For individuals dealing with chronic sciatica, when pain and other symptoms significantly impact daily activities and the ability to walk, can a musculoskeletal healthcare provider help relieve and manage symptoms through a multidisciplinary treatment plan?
Chronic Sciatica
Sciatica is a common condition that results from compression of the sciatic nerve in the lower back or leg. Chronic sciatica occurs when symptoms last for 12 months or longer.
Advanced Sciatica Symptoms
Advanced or chronic sciatica usually produces pain that radiates or travels down the back of the leg. Long-term sciatic nerve compression can result in:
Leg pain
Numbness
Tingling
Electrical or burning sensations
Weakness
Weakness
Instability of the legs, which can impact the ability to walk.
Severe nerve compression can progress to leg paralysis if the nerve is significantly damaged from chronic compression. (Antonio L Aguilar-Shea, et al., 2022)
Sciatica can progress to nerve damage of the smaller nerves and travel into the legs and feet. Nerve damage/neuropathy can result in pain, tingling, and loss of sensation. (Jacob Wycher Bosma, et al., 2014)
Disabling Sciatica Treatment Options
When sciatica becomes disabling, affecting an individual’s ability to walk, more involved treatment is needed to bring relief. Many cases of chronic and disabling sciatica are caused by problems with the lumbar spine. Compression of the nerve roots that form the sciatic nerve can occur from bulging or herniated discs or spinal stenosis. If symptoms of sciatica persist beyond 12 months with little or no relief from physical therapy, non-surgical mechanical decompression, stretches and exercises, or pain management techniques, surgical procedures may be needed. (Lucy Dove, et al., 2023)
Lumbar decompression surgery encompasses several procedures to create more space in the lumbar spine and relieve nerve compression. Lumbar decompression surgery can include: (Mayfield Clinic. 2021)
Discectomy
This procedure removes a portion of a damaged disc between vertebrae to alleviate root compression from a bulging or herniated disc.
Laminectomy
This procedure removes the lamina, a portion of the vertebrae causing nerve compression, especially if there is a bone spur due to arthritic and degenerative changes in the spine.
Foraminotomy
This procedure widens the foramina, the openings in the vertebrae where the nerve roots exit to relieve compression.
Spinal Fusion
This procedure takes two or more vertebrae fusing them together with metal rods and screws for stabilization.
The procedure can be performed if:
An entire disc is removed.
Multiple laminectomies were performed.
One vertebra has slipped forward over another.
Daily Relief Management for Advanced Sciatica
Achieving relief from advanced sciatica symptoms at home can include regularly practicing methods like taking a hot bath or shower massage, and applying a heating pad to the lower back or glutes to relax tight muscles to help release the tightness surrounding the sciatic nerve.
Corrective or therapeutic exercises like sciatic nerve glides can help reduce tension along the nerve while low-back exercises that move the spine into forward or backward bending can reduce compression. (Witold Golonka, et al., 2021)
Medications like nonsteroidal anti-inflammatory drugs/NSAIDs, muscle relaxants, or nerve-pain medications may be recommended. (Antonio L Aguilar-Shea, et al., 2022)
Advanced sciatica may not be as responsive to conservative treatment methods, as the injury has set in and the nerve and surrounding tissues have become significantly restricted.
