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.
You get up with it. You go to sleep with it. An incredible number of men and women live with chronic back or neck pain every day. What’s chronic pain? It is technically defined as pain that lasts for 12 weeks or more�even after pain isn’t any longer acute (short-term, serious pain) or the injury has healed.
Accurate Analysis
Getting an exact identification of the reason for neck pain or your back is vital to the outcome of your treatment plan. Depending on the severity and cause of your pain that is chronic, you might need to find out different specialists in addition to your own primary care physician�pain medicine specialist, orthopaedic spine surgeon, neurosurgeon, physiatrist, rheumatologist, physical therapist among others. Over time your chronic pain need to be reevaluated, and may transform, which might affect the way it is handled.
Your chronic back or neck pain treatment generally features a variety of treatments to maximize results that are great. A number of the treatments your doctor prescribes and recommends may include:
Physical Therapy:
Extending and strengthening muscles is vital in the treatment of neck pain or chronic back.
Chiropractic Care:
Depending on your own diagnosis, chiropractic care may be recommended by your doctor. Studies have demonstrated that two weeks of day-to-day exploitation by a chiropractor can result in considerable progress in a few patients with persistent low back pain and referred leg pain.
Medicines:
There are lots of different prescription medications to take care of neuropathic pain, inflammation, muscle spasms, and pain. Additionally, you will find drugs to treat conditions that often accompany chronic pain, including drugs that will help you sleep, alleviate depression, and reduce nervousness.
Processes:
Your doctor may recommend a spinal cord stimulator, spinal injections, drug heart, or spine surgery. You can get a second opinion, in the event you might be uncertain about the treatment plan recommended.
Coping skills:
Never underestimate the power of your head. Your mood and mental perspective can greatly make an impact on your level of pain. Talk with a trained specialist to understand relaxation and coping skills.
Complementary Treatments:
Many physicians recommend acupuncture and other types of traditional Chinese medicine. Speak to your doctor about these choices.
A couple of words about …. age, fitness, body weight
You probably involve some control over body weight and your level of fitness, although you can�t stop aging or its effects. While you can�t stop the clock on the cellular changes that are recognized to accompany aging�such as loss of muscle mass and bone density �you can take little steps today to build a more stronger�you tomorrow.
It�s understood that patients with chronic back or neck pain may not feel like being active, going to the gym and even adhering to a home exercise program. Yet, being active can help chronic pain because during exercise your body releases endorphins�your body�s natural painkiller.
Moreover, by teaming up together with and/or your physician physical therapist you can start to build abdominal muscles that are strong �essential to your own body�s center strength which helps support your back.
Did you know that by simply losing even 5 to 10 pounds you can reduce back pain? It�s true. Carrying around extra weight translates to added stress to the low back that may exacerbate pain.
Conclusion
In many instances, aggressive and early treatment of chronic back or neck pain can make a life-changing difference. But remember that knowledge is power: Be certain you comprehend your alternatives before deciding which route to take.
Viewers can�t get enough of the informative clip that sees a chiropractor helping a patient suffering from lower back pain.�Dr Jeffrey Gerdes of the ChiroCare and Rehab centre based in North Carolina, US, talks his way through the demonstrationHis patent tells him: �I�m getting excruciating pains in my back and they�re very instant and they�re immobilising.�It�s so excruciating that I have to stop for a second and re-coup so I�m not sure what�s happening.� The doctor asks her to lie on her side and gently cracks her back.
CRACKING:
But the sound that emerges leaves him stunned. �Wow, gosh that was loud,� Dr Jeffrey says.Viewers can�t get enough of the footage, with more than 876,000 people watching the clip on the chiropractor�s YouTube channel.But many seem to have been distracted more by the stunner getting treatment than the actual techniques involved.�Well, did anyone else manage to take any of that in?� one viewer said.
Ergonomics is a scientific discipline that’s been in existence for many years. Keeping their work environments safe and efficient and traditionally concerned with factory workers, ergonomic professionals have expanded their work to include all types of workers from laborers to seniors to office workers & students.
In addition, it looks for means to adjust our environment to lower the risks of illness and harm, enhance productivity, and improve the caliber of our work life.
The Goals of Ergonomics
The profession of ergonomics has two main concentrations (which frequently overlap):
1. Industrial ergonomics – occasionally called work-related biomechanics – is concerned with the physical aspects of work including force, position, and repetitive movements.
