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Understanding Healthy Spinal Rotation

Understanding Healthy Spinal Rotation

For individuals trying to maintain a healthy spine, can understanding the causes and prevention of rotated vertebrae help protect the spine from harmful rotation of vertebrae?

Understanding Healthy Spinal Rotation

Spinal Rotation

Healthy spine rotation is an important aspect of injury prevention, and rotated vertebrae or a twisted spine can result from spine, nerve, or muscle disease or certain movements.

Normal Spine Twisting Capability

The spine can move in several ways. Spine movements include:

  • Bending  – Rounding forward
  • Extending – Arching backward
  • Tilting sideways is powered by muscles that aid in twisting.

Although the spine can move in many directions, there are limits to how far it can and should go. (Xinhai Shan et al., 2013). This is especially true with twisting. The spinal column is made of 26 interconnected bones called vertebrae. When moving, each vertebrae bone moves accordingly. Rotated or twisted vertebrae, especially when bending forward like lifting heavy objects, are associated with a risk of back injuries like strain and herniated discs.

How Rotation Works

Rotation is a basic movement in which individuals can turn their spinal column. When twisting, the spine also bends to the side. The muscles involved in spine rotation include:

  • The internal oblique abdominals and the external oblique abdominals don’t directly attach to the spine but are the primary muscles responsible for powering spinal rotation in the lower back.
  • Intrinsic muscles, including the multifidus and longissimus, contribute to twisting movement as well.
  • The multifidus helps the spine twist when one side is contracted/activated and extends the lumbar spine when both sides contract.
  • The multifidus helps control the movement, and the longissimus provides the movement with some extension.

Age and The Spine

As individuals age, the body accumulates tension and/or weakness in the oblique abdominal and other trunk muscles. Sedentary habits primarily bring on these changes. (Pooriput Waongenngarm et al., 2016)

  • Chronically tight back and abdominal muscles impair the range of motion of the trunk, as well as twisting ability.
  • Muscle weakness and tightness affect spinal movements.
  • Weakened muscles can decrease support for spinal movement and decrease overall trunk stability.

Spinal Rotation and Scoliosis

Scoliosis is a common condition that causes a lateral curve of the spine. Some of the vertebrae become displaced to the side. Often, abnormal vertebral rotation underlies this displacement. Treatment often focuses on controlling vertebral rotation with medical guidance and physical therapy. (John P. Horne et al., 2014)

Over-Rotating The Spine

Many individuals over-rotate their spines with manual work, which can increase the risk of back injuries. (National Institutes of Health. 2020). Over-rotation can happen with activities like digging or shoveling.

Exercise For A Healthy Spine

A recommended way to achieve optimal rotation of the spine is with daily back exercises. (National Spine Health Foundation. 2015). An effective back exercise program will consist of movements in every direction.

  • Yoga is recommended because it places emphasis on developing flexibility and strength in all directions.
  • Pilates does the same.
  • An injury prevention exercise program will work the hip and pelvic muscles as well.
  • Individuals with a spine condition should consult their healthcare provider or physical therapist about how to exercise the spine safely, as rotation exercises could worsen back problems like bulging or herniated discs.

Core Strength For A Pain-Free Back


References

Shan, X., Ning, X., Chen, Z., Ding, M., Shi, W., & Yang, S. (2013). Low back pain development response to sustained trunk axial twisting. 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, 22(9), 1972–1978. https://doi.org/10.1007/s00586-013-2784-7

Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and health at work, 7(1), 49–54. https://doi.org/10.1016/j.shaw.2015.08.001

Horne, J. P., Flannery, R., & Usman, S. (2014). Adolescent idiopathic scoliosis: diagnosis and management. American family physician, 89(3), 193–198.

National Institutes of Health. (2020). Low Back Pain Fact Sheet.

National Spine Health Foundation. (2015). Breaking Down The Exercises That Break Down Your Spine.

Stand Desks to Improve Circulation, Back Pain, and Energy

Stand Desks to Improve Circulation, Back Pain, and Energy

For individuals working at a desk or work station where the majority of the work is done in a sitting position and increases the risk for a variety of health problems, can using a standing desk help prevent musculoskeletal problems and improve short and long-term wellness?