Sciatica symptoms lasting longer than 12 months require more involved treatment like injections or surgery to address symptoms effectively. (Antonio L Aguilar-Shea, et al., 2022)
Healing Chronic Sciatica
If the underlying cause can be effectively treated then chronic sciatica can be healed. Chronic sciatica often results from spinal conditions like herniated discs or lumbar spinal stenosis. These conditions narrow the space around the nerve roots that exit from the spinal cord and merge to form the sciatica nerve. Surgery is performed to open the space in the spine. (Mayfield Clinic. 2021) Sometimes sciatica is brought on by less common causes like a tumor or a spinal infection. In these cases, symptoms will not resolve until the underlying cause is addressed. Tumors may need to be surgically removed while infections require aggressive antibiotics to prevent spreading to other regions of the body. (Hospital for Special Surgery. 2023)
Pain Specialist Treatment Plan Development
Ongoing pain, numbness, tingling, and weakness are all symptoms that should be addressed with a healthcare provider. A pain specialist can help create a treatment plan that involves: (Hospital for Special Surgery. 2023)
Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-González, R., & Paredes, I. (2022). Sciatica. Management for family physicians. Journal of family medicine and primary care, 11(8), 4174–4179. doi.org/10.4103/jfmpc.jfmpc_1061_21
Bosma, J. W., Wijntjes, J., Hilgevoord, T. A., & Veenstra, J. (2014). Severe isolated sciatic neuropathy due to a modified lotus position. World journal of clinical cases, 2(2), 39–41. doi.org/10.12998/wjcc.v2.i2.39
Dove, L., Jones, G., Kelsey, L. A., Cairns, M. C., & Schmid, A. B. (2023). How effective are physiotherapy interventions in treating people with sciatica? A systematic review and meta-analysis. 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, 32(2), 517–533. doi.org/10.1007/s00586-022-07356-y
Golonka, W., Raschka, C., Harandi, V. M., Domokos, B., Alfredson, H., Alfen, F. M., & Spang, C. (2021). Isolated Lumbar Extension Resistance Exercise in Limited Range of Motion for Patients with Lumbar Radiculopathy and Disk Herniation-Clinical Outcome and Influencing Factors. Journal of clinical medicine, 10(11), 2430. doi.org/10.3390/jcm10112430
For individuals dealing with chronic pain conditions can having a better understanding of pain management specialists help in developing effective multidisciplinary treatment plans?
Pain Management Specialists
Pain management is a growing medical specialty that takes a multi-disciplinary approach to treating all types of pain. It is a branch of medicine that applies scientifically proven techniques and methods to relieve, reduce, and manage pain symptoms and sensations. Pain management specialists evaluate, rehabilitate, and treat a spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, chronic pain conditions, and more. Many primary healthcare providers refer their patients to pain management specialists if pain symptoms are ongoing or significant in their manifestation.
Specialists
Healthcare providers specializing in pain management recognize the complex nature of pain and approach the problem from all directions. Treatment at a pain clinic is patient-centric but depends on the clinic’s available resources. Currently, there are no set standards for the types of disciplines needed, another reason treatment options vary from clinic to clinic. Experts say that a facility should offer patients:
A coordinating practitioner specializing in pain management and consulting specialists on the patient’s behalf.
Other specialties represented in pain management are anesthesiology, neurosurgery, and internal medicine. A coordinating healthcare provider may refer an individual for services from:
A healthcare provider should have completed additional training and credentialing in pain medicine and be an MD with board certification in at least one of the following (American Board of Medical Specialties. 2023)
Anesthesiology
Physical rehabilitation
Psychiatry
Neurology
A pain management physician should also have their practice limited to the specialty they hold the certification.
Management Goals
The field of pain management treats all types of pain as a disease. Chronic, such as headaches; acute, from surgery, and more. This allows for applying science and the latest medical advances to pain relief. There are now many modalities, including:
Medication
Interventional pain management techniques – nerve blocks, spinal cord stimulators, and similar treatments.
Physical therapy
Alternative medicine
The objective is to minimize and make symptoms manageable.
Individuals determined that surgery does not benefit their condition.
A better understanding of pain syndromes by communities and insurance companies and increased pain studies will help increase insurance coverage for treatments and technology to improve interventional outcomes.
Nalamachu S. (2013). An overview of pain management: the clinical efficacy and value of treatment. The American journal of managed care, 19(14 Suppl), s261–s266.
American Society of Interventional Pain Physicians. (2023). Pain Physician.
In many working individuals with back pain, how does non-surgical decompression achieve pain reduction to the intervertebral disc in pain management?
