Back Clinic Chronic Back Pain Team. Chronic back pain has a far-reaching effect on many physiological processes. Dr. Jimenez reveals topics and issues affecting his patients. Understanding the pain is critical to its treatment. So here we begin the process for our patients in the journey of recovery.
Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting.
Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.
Chronic back pain can have real effects on your day-to-day life and your mental health. But you and your doctor can work together to treat it.
Do call upon us to help you. We do understand the problem that should never be taken lightly.
Kinesthesia is the body’s ability to sense movement, position, action, and location, also known as proprioception. An example is when moving the arm, the brain and body are aware that the arm has moved. When dealing with chronic back pain, individuals are unable to function normally with regular everyday movements causing discomfort.
Chronic back pain can make an individual feel like a stranger in their body, altering their perception. Tension develops throughout the body due to the pain, causing tightness and positional adaptations that are unfamiliar, awkward, and unhealthy for the musculoskeletal system. These body positioning changes continue while the individual is unaware of what they are doing, causing further strain and injury.
Kinesthesia
Kinesthesia is essential for overall coordination, balance, and posture as long as the movements are done correctly with proper form. Chronic back pain can affect kinesthesia differently. Individuals can misjudge and estimate that their bodies’ ability to lift, carry, or open something is more complicated or easier than it is. This can exceed the body’s tolerances, causing:
Strains
Sprains
Severe injuries
Once the back starts to hurt, this causes the individual’s sense of kinesthesia to compensate for the pain. As a result, individuals may knowingly or unknowingly attempt to carry out uncoordinated, awkward movements and positions, making things worse.
Motor Control
Motor control is the ability to control movement. When experiencing back pain, individuals adjust their motor control to avoid specific movements that cause back pain. Motor control adaptations and kinesthesia involve body positioning and heightened responsiveness to stimuli, like muscle spasms. Even moderate back pain can cause awkward and dangerous responses causing individuals to overcompensate or become too cautious, worsening or creating new injuries in the process. The body is performing movements that do not follow proper form, even though an individual thinks they are protecting themselves.
Building Healthy Proprioception
A recommended strategy for building kinesthesia to benefit the back and the rest of the body is yoga. Yoga helps build bodily sensory awareness. It trains the body when sending significant signals from the muscles, joints, and tendons back to the proprioceptive centers in the brain. This happens immediately and increases over time.
Yoga Poses
Creating positive awareness of the body’s movements will help relieve back pain as the body learns to feel, understand, and control the muscles. Here are a few poses to help, along with video links.
Body awareness is critical, but if an individual moves in a way that’s not natural to the body, it can cause injury. Kinesthesia and healthy posture can help avoid back pain and other health issues. A professional chiropractor can alleviate back pain, educate on proper form and recommend specific stretches and exercises to strengthen the body to prevent injury.
Body Composition
Magnesium
Magnesium supports a healthy immune system. It helps maintain:
Healthy bone structure
Muscle function
Insulin levels
Magnesium assists the body with ATP energy metabolism and acts as a calcium blocker. This reduces cramping and aids in muscle relaxation after physical activity/exercise. Magnesium is essential in biochemical reactions in the body. A slight deficiency can lead to an increased risk of cardiovascular disease and a higher risk of insulin resistance. Many magnesium-rich foods are high in fiber, like:
Studies have shown that consuming a diet rich in Magnesium also provides a higher intake of dietary fiber. Dietary fiber aids in:
Digestion
Helps control weight
Reduces cholesterol
Stabilizes blood sugar
The best sources of Magnesium include:
Spinach, swiss chard, and turnip greens
Almonds and cashews
Flax, pumpkin, and chia seeds
Cocoa
References
Meier, Michael Lukas et al. “Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception.” The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry vol. 25,6 (2019): 583-596. doi:10.1177/1073858418809074
Tong, Matthew Hoyan et al. “Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis.” Archives of physical medicine and rehabilitation vol. 98,1 (2017): 120-136.e2. doi:10.1016/j.apmr.2016.05.016
Wang, Jinsong, et al. “Dietary magnesium intake improves insulin resistance among non-diabetic individuals with metabolic syndrome participating in a dietary trial.” Nutrients vol. 5,10 3910-9. 27 Sep. 2013, doi:10.3390/nu5103910
Medical experts have seen how pain education and cognitive behavioral therapy or CBT classes effectively manage chronic back pain; even a one-time pain management class can help. Individuals experiencing back pain often try a variety of remedies to find relief. These include:
Eliminating activities
Over-the-counter medications
Prescription pain medications
Support devices and braces
Pain specialists
Surgery
All treatment options can help alleviate discomfort and pain, but sometimes taking a pain management class and getting educated on what is happening in the body has been shown to help individuals gain a better understanding helping them to find relief. A recent study suggests that a one-time class may be all that is needed. These quick classes can give more individuals immediate access to information and skill sets that can help reduce the pain and everything that comes with it.