Stand Desks to Improve Circulation, Back Pain, and Energy

Stand Desks

More than 80% of jobs are done in a seated position. Stand desks have proven to help. (Allene L. Gremaud et al., 2018) An adjustable stand desk is intended to be the standing height of an individual. Some desks can be lowered to use while sitting. These desks can improve:

  • Blood circulation
  • Back pain
  • Energy
  • Focus
  • Individuals who are less sedentary may experience decreased depression, anxiety, and risk of chronic disease.

Improve Posture and Decrease Back Pain

Sitting for prolonged periods can cause fatigue and physical discomfort. Back pain symptoms and sensations are common, especially when practicing unhealthy postures, already dealing with existing back problems, or using a non-ergonomic desk set-up. Instead of only sitting or standing for the whole workday, alternating between sitting and standing is far healthier. Practicing sitting and standing regularly reduces body fatigue and lower back discomfort. (Alicia A. Thorp et al., 2014) (Grant T. Ognibene et al., 2016)

Increases Energy Levels

Prolonged sitting correlates with fatigue, reduced energy, and productivity. A sit-stand desk can provide benefits like increased productivity levels. Researchers discovered that sit-stand desks could improve the general health and productivity of office workers. Individuals in the study reported:

  • A significant increase in subjective health.
  • Increased energy in work tasks.
  • Improved work performance. (Jiameng Ma et al., 2021)

Chronic Disease Reduction

According to the CDC, six in 10 individuals in the U.S. have at least one chronic disease, like diabetes, heart disease, stroke, or cancer. Chronic disease is the leading cause of death and disability, as well as a leading force of healthcare costs. (Centers for Disease Control and Prevention. 2023) While further research is needed to see if standing desks can reduce the risk of chronic disease, one study looked to quantify the association between sedentary time and the risk of chronic disease or death. Researchers reported that sedentariness for prolonged periods was independently associated with negative health outcomes regardless of physical activity. (Aviroop Biswas et al., 2015)

Improved Mental Focus

Sitting for extended periods slows down blood circulation. This decreased blood flow to the brain lowers cognitive function and increases the risk of neurodegenerative conditions. One study confirmed that healthy individuals who worked in a prolonged sitting position had reduced brain blood flow. The study found that frequent, short walks could help prevent this. (Sophie E. Carter et al., 2018) Standing increases blood and oxygen circulation. This improves cognitive function, which also helps improve focus and concentration.

Depression and Anxiety Reduction

Modern lifestyles typically contain large amounts of sedentary behavior.

However, there is a small amount about the mental health risks of prolonged sedentary behavior. There have been a few studies aimed at improving public understanding. One study focused on a group of older adults, having them self-report sedentary habits that included television, internet, and reading time. This information was compared to their individual scoring on the Centre of Epidemiological Studies Depression scale. (Mark Hamer, Emmanuel Stamatakis. 2014)

  • The researchers found that certain sedentary behaviors are more harmful to mental health than others.
  • Television watching, for example, resulted in increased depressive symptoms and decreased cognitive function. (Mark Hamer, Emmanuel Stamatakis. 2014)
  • Internet use had the opposite effect, decreasing depressive symptoms and increasing cognitive function.
  • Researchers theorize that the results come from the contrasting environmental and social contexts in which they are happening. (Mark Hamer, Emmanuel Stamatakis. 2014)
  • Another study looked at the possible correlation between sedentary behavior and anxiety.
  • Increased amounts of sedentary behavior, especially sitting, seemed to increase the risk of anxiety. (Megan Teychenne, Sarah A Costigan, Kate Parker. 2015)

Incorporating a standing desk into the workspace can help to reduce the negative effects of sedentary behaviors, leading to improved productivity, improved mental and physical health, and a healthy work environment for individuals who work long hours at a desk or workstation.


