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.
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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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.
Doctor of Chiropractic, Dr. Alexander Jimenez discusses chiropractic care for back pain.
Back pain, especially lower back pain, is a constant for many people in El Paso and around the world. Chiropractors have always been known as �back pain doctors� to a certain degree, and while they can treat a much wider range of ailments, this moniker is certainly true. El Paso chiropractic care for back pain includes a range of individualized treatments designed to remove the pain permanently.
Some Facts About Back Pain
One estimate places the number of back pain sufferers in America at roughly 31 million.
Here are some other interesting facts that illustrate just how serious the problem is:
A 2010 report entitled Global Burden of Disease placed lower back pain as the leading cause of disability around the world.
Back pain is one of the most common reasons for missed work days and the second-leading reason for doctor�s visits behind infections in the upper-respiratory tract.
50 percent of all working Americans say they experience back pain symptoms each year.
Mechanical issues cause the majority of back pain cases, meaning they are not the result of an underlying health condition.
Conservatively, Americans spend about $50 billion on back pain.
Some experts say that as much as 80% of the population will experience back pain at some point in their lives.
Why Do I Have Back Pain?
The causes of back pain can vary quite a bit. With so many muscles, bones, ligaments, and joints all working together in a complex structure, strains and other injuries leading to back pain are common. You may be experiencing back pain due to improper lifting, poor posture, stress, being overweight, a past sports injury, or a car accident. Conditions like arthritis and osteoporosis also cause back pain, as does disease that originates in certain internal organs.
Chiropractic To The Rescue
Chiropractic care is a safe and effective way to treat many types of back pain. With proper chiropractic care for back pain, you will have greater mobility and fewer flare ups. For many patients eliminating the side effects of prescription pain medication is a welcomed benefit they never even considered. Chiropractic treatment focuses on the underlying cause of the back pain while most conventional treatments focus on the symptoms. When only treating the symptom or the pain you may experience relief, but whatever is causing that pain will still be there.
Reputable chiropractors will also suggest lifestyle changes you can make to help prevent back pain from returning. These include maintaining a healthy weight, avoiding prolonged sitting, staying active throughout your life, staying hydrated, wearing low-heel shoes, stretching your body, and using proper body posture. By helping yourself and receiving high quality chiropractic care, back pain should be a thing of the past.
Doctor of Chiropractic, Dr. Alexander Jimenez looks at four ways of reducing back pain.
1. Understand The Way Your Spine Works
The best approach to take care of your spine and prevent back pain is to begin with a superb understanding of how the spine works. By understanding how your backbone works when you’re performing jobs that are day-to-day or moving during your day, you may be able to take care of your spine and keep it working for a long time with fewer problems and less back pain.
2. Incorporate Safe Body Mechanics Into Activities
Use good body mechanics during day-to-day jobs at home and work. What does that mean? Good body mechanics means while you go, keeping your back in a safe posture that is balanced. You can help to prevent back pain and injury, by remembering several easy notions. You should employ your leg and arm muscles when lifting and stooping �not your back muscles. Second, keep your back straight when bending and lifting. And last but not the very least, be sure to bend at your hips and knees, not at your waist.
An example of correctly bending at the hips and knees
3. Exercise On A Regular Basis
Regular care of stuff we possess helps to keep them working efficiently, with less effort and safely. Exactly the same is true of the back.
Exercising on a regular basis really helps to keep up long term to a healthy back.
Regular exercise helps to increase endurance and reduces fatigue.
But Don’t I Get Enough Exercise At Work?
Many people believe their occupations provide enough exercise�specially occupations which are physical and could include manual labor. Regrettably this really isn’t accurate. Individuals need daily exercise to state and strengthen their muscles to perform job tasks safely and efficiently.
Exercise could be fun! There are lots of types of exercise. One method when selecting to start a workout program to ensure success would be to pick some form of exercise that fits into your lifestyle. If exercise is accessible and convenient, you’ll be prone to continue exercising on a longterm basis. As an example, determining to swim daily or do water aerobics without easy use of a pool year round would make success less likely and consistency difficult.
