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Preoperative Anxiety Spine Surgery

Preoperative Anxiety Spine Surgery

Nervousness, fear, anxiety, and discouragement are common and natural feelings to have while awaiting surgery. Preparing for spinal surgery can cause individuals to experience what is known as preoperative anxiety. A study suggests that preoperative anxiety affects from 60 to 80% of individuals. There can be a lot of unknowns going into spinal surgery. Individuals can experience preoperative anxiety:

  • Over the procedure itself.
  • By imagining what could go wrong?
  • How is the body going to recover?
  • The temporary changes in functioning post-surgery.
  • The post-surgical pain and discomfort.
  • What will the results be?

Learning how to decrease surgery stress will improve the procedure and recovery. There are ways to overcome this anxiety with tips from a pain psychologist. 

Preoperative Anxiety Spine Surgery

Getting Educated and Informed

A pain psychologist recommends spending as much time as needed to discuss the surgery with the surgeon/provider. Ask the doctor if it is possible to speak with other patients who have gone through the same surgery to learn more about the procedure and what to expect with the recovery. Searching the internet is fine, but it is recommended not to get caught up searching non-reputable websites as there is a lot of misleading information that can lead to unnecessary stress. Ask the doctor to share statistics of positive outcomes versus complications to provide reassurance and to determine if surgery is the right option based on the specific condition.

Going In With The Right Mindset

Having a heightened level of anxiety or depression can contribute to poor surgical outcomes. Individuals that focus on the worst-case scenario are more likely to have higher levels of pain after surgery. Having the right mindset, staying calm and positive can decrease preoperative anxiety and can optimize recovery.

Preparation and Planning

Mental preparation and planning for surgery will set the mind and body at ease. This means:

  • Knowing the anticipated healing timeline.
  • The recovery phases the body will go through.
  • How long they will last?
  • What is needed for optimal recovery?
  • Support during each step.
  • Recommended medical follow-up.
  • Post-surgical treatment/rehabilitation plan.

Understand the Pros and Cons

Before surgery, it can be beneficial to understand the pros and cons of the surgery. Speaking with the surgeon to learn this information can create a clear, concise picture of what to expect and the recovery timeline.

Relaxation

It is important to learn relaxation skills to stay positive and calm before and after surgery. Relaxation exercises can be very effective at all stages of pre-and post-surgery. Learn how to:

  • Manage thinking positively.
  • Avoid catastrophizing.
  • These can be accomplished through:
  • Meditation
  • Slow walks
  • Gentle yoga as long as it is cleared by the doctor.

Understand the Time

Knowing what will go into post-surgery recovery and having realistic expectations will create a sense of confidence.

Support System

Having a healthy support system will increase positivity and can speed up recovery. This can include:

  • A partner.
  • Family members.
  • Close friends.
  • They can help before and after surgery with physical assistance or just to listen.

Consult a Professional Pain Psychologist

Help from a behavioral health specialist or a pain psychologist can be beneficial in reducing anxiety and promoting positive surgical outcomes. They help deal with the pain, pre, and post-surgery, rehabilitation, life moving forward, etc.


Body Composition


Carbohydrates Simple and Complex

Simple carbs are a quick, scattered source of energy, and complex carbs are a healthy source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are, but they are more efficient and healthier. Complex carbs provide sustainable energy, meaning the energy is constant with no crash like simple carbs. Complex carbs release slowly and should be the most significant component of daily energy intake. When it comes to muscle gain, complex carbohydrates can help:

Prevent Muscle Weakness

Glycogen is stored in the muscles. When the muscles are used during physical activity or exercise, the body taps into the glycogen stores for that particular muscle. Athletes take advantage of glycogen by consuming carbs (carbo-loading) a day or more before a workout to maximize the muscle glycogen stores. This helps delay fatigue and improve performance, making for a better workout and stronger muscles.

Prevent Muscle Degradation

One concern about consuming a low-carb diet is muscle loss. A study compared a low-carb diet to other diets and found that restricting carbohydrates results in protein loss. This is because restricting carbohydrates causes an increase in the amount of nitrogen that gets excreted by the body. Nitrogen is a component of amino acids that forms muscle proteins, with a loss in nitrogen indicating that the muscles are breaking down.