Understanding Academic Low Back Pain: Impact and Chiropractic Solutions


References

Gremaud, A. L., Carr, L. J., Simmering, J. E., Evans, N. J., Cremer, J. F., Segre, A. M., Polgreen, L. A., & Polgreen, P. M. (2018). Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers. Journal of the American Heart Association, 7(13), e007735. https://doi.org/10.1161/JAHA.117.007735

Thorp, A. A., Kingwell, B. A., Owen, N., & Dunstan, D. W. (2014). Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occupational and environmental medicine, 71(11), 765–771. https://doi.org/10.1136/oemed-2014-102348

Ognibene, G. T., Torres, W., von Eyben, R., & Horst, K. C. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of occupational and environmental medicine, 58(3), 287–293. https://doi.org/10.1097/JOM.0000000000000615

Ma, J., Ma, D., Li, Z., & Kim, H. (2021). Effects of a Workplace Sit-Stand Desk Intervention on Health and Productivity. International journal of environmental research and public health, 18(21), 11604. https://doi.org/10.3390/ijerph182111604

Centers for Disease Control and Prevention. Chronic disease.

Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 162(2), 123–132. https://doi.org/10.7326/M14-1651

Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. Journal of applied physiology (Bethesda, Md. : 1985), 125(3), 790–798. https://doi.org/10.1152/japplphysiol.00310.2018

Hamer, M., & Stamatakis, E. (2014). Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Medicine and science in sports and exercise, 46(4), 718–723. https://doi.org/10.1249/MSS.0000000000000156

Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15, 513. https://doi.org/10.1186/s12889-015-1843-x

Pathology of Lumbar Disc Degeneration: Expert Guide

Pathology of Lumbar Disc Degeneration: Expert Guide

Can healthcare providers help many individuals with lumbar disc degeneration find relief through spinal decompression treatments?

Introduction

Many individuals often do everyday motions that can allow the spine to bend, twist, and turn in various ways without feeling pain and discomfort. However, as the body ages, so does the spine, as the spinal discs begin the natural process of degeneration. Since the spinal discs in the spinal column absorb the vertical pressure weight, it stabilizes the upper and lower extremities and provides motion. To that point, when many individuals suffer from various injuries or environmental factors that cause the spinal disc to be compressed, it can lead to low back issues that cause pain and discomfort when a person is doing an activity. Since low back pain is one of the three most common problems that many people worldwide have dealt with, it can become a socio-economic issue that can lead to a life of disability and misery. Low back pain is often correlated with disc degeneration, and the surrounding ligaments and muscle tissues can affect the upper and lower extremities. This causes referred pain to the different musculoskeletal groups, causing many people to seek treatment that can not only be affordable but also effective in reducing the pain. Today’s article looks at the anatomy of the lumbar disc, how disc degeneration affects the lumbar spine, and how spinal decompression can reduce lumbar disc degeneration from causing more pain to the lower back. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease the pain-like symptoms associated with lumbar disc degeneration causing low back pain. We also inform our patients that there are non-surgical options to reduce these pain-like issues correlated with disc degeneration and restore lumbar mobility to the body. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

 

The Anatomy Of The Lumbar Disc

Do you feel tension or stiffness in your lower back after waking up in the morning? Do you feel sudden or gradual pain from bending down to lift a heavy object that is affecting your lower back? Or do you feel the pain in one location or another in your back that is causing you pain and discomfort in your lumbar spinal region? Many of these pain-like issues are often correlated with disc degeneration combined with low back pain. The spinal disc’s anatomy comprises three elements that work together in a specific pattern to resist forces placed in the lumbar spine. (Martin et al., 2002) Since the lumbar spine is the thickest portion of the back, the spinal disc supports the upper body’s weight while stabilizing the lower body. However, the spinal disc will shrink over time when the body ages. Since degeneration is a natural process, many individuals will begin to feel less mobile, which can cause many issues within the lumbar spine.

 

How Disc Degeneration Affects The Lumbar Spine

 

When disc degeneration occurs in the lumbar spine, the spinal disc begins to decrease in volume, and the nutrients that hydrate the disc start to deplete and become compressed. When disc degeneration affects the lumbar spine, the nerve roots from the central system are affected. They can be associated with any particular group of pathological conditions that may irritate the surrounding nerves and produce pain-like symptoms. (Bogduk, 1976) To that point, this causes referred pain in the lower limbs and radiating pain in the lower back. At the same time, glycosphingolipid antibodies are activated in the immune system, causing inflammatory effects. (Brisby et al., 2002) When people are dealing with low back pain associated with disc degeneration, many people will feel their lower back lock up, causing limited mobility and stiffness. At the same time, the surrounding muscle and soft tissues are overstretched and tightened. The spinal disc will also affect the nerve fibers surrounding the spine, leading to nociceptive lower back pain. (Coppes et al., 1997) However, many individuals can find available treatments to reduce low back pain associated with disc degeneration.

