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.
Question: My parents are elderly, and both hurt their backs. What type of doctor or physician should I look for?
Chiropractic care is safe and effective for elderly adults with back pain, according to new research. To better understand the risk and benefits of chiropractic care in elderly individuals, El Paso, TX. Chiropractor, Dr. Alexander Jimenez, answers questions regarding chiropractic care for elderly individuals with back pain.??
Q: Is Chiropractic Care Safe For Elderly People?
Dr. Jimenez: Chiropractic care is one of the safest interventions for the care of back pain. The dangers of a serious problem after a chiropractic adjustment would be like the danger of having a serious problem after an immunization–exceptionally small. However, minor side effects lasting up to approximately 3 days are very common, most commonly muscle stiffness and soreness. These side effects are similar to those you get when you begin a workout program. People have a smaller chance of severe side effects from manipulation and manual treatment than they do from medication taken for the very same ailments. You should always discuss any side effects from treatment with your chiropractor right away.
Q: What Are The Benefits Of Chiropractic Care For The Treatment Of Low Back Pain In Older Adults?
Dr. Jimenez: Chiropractic care has been used for over 100 years to assist patients with back pain. One of the best benefits of trying chiropractic care first is that you can avoid the risk of side effects from taking medications for pain. Opioid drug addiction is a serious crisis in America. Trying non-drug therapies, such as chiropractic care first may help to reduce the high rates of opioid dependency in the USA.
Actually, the most recent treatment principle for low back pain (from the American College of Physicians), specifically states that people should attempt non-drug options first. The health dangers of pain medications are even greater for older adults compared to younger people, since many older people have other illnesses that affect their wellbeing, and their own bodies process drugs more slowly. Also, many drugs, particularly opioids, increase older people’s risk of falls, which is a very considerable risk in this age group.
Q: What Questions Should I Ask My Chiropractor Before Receiving Treatment?
Dr. Jimenez:�When first talking with a chiropractor, inquire which sort of treatments he or she may use for back pain. Chiropractic care incorporates many different non-drug approaches in addition to spinal manipulation, including other kinds of manual therapy in addition to exercise. �Ask the chiropractor to explain or illustrate the type of spinal manipulation he or she uses (many chiropractors have photographs or can demonstrate what they do), so that you feel comfortable with it. Should you feel uncomfortable with the therapy, feel free to ask whether there are alternate kinds of manipulation he or she may use as there are many different ways to perform spinal manipulation for optimum patient comfort, and also achieve the same targets.
Q: What Should I Tell A Chiropractor About My Medical History, Medicines, & Spinal Condition?
Dr. Jimenez: First of all, since chiropractors are trained to choose a thorough patient history, including questions regarding medication, past injuries or surgeries, and any recent changes in your health, most likely you won’t have to volunteer this information. You’ll be asked about your health history on a patient intake form. Then the doctor will ask you more questions in person. Make sure to talk about all health information about current and previous conditions, drugs, history of accidents and surgeries or alternative therapy, and current changes in your health, even if you think they are not important, they may be.
The chiropractor will also inquire what makes your pain worse or better, and if you have had changes in strength, recent falls, or balance issues, changes in your bowel or bladder function along with other relevant health factors like eating and sleep habits. The chiropractor should then perform a thorough physical examination, including your neurological system, to be certain that spinal manipulation is ideal for you. He or she’ll also see what kinds of adjustments will make your pain better or worse. The chiropractor will use all of this information to develop a treatment plan that’s specific for you to help you fulfill your goals for returning to a normal lifestyle.
The Narrative Of JFK Shows The Difficulty In Diagnosing & Treating Spinal Disorders.
At age 43, John F. Kennedy was the youngest president elected into U.S. workplace, and has been depicted as full of youth and vitality. But he was far from healthy, and spent most of his adult life fighting with many medical issues, including back pain which started during college and continued until his death, according to a recent review article from the Journal of Neurosurgery: Spine.
