. Studies indicate that an increasing number of individuals are feeling worried, anxious, or depressed regularly from various stressors. Maintaining the body’s health includes:
Following a balanced diet
Getting enough exercise
Taking vitamins or supplements to ensure the body gets what it needs for optimal function.
However, research has found that a sudden increase in stress, specifically stress associated with anger, can trigger:
This type of stress can affect individuals that did not know they had heart disease. Intense short-term stress can have dangerous effects on the body’s health, leading to chronic stress. Chronic stress continues at a low level for weeks, months, or years. It can significantly change the way the body functions. Stress management is very important for overall well-being. Learning how to handle stress properly is the goal.
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Poor Stress Management
When stress hits it triggers the brain to release various hormones. These hormones increase heart rate and raise blood pressure. This comes from evolution that helped early humans escape from predators and stay safe from different types of physical danger. This same stress reaction is what we go through, however, it is not to escape danger but to deal with work, family, school, commuting, and social issues, etc. And when the stress response happens on a regular basis it can have serious and long-term effects on the body’s ability to function properly. Stress includes mental, behavioral, and physical symptoms. The effects of stress that are most familiar are related to mood. Mood changes that can result from chronic low-level stress include:
These mood changes can be tied to changes in behavior. The following behaviors are associated with increased stress levels:
Alcohol and/or drug abuse
Starting or increasing tobacco use
Eating changes – undereating or overeating
Withdrawing from friends and family
Avoiding social interaction
Little to no physical activity
Physical effects that are associated with long-term stress.
Chronic stress that lasts for a long period can affect the whole body. The immune system, digestive system, sleep cycles, etc. Physical symptoms include:
Tension in the neck and back
Persistent headaches
Stomach aches
Constant fatigue, even after waking up
Sleeping pattern changes
Insomnia
Muscle pain
Changes in libido
Being more prone to infections because of a weakened immune system
Chest pain
Learning Healthy Stress Management
Mental health is now an important part of living a healthy life. Stress comes from all kinds of different places. We can’t always change these moments, but we can change our reactions to reduce the negative effects and results. To manage stress, it is important to know what is causing it.
It could be an argument with a boss, co-worker, family member, or significant other.
Work deadlines
School grades, teachers, kids, etc
Bills
Repairs
Clearly identifying the main stressors will help individuals anticipate them and form a plan. There are different ways of dealing with it. The different strategies need to be researched and tried by individuals to see what works for them. Think about what helps the mind and body relax and unwind. A few recommended ways include:
These are strategies that can be incorporated into regular daily life. Be sure to set time aside to focus on mental wellbeing. Learn to recognize the signs when getting overwhelmed. Don’t hesitate to ask for help when needed. This can be a support system or mental health professional. This is to empower individuals to take better care of themselves in both body and mind.
Body Composition
Setting Attainable Goals
Individuals that have trouble achieving health goals might want to look at the goals themselves. Individuals typically have a general idea of their fitness journey. However, it is hard to reach those goals without a map. Losing weight or getting healthy is the goal but these goals are not measurable. This is too broad that can be different things to different people. Trying to accomplish a vague goal makes it hard to plan, making it happen, or seeing progress. A recommended strategy for goal setting is to use the SMART system. The acronym stands for:
Specific
Measurable
Attainable
Realistic
Timed
When goals fall into these parameters, it provides a clear picture of what is trying to get accomplished and the ability to plan accordingly. An example could be: An individual will work out at home or the gym for one hour, five days a week for one month. This is a specific and measurable goal when compared to I’m going to work out more. This provides clear guidelines of what needs to happen to achieve success.