 


An Overview Of Spinal Decompression- Video


Spinal Decompression Can Reduce Lumbar Disc Degeneration

Many individuals can seek out non-surgical treatments to reduce low back pain associated with disc degeneration as it is cost-effective and, through consecutive treatments, can start feeling better. Some non-surgical treatments like spinal decompression can help rehydrate the spinal disc through gentle traction and promote natural healing. Spinal decompression can be manual or mechanical, using negative pressure to increase disc height. (Vanti et al., 2021) This allows many individuals to feel the relief they deserve and feel better over time. Spinal decompression can reduce disc degeneration, stabilize the lumbar spine, and help regain spinal mobility back to the lower portions. (Daniel, 2007) When many individuals begin to take care of their bodies and reduce the chances of low back pain from returning to cause more issues to the back.

 


References

Bogduk, N. (1976). The anatomy of the lumbar intervertebral disc syndrome. Med J Aust, 1(23), 878-881. https://www.ncbi.nlm.nih.gov/pubmed/135200

Brisby, H., Balague, F., Schafer, D., Sheikhzadeh, A., Lekman, A., Nordin, M., Rydevik, B., & Fredman, P. (2002). Glycosphingolipid antibodies in serum in patients with sciatica. Spine (Phila Pa 1976), 27(4), 380-386. https://doi.org/10.1097/00007632-200202150-00011

Coppes, M. H., Marani, E., Thomeer, R. T., & Groen, G. J. (1997). Innervation of “painful” lumbar discs. Spine (Phila Pa 1976), 22(20), 2342-2349; discussion 2349-2350. https://doi.org/10.1097/00007632-199710150-00005

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. https://doi.org/10.1186/1746-1340-15-7

Martin, M. D., Boxell, C. M., & Malone, D. G. (2002). Pathophysiology of lumbar disc degeneration: a review of the literature. Neurosurg Focus, 13(2), E1. https://doi.org/10.3171/foc.2002.13.2.2

Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. https://doi.org/10.1186/s40945-021-00102-5

 

Disclaimer

Managing Facet Hypertrophy Pain: A Guide

Managing Facet Hypertrophy Pain: A Guide

Facet hypertrophy is an incurable, chronic disease that affects the facet joints in the spine. Can recognizing symptoms, help in diagnosis, and treatment?

Managing Facet Hypertrophy Pain: A Guide

Facet Hypertrophy

Facet hypertrophy causes the facet joints in the spine to enlarge. They are found where the vertebrae come into contact on the back of the vertebrae that form the backbone. These joints stabilize the spine when twisting and bending. Hypertrophy results when damage wears down the cartilage that cushions the bones that meet in the joint. This can include:

  • Aging
  • Wear and tear
  • Arthritis
  • Other joint diseases can damage facet joints.

Swelling, new bone growth, and bone spurs can occur as the joint tries to repair the damaged cartilage. The swelling and new bone growth can narrow the spinal canal and compress surrounding nerves, causing pain and other sensation symptoms. This ailment does not have a cure and worsens over time. The objective of treatment is to manage the pain symptoms and slow down the disease’s progress.

Types

Facet hypertrophy can be described as unilateral or bilateral.