John F. Kennedy’s back pain is thought to have started following a football injury, while Kennedy was in undergraduate school at Harvard, clarified coauthor Justin T. Dowdy, MD, who is a neurosurgeon at Hot Springs Neurosurgery Clinic, in Hot Springs, Arkansas.
Based on 10 years of study on Kennedy’s medical documents and reported symptoms, senior author T. Glenn Pait, MD, believes Kennedy had discogenic disease stemming from an accident in his childhood that began a cascade of problems in his low back. Dr. Pait is Director of the Jackson T. Stephens Spine and Neurosciences Institute at the University of Arkansas for Medical Sciences.
Kennedy was originally rejected when trying to enlist in the Army due to his medical issues, such as back pain, but was eventually accepted in the U.S. Naval Reserve during his dad’s connections. “This is a testament to his decision to serve his country,” Dr. Pait said. “Kennedy was originally given a desk job, but that was not enough for him, and he was later admitted into a patrol torpedo program.”
Kennedy’s back issues worsened when his naval boat was hit by a Japanese destroyer, and Kennedy drifted for 5 hours to a nearby island while towing an injured crewman to shore by holding the ring of the man’s life jacket between his teeth, Drs. Dowdy and Pait noted in their newspaper.
The review article refers to a series of 4 ineffective surgeries, including a sacroiliac (SI) and lumbosacral fusion. Various doctors who treated Kennedy had different theories about the reason for his back pain, also suggested a variety of different treatments ranging from trigger point injections and an exercise program (swimming and weight lifting), to massage and a back brace, to methamphetamine-containing shots. The exercise program, started later in his life, produced “dramatic” improvement, according to the researchers. The program consisted of weight lifting three times each week and everyday swimming plus massage and heat therapy.
“JFK’s narrative illustrates the difficulty and complexity in diagnosing and treating spinal disorders, especially in the context of chronic pain,” Dr. Dowdy advised SpineUniverse. “Our spines age as we age if it’s degenerative disk disease, pinched nerves, or spinal stenosis–imaging abnormalities are certain to appear later in life. Treating and preventing these disorders is just as much of an art as it’s a science, particularly in determining those individuals who will probably benefit from surgery.”
Dr. Dowdy noted that much progress has been made in how spinal conditions are diagnosed and treated as the time when Kennedy sought attention, such as “that the refinement of both less-invasive spine surgery methods and diagnostic imaging.” Dr. Dowdy also emphasized an important point that applies to any era: “the significance of having a trusted spine surgeon who is prepared and capable of supplying the right surgery in the appropriate conditions.”
John F. Kennedy’s story also suggests that “the most beneficial methods to prevent chronic back pain may be accessible and affordable,” Dr. Dowdy stated. “Often the most appropriate strategy for chronic low back pain is actively pursuing proper spine hygiene: maintaining healthy body weight, refraining from smoking, and pursuing a nutritious diet and exercise–especially workouts comprising yoga-style stretches,” Dr. Dowdy emphasized. “It boils down to pursuing a healthy and active way of life.”
“Individuals who suffer from chronic pain may hopefully be inspired to know that Kennedy remained physically energetic and driven to accomplish his goals despite his annoyance,” Dr. Dowdy concluded.
Backpack pain is an all too common condition of school-age children. While back pain is a known and widely-studied issue in adults, its prevalence in school-aged children has received relatively little scientific attention. Elementary, middle, and high school students must often carry backpacks that weigh enough to trigger chronic back pain, bad posture, and even decreased lung volume. I have written about this issue earlier, but lately, several studies reveal the truths behind childhood back pain and ways to mitigate it.
Are Backpacks Too Heavy For Kids?
Recent research supports that children carrying backpack loads of over ten percent of their body weight have a greater chance of creating back pain and related difficulties. An global study found that an alarmingly large percentage of school-age kids in Australia, France, Italy, and the United States often carried backpacks weighing more than the ten percent threshold.
