Back Clinic Spinal Hygiene. The spine is the protective housing for the nervous system, a system so powerful that it controls every function in the human body. The nervous system tells your body to breath, tells your heart to beat, tells your arms and legs to move, tells your body when and how to produce new cells and it even has the power to control healing. A damaged or misaligned spine can dramatically interfere with the signals constantly being sent through the nervous system, eventually resulting in bodily pain, internal deterioration and loss of many of the everyday functions we take for granted.
Spinal hygiene is extremely important, yet 89 percent of the world’s population does not realize the importance of maintaining proper alignment of the vertebrae through chiropractic adjustment, as well as protecting the spine from injury through healthy living practices. Instead we neglect our spines. As children we start our lives with tumbles and trips that jar our spines, we grow into adults with poor posture, we lift things that are too heavy, carry overloaded back packs, and we suffer injury through car accidents, sports impacts and stress.
Get in on the health trend of the future-today. Join the growing percentage of the population that enjoys greater health and wellness through regular care of their spines. Talk to your chiropractor today about ways you can improve your spinal hygiene.
What is the body’s center of gravity to understand and maintain a healthy posture and balance?
Center of Gravity
The human center of gravity, or COG, also known as the center of mass, with the two terms being interchangeable, is where the body’s weight appears to be concentrated. It’s a point in space where the entire body’s mass can be concentrated. When standing upright, the COG is generally located behind the navel and in front of the sacrum, around the level of the second vertebra. (Le Huec, J. 2011) The center of gravity is related to posture, including issues such as swayback, the design of posture exercise programs, and much more.
Gravity is a downward pull or force the Earth exerts on the body, creating weight. (NASA, 2013)
The center of gravity (COG) is where a body’s weight is equally balanced in all directions. (Physiopedia, 2025)
When the COG is defined, it is done from the reference of a static, standing position.
Because the body is in motion when we change positions, the COG is located in a new position with each new position.
The center of gravity is the point around which all the parts balance, which may be inside or outside the body.
Even slight changes in position can change where the COG is. (Physiopedia, 2025)
Key aspects of the COG
Location
When standing upright, the COG is typically found at the second vertebral level, behind the navel and in front of the sacrum. (Le Huec, J. 2011)
Shifting COG
The COG can shift depending on body position, posture, and movements like bending forward or backward. (Physiopedia, 2025)
Balance Impact
The relationship between the COG and the base of support (the area of the body in contact with the ground) is fundamental to maintaining balance.
Variations
There can be variations in the COG location based on factors like gender (men tend to have a slightly higher COG), body shape, and even conditions like obesity or chronic low back pain. (Physiopedia, 2025)
Biomechanics
Understanding the COG is crucial in biomechanics and movement analysis, as it’s an index of total body motion and how the body responds to external forces.
The Human Center
The center of gravity is the point at which the body’s mass is equally balanced. This point changes depending on one’s position:
Arms up/down
Leaning
Turning
With strength and flexibility training, the human body can change its center of gravity, as gymnasts and dancers do.
When standing, the center of gravity is normally located behind the navel and in front of the sacrum bone (made up of five vertebrae fused vertically) at about the second vertebra level. (Hasegawa K. et al., 2022)
Because the body has moving parts, its overall shape changes every time it moves. Carrying something like a suitcase or grocery bag or wearing a backpack adds weight to some areas but not others, changing the center of gravity as it does.
The center of gravity is a continually changing point inside or outside the body that represents where the weight or mass of the rest of the body is equally balanced in every direction.
This point can and does change based on what is being carried and how it is carried, as well as body position and movements.
Chronic Lower Back Pain
A study in the Journal of Back and Musculoskeletal Rehabilitation found that individuals with chronic lower back pain tend to have their center of gravity located excessively towards the back. (Kim D. H., Park J. K., & Jeong M. K. 2014)
In the study, the individuals had decreased low back strength upon extension and a reduced normal low back curve.
The researchers found that those with chronic lower back pain whose center of gravity was too far back may need physical therapy to retrain the body to overcome strength and balance challenges to re-establish and maintain a healthy posture.
Injury Medical Chiropractic and Functional Medicine Clinic
As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.