References
Bailey, Ryan R. “Goal Setting and Action Planning for Health Behavior Change.” American journal of lifestyle medicine vol. 13,6 615-618. 13 Sep. 2017, doi:10.1177/1559827617729634
Carlson, Linda E et al. “Integrative Approaches to Stress Management.” Cancer journal (Sudbury, Mass.) vol. 25,5 (2019): 329-336. doi:10.1097/PPO.0000000000000395
Jamison, J R. “Stress management: an exploratory study of chiropractic patients.” Journal of manipulative and physiological therapeutics vol. 23,1 (2000): 32-6. doi:10.1016/s0161-4754(00)90111-8
Jamison, J. “Stress: the chiropractic patients’ self-perceptions.” Journal of manipulative and physiological therapeutics vol. 22,6 (1999): 395-8. doi:10.1016/s0161-4754(99)70085-0
The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.
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Quadriceps Strain
Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:
Exhaustion
Muscle weakness
The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
Consistent sprinting and/or kicking
Previous strain and/or injury
The quadriceps is made up of four muscles. One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.
Symptoms and Injury Grades
Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:
Pain
Swelling
Bruising
Muscle tenderness
For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.
Grades categorize the severity of the strain:
Grade 1 presents with mild discomfort in the thigh with no loss of strength.
Grade 2 presents with moderate pain, swelling, and some loss of strength.
Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
Grade 3 is where surgery is required.
Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.
Injury causes
Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.
Treatment
In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:
Rest
Ice
Compression
Elevate
The leg needs to be rested every 2-3 hours in 20-minute sessions.
A bandage can provide added support.
For slight tears and strains, it is recommended to stretch the quadriceps gently.
This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.
Chiropractic Physical Therapy Rehabilitation
After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.
Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
Following correct post-injury-care, exercises, and physical therapy.
Healing time can be 4- 6 weeks.
Body Composition
Strength Training: The Inverted Row
This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:
Lie flat on your back.
Grab a stable barbell or set of straps that are above you.
Pull your upper body up as high as possible while keeping the back straight.
Squeeze the shoulder blades together at the top.
Complete as many reps as possible.
Once enough strength and endurance have been built, try a pullup.
References
Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5
Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003
Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015
Poor spinal health in adolescence can lead to chronic pain in adulthood. Teenagers, just like adults, can experience back pain from accidents, sports injuries, a sedentary lifestyle, part-time jobs, chores, etc. However, sitting too long in school along with heavy backpacks can also contribute to compromised spinal health. Chiropractic professionals can help these young individuals address and prevent spinal issues/injuries to maintain a healthy spine.
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Teenagers Spine Issues
If discomfort or pain is present, much push through, as they and their spines are young. There are common spinal dysfunctions that teens and parents should be aware of. These include:
Disc injuries
Teenagers can put a serious strain on the spine from various forms of physical activity, jumping, dancing, and playing. This pressure gets transmitted through the spine. During a teenager’s development, this can result in permanent disc damage.
Scoliosis
A spinal deformity or exaggerated curvature of the spine is common and affects young children and teens. It usually happens during the growth spurt just before puberty. This is why it is important to have a teenager’s spine checked regularly and analyzed for signs/symptoms of scoliosis.
Spondylolysis
This condition is often associated with sports injuries. It happens when teenagers overextend/overreach their backs. It’s most common in gymnastics, weight lifting, tennis, football, diving, and other similar sports.
Protection and Prevention
There are several ways that parents and healthcare providers can help teenagers make healthy decisions to achieve and maintain optimal spinal health.
Sitting less, moving more.
Children are taught to sit from a very young age. In school, watching t.v., or doing homework, teenagers spend more time sitting than their bodies should. Teenagers need to stand, walk and move around just like adults to protect their spines from degeneration and injury.
Playing sports is healthy. However, there is a risk associated with teen sports. Although they are taught to play safely, encourage them to continue to educate themselves about sports injuries and know how to address them.
Chiropractic Support
At Injury Medical Chiropractic and Functional Medicine Clinic, we’re committed to helping young adults and adolescents overcome and prevent spinal injuries that could turn into chronic pain conditions. We are continually developing our chiropractic, and physical therapy treatment approaches to achieve optimal results.