References

Beck, Kathryn L et al. “Role of nutrition in performance enhancement and postexercise recovery.” Open access journal of sports medicine vol. 6 259-67. 11 Aug. 2015, doi:10.2147/OAJSM.S33605

First, Get Educated: The Spine Journal (July 2018) “Anxiety and depression in spine surgery—a systematic integrative review” https://www.sciencedirect.com/science/article/pii/S1529943018301281.

Hearris, Mark A, et al. “Regulation of Muscle Glycogen Metabolism during Exercise: Implications for Endurance Performance and Training Adaptations.” Nutrients vol. 10,3 298. 2 Mar. 2018, doi:10.3390/nu10030298

How Attitude Can Affect Recovery: Journal of Neurosurgery. (November 2017) “Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery” https://thejns.org/spine/view/journals/j-neurosurg-spine/28/1/article-p119.xml

International Journal of Surgery Open. (2018) “Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study” https://www.sciencedirect.com/science/article/pii/S2405857217300475

Thoracic Upper Back Pain

Thoracic Upper Back Pain

The thoracic upper back or middle back is designed for stability to anchor the rib cage and protect the organs within the chest. Compared to the neck and lower back, the upper back is highly resistant to injury and pain. When thoracic upper back pain does present, it is usually brought on from long-term poor posture or an injury that overwhelms the sturdiness. It is less common than lower back and neck pain, but it does affect around 20% of the population and primarily women. It can occur for a variety of reasons, and chiropractic treatment can bring long-term relief.

Thoracic Upper Back Pain

Thoracic Upper Back Pain

The thoracic upper back is crucial for various functions related to:

  • Neural tissue health
  • Organ protection
  • Arm function
  • Breathing mechanics
  • Trunk support

The delicate balance and function can create potential issues and imbalances, causing soreness, strain, and pain. Underlying causes for thoracic upper back pain include:

  • Direct impact on the area.
  • Injury from a fall, sports, or automobile accident.
  • Unhealthy posturing/positions that place added strain on the spine, causing misalignment.
  • Repetitive motions and overuse like pulling, pushing, reaching, and twisting.
  • Repetitive/Improper shoulder mechanics can lead to muscle imbalance and poor movement.
  • Poor core mechanics.
  • Nerve dysfunction.

Muscular irritation

  • Muscular irritation usually comes from unconditioned muscles and a lack of strength.
  • The shoulder attaches large muscles to the shoulder blade and the back of the rib cage.
  • These are large muscles and are prone to developing strains or tightness.

Joint dysfunction

  • Caused by a sudden injury.
  • Natural spinal degeneration from aging.
  • Facet joint cartilage and/or joint capsule tearing.

Chiropractic

Chiropractic can realign the spine and body if experiencing any of the following:

  • Symptoms that keep returning even with the use of medication.
  • Home remedies do not bring adequate relief.
  • Unable to prevent symptoms from presenting.
  • Chronic pain.

Injury Medical Chiropractic and Functional Medicine Clinic will develop a personalized/customized treatment plan specific to the individual’s needs. Treatment will include:

  • Spinal adjustments to improve alignment and nerve integrity.
  • Therapeutic massage.
  • Posture training to increase spinal alignment.
  • Exercise training to restore muscular balance.
  • Health coaching.
  • Anti-Inflammatory Diet.

Body Composition


Sitting For Prolonged Periods

Weakened Muscles

Metabolism is linked with body composition, meaning that increased muscle increases metabolism helping to burn more calories.

  • When sitting, the gluteal muscles, abdominal muscles, and legs become inactive.
  • Sitting for extended periods day after day can cause these muscles to degenerate.
  • Consistent muscle loss from the lower body can hurt the body’s functional strength and, with age, increase the risk of injury.
  • Any muscle loss, especially from the lower body, and is the largest muscle group, can lead to consistent fat gain.

Circulation Slows Down

Sitting for too long also slows down blood flow to the brain and the legs, causing them to become sluggish.

