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The Impact of Forward Head Posture on Neck Pain

The Impact of Forward Head Posture on Neck Pain

Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?

The Impact of Forward Head Posture on Neck Pain

Forward Head Posture

Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it’s important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.

Postural Deviation

  • The head is in a healthy alignment with the neck when the ears line up with the gravity line.
  • The gravity line is an imaginary straight line that represents gravity’s downward pull.
  • It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
  • A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
  • Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)

Muscle Imbalances

  • Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
  • The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.

Kyphosis

Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.

  • This occurs because the upper back area supports the neck and head.
  • When the upper back moves or changes position, the head and neck follow.
  • The majority of the head’s weight is in the front, and this contributes to the forward movement.
  • An individual with kyphosis has to lift their head to see.

Treatment

A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.

  • Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
  • Targeted stretching can help if the neck muscles are tight.
  • At-home stretches may also relieve pain

Risk Factors

Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:

  • Constantly looking down at a phone and staying in this position for a long time aka text neck.
  • Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
  • Driving for a living causes prolonged back, neck, and shoulder positioning.
  • Sleeping or reading with a large pillow under the head can contribute to forward head posture.
  • Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
  • Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
  • An example is carrying a child or another load in front of the body.
  • Large breasts can also increase the risk of kyphosis and forward head posture.

Neck Injuries


References

Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. doi.org/10.5535/arm.2012.36.1.98

Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. doi.org/10.24171/j.phrp.2018.9.6.04

Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. doi.org/10.13075/ijomeh.1896.01293

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.

Managing Paresthesia: Relieve Numbness and Tingling in the Body

Managing Paresthesia: Relieve Numbness and Tingling in the Body

Individuals feeling tingling or pins and needles sensations that overtake the arms or legs could be experiencing paresthesia, which occurs when a nerve has been compressed or damaged. Can knowing the symptoms and causes help in diagnosis and treatment?

Managing Paresthesia: Relieve Numbness and Tingling in the Body

Paresthesia Body Sensations

The numbness or tingling feeling when an arm, leg, or foot has fallen asleep is not so much about blood circulation but nerve function.

  • Paresthesia is an abnormal sensation felt in the body due to the compression or irritation of nerves.
  • It can be a mechanical cause like a compressed/pinched nerve.
  • Or it may be due to a medical condition, injury, or illness.

Symptoms

Paresthesia can cause various symptoms. These symptoms can range from mild to severe and can be brief or long-lasting. Signs can include: (National Institute of Neurological Disorders and Stroke. 2023)

  • Tingling
  • Pins and needles sensations
  • Feeling like the arm or leg has fallen asleep.
  • Numbness
  • Itching.
  • Burning sensations.
  • Difficulty contracting the muscles.
  • Difficulty using the affected arm or leg.
  1. The symptoms typically last for 30 minutes or less.
  2. Shaking the affected limb often relieves the sensations.
  3. Paresthesia usually affects only one arm or leg at a time.
  4. However, both arms and legs can be affected, depending on the cause.

Consult a healthcare provider if the symptoms last for more than 30 minutes. Treatment may be required if paresthesia body sensations are brought on by a serious underlying cause.

Causes

Sitting with incorrect and unhealthy postures can compress a nerve and generate symptoms. However, some causes are more concerning and can include:

Seeking Medical Assistance

If the symptoms don’t go away after 30 minutes or keep returning for unknown reasons, call a healthcare provider to find out what is causing the abnormal sensations. A worsening case should be monitored by a healthcare provider.

Diagnosis

A healthcare provider will work with the individual to understand the symptoms and perform the appropriate diagnostic tests to determine the cause. A healthcare provider will choose the tests based on a physical examination. Common diagnostic procedures include: (Merck Manual Professional Version. 2022)

  • Magnetic resonance imaging – MRI of the spine, brain, or extremities.
  • X-ray to rule out bone abnormalities, like a fracture.
  • Blood tests.
  • Electromyography – EMG studies.
  • Nerve conduction velocity – NCV test.
  1. If paresthesia is accompanied by back or neck pain, a healthcare provider may suspect a compressed/pinched spinal nerve.
  2. If the individual has a history of diabetes that is poorly controlled, they may suspect peripheral neuropathy.

Treatment

Treatment for paresthesia depends on the diagnosis. A healthcare provider can help determine the best course of action for the specific condition.

Nervous System

  • If symptoms are triggered by a central nervous condition like MS, individuals will work closely with their healthcare provider to get the appropriate treatment.
  • Physical therapy could be recommended to help improve overall functional mobility. (Nazanin Razazian, et al., 2016)

Spinal Nerve

  • If paresthesia is caused by compression of a spinal nerve, like sciatica, individuals may be referred to a chiropractor and physical therapy team to release the nerve and pressure. (Julie M. Fritz, et al., 2021)
  • A physical therapist may prescribe spinal exercises to relieve compression of the nerve and restore normal sensations and motion.
  • Strengthening exercises to restore flexibility and mobility may be prescribed if weakness presents along with paresthesia body sensations.

Herniated Disc

  • If a herniated disc is causing the abnormal sensations, and there has been no improvement with conservative measures, a healthcare provider may suggest surgery to relieve pressure on the nerve/s. (American Association of Neurological Surgeons. 2023)
  • In surgical procedures like a laminectomy or discectomy, the objective is to restore nerve function.
  • Post-surgery, individuals may be recommended to a physical therapist to help regain mobility.

Peripheral Neuropathy


What Is Plantar Fasciitis?


References

National Institute of Neurological Disorders and Stroke. (2023) Paresthesia.

American Association of Neurological Surgeons. (2023) Herniated disc.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Peripheral neuropathy.