Introduction
Low back pain is a common complaint in the workforce. It can cause individuals to miss work, become disabled, and frequently visit their primary doctors. Many factors contribute to the development of low back pain. You may have experienced constant back muscle aches from sitting down and hunched over a computer. Or maybe you have felt your back muscles strain from carrying heavy objects from one location to another. Carrying equipment around your hips, like a utility belt in construction or a law enforcement job, can also contribute to back pain. These scenarios can all be related to the development of low back pain. When the lower extremity muscles are over or under-active, it can cause muscle and tissue fibers to shorten or become overstretched. This can lead to tiny nodules known as trigger points forming. Additionally, repetitive motions caused by overload axial pressure can compress the lumbar spinal structure and cause the spinal disc to care constantly. However, there are ways to manage low back pain. By focusing on common issues associated with each back pain syndrome, non-surgical treatments like spinal decompression can achieve pain management for the intervertebral disc. As we work with certified medical providers who use our patients’ information to treat working individuals suffering from low back pain combining non-surgical decompression as part of their routine can alleviate the pain-like symptoms. We inform them about non-surgical treatments to ease low back pain issues while achieving pain management. We encourage our patients to ask essential questions while seeking education from our associated medical providers about their situation. Dr. Alex Jimenez, D.C., provides this information as an educational service. Disclaimer
Each Low Back Pain Syndrome Is Common
When it comes to low back pain, many individuals will come to their primary doctor and inform them that they are in constant pain in their lower back. As stated earlier, repetitive motions from normal factors can cause the back muscles to be over or under-stretched, causing muscle aches. At the same time, the spinal discs are constantly being compressed with unnecessary pressure. When the spinal discs are under constant pressure, they can begin to bulge or herniate, depending on the severity of the issue. To that point, the compressed spinal discs can aggravate the spinal nerve roots to cause referred localized pain down to the legs or arms, causing symptoms of numbness or tingling sensations in the hands and feet. Low back pain has four categories that can affect many individuals and has different treatment pathways. (Bogduk & Twomey, 1991) These four categories can vary with intense symptoms that pertain to the pain and how they were developed. These include:
Acute muscularity (can involve sciatic radiation)
With or without neurological dysfunction
Chronic muscularity (can have recurring symptoms)
Neoplastic low back pain (can have frequent symptoms and become progressive)
These four categories of low back pain all have common features, as well as regional pain, muscle impairment, mechanical dysfunction exacerbated by daily activities, and mood/behavioral changes. Additional low back pain can be specific or non-specific, associated with many working individuals. Many individuals dealing with low back pain will often work through the pain rather than find the proper relief because of that fear of missing out on work. (Becker & Childress, 2019) Luckily, many ways exist to reduce low back pain and alleviate compressed spinal discs.
Revolutionizing Healthcare-Video
Have you or your loved ones felt aches and pains in your lower back after regular activities? Do your legs and lower back feel stiffer than usual when walking with heavy equipment? Or do you hunch or slouch constantly while relaxing on a chair or sofa? Many of these factors are the root cause of low back pain, and it can affect a person’s routine without treatment right away. When many individuals deal with low back pain in the workforce, they often try home remedies to alleviate the pain temporarily to get back to work, only to cause more issues in the future. To that point, this causes the working individual to be under constant pain and miss out on work, which then causes more unnecessary stress and pressure on the lower back. Luckily there are available treatments that can reduce the effects of low back pain and ease the minds of many individuals looking for cost-effective and safe options. Non-surgical treatments for low back pain are safe for the spine and can be cost-effective to help manage the pain associated with compressed spinal discs and allow people to be more mindful of their back and spine. Non-surgical treatments can range from chiropractic care to spinal decompression, depending on the severity of the pain that the person is experiencing. The video above goes more in-depth with how non-surgical treatments can revolutionize healthcare.
The Biomechanic Principal Of Decompression
When it comes to individuals trying to find relief for their low back pain, many will opt for traditional surgical treatments if the home treatments are not working. While conventional surgical treatments can provide more rapid relief, they can be pricey and cause a financial burden to the working individual. Hence why many will often seek out non-surgical therapies. (Schoenfeld & Weiner, 2010) Non-surgical treatments are affordable to the active individual and can be customizable depending on the issue. One of the non-surgical treatments is decompression. Decompression incorporates mechanical traction to gently stretch the spine as a distracting force to realign the spine back to normal, increase the body’s fluids and nutrients to promote healing factors, and relieve abnormal pressure on the nociceptive receptors system. (Judovich, 1954) The effects of spinal decompression allow the spine to regain mobility, stability, and reduction of low back pain, allowing the compressed spinal disc to return to its original position.
The Decompression Benefits For Common Occurring Back Pain Syndrome
During the mechanical traction process of spinal decompression, the spinal disc space is slightly increased, which reduces the lumbar disc protrusion and causes the disc herniation to disappear over time after a few sessions. (Andersson, Schultz, & Nachemson, 1983) These are a few benefits of spinal decompression, as traction therapy can also alleviate additional musculoskeletal disorders associated with low back pain. (Bettmann, 1957) Musculoskeletal disorders associated with low back pain can be treated with spinal manipulation combined with decompression, as it is used to improve spinal and hip mobility in the lower extremities, thus reducing pain and incapacity in people with low back pain. (Fagundes Loss et al., 2020) Additionally, mechanical traction from decompression can help inhibit positive results for many individuals looking for relief from mechanical stress from their backs. (Wegner et al., 2013) Spinal decompression can help reduce low back pain and its associated symptoms for many working individuals who want the relief they deserve.