  • Sitting without standing can increase the risk of developing blood clots.
  • Blood clots can break off and cause blockages throughout the body.
  • One study showed a significant reduction in the vascular flow after sitting for just three hours.
  • But individuals who took breaks and got up to walk around for two minutes every hour showed improved circulation.
References

Beddhu, Srinivasan et al. “Light-intensity physical activities and mortality in the United States general population and CKD subpopulation.” Clinical journal of the American Society of Nephrology: CJASN vol. 10,7 (2015): 1145-53. doi:10.2215/CJN.08410814

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

McManus, Ali M et al. “Impact of prolonged sitting on vascular function in young girls.” Experimental physiology vol. 100,11 (2015): 1379-87. doi:10.1113/EP085355

Sciatic Nerve Branches

Sciatic Nerve Branches

The sciatic nerve is formed through a combination of motor and sensory fibers based on the spinal nerves of the lower back L4 to S3, known as the lumbosacral plexus. It is the largest and longest nerve in the human body and about as wide as an adult thumb. It begins at the base of the spine, runs along the back of each leg, and ends at the foot supplying the areas with fresh blood and nutrients. There are sciatic nerve branches that consist of primary branches and smaller branches.

Sciatic Nerve Branches

Sciatic Nerve Branches

  • The nerve splits into two main branches near the back of the knee called the popliteal fossa.
  • This fossa is located slightly above the joint behind the knee.
  • The popliteal fossa is a diamond-shaped space that acts as the conduit for the blood vessels and nerves.

Primary branches

From the popliteal fossa:

  • The tibial nerve continues down the back of the calf to the heel and bottom of the foot.
  • The common peroneal nerve, aka common fibular nerve, travels sideways along the outer part of the knee to the outer border of the lower leg and foot.
  • Both nerves convert into small sensory nerves in the calf that supply the outer side of each foot.
  • These sensory nerves are called sural nerves.

Collateral branches

The sciatic nerve breaks off into smaller branches, known as collaterals, that include:

  • These are muscle branches that supply the muscles in the thigh, including the hamstring group and the adductor magnus muscles along the inner thigh.
  • Other small branches supply the leg and foot muscles.
  • Articular branches supply the back of the hip joint, the back and side of the knee joint.

The sciatic nerve does not supply structures in the buttocks; however, pain commonly radiates/spreads into this area when the nerve is impaired, impinged, and inflamed.

Blood Supply

The delivery of nutrients to the sciatic nerve is done through blood vessels that also contribute to the nerve’s function. Any interruption of blood flow to the sciatic nerve can cause pain and dysfunction. The sciatic nerve and the sciatic nerve branches receive their blood supply from two sources that include:

  • The extrinsic system is made up of nearby arteries and veins.
  • The intrinsic system includes arteries and veins that run along the nerve and are embedded deep in a sheath known as the epineurium of connective tissue that envelops the nerve.
  • The intrinsic blood supply can be affected by conditions like diabetes, which can contribute to symptoms associated with diabetic neuropathy.
  • Both systems connect at various junction points.

Nerve Function

The combination of sensory and motor fibers that make up the sciatic nerve provides the essential functions in the lower limbs allowing the body to:

  • Stand
  • Walk
  • Run
  • Climb
  • Lift

A healthy sciatic nerve is well protected around the low back and buttock muscles where it starts, and it cannot be palpated or felt by touching or pressing on the area. When the nerve gets inflamed, injured, or pinched, the leg can feel stiff and inflexible when trying to move and can lead to pain, weakness, and tingling in the lower back, buttock, leg/s, and feet.

Anatomical Variations of the Nerve

Individuals can have variations in the anatomical structure of the sciatic nerve. These variations are considered normal, but they can increase the risk of developing sciatica brought on by impingement, entrapment, or irritation of the nerve root/s. Variations in sciatic nerve branches include:

  • The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis below the muscle. This is the most common variation.
  • The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis above the muscle.
  • The nerve divides above the piriformis, with one portion traveling in front while the other travels behind it.
  • Undivided sciatic nerve exits through the piriformis muscle.
  • Undivided sciatic nerve exits from behind the top part of the piriformis.
  • Around 10% of individuals have a nerve that divides above the popliteal fossa and does not merge but courses down in two separate branches.

The sciatic nerve and the sciatic nerve branches are significant components of the body. It supplies motor functions to move the legs and feet and provides sensory functions along the nerve path. Keeping the sciatic nerve healthy is key in helping to prevent back and spinal issues. Chiropractic can help realign the sciatic nerve and educate on maintaining the nerve’s health.