Merck Manual Professional Version. (2022) Numbness.

Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, D. S., Holsboer-Trachsler, E., & Brand, S. (2016). Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and science in sports and exercise, 48(5), 796–803. doi.org/10.1249/MSS.0000000000000834

Fritz, J. M., Lane, E., McFadden, M., Brennan, G., Magel, J. S., Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial. Annals of internal medicine, 174(1), 8–17. doi.org/10.7326/M20-4187

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Individuals dealing with back pain problems could be suffering from a bulging disc. Could knowing the difference between slipped and herniated disc symptoms help with treatments and finding relief?

Bulging Disc Pain: Physical Therapists & Chiropractic Relief

Bulging Disc Pain

Back pain can become debilitating if not treated properly. A bulging disc is a common cause of cervical, thoracic, and lower back pain symptoms. It happens when one of the fluid-filled cushions between the vertebrae begins to shift out of place. Instead of being aligned with the edges, the disc bulges over. This begins to generate pressure on the nerves causing pain and inflammation.

  • Bulging discs are often caused by age, but repetitive movements and/or lifting heavy objects can contribute to the condition.
  • Symptoms can resolve on their own, but individuals are recommended to consult with a physical therapist and/or chiropractor to make sure the disc healed properly, otherwise, it can lead to worsening and/or further injuries.

Bulging Disc vs. Herniated Disc

Bulging and herniated discs cause pain symptoms.

  1. Bulging – the intervertebral disc moves out of place but stays intact.
  2. Herniated – the thick outer layer of the disc ruptures, causing the cushioning gel inside to leak onto the spinal nerves.

Location of Symptoms

  • A bulging disc can happen anywhere along the spine.
  • However, most occur between the last five vertebrae in the lower back.
  • This is the lumbar spine. (American Academy of Orthopaedic Surgeons. 2022)
  • This is because the lower back is subject to all kinds of pressure and movement with daily activities, increasing the chances of pain and injuries.
  • The next most common place is the neck/cervical spine where there are constant movements making it prone to injury and pain symptoms.

Causes

Bulging discs are most often caused by body aging and normal wear and tear. As time goes on the intervertebral discs naturally degenerate, known as degenerative disc disease. This can cause the discs to pull downward, causing them to bulge from their placement. (Penn Medicine. 2018) Factors that can cause or worsen the condition include:

  • Practicing unhealthy postures.
  • Repetitive motions.
  • Lifting heavy objects
  • Spinal injuries.
  • Medical history of spinal or disc disease in the family.

Treatment

Treating a bulging disc takes time and patience. (American Academy of Neurological Surgeons. 2023)

Examination

Individuals with back pain that interferes with daily functions or has lasted longer than six weeks, should see a healthcare provider for a diagnosis. They will order a magnetic resonance imaging scan/MRI, which can show where a disc is protruding. (American Academy of Neurological Surgeons. 2023)

Rest

  • For bulging disc pain, resting the back is necessary. However,
  • Many patients benefit from a day or two of bed rest. (American Academy of Orthopaedic Surgeons. 2022)
  • After that, start light activities like walking. Avoid any movements that make your pain worse.

NSAIDs

  • NSAID pain medications like Advil, Motrin, or Aleve can keep pain symptoms and inflammation reduced.
  • However, this is for short-term use, as the underlying cause still needs to be addressed.
  • A healthcare provider will recommend safe dosage and how long these medications should be taken. (American Academy of Orthopaedic Surgeons. 2022)

Physical Therapy

Steroid Injection

  • An epidural steroid injection can provide relief for individuals still experiencing symptoms after six weeks.
  • A healthcare provider will inject cortisone into the spine to reduce inflammation and pain. (American Academy of Orthopaedic Surgeons. 2022)

Surgery

  • If conservative treatments don’t work, a healthcare provider may recommend surgery, like a microdiscectomy.
  • This procedure uses small incisions to remove all or part of a bulging disc.
  • Most individuals with a bulging disc will not require surgery. (American Academy of Neurological Surgeons. 2023)

Inflammation: Integrative Medicine Approach


References

Penn Medicine. (2018) Bulging disc vs. herniated disc: What’s the difference?

American Academy of Orthopaedic Surgeons. (2022) Herniated disk in the lower back.

American Academy of Neurological Surgeons. (2023) Herniated disc.

National Institutes of Health. (2022) Spinal Manipulation: What You Need To Know.

The Benefits of Eating Onions – A Comprehensive Guide

The Benefits of Eating Onions – A Comprehensive Guide

For individuals looking to maintain wellness or begin their wellness journey like increasing antioxidants, protection against cancer, immune system support and other health benefits, can adding onions be a nutritious way to improve overall health?

The Benefits of Eating Onions - A Comprehensive Guide

Onions

Onions are nutritious vegetables like garlic, chives, leeks, and shallots. The most common types are red, white, yellow, and Spanish onions. They have antifungal, antibacterial, anti-inflammatory, and other healthful properties.

  • Whichever way they are prepared they do lose some of their nutritional value when cooked.
  • They contain flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C.
  • When selecting onions, look for those without blemishes or discoloration, that are firm, and have dry, papery skins.

Benefits

They contain phytochemicals – compounds plants produce to fight off harmful bacteria, viruses, and fungi. These phytochemicals provide health benefits when consumed and provide the following properties: (Xin-Xin Zhao, et al., 2021)

  • Anti-obesity
  • Antioxidants
  • Antidiabetic
  • Anti-inflammatory
  • Antimicrobial
  • Anticancer
  • Protect the cardiovascular, digestive, respiratory, reproductive, and neurological systems.
  • Protect against liver disease.
  • Support a healthy immune system.