Enhance Your Lifestyle Today with Chiropractic Care
References
Le Huec, J. C., Saddiki, R., Franke, J., Rigal, J., & Aunoble, S. (2011). Equilibrium of the human body and the gravity line: the basics. European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 20 Suppl 5(Suppl 5), 558–563. doi.org/10.1007/s00586-011-1939-7
Hasegawa, K., Amabile, C., Nesme, M., & Dubousset, J. (2022). Gravity center estimation for evaluation of standing whole body compensation using virtual barycentremetry based on biplanar slot-scanning stereoradiography – validation by simultaneous force plate measurement. BMC musculoskeletal disorders, 23(1), 22. doi.org/10.1186/s12891-021-04948-5
Kim, D. H., Park, J. K., & Jeong, M. K. (2014). Influences of posterior-located center of gravity on lumbar extension strength, balance, and lumbar lordosis in chronic low back pain. Journal of Back and Musculoskeletal Rehabilitation, 27(2), 231–237. doi.org/10.3233/BMR-130442
For individuals experiencing back pain, can lying in the supine position help bring relief?
Supine Position
The supine position describes the body’s position when lying on your back with your face up. The individual is flat on their back with no incline, arms at their sides or bent at a 90-degree angle. It’s commonly used in medical settings for examinations, surgeries, and procedures, particularly when access to the anterior/front of the body is needed. It can benefit certain conditions, like helping relieve pain, but exacerbate others, like acid reflux. The term is also used as a modifier for exercises and stretches that begin with the individual on their back. (ScienceDirect Topics, 2009)
Medical Uses
Examinations
Healthcare providers often use the supine position for physical examinations, including vital signs, palpation of the abdomen, and chest inspection. (Nurse.com, 2024)
Procedures
It’s also used for various procedures, such as lumbar punctures and injections. (Steris Healthcare, 2025)
Surgery
Due to its accessibility to the front of the body, the supine position is frequently used for surgeries such as cardiac, abdominal, thoracic, and cranial procedures.
It allows for easy access to the airway, facilitates anesthesia choices, and can be readily converted to an open procedure if necessary. ScienceDirect Topics, 2009)
Overall Health
Natural Position
Many individuals naturally fall asleep in the supine position, finding it comfortable and conducive to spinal alignment.
Back Pain Relief
Sometimes, lying supine with proper support can relieve back pain, particularly in individuals with lumbar spinal issues. (MedicalNewsToday, 2022)
Acid Reflux
However, the supine position can exacerbate acid reflux, as gravity allows stomach acid to travel up the esophagus. (MedicalNewsToday, 2022)
Sleep Apnea
The supine position can worsen sleep apnea in some individuals.
Clinical Uses
A physical therapist, trainer, or clinician may use supine to describe positions used for manual therapy or when having the patient do stretching and back exercises as part of a home exercise program.
If the therapist or personal trainer is training the individual on core stabilization exercises for the first time, the individual will most likely start in the supine position.
This is because when the body is supine, the muscles have the least work to do to maintain correct posture and position against the force of gravity.
Many bed exercises begin in this position for rehabilitation.
Back Care
Here are a few recommendations to relieve low back pain using the supine position.
First, individuals can release the tension in the back by assuming the hook-lying position, a modification of the supine position in which the knees are bent and the feet are resting flat on the floor (Aurora BayCare Medical Center, N.D.).
Start breathing and relaxing, allowing the tension to drain out of the muscles.
In a hook-lying position with the fingertips on the lower belly, inhale deeply, then exhale naturally and puff out the remaining air.
At that point, the fingertips should feel the transverse abdominal muscle engage.
Release and repeat 10 times.
After the body is warmed up, move on to actual exercise. For example, beginners may be given hip stretches to help relieve back pain. These might be done to maintain or prevent back pain. Individuals can do yoga for their back while in the supine position. As with any exercise program, not all yoga poses involve lying on the back, but many beginners and restorative ones do.
For example, the supine spinal twist involves lying on the back, bending the knees, and gently placing them to one side. The idea is to stay in that position for a few moments—and breathe—to allow the oblique abdominal and back muscles to release.
Variations
Lawn Chair Position
This variation involves slightly bending the hips and knees and elevating them above the heart, which can help relieve lower back pain.
Frog-Leg Position
The frog-leg position involves lying on the back with bent knees pushed out to the sides, providing access to the groin and perineum. (Steris Healthcare, 2025)
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Are there benefits to back cracking, risks, and how can it be done safely?