Body Composition


Fitness Motivation

New workout routine

Individuals that don’t feel like returning to previous workout routines are recommended to try out other fitness options. If the gym isn’t cutting it or there is burnout with the current routine, switch things up. This can include:

  • Virtual group classes.
  • 1-on-1 personal training.
  • Outdoor activities.
  • All are valid options to explore if in a rut with the current routine.
  • The important thing is to find what works for you.

Allow the body to rest

Individuals may want to push it to the limit to get back into shape, but rest days are essential for healthy muscle development and improved performance.

  • Noticing the body is more sore and exhausted after a workout is an indication that the body needs rest. This also includes:
  • Maintaining proper hydration.
  • Stretching out the muscles regularly.
  • Taking days off from exercising are necessary to:
  • Prevent muscle fatigue.
  • Reduce the risk of injury.
  • Allow for adequate muscle recovery.

Long term commitment is key

It can be discouraging to commit to a workout schedule only to notice minor changes to strength and fitness.

  • However, small improvements do accumulate over time.
  • Small increases over time can have a huge impact on overall strength and fitness.
  • Keep the bigger picture in mind to remain positive.
References

Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Barral J, Croibier A. Manual Therapy for the Peripheral Nerves. Elsevier Health Sciences; 2007.

Ryan MM, Jones HR Jr. Mononeuropathies. In: Neuromuscular Disorders of Infancy, Childhood, and Adolescence. Elsevier; 2015:243-273. doi:10.1016/b978-0-12-417044-5.00014-7

Neuromuscular Massage For Muscular Pain

Neuromuscular Massage For Muscular Pain

A neuromuscular massage is a form of manual massage used to release strained muscles. Strained areas are also known as trigger points that tend to be the cause of muscular pain symptoms. Trigger points are small areas of the muscle that contract the tissue. The lack of blood and nutrients in these areas causes an inability for the muscles to relax. The area becomes hypersensitive, causing fatigue, weakness, inflammation, and pain. Trigger points can lead to referred pain in which other areas of the body experience sensations of pain, tingling or numbness.

Neuromuscular Massage For Muscular Pain

Neuromuscular Massage

Neuromuscular massage treatment involves applying alternating levels of concentrated pressure on the trigger point/s done through manual and instrument manipulation. Neuromuscular therapy is also called trigger point myotherapy. The American Academy of Pain Management recognizes this form of treatment as an effective treatment for pain caused by soft tissue injury.

Deep Tissue Massage

A deep tissue massage is generally used to address muscle aches and pains and is administered on an on-off basis. Neuromuscular manual therapy techniques are specialized and designed to correct pain and movement dysfunction by treating:

Problems are usually caused by:

  • Specific trauma
  • Repetitive movements
  • Unhealthy posture

Neuromuscular massage is considered an ongoing treatment.

Massage Reduces Pain

Muscles, when spasming, are painful to the touch. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow because of the spasm. This causes adverse effects because the muscles are not receiving enough blood; the muscles also do not receive enough oxygen.

  • The lack of oxygen causes the muscles to produce lactic acid.
  • The lactic acid causes the muscles to feel sore following physical activity.

Neuromuscular massage therapy relaxes the muscles releasing the lactic acid, allowing the muscles to receive enough blood and oxygen. Neuromuscular therapy can feel painful at first, but the pressure of the massage will alleviate the muscle spasm/s. It is crucial to communicate with the chiropractor and massage therapist about the pressure – whether it is too much, too little, feels better, feels worse, etc. Massage therapy pressure should never be overly painful. Individuals often describe the pressure as good pain, where they can feel the difference. Following a neuromuscular massage, the soreness should fade after twenty-four to thirty-six hours. The tight muscles should remain relaxed for four to fourteen days, depending on activities and stress levels.

Massage Treatment

Medical issues and conditions for which neuromuscular massage can treat include:

  • Tendonitis
  • Headaches
  • Temporomandibular joint pain – TMJ disorders
  • Jaw pain
  • Carpal tunnel
  • Upper back pain
  • Low back pain
  • Sciatica
  • Hip pain
  • Knee pain
  • Iliotibial band syndrome
  • Calf cramps
  • Plantar fasciitis

Neuromuscular Massage Benefits

Individuals who undergo neuromuscular massage therapy can experience the following benefits:

  • Reduced and/or complete elimination of pain.
  • Increased blood circulation.
  • Body toxin release.
  • Increased flexibility and strength.
  • Better movement.
  • Improved posture.
  • Balanced musculoskeletal and nervous systems.
  • Increased energy and vitality.