Cognitive Behavioral Therapy Classes
Cognitive Behavioral Therapy for chronic pain provides individuals with information and pain management skills. Cognitive-behavioral therapy is handled by a therapist and can take multiple individual or group sessions that last one or two hours. A session can include:
Education on pain and how it works.
How thoughts and emotions influence pain.
How pain affects mood.
Sleep and pain.
Activity and action plan development.
Chronic lower back pain or CLBP is considered a physical ailment; cognitive behavioral therapy can provide mental health strategies to manage symptoms better. For example, individuals with chronic pain begin to fear doing activities that could increase their pain level and begin to constantly worry about worsening the injury or creating a new injury. This can lead to severe stress that exacerbates the chronic symptoms and can lead to other health issues.
Single Session Vs. Multiple
Doctors and medical experts are trying to make pain education and relief skills more accessible. They do not require multiple sessions and instead consist of single-session, two-hour management classes. A randomized clinical trial of adults with chronic low back pain was compared to:
2-hour back pain health education class with no skill set training.
16-hour, 8-session cognitive behavioral therapy group class.
The study found that three months after treatment, the Empowered Relief group showed positive results. In the randomized trial, a single-session pain relief class was found to be non-inferior to an eight-session cognitive behavioral therapy class to:
Reduce pain-related distress
Pain intensity
Pain interference
Benefits
The individuals that completed the one-time 2-hour class reported positive results after three months. They found that the course had significantly reduced:
Pain intensity
Pain interference
Sleep disturbance
Anxiety
Fatigue
Depression
However, doctors caution that the two-hour class does not replace comprehensive cognitive-behavioral therapy. This is to get individuals on a positive path of pain management that can further develop into a healthy lifestyle. The objective is to create a range of options that meets an individual’s needs. The most significant advantage of a two-hour class is the convenience. Individuals can participate in these classes in person or online.
Body Composition
Supplements That Can Help Improve Lean Body Mass
A few dietary supplements that directly support body composition improvement.
Protein Powders
Protein powders are common nutritional/dietary supplements. Protein powders come in a variety of sources:
Plant-based – rice, hemp, pea, pumpkin seed, and soy.
Rice Protein
Rice protein is a plant-based protein powder used by vegans, vegetarians, and individuals who can’t tolerate dairy products. Research has found that rice protein has similar effects on body composition as whey. Scientists found that individuals who took rice protein and individuals that took whey protein both experienced positive body composition changes.
References
Cochrane Database of Systematic Reviews. (Oct 2015) “Psychological therapies for the management of chronic neuropathic pain in adults.” www.ncbi.nlm.nih.gov/pmc/articles/PMC6485637/
Darnall BD, Roy A, Chen AL, et al. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401
HRB Open Research. (Aug 2020) “The relative effectiveness of psychotherapeutic techniques and delivery modalities for chronic pain: a protocol for a systematic review and network meta-analysis” www.ncbi.nlm.nih.gov/pmc/articles/PMC7459872/
Journal of Psychosomatic Research. (Jan 2010) “Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.”
Pain. (Feb 2008). “Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. www.ncbi.nlm.nih.gov/pmc/articles/PMC2254507/
Pain and Therapy. (Jun 2020) “Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.” www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/
Back pain usually comes from lifting an object the wrong way or awkwardly moving the body, injuring the spinal structures or muscles. However, sometimes it could be signs/symptoms of a more serious medical condition. The back pain could be caused by:
How to know when the root cause of back pain is from something else in the body? There are two types of pain that pain specialists look at. These are visceral pain and somatic pain. Visceral pain comes from damage or injury to the organs or organ tissues. This internal pain can radiate to the spine from conditions like:
Pancreatitis
Ulcerative colitis
Crohn’s disease
Gall stones
Cancers
Kidney pain
Urinary tract infections
Somatic pain is injury or damage to the muscles, skin, and soft tissues. It can be caused by:
Regular wear and tear
Aging
Injury
Sedentary lifestyle
However, visceral pain can cause somatic/bodily pain to flare up. The stress the body is going through because of the medical condition can cause inflammation.
