Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).
Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.
With so much at stake, our bodies have developed a complex self-defense system to protect the spinal cord and its critical two-way�sensory information flow. As the body�s nerve center the spinal cord controls almost all voluntary and involuntary movements throughout the torso, arms, and legs.�It also receives sensory input from the torso and limbs. The�spinal cord plays a critical role and needs to be defended. The most prominent protection for the brain is the skull, for the spinal cord, it is more complicated.
Self Defense
The spinal cord consists of a bunch of nerves. One of the self-defenses is the cerebrospinal fluid (CSF) that cushions and nourishes them. On the outside, the spinal cord is protected by the tube structure known as the meninges. Three-layered membranes make up the meninges, each with its own protective role:
Pia mater
Arachnoid mater
Dura mater
Self-defenses do not stop there. Another self-defense includes the vertebrae or the backbones themselves, intervertebral discs, and various muscles and ligaments.
Meninges
The meninges are three layers of membranes that encapsulate the spinal cord at the brainstem from the top to the bottom of the spine. The innermost layer is the pia mater and is attached directly to the spinal cord. It is made up of mostly collagen that has an elasticity that allows the cord to maintain its shape. Next comes the arachnoid mater and is the middle layer.
Its primary role is to maintain the cerebrospinal fluid that fills the subarachnoid space between the pia and the arachnoid. A common condition known as arachnoiditis involves the arachnoid mater. It is a painful inflammation of the membrane that requires medical treatment. It can lead to disability if it is progressive.
Dura Mater
The outer layer is the dura mater and is the toughest. The dura rests on the arachnoid with a small amount of fluid in-between. The epidural space separates this membrane from the wall of the vertebral canal. Although it is tough, tears can occur. Tears can result from:
Injury
Epidural injections
Lumbar punctures
Complications from spine surgery
Some individuals can even develop tears spontaneously, sometimes as a result of a connective tissue disorder. When the dura tears cerebrospinal fluid leaks out of the space, leaving the brain and spine with less cushion and support.
Postural headaches are worse standing than sitting or laying down and can be severe are the most common symptom of spinal fluid leaks. But these tears typically heal quickly with bed rest.
Cerebrospinal Fluid
Cerebrospinal fluid is the clear liquid that fills the space between the pia and the arachnoid. It is made in the brain�s ventricles with its primary function to protect and nourish the spinal cord and brain. The fluid also removes waste products from the brain. The fluid also plays a role in helping doctors diagnose disease/s.
If a doctor suspects a severe infection or disorder of the central nervous system, they perform a lumbar puncture or spinal tap. The fluid can also contain evidence of inflammation or infection from waste products that the central nervous system discarded into the fluid. A doctor inserts a needle between two vertebrae in the lower back to remove a small amount of cerebrospinal fluid. The fluid is sent to the lab and analyzed. Lumbar punctures can be used to diagnose conditions like:
Infectious brain and spinal diseases like meningitis and encephalitis
To see how the fluid is moving diagnostic images are done by injecting dye know as myelography or radioactive substances known as cisternography into the subarachnoid space before imaging. Lumbar punctures can also be used to measure the pressure of the cerebrospinal fluid.
Vertebrae
There are 33 bones that make up the spine that forms a framework shaping the body and protecting the spine.�In a healthy spine, the neck vertebrae curve slightly inward called lordosis, while the middle vertebrae curves outward called kyphosis before meeting the low vertebrae curved inward. This makes the spinal cord flexible and balanced.
Each vertebra has a complex shape with a precise configuration determined by the location in the spine. Many conditions of the vertebrae involve nerves that get pinched/compressed as they exit the spine. Pinched nerves usually result from bone spurs on the vertebrae that crowd the canal and from herniated discs.