Body Composition


Fatigue

When it comes to getting fit, remember it is a long-distance marathon, not a quick sprint. Whether physical, mental, or a combination, fatigue is a common obstacle for successfully reaching health goals. Physical fitness requires energy:

  • Energy for work or school.
  • Energy to set up the gear or get to the gym.
  • Energy for the workout.
  • Energy to prepare regular healthy meals.

Combined with the pressures of everyday life can make it a challenge to work out consistently. The objective is to make gradual changes rather than significant immediate changes. This will help prevent/avoid early burnout and help lead to maintaining healthy habits. One tip could be scheduling the workouts and meal prep time for the day or week when most active. For example, knowing that after work or school, the body can’t take a workout and needs to crash at the end of the day, set up the exercise for the morning or afternoon. And once the workouts become a routine, energy levels will improve, allowing for more activity.

References

Bervoets, Diederik C et al. “Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review.” Journal of physiotherapy vol. 61,3 (2015): 106-16. doi:10.1016/j.jphys.2015.05.018

Field, Tiffany. “Massage therapy research review.” Complementary therapies in clinical practice vol. 24 (2016): 19-31. doi:10.1016/j.ctcp.2016.04.005

Furlan, Andrea D et al. “Massage for low-back pain.” The Cochrane database of systematic reviews,9 CD001929. 1 Sep. 2015, doi:10.1002/14651858.CD001929.pub3

Qaseem, Amir et al. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Annals of internal medicine vol. 166,7 (2017): 514-530. doi:10.7326/M16-2367

Sports Hernia: Core Muscle Injury

Sports Hernia: Core Muscle Injury

A sports hernia is a soft tissue injury that happens in and around the groin area. It is a strain or tear of any soft-tissue muscles, tendons, or ligaments in the lower abdomen or groin area. It usually happens during physical sports activities that require fast, quick, sudden changes of direction and/or intense twisting movements. Despite its name, a sports hernia is not a hernia in the classic sense. The condition’s proper term is athletic pubalgia. However, a sports hernia can lead to an abdominal hernia. The condition can happen to both men and women.

Sports Hernia: Core Muscle Injury

Anatomy

The soft tissues most affected by sports hernias are the oblique muscles in the lower abdomen, along with the tendons that attach the oblique muscles to the pubic bone, are the most at risk. In many cases, the tendons that attach the thigh muscles to the pubic bone or adductors are also stretched or torn.

Core Muscle Injury

A core muscle injury is when the deep layers of the abdominal wall weaken or tear. This can cause nerve irritation and contribute to uncomfortable symptoms of numbness or tingling. The most common causes include:

  • Planting the feet and turning or twisting with maximum force.
  • Constant repetitive hip and pelvic twisting motions.
  • Imbalances between the hip and abdominal muscles can also, over time, cause overuse injuries.
  • Weakness in the abdominals and improper or no conditioning can also contribute to injuries.
  • Aggressive abdominal exercises can cause and/or aggravate a core muscle injury.

Symptoms

  • Chronic groin pain is the primary symptom of a core muscle injury.
  • Sharp groin pain with exertion.
  • Basic movements like sitting down or getting out of bed can also present with pain or discomfort.
  • Pain on one side of the groin.
  • Pain or numbness that radiates into the inner thigh.
  • Pain when coughing or sneezing.
  • Tenderness or pressure on the lower abdominal area.
  • Pain decreases with rest.

Diagnosis

A doctor will discuss symptoms and how the injury occurred. They will run a series of strength tests like a sit-up or trunk flex against resistance. If it is a sports hernia, there will be tenderness in the groin or above the pubis, along with discomfort and pain. Further tests will include MRI, ultrasound, or X-rays to rule out hip, low back, or pelvis injuries to confirm a core muscle injury.

Non-Surgical Treatment

Rest

  • In the first 7 to 10 days after the injury resting and icing the area is recommended.
  • If there is a bulge in the groin, compression or a wrap can help relieve symptoms.