Body Composition
Sleep and Growth Hormone In Children
Growth hormones primarily control growth. The hypothalamus and the pituitary gland regulate this hormone. Sleep plays an important role in the proper function of these glands. A review showed that:
Growth hormone levels rise and peak at the onset of deep sleep
Multiple but smaller peaks were seen during other sleep stages
Individuals that have a delay in the onset of deep sleep have delayed peaks in growth hormone levels
For children to grow properly, they need to have adequate levels of growth hormone. This means they need to have a sufficient amount of sleep. The proper amount of sleep is vital for healthy body composition. A study measured the body composition of preschool-aged children. The study found that children who had proper sleep levels had less overall fat mass and reduced body fat. Children and teenagers need to get the proper amounts of sleep for their bodies to grow healthily.
References
Clement, R Carter et al. “What are normal radiographic spine and shoulder balance parameters among adolescent patients?.” Spine deformity vol. 8,4 (2020): 621-627. doi:10.1007/s43390-020-00074-9
Driehuis, Femke et al. “Spinal manual therapy in infants, children and adolescents: A systematic review and meta-analysis on treatment indication, technique, and outcomes.” PloS one vol. 14,6 e0218940. 25 Jun. 2019, doi:10.1371/journal.pone.0218940
Manansala, Christian et al. “Change in young people’s spine pain following chiropractic care at a publicly funded healthcare facility in Canada.” Complementary therapies in clinical practice vol. 35 (2019): 301-307. doi:10.1016/j.ctcp.2019.03.013
A non-invasive method of treating scoliosis. Yoga Has Been Shown To Help Reverse Scoliosis. Scoliosis is the lateral curvature of the spine. The spine bends inward toward the front of the body at the neck region and lower back region. This curve is known as lordosis and bows outward in the middle-back region. This is known as kyphosis. If the spine curves to the side, this could indicate curvature that could be scoliosis. It can be painful and often can affect an individual’s appearance once the measurement goes beyond 25 – 30 degrees. One shoulder is usually higher than the other, and clothing cannot fit properly. If the curve goes beyond 60 degrees, it can affect breathing and cardiac function.
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Idiopathic Causes Unknown
This condition can consist of various components, especially with more intense curves. The ribs can shift backward on the side where the curve bulges. Most cases consist of adolescent idiopathic (without a known cause) scoliosis. Because the cause is unknown, there are not a variety of effective treatment besides surgery. Physicians carefully keep an eye for:
Curves under 25 degrees.
Bracing between 25 and 45 degrees.
Consider surgery for intense curvature.
Curves in individuals typically appear between 12 and 20 years old.
Yoga Shown To Reverse Scoliosis
Individuals are recommended to do just one yoga pose daily. However, depending on the type and severity of the curves, it could be more than one. They are asked to perform the pose for 5 minutes or less, depending on the condition. A yoga therapist, chiropractor, and physical therapist can generate significant spinal improvement. This could mean that a curve of 30 degrees could be reduced to around 18 degrees in 10-12 months. Individuals that do the poses at least 4 times a week have shown 80-90% improvement. The pose can be done at work during breaks, etc.
The biggest advantage of this technique is that it is non-invasive; it can help individuals with developing curves, reversing the curvature early. Most curves do not reach the point of surgery. In late adolescence and teen years, the spine is still quite flexible. This can help accelerate the effectiveness of the yoga pose to straighten the spine. The technique reduces the curve from worsening. X-rays will show if the curvature has improved or not. Patients could be asked to do the pose/s twice or more daily depending on the direction the condition is taking.
Body Composition
Gluten Effects
Gluten causes digestive issues for individuals that have celiac disease or autoimmune thyroid disease. Individuals with these conditions could experience a variety of uncomfortable and/or painful effects. These symptoms can vary based on their presentation. They fall into classifications.
Classical Celiac Disease
With classical celiac disease, symptoms include:
Diarrhea
Discolored stools
Constipation
Abdominal bloating and pain
Weight loss
However, these symptoms are more common in children than adults. In adults, symptoms are more similar to non-classical celiac disease.