Types and Varieties

They belong to the Allium plant genus which includes plants like garlic, leeks, and chives. (Oregon State University. 2022)

  • They vary in flavor and can be sweet, tangy, and sour.
  • Different varieties combined with farming practices contribute to the flavor profile of onions.
  • There are many varieties of onions.
  • The most common and widely available are red, white, yellow, and Spanish.
  • Other types include cipollini, pearl, and Vidalia.

Raw or Cooked

They are beneficial whether eaten raw or cooked, cooking them reduces the number of thiosulfinates – compounds that provide antimicrobial, antifungal, and antibiotic properties.

  • Research shows that onions that are crushed before cooking retain their health benefits. (Holly L. Nicastro, et al., 2015)
  • Boiling and frying onions has been shown to cause the most significant loss in nutritious value.
  • Other preparation methods that decrease health benefits include sautéing, steaming, and microwaving.
  • Baking onions is shown to increase flavonoid levels.
  • Consuming dried, powdered onions can also provide nutritious value to foods, especially if the powder is freeze-dried. (Damini Kothari, et al., 2020)

Nutrition Facts

Onions can contribute to a healthy diet. The flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C, contribute to the antioxidant properties of the vegetable. (Holly L. Nicastro, et al., 2015) The nutrition information for one medium onion: (U.S. Department of Agriculture. N.D.)

  • Total calories: 44
  • Total fat: 0 grams
  • Cholesterol: 0 milligrams
  • Carbohydrates: 10 grams
  • Dietary fiber: 2 grams
  • Total sugars: 5 grams
  • Protein: 1 grams
  • Calcium: 2 milligrams
  • Sodium: 4 milligrams
  • Iron: 1 milligrams
  • Vitamin D: 0 micrograms

When Selecting

Onions can contain pesticide residue, heavy metals, microbial contamination, and nitrate accumulation. Knowing where the onions come from can help ensure there was no incorrect use of pesticides or that the soil they were grown in was not enriched with heavy metals. When possible, purchase from reputable sources with transparent farming practices, like the farmers markets. (Xin-Xin Zhao, et al., 2021)

  • Onions found in environments that have not been effectively sterilized have an increased risk of growing harmful bacteria.
  • To avoid contamination of Escherichia. coli or E. coli, salmonella, and mold, it’s safest to purchase whole onions and cut them at home rather than purchasing pre-chopped onions. (Xin-Xin Zhao, et al., 2021)
  • Select those that feel firm, have little to no bruises or discolored spots, and have dry papery skin.
  • Avoid those that show evidence of mold, like white or black spots on the surface or inside the layers, and those with green shoots, which means the onion is still edible but won’t last that long.

Hypertension Diet


References

Zhao, X. X., Lin, F. J., Li, H., Li, H. B., Wu, D. T., Geng, F., Ma, W., Wang, Y., Miao, B. H., & Gan, R. Y. (2021). Recent Advances in Bioactive Compounds, Health Functions, and Safety Concerns of Onion (Allium cepa L.). Frontiers in nutrition, 8, 669805. doi.org/10.3389/fnut.2021.669805

Oregon State University. Types of onions and varieties.

Nicastro, H. L., Ross, S. A., & Milner, J. A. (2015). Garlic and onions: their cancer prevention properties. Cancer prevention research (Philadelphia, Pa.), 8(3), 181–189. doi.org/10.1158/1940-6207.CAPR-14-0172

Kothari, D., Lee, W. D., & Kim, S. K. (2020). Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability. Antioxidants (Basel, Switzerland), 9(9), 888. doi.org/10.3390/antiox9090888

U.S. Department of Agriculture. Onions.

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Individuals who engage in a regular fitness regimen can begin to lose interest and motivation. Can knowing the signs of exercise burnout help individuals rediscover their motivation?

Unwind & Recharge: Exercise Burnout Symptoms & Recovery

Exercise Burnout

When maintaining fitness and health becomes a chore and doing anything else is better than working out, individuals could be experiencing exercise burnout. Here are a few signs an individual is getting burned out.

Procrastination

One sign is constantly putting things off.

  • An individual may put on workout clothes, set up the equipment, etc.
  • However, the workout never happens as the individual continues to find other things to do.
  • At some point, they decide it’s too late and they’ll work out tomorrow.

Solution

Simplify the workout. Make some small goals or adjustments and keep the workout light. (Nemanja Lakicevic, et al., 2020) An example could be:

  • Focus only on stretching.
  • Take a walk around the block.
  • Go up and down some stairs equivalent to a few laps.
  • Do 10 pushups, 10 squats, and 10 lunges, or other exercises and that’s it.

No Longer Interesting

When burned out, exercise is not interesting and disenchanting. (Franklin Velasco, Rafael Jorda. 2020) Trainers will suggest finding something positive about the workouts.

Solution

Switch to a new or different activity. (Nemanja Lakicevic, et al., 2020)

  • When the interest and passion are nowhere to be found don’t engage in the usual workouts, as this can further decrease motivation.
  • This is the time to change up the routine and go for a leisurely bicycle or rollerblade, skateboard, etc., session.
  • Go to a park, just walk around, and forget about exercise just taking in everything.
  • Play a game with a friend or toss a ball around.

Exhaustion

Not just physical, but mental fatigue could be a sign of exercise burnout.

Solution

  • Rest.
  • Individuals may think they have to work out every day and stick to the regimen or else they’ve failed.
  • This type of mindset can lead to burnout and added stress.
  • The body and mind require adequate recovery time.
  • Forget about structured exercise for a day, and see how the mind and body feel the next day.
  • Two or three days off in a row can make a significant difference in motivation and offer a new perspective on the workout routine.