2. Human factors ergonomics looks as the psychological features of work like mental anxiety and decision-making.
The aims of ergonomics contain the following:
Reduce work-related injury and illness
Help include workers’ compensation costs for companies
Enhance the standard of work
Reduce absenteeism
Help companies comply with government regulations regarding work surroundings
Ergonomics professionals include:
Engineers
Security professionals
Industrial hygienists
Physical therapists
Occupational therapists
Nurse practitioners
Chiropractors
Occupational doctors
How Ergonomics Enhances Work & Safety
The association between work injury and illness is old. It is even believed that Ancient Man concerned himself with developing the right tools that allowed for the efficiency and least amount�of distress.
Now, we continue to look for ways to boost the relationship between our “tools” and�our jobs. One means to do that is to look at the risk factors in the workplace. These are able to be divided into 3 areas: physical characteristics, environmental features, and workplace hazards.
1. Physical Characteristics Of Work:
Bearing
Drive
Repetition
Duration
Recovery time
Velocity/acceleration
Heavy exertion that is dynamic
2. Segmental Vibration Environmental Characteristics Of Work:
Living with chronic back or neck pain can lead to depression, feelings of worry, nervousness, hopelessness, as well as other mental health-associated symptoms. Your pain medicine physician or your back specialist may refer you to a psychologist or psychiatrist. Referring you doesn�t mean your physician believes your pain is all in your mind! Rather, he/she is taking an optimistic step in treating you as a whole individual � by treating both the physical and psychological pain.
Chronic Neck &�Back�Pain Is Complicated
As someone living with chronic pain caused spondylosis, degenerative disc disease, spinal cord injury or some other back problem, you understand pain is a complicated issue, and treatment requires the expertise of a spine�specialist. Perhaps your pain management plan features a blend of treatments � medication for neuropathic pain, a periodic epidural spinal shot, a muscle relaxant, or physical therapy. Treatment of stress, nervousness, and depression (there are various types) needs the same level of expertise but from somebody who focuses on managing mental health problems.
Depression & Chronic Pain
Are you aware that depression and chronic pain often go together? Depression is a critical condition, and nothing to be embarrassed of. It has been reported that as many as 50% of individuals with chronic pain are depressed.1 So, if you are depressed, you’re far from being alone.
The signs and symptoms of depression can manifest themselves differently in each individual, but tiredness, sleep disruption, changes in eating habits, listlessness, and feelings of hopelessness are all quite common. Aches and pains are a very common symptom of depression notably, depression can lead directly to neck and long-term back pain.
Treating Depression & Pain
Two classes of antidepressants often used to treat depression in those that experience chronic pain are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Generally prescribed SSRIs include and fluoxetine (Prozac) and sertraline (Zoloft), whereas usually prescribed SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor). These drugs have now been demonstrated to be effective and safe for handling depression in the context of continual pain, but like all medicines, they come with some risk of unwanted effects. As always, be sure to go over these drugs in detail together with your physician before beginning any treatment regimen that includes them, and inform your physician of all of the medicines (including over the counter medicines), herbal remedies, and nutritional supplements you’re currently taking so as to avoid any negative drug interactions.
Moreover, or in addition to medications, other types of treatment may include:
Talk therapy, more officially called cognitive behavioral therapy (CBT). The focus of CBT is to help the individual manage their situation and may include learning how to problem solve, thus engaging the individual to alter specific thought patterns to your more positive outlook, and conquering�fears.
Practice relaxation techniques such as meditation or breathing exercises.
Routine exercise might help curb feelings of worry, stress as well as depression. Exercise causes the entire body to release endorphins, which can cause you to feel much better and may reduce pain perception too.
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Reference
1. Tartakovsky M. Living with chronic pain and melancholy. PsychCentral.com. http://psychcentral.com/lib/living-with-chronic-pain-and-depression/. Got July 30, 2015.
Pain in the upper and/or mid back is not as common than lower back or neck pain. The upper back is called the thoracic spinal column, and it is the most secure part of the spine. The reach of movement in the upper back is limited because of the backbone�s attachments to the ribs (rib cage).
Upper back pain is generally caused by soft tissue injuries, like sprains or strains, muscle tension caused by bad posture, or looking downward for long time spans (eg, texting, mobile phone use).
Pain
Tightness
Stiffness
Muscle spasm
Tenderness to touch
Headache
What causes or leads to upper back pain?
An episode of upper back pain can be actuated by distinct moves and actions, including:
Twisting
Excessive bending
Whiplash or alternative neck injury
Lifting improperly
Poor muscle tone
Persistent movements, overuse
Contact sports
Carrying a load that is heavy
Smoking
Being overweight
Poor posture�working at the computer for�a long time without taking a break to walk around and extend, or in general can promote upper back pain. Both muscle fatigue and muscle pull, which often result from poor posture, can trigger the pain.
