Back Clinic Chiropractic Spine Care Team. The spine is designed with three natural curves; the neck curvature or cervical spine, the upper back curvature or thoracic spine, and the lower back curvature or lumbar spine, all of which come together to form a slight shape when viewed from the side. The spine is an essential structure as it helps support the upright posture of humans, it provides the body with the flexibility to move and it plays the crucial role of protecting the spinal cord. Spinal health is important in order to ensure the body is functioning to its fullest capacity. Dr. Alex Jimenez strongly indicates across his collection of articles on spine care, how to properly support a healthy spine. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Can individuals dealing with joint pain incorporate turmeric as part of their treatment to reduce inflammation and restore joint health?
Introduction
Many people realize that when the body ages, so do the bones, joints, and spinal discs. This causes musculoskeletal issues to develop and lead to joint pain. Many environmental factors, like improper posture, injuries, accidents, and heavy-loaded objects, are pain-like issues that can affect an individual’s health and well-being. This is because joint pain is associated with these environmental factors, which cause pain and inflammatory effects that can impact their well-being. Additionally, many people will try to find ways to reduce the inflammatory effects caused by joint pain, and one of them is found in their kitchen pantry, which is known as turmeric. Today’s article focuses on the connection between the joints and inflammation, what is turmeric, and its beneficial properties for the joints. We talk with certified associated medical providers who inform our patients about how adding turmeric to their daily routine can reduce the inflammatory effects on the joints. While asking associated medical providers intricate questions, we advise patients to incorporate turmeric in their meals and find therapeutic ways to reduce joint pain in their upper and lower extremities. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
Joint Pain & Inflammation Connection
Do you feel localized or referred pain in your joints that causes you to rest for an extended period? Do general morning aches and pains get better throughout the day? Or do you notice that you are losing your grip occasionally? Many of these scenarios are correlated with joint pain. The joints are part of the musculoskeletal system, and their primary job is to provide movement to the upper and lower extremities without pain. However, when the human body ages, the joints also gradually age. When the joints start to lose their cartilage, environmental factors can cause pain-like symptoms like inflammation to affect the joints, thus causing pain, stiffness, and inflammation. Additionally, it can also lead to joint disorders in the body. While inflammation helps heal the affected area in the body, it is beneficial for the natural healing process; however, when inflammation is chronic, it can do more harm than good.
This is because the immune cells are involved in neuroimmune interplay, which plays a key role in generating and maintaining pain in diseases with an inflammatory component. (Vasconcelos et al., 2022) Additionally, when environmental factors start to affect the joints, the inflammatory effects can cause peripheral nerve damage, and that can cause structural damage to the joints, leading to altered gait and abnormal loading patterns through movement. (McDougall & Reid, 2022) When individuals experience inflammatory effects that affect their joints, many will try to find ways to reduce the pain-like effects in their joints.
Fighting Inflammation Naturally-Video
What Is Turmeric?
Many individuals dealing with pain and inflammation in their joints will seek out therapeutic options to restore joint health. Many people can incorporate anti-inflammatory supplements and treatments to reduce joint inflammation. Turmeric is one of the anti-inflammatory supplements found in India and Southern Asia; anti-inflammatory components can help treat a wide variety of conditions and general health and wellness. (“Turmeric,” 2012) Turmeric is also a functional food due to its health-promoting properties that can help decrease inflammatory cytokines and reduce joint pain, which can help improve joint mobility. (Kepinska-Pacelik & Biel, 2023)
Turmeric’s Beneficial Properties For The Joints
Now, when it comes to the beneficial properties of turmeric for joint pain, many people can take turmeric in supplement form and, over time, will begin to notice less pain in their joints. This is because the main purpose of incorporating turmeric as part of a therapeutic routine is to relieve pain, delay joint degeneration progression, and restore joint function. (Zeng et al., 2021) Additionally, turmeric can help control inflammation and improve joint health since it can have a positive effect or equivalency of anti-inflammatory medication for individuals wanting to reduce joint pain’s life effects. (Panknin et al., 2023) When people want to think about their well-being and joint health, taking turmeric supplements or incorporating them in dishes can be a stepping stone to improving joint function. At the same time, incorporating strength training exercises into the surrounding muscles can help with joint improvement, and non-surgical treatments like chiropractic care can help reduce the inflammatory effects of degenerating the joints. This, in turn, can help people live pain-free lives, giving them a sense of control over their well-being.