Back Cracking
Back cracking is intentionally applying pressure or twisting movements, producing a popping or cracking sound in the spine. Back cracking involves stretching or extending the spine. In most cases, it is considered safe when done gently as it can provide temporary relief from back pain and stiffness by:
Stretching the ligaments and muscles around the spine
Releasing gas bubbles that may be causing pressure
Improving joint mobility
Mechanism of Action
Cracking your back creates small gas bubbles in the synovial fluid (the lubricating fluid in the joints).
These bubbles form when the pressure in the joints is suddenly released, causing a popping or cracking sound.
It is generally safe, but there are certain conditions under which individuals should avoid cracking their backs.
Popping Sound
Research has used a new type of magnetic resonance imaging (MRI), cine MRI, to study the noise source. Cine MRI produces moving images.
This study using this MRI found that the formation of bubbles makes a popping sound.
The popping sound does not come from the popping of bubbles in the synovial fluid, as previously believed. (Kawchuk G. N. et al., 2015)
When someone cracks their back, the force pulls the bones of the joint apart, causing the pressure within the joint to drop and form a bubble, which eventually dissipates. (Kawchuk G. N. et al., 2015)
Crepitus
Crepitus is the medical term for cracking or popping noise from joints.
It is not a condition or disease but can be a symptom of one.
Other terms include clicking or crunching.
Is It Safe To Perform Daily?
Back cracking once a day is generally considered safe. But if it causes pain or swelling, then stop and contact a healthcare provider. If someone feels the need to crack their back more throughout the day, it could be a sign that they need to see a professional chiropractic healthcare provider. (AICA Orthopedics, 2022) Individuals may crack their backs to address certain conditions or to relieve various discomfort symptoms that can include: (National Center for Complementary and Integrative Health, 2025)
Headache
Neck pain
Lower back pain
Sciatica
Individuals may often experience mild side effects like headache, stiffness, or pain. These side effects tend to resolve within a day. Though back cracking can provide temporary relief for some conditions, some serious side effects like neurological problems or strokes have been reported. (National Center for Complementary and Integrative Health, 2025)
Rotate the upper body to the right side and press against the right knee with the left elbow.
Hold the stretch for 30 seconds and come back to the center.
Repeat on the other side.
Knee to Chest
Lie flat on the ground.
Lift one leg and bring the knee to the chest, pulling the knee in with your hands.
Hold for five seconds.
Repeat with the other leg.
Several back-cracking assistive devices, such as poles and wheels, are available. Talk to a healthcare provider to determine the right type and ensure it is safe for you and your condition or injury.
Individuals Who Should Avoid Back Cracking
Back cracking can cause additional stress or damage to the joints in those with back injuries or other conditions. Individuals with these conditions should avoid back cracking (AICA Orthopedics, 2022)
Numbness or tingling of the arms or legs.
Osteoporosis
Spinal cancer
Spinal abnormalities
Individuals who have a high stroke risk.
A Professional Back Adjustment
A chiropractor is a healthcare provider who specializes in spine and spinal adjustments. They adjust the spine and other areas of the body to correct misalignment problems, reduce and relieve pain, and allow the body to recover independently. (National Library of Medicine. MedlinePlus, 2023) The chiropractor will take a health history to learn about previous injuries and conditions. Then, they will evaluate the patient and determine the best course of action. Although a chiropractor performs spinal adjustments, they may also incorporate other treatments, including: (National Library of Medicine. MedlinePlus, 2023)
Injury Medical Chiropractic & Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Chiropractic Secrets
References
Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. doi.org/10.1371/journal.pone.0119470
For individuals experiencing periodic limb movements of sleep, can understanding how movements at night may relate to other sleep disorders help bring healthy sleep?
Periodic Limb Movements of Sleep
Periodic limb movements of sleep (PLMS) are involuntary, repetitive leg and sometimes arm movements during sleep. PLMS is one of the sleep disorders that may cause disruptive movement of the legs, like restless legs syndrome (RLS). It can lead to sleep disruption, insomnia, and daytime sleepiness.