So what can I do about it?
Usually, upper back pain is not a cause for worry; however, it can be uncomfortable, painful, and inconvenient. Also, if pain develops suddenly and is serious�such as from an injury (eg, fall)�and, certainly if pain and symptoms (eg, weakness) progressively worsen you should seek medical attention.
Generally, the next home treatments can help relieve back pain that is upper.
Short term rest
Mild�Stretches
Over the counter medicine, for example ibuprofen, (Motrin�), naproxen sodium (Aleve�), or acetaminophen (Tylenol�). Take with food, and don’t take more than the recommended dose.
Use a cold pack that is commercially available or fill a plastic bag with ice and seal it wrap it. Apply to the painful area for 20 minutes every 2-3 hours for the first 2 to 3 days.
Heat (after the very first 72 hours). After using moist heat, gently stretch the muscles to enhance mobility and alleviate stiffness.
Your physician may prescribe drugs, like a muscle relaxant or perform trigger point injections to greatly help break up muscle spasms. He or she may also recommend physical therapy to increase flexibility, mobility and alleviate pain. Other treatments your doctor may suggest include acupuncture and chiropractic care.
Most cases of upper back pain resolve in 1 to 2 weeks without additional treatment. When you’re able to perform them without pain restart your regular activities slowly. Don�t rush matters, however: you could interfere with your healing and risk reinjury.
As always, abrupt or severe pain ought to be dealt with promptly.
Back pain may be common, but it is not normal. It is so common that half of all working Americans admit to having back pain symptoms each year. That means there are potentially 150,000 people who suffer from back pain in the city of St. Louis alone. Low back pain is the single leading cause of disability worldwide per the Global Burden of Disease 2010 and it is also one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor�s office, outnumbered only by upper-respiratory infections.
Imaging will show all my back problems
Imaging may not reveal everything. Back pain is often a complex and multi-factorial issue, meaning that a spinal diagnosis isn�t always straightforward. To uncover what�s causing your back pain and what�s necessary for recovery requires a full clinical diagnostic process. This typically requires three steps. First you need a review of your medical history. To get to the root of your back pain, your physician should spend time asking you a series of questions about your symptoms, history, activities, positions, treatments, and more. After that is explored you will need a physical examination. A competent physician should check your spine to determine function, strength, discomfort in certain positions, and more. Lastly, you will go through diagnostic testing. Only after a physician has reviewed your medical history and given you a physical examination is imaging appropriate. Everything from an X-ray to CT scans and MRI scans can be appropriate to assess certain conditions.
Back pain that comes and goes isn�t a problem
Our bodies are incredible at adapting. However, what we know is that in nature nothing stays the same.� When someone tells me that their problem comes and goes it concerns me because it due to something that they are doing or not doing that�s causing them to either notice the problem or not notice the problem. Either way the underlying problem is still there and needs to be corrected. When the pain comes and goes, it�s usually the lead up to your back �going out� without warning. The reality for many individuals is that back pain is a result of a cumulative effect from simple movements.�� There�s always a cause for back pain and seeing a physician is your best chance for appropriate diagnosis and recovery
In fact if you find yourself saying, �back pain runs in my family� or �I just learned to live with it,� those are concerning statements because it means that the current approach you�re taking to correct the problem isn�t working, and you should make a change in order to actually correct the problem.
Drugs and Surgery are the only way to correct your back pain
In 2013 The Journal of the American Medical Association suggested chiropractic care as an option for people suffering from low back pain and noted that surgery is usually not needed and should only be tried if other therapies fail. In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research recommended that low back pain sufferers choose the most conservative care first. They also recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults
�Back pain is a normal part of aging
While we see back pain in older populations we also see it in younger populations as well.� We are seeing more and more people starting to have more back pain and arthritis at younger ages.� There are even times where I hear patients ask if arthritis in their spine is normal at their age. Again this may be common, but it is not normal.� If it were normal it would likely be seen in the entire spine not just in specific segments of the spine.
Tips to Prevent Back Pain
�Maintain a healthy diet and weight.
�Remain active�under the supervision of your doctor of chiropractic.
�Avoid prolonged inactivity or bed rest.
�Warm up or stretch before exercising or physical activities, such as gardening.
�Maintain proper posture.
�Wear comfortable, low-heeled shoes.
�Sleep on a mattress of medium firmness to minimize any curve in your spine.
� Lift with your knees, keep the object close to your body, and do not twist when lifting.