Intervertebral Discs
The intervertebral discs are the spine�s shock absorbers. They fill the space between two vertebrae with no direct contact. The endplates of each are coated with protective cartilage which anchors the discs in place. The gel substance part of each disc is called the nucleus pulposus. The tough cover known as the annulus fibrosus wraps around each disc to protect and shape it. There are no blood vessels in the discs and are nourished by the endplates of the vertebrae.
Herniated discs are the most common disc-related condition. When a disc herniates, the annulus fibrosus tears. The tear leaks out the protective gel to bulge out into the spinal canal. With no room in the canal for anything but the spinal cord and spinal fluid, the gel puts pressure on the surrounding nerve/s and the spinal cord itself. This is called myelopathy when the spinal cord gets compressed. Non-surgical treatments are quite successful in healing herniated disc/s.
The spine�s self-defense is elaborate, effective, and complicated. Consult an experienced spine specialist/chiropractor who can produce the best results and benefits.
Dr. Alexander Jimenez takes a look at how to keep your back healthy while doing yard work and gardening. We�re looking for ways to find mental and physical engagement without socializing. Many individuals are breaking up isolation and monotony by doing some home projects out in the yard and garden.
Doctors may tell patients that yard work and gardening should be avoided if they have a bad back. Individuals with a history of back pain/issues or have had spinal surgery might think that gardening is out of the question.�None of this is true. Yard work and gardening can be therapeutic physically and mentally for individuals with compromised backs as long as they follow some common-sense safety concepts.
Gardening with an ergonomic approach can make yard work and gardening very back/spine-friendly. If possible try to get tools for gardeners with neck and back problems or modify your own. Modified tools can highly reduce the chances of injuring your back. Try to set up the yard or garden in a way where there is minimal bending and reaching.
If this cannot be achieved set up the work to be done in an order where any bending/reaching tasks are spaced out so as not to be doing them all at once. Here are some ways for back-preservation when doing yard work and gardening. They will make your work more productive and reduce fatigue, discomfort, and minimize the risk of exacerbating any back injuries/problems.
Environment
Working in the right environment is an important step for those with a bad back. If possible garden on a raised platform or a raised garden that is at a comfortable height to be able to stand and garden without bending and reaching. Structures can be purchased, or make them yourself with old broken used furniture like tables, shelves, etc. Garden beds can be worked using the square foot technique to minimize bending, reaching and squatting.
The Square Foot gardening technique was invented in 1976 by Mel Bartholomew, a civil engineer, and efficiency expert that took up gardening after retiring. These types of gardens are made to be waist level using old furniture, self-made or store-bought frames that are back-friendly. Gardening like this means less time weeding, bending and reaching with more time enjoying the therapeutic benefits.
Preparation with the Spine in Mind
Here are some tips on modifying your methods and tools for safe yard work and gardening. One example is using a golf bag with wheels for carrying and select long tools. Also using a two-wheeled garden cart/wheel-barrow. It is more balanced than a standard wheelbarrow and is better for the spine.
Practice Safe Posture/Position
Never use the back muscles to lift. Lift with the legs. Bend the knees, hinge at your hips and keep the back straight. If needed practice bending in front of a mirror to see your form and make sure the technique is being done properly. Check out this YouTube video on raking and hoeing. Plant containers while standing using a potting bench, or an old table. Have a stool, chair or heavy-duty bucket to sit down easily when a break is needed.
Containers
One back-friendly gardening technique is to plant in containers. Plant them where they will sit, which minimizes having to lift or carrying to a location. Styrofoam peanuts can be placed at the bottom third of the container instead of gravel to make the containers lighter. If using large containers, invest in a wheeled pot dolly to move the containers easily.
Focus on the Time and Not the Task
With big projects, break them down into smaller more manageable tasks. Dividing the bed/s into halves or thirds makes the work more pleasant. Underestimating how long a project might take can be a major set back. So set time limits and follow through. When recovering from surgery or a back injury, set a limit of 15 minutes of work and see how it feels.If your back is not irritated or sore then expand to 30 minutes and so on.