Causes
The exact cause of PLMS is unknown, but it is thought to be related to:
Underlying medical conditions (e.g., restless legs syndrome, sleep apnea)
Nerve dysfunction
Neurochemical imbalances (e.g., dopamine, iron)
Symptoms
Repetitive leg and/or arm movements during sleep, typically lasting 0.5-5 seconds.
It may be accompanied by sensations of tingling, crawling, or pulling in the legs.
It can cause sleep disturbances, leading to daytime fatigue.
Type of Movements
Periodic limb movements during sleep (PLMS) consist of sudden jerking movements of the legs that occur involuntarily during sleep, which the affected individual may not realize is happening. It can be kicking, twitching, or extension of the legs.
Restless legs syndrome (RLS) symptoms are noted when awake.
The movements associated often consist of flexion or extension at the ankle.
In some cases, this can also occur at the knee.
It may occur on one side or alternate back and forth between the left and right sides. (Cleveland Clinic, 2023)
It tends to increase with age and often but is not always accompanied by restless leg symptoms.
If PLMS causes daytime impairment, such as significant sleep disruption, excessive daytime sleepiness, and insomnia, it may be diagnosed as periodic limb movement disorder (PLMD). (Sleep Foundation, 2024)
Diagnosis
PLMS is diagnosed through a sleep study (polysomnography), which records brain waves, eye movements, muscle activity, and breathing patterns during sleep. As part of the study, superficial electrodes are placed on the legs and sometimes the arms to detect muscle contractions or movements.
In individuals with PLMS, repetitive movements at least four in a row may last from 1/2 second to 5 seconds.
The movements may be more significant if they are associated with arousal or awakenings from sleep.
They also may be deemed important if they become disruptive to a bed partner.
No further treatment may be necessary when noted in isolation on a sleep study without associated symptoms or impacts.
If another disorder cannot explain the movements, PLMS may be the likely diagnosis.
Again, if the movements lead to sleep disruption, insomnia, and excessive daytime sleepiness, it is called PLMD.
Isolated PLMS noted on a sleep study, without consequence, are insignificant and do not require treatment with medication.
Restless leg syndrome is diagnosed based on clinical criteria of having an uncomfortable feeling in the legs associated with an urge to move that occurs in the evening when lying down and is relieved by movement. (Stefani, A., & Högl, B. 2019)
Treatment
Treatment for PLMS depends on the underlying cause and severity of symptoms. Options include:
Medications (e.g., dopamine agonists, iron supplements)
Lifestyle changes (e.g., exercise, avoiding caffeine before bed)
Treating the underlying medical condition
In general, it is unnecessary to treat PLMS if the individual affected has no complaints of sleep disruption. Treatment can be considered if it causes:
Partial or total arousal from sleep
Contributes to insomnia
Undermines sleep quality
Also, if the movements are disruptive to a bed partner, getting them under control may be desirable.
Prescription medications can be effective in treating PLMS. (Cleveland Clinic, 2023) Many of the meds used to treat RLS can be helpful. These may include benzodiazepines (clonazepam), Mirapex (generic name pramipexole), and ropinirole. Movements may also occur with obstructive sleep apnea events, and then the treatment would target the breathing disorder.
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to restore health. Individuals can recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Revitalize and Rebuild with Chiropractic Care
References
Walters, A. S., & Rye, D. B. (2009). Review of the relationship of restless legs syndrome and periodic limb movements in sleep to hypertension, heart disease, and stroke. Sleep, 32(5), 589–597. doi.org/10.1093/sleep/32.5.589
Stefani, A., & Högl, B. (2019). Diagnostic Criteria, Differential Diagnosis, and Treatment of Minor Motor Activity and Less Well-Known Movement Disorders of Sleep. Current treatment options in neurology, 21(1), 1. doi.org/10.1007/s11940-019-0543-8
Can knowing how to stretch your back help reduce pain and improve your range of motion?
Stretch Your Back
Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:
When stretching, don’t try to push past your pain limit.
Listen to your body, which leads to a calmer nervous system.
Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.
Warm Up
Stretching cold muscles can lead to injury. Always warm up first.
Do between five and 10 minutes of mild activity, such as walking.
Apply heat for 15 to 20 minutes before stretching.
Knees-to-Chest Back Stretch
To perform:
Lie on your back with your feet flat on the floor.
Bring your legs toward your chest With your knees bent.
Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
Pull until there is a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Do a total of 10 reps.