Kidney Infections and Stones
The kidneys are located in the rear of the body toward the middle of the back. The kidneys:
Filter waste products from the body
Regulate bodily fluids
Perform other vital functions.
Kidney infections and kidney stones can easily mimic a sprain or strain in the back. Infections or stones can also present with other symptoms like:
Side and groin pain could accompany the back pain.
The pain does not go away after shifting positions or lying down.
Urinary Tract Infection UTI
Upper urinary tract infections in the kidneys or ureters can cause back pain. Upper UTIs happen when a lower UTI in the bladder or urethra goes unnoticed or does not respond to antibiotic treatment. Infections can occur at any age, with women and older men being more susceptible. The pain usually presents in the lower back and groin area. Other possible symptoms include:
Pain in the back, sides of the lower abdomen between the lower ribs and hips.
Fever
Vomiting
Frequent urination in small amounts
Burning during urination
Strong urge to urinate
Foul-smelling urine
Cloudy urine
Fatigue.
The pain can feel like:
Cramping pain
Pressure
Soreness
Pancreatitis
Pancreatitis is inflammation of the pancreas, the long flat organ located in the upper abdomen behind the stomach. It assists digestion and sugar management. The American Pancreatic Associationreports acute pancreatitis can make individuals feel sick with moderate to severe abdominal pain that can radiate to the back and often worsens after eating. The pain is felt in the upper to middle back. Other possible symptoms include:
Abdominal pain that radiates to the back
Abdominal pain after eating
Fever
Nausea
Vomiting
Tenderness in the abdomen
The pain can feel like a pulled muscle or joint pain that increases and decreases at first and then strengthens after eating or lying down.
Inflammatory Bowel Diseases IBD
Ulcerative colitis and Crohn’s disease are inflammatory bowel diseases not to be confused with irritable bowel syndrome.
Ulcerative colitis affects the colon.
Inflamed intestinal areas characterize Crohn’s disease.
Both can cause spreading back pain.
A study found 25% of individuals with IBD have chronic back pain. Other possible symptoms include:
The pain can feel mild or severe, like a cramp in the lower abdomen around the low back. It can present in cycles as a flare-up, then goes away. It’s essential to read the body’s warning signs and not push through the pain or ignore it. If any back pain goes on for more than a week, consult a doctor or chiropractor for a thorough examination. A pain specialist could be recommended if there is chronic back pain from a severe medical condition. A primary doctor or specialist helps keep the medical condition in check, while a pain specialist and/or chiropractor can alleviate chronic musculoskeletal pain from inflammation, irritation, and overstimulated nerves.
Body Composition
Personalized Lifestyle Medicine
Personalized lifestyle medicine develops customized treatment/health plans to fit the individual. It includes:
Research on how the body works as an integrated system.
Combines new technology approaches in medicine.
The relationship between nutrients and gene expression.
Life and behavioral sciences.
Nutrigenomics testing helps individuals understand the influence of dietary components on their genes, which can help prevent the development of certain chronic diseases.
It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.
Inflammatory vs. Mechanical Pain
Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.
Inflammatory
Pain caused by inflammation can be described as:
Not having a known definite cause.
Characterized by stiffness, especially after waking up.
Pain reduces with movement, activity, stretching, exercise.
Is worst during the early hours of the morning.
Is often accompanied by pain in the buttocks/sciatica symptoms.
Mechanical
Mechanical pain can be described as:
Pain that becomes worse with activity, stretching, or exercise.
Pain reduces with rest.
There is no stiffness after sleeping.
This pain is not constant but can become intense/severe for short periods.
Pain in the buttocks/sciatica symptoms do not present.
Inflammatory and Non-Inflammatory
Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:
Chiropractic adjusting
Physical therapy
Spinal decompression
Contributing Autoimmune Diseases
When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:
Rheumatoid Arthritis
Arthritis causes the immune system to attack the joints throughout the body.
Ankylosing Spondylitis
This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.
Multiple Sclerosis
This is a disease where the immune system attacks nerve fibers and can lead to back pain.
Psoriatic Arthritis
This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.
Inflammatory Pain Treatment
Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.
Chiropractic and Physical Therapy
These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:
Chiropractic adjustments
Flexion-distraction
Posture correction
Personalized exercises
Inflammation Night Pain
Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.
Stretch Before Bed and When Waking
Performing stretches before going to bed and after waking up helps keep the body limber.