Work smarter not harder. Under no circumstances should you shovel or pull up heavy, deep-rooted plant/s. This type of movement could put an end to yard work and gardening for some time. Do not forget that pain is our body’s way of telling us to stop. Be sure to talk with a spine specialist or chiropractor before starting yard work or gardening.
Gardening Benefits
Activity and fresh air can make us feel healthy and happy. Gardening can provide this along with healthy exercise. Therapeutic benefits of yard work and gardening have been well documented. Gardeners that did daily work were found to experience significant reductions in stress and improvement in overall health and quality of life compared to non-gardeners.
Gardening can significantly raise levels of energy, optimism, zest for life, self-esteem, openness and other factors relevant to self-image. Even a little gardening goes a long way. Just being outside and the physicality of yard work and gardening contributes to stress reduction. Another benefit from gardening is if planting herbs, and veggies you can cook even healthier. Much like a farm to table restaurant.
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Can irritable bowel syndrome cause back pain? Is there some relation, what are the treatment options, and can those therapies help with the aches, soreness, and overall discomfort? Irritable bowel syndrome (IBS) is not life-threatening but is definitely life-changing with the gas, bloating, abdominal pain and changes in bathroom habits. Many with IBS develop symptoms outside of the stomach. The most common is back pain. Here�s what to know.
Irritable Bowel Syndrome
Irritable bowel syndrome is a chronic disorder that affects the lower part of the digestive tract. The common symptoms are abdominal pain, diarrhea, and constipation. There could be some combination of the two. Individuals also experience cramping, gas and bloating. Symptoms can be mild or severe and come and go. Sometimes there are no symptoms at all. Around 10-20% of adults have IBS, and women are twice as likely to develop the syndrome. It’s usually diagnosed in people under 50, and if a family has a history of IBS, this increases the chances of also having it.
The exact cause of IBS is still unknown, but it is believed to involve the way the brain interacts with the gastrointestinal tract.
Anxiety
Hormone fluctuations
Certain foods
These can trigger or worsen symptoms. There is no single test to diagnose IBS. Doctors rely on medical history, physical exams and ruling out other illnesses. No cure exists for IBS but there is a variety of treatments that can help relieve symptoms. Many experience anxiety along with job, school and relationship disruptions, all that can begin to lower quality of life.
IBS and Back Pain
Individuals can develop extraintestinal symptoms or symptoms involving other areas of the body.
This includes:
Sleep problems
Headaches
Urination problems
Fatigue
Muscle pain
Pelvic pain
Jaw pain
Back pain
Backaches and pain are common with irritable bowel syndrome. Studies have shown it affects 28-81 percent of individuals with the syndrome. Some believe that it is what is known as referred pain that originates elsewhere in the body and is felt in the back. Gastrointestinal symptoms like gas and bloating have been linked to back pain.
Other health conditions associated with back pain can also present at the same time. Interstitial cystitis is a chronic illness that causes bladder pressure and pain, and also cause fibromyalgia. 3 in 10 individuals with irritable bowel syndrome check-off the criteria for fibromyalgia. Rheumatoid arthritis is another condition.
Treatment
Treatment is different for everyone. There are treatment options available. The best approach is usually a mix of these strategies. Treating the irritable bowel syndrome could also help ease back pain. Surgery is not needed for IBS-related back pain, as well as long-term painkillers. Speak with a healthcare provider to find the right combination for you.
Treatments include:
Dietary changes: There is no specific diet for IBS but your doctor could recommend changing fiber intake or keeping a food diary to pinpoint foods that trigger symptoms. Limiting citrus, carbonated drinks, and foods that contain carbohydrates linked to gastrointestinal troubles. These include:
Wheat
Dairy
Legumes/beans
Stress reduction: People who experience high levels of stress can feel pain more intensely, whether gastrointestinal or back pain. Deep breathing, meditation, progressive muscle relaxation, and guided imagery can help ease tensions. Exercise can also help like yoga, tai chi, walking, swimming, jogging, and biking are often recommended.