References
Andersson, G. B., Schultz, A. B., & Nachemson, A. L. (1983). Intervertebral disc pressures during traction. Scand J Rehabil Med Suppl, 9, 88-91. www.ncbi.nlm.nih.gov/pubmed/6585945
Becker, B. A., & Childress, M. A. (2019). Nonspecific Low Back Pain and Return To Work. American Family Physician, 100(11), 697-703. www.ncbi.nlm.nih.gov/pubmed/31790184
Bettmann, E. H. (1957). Therapeutic advantages of intermittent traction in musculoskeletal disorders. GP, 16(5), 84-88. www.ncbi.nlm.nih.gov/pubmed/13474126
Fagundes Loss, J., de Souza da Silva, L., Ferreira Miranda, I., Groisman, S., Santiago Wagner Neto, E., Souza, C., & Tarrago Candotti, C. (2020). Immediate effects of a lumbar spine manipulation on pain sensitivity and postural control in individuals with nonspecific low back pain: a randomized controlled trial. Chiropr Man Therap, 28(1), 25. doi.org/10.1186/s12998-020-00316-7
Schoenfeld, A. J., & Weiner, B. K. (2010). Treatment of lumbar disc herniation: Evidence-based practice. International Journal of General Medicine, 3, 209-214. doi.org/10.2147/ijgm.s12270
Wegner, I., Widyahening, I. S., van Tulder, M. W., Blomberg, S. E., de Vet, H. C., Bronfort, G., Bouter, L. M., & van der Heijden, G. J. (2013). Traction for low-back pain with or without sciatica. Cochrane Database Syst Rev, 2013(8), CD003010. doi.org/10.1002/14651858.CD003010.pub5
Sciatica is one of the most common injuries, with as many as 40% of individuals experiencing the condition, and it becomes more frequent as the body ages. The pain originates with the sciatic nerves and can go on for several weeks, months, or years. Staying active is a major recommendation to relieve the pain and prevent future flare-ups. Injury Medical Chiropractic and Functional Medicine Clinic can decompress and release the nerve and educate individuals on an anti-inflammatory diet and staying active to expedite healing.
Staying Active
Sciatica is most commonly caused by a slipped disc, which puts pressure or irritates the sciatic nerve, and causes discomfort and painful sensations. The most common factors for developing sciatica include the following:
As the body ages, the spinal discs wear out and break down, leading to the spine shifting out of alignment.
Job occupations that place added strain on the back, like sitting or standing for extended periods, repetitive heavy lifting, or bending, reaching, and twisting movements.
Doctors and chiropractors have found that only resting with sciatica can worsen the injury.
This is because if it is a slipped/bulging/herniated disc, the disc remains in this state, the nerve stays compressed or irritated, and the muscles that control the low back become weak and unable to provide support.
Recommendations
Don’t Sit For Too Long
Prolonged periods of sitting place added pressure on the discs and ligaments in the low back.
Even when sitting doesn’t make it worse, the muscles can develop unhealthy muscle memory that causes partial contracting when there shouldn’t be any that tightens the gluteal muscles causing added strain.
Individuals with a job requiring a lot of sitting or standing are recommended to take frequent breaks to stretch out their muscles or use a standing desk to change positions.
Posture Adjustments
Slouching, hunching, and continuing to practice unhealthy postures will exacerbate sciatica.
Pay attention to the body’s position when standing or sitting.
To prevent slouching, pull the shoulders down and back.
Imagine the shoulder blades touching.
Individuals working at a desk or workstation should take frequent breaks.
Position the screen to see it without tilting the head down.
Increase Physical Activity and Exercise
Exercise is highly recommended to keep the muscles and nerves moving and circulation flowing.
Aerobics
Walking, light jogging, swimming, cycling, and dancing, increase heart rate without causing added strain or pain.
Strength Training
Exercises using free weights, weight machines, or isometric exercises strengthen the muscles and can help restore their position.