In a second study involving a sample of 1540 metropolitan school-aged children, more than a third of the children surveyed reported backpack pain. Along with carrying heavy backpacks, female students and those diagnosed with scoliosis had a larger association with back pain pain. Children with access to lockers reported less pain.
The number of straps on the back had little effect on the respondent’s replies. Children also reported restricted physical activity due to back pain, and some took drugs to alleviate the pain.
Girls who transported bags in addition to wearing a backpack reported considerably greater back pain. Adolescents with back pain spent more time watching television than their peers. More than 80 percent of the surveyed thought that carrying a heavy backpack due to their back pain.
Backpack Pain Solutions
The research revealed several things that might help reduce back pain in school-aged children. The best way to prevent back pain is to refrain from carrying heavy loads.
Kids ought to make the most of locker breaks and only carry items necessary for a couple of courses at one time. When lifting a back pack, children should crouch down and bend their knees rather than curve the spine.
Backpack Safety
Appropriate Backpack Carrying Techniques
While not conclusive, research also supports that carrying the weight otherwise, e.g., by hand rather than by back pack, may help stop or reduce back pain. The American Occupational Therapy Association and the American Chiropractic Association provide these additional safe backpack etiquette tips:
Children should avoid carrying over 10 percent of the bodyweight in their backpack. For instance, an 8th-grader weighing 120 pounds should take no more than 12 lbs.
Place the heaviest objects at the back of the pack.
Make sure the items fit as snugly as possible to minimize back pain due to shifting weight.
Adjust the shoulder straps so they fit snugly over your kid’s shoulders and the back pack doesn’t drag your child backward. The bottom of the pack ought to be less than four inches under your child’s waist.
Children should avoid carrying backpacks slung over one shoulder, as it could cause spinal pain and general discomfort.
Encourage your child to carry only necessary items in their own backpack. Extra items can be carried in hand.
Look for backpacks with useful features like multiple compartments for even weight distribution, cushioned straps to protect the neck and shoulders, and waist belt.
If your child’s school permits, think about a roller pack, which rolls on the floor like luggage.
If problems persist, talk to your child’s teacher or principal about implementing paperback textbooks, lighter materials, or electronic versions.
Chiropractor, Dr. Alexander Jimenez�Finds Prescription Painkillers Most Common Treatment for Patients Seeking Care for Back Pain More than half of Americans suffer from back pain, as well as for those that seek treatment, doctors turn most often to prescription drugs
Ann Arbor, MI, May 19, 2017 � Many Americans (51 percent) have experienced back pain in the last 12 months, and of the 58% of those who sought treatment from a medical professional, 40 percent said they were recommended prescription painkillers, according to the Truven Health Analytics-NPR Health Poll.
Truven Health Analytics�, element of the IBM Watson Health business, and NPR run a national poll that is bimonthly to gauge opinions and attitudes on a broad variety of health�issues.
Following Are The Poll�s Findings:
Back Pain Plagues�Americans: Fifty one percent of Americans said they’ve endured from back pain in the last 12 months, and 46 percent of people who experienced pain said they are still in distress. Over half (58 percent) of back pain sufferers sought attention, with 70 percent visiting a medical doctor and 14 percent seeing a chiropractor.
Prescription Pain Killers are the Most Common Treatment: Of the 70 percent of back pain sufferers who sought care from a medical doctor, 40 percent were prescribed prescription pain killers, a rate that tended to decrease with increasing age of the patient. Other treatments prescribed were exercise/physical therapy (31 percent), shots (20 percent), massage (17 percent), steroids (17 percent), over-the-counter painkillers (13 percent), operation (12 percent), or another form of treatment (37 percent).
Almost a Third Stay in Pain with Treatment: Among all respondents, 25 percent said their back pain remained the same and five percent said their pain got worse. Forty-five percent said their pain improved, and 25 percent said it went away entirely.