Inspect Pillows and Mattress
Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.
Exercises
Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.
Cardio
These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:
Swimming
Walking
Cycling
Strength-Building
Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:
Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:
Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
Go vegetarian for one day a week.
Cut out processed meats with high levels of preservatives.
Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2
Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5
Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001
Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745
Individuals and doctors have praised the anti-inflammatory, pain-relieving properties of drinking tea. Inflammation is the body’s natural immune response when injury and infection present. This is good. However, it’s meant to be a temporary response that deactivates when there is no longer any danger. When the body is exposed to various irritants like industrial chemicals, inflammatory foods like sugar, refined carbohydrates, and autoimmune disorderscan cause the immune system to go into overdrive. Chronic inflammation can develop, circulating powerful hormones and chemicals through the body, causing damage to the cells. One consequence of chronic inflammation is back pain. Besides standard backaches, some chronic conditions are directly tied to inflammation. These include forms of arthritis:
Ankylosing spondylitis
Rheumatoid arthritis
Transverse myelitis
Multiple sclerosis
These conditions involve inflammation of the central nervous system.
Drinking tea can help with back pain and pain in general.
Teas With Anti-Inflammatory Properties
Certain teas contain anti-inflammatory compounds. These compounds are called polyphenols and work to decrease the chemicals in the body responsible for pain and inflammation. There are varieties of teas that contain anti-inflammatory properties.
Certain Teas Reduce Inflammation
Drinking specific teas with more polyphenols can better decrease inflammation. For example, green tea is higher in polyphenols than black tea. Recent studies centered on individuals with rheumatoid arthritis over six months found significant improvement in symptoms in those who drank green tea. Green tea works best when part of an anti-inflammatory and nutritional lifestyle adjustment. This supports combating inflammation. Other teas that are believed to reduce inflammation include:
Turmeric
Holy basil
Ginger
Three Cups a Day
The amount of tea depends on the quality of the tea and how it is prepared. Doctors recommend around three cups a day for individuals with rheumatoid arthritis. However, these could contain caffeine. If this is an issue, there are decaffeinated versions with the same anti-inflammatory properties.
Drinking Tea Works Best When Combined with Other Treatments
If experiencing back pain or looking to combat a specific condition, it’s recommended to utilize various treatment approaches combined with drinking tea. This includes:
Certain back conditions benefit from drinking tea regularly; however, spine structural issues or fractures will not benefit from tea’s mild anti-inflammatory properties. It is vital for individuals with back pain that a spine specialist or chiropractor perform a proper and thorough examination, especially for Individuals that take medication that could directly interact with anti-inflammatory teas.
Drinking Tea for Back Pain
For most individuals, drinking tea is safe to help treat back pain conditions and added health benefits. For example, studies have found that green tea has mild anti-cancer, anti-diabetic properties and can help in maintaining a healthy weight. If tea helps reduce pain, it’s worth trying. Remember, pain is the body’s way to alert the individual that something is wrong.
Body Composition
Alcohol and Heart Health
According to the Mayo Clinic, consuming more than three alcoholic drinks in one sitting causes a temporary blood pressure elevation. Foods often served with alcohol are usually high in salt, which can also raise blood pressure. A few alcoholic beverages on a night out is fine, but heavy or binge drinking can lead to short-term spikes in blood pressure that could cause cardiac health problems. These are the short-term effects of alcohol on blood pressure. Heavy alcohol consumption can lead to long term health risks like:
Hypertension
Heart disease
Digestive issues
Liver disease
Stroke
It’s recommended that individuals incorporate regular exercise/physical activity and healthy diet changes and watch alcohol intake to improve heart health.
References
The Clinical Journal of Pain. (October 2019) “Nonspecific Low Back Pain:
Certain Teas Bring Down Inflammation More Than Others: Journal of Physical Therapy Science. (October 2016) “Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis” www.ncbi.nlm.nih.gov/pmc/articles/PMC5088134/
The Bottom Line: Proceeding of the Japan Academy, Series B Physical and Biological Sciences. (March 2012) “Health-promoting effects of green tea” www.ncbi.nlm.nih.gov/pmc/articles/PMC3365247/
At home or a gym, working out with cardio exercise equipment can be a highly beneficial treatment for back discomfort, soreness, and pain. However, when checking out all the cardio machines it is recommended to use those that will help with back pain and not worsen or cause further injury. The same goes for purchasing cardio equipment to use at home. Research has found that exercise training could be highly effective in the treatment of back pain. A study on pain found that the endorphins generated from aerobic exercise help to lessen low back pain. The North American Spine Society announced evidence-based recommendations for the treatment of back pain, and one of the top recommendations was aerobic exercise. Individuals can always go outside to:
Walk
Hike
Run
Bike ride
But mixing it up with cardio equipment can have its own benefits for different reasons. It could be too hot, raining, sometimes individuals prefer a set workout program to reach calorie or distance goals, and it could be easier on the spine. Working out at home or at a gym, cardiovascular machines can help bring relief for back pain.