References
Kepinska-Pacelik, J., & Biel, W. (2023). Turmeric and Curcumin-Health-Promoting Properties in Humans versus Dogs. Int J Mol Sci, 24(19). https://doi.org/10.3390/ijms241914561
McDougall, J. J., & Reid, A. R. (2022). Joint Damage and Neuropathic Pain in Rats Treated With Lysophosphatidic Acid. Front Immunol, 13, 811402. https://doi.org/10.3389/fimmu.2022.811402
Panknin, T. M., Howe, C. L., Hauer, M., Bucchireddigari, B., Rossi, A. M., & Funk, J. L. (2023). Curcumin Supplementation and Human Disease: A Scoping Review of Clinical Trials. Int J Mol Sci, 24(5). https://doi.org/10.3390/ijms24054476
Vasconcelos, D. P., Jabangwe, C., Lamghari, M., & Alves, C. J. (2022). The Neuroimmune Interplay in Joint Pain: The Role of Macrophages. Front Immunol, 13, 812962. https://doi.org/10.3389/fimmu.2022.812962
Zeng, L., Yu, G., Hao, W., Yang, K., & Chen, H. (2021). The efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis: a systematic review and meta-analysis. Biosci Rep, 41(6). https://doi.org/10.1042/BSR20210817
Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?
Correct Manual Lifting Technique
Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)
Lifting Guide
Individuals can protect their backs and prevent injury by following simple steps when lifting objects.
Support Base
Ensure there is a healthy support base from which to lift.
Keep feet shoulder-width apart with one foot slightly in front of the other.
Ask For Help
If coworkers or colleagues are available, ask for assistance.
If the load is too heavy, ask for help lifting and moving the object/s.
Use Mechanical Assistant Devices
Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.
Squat To Lift Object
Bend at the hips and knees only, not the back.
Put one knee on the ground to ensure stability before lifting.
Check Posture
Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.
Lift Slowly
Lift with the knees and hips only, gradually straightening the lower back.
Load Positioning
Once upright, hold the load close to the body around the stomach.
Move and Maintain Alertness
Always take small steps.
Maintain alertness as to where you are going.
Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.
Rest
If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.
Squat To Set Object Down
Squat with the knees and hips and set the load down slowly.
Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.
Planning and Tips
Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:
Make a Plan Before Lifting
Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
Set and clear a path.
If lifting something with another person, ensure both agree and understand the plan.
Lift Close to The Body
Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
Make sure there is a firm hold on the object.
It is easier to maintain balance close to the body.
Maintain Feet Shoulder-Width Apart
Keep the feet about shoulder-width apart.
Having a solid base of support is important while lifting.
Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
Take short steps.
Visualize The Motions Involved and Practice The Motions Before Lifting
Think about the motion before lifting.
Practice the lifting motion before lifting the object.
Focus on keeping the spine straight.
Raise and lower to the ground by bending the knees.
Avoid bending at the waist or hips.
Tighten the Stomach Muscles
Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.
Lift With the Legs
The legs are stronger than the back muscles, so let the leg strength do the work.
Lower yourself to the ground by bending the knees, not the back.
Keep Eyes Up
Looking slightly upwards will help maintain a better spine position and help keep the back straight.
Avoid Twisting or Bending
Face in the direction you are walking.
Stop, take small steps, and continue walking if turning is required.
Back Belts
It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.
Injury Medical Chiropractic and Functional Medicine Clinic
Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. 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 Care For Injury Recovery
References
CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from https://www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf
CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts – Do They Prevent Injury? (No. 94-127). Retrieved from https://www.cdc.gov/niosh/docs/94-127/
Individuals experiencing persistent pain, weakness, numbness, and tingling in the back could be suffering from nerve root encroachment. Could surgery ease nerve compression and improve symptoms for persistent and severe cases?
Surgical Decompression
The pain, weakness, numbness, and tingling associated with nerve root encroachment are usually first treated with non-surgical therapies that include:
Anti-inflammatory medications
Physical therapy
This can be enough to address the irritation of the spinal nerve root. But when cases become severe, surgical decompression may be recommended and necessary. It can be done in a couple of different ways.
Causes and Symptoms
Vertebrae are bones in the spine. Small openings called foramina allow a spinal nerve root to pass through on each side of the vertebra. When nerve root encroachment is present, the spinal nerve root gets compressed, pinched, and trapped, which can cause peripheral symptoms such as numbness, tingling, pain, or weakness to develop. Nerve root encroachment is typically caused by normal aging degenerative wear and tear changes in the vertebrae. (Choi Y. K. 2019) These degenerative changes can include:
Facet joint hypertrophy
Ligament and bone hypertrophy
Disc disorders
Formation of bone spurs or osteophytes.
If these degenerative changes progress, they can encroach and compress a nerve root, leading to peripheral symptoms. (Choi Y. K. 2019)
When Surgery Is Recommended
When symptoms occur, initial treatment will involve:
Physical therapy
Chiropractic realignment
Massage therapies
Rest
Lifestyle adjustments
Nonsteroidal anti-inflammatories – NSAIDs
Corticosteroid injections into the spine
If conservative therapies don’t fully heal or improve symptoms or there are neurological problems like difficulty with balance or walking, then surgery may be recommended. Severe pain that limits normal function is an indication for surgery, and rapidly progressive weakness of the arms and/or legs or signs of cauda equina syndrome are indications for emergency surgery.