Supine Twist Back Stretch
To perform:
Lie on your back with your knees bent and feet flat on the floor.
Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
Hold for 15 seconds.
Return to the starting position.
Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.
Prone Bridging Back Stretch
To perform:
Lie on your stomach.
Prop yourself up on your elbows.
Extend your back.
Start straightening your elbows, further extending the back.
Continue straightening the elbows until the stretch is felt.
Hold for 15 seconds.
Return to the starting position.
Repeat for nine reps.
Supine Butt Lift Back Stretch
To perform:
Lie on your back with your knees bent and feet flat on the floor.
Push down through the feet as you slowly raise yourself off the floor.
Hold for 10 seconds.
Return to starting position.
Repeat for nine reps.
Seated Forward Curl Back Stretch
To perform:
Sit in a chair with your feet flat on the ground.
Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
Hold for 10 seconds.
Return to the starting position.
Repeat for nine reps.
Side Stretch
To perform:
Stand up straight with your arms at your sides and feet shoulder-width apart.
Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
Hold for 10 seconds.
Return to the starting position.
Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
Hold for 10 seconds.
Repeat for nine reps.
Other Treatments to Loosen a Tight Back
Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)
Acupuncture
Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.
Stretching Benefits
References
Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. doi.org/10.1089/acu.2020.1499
Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. doi.org/10.1089/acu.2023.0054
Can individuals dealing with scoliosis incorporate various exercises and stretches to improve their posture and reduce pain?
What Is Scoliosis?
More often than anything, many people have tried to maintain proper posture to prevent musculoskeletal and spinal conditions from forming. However, it can be difficult to maintain an appropriate posture when strenuous environmental factors come into play. This can range from being in a hunched position to developing spinal conditions that can affect the curvature of the spine. One of the most well-known spinal conditions many people can develop through numerous risk factors is spinal scoliosis. Spinal scoliosis is often defined as a curvature deviation in the normal vertical spinal line. (Janicki & Alman, 2007) This causes the spine to develop an S or C curve in the thoracic or lumbar portion of the spine, leading to overlapping risk profiles in the body and causing pain-like symptoms that can make a person feel miserable. Today’s article looks at scoliosis, how it affects the body, and how various exercises can help manage scoliosis. We discuss with certified medical providers who inform our patients how non-surgical treatments, like various exercises, help manage symptoms associated with scoliosis. While asking informed questions to our associated medical providers, we advise patients to include various exercises and pain management techniques to reduce pain-like symptoms correlating with scoliosis. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
How Does It Affect The Body?
Since scoliosis is a spinal deformity condition that affects the spine, it can happen at any age and is categorized into four group forms:
Congenital (Presented by birth)
Neuromuscular (Resulted from cerebral palsy or muscular dystrophy)
Idiopathic (The common spinal condition)
Degenerative (Adult-onset scoliosis)
Within these four groups of scoliosis, some of the pain-like symptoms can vary depending on the size of the curve and how far the progression leads to overlapping risk profiles in the thoracic and lumbar spine portions. (Aebi, 2005) Some of the symptoms that are associated with scoliosis are back pain. Many individuals with scoliosis, especially adolescent individuals, have back pain associated with adolescent idiopathic scoliosis due to increasing age, injuries, and how severe the spine is curved. (Achar & Yamanaka, 2020) Additional symptoms that many individuals experience with scoliosis that can affect their bodies have specific features that cause pain. Individuals with scoliosis often have increasing asymmetrical pain when standing for prolonged periods and residing at rest, thus mimicking sciatica pain. (Zaina et al., 2023) This is because pain is one of the biomarkers for scoliosis. When pain starts to affect the body, issues like muscle dysfunction, concave disc pressure, asymmetrical facet joint strains, and a high BMI (body mass index) become the main mechanical parameters in the body. They are assessed by doctors when being examined. (Ilharreborde et al., 2023) When individuals are being assessed by their doctors to manage scoliosis, non-surgical treatments can help manage the pain-like symptoms and restore joint stability and mobility to the body.