A typical exercise that a lot of people start successfully with is walking. Walking just takes a superb pair of walking shoes, may be done any day of the year, and is usually simple to fit right into a daily program.
Remember, whatever type of exercise you decide on, always start out small (10 minutes vs 60 minutes), and slowly increase your own exercise time. This may help to make sure your success at getting started and sticking with a fitness plan. Add two or one stretching exercises, like a calf stretch, for your routine for one more benefit.
An example of a calf stretch
4. Fuel Your Body With Proper Nutrition
Eating a healthy diet supplies the fuel your body has to make energy. And energy must do work, meaning the jobs we do throughout the day, like work tasks and exercise. Appropriate nutrition also helps to maintain your ideal body weight. Weight management is a great way to restrain stress on the joints in your body, including the spine.
Unsure where to start to understand about proper nutrition and establishing a healthier diet for you personally as well as your lifestyle? Then take a look at Introduction to Nutrition. By integrating these suggestions into your everyday life, you’ll be able to promote a healthier back�and lifestyle�for a long time.
Doctor of Chiropractic, Dr. Alexander Jimenez looks into Tai Chi for back pain.
Q&A with Tai Chi Specialist Dr. Paul Lam
While lots of people take a �no pain, no increase� approach to work out, that�s for handling back and neck pain not always safe or effective. That�s where tai chi comes in. This low-impact, slow moving form of exercise delivers results without the sweat and soreness. Though it�s tender and meditative tai chi promotes strength, flexibility, and balance�the trifecta to get a healthier spine.
In case you have back or neck pain�or you�re looking for methods to prevent it in the first place �tai chi may be worth investigating. To help answer common questions and shed light on lesser-known facts relating to this ancient Chinese mind and body practice, we reached out to Dr. Paul Lam, manager of the Tai Chi for Health Institute in Australia.
Tai Chi Can Help
Q: During your research, what has become the most insightful finding you�ve found about tai chi as it relates to back pain?
A: The most insightful finding in my research concerning tai chi involved the mental impact and the deep stabilizer muscles to back pain.
Ninety percent of men and women have back pain at some period in their own lives, and more than 60 percent of that is continual. I discovered that nearly all individuals with back pain, no matter what the cause, have poor stabilizer muscles. Research has shown that strong stabilizers will prevent back pain and hasten healing.
Reinforcing the stabilizer muscles that are back is quite similar to tai chi training. The main element is an erect pose, exercising the stabilizers through the pelvic floor along with the transverse abdominus muscles, and using abdominal breathing. This really is among the important reasons why tai chi works so well for back pain.
One other insight I�ve discovered involves your head. Anxiety makes pain worse. Oftentimes with the continuing and persistent back pain, the cause of the pain might have gone, but the pain continues. Like a phantom pain, the thoughts�s ingrained custom proceeds to provide pain signals to the brain. Tai chi trains body and the mind, making both integrated and more powerful. It is but one of the utmost effective tools to greatly help with the mental aspects of back pain.
Q: What�s your best advice for somebody who’s apprehensive about beginning tai chi?
A: The reason why they are apprehensive about beginning tai chi, it depends. I can guarantee them it is safe, simple to understand, and proven effective, if people believe tai chi is a martial art and might be overly hard to learn. Millions of people around the globe have learned and profited from it, although the other consideration is the fact that individuals might believe tai chi is too tough to learn.
Q: How do individuals get the most?
A: I advocate people to practice tai chi for 30�40 minutes daily (it may be performed in separate sittings) most days each week. You will gain significant improvement in your quality of life and relief from back pain.
Q: Do you have some success stories that are personal which you can share regarding the benefits of tai chi for back pain?
A: Thousands! But to pick on only one, I�ve comprised a letter below written by a woman named Amatullah from Saudi Arabia.
“In 2009, I ‘d back pain for quite a while. Nothing worked, although I attempted many types of therapy. My friend said, �Try tai chi, it’s a gentle exercise.� Because my back was sore, I refused at first, but I attempted it. It was really surprising to me how people from 35 to 80 years old could do the movements, when I couldn�t. I found to be able to steadfastly keep up their health, some of them had been practicing for up to 35 years. I understood they were much fitter and much more flexible than my parents, therefore I decided to learn it. I practiced in all weather, in the park every day. My back pain vanished and has never return.”