Surgery Options
Different types of spinal surgery may be performed. A neurosurgeon will decide the best procedure for each patient based on their case, age, medical conditions, and other factors. Specific spinal surgical decompression depends on what is causing the nerve compression. In most cases, it involves removing bone or tissue to relieve nerve pressure or provide support to stabilize the joint. The most common types of surgical decompression include: (Mayo Clinic Health System, 2022)
Maintain the stability and alignment of the spine.
Improve the stability and alignment of the spine.
Anterior Surgery
The anterior approach to surgery means that the spine is accessed through the anterior/front of the spine. In this surgery, one or more discs and bone spurs may be removed through an incision in the front of the neck. (American Association of Neurological Surgeons, 2024) For example, an anterior cervical discectomy may alleviate pressure on one or more nerve roots in the neck. With an anterior lumbar interbody fusion, a surgeon removes a degenerative disc in the lower spinal area by going through a patient’s lower abdomen. (American Association of Neurological Surgeons, 2024) After the disc is removed, a structural device, usually made of bone, fills the space where it once was. This device encourages bone healing and helps the vertebrae’s bodies fuse.
Posterior Surgery
Posterior surgery means the spine is accessed through the posterior/back of the spine. An example is removing a thickened ligament, bone spur, or disc material in the neck. To do this, a small incision in the back of the neck may be made to remove part of the back of the vertebrae called the lamina. This is called a posterior cervical laminectomy. (American Association of Neurological Surgeons, 2024) A posterior lumbar interbody fusion removes a degenerative disc by going through the back. (American Association of Neurological Surgeons, 2024) Like the anterior approach, a structural device often contains bone to fill the space where the disc once was to fuse the bones.
Potential Risks
As with any surgery, it’s important that the individual and their healthcare provider carefully discuss the benefits and risks. Spinal surgical decompression includes: (Proietti L. et al., 2013)
Bleeding
Blood clots
Surgical site infection
Urinary tract infection
Lung infection
Intestinal blockage
There are also specific risks to the area of the spine being operated on and how it is surgically approached. For example, a cervical anterior procedure may injure the esophagus, trachea, or carotid artery. Likewise, damage to the C5 nerve root/C5 palsy can occur from cervical spinal decompressive surgery. This complication causes weakness, numbness, and pain in the shoulders. (Thompson S. E. et al., 2017) The spinal cord may also be injured during surgery and result in paralysis, although this is rare. (American Association of Neurological Surgeons, 2024)
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.
The Non-Surgical Solution
References
Choi Y. K. (2019). Lumbar foraminal neuropathy: an update on non-surgical management. The Korean journal of pain, 32(3), 147–159. https://doi.org/10.3344/kjp.2019.32.3.147
Mayo Clinic Health System. (2022). Decompress and stabilize: understanding types of back surgery. Speaking of Health. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/understanding-types-of-back-surgery
American Association of Neurological Surgeons. (2024). Cervical spine. https://www.aans.org/patients/conditions-treatments/cervical-spine/
American Association of Neurological Surgeons. (2024). Lumbar spinal stenosis. https://www.aans.org/patients/conditions-treatments/lumbar-spinal-stenosis/
Proietti, L., Scaramuzzo, L., Schiro’, G. R., Sessa, S., & Logroscino, C. A. (2013). Complications in lumbar spine surgery: A retrospective analysis. Indian journal of orthopaedics, 47(4), 340–345. https://doi.org/10.4103/0019-5413.114909
Thompson, S. E., Smith, Z. A., Hsu, W. K., Nassr, A., Mroz, T. E., Fish, D. E., Wang, J. C., Fehlings, M. G., Tannoury, C. A., Tannoury, T., Tortolani, P. J., Traynelis, V. C., Gokaslan, Z., Hilibrand, A. S., Isaacs, R. E., Mummaneni, P. V., Chou, D., Qureshi, S. A., Cho, S. K., Baird, E. O., … Riew, K. D. (2017). C5 Palsy After Cervical Spine Surgery: A Multicenter Retrospective Review of 59 Cases. Global spine journal, 7(1 Suppl), 64S–70S. https://doi.org/10.1177/2192568216688189
For individuals with cervical arthritis, can physical therapies help manage symptoms and bring pain relief?