Movement Medicine: Chiropractic Care- Video
Various Exercises For Managing Scoliosis
When many individuals dealing with scoliosis go in for non-surgical treatments, they will be assessed and evaluated by pain specialists to determine what the next steps for treatment can be provided for them. For scoliosis, non-surgical treatments like chiropractic care can be provided to reduce the musculoskeletal conditions associated with scoliosis. Chiropractors utilize mechanical and manual spinal manipulation of the spine. They can set the vertebra back in place while restoring the spinal joint with optimal motion, improving the range of motion, and allowing the body to function properly. (Milne et al., 2022) At the same time, chiropractors can recommend various exercises and stretches to help manage symptoms associated with scoliosis as part of their treatment plan. Incorporating various exercises can help rectify spinal deformity, help the different muscle groups become stronger, and allow the individual to work a bit on managing scoliosis symptoms. Below are some of the various exercises and stretches to manage scoliosis.
Practicing Good Posture
Practicing good posture can benefit many individuals with scoliosis, especially young ones. Many people realize that maintaining good posture can help reduce muscle pain and tension in the back. It allows many people to realign their bodies and retrain them to stand with good posture naturally. Maintaining good posture, whether standing or seated, can allow doctors to scan the body for any tension signs. For those with scoliosis, it can gradually strengthen the weak core muscles in their bodies.
Abdominal Presses
Abdominal presses allow the individual to maintain neutral spinal alignment while strengthening the abdominal core muscles. To do this:
Individuals must lie on their backs on a yoga mat, keeping their backs in a neutral, tension-free position with bent knees.
They raise both feet and thighs off the mat to form a 90-degree angle with their knees above the hips. *They can support themselves with a chair or wall.
Next, individuals can use their hands to push and pull the knees with their abdominal muscles.
When doing this static exercise, make sure that they hold for three full breaths in two sets of ten and relax in between.
Bird-Dog
Bird-dog is a yoga move that can help stretch tight and weak muscles in the back and allow the body to balance itself. To do this:
Individuals can be on their hands and knees with a neutral spine position on a yoga mat, ensuring their hands are under their shoulders and their knees are under their hips.
With controlled breathing, extend one arm straight out while extending the opposite leg back.
Maintain the position for five to thirty seconds, andslowly return to the neutral spine.
Repeat the motion with the opposite for 10 to 15 reps.
Incorporating these exercises can help manage pain-like symptoms associated with scoliosis, help many individuals strengthen their weak muscles, and help improve their posture on their health and wellness journey.
References
Achar, S., & Yamanaka, J. (2020). Back Pain in Children and Adolescents. American Family Physician, 102(1), 19-28. www.ncbi.nlm.nih.gov/pubmed/32603067
Ilharreborde, B., Simon, A. L., Shadi, M., & Kotwicki, T. (2023). Is scoliosis a source of pain? J Child Orthop, 17(6), 527-534. doi.org/10.1177/18632521231215861
Janicki, J. A., & Alman, B. (2007). Scoliosis: Review of diagnosis and treatment. Paediatr Child Health, 12(9), 771-776. doi.org/10.1093/pch/12.9.771
Milne, N., Longeri, L., Patel, A., Pool, J., Olson, K., Basson, A., & Gross, A. R. (2022). Spinal manipulation and mobilisation in the treatment of infants, children, and adolescents: a systematic scoping review. BMC Pediatr, 22(1), 721. doi.org/10.1186/s12887-022-03781-6
Zaina, F., Marchese, R., Donzelli, S., Cordani, C., Pulici, C., McAviney, J., & Negrini, S. (2023). Current Knowledge on the Different Characteristics of Back Pain in Adults with and without Scoliosis: A Systematic Review. J Clin Med, 12(16). doi.org/10.3390/jcm12165182
For individuals trying to retrain their body movements for back health improvement, what is the spinal area that helps the body twist, bend, and stand upright?
Lumbosacral Joint L5-S1
The L5-S1, also called the lumbosacral joint, is a term used to describe a part of the spine. It is where the lumbar spine ends and the sacral spine begins, and it connects these bones. The lumbosacral joint is also susceptible to misalignment and injury, such as disc herniation or a spinal disorder called spondylolisthesis.
The spinal column is the structure that allows the body to stand upright and helps you twist, bend, and alter trunk and neck position. Typically, 24 movable bones in the spine connect to the sacrum and the coccyx, or the tailbone. The sacrum and the coccyx each have multiple bones that fuse over time. L5-S1 consists of the last bone in the lumbar spine, called L5, and the triangle-shaped bone under it, known as the sacrum. S1 is at the top of the sacrum and comprises five fused bones.