Low Energy Levels After Exercise

Workouts, although tiring in a good way, should energize the individual. Most workouts should leave the body feeling better than before. When the body feels worse or energy levels are low, this could be a sign of overtraining that could lead to exercise burnout.

Solution

  • This could be the time to ease off of the fitness regimen.
  • Forget intense workouts and/or heavy-weight training.
  • This is the time to soothe the body.
  • Light yoga workouts or Pilates could help.
  • This is a form of active recovery, allowing the mind and body to rest from the overwork.

Mood Changes and/or Irritability

When the mind and body are overworked and over-trained, it can cause moodiness, irritability, and frustration that leads to burnout.

Solution

Do something that feels good. This could include:

  • A therapeutic massage.
  • A spa session.
  • Taking a long nap.
  • Soaking the feet.
  • Taking a therapeutic bath.
  • Meditation

Burnout can happen, the objective is to keep the solutions simple like taking a few days off or trying something new to come back feeling refreshed and energized.


Multidisciplinary Evaluation and Treatment


References

Lakicevic, N., Gentile, A., Mehrabi, S., Cassar, S., Parker, K., Roklicer, R., Bianco, A., & Drid, P. (2020). Make Fitness Fun: Could Novelty Be the Key Determinant for Physical Activity Adherence?. Frontiers in psychology, 11, 577522. doi.org/10.3389/fpsyg.2020.577522

Velasco, F., & Jorda, R. (2020). Portrait of Boredom Among Athletes and Its Implications in Sports Management: A Multi-Method Approach. Frontiers in psychology, 11, 831. doi.org/10.3389/fpsyg.2020.00831

Small Fiber Neuropathy: What You Need to Know

Small Fiber Neuropathy: What You Need to Know

Individuals diagnosed with peripheral neuropathy, or with small fiber neuropathy, can understanding symptoms and causes help with potential treatments?

Small Fiber Neuropathy: What You Need to Know

Small Fiber Neuropathy

Small fiber neuropathy is a specific classification of neuropathy, as there are different types, which are nerve injury, damage, disease, and/or dysfunction. Symptoms can result in pain, loss of sensation, and digestive and urinary symptoms. Most cases of neuropathy like peripheral neuropathy involve small and large fibers. Common causes include long-term diabetes, nutritional deficiencies, alcohol consumption, and chemotherapy.

  • Small fiber neuropathy is diagnosed after diagnostic testing showing it is clear that the small nerve fibers are involved.
  • The small nerve fibers detect sensation, temperature, and pain and help regulate involuntary functions.
  • Isolated small-fiber neuropathy is rare, but research is ongoing on the type of nerve damage and potential treatments. (Stephen A. Johnson, et al., 2021)
  • Small fiber neuropathy is not specifically dangerous but is a sign/symptom of an underlying cause/condition that is damaging the body’s nerves.

Symptoms

Symptoms include: (Heidrun H. Krämer, et al., 2023)

  • Pain – symptoms can range from mild or moderate discomfort to severe distress and can happen at any time.
  • Loss of sensation.
  • Because the small nerve fibers help with digestion, blood pressure, and bladder control – symptoms of autonomic dysfunction can vary and can include:
  • Constipation, diarrhea, incontinence, urinary retention – the inability to completely drain the bladder.
  • If there is progressing nerve damage, the intensity of the pain can decrease, but the loss of normal sensation and autonomic symptoms can worsen. (Josef Finsterer, Fulvio A. Scorza. 2022)
  • Hypersensitivity to touch and pain sensations can cause pain without a trigger.
  • The loss of sensation can make individuals unable to accurately detect sensations of touch, temperature, and pain in affected areas, which can lead to various types of injuries.
  • Although more research is needed, certain disorders that were not considered neuropathies may have small fiber neuropathy components involved.
  • A study suggested that neurogenic rosacea, a skin condition, could have some elements of small fiber neuropathy. (Min Li, et al., 2023)

Small Nerve Fibers

  • There are several types of small nerve fibers; two in small fiber neuropathy include A-delta and C. (Josef Finsterer, Fulvio A. Scorza. 2022)
  • These small nerve fibers are distributed throughout the body including the tops of the fingers and toes, trunk, and internal organs.
  • These fibers are usually located in the superficial areas of the body, such as close to the skin’s surface. (Mohammad A. Khoshnoodi, et al., 2016)
  • The small nerve fibers that get damaged are involved in transmitting pain and temperature sensations.
  • Most nerves have a special type of insulation called myelin that protects them and increases the speed of nerve impulses.
  • Small nerve fibers may have a thin sheath, making them more susceptible to injury and damage at earlier stages of conditions and diseases. (Heidrun H. Krämer, et al., 2023)

Individuals At Risk

Most types of peripheral neuropathy cause damage to the small and large peripheral nerve fibers. Because of this, most neuropathies are a mix of small-fiber and large-fiber neuropathy. Common risk factors for mixed fiber neuropathy include: (Stephen A. Johnson, et al., 2021)

  • Diabetes
  • Nutritional deficiencies
  • Overconsumption of alcohol
  • Autoimmune disorders
  • Medication toxicity

Isolated small-fiber neuropathy is rare, but there are conditions that are known to contribute to the cause and include: (Stephen A. Johnson, et al., 2021)

Sjogren Syndrome

  • This autoimmune disorder causes dry eyes and mouth, dental problems, and joint pain.
  • It can also cause nerve damage throughout the body.

Fabry Disease

  • This condition causes a buildup of certain fats/lipids in the body that can lead to neurological effects.