Cardiovascular Exercise Back Pain Treatment
Cardiovascular exercise is highly recommended for everyone. For individuals dealing with back pain, exercise combined with conservative therapy is usually part of a treatment plan. This includes:
Physical therapy
Chiropractic care
Health coaching
Diet
Aerobic exercise regimen
With an exercise program, experts recommend starting with moderate-intensity aerobic exercise. Moderate intensity workouts are meant to get an individual’s heart and blood pumping, sweating a little, and slightly deep breathing. These types of exercise include:
Power walking outside
Power walking on a treadmill
Stationary biking
As long as the physical activity gets the heart rate up, these exercises have been shown to decrease back pain, relieve stress, and elevate mood. 20 minutes of moderate-intensity exercise three to five times a week for six weeks is what is recommended. This will help the back become healthier, feel better, and is recommended by the American Heart Association.
Exercise Not For All Spine Conditions
However, not all spinal conditions benefit from regular exercising. Getting an evaluation from a doctor, spine specialist, or chiropractor is recommended for injuries, severe and/or persistent back pain before starting a cardiovascular exercise program. This could be a spinal fracture, or spinal condition that requires bracing, or intense physical therapy/rehabilitation. Individuals that do not exercise regularly or have a medical or heart condition/s definitely need to get a doctor’s clearance before beginning a cardiovascular workout regimen.
Top Cardiovascular Exercises and Equipment
Once a doctor clears the individual for aerobic exercise there is no cardio equipment that is off-limits. Elliptical machines and stationary bikes are the most well-tolerated by individuals with back problems/conditions. Because they are low impact. However, if it is tolerable using a jogging treadmill is beneficial as well. Listen to the body. If a workout on a treadmill causes back pain that is not just workout soreness, stop with that machine and try different cardiovascular equipment that is more low impact. Do not ignore back pain. If pain is continuous and exercising is not helping, stop and see a doctor, or chiropractor to evaluate and analyze the situation. Then they can adjust the exercise part of the treatment plan according to the presenting symptoms.
Body Composition
Concurrent Training
Concurrent training is the combination of aerobic and resistance exercises during the same workout session. Aerobic and resistance exercise impacts the body in different ways. The type of aerobic training determines how it interacts with resistance exercise. The order of the types of exercises like aerobic and resistance workouts can make a difference. Having an understanding of a few specifics about concurrent training will help to make decisions about an exercise program.
Aerobic/interval and resistance training does not seem to interfere with the others’ adaptations
However, gaining strength could be lowered by adding running to a resistance program
Whereas bicycling does not have the same effect.
Cycling and the ergonomics that go with it are similar to traditional lower-body resistance exercises. The muscle contractions that come with running result in muscle damage, while the contractions in cycling also cause muscle damage, it is not to the same extent. Pairing the exercise programs correctly is key, such as a running program in combination with an upper-body lifting exercise can be beneficial. While running and doing leg presses every day could interfere with each other and could cause injuries. Or if doing both aerobic and resistance exercises in the same session, or on the same day, consider the order of the exercises, depending on what the goal is.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
British Journal of Sports Medicine. (November 2020) “Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis” https://bjsm.bmj.com/content/54/21/1279
Pain. (December 2020) “Are endogenous opioid mechanisms involved in the effects of aerobic exercise training on chronic low back pain? A randomized controlled trial” https://journals.lww.com/pain/Citation/2020/12000/Are_endogenous_opioid_mechanisms_involved_in_the.23.aspx
North American Spine Society. (2020) “Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care” https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf
The diabetic disease processes can be a contributor to chronic back pain. Diabetes can damage the human body from the eyes to the feet if left untreated, and the spine/back is a prime target. Data from 11 studies consisted of individuals over 18 years of age diagnosed with type 1 or type 2 diabetes. The results showed individuals with diabetes had a 35% increased risk of experiencing lower back pain. According to the Centers for Disease Control and Prevention, around 34 million people were found to have diabetes in 2021. Diabetes primarily impacts blood sugar/glucose levels. However, the disease can affect several of the body’s systems. It is a state of chronic inflammation.