Cervical Arthritis
Cervical spondylosis, more commonly known as cervical arthritis or arthritis of the neck, refers to the wearing down of neck bones, discs, tendons, ligaments, and joints. The primary symptoms are neck pain and stiffness. However, it is also possible to have cervical spondylosis and not have any symptoms. The condition affects over 85% of individuals over age 65. (American Academy of Orthopaedic Surgeons, 2021) Treatment can consist of conservative therapies and includes physical therapies, alternative medicine therapies, at-home self care, and over-the-counter and prescription medications. Severe cases of cervical spondylosis are treated with surgery to repair damaged parts of the spine.
Symptoms
Neck pain and headaches at the back of the head are usually the first symptoms. (Kazeminasab S. et al., 2022) The neck can also feel stiff, with worse morning symptoms that improve throughout the day. (Johns Hopkins Medicine, 2024) Symptoms can range from mild discomfort to severe pain. As cervical spondylosis progresses, individuals can experience:
Inability to turn the head or bend the neck.
A clicking or grinding noise when turning the neck.
Tenderness with pressure on the neck.
Pain that radiates to the shoulders or shoulder blades.
Pain and symptoms that disrupt sleep, sometimes causing waking up throughout the night.
Symptoms that decrease with rest.
More severe symptoms include:
Cervical Bone Spurs – Osteophytes
Some with cervical spondylosis have bony growths that can place pressure on the spinal nerves (a pinched nerve) (Bon Secours, 2024). Compression of spinal nerve roots produces cervical radiculopathy, which leads to pain, tingling, and weakness that radiates into the shoulders, arms, and hands.
Cervical Myelopathy
This refers to spinal impingement that leads to spinal cord dysfunction. (Spinal cord dysfunction is a nervous system disorder with interruptions in the spinal cord’s motor, sensory, and autonomic functions.) Symptoms include pain, tingling, numbness, muscle spasms, and weakness in areas below the neck. Spinal cord dysfunction can affect mobility, hand use, and bladder or bowel function control.
Causes
Where degenerative changes are commonly associated with cervical spondylosis, other conditions, and factors can lead to it and include:
Autoimmune Diseases
Rheumatoid arthritis and psoriatic arthritis can cause chronic inflammation in the cervical spine.
Trauma
Neck trauma, including injury and repetitive stress on the neck.
Cervical spondylosis is commonly seen in occupations that involve neck-stressing activities, such as sports.
Age
Wearing down of the spinal discs cartilage between the vertebrae.
Genetic components have been identified in connection with cervical spondylosis, meaning that some types of arthritis that lead to spinal damage are hereditary. (Kazeminasab S. et al., 2022)
Treatment
Treatment begins conservatively, using protocols to preserve function and avoid surgery. Nonsurgical treatments include medications, physical therapy, at-home exercises, and alternative medicine. The treatment method a healthcare provider chooses will depend on how severe the spondylosis is and other factors like age, how much pain is being experienced, the cause, and overall health. The main objectives are to relieve pain, prevent long-term damage to the spinal cord and nerves, and help maintain performing daily activities. (Bon Secours, 2024)
Medications
Medicines used to treat cervical spondylosis include:
Nonsteroidal Anti-inflammatory Drugs NSAIDs
NSAIDs, including ibuprofen and naproxen sodium, are available without a prescription to relieve pain and inflammation.
A healthcare provider can prescribe a more powerful NSAID to help manage severe symptoms.
Corticosteroids
A corticosteroid injection or a short course of an oral corticosteroid, like prednisone, can ease pain and reduce inflammation.
Muscle Relaxants
If cervical spondylosis causes muscle spasms, a healthcare provider can prescribe cyclobenzaprine, a muscle relaxant, to manage symptoms.
Antidepressants
Some types of antidepressants can ease neck pain from cervical spondylosis.
Anti-seizure Meds
Some anti-seizure drugs can cause nerve pain resulting from damaged nerves.
Physical Therapies
Physical therapy will help manage pain and stiffness and keep muscles loose and relaxed.
A physical therapist will teach the patient exercises to stretch and strengthen neck and shoulder muscles.
At-Home Self Care
At-home exercises can help relieve pain, stiffness, and swelling. Some can include:
Reducing inflammation and stress on the neck through posture training.
At-home targeted stretches and exercises will help bring pain relief.
Ice treatment reduces swelling.
Heat will increase circulation.
A neck brace may be recommended briefly to avoid muscle weakness and stiffness.
Alternative Medicine
Chiropractic adjustments and massage therapy are alternative treatments that will help manage cervical spondylosis.
Acupuncture can also be beneficial in reducing neck pain and increasing energy circulation. (Gu C. L. et al., 2019)
Various therapeutic massage therapies will help relieve neck pain and stiffness. Talk to a healthcare provider before starting treatment so they can advise on whether neck massages are safe.