Amyloidosis

  • This is a rare disorder that causes a buildup of proteins in the body.
  • The proteins can damage tissues like the heart or nerves.

Lewy Body Disease

  • This is a neurological disorder that causes dementia and impaired movement and can lead to nerve damage.

Lupus

  • This is an autoimmune disease that affects joints, skin, and sometimes nerve tissue.

Viral Infection

  • These infections typically cause a cold or gastrointestinal/GI upsetness.
  • Less often they can cause other effects like small fiber neuropathy.

These conditions have been seen to cause isolated small-fiber neuropathy or begin as small-fiber neuropathy before progressing to the large nerve fibers. They can also begin as a mixed neuropathy, with small and large fibers.

Progression

Often the damage progresses at a relatively moderate rate, leading to added symptoms within months or years. The fiber nerves that are affected by the underlying condition usually progressively deteriorate, regardless of where they are located. (Mohammad A. Khoshnoodi, et al., 2016) Medications can help alleviate damage to the peripheral nerves. For individuals that are diagnosed in the early stage, it is possible to stop the progression, and potentially prevent involvement of the large fibers.

Treatments

Treatment toward preventing the progression requires controlling the underlying medical condition with treatment options depending on the cause. Treatments that can help prevent the progression include:

  • Blood sugar control for individuals with diabetes.
  • Nutritional supplementation for the treatment of vitamin deficiencies.
  • Quitting alcohol consumption.
  • Immune suppression for control of autoimmune diseases.
  • Plasmapheresis – blood is taken and the plasma is treated and returned or exchanged for the treatment of autoimmune diseases.

Symptom Treatment

Individuals can get treatment for the symptoms that will not reverse or cure the condition but can help with temporary relief. Symptomatic treatment can include: (Josef Finsterer, Fulvio A. Scorza. 2022)

  • Pain management can include medications and/or topical analgesics.
  • Physical therapy – stretching, massage, decompression, and adjustments to keep the body relaxed and flexible.
  • Rehabilitation to help improve coordination, which can be impaired by loss of sensation.
  • Medications to relieve GI symptoms.
  • Wearing specialized clothes such as neuropathy socks to help with foot pain symptoms.

Treatment and medical management of neuropathies usually involve a neurologist. A neurologist may prescribe medication to help alleviate pain symptoms and provide medical interventions like immunotherapy if there is concern that an autoimmune process could be the cause. Additionally, treatment could include the care of a physical medicine and rehabilitation physician or a physical therapy team to provide stretches and exercises to help strengthen the body and maintain mobility and flexibility.



References

Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. doi.org/10.1212/WNL.0000000000012894

Finsterer, J., & Scorza, F. A. (2022). Small fiber neuropathy. Acta neurologica Scandinavica, 145(5), 493–503. doi.org/10.1111/ane.13591

Krämer, H. H., Bücker, P., Jeibmann, A., Richter, H., Rosenbohm, A., Jeske, J., Baka, P., Geber, C., Wassenberg, M., Fangerau, T., Karst, U., Schänzer, A., & van Thriel, C. (2023). Gadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers. Journal of neurology, 270(8), 3981–3991. doi.org/10.1007/s00415-023-11740-z

Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., & Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Frontiers in pain research (Lausanne, Switzerland), 4, 1122134. doi.org/10.3389/fpain.2023.1122134

Khoshnoodi, M. A., Truelove, S., Burakgazi, A., Hoke, A., Mammen, A. L., & Polydefkis, M. (2016). Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA neurology, 73(6), 684–690. doi.org/10.1001/jamaneurol.2016.0057

Relieving Low Back Pain Through Chiropractic Spinal Decompression

Relieving Low Back Pain Through Chiropractic Spinal Decompression

Can individuals with low back pain find relief with spinal decompression combined with chiropractic care to reduce muscle pain?

Introduction

Everyone worldwide has dealt with low back pain, a multifactorial common problem that can mask other musculoskeletal disorders. Low back pain can develop naturally through spinal degeneration, normal environmental factors people put their bodies through, or traumatic factors that can gradually affect the lumbar region over time. The lower back is part of the lumbar spine region as it takes most of the upper body’s weight and stabilizes the lower body when in motion. The lumbar region is thick to support the upper body’s weight and is protected by the surrounding ligaments, muscles, and tissues; however, it is the most susceptible to injury. Many people don’t realize they are experiencing low back pain until an accident or repetitive motions begin to affect the surrounding ligaments or the lumbar intervertebral discs are severely compressed. To that point, many individual are experiencing radiating pain in their lower extremities. However, all is not lost, as there are numerous ways to alleviate low back pain and provide relief to many individuals. Today’s article focuses on the factors that lead to the development of low back pain and how treatments like chiropractic care and spinal decompression can help reduce low back pain and its symptoms. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease low back pain and its associated symptoms. We also inform our patients that there are non-surgical options like chiropractic care and spinal decompression to minimize the radiating pain associated with low back pain. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

 

Factors That Lead To The Development Of Low Back Pain

Do you feel muscle aches and pains in your lower back when stretching? Does the pain cause issues in your mobility when going to run errands? Or do you feel sudden or gradual pain after a long workday of carrying heavy objects or excessively sitting at your desk? When many individuals are experiencing pain in these various scenarios, it can lead to the development of a lower back that correlates with these environmental factors. Low back pain is a common nuisance that many working and non-working individuals experience occasionally. When various risk factors are associated with low back pain, it can cause many individuals to deal with the physical and psychological demands that cause them to do multiple things like heavy lifting, awkward positions, and excessive bending, which can develop pain-like symptoms in the lumbar region. (To et al., 2021) At the same time, compared with other health conditions, low back pain is the highest global burden, causing many individuals to miss out on important events like work and daily activities. (Petrozzi et al., 2020) This causes them to live a life of disability and causes them to feel miserable. Low back pain can affect a person’s socioeconomic demographic and the functionality that they seek the treatment they deserve. 