�Quit smoking. Smoking impairs blood flow, resulting in oxygen & nutrient deprivation to spinal tissues.
�Work with your doctor of chiropractic to ensure that your
Dr. Vidan�is�a private practice Chiropractor in St. Louis. He�is very passionate about helping athletes from peewee�s to pro�s get back on the field after an injury and stay on the field. This allows athletes to enjoy the most out of their sporting experience. Dr. Vidan provided chiropractic care for the St. Louis Cardinals players and staff during the 2011 World Championship season, and continues to enjoy the opportunity to help athletes and organizations at the highest levels.
Many of us experience back and neck pain. But when is it the right time to see a chiropractor for a diagnosis or treatment? And can they really help? The answer is yes.
Chiropractors have been around for a hundred years, and are licensed doctors who are required to pass a series of four national board exams and are regulated by state licensing boards. They are medical professionals who diagnose and treat musculoskeletal and nervous system disorders.
A chiropractor can use many different techniques to relieve pain, including applied pressure, massage, and hands-on manipulation (adjustment) of the vertebrae and joints. They may also order X-rays, MRI studies, and lab work. Chiropractors don�t prescribe medications, but they do recommend such things as therapeutic and rehabilitative exercises and nutritional and lifestyle counseling to help the body heal itself.
Chiropractors believe one of the main causes of back or neck pain is subluxation. Subluxation occurs when your vertebrae become misaligned. Treating subluxations can help to alleviate pain associated with a myriad of conditions, including:
headaches
sciatica
trauma, such as whiplash
scoliosis
leg pain
sports injuries
bursitis and tendonitis
fibromyalgia
spinal arthritis (spondylosis)
Sometimes chiropractic care (eg, an adjustment) can cause mild soreness or aching but that usually resolves itself within 12 to 48 hours.
Chiropractic Tests
When you visit your chiropractor for the first time, he/she will probably ask you to perform a series of simple tests to evaluate your posture and range of motion. You may be asked to bend forward,� backward or side-to-side. The chiropractor will also check the way you walk and how your posture looks sitting down and standing up.� Other tests may include:
Piriformis Test: The patient flexes and bends the knee while lying down.
Straight Leg Raise: One leg at a time is raised in a locked-knee position to check the sciatic nerve and flexibility of the hamstring muscle.
Measuring the length of each leg helps determine if there is a discrepancy in leg length or if the pelvis is out of balance.
Hand strength (grip)
Evaluation of reflexes and muscle testing
Sometimes you might hear a pop while the chiropractor is testing or adjusting you, which is perfectly normal. This is caused by small pockets of air or bubbles in the fluid that surrounds your joints. When joint tissues are stretched, those pockets of air �pop,� which creates the cracking sound you hear.
Diagnosis
Once the chiropractor identifies the problem, he/she can recommend treatment options, and explain how many chiropractic visits are necessary to reach an expected outcome (eg, resolution of pain). He/she may also suggest improvements to your diet and lifestyle, such as quitting smoking or increasing/modifying certain activities. A chiropractor may also recommend certain types of exercises in conjunction with chiropractic treatment to stretch and/or strengthen the back and neck.
Adjustment Techniques
A chiropractor is educated in dozens of ways to treat pain. Here is a sampling of the different techniques that may be used.
Toggle Drop � The chiropractor presses down firmly on a particular area of the spine followed by a quick and precise thrust.
Lumbar Roll � With the patient on his/her side, a quick thrust is applied to the misaligned vertebrae.
Release Work � The chiropractor uses gentle pressure with the fingertips to separate the vertebrae.
TENS (Transcutaneous electrical stimulation) � This device sends stimulating pulses across the surface of the skin and nerve strands to block pain signals along the nerves and release endorphins which are natural painkillers.
Cold/Heat Treatment � Chiropractors may alternate between ice and heat therapy to treat back or neck pain. Ice packs are used to reduce inflammation (swelling) for 15 minutes at a time. A heating pad (or other heat source) helps increase circulation and may promote faster healing.
Table Adjustments � The patient lies on a special table with a �drop piece� then a quick thrust is applied when the table drops.
Instrument Adjustments � Instead of hands-on manipulation, the patient lies on the table face down while the chiropractor uses a spring-loaded activator instrument to perform the adjustment.
Manipulation Under Anesthesia � This is performed by chiropractors certified in this technique. The treatment is performed in a hospital outpatient setting.
Keep in mind that chiropractic care is not a cure-all for your back and neck pain! However, it is considered by many to be a safe and effective way to help relieve pain and improve spinal function. Many physicians and surgeons recommend chiropractic care to their patients.
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