�Experiencing back pain is extremely common among Americans, and there are a number of factors that may contribute to it, some of which are treatable without prescription pain killers, � said Anil Jain, MD, Vice-President and Chief Health Informatics Officer, Value-Based Care, IBM Watson Health. �These data reveal that when care is sought by the patients, they are generally prescribed painkillers. Compounding this challenge, back pain sufferers that are prescribed opioids for pain may be particularly at risk for dependency and addiction. Checking inappropriate opioid prescriptions for long-term pain is a focus of efforts by suppliers to fight the current opioid epidemic.�
To date, the Truven Health Analytics-NPR Health Survey has investigated numerous health topics, including vaccines generic drugs, data privacy, narcotic painkillers, and sports-related concussions. NPR archives reports on the surveys online in the Photos health blog here. Truven Health keeps a library of survey results here.
The Truven Health Analytics-NPR Health Poll is powered by the Truven Health PULSE� survey, an independently funded, nationally representative, multimodal poll that collects information about health-related behaviours and approaches and healthcare use from 80, 000 U.S. homes annually.
The results represent responses from 3, 002 survey participants interviewed from March 1 � 16 , 2017. The margin of error is /- 1.8 percentage points.
About NPR
NPR is an award winning, multimedia news organization and an influential force in American life. In collaboration with more than 900 independent public radio stations nationwide, NPR strives to generate a more educated public�one challenged and invigorated by way of a deeper understanding and grasp of ideas, events and cultures.
About Truven Health Analytics, section of the IBM Watson Health Company
Truven Health Analytics�, a part of the IBM Watson Health� company, supplies market-leading performance development solutions built on advanced analytics, data integrity and domain expertise. For over 40 years, our insights and alternatives have already been providing hospitals and clinicians, employers and health plans, state and government services, life sciences companies and policymakers, the facts they must make confident choices that directly alter the health and well-being of people and organizations in america and around the world. The firm was acquired by IBM in 2016 to help form a new business, Watson Health. Watson Health aspires to improve lives and give expectation by presenting innovation to deal with the world�s most pressing health challenges through cognitive insights and data.
Doctor of Chiropractic, Dr. Alexander Jimenez breaks down how pinched nerves cause back and neck pain.
You hear people say it a lot:
�I have a pinched nerve, and wow, it hurts.�
But what exactly is a pinched nerve? How does it cause back pain or neck pain? What are the symptoms of a pinched nerve�beyond pain? And most importantly, what can you do about a pinched nerve? Learn the basics of pinched nerves here.
Pinched Nerves: A Common Cause of Back & Neck Pain
What Is A Nerve?
Nerves are your body�s messengers. They transport signals to and from your brain�messages like �Move this toe� or �Ouch, that cactus needle really is sharp.� You have a central nervous system, which is made up of your brain and spinal cord. You also have a peripheral nervous system, which is the system of nerves that branches off the brain and spinal cord.
What Do Nerves Look Like?
If it helps, think of nerves like a garden hose (except they aren�t green). They have an outside membrane that transports those electrical messages. Inside nerves, there�s a fluid that nourishes and replenishes the outer membrane.
You�re Getting on My Nerves
When a nerve gets pinched, the messages and the nourishing fluid don�t flow quite as well as they should (still helpful to think of a garden hose here). A pinched nerve can start sending the �Ow, pain� message to the brain, and it can also have trouble communicating clear messages, possibly leading to weakness, numbness, or tingling.
What Can Pinch a Nerve?
As a nerve exits the spinal canal, it can be pinched by a herniated disc or a bone spur. Bone spurs, also known as osteophytes, are bony bumps that can develop on a spinal joint over time. They can push into the spinal nerve, as you can see in this illustration (red = pain generator, of course).
What Does a Pinched Nerve Feel Like?
A pinched nerve mostly feels like pain. If you have a pinched nerve in your low back, it can cause pain to travel (or radiate, in doctor-speak) down your leg. You may also know that as sciatica. A pinched nerve in the neck can create pain that shoots down your arm. Other symptoms of pinched nerves include muscle spasms, burning, tingling, and a hot/cold sensation.