Non-Classical Celiac Disease
With non-classical celiac disease, severe digestive symptoms may not present as classic celiac disease symptoms but develop other symptoms. These include:
Silent celiac disease is less visible. Individuals might not see any symptoms. However, damage to the intestines is still happening from gluten consumption.
Autoimmune Thyroid Disease
Autoimmune Thyroid Disease or ATD. Autoimmune thyroid disease includes conditions like Hashimoto’s disease. This affects the thyroid gland and causes:
Extreme fatigue
Sensitivity to cold
Hair loss
Body aches
Joint aches
Negative health effects
Studies have shown that gluten-free helps alleviate symptoms.
References
Loren M. Fishman, M.D., B.Phil. (oxon). Healing Yoga. (New York: W.W. Norton, 2014).
Loren M. Fishman, M.D., B.Phil. (oxon). “Isometric Yoga-Like Maneuvers Improve Adolescent Idiopathic Scoliosis—A Nonrandomized Control Trial.” Global Advances in Health and Medicine. February 24, 2021. https://journals.sagepub.com/doi/full/10.1177/2164956120988259
Fishman LM, Groessl EJ, Sherman KJ, “Serial Case Reporting Yoga for Idiopathic and Degenerative Scoliosis.” Global Advances in Health and Medicine. September 1, 2014. https://journals.sagepub.com/doi/10.7453/gahmj.2013.064
Scoliosis in adolescents and teens can be corrected with proper bracing, adjustments and lead a normal life. For adult scoliosis correcting the problem is more difficult. Fortunately, cases of adult scoliosis are rare. Scoliosis cases that follow from childhood into adulthood require a comprehensive diagnosis to determine severity. Thoracolumbar scoliosis adult-onset scoliosis requires an understanding of the catalysts to develop an effective treatment plan. Chiropractors use a full range of diagnostic tools to measure the severity of adult scoliosis.
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Diagnosis
Adult scoliosis is the presentation of abnormal curvature of the spine. It can happen in the thoracic, lumbar spine, or both. This can have varying degrees of severity. Severe adult scoliosis can be apparent through visual assessment and examination. Cases that are not as obvious require utilizing diagnostic tools. These include:
Imaging
X-rays will show any asymmetry that is associated with scoliosis. This asymmetry can be present in the hips or shoulder and is usually qualified by spinal misalignment.
Walking Gait Examination
Inspecting how worn out an individual’s shoe/s are and having them perform various walking tests can reveal problems with gait. In adults, this can present instability. For example, having problems with balance or fast-twitch muscle response.
Neuromotor Exams
These exams are general and first performed to get a baseline diagnosis for the presence of adult scoliosis. Tests look at the left and right coordination along with the sense of touch capabilities. This measures the severity of the improper spinal curvature and how much it has affected the development of an individual’s motor functions. It is also done in the context of how it’s affecting the body’s biomechanics. Following these exams are quantitative tools/techniques for measuring the severity of adult thoracolumbar scoliosis. These include:
Cobb Angle Measurement
This tool determines the maximum degree of spinal curvature variation and provides a context for severity.
King Classification Tool
This examines the vertebral alignment to determine the spinal variance in specific vertebrae from the neutral center position.
Lenke Classification Tool
This spinal exam relies on measurements of three positions and looks for flexibility.
Combined Approaches
When assessing adult scoliosis, this is important to understand and helps determine how to proceed with treatment. The body is no longer in development as an adolescent. This means bracing does not come with a one-size-fits-all approach. Chiropractic can help with the assessment modalities used to investigate adult scoliosis cases. These measurement and analyses tools are often used in combination to develop a complete picture of what is going on.
Body Composition
Fill Up With Prebiotics
Individuals can help their gut bacteria thrive in the digestive tract by consuming prebiotics. Prebiotics are a form of soluble fiber. The body cannot digest these prebiotics, but gut bacteria can. Recommended sources of fiber-rich prebiotics can be found in nutrient-dense foods like:
Leeks
Garlic
Onions
Fruits
Legumes
Raw chicory
A diet with various fiber types has been shown to reduce the risk of obesity and prevent weight gain. Resistant starches like plantains, green bananas, and cooled potatoes have increased beneficial bacteria in the colon. Barley, oats, and wheat bran are insoluble high-fiber grains that are also recommended sources.