Chiropractic and Physical therapy

  • Two weeks after the injury, chiropractic adjustments and physical therapy exercises are recommended to improve strength and flexibility in the abdominal and inner thigh muscles.
  • For most cases, 4 to 6 weeks of chiropractic and physical therapy will resolve any pain and allow the individual to return to their exercise or sports activity.

Anti-inflammatory Medications

  • A doctor could recommend non-steroidal anti-inflammatory medications to reduce swelling and pain.
  • If the symptoms persist over a prolonged period, a doctor may suggest a cortisone injection.

If the pain comes back when resuming the physical activities, surgery could be needed to repair the torn tissues.

Surgical Treatment

Repairing the torn tissues can be done with a traditional open procedure that involves one long incision or a minimally invasive endoscopic procedure. In an endoscopy, the surgeon makes smaller incisions and uses a small camera, called an endoscope, to see inside the abdomen. The results of traditional and endoscopic procedures are the same. Most individuals can return to sports and physical activities 6 to 12 weeks after surgery.


Body Composition


Muscle Gain

Individuals can’t lose fat forever. At some point, they need to work on developing muscle or work to preserve the muscle that is already present. This requires a different diet and exercise plan than one designed for fat loss. Instead of getting the body into a catabolic state, the body needs to be in an anabolic state where the body builds tissue instead of breaking it down. To build muscle, the body needs resources meaning proper nutrition and sufficient protein intake to increase muscle mass. Maintaining an energy surplus of around 15% is appropriate for developing musculature, meaning a moderately active individual with a BMR of 1,600 calories would want to their intake to about 2,852 calories a day.

References

Hoffman, Jay R et al. “Effect of protein intake on strength, body composition and endocrine changes in strength/power athletes.” Journal of the International Society of Sports Nutrition vol. 3,2 12-8. 13 Dec. 2006, doi:10.1186/1550-2783-3-2-12

Larson, Christopher M. “Sports hernia/athletic pubalgia: evaluation and management.” Sports health vol. 6,2 (2014): 139-44. doi:10.1177/1941738114523557

Poor, Alexander E et al. “Core Muscle Injuries in Athletes.” Current sports medicine reports vol. 17,2 (2018): 54-58. doi:10.1249/JSR.0000000000000453

Thorborg, Kristian et al. “Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management.” The Journal of orthopedic and sports physical therapy vol. 48,4 (2018): 239-249. doi:10.2519/jospt.2018.7850

Tyler, Timothy F et al. “Groin injuries in sports medicine.” Sports health vol. 2,3 (2010): 231-6. doi:10.1177/1941738110366820

Dealing With a Job-Related Injury: What You Need to Know

Dealing With a Job-Related Injury: What You Need to Know

Any job-related back injury can significantly complicate an individual’s life. Dealing with the pain, trying to figure out how to get things done while in recovery, and workers’ compensation to protect individuals who are injured on the job, getting them healthy without the stress of worrying about losing money from missing work.

Dealing With a Job-Related Injury: What You Need to Know

Job-Related Injury

According to the Occupational Safety and Health Administration or O.S.H.A., a job-related injury is one that either contributed to or is caused by something in the work environment that injures an individual or exacerbates/worsens a previous injury. This is a general overview of the definition, and there are some exceptions. For example, being at the place of work as a general public citizen and not working when an injury happens will not be covered. If not sure whether a back injury is job-related, it’s better to be cautious and report the incident as soon as it happens.

Common Back Injuries

Back injuries are the most common job-related injuries. Back injuries are the number one reason individuals cannot work, whether they hurt their back at home or on the job. The Bureau of Labor Statistics found that nearly 40% of all musculoskeletal injuries that resulted in lost workdays were because of back injuries. The most common back injuries include:

  • Sprains
  • Strains
  • Herniated Discs
  • Whiplash
  • Spinal Cord Injuries
  • Vertebral Fractures

Compensation

Every state’s workers’ compensation program is different; however, the basic components are the same throughout. This means that if a workers’ compensation claim is approved and an individual cannot work because of their injury, they can expect to receive a regular base salary during treatment, rehabilitation, and recovery. Individuals also continue to receive medical coverage through the company, while the workers’ compensation fund should pay for treatment and diagnostics related to the injury.