 

 

Many individuals who experience low back pain will often lead a life of disability and socioeconomic burden correlated with these factors. (Wong et al., 2022) Many people often think that low back pain only happens to older adults, but low back pain can happen to anybody at any age. Many factors that correlate to the development of low back pain include:

  • Improper heavy lifting
  • Walking incorrectly
  • Being in a slouched or hunched position
  • An auto accident
  • Obesity 
  • Gastrointestinal issues
  • Referred musculoskeletal disorders
  • Physical inactivity

Many of these environmental factors are associated with low back pain that many people are unaware of when doing their routine. This is due to the surrounding tissues, ligaments, and muscles being overused and affected and the intervertebral disc being constantly compressed from repetitive motions. When this happens, many individuals will often seek treatment to reduce the painful effects of low back pain.

 


How Chiropractic Care Can Transform Pain Into Relief- Video

When it comes to reducing low back pain, many individuals will try home remedies to mitigate muscle pain and reduce inflammation associated with low back pain. This provides temporary relief to acute low back pain, but many will seek non-surgical treatment when it comes to chronic low back pain. Non-surgical treatments can help reduce low back pain and its associated symptoms through mechanical and manual techniques. Non-surgical treatments, which include chiropractic care and spinal decompression, could help alleviate low back pain. Since low back pain is associated with altered motor control within the lumbar region, it can hinder lumbar stability, cause impaired detection of passive motion, and affect postural stability. (Fagundes Loss et al., 2020) With non-surgical treatments, many pain specialists can incorporate vertebral mobilizations and manipulation procedures to improve spinal mobility and reduce pain in the lumbar region. The video above explains how chiropractic care and spinal decompression can alleviate lower back pain and help restore functionality in the body. 


Chiropractic Care & Low Back Pain

When it comes to reducing low back pain associated with environmental factors, many pain specialists can look at the physical distress cognitive, and functional patterns that are correlated with faulty lumbar movement. (Khodadad et al., 2020) This allows the pain specialist to create a personalized treatment plan for low back pain. Non-surgical treatments like chiropractic care are excellent for reducing low back pain. Chiropractic care incorporates spinal manipulation techniques to realign the spine and help stretch the affected surrounding muscles. Many individuals who include chiropractic care in their routine find significant pain reduction and reduced disability after a few consecutive treatments. (Gevers-Montoro et al., 2021) Chiropractic care can be combined with physical and massage therapy to stretch and strengthen the affected muscles. This, in turn, helps the individual regain spinal mobility and reduce pain.

 

Spinal Decompression & Low Back Pain

Spinal decompression is another non-surgical treatment that can help alleviate low back pain, like chiropractic care. Spinal decompression utilizes gentle traction on the lumbar spine to be gently pulled to relieve the affected muscles causing lower back pain. Spinal decompression can also ease leg pain associated with low back pain and reduce referred pain affecting the lower extremities. (Wang et al., 2022) Spinal decompression can also improve spinal disc height and help improve muscle strength and trunk endurance. (Kang et al., 2016) The combination of spinal decompression and chiropractic care to reduce lower back pain is effective as these two forms of non-surgical treatments can effectively reduce many people’s musculoskeletal pain and make them aware of the environmental factors that are the root causes of their lower back pain and prevent it from returning.

 


References

Fagundes Loss, J., de Souza da Silva, L., Ferreira Miranda, I., Groisman, S., Santiago Wagner Neto, E., Souza, C., & Tarrago Candotti, C. (2020). Immediate effects of a lumbar spine manipulation on pain sensitivity and postural control in individuals with nonspecific low back pain: a randomized controlled trial. Chiropr Man Therap, 28(1), 25. doi.org/10.1186/s12998-020-00316-7

 

Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piche, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Front Pain Res (Lausanne), 2, 765921. doi.org/10.3389/fpain.2021.765921

 

Kang, J.-I., Jeong, D.-K., & Choi, H. (2016). Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. Journal of Physical Therapy Science, 28(11), 3125-3130. doi.org/10.1589/jpts.28.3125

 

Khodadad, B., Letafatkar, A., Hadadnezhad, M., & Shojaedin, S. (2020). Comparing the Effectiveness of Cognitive Functional Treatment and Lumbar Stabilization Treatment on Pain and Movement Control in Patients With Low Back Pain. Sports Health, 12(3), 289-295. doi.org/10.1177/1941738119886854

 

Petrozzi, M. J., Rubinstein, S. M., Ferreira, P. H., Leaver, A., & Mackey, M. G. (2020). Predictors of low back disability in chiropractic and physical therapy settings. Chiropr Man Therap, 28(1), 41. doi.org/10.1186/s12998-020-00328-3

 

To, D., Rezai, M., Murnaghan, K., & Cancelliere, C. (2021). Risk factors for low back pain in active military personnel: a systematic review. Chiropr Man Therap, 29(1), 52. doi.org/10.1186/s12998-021-00409-x

 

Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303

 

Wong, C. K., Mak, R. Y., Kwok, T. S., Tsang, J. S., Leung, M. Y., Funabashi, M., Macedo, L. G., Dennett, L., & Wong, A. Y. (2022). Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis. J Pain, 23(4), 509-534. doi.org/10.1016/j.jpain.2021.07.012

 

Disclaimer

Boost Gut Microbes With Avocado for Optimal Health

Boost Gut Microbes With Avocado for Optimal Health

Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?