References
Aebi, Max. “The adult scoliosis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 14,10 (2005): 925-48. doi:10.1007/s00586-005-1053-9
Haenen, Daniëlle et al. “A diet high in resistant starch modulates microbiota composition, SCFA concentrations, and gene expression in pig intestine.” The Journal of nutrition vol. 143,3 (2013): 274-83. doi:10.3945/jn.112.169672
Lowe, Thomas et al. “The SRS classification for adult spinal deformity: building on the King/Moe and Lenke classification systems.” Spine vol. 31,19 Suppl (2006): S119-25. doi:10.1097/01.brs.0000232709.48446.be
Bursitis types: This is a condition that affects the bursae, which are the small, fluid-filled sacs that provide cushion for the:
Muscles
Tendons
Bones near joints
The bursae make it easier for tissues to slide over each other. The body has around one hundred and sixty bursae. However, only a few become clinically affected. These include the:
Wrist
Elbow
Shoulder
Hips
Knees
The base of the big toe and heel
The condition typically presents near joints constantly being used repetitively, like a job, sports, house/yard chores, etc. What happens is one or more of the bursae sacs become inflamed, resulting in pain.
Contents
Causes
Inflamed or irritated bursae typically cause it from overuse or intense/vigorous activity.
It can also be caused by bacterial infection.
Arthritis and gout can also cause bursitis.
Another cause is age.
As tendons age, they can tear easily, lose their elasticity, and can’t take too much stress.
Intense physical activities can lead to bursitis. These include:
Gardening
Typing
Working with a computer mouse
Throwing
Golf
Tennis
Manual tasks
Carpentry
These types of activities can lead to incorrect posture, overuse, and injury/damage.
Symptoms
The main symptom is pain in and around the affected area that worsens with movement. Depending on the severity of the strain and the length of time it has been going on, the pain can be intense with active and passive movements. Other symptoms include:
Tenderness
Stiffness
For some individuals, it can present as acute, with the intensity increasing.
This happens when movement aggravates the condition.
Bursitis Types
Four major types include:
Prepatellar
Trochanteric
Olecranon
Retrocalcaneal
Prepatellar Bursitis
Prepatellar is an inflammation of the sac situated between the skin and the patella/kneecap. The most common causes are trauma from a fall and direct pressure/friction from repetitive kneeling. This is one of the bursitis types that can get infected. Overproduction of liquid places pressure on the other areas of the knee, causing swelling. Most individuals report swelling and knee pain just over the front of the knee.
Trochanteric Bursitis
This bursitis type goes over the lateral area of the hip. There is a distinctive tenderness and aching pain. This type is more common for individuals with arthritis conditions and fibromyalgia. This condition is also seen after surgery, mainly osteotomies. The bursa can become inflamed in case of injury or overuse. It tends to affect middle-aged or older folks. Common causes include:
Muscle tears
Hip injuries
Tight hip or leg muscles
Disc disease of the low back
Leg-length inequality
Improper walking technique from a minor injury or strain
Overuse of the gluteal muscles
Flat feet
Improper footwear
Olecranon Bursitis
Olecranon is a common bursitis type. It is diagnosed by the appearance of swelling over the elbow. The swelling happens just behind the olecranon process of the ulna. The bursa can become infected. This bursitis does cause blood to rupture out, and fluid could be present. Individuals are advised to avoid leaning or resting on the elbows.
Retrocalcaneal Bursitis
This is characterized by pain in the Achilles tendon. Chronic inflammation of the bursa is brought on by friction, supination, and overpronation. The flexibility of the calf muscles can be significantly reduced. Severe pain and swelling of the posterior soft tissue in front of the Achilles tendon are common symptoms. This bursitis type is often accompanied by mid-portion insertional tendinosis.