Stretching and Flexibility Training
Yoga, tai chi, and Pilates increase flexibility and strength.
The stretching will keep the nerves and muscles from spasms that can worsen the injury.
Strengthen The Core
A stronger core will improve spinal health. Actively engaging the abdominal muscles protects sciatic nerve roots by minimizing spinal pressure.
The back muscles can become increasingly stressed and tired when they have to do all the work without core muscle support.
A weak core can cause additional back pain and worsen sciatica symptoms.
Stand Up Straight
Keep the head and shoulders straight.
Focus On Breathing
Rhythmic breathing helps keep the mind focused and alert while engaged in an activity.
Core Muscles
The back, side, pelvis, and buttock muscles are also part of the core.
Strengthening all of these muscles helps to support the spine.
Exercises for core strengthening include yoga and Pilates, planks, and bridges.
Nerve Recovery
As the nerve recovers, the area the nerve supplies could experience tingling discomfort.
This could be accompanied by an electric sensation at the level of the healing nerve fibers.
The location of this sensation should move as the nerve heals.
With time the sensations should subside, and the area should begin to feel more normal.
Spinal Decompression Demonstration
References
Jensen, Rikke K et al. “Diagnosis and treatment of sciatica.” BMJ (Clinical research ed.) vol. 367 l6273. 19 Nov. 2019, doi:10.1136/bmj.l6273
Kuai, Shengzheng, et al. “Influences of lumbar disc herniation on the kinematics in multi-segmental spine, pelvis, and lower extremities during five activities of daily living.” BMC musculoskeletal disorders vol. 18,1 216. 25 May. 2017, doi:10.1186/s12891-017-1572-7
Ma, Xiao, et al. “The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults.” Frontiers in psychology vol. 8 874. 6 Jun. 2017, doi:10.3389/fps.2017.00874
Ramaswami, Ramya, et al. “Management of Sciatica.” The New England journal of medicine vol. 376,12 (2017): 1175-1177. doi:10.1056/NEJMclde1701008
Cervical spinal stenosis is a condition that causes narrowing of the neck region of the spine. This narrowing can compress the nerves causing pain and discomfort. The symptoms are caused by the misalignment/subluxation of the neck, which is usually the c1 and c2 vertebrae. Misalignments can be caused by daily wear and tear; injuries and tumors can cause or worsen the condition. Cervical spinal stenosis is a severe condition that worsens as time progresses and can cause permanent damage and paralysis. Chiropractor recommendations and non-invasive techniques can alleviate the symptoms, along with therapeutic stretches and exercises, and diet is all part of a personalized treatment plan.
Stenosis Symptoms
The most common symptom is neck pain. Doctors recommend avoiding all activities that worsen the pain; however, chiropractors suggest remaining as active as possible to keep the muscles strong. This is because inactivity over time can lead to muscular deterioration around the neck. Other symptoms besides neck pain include:
Neck discomfort and pain
Headaches
Numbness, tingling in the shoulder, arm, hand
Difficulty maintaining balance
Walking problems
Chiropractor Recommendations
Pain Or Stiffness In The Neck Should Not Be Ignored
Pain or stiffness in the neck that worsens rapidly or does not ease up or go away after two weeks requires medical attention.
Ignoring or dismissing the pain or stiffness can worsen the condition.
Looking Down At A Phone Too Long
Looking down too long increases the strain on the neck.
Keeping the head forward for extended periods increases the chances of pinching/compressing nerves and causing radiculopathy.
Exercises That Roll The Neck Around
Exercises that roll or pull the neck are not advised as they can exacerbate the condition.
A chiropractor will recommend specific neck stretches and exercises on a case-by-case basis.
Heavy Bag, Purse, BackPack On One Shoulder
It is recommended to carry a backpack with both shoulders to distribute the weight evenly.
Over time, a backpack, bag, or purse on the same shoulder will disrupt the walk cycle and pull down on one side of the neck, exacerbating cervical spinal stenosis.
For bags and purses with one strap, it is recommended to alternate shoulders or use a crossbody strap.
Sleeping On The Stomach
Sleeping on the stomach means having to turn the neck to one side.
This stresses and aggravates cervical stenosis.
It is recommended to sleep on the side or back.
Treatment, Therapy, and Rehabilitation
Chiropractic is recommended for spinal stenosis because it corrects and re-aligns dislocated and herniated discs and decompresses the spine.