Surgery
A healthcare provider may recommend surgical treatment when all other treatments have failed, if neurological symptoms are severe, or if neck arthritis causes extreme pain or disability. Surgery to treat cervical spondylosis can involve removing bone spurs, part of the cervical vertebra, or a herniated disc. The removed portions of the cervical spine are fused with hardware and bone grafts.
Injury Medical Chiropractic and Functional Medicine Clinic
Chiropractic therapy is among the more conservative treatment options and may be tried first before proceeding with surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.
Arthritis Explained
References
American Academy of Orthopaedic Surgeons. (2021). Cervical spondylosis (arthritis of the neck). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-spondylosis-arthritis-of-the-neck/
Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC musculoskeletal disorders, 23(1), 26. https://doi.org/10.1186/s12891-021-04957-4
Johns Hopkins Medicine. (2024). Spinal arthritis (arthritis in the back or neck). https://www.hopkinsmedicine.org/health/conditions-and-diseases/spinal-arthritis
Bon Secours. (2024). Cervical osteoarthritis (arthritis in the neck). https://www.bonsecours.com/health-care-services/spine-care/conditions/cervical-osteoarthritis
American Chiropractic Association. (2024). Neck pain. https://www.acatoday.org/patients/neck-pain-and-chiropractic/
Jenkins, H. J., Downie, A. S., Moore, C. S., & French, S. D. (2018). Current evidence for spinal X-ray use in the chiropractic profession: a narrative review. Chiropractic & manual therapies, 26, 48. https://doi.org/10.1186/s12998-018-0217-8
Gu, C. L., Yan, Y., Zhang, D., & Li, P. (2019). An evaluation of the effectiveness of acupuncture with seven acupoint-penetrating needles on cervical spondylosis. Journal of pain research, 12, 1441–1445. https://doi.org/10.2147/JPR.S199798
Can incorporating these 7 exercises help individuals dealing with back pain help promote a healthy spine and functionality?
Introduction
Many individuals have dealt with back pain in their body’s upper, middle, and lower portions, which can correlate with other issues in the upper and lower body extremities. This is due to how many environmental factors affect a person’s daily routine. From stressful days that impact a person’s day to physical inactivity or even spinal issues that have developed over time can cause back pain. When individuals decide to make changes in their health and wellness journey to not only reduce back pain but also improve how they present themselves. Many individuals can start with exercises to reduce back pain and help their spinal health by making sure that they are doing it correctly to prevent injuries. Today’s article looks at how spinal issues correlate with back pain and how these seven simple exercises and stretches can help reduce lower back pain and help you have a healthy spine. We talk with certified associated medical providers who provide our patients’ information to assess back pain correlated with their spine. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce back pain by integrating exercises to help reduce the pain and promote wellness. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.
Spinal Issues Correlating To Back Pain
Do you feel stiffness or muscle aches in your back’s upper, middle, or lower areas? Have you noticed that your posture is hunched more than normal when looking at the phone or being on the computer for an extended period? Or does your back ache from lifting a heavy object or sleeping incorrectly? More often than not, these pain-related scenarios are associated with back pain combined with spinal issues. As one of the leading causes of disability, loss of productivity, and more visits to a health clinic, back pain can impact the body and cause individuals to be miserable. (Bang et al., 2021) Back pain can be specific or non-specific and can cause a person’s spine to degenerate through the spinal disc. The spinal disc provides stability, flexibility, and mobility to the spine, which then helps keep the host upright. However, as the body ages, so does the spine, as lower back pain is multifactorial. When the spinal disc degenerates, the spine has a reduced capacity for intrinsic self-repair within the tissues. (Mohd Isa et al., 2022)
At the same time, when many individuals are dealing with low back pain, depending on the severity of the issue, theywill often change their gait mechanics by adapting different strategies to mitigate the loading on the primary muscles associated with the locomotion that protects the pain-producing tissues. (Smith et al., 2022) When that happens, the pain from the lower back muscles can aggravate the spine further and lead to more chronic issues; however, there are ways to reduce the effects of lower back pain and to help keep the spine healthy.
Can Core Exercises Help with Back Pain?-Video
The 7 Exercises To Incorporate For Back Pain
When it comes to making sure that lower back pain can be reduced and to help with keeping a healthy spine, many people often seek out physical therapy to reduce the pain. Since low back pain is costly in a clinical approach, physical therapy is cost-effective, non-invasive, and can help individuals get a kick start in their health journey. Physical therapy involves whole-body movement that emphasizes breathing coordination, reducing pain from the lower back, and helping stabilize the lumbar spine to improve physical function. (Li et al., 2023) By going through a treatment plan that incorporates physical therapy, many individuals will begin to notice their pain is improving and their quality of life is getting better. (Fischer et al., 2021) Additionally, stretching and core stability exercises can activate the deep and superficial spinal muscles by strengthening them and help stretch out sore muscles affected by low back pain to help many individuals recover. (Calatayud et al., 2019) Below are seven exercises that can help reduce back pain and, when done correctly and consecutively, can help many individuals have a healthier spine while being more mindful of their bodies.