Now the Good Stuff: Pinched Nerve Treatments
Pinched nerve treatments fall into two categories: what you can do at home (self-care) and what your doctor may prescribe for you.
Pinched Nerve Self-care #1: Heat and Ice
Heat and ice can work wonders on a pinched nerve. Switch between 20 minutes of heat and 20 minutes of ice�and remember that you shouldn�t put the heat and ice packs directly on your skin.
Pinched Nerve Self-care #2: Get a Massage
The muscles around a pinched nerve can become tight, so having a professional massage therapist work the painful area can bring pain relief. You may also consider a handheld massager.
Pinched Nerve Self-care #3: Take a Walk
Let�s say it�s your low back�a pinched nerve in your low back�that�s hurting you. A nice, easy stroll is a good way to stay active and address your pain. Gone are the days of extended bed rest for back pain: doctors now are more likely to recommend you exercise and stretch to help relieve your pain.
When Should You Call a Doctor?
If you try the self-care thing and yet your pinched nerve pain persists, you should consider calling the doctor. If you�ve been in pain for more than a couple of days, schedule an appointment. You should also call the doctor if you experience a very sudden onset of weakness, or if you experience profound numbness. Losing bowel and/or bladder control is also a good reason to call the doctor.
How a Doctor Treats a Pinched Nerve
The doctor will try to diagnose the cause of your pinched nerve, and then the doctor will be able to develop a treatment plan. That plan may include prescription pain medications, physical therapy, or cortisone injections. But keep this in mind: the treatment plan will be specifically tailored for you, and it�s in your best interest to follow it closely.
Doctor of Chiropractic, Dr. Alexander Jimenez examines people that see�a chiropractor and their reduced�usage of opioids and other types of drugs.
The draft Guidance for Prescribing Opioids for Chronic Pain, issued in December 2015 by the U.S. Centers for Disease Control and Prevention, included �many complementary and alternative therapies (e.g., manipulation, massage, and acupuncture)� among its recommended non-pharmacologic approaches. However, when the final Guidance was released three months later, manipulative therapy and its 75,000 licensed chiropractic practitioners was not directly referenced. A recent study from James �Jim� Whedon, DC, MS, pictured, suggests that the CDC harmed its mission with its excision of explicit reference to manipulation. Patients using chiropractors were less likely to use prescription opioids.
Whedon is currently a researcher at the Southern California University of Health Sciences, and is co-chair of the Research Working Group of the Academic Collaborative for Integrative Health. He is a relatively rare resource in the integrative health community, as a specialist in diving into huge data sets of insurers and seeking to extract useful information. Whedon is a veteran of arguably the most important research center in this type of work, The Dartmouth Institute at the Geisel Medical School at Dartmouth College.
Whedon�s research began with awareness that �little is known about the comparative effectiveness of non-pharmacological care for low back pain as a strategy for reducing the use of opioid analgesics.� What is well known, as Whedon shared in his poster and presentation at the 2016 conference of the Academy of Integrative Health and Medicine, is that patients with such pain are swimming in opioid prescriptions. Whedon�s presentation included a Baskin-Robbins-like list of 39 opioid varieties. He postulated that opioid use would be less likely among those receiving chiropractic care.
Association Between Utilization Of Chiropractic For Back Pain & Use Of Prescription Opioids
Preliminary results of a health claims study,� Whedon reports what he found through examining the New Hampshire All Payer Claims Database.� Of roughly 33,000 adults registered as having low back pain, slightly over a third saw a chiropractor. Of these, 38 percent had at least one opioid prescription. Of those who did not see a chiropractor, 61 percent had at least one opioid prescription.
The core question that interested Whedon was how many prescription fills the two sets of insured patients received. Those whose opioid prescription was integrated with chiropractic care had an average of 3.9 fills. Those who did not receive chiropractic manipulative therapy averaged 8.3 fills per patient. He estimated that the average per person opioid charges were $88 for those using chiropractors. The figure was $140, or 60 percent higher for those not using chiropractic care.