Treatment reduces pressure on the spinal cord and its joints and nerve networks.
Various techniques include physiotherapeutic massage, spinal adjustments, cervical traction, spinal decompression, and flexion-distraction, which will address stenosis symptoms, treat pain, reduce inflammation, numbness, and restore muscle function.
Non-Surgical Cervical Decompression
References
Clark, Aaron J et al. “Cervical spinal stenosis and sports-related cervical cord neurapraxia.” Neurosurgical focus vol. 31,5 (2011): E7. doi:10.3171/2011.7.FOCUS11173
Kukurin, George W. “The amelioration of symptoms in cervical spinal stenosis with spinal cord deformation through specific chiropractic manipulation: a case report with long-term follow-up.” Journal of manipulative and physiological therapeutics vol. 27,5 (2004): e7. doi:10.1016/j.jmpt.2004.04.009
Setting spinal goals is important for an individual’s treatment plan to ensure a thorough and successful recovery following:
Surgery
Trauma
Spinal condition
When developing goals with a surgeon or spine specialist, utilizing a well-known method known as SMART is recommended. Individuals are encouraged to set goals to accomplish personal growth and improvement. It is a model for forming goals and objectives that for medical purposes include:
This could be fitness trackers, daily journaling – writing, video, health coach, etc.
Attainable
Determine if the goal is achievable.
Figure out what tools or skill sets are needed to reach the goal.
Realistic
Results-oriented goals.
Measure results or output, including accomplishments.
Time Frame
Set goals within a doable time frame.
Goal setting helps individuals monitor their progress when recovering from injury, surgery, and/or spinal conditions. Making goals smaller makes it easier to achieve improvements. It’s recommended to have a partner assistant during the goal-setting because the pain can compromise decision-making. Pain affects the mind’s abilities to assess improvement and treatment response rationally. Taking the most important goals and focusing on small building blocks helps individuals maintain motivation during a long recovery process.
Difference Between Goal Setting and Treatment
A standard treatment plan is structured for a specific result and is not set up for adjusting the way goal setting does. A treatment plan is created and prescribed to a patient with little patient input. Goal setting is a collaboration between a patient and a doctor setting objectives as stepping-off points to achieve goals. Goal setting empowers patients with education, skillsets, and tools to succeed and continue that mindset as their lives move on. Achieving short-term goals helps individuals reflect positively on small gains that set a solid foundation for more challenging future goals.
Spinal Treatment Goals
Goals are personalized/custom-tailored to the individual’s case and condition. For example, a patient could set a goal of returning to weekend sports activities. Therefore, achieving the goal could require the individual to engage in exercise five days a week for the next two weeks that could include physical therapy rehabilitation:
These activities are small goals that help the body adapt to handling additional physical stress.
Goal Setting When In Recovery
Spinal issues are dealt with by creating reasonable small objectives to reach a goal. SMART goal setting is an instrumental framework for medical providers to help identify what is important to the patient. Modifications on SMART goals can be done to adjust to the individual’s needs. Spinal goals help patients accomplish what is necessary, keeping them empowered and motivated.
Body Composition
Too Comfortable With Goals
An individual may have a great deal of success doing the same workouts initially but then notice they’re getting easier and are not seeing the same rate of progression. That same workout routine, same weights, and equipment will only go so far in goal achievement. In recovery, as the body gets stronger and fitness levels improve, it is recommended to consistently challenge yourself to avoid falling into a rehabilitation fitness plateau. Part of the recovery process is to change up workouts to challenge the body to achieve optimal health and healing. Individuals are recommended to:
Increase weight and or reps
Increase the amount of weight or the number of reps in each set.
Increase or decrease the tempo
Shorten the rest period between sets to keep the heart rate high or slow down to focus on muscle contraction.
Experiment with different types of workout sets
If you’ve been doing the same kinds of lifts, try drop sets, supersets, or AMRAP (as many reps as possible) to challenge your muscles differently.
Individuals doing high-intensity interval training are recommended to incorporate a long run or bike ride.
Changing the workout routine will keep challenging the body, which is great for health progress.