Knee-To-Chest Exercise
This knee-to-chest exercise can help stretch the lower back muscles and can be done in the morning or evening.
Lying on your back with knees bent and feet flat for stability.
Pull one knee up with both hands and press it towards your chest.
Keep the stomach muscles tight while pressing your spine to the floor, holding for at least 30 seconds before returning to position.
Repeat with the other knee and do each stretch 2-3 times.
Lower Back Rotational Stretch (On the Floor)
This lower back rotational stretch can help stretch tight muscles in the lower back.
Laying on the mat, ensure you are on your back with knees bent and feet flat.
Make sure the shoulders are firmly on the floor, and slowly roll the knees to one side until 45 degrees.
Hold that position for 30 seconds before slowly rotating the knees back to the starting position.
Repeat on the other side and do each stretch 2-3 times.
Lower Back Flexibility Exercise
This lower back flexibility will help stretch and strengthen the lower back and core muscles.
Lay flat on the mat. For stability, make sure that the knees are bent with feet are flat on the floor.
Tighten the stomach muscles so the lower back can be pulled away from the floor.
Hold the position for 5 seconds and relax, slowly lowering to the floor.
Flatten the back as your belly button starts to go towards the floor, and hold the position for 5 seconds before relaxing.
Do five repetitions a day to slowly work up to 30 reps.
Bridge Exercise
The bridge exercise can help with core stability and help strengthen core muscles.
Laying flat on your back on the floor, with knees bent and feet flat. Make sure that your shoulders and head are relaxed.
Tighten the core and glute muscles while slowly raising from the hips to form a straight line from the knees to the shoulders.
Stay in that position for 30 seconds while taking deep breaths.
Slowly go down to the floor and relax.
Do five repetitions a day to slowly work up to 30 reps.
Cat-To-Cow Stretch
The cat-to-cow stretch helps with shoulders, upper back, and lower back muscles.
On your hands and knees, hip-width apart on the mat, be in a neutral spine position.
Slowly arch your back by pulling your belly towards the ceiling and your head down for 30 seconds.
Then, slowly let the back and belly sag towards the floor as the head rises for 30 seconds.
Return to the neutral spine position and repeat about 3-5 times twice daily.
Lower Back Rotational Stretch (Seated)
This lower back rotational stretch is seated if the floor is uncomfortable for individuals with severe back pain.
Sitting in an armless chair or stool in a seated upright position, cross one leg over the other.
Then, place the left elbow against the outside of the right knee and twist and stretch the side.
Hold the postion for 10 seconds before slowly returning to a seated position.
Repeat the stretch on the opposite side.
Do this stretch 3-5 times on each side to stretch tight back muscles about twice daily.
Shoulder Blade Squeeze
This shoulder blade squeeze helps individuals properly posture while stretching and strengthening tight upper back and shoulder muscles.
Start in a seated upright position on an armless chair or stool.
Slowly pull the shoulder blades together in the upright position and hold for 5-30 seconds.
Relax, return to the upright position, and repeat 3-5 times twice daily.
References
Bang, A. A., Bhojraj, S. Y., & Bang, A. T. (2021). Back pain and musculoskeletal pain as public health problems: Rural communities await solution. J Glob Health, 11, 01007. https://doi.org/10.7189/jogh.11.01007
Calatayud, J., Escriche-Escuder, A., Cruz-Montecinos, C., Andersen, L. L., Perez-Alenda, S., Aiguade, R., & Casana, J. (2019). Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain. Int J Environ Res Public Health, 16(19). https://doi.org/10.3390/ijerph16193509
Fischer, S. C., Calley, D. Q., & Hollman, J. H. (2021). Effect of an Exercise Program That Includes Deadlifts on Low Back Pain. J Sport Rehabil, 30(4), 672-675. https://doi.org/10.1123/jsr.2020-0324
Li, Y., Yan, L., Hou, L., Zhang, X., Zhao, H., Yan, C., Li, X., Li, Y., Chen, X., & Ding, X. (2023). Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis. Front Public Health, 11, 1155225. https://doi.org/10.3389/fpubh.2023.1155225
Mohd Isa, I. L., Teoh, S. L., Mohd Nor, N. H., & Mokhtar, S. A. (2022). Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci, 24(1). https://doi.org/10.3390/ijms24010208
Smith, J. A., Stabbert, H., Bagwell, J. J., Teng, H. L., Wade, V., & Lee, S. P. (2022). Do people with low back pain walk differently? A systematic review and meta-analysis. J Sport Health Sci, 11(4), 450-465. https://doi.org/10.1016/j.jshs.2022.02.001
Individuals who have experienced spinal or back trauma, suffered fractures, are going through spinal degeneration, or are dealing with a spinal condition have an increased risk of anterolisthesis, where a vertebra slips forward relative to the vertebra below it. Can healthcare providers help prevent and treat the condition?