Boost Gut Microbes With Avocado for Optimal Health

Avocado Gut Support

A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)

Gut Diversity

The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)

  • Arthritis
  • Obesity
  • Type 1 diabetes
  • Type 2 diabetes
  • Inflammatory bowel disease
  • Celiac disease
  • Arterial stiffness
  • Atopic eczema

Why Avocados?

  • The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
  • Approximately 95% of adults and children do not consume the recommended amount of fiber. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
  • Including foods like avocados in a healthy diet can help meet daily fiber requirements.
  • Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
  • Researchers suggest this could be because of pectin’s positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
  • Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
  • Fiber also adds bulk to an individual’s diet and slows the speed of digestion, which makes the body feel fuller longer.

Improved Gut

Individuals can support a healthy microbiota by making small adjustments in their diet, including:

  • Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
  • Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
  • Limiting consumption of processed foods, sugar, and artificial sweeteners.
  • More whole-grain foods.

Ways to eat more avocados include adding them to:

  • Smoothies
  • Salads
  • Sandwichs
  • Guacamole
  • If there are more avocados that can be eaten before they overripen, they can be frozen.
  • Peel and slice them first, then place them in freezer bags to have year-round.
  • They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.

Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.


Smart Choices, Better Health


References

Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. doi.org/10.1093/jn/nxaa219

Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. doi.org/10.1093/cdn/nzz068

Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. doi.org/10.1136/bmj.k2179

Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079

Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. doi.org/10.1038/s12276-020-0449-2

Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. doi.org/10.1016/j.fm.2018.02.015

Jumping Rope: Benefits for Balance, Stamina & Quick Reflexes

Jumping Rope: Benefits for Balance, Stamina & Quick Reflexes

Individuals trying to get and stay in shape can find it difficult to get a regular workout. Can jumping rope help when there is no time?

Jumping Rope: Benefits for Balance, Stamina & Quick Reflexes

Jumping Rope

Jumping rope can be a highly cost-effective exercise to incorporate high-intensity cardiovascular fitness into a workout routine. It is inexpensive, efficient, and done properly can improve cardiovascular health, improve balance and agility, increase muscular strength and endurance, and burn calories. (Athos Trecroci, et al., 2015)

  • Jumping rope can be utilized in interval training to keep the heart rate elevated and allow the muscles to rest in between weight lifting and other intense exercises.
  • A jump rope can be used when traveling as its portability makes it a top piece of workout gear.
  • It can be combined with bodyweight exercises for a dependable and portable exercise routine.

Benefits

Jumping rope is a medium-impact exercise with benefits that include:

  1. Improves balance, agility, and coordination
  2. Builds stamina and foot speed for coordination, agility, and quick reflexes.
  3. Variations include one-leg jumping and double unders or with each jump, the rope goes around twice to add difficulty.
  4. Builds Fitness Fast
  5. Burns calories
  • Depending on skill level and jumping rate, individuals can burn 10 to 15 calories a minute by jumping rope.
  • Faster rope jumping can burn calories similar to running.

Precautions

For individuals who have high blood pressure, jumping rope may not be recommended. The downward arm position can reduce blood circulation back to the heart which can further increase blood pressure. Studies have shown that jumping at a moderate intensity is beneficial for individuals who are pre-hypertensive. (Lisa Baumgartner, et al., 2020) Individuals with hypertension and/or a heart condition, are recommended to discuss the potential risks with their doctor before beginning a new exercise routine.

Choosing a Rope

  • Jump ropes are available and made from various materials and come with different handles.
  • Cordless jump ropes are great for working out in limited spaces.
  • Some of these materials help jump ropes spin faster with a smooth motion.
  • Some options have a swivel action between the cords and handles.
  • The rope you buy should be comfortable to hold and have a smooth spin.
  • Weighted jump ropes can help develop upper body muscle tone and endurance. (D. Ozer, et al., 2011) These ropes are not for beginners and are not necessary for an agility workout.
  • For individuals who want a weighted rope, be sure the weight is in the rope and not the handles to prevent straining the wrists, elbows, and/or shoulders.
  1. Size the rope by standing on the center of the rope
  2. Pull the handles up along the sides of the body.
  3. For beginners, the handles should just reach the armpits.
  4. As the individual’s skills and fitness develop, the rope can be shortened.
  5. A shorter rope spins faster, forcing more jumps.

Technique

Following proper technique will ensure a more safe and effective workout.

  • Start slowly.
  • The proper jumping form keeps the shoulders relaxed, elbows in, and slightly bent.
  • There should be very few upper-body movements.
  • The majority of the turning power and motion come from the wrists, not the arms.
  • During jumping, keep the knees slightly bent.
  • Bounce softly.
  • The feet should leave the floor just enough to allow the rope to pass.
  • Land softly on the balls of the feet to avoid knee injuries.
  • It is not recommended to jump high and/or land hard.
  • Jump on a surface that is smooth and free of obstacles.
  • Wood, a sports court, or a rubberized mat are recommended.

Warming Up

  • Before beginning jumping rope, do a light, 5 to 10-minute warm-up.
  • This can include walking or jogging in place, or slow-paced jumping.

Increase Time and Intensity Gradually

The exercise can be relatively intense and high-level.

  • Start slowly and increase gradually.
  • An individual might try three 30-second sets at the end of a routine workout for the first week.
  • Depending upon fitness level, individuals may feel nothing or some slight soreness in the calf muscles.
  • This can help determine how much to do for the next jump rope session.
  • Gradually increase the number of sets, or the duration, over several weeks until the body can go for about ten minutes of continuous jumping.
  • One way is to jump after each weight-lifting set or other circuit exercise – like adding jumping for 30 to 90 seconds in between exercise sets.