Diabetic Back Pain Connection
The connection between diabetes and back pain include:
Neuropathy
Diabetic neuropathy happens when constant high glucose levels damage/injure the nerves. The result is symptoms like pain, tingling, and numbness. It affects up to 50% of individuals with diabetes and can lead to severe chronic back pain. High sugar levels damage various organ systems including the nervous system that results in neuropathy that causes pain/discomfort.
Bone Health
A complication that diabetes can cause is compromised bone health.High glucose levels can damage the collagen that makes up bone. This creates an increased risk of vertebral and other types of fractures. The high-risk compounds fractures that do not heal properly or correctly. Diabetics have an increased risk of fracture because of the accumulation increase of advanced glycation products. This substance forms when proteins or lipids combine with sugar. With time these products can cause damage to various tissues that include bone.
Obesity
Obesity contributes to the development of type 2 diabetes and is also a complication that results from incorrect glucose level management. Regardless of which came first, the added weight is a major contributor to back pain because of the added pressure/load on the spine. Excess weight and physical inactivity can result in serious issues of the musculoskeletal system.
Additional Factors
Poorly controlled diabetes also reduces muscle blood flow and increases cartilage inflammation. Other types of tissue damage can occur like degeneration of intervertebral discs and spinal canal stenosis. Disc degeneration and spinal stenosis are common causes of back and neck pain. Diabetics are prone to infection/s. This can cause back pain if it is in the bone known as osteomyelitis.
Diabetic Back Pain Management
There are steps that can help ease pain and discomfort.
Getting Involved In Physical Activity
Exercising/physical activity is a must. The body needs to move to get all the systems flowing improving diabetes and back pain. A sedentary lifestyle can take back pain to new levels with time. Even though when pain presents the first instinct is to stop and rest. Simple ways to get moving include:
Walks
Stretches
Gentle laps in a pool
All can help with:
Improved blood flow
Aids in weight loss
Recommended for both conditions
Exercising releases endorphins, which are the pain relief chemicals that the body produces naturally.
Yoga can reduce physical pain and discomfort throughout the body
Quitting Bad Habits
Smokers have a significantly higher risk for low back pain compared to non-smokers. Nicotine can alleviate pain short term, but over time the nerves become more sensitive and can increase the pain. Alcohol use can help numb the pain short term, but it can cause muscle spasms and dehydration intensifying the pain. Complications can arise if taking pain medication. The most important thing is managing diabetes effectively.Injury Medical Chiropractic and Functional Medicine Clinic will help the individual feel better, move better, and keep back pain away.
Body Composition
Vitamin D and Healthy Blood Sugar Levels
Vitamin D benefits muscle health, muscle mass, and blood sugar. Insulin is the hormone that lets blood sugar into the muscles. Individuals with adequate blood vitamin D levels significantly lower the risk of hyperglycemia than those with below-recommended levels. Research shows daily vitamin D supplements used in combination with calcium decelerate the gradual rise in blood sugar in those with prediabetes. Adequate vitamin D levels can prevent the progression of hyperglycemia. Supplementation is beneficial for individuals going through a deficiency. Adults should aim for a dietary intake of 600 – 800 IU per day. However, supplements are never a substitute for a healthy and diverse diet.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP, CIFM, CTG* email: coach@elpasofunctionalmedicine.com phone: 915-850-0900 Licensed in Texas & New Mexico
References
Pozzobon, Daniel, et al. “Is There an Association between Diabetes and Neck and Back Pain? A Systematic Review with Meta-Analyses.” PLOS ONE, vol. 14, no. 2, 2019, doi:10.1371/journal.pone .0212030.
Murray, Cliodhna E, and Cynthia M Coleman. “Impact of Diabetes Mellitus on Bone Health.” International Journal of Molecular Sciences, MDPI, 30 Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6801685/.
Groen BBL, Hamer HM, Snijders T, van Kranenburg J, Frijns D, Vink H, et al. Skeletal muscle capillary density and microvascular function are compromised with aging and type 2 diabetes. Journal of Applied Physiology. 2014;116(8):998–1005. pmid:24577061
Eivazi M, Abadi L. Low Back Pain in Diabetes Mellitus and Importance of Preventive Approach. Health Promotion Perspectives. 2012;2(1):80–8. pmid:24688921
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