Risk Of Getting Bursitis
Anybody at any age can develop bursitis, but older individuals, specifically those in their forties and beyond, are more susceptible. This comes from all the wear and tear of the muscles and bones.
Risk Factors
Overpronation of the foot
Leg length deviation
Osteoarthritis
Obesity
Tight hamstring muscles
Incorrect physical training
Not stretching properly
Body Composition
When Inflammation Becomes Permanent
When white blood cells cause inflammation, it’s signaling that the body’s immune system works properly. The process works like this:
Inflammation activates
White blood cells attack the foreign invader
The invader is neutralized
The inflammation deactivates
This is how the body’s defense system naturally works. But, white blood cells are not the only type of cell that emit cytokines. Adipocytes or fat cells are another type of cell that can emit cytokines and cause inflammation. Scientists have learned that fat is an active endocrine organ that secretes various proteins and chemicals, including inflammatory cytokines. The body stores excess calories as fat to be used later for energy. When the body keeps adding more adipose tissue, cytokines are released by the fat cells, triggering inflammation. Obesity is characterized as a state of low-grade, chronic inflammation. Increased fat cells place the body in a constant state of stress activating immune responses. This means the body is in a constant state of inflammation with the immune system switch permanently on.
References
Aaron, Daniel L et al. “Four common types of bursitis: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 19,6 (2011): 359-67. doi:10.5435/00124635-201106000-00006
Coelho, Marisa et al. “Biochemistry of adipose tissue: an endocrine organ.” Archives of medical science: AMS vol. 9,2 (2013): 191-200. doi:10.5114/aoms.2013.33181
Khodaee, Morteza. “Common Superficial Bursitis.” American family physician vol. 95,4 (2017): 224-231.
Surgery options when back pain is becoming chronic or so severe that an individual cannot function normally and negatively affects their life. Pretty much everyone experiences back pain at some point. This is often from:
Lifting heavy/non-heavy objects incorrectly
Improper posture
Twisting in an awkward way
Overreaching
Muscle spasms
Physical activity the body is not used to doing
Most cases of backaches and pain go away by themselves or with conservative treatment. But sometimes, surgery is necessary.
Contents
When Surgery Is Necessary
Acute back pain can last for days or weeks and can often resolve with physical therapy, chiropractic, and self-care. Back pain that continues for 12 weeks or longer is considered chronic. Around twenty percent of individuals who experience acute low back pain after a year begin developing chronic back pain. Doctors try to treat most back pain cases with non-surgical approaches.
They usually begin with physical therapy/chiropractic.
If that doesn’t work, then medication is incorporated.
However, many individuals do not want to take long-term medication, which is when surgery may be recommended.
In most cases, surgery is a last resort.
When the pain radiates to the legs or if it is causing problems with bladder and/or bowel function, these are definite signs/symptoms that surgery is needed. If the pain/dysfunction continues after thorough and effective non-surgical treatment, surgery could be recommended to preserve the spine to improve spinal strength and function before the problem worsens, causing further injury and damage. Some of the most common and effective spine surgery options include.
Surgery Options
Microdiscectomy
Microdiscectomy is the most common back surgery in the United States. It is minimally invasive spine surgery. Microdiscectomy patients have low back pain combined with leg pain, tingling, numbness, and weakness. In between the vertebrae are the body’s shock-absorbing discs. The discs can begin to bulge out, a bulging or herniated disc, and press on the surrounding nerve roots, causing pain, tingling, numbness, or weakness. A microdiscectomy removes the portions of the disc pressing on the nerve.
It is called micro because the surgeon wears specialized glasses known as loupes that act as microscopes. This is so the surgeon can see the details when they’re operating. The surgery is performed through a small incision in the middle of the back or on the affected side. Patients can go home a few hours after the surgery and return to normal activities within two weeks. The success rate is 85 – 95%, especially if the surgery is done early before the damage begins to spread out.