Risk of Injury
Each area of the spine has a curve that goes in opposite directions. The places where the spinal curve directions change are junctional levels. The risk of injuries may be higher at junctional levels because the body weight shifts direction as the curves shift. The L5-S1 junction is located between the lumbar curve and the sacral curve. The lumbar curve sweeps forward, and the sacral curve goes backward.
The lumbosacral joint L5-S1 junction is highly vulnerable to misalignment, wear and tear, and injury. This is because the top of the sacrum is positioned at an angle for most individuals. Aging and injury increase the vulnerability of the L5-S1 junction even more. Pain coming from L5-S1 is usually treated with:
Heat and/or ice
Over-the-counter anti-inflammatory medications
Prescription pain medications
Muscle relaxers
Physical therapy
Chiropractic adjustments
Epidural steroid injections
If these therapies do not help, surgery may be recommended. L5-S1 is one of the two most common sites for back surgery.
Conditions
Disc herniation at L5-S1 is a common injury and cause of sciatica, which can cause pain and other issues (MedlinePlus, 2024). The L5-S1 junction is often the site of a condition known as spondylolisthesis.
Disc Herniation
Discs separate the vertebrae, cushioning the spinal column and allowing movement between vertebrae. A disc herniation means the disc slips out of place. (MedlinePlus, 2022) A disc herniation at L5-S1 is a common cause of sciatica. Symptoms of sciatica include:
Burning
Numbness
Pain or tingling that radiates from the buttock down the leg to the knee or foot.
Disc herniation can also cause chronic back pain and stiffness and trigger painful muscle spasms. Bowel problems are also possible with disc issues at L5-S1. Research links irritable bowel syndrome to herniated discs in the lower back. (Bertilson BC, Heidermakr A, Stockhaus M. 2015) Additional studies found disc problems at L5-S1 can lead to difficulty with sphincter control. (Akca N. et al., 2014) Initial treatments for disc herniation include rest and pain relievers to reduce inflammation and swelling, then physical therapy. Most recover with conservative interventions, and those who don’t may require a steroid injection or surgery. (MedlinePlus, 2022)
Spondylolisthesis
Spondylolisthesis occurs when a vertebra slips forward relative to the bone below it. The most common form of this condition is degenerative spondylolisthesis, which generally begins when the spine wears down with age. Isthmic spondylolisthesis is another common variation and starts as a tiny fracture in the pars interarticularis, a bone that connects the adjoining parts of the facet joint. (American Academy of Orthopaedic Surgeons, 2020) These fractures often occur before age 15, but symptoms do not develop until adulthood. Degeneration of the spine in later adulthood can further worsen the condition.
The angle of the sacrum can also contribute to spondylolisthesis. This is because the S1 tips down in the front and up in the back rather than being horizontal. Individuals with a greater tilt are usually at a higher risk of spondylolisthesis. (Gong S. et al., 2019) However, individuals with spondylolisthesis may not have any symptoms. Those who do may experience: (American Academy of Orthopaedic Surgeons, 2020)
Back stiffness
Standing difficulties
Walking difficulties
Lower back pain
Hamstring tightness
Spondylolisthesis is typically treated with non-surgical interventions that can include:
Pain medications
Heat and/or ice application
Physical therapy
Epidural steroid injections
Usually, non-surgical care is tried for at least six months. If pain and symptoms persist, surgery may be an option. Spinal fusion surgery can be effective but requires a long recovery time and can have additional risks.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Bertilson, B. C., Heidermark, A., & Stockhaus, M. (2015). Irritable Bowel Syndrome–a Neurological Spine Problem. Journal of Advances in Medicine and Medical Research, 4(24), 4154–4168. doi.org/10.9734/BJMMR/2014/9746
Akca, N., Ozdemir, B., Kanat, A., Batcik, O. E., Yazar, U., & Zorba, O. U. (2014). Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness. Journal of craniovertebral junction & spine, 5(4), 146–150. doi.org/10.4103/0974-8237.147076
Gong, S., Hou, Q., Chu, Y., Huang, X., Yang, W., & Wang, Z. (2019). Anatomical factors and pathological parts of isthmic fissure and degenerative lumbar spondylolisthesis.
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