Stretch Out After

Sample Workouts

There are variations of workouts. Here are a few:

Double foot jump

  • This is the basic jump.
  • Both feet slightly lift off from the ground and land together.

Alternate foot jump

  • This uses a skipping step.
  • This allows landing more prominently on one foot after each spin.

Running step

  • A slight jog is incorporated while jumping.

High step

  • A moderate pace with a high knee raise increases intensity.

Rope jumping is a great addition to an interval training or cross-training routine that creates an efficient whole-body workout that incorporates both cardiovascular endurance and muscular strength.


Overcoming ACL Injury


References

Trecroci, A., Cavaggioni, L., Caccia, R., & Alberti, G. (2015). Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players. Journal of sports science & medicine, 14(4), 792–798.

Baumgartner, L., Weberruß, H., Oberhoffer-Fritz, R., & Schulz, T. (2020). Vascular Structure and Function in Children and Adolescents: What Impact Do Physical Activity, Health-Related Physical Fitness, and Exercise Have?. Frontiers in pediatrics, 8, 103. doi.org/10.3389/fped.2020.00103

Ozer, D., Duzgun, I., Baltaci, G., Karacan, S., & Colakoglu, F. (2011). The effects of rope or weighted rope jump training on strength, coordination and proprioception in adolescent female volleyball players. The Journal of sports medicine and physical fitness, 51(2), 211–219.

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. doi.org/10.1007/s40279-018-0916-2

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing spondylitis is an inflammatory arthritis that causes changes in posture that occur over time. Can exercise and maintaining spinal alignment help improve posture problems?

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing Spondylitis Posture Improvement

Ankylosing spondylitis/AS is an autoimmune arthritis that primarily affects the spine. It can also spread to other joints of the body and affect the internal organs. Back pain problems are a common side effect of the condition and depending on the severity of damage to the spine, it can have a serious impact on posture.

Affects Posture

The condition usually first affects the sacroiliac joints at the bottom of the spine where they attach to the pelvis. As the condition progresses it works its way to the upper spine. The spine consists of 26 vertebrae/bones stacked on top of each other.

  • Ankylosing spondylitis can cause the bones to fuse together. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
  • The condition causes kyphotic deformity – rounding of the upper back, and the lower back flattening.
  • As the disease progresses, the spine becomes immobilized in a stooped-over position and causes significant difficulty with daily tasks.
  • A stooped posture can place pressure on the internal organs and lead to breathing difficulties.
  • The condition leads to balance problems which increase the risk of falls. (Alessandro Marco De Nunzio, et al., 2015)

Posture Improvement Tips

Standing and Walking

When standing or walking try to remember to:

  • Maintain a straight spine.
  • Line up the ears, shoulders, hips, knees, and ankles in a straight line.
  • Squeeze the shoulder blades together and down toward the back pockets.
  • Relax the arms at the sides.
  • Look straight ahead.
  • Tuck the chin back slightly.

Sitting

The natural curves of the spine need support for proper posture when sitting. Try these tips when at a desk or at a table:

  • Position the height of the chair so the hips and knees are bent at 90-degree angles.
  • Place the feet flat on the floor or use a footstool based on chair height.
  • Place a lumbar support pillow or rolled-up towel behind the lower back.
  • Position the screen monitor at eye level to keep the upper back straight.
  • Keep the keyboard and mouse close to the body to prevent overreaching which can increase the rounding of the shoulders and upper back.

Lying Down

Ankylosing spondylitis can make lying down uncomfortable. To support the spine while lying down try to:

  • Sleep on a semi-firm mattress or type like memory foam to conform to the body.
  • Place a pillow between the knees to maintain a straight spine when lying on the side.
  • Use a specialized pillow to prevent placing the upper back in a rounded position.

Posture Exercises

For individuals with ankylosing spondylitis stretching and strengthening exercises can help improve body posture. Individuals are recommended to talk to their healthcare provider before beginning an exercise program.

Chin Tucks

  • Sit up straight.
  • Squeeze the shoulder blades together.
  • Rest the arms at your sides.
  • Look straight ahead, pull the chin back and in until the stretch is felt along the muscles of the neck.
  • Hold for three to five seconds and relax.
  • Repeat 10 times.

Corner Stretch

  • Stand facing a corner.
  • Raise the arms to shoulder height.
  • Place one forearm flat against each wall.
  • Stagger the feet.
  • Slowly shift weight over the front leg and lean in toward the corner.
  • Stop once the stretch is felt across the chest.
  • Hold for 10 to 20 seconds and relax.
  • Repeat three times.

Scapular Squeezes

  • Sit up straight with arms resting at the sides.
  • Squeeze the shoulder blades together like they are holding an object between them.
  • Hold for three seconds and relax.
  • Repeat 10 times.

Maintaining spinal alignment will help decrease back pain that occurs with AS.

  • Targeted exercises can help stretch tight muscles and strengthen the muscles responsible for maintaining spinal alignment.
  • Maintaining healthy posture when sitting, standing, and sleeping can help prevent deformities in the spine.
  • Regular physical activity can help combat stiffness and help maintain overall strength.

For an individualized exercise program, see a physical therapist or chiropractor on incorporating posture exercises to help prevent complications from developing.


Arthritis


References

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

De Nunzio, A. M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V., Peluso, R., Di Minno, M. N., & Pappone, N. (2015). Ankylosing spondylitis and posture control: the role of visual input. BioMed research international, 2015, 948674. doi.org/10.1155/2015/948674