Laminectomy
The spinal canal contains a special lining. This is where the nerves and ligaments run through. Age, along with normal wear and tear on the body, causes the ligaments to thicken. This is when bone spurs can develop from osteoarthritis, and the discs can begin to bulge or rupture/herniate. This clogs and impinges the space where the nerves should easily flow through. This narrowing is called spinal stenosis. A laminectomy opens up the space relieving the compression/pressure. The procedure requires removing part of the back of a vertebra called the lamina. This enlarges the spinal canal and relieves the pressure on the nerves. The procedure is done through a small incision in the middle of the back but can also be done through a minimal incision. Leg pain improves after surgery. A traditional incision full recovery takes 6 to 12 weeks. The success rate is around 85 percent.
Spinal Fusion
A spinal fusion joins/fuses two or more bones in the spine. This is done when an individual has severe compression of the nerves, severe instability, or spinal revision surgery. A fusion can help stabilize spinal fractures. Other reasons for a spinal fusion are spine deformity, cancer of the spine, and sometimes used for intractable pain. A fusion stabilizes the spine with screws and rods. The disc causing the compression is replaced with a fusion device and bone graft. The surgery is often performed in combination with a laminectomy. Recovery and returning to activities can take around 3-4 months after the procedure. The success rate is 85-90% with pain improvement.
Kyphoplasty
Spinal compression fractures are common in individuals with osteoporosis. When they happen, the pain can be so intense that braces and medication don’t help. Kyphoplasty can bring pain relief. It can be performed by a pain management doctor, interventional radiologist, or surgeon in an outpatient X-ray facility and operating room. The procedure involves conscious sedation, sometimes accompanied by general anesthesia. A small instrument is inserted into the vertebra, and a balloon is inflated to make room for bone cement. After the bone cement is injected, patients can go home within a few hours. The success rate is around 85%, and recovery time could be several days.
Disc Replacement
This is a procedure that can replace spinal fusion for certain cases. A disc replacement can be done in the lumbar/low back or the cervical/neck spine. This procedure is performed to treat a pinched nerve and/or spinal cord compression. The injured/damaged disc is removed and is replaced with an artificial disc. The device allows for motion, whereas fusion procedures fuse the bones to stabilize and immobilize the area. Disc replacement is recommended for younger patients that don’t have serious arthritis. This is because they still have mobility. If significant arthritis is present, the patient could experience more pain and require spinal fusion. Recovery takes around six weeks. Intense physical activity is off-limits for two or three weeks after the initial recovery period. The success rate is more than 90%.
Anterior Cervical Discectomy and Fusion – ACDF
This is a common neck/cervical spine procedure. This surgery is for pain relief, weakness, tingling, and numbness of the arms caused by a pinched nerve or stenosis. The damaged disc is removed through a small incision in the side of the front of the neck. The disc is replaced with a bone graft or specialized spacer and a small plate with screws. This is to stabilize the spine. It is highly effective in relieving pain and in preventing neurological decline from spinal cord compression. Recovery time is around 12 weeks before a full return to normal activities. However, individuals report feeling better after two weeks.
Back Surgery Options
The majority of cases involving back pain get better on their own or with conservative treatment. But if an individual cannot find relief, there are safe and effective surgery options that can help.
Body Composition
When The Immune System Activates
When the body gets sick from a bacterial infection, virus, etc., the body’s defense system activates, causing inflammation. This immune response serves as the first wave of defense against foreign invaders. The infected area becomes red and swollen from increased blood flow. For example, when the nose gets red from a cold, this is inflammation. The reaction is caused by white blood cells known as macrophages, and the proteins they emit called cytokines encourage inflammation. Inflammation that’s triggered by the immune system is normally a good thing. It means the body is releasing a proper amount of hormones and proteins. These activate the white blood cells to start the healing process and work to fight the infection.
References
Low Back Pain Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
A review of complication rates for Anterior Cervical Diskectomy and Fusion (ACDF). Surg Neurol Int. 2019. https://pubmed.ncbi.nlm.nih.gov/31528438/
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