Anterolisthesis
The spine consists of 33 individual bones or vertebrae stacked on one another. Anterolisthesis occurs when one vertebral segment slips forward over another. The condition can be mild, asymptomatic, or cause significant pain and neurological symptoms. Many different things, including osteoarthritis, osteoporosis, trauma, or a fracture, can cause this vertebral shifting. (Cedars Sinai, 2022) Spondylolisthesis is a general term for shifting a spinal vertebra over the one below it. It includes anterolisthesis, forward moving, and the less common retrolisthesis, or backward shifting.
Grades
Anterolisthesis is typically graded using the Meyerding scale, which assigns one of five grades according to how much slippage has occurred. These grades include:
Anterolisthesis can lead to various symptoms, depending on the severity and if the surrounding spinal nerves have been affected. The most common complaints include:
Diagnosis begins with a subjective evaluation and a physical examination. During these, the healthcare provider will assess sensation, strength, and reflexes and will order one of several diagnostic tests, including:
X-rays
Visualizes the vertebrae in the spine and their position relative to those above and below.
Also provides a clear picture of spinal arthritis or disc degeneration.
Magnetic Resonance Imaging – MRI
Allows the spinal cord, nerves, muscles, and discs to be assessed for compression or damage.
Several factors determine how the condition is treated, including:
The grade of the slippage.
The cause.
The symptoms.
The presence of instability on a diagnostic test such as an X-ray.
Stable and mildly symptomatic cases are usually treated with a combination that can involve:
Physical therapy
Activity modification
Bracing
Nonsteroidal anti-inflammatory medications/NSAIDs like ibuprofen.
Spinal injections
In more severe cases in which spinal instability or significant neurological symptoms are present, surgery may be recommended. This commonly involves a spinal decompression or fusion procedure. The technique varies based on the surgeon’s preferences and anatomy. (Koslosky E., and Gendelberg D. 2020)
Prognosis
Most individuals with this condition don’t know they have it until it is found accidentally on an X-ray or an MRI for something else. Mild cases can cause minimal symptoms and can be well-managed with conservative treatments. Cases of unstable anterolisthesis or those with neurological compression often require surgical intervention. These surgeries restore stability to the spine and alleviate any pressure on the nerves. More than 85% of individuals who need surgery have a successful outcome. (American Academy of Orthopaedic Surgeons, 2021)
Self-Care and Management
For individuals experiencing pain, numbness, or tingling from anterolisthesis, getting symptoms evaluated by a healthcare provider is an important first step. The healthcare provider may suggest one of several management strategies, which include:
Core Strengthening
To alleviate symptoms, exercises targeting the core muscles in the hips, pelvis, abdomen, and lower back are recommended.
Formal physical therapy may also be recommended.
Over-the-counter Meds
A healthcare provider may suggest pain-relieving medications like ibuprofen or naproxen to reduce soreness.
Activity Modification
Sticking to gentle, pain-free activities and avoiding excessive or repetitive extension of the spine can help prevent symptom aggravation. (American Academy of Orthopaedic Surgeons, 2021)
Injury Medical Chiropractic and Functional Medicine Clinic
At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.
Koslosky, E., & Gendelberg, D. (2020). Classification in Brief: The Meyerding Classification System of Spondylolisthesis. Clinical orthopaedics and related research, 478(5), 1125–1130. https://doi.org/10.1097/CORR.0000000000001153
American Academy of Orthopaedic Surgeons. (2021). Adult spondylolisthesis in the low back. https://orthoinfo.aaos.org/en/diseases–conditions/adult-spondylolisthesis-in-the-low-back
Hospital for Special Surgery. (2023). Spondylolisthesis. https://www.hss.edu/condition-list_spondylolisthesis.asp
Can knowing the characteristics of each stage of healing help expedite recovery for individuals who are healing after neck and back injuries?