When A Back Injury Occurs at Work

When a back happens at work, inform the employer as soon as possible. Do not be embarrassed or feel as if it is not a big deal to seek workers’ compensation.  It is an insurance program for both the individual and the employer. An employer pays into the state’s workers’ compensation program for limited liability when employees get injured. Individuals don’t pay for the program, but it protects the individual in case something happens.

Letting an injury go untreated might not be anything at first, but months and years later, it can come back and be worse than when it first happened, causing greater damage, added medical costs, and procedures that the individual has to pay for out of pocket. 

Once an individual knows they have a back injury, it is recommended to seek treatment as soon as possible to prevent worsening the injury or create new ones and develop a treatment, rehabilitation, and strengthening program. If an individual needs emergency care, tell the doctors about the work injury and precisely what happened. Emergency medical care should be sought out when:

  • There is a loss of function in any of the limbs.
  • There is a persistent numbness with the back pain.
  • There is nausea, dizziness, or vomiting after the injury.
  • There is a fever with back pain.
  • Loss of consciousness.
  • Loss of bowel or bladder control.

If the injury is not immediate and progresses gradually, but suspect that it is from work, it should be reported and examined by a medical professional.

Treatment

Proper treatment for a back injury depends on the severity of the injury. Those who prefer non-invasive, medication-free treatment are able to recover with chiropractic or physical therapy. Chiropractic doctors are experts in the spine and the musculoskeletal system. Chiropractic treatment is safe, and proven, and can help relieve pain, restore function, to get back to work safely.


Body Composition


Resistance Exercise

Resistance workouts are made to stress the muscles resulting in muscle gain. Resistance exercise makes the body adapt by growing the muscles to make them more capable of handling intense forces without strain. The stress of resistance exercise causes the muscle fibers to tear at the cellular level. Then, special muscle cells, known as satellite cells, jump into action to repair, rebuild, and grow the muscle. These types of exercises include high-intensity workouts or compound exercises that increase muscle growth. However, there needs to be a healthy balance between workouts and rest to support healthy hormone levels and maximize muscle gain.

Hormones

There are three primary hormones that stimulate muscle hypertrophy. They are:

  • Insulin-like growth factor 1 IGF-1
  • Growth hormone GH
  • Testosterone

Muscle protein synthesis is a critical process in muscle hypertrophy and happens after weight training. The hormones signal to the muscle to repair and rebuild after workout sessions. GH is released in high quantities during sleep, which is why proper sleep is needed to help reach body composition goals. When nutrition, workouts, and hormonal effects are combined, muscle-building happens. Figuring out the right balance is essential for reaching health goals.

References

Burton, A K, and E Erg. “Back injury and work loss. Biomechanical and psychosocial influences.” Spine vol. 22,21 (1997): 2575-80. doi:10.1097/00007632-199711010-00021

https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.5

https://www.bls.gov/opub/ted/2018/back-injuries-prominent-in-work-related-musculoskeletal-disorder-cases-in-2016.htm

Marjorie L Baldwin, Pierre Côté, John W Frank, William G Johnson, Cost-effectiveness studies of medical and chiropractic care for occupational low back pain: a critical review of the literature, The Spine Journal, Volume 1, Issue 2, 2001, Pages 138-147, ISSN 1529-9430, https://doi.org/10.1016/S1529-9430(01)00016-X.(https://www.sciencedirect.com/science/article/pii/S152994300100016X)

Randall, Sara. “1. Avoiding back injury.” The practicing midwife vol. 17,11 (2014): 10, 12-4.

Kinesthesia: Body Sense Positioning

Kinesthesia: Body Sense Positioning

Kinesthesia is the body’s ability to sense movement, position, action, and location, also known as proprioception. An example is when moving the arm, the brain and body are aware that the arm has moved. When dealing with chronic back pain, individuals are unable to function normally with regular everyday movements causing discomfort.

Chronic back pain can make an individual feel like a stranger in their body, altering their perception. Tension develops throughout the body due to the pain, causing tightness and positional adaptations that are unfamiliar, awkward, and unhealthy for the musculoskeletal system. These body positioning changes continue while the individual is unaware of what they are doing, causing further strain and injury.