Therapy: Some individuals can benefit by speaking with a mental health professional. Studies have found that cognitive-behavioral therapy that shows you how to recognize and change stress response can be especially valuable for dealing with IBS and back pain.
Medication: Depending on the symptoms and underlying cause of the irritable bowel syndrome medication can help. Antidepressants are used to ease the pain for some patients, while anti-diarrheal loperamide is for reducing diarrhea in others. Discuss any medication you take with a doctor.
Functional medicine/Complementary health: Many find relief with alternative therapies. Hypnosis, for example, has been linked to improved gastrointestinal symptoms, lower levels of anxiety and other benefits.
Probiotics/supplements: Supplements are believed to help balance out beneficial gut bacteria. There is also evidence that probiotics can help relieve certain IBS symptoms. Ask your doctor if probiotics could help.
If you have irritable bowel syndrome along with back pain, get in touch with a healthcare provider. They can help you learn what is causing the uncomfortableness, test for other conditions and set up a treatment plan. The faster you reach out, the faster you can start to feel better.
While we have this time at home, working, teaching, we might be realizing that the chairs we are using are great for kicking back or sitting only for a short while. It could be time for a proper office chair with back support for those with back pain, as well as to help prevent poor posture conditions that can generate back pain.Here are a few of the top picks for back pain. Experts offer guidance on how to purchase an ergonomic office chair. Author of the book Wellness by Design�is a consumer guide to optimizing your home for physical and mental health. Hopefully, this will aid you as you navigate chairs for back pain.
Posture Importance
One way proper posture is gained is by walking with a book on your head. That won’t be necessary, as good office chairs that offer back support lend themselves to healthy posture, which helps back pain. Studies confirm that improved ergonomics greatly decreases back pain. Proper posture keeps your body positioned to minimize stress on the muscles, joints, ligaments. Sitting the wrong way for a long time drains you and can cause fatigue, back pain or aching neck after a long day.
What to Look For
When it comes to chairs for back pain you want the best ergonomic office chair for your home. Keep an eye out for these key elements.
Adjustable
This is important, as our bodies are all different and require different settings for optimal posture. A chair should have adjustments for the seat, arms and back. The more adjustability the chair offers in terms of height and angle, the more it can be customized to your body.
Rolls Easy
A chair that rolls easily is one essential component for back pain support and prevention. Easily rolling allows you to stay close to your work, move around the work area comfortably, and optimal visibility. Be sure the construction of the casters is heavy-duty and that it will roll on your floor’s surfaces.
Durability
Durability goes a long way. Established brands with a reputation for high quality shows their confidence in the chair�s ability to serve you long-term. It might be a bit expensive but it�s an investment in health and productivity. The United States Department of Labor offers a how-to guide to create the best ergonomics set up for you. Their guide includes the backrest, seat, armrests and the chair base. Chairs for back pain are focused on the overall comfort of the individual.
The right chair helps position your body so that you don’t activate trigger points and lets you roll smoothly so that you�re consistently working in a more ergonomic fashion.
Best Budget
The best chair for a budget was the Zipcode Design Bret Ergonomic Mesh Task Chair, which runs about $159.99 depending on where you shop. This office chair checks off many ergonomic guidelines set by the Department of Labor and is price friendly. The chair has a five-legged sturdy�base, casters that move easily and a backrest that follows the natural curve of the spine.
Best Mid-Range
The best mid-range model is the Tempur-Pedic TP9000 Mesh Task Chair, $318.99. The Tempur-Pedic company that makes mattresses have created an office chair that helps the body. It is created with memory foam has straightforward levers that allow you to adjust the armrests and seat easily. Easy-to-clean material is another benefit when working from home.