References
Alexanders, Jenny et al. “Goal setting practices used within anterior cruciate ligament rehabilitation: An exploration of physiotherapists understanding, training, and experiences.” Musculoskeletal care vol. 19,3 (2021): 293-305. doi:10.1002/msc.1535
Bovend’Eerdt, Thamar J H et al. “Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide.” Clinical rehabilitation vol. 23,4 (2009): 352-61. doi:10.1177/0269215508101741
Haas, B et al. “Rehabilitation goals of people with spinal cord injuries can be classified against the International Classification of Functioning, Disability and Health Core Set for spinal cord injuries.” Spinal cord vol. 54,4 (2016): 324-8. doi:10.1038/sc.2015.155
Medical experts have seen how pain education and cognitive behavioral therapy or CBT classes effectively manage chronic back pain; even a one-time pain management class can help. Individuals experiencing back pain often try a variety of remedies to find relief. These include:
Eliminating activities
Over-the-counter medications
Prescription pain medications
Support devices and braces
Pain specialists
Surgery
All treatment options can help alleviate discomfort and pain, but sometimes taking a pain management class and getting educated on what is happening in the body has been shown to help individuals gain a better understanding helping them to find relief. A recent study suggests that a one-time class may be all that is needed. These quick classes can give more individuals immediate access to information and skill sets that can help reduce the pain and everything that comes with it.
Cognitive Behavioral Therapy Classes
Cognitive Behavioral Therapy for chronic pain provides individuals with information and pain management skills. Cognitive-behavioral therapy is handled by a therapist and can take multiple individual or group sessions that last one or two hours. A session can include:
Education on pain and how it works.
How thoughts and emotions influence pain.
How pain affects mood.
Sleep and pain.
Activity and action plan development.
Chronic lower back pain or CLBP is considered a physical ailment; cognitive behavioral therapy can provide mental health strategies to manage symptoms better. For example, individuals with chronic pain begin to fear doing activities that could increase their pain level and begin to constantly worry about worsening the injury or creating a new injury. This can lead to severe stress that exacerbates the chronic symptoms and can lead to other health issues.
Single Session Vs. Multiple
Doctors and medical experts are trying to make pain education and relief skills more accessible. They do not require multiple sessions and instead consist of single-session, two-hour management classes. A randomized clinical trial of adults with chronic low back pain was compared to:
2-hour back pain health education class with no skill set training.
16-hour, 8-session cognitive behavioral therapy group class.
The study found that three months after treatment, the Empowered Relief group showed positive results. In the randomized trial, a single-session pain relief class was found to be non-inferior to an eight-session cognitive behavioral therapy class to:
Reduce pain-related distress
Pain intensity
Pain interference
Benefits
The individuals that completed the one-time 2-hour class reported positive results after three months. They found that the course had significantly reduced:
Pain intensity
Pain interference
Sleep disturbance
Anxiety
Fatigue
Depression
However, doctors caution that the two-hour class does not replace comprehensive cognitive-behavioral therapy. This is to get individuals on a positive path of pain management that can further develop into a healthy lifestyle. The objective is to create a range of options that meets an individual’s needs. The most significant advantage of a two-hour class is the convenience. Individuals can participate in these classes in person or online.
Body Composition
Supplements That Can Help Improve Lean Body Mass
A few dietary supplements that directly support body composition improvement.
Protein Powders
Protein powders are common nutritional/dietary supplements. Protein powders come in a variety of sources:
Plant-based – rice, hemp, pea, pumpkin seed, and soy.
Rice Protein
Rice protein is a plant-based protein powder used by vegans, vegetarians, and individuals who can’t tolerate dairy products. Research has found that rice protein has similar effects on body composition as whey. Scientists found that individuals who took rice protein and individuals that took whey protein both experienced positive body composition changes.
References
Cochrane Database of Systematic Reviews. (Oct 2015) “Psychological therapies for the management of chronic neuropathic pain in adults.” www.ncbi.nlm.nih.gov/pmc/articles/PMC6485637/
Darnall BD, Roy A, Chen AL, et al. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401
HRB Open Research. (Aug 2020) “The relative effectiveness of psychotherapeutic techniques and delivery modalities for chronic pain: a protocol for a systematic review and network meta-analysis” www.ncbi.nlm.nih.gov/pmc/articles/PMC7459872/
Journal of Psychosomatic Research. (Jan 2010) “Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.”
Pain. (Feb 2008). “Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. www.ncbi.nlm.nih.gov/pmc/articles/PMC2254507/
Pain and Therapy. (Jun 2020) “Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.” www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/
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