Whedon�s conclusions were, first, that the likelihood of filling a prescription for a high-risk drug of any type was 27 percent lower. Secondly, the likelihood of filling a prescription for an opioid analgesic was 57 percent lower in the chiropractic-using population.
�These are preliminary results,� Whedon cautioned. �We intend to analyze the data further, applying robust methods to reduce the risk of bias that can result from other differences between people who use chiropractic care and those who do not.�
Comment: While Whedon takes care to note that �no causal inferences can be made,� the associations should be of real interest to the CDC and other policy makers. A follow-up study might attempt to compare the whole costs of the chiropractic-using population and those who didn�t.� These costs could include, on the one hand, the cost of chiropractic treatment, and on the other, the costs of other medications or treatment that may be prescribed for those on longer-term opioid treatment who may end up cycling into the addiction.
Doctor of Chiropractic, Dr. Alex Jimenez examines Tiger Woods’ and his latest back surgery.
We have a look at Tiger Woods’ extensive history of injuries during his career. USA TODAY Sports
Tiger Woods Won�t Be Back For Some Time
Woods, that has made just three starts in a couple of years, likely won�t play again this year after he’d his back surgery that is fourth in Texas. The latest procedure alleviated pain in his back and leg, Woods announced on his web site Thursday.
That I’m confident this will relieve my back spasms and pain, and The operation went well,� Woods said in a statement. When fixed, �, I anticipate playing with my kids getting back to a normal life, competing in professional golf and living without the pain I’ve been fighting so long.�
Woods, who also has had four surgeries on his left knee, first had surgery on his back and then had two procedures in the autumn of 2015.
According to his statement, a disc in Woods back seriously narrowed because of causing sciatica, the three surgeries and severe back and leg pain. During the recent operation, the damaged disc was removed and the collapsed disc space was elevated to levels that were regular. The goal is to relieve the pressure on the nerve, the statement said. The procedure was performed by Dr. Richard Guyer of the Centre for Disc Replacement at the Texas Back Institute.
A Look At Tiger Woods’ Injury History
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About playing on Champions Tour, Tiger Woods jokes around
Woods, 41, last played in February, where he shot a birdie-free 77 in the very first round before removing. Where he missed the cut his only other start was in the Farmers Insurance Open the week prior.
His only appearance on the golf course in 2016 arrived at the Hero World Challenge in December. While he finished 15th in the 17-man field, he tied for the tournament lead in birdies (24), seemed healthy and upbeat.
Before beginning therapy, he will be resting for several weeks. The recovery interval is usually about half a year. That would mean Woods, a winner of 14 major tournaments and 79 PGA Tour titles, won�t play in any of the four majors for a second straight year. He is now rated No. 788 in the world.
Woods is in good spirits after the surgery, said his agent, Mark Steinberg.
USA TODAY Sports, he believes somewhat that the large weight was lifted off his shoulders,� Steinberg told. �The three previous operations were somewhat temporary repairs. But it got to the point where the pain was more common and this latest surgery was something he had to do.�
Steinberg said Woods decided to take a conservative approach along with his back previously three years with his difficulties. That alternative wasn�t accessible this time.
�This just isn’t a temporary repair,� Steinberg said. � his physicians proposed him that this is the top path to a healthy, energetic lifestyle. He and his children were playing but he was in so much pain.
�Now he �ll possess a healthy life without pain.�
One, Steinberg said, that can include playing golf.
�Entirely,� Steinberg said. �He desires to get out (on the PGA Tour) again.�
Woods� last public appearance ahead of the operation was Tuesday in Hollister, Missouri, where he pronounced he�s designing his first public golf course. The course will probably be called Payne’s Valley in honor of Missouri native Payne Stewart. Woods is a partner on the project with CEO Johnny Morris and Bass Pro Shops founder.
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Are Backpacks Too Heavy For Kids?