Best High-end Option
The best high-end model is the Herman Miller Aeron Chair, $1,395. This one is priced pretty high because of its plush ergonomic features. Think of chairs for back pain as an investment for your health and high quality of life. This is a cult-favorite chair that was designed 20 years ago and has sold over 7 million. It is completely customizable, from the chair size, level of back support, preferred tilt and seat angle, custom armrests and custom casters made for your floor type.
Honorable Mention
An honorable mention is the Humanscale� Freedom Task Swivel Desk Chair, $1,049.
This is a sleek cutting-edge office chair for back pain. The seat relies on body weight and physics for its ergonomic superiority and checks off the Department of Labor�s recommendations for optimal office chairs. It has adjustable arms, independent-adjustable seat and more.
Fibromyalgia pain is not just physical. Around 30% of individuals experience depression, anxiety, or some form of mood disturbance/swing. Fibromyalgia is still being researched if it causes these conditions or vice versa, but what is clear is that when the mental state gives in to the physical pain, your pain gets worse and worse.
A doctor may recommend a:
Counselor
Psychologist
Psychiatrist
Symptoms are varied and impact an individual’s life in ways that go beyond physical pain. Fatigue alone can be enough to alter lifestyle in a negative way, which affects mood.
Taking control of symptoms usually means taking a multi-disciplinary approach that includes:
Medications
Physical therapy
Psychology
Mental and emotional therapy could be a part of a treatment plan.
Depression and Anxiety Difference
Depression and anxiety are sometimes put in the same category. Symptoms can include depression and anxiety occur at the same time but they are not synonymous disorders. Depression is characterized by chronic sadness. Individuals handle depression, their own way. Some cry or lash out in anger/frustration. Some days are spent in bed, other days/nights are spent eating excessively, as a response to the pain. The most important thing is recognizing the change in behavior. Talk to your doctor or a therapist.
Anxiety is known for feelings of panic, fear, and excessive worry. Individuals feel their heart is racing that can get confused with a heart problem.
Fibromyalgia Depression Connection
To understand how fibromyalgia relates to depression and anxiety, and see the difference between depression and anxiety, here are some symptoms.
The symbols show symptoms most associated with the disorder. However, it’s possible to experience less sleep than normal if you have depression, but the more common symptom is sleeping more than usual.
Finding a Mental Health Professional
Professionals include:
Licensed professional counselors (PCs)
Psychologists
Psychiatrists
These professionals are trained to diagnose and treat mental/emotional issues. Your doctor can help in figuring out which is best for you.
Licensed professional counselors require a master’s degree in counseling and are approved to diagnose and treat mental and emotional disorders.
Psychologists are considered as a separate group of non-physician mental health professionals. They have a doctorate and are approved to treat emotional problems using therapies like cognitive-behavioral therapy.
Psychiatrists are medical doctors that are licensed to prescribe medications to help depression and anxiety, along with several mental disorders.
Adding the impact this disorder has on a person’s mental and emotional state can seriously damage their quality of life. Recognizing when the pain is not just physical is difficult. Therefore setting up a telemedicine/video conference with a mental health professional could help in dealing with the mental stresses that come with fibromyalgia. Even for those that don’t require medication seeing a mental health professional can be highly beneficial.
You can openlytalk about experiences having to do with fibromyalgia, how it affects your family, etc,� which is therapeutic in itself. Do not hesitate to seek the help of a mental health professional. The focus is to help you feel better, become educated on ways to help yourself and improved quality of life.
Steroid injections into the cervical spine can help with�radiating�neck pain. Neck pain affects people all over the world. Although it is not as common as back pain, neck pain can really take a toll on a person�s quality of life and ability to work.� This comes in the form of:
Sleep problems
Radiating/Spreading pain
Mental health issues and more
Much like back pain neck pain can be hard to treat effectively without identifying the root cause known as the pain generator. If natural treatments like chiropractic aren’t working then injections could be the next phase.