Q: Are there tai chi resources you can recommend?
A: Yes, the Tai Chi for Health Institute web site has many resources, including a summary of accredited educators around the planet.
El Paso, TX. Chiropractor Dr. Alex Jimenez looks at sleep posture for back pain.
Whether you got back, neck, or pregnancy pain, your slumber posture makes a big difference in the way you feel each morning.
Great posture is a key to a healthier spine, but posture isn�t just about sitting or standing straight. Your sleep bearing has a significant effect on neck and your back. While some postures allow you to feel refreshed morning, come, others can leave you stiff, sore, and in pain.
Believe neutral, as it pertains to locating the very best sleep pose to your back and neck. Postures that put your spine in a neutral, or direct, alignment place the smallest amount of pressure on your own back and neck. Learn which postures set your back in a neutral state and those who must be prevented below.
The Very Best Sleep Posture For The Back: On Your Own Back
Sleeping in your back is for putting your spine in a neutral alignment, the very best, but only 8% of people sleep in this pose.
A few strategically placed pillows can boost the advantages of back sleep. A little pillow underneath your head and neck (but not your shoulders) will help to keep your back straight. Including a pillow under your knees will provide comfort and much more support, as it encourages your back to preserve its natural curve.
It’s a few drawbacks, though back sleeping is the best on your spine:
It�s not best for individuals with sleep apnea. Back sleeping may create the tongue to obstruct the breathing tube, so those with sleep apnea must not sleep on their backs. Instead, they ought to sleep on their side with legs right.
It�s not best for snorers. Back sleeping can worsen snoring. People who snore should sleep on their side with legs right.
It’s not best for women that are pregnant. Pregnant women who sleep on their backs danger growing a multitude of health issues, from back pain to low blood pressure. Plus, the on-the-back position decreases blood flow to the baby and also the heart. The very best sleep position during pregnancy is sleeping on the side with legs bent.
�
The Next Best Choice: On Your Side With Legs�Straight
For those that snore or have sleep apnea�or in the event you just discover sleeping on your back uncomfortable�side sleeping with your torso and legs is a fantastic choice. That is the perfect sleeping pose for people and snorers with sleep apnea because it keeps your airways open. Adding a tiny pillow between your legs will also help in keeping your back neutral.
In Third: On Your Side With Legs Bent Upwards
Sleeping on your side together with your legs bent upwards�also generally known as the fetal position�is the most typical sleep pose (41% of adults sleep this manner). This posture keeps your neck and upper back, though it�s a popular alternative. The fetal position also promotes an uneven distribution of weight, which can cause tender joints and back pain. You can help reduce your odds of waking up by pulling your knees and maintaining your turning angle up as high as they can go.
While this is the third-best slumber pose for most, sleeping on your side with bent legs is the best sleeping position for women that are pregnant. It supplies the most comfort and safety for a growing abdomen, and sleeping on the left side adds the additional benefits of boosting blood and nutrients to the baby. For additional support, pregnant women may put in a pillow between their bent legs and knees.
The One Sleep Position Everyone Should�Avoid
No matter the sort of pain you might have, whether it�s neck, low back, joint, or related to pregnancy, sleeping on your stomach just isn’t recommended. This posture places the most pressure on joints and your back�s muscles as it flattens the natural curve of your back. Sleeping on your stomach also compels you to turn your neck, which may cause neck and upper back pain.
Getting the sleep you need is much more important while stomach sleeping is better prevented. You are able to calm some pressure off your back by placing a pillow under your pelvis and lower abdomen, and another pillow under your head if stomach sleeping is the sole way you can snooze soundly. In the event the pillow under your head causes pain, remove.
Still Feeling Sleepy?
You struggling to get a great night�s rest, although when you yourself have sleep bearing that is healthful, factors outside your sleep position may be the offender. As an example, environmental disruptions (for example bright lights in your bedroom) or dietary customs (like eating a substantial meal before bed) could be interfering together with your slumber. Learn about some common sleep burglars and how you can combat them in Sensible Sleep Advice to get a Wholesome Spine.
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