Back or Neck Injury Healing Stages
At each stage, different things happen at the injury site. This means recommended exercises and activity levels will vary depending on how long it’s been since the injury. The stages to know about when healing from a neck or back injury. (Brumitt J., and Cuddeford T. 2015)
Inflammation or Acute Stage
Also known as the inflammatory stage, the acute stage occurs during the injury and can continue for 72 hours. The body releases repair chemicals in response to tissue damage, causing inflammation and pain. Symptoms of inflammation, including redness, swelling, pain at rest, and diminished function, are expected. Inflammation and pain during the inflammation stage are caused by the body’s repair chemicals released in response to tissue damage. (Wu, Y. S. and Chen S. N. 2014) The biological reaction decreases mobility so the injured area can rest and heal, but the substances that promote healing also cause pain and swelling. (Shah A. and Amini-Nik S. 2017) Scar tissue also begins to form during the inflammatory stage. (Wilgus T. A. 2020) Initial treatment focuses on reducing pain, swelling, and muscle spasms. Individuals are encouraged to use ice packs, compression, and over-the-counter anti-inflammatory medications like ibuprofen or naproxen. (Duchesne E., Dufresne S. S., and Dumont N. A. 2017)
Subacute Stage
Inflammation decreases, and new connective tissue and capillaries grow to help repair damaged structures. The subacute phase generates new connective tissue and capillary growth and reduced inflammation. (Brumitt J., and Cuddeford T. 2015) Scar tissue continues to grow during this time, as well. The tissues are still fragile at this stage, stressing the injured area should be limited to when the therapist or doctor is examining or working with the patient. Most physical therapists recommend beginning with gentle movement during the subacute phase and gradually building up the intensity of exercise. Mild isometric and low-intensity exercises are often used. Because activity is restricted, the muscles may seem weak. Depending on the severity of the injury and the type of tissue that was injured (i.e., tendons have less blood circulation and tend to heal more slowly, it can take a few days to several weeks. (Brumitt J., and Cuddeford T. 2015)
The Chronic Stage or Maturation
The inflammation disappears entirely during the chronic or maturation stage of neck or back injury healing. The new collagen fibers build strength, and the wound shrinks. (Brumitt J., and Cuddeford T. 2015) During this stage, pain associated with the injury tends to be limited to the end joint’s range of motion. The first ten weeks of the chronic stage are essential for engaging in exercises that enhance healing and help remodel the fibers so they will function as close as possible to the way they did before the injury. (Azevedo P. S. et al., 2016) Exercises during the ten weeks are important because otherwise, individuals can permanently lose some of their ability to move and function.
After around ten weeks, the scar tissue can permanently change, so re-acquiring strength and flexibility may necessitate surgery or manual release treatment from a physical therapist or chiropractor. During this time, the scar tissue can be remodeled with exercise, meaning that the activities and motions performed on the injured area will affect the formation of new tissue fibers. The chronic stage of healing begins after 21 days and doesn’t end after the 10-week prime time (Brumitt J., and Cuddeford T. 2015). It can continue for quite some time.
Treatment
Treatment focuses on engaging the injured muscles in light isometric contractions to help align new collagen fibers. Physical therapy helps rebuild mobility, strength, balance, and flexibility and can also help learn about injury and how to recover. A treatment that may also help during these phases is massage therapy. Extended bed rest or immobility can prolong symptoms and delay recovery. Tips to manage pain and recovery:
When sitting for long periods, get up and move around frequently.
Wear comfortable shoes.
When driving long distances, stop frequently to stand up and walk around.
Sleep on the side with a small pillow between the knees.
Limit how much weight is carried.
Add exercises gradually.
Most symptoms of back strain or sprain improve in about two weeks. Individuals may need additional treatment if symptoms continue for longer than two weeks. Maintaining exercises will continue to make the body stronger, more flexible, more functional, and pain-free.
Chiropractic Care for Healing After Trauma
References
Brumitt, J., & Cuddeford, T. (2015). CURRENT CONCEPTS OF MUSCLE AND TENDON ADAPTATION TO STRENGTH AND CONDITIONING. International journal of sports physical therapy, 10(6), 748–759.
Wu, Y. S., & Chen, S. N. (2014). Apoptotic cell: linkage of inflammation and wound healing. Frontiers in pharmacology, 5, 1. https://doi.org/10.3389/fphar.2014.00001
Shah, A., & Amini-Nik, S. (2017). The Role of Phytochemicals in the Inflammatory Phase of Wound Healing. International journal of molecular sciences, 18(5), 1068. https://doi.org/10.3390/ijms18051068
Wilgus T. A. (2020). Inflammation as an orchestrator of cutaneous scar formation: a review of the literature. Plastic and aesthetic research, 7, 54. https://doi.org/10.20517/2347-9264.2020.150
Duchesne, E., Dufresne, S. S., & Dumont, N. A. (2017). Impact of Inflammation and Anti-inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic. Physical therapy, 97(8), 807–817. https://doi.org/10.1093/ptj/pzx056
Azevedo, P. S., Polegato, B. F., Minicucci, M. F., Paiva, S. A., & Zornoff, L. A. (2016). Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment. Arquivos brasileiros de cardiologia, 106(1), 62–69. https://doi.org/10.5935/abc.20160005
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