Kinesthesia: Body Sense Positioning

Kinesthesia

Kinesthesia is essential for overall coordination, balance, and posture as long as the movements are done correctly with proper form. Chronic back pain can affect kinesthesia differently. Individuals can misjudge and estimate that their bodies’ ability to lift, carry, or open something is more complicated or easier than it is. This can exceed the body’s tolerances, causing:

  • Strains
  • Sprains
  • Severe injuries

Once the back starts to hurt, this causes the individual’s sense of kinesthesia to compensate for the pain. As a result, individuals may knowingly or unknowingly attempt to carry out uncoordinated, awkward movements and positions, making things worse.

Motor Control

Motor control is the ability to control movement. When experiencing back pain, individuals adjust their motor control to avoid specific movements that cause back pain. Motor control adaptations and kinesthesia involve body positioning and heightened responsiveness to stimuli, like muscle spasms. Even moderate back pain can cause awkward and dangerous responses causing individuals to overcompensate or become too cautious, worsening or creating new injuries in the process. The body is performing movements that do not follow proper form, even though an individual thinks they are protecting themselves.

Building Healthy Proprioception

A recommended strategy for building kinesthesia to benefit the back and the rest of the body is yoga. Yoga helps build bodily sensory awareness. It trains the body when sending significant signals from the muscles, joints, and tendons back to the proprioceptive centers in the brain. This happens immediately and increases over time.

Yoga Poses

Creating positive awareness of the body’s movements will help relieve back pain as the body learns to feel, understand, and control the muscles. Here are a few poses to help, along with video links.

Reclining Hand-to-Big-Toe Pose

  • Lie with the back flat on the floor.
  • Grasp the big toe, foot, or ankle in both hands, or use a yoga strap or towel if you cannot reach the toes.
  • Hold the pose as long as possible while comfortable.
  • Repeat steps two and three on the other side.
  • Perform twice a day.
  • This pose stretches the lower back muscles, prevents spasms, and alleviates pain.
  • Avoid this pose if you have a herniated disc or retrolisthesis.

Bridge Pose

  • Lie flat on the floor with knees bent.
  • Arms bent on the floor.
  • Press down on the elbows and feet to raise the torso off the floor.
  • Hold and Repeat 4 to 5 times
  • Perform daily to relieve herniated disc, retrolisthesis, and vertebral fracture pain.
  • Avoid this pose if dealing with spinal stenosis, anterolisthesis, facet syndrome, or quadratus lumborum spasm.

Lord of the Fishes Pose

Body awareness is critical, but if an individual moves in a way that’s not natural to the body, it can cause injury. Kinesthesia and healthy posture can help avoid back pain and other health issues. A professional chiropractor can alleviate back pain, educate on proper form and recommend specific stretches and exercises to strengthen the body to prevent injury.


Body Composition


Magnesium

Magnesium supports a healthy immune system. It helps maintain:

  • Healthy bone structure
  • Muscle function
  • Insulin levels

Magnesium assists the body with ATP energy metabolism and acts as a calcium blocker. This reduces cramping and aids in muscle relaxation after physical activity/exercise. Magnesium is essential in biochemical reactions in the body. A slight deficiency can lead to an increased risk of cardiovascular disease and a higher risk of insulin resistance. Many magnesium-rich foods are high in fiber, like:

  • Dark leafy greens
  • Nuts
  • Legumes
  • Whole grains

Studies have shown that consuming a diet rich in Magnesium also provides a higher intake of dietary fiber. Dietary fiber aids in:

  • Digestion
  • Helps control weight
  • Reduces cholesterol
  • Stabilizes blood sugar

The best sources of Magnesium include:

  • Spinach, swiss chard, and turnip greens
  • Almonds and cashews
  • Flax, pumpkin, and chia seeds
  • Cocoa

References

Meier, Michael Lukas et al. “Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception.” The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry vol. 25,6 (2019): 583-596. doi:10.1177/1073858418809074

Tong, Matthew Hoyan et al. “Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis.” Archives of physical medicine and rehabilitation vol. 98,1 (2017): 120-136.e2. doi:10.1016/j.apmr.2016.05.016

Wang, Jinsong, et al. “Dietary magnesium intake improves insulin resistance among non-diabetic individuals with metabolic syndrome participating in a dietary trial.” Nutrients vol. 5,10 3910-9. 27 Sep. 2013, doi:10.3390/nu5103910

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