Injections can help with:
Identifying the source/root cause of the pain as a diagnostic
Treats the pain as a therapeutic
The most commonly used are cervical epidural steroid injections,medial branch blocks (MBBs), and facet joint injections. Learn about what they are, what they treat, and the scientific research behind their risks and benefits.
Cervical Epidural Steroid
The phrase cervical epidural steroid injection:
Injection means that medicine is delivered through a needle.
Cervical means the cervical spine, which is the neck.
Epidural means the dura or outer layer of the soft tissue that encases the spinal cord, nerve roots, and cerebrospinal fluid. Epidural means the medicine goes into the space around the dura.
Spine specialists use image guidance with a contrast dye called fluoroscopy ensuring the medicine gets delivered to the proper area.
2 Types
The needle enters the space through a transforaminal approach or interlaminar approach. Words like epidural just refer to where the needle goes. These injections also called nerve root blocks, are performed by entering the epidural space through the opening where the nerve roots branch out. This space is known as the intervertebral foramen.
When it is called a selective nerve root block, this is for cases where multiple nerve roots are being compressed and the injection is being used in a diagnostic purpose to identify which nerve is the pain generator. The needle in an interlaminar epidural injection goes through the opening that exists between two adjacent vertebrae.
Candidates
Cervical epidural steroid injections may be appropriate for someone who has severe neck pain with:
Numbness
Weakness
Altered sensation in the arm, shoulder, or between the shoulder blades
Cervical epidural steroid injections are reserved as a second-line treatment for individuals that have neck pain that does not stop for more than 4 weeks despite conservative treatment like physical therapy, chiropractic, or medical pain management using NSAIDs or acetaminophen.
The source of the pain is usually what determines if injections are appropriate.
With a patient�s:
Past medical and surgical history
Pain history
Physical exam findings
Imaging Results like CT computed tomography scan, MRI magnetic resonance imaging or a nerve test like an EMG�electromyography test all can help in finding the source of the pain.
If a spine specialist thinks the nerve compression was brought on by a disc herniation, spondylolisthesis or the shifting of vertebral levels, scarring, or arthritic conditions is causing the pain, then an injection may be appropriate. If the pain comes from an infection or cancer, then this treatment is unlikely to be recommended.
Potential Benefits
The effects of injections are different for everyone, because of the variables:
The Duration of symptoms
The Cause of symptoms
Any Additional treatment
More than 50% will have at least 50% improvement in their pain for around 4 weeks. Then there are individuals that experience relief, up to 6 months. There are no significant differences in outcomes between the transforaminal and interlaminar approaches.
Overall alleviation from the pain is enhanced/improved when the injections are combined with a full-on treatment plan that includes physical therapy/chiropractic and pain medications.
Possible Risks
Common complications associated with injections are usually minor and temporary. These are:
Headache/s
Facial flushes
Light Headedness
Rash
Pain increase
Extended Numbness
Major complications are rare, but they can happen. These include�infection, paralysis, stroke, and death. However, this happens in less than 1% of individuals undergoing this treatment. These complications are thought to happen from direct spinal cord penetration of the needle, bleeding into the spinal canal, or the medicine inadvertently getting injected into the blood vessels. Surgical groups and facilities have strict guidelines to limit these complications.
This treatment is commonly used, and when done correctly can be a powerful tool in the treatment of persistent, severe neck pain. Everyone is different so if you are considering a cervical epidural spinal injection find a qualified spine specialist or consult with a chiropractor to find out if injections are necessary.
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Symptoms are varied and impact an individual’s life in ways that go beyond physical pain. Fatigue alone can be enough to alter lifestyle in a negative way, which affects mood.
Taking control of symptoms usually means taking a multi-disciplinary approach that includes:
The symbols show symptoms most associated with the disorder. However, it’s possible to experience less sleep than normal if you have depression, but the more common symptom is sleeping more than usual.