  • Unilateral – the pain is felt on one side.
  • Bilateral – the pain is felt on both sides

On the following areas: (Romain Perolat et al., 2018)

  • Buttocks
  • Sides of the groin
  • Thighs

Symptoms

Symptoms can have a wide range of intensity, from a dull ache to chronic, disabling pain. The location of symptoms depends on the affected joint and the nerves involved, Pain manifests when the enlarged joints and new bone growth compresses the nearby nerves. The result leads to nerve damage and the following symptoms: (Weill Cornell Medicine Brain & Spine Center. 2023) (Cedars Sinai. 2022)

  • Stiffness, especially when standing up or getting out of a chair.
  • Inability to stand straight when walking.
  • Inability to look up to the left or right without turning the whole body.
  • Reduced range of motion and mobility.
  • Numbness or a tingling sensation of pins and needles.
  • Muscle spasms
  • Muscle weakness
  • Burning pain

The following symptoms are specific to the location of the affected joint (Weill Cornell Medicine Brain & Spine Center. 2023) (Cedars Sinai. 2022)

  • Radiating pain from the affected joint into the buttocks, hips, and upper thigh when the affected joint/s are in the lower back.
  • Radiating pain from the affected joint into the shoulder, neck, and back of the head when the affected joint/s are in the upper back.
  • Headaches when the affected joint is in the neck.

Causes

A common cause is the age-related degeneration of the joints, called spondylosis. Research indicates that more than 80% of individuals who are 40 or older have radiologic evidence of spondylosis, even though they may not have symptoms. (The University of Toledo Medical Center. N.D.) The following conditions can also increase the risk of facet hypertrophy (Weill Cornell Medicine Brain & Spine Center. 2023)

  • Unhealthy posture
  • Being overweight or obese
  • Sedentary lifestyle
  • Injury or trauma to the spine
  • Inflammatory conditions like rheumatoid arthritis or ankylosing spondylitis
  • Osteoarthritis
  • Genetic predisposition to the condition

Diagnosis

Diagnosis can be challenging when neck or back pain is the main complaint, as symptoms can mimic conditions such as sciatica from a herniated disc or hip arthritis. (Weill Cornell Medicine Brain & Spine Center. 2023)

  1. CT scans with or without myelogram – the use of contrast dye in the space around the spinal cord.
  2. MRI
  3. X-rays with or without a myelogram

A diagnosis is confirmed by injecting a diagnostic block that involves administering an anesthetic injection, sometimes with an anti-inflammatory like cortisone, into the joint or nerves near the affected joint. Two injections are given at different times to confirm the effect. (Romain Perolat et al., 2018)

  • If immediate relief improves after each injection, the facet joint is confirmed as the source of the pain symptoms.
  • If the block does not decrease the pain, the facet joint is probably not the source of the pain symptoms. (Brigham and Women’s Hospital. 2023)

Treatment

There is no cure for facet hypertrophy.
The goal of treatment is to make the pain more manageable.
Conservative treatment is usually successful in making a difference.

Conservative Treatment

First-line treatment involves utilizing conservative therapies (Romain Perolat et al., 2018)

  • Massage therapy
  • Physical therapy to strengthen the core muscles and spine.
  • Targeted exercises to help maintain flexibility.
  • Chiropractic adjustments to realign the spine.
  • Healthy posture retraining.
  • Non-surgical mechanical decompression.
  • Bracing to stabilize the spine
  • Acupuncture
  • Nonsteroidal anti-inflammatory – aspirin, ibuprofen, and naproxen.
  • Muscle relaxers – cyclobenzaprine or metaxalone.
  • Steroid injection into the facet joints.
  • Injection of platelet-rich plasma/PRP into the joints.

Medial Branch or Facet Block

  • A medial branch block injects local anesthetic near the medial nerves that connect to an inflamed joint.
  • Medial nerves are small nerves outside the joint space near the nerve that transmit signals and other impulses to the brain.
  • A facet block injects the medication outside the joint space near the nerve that supplies the joint called the medial branch.

Neurolysis

Neurolysis, also known as rhizotomy or neurotomy, is a procedure that destroys affected nerve fibers to relieve pain, reduce disability, and reduce the need for analgesics. This treatment can relieve pain for six to 12 months until the nerve regenerates, where further treatments may be necessary. (Matthew Smuck et al., 2012) Neurolysis can be performed using one of the following techniques (Romain Perolat et al., 2018)

  • Radiofrequency ablation RFA – the application of heat through radiofrequency.
  • Cryoneurolysis – the application of cold temperatures to the targeted nerve.
  • Chemical neurolysis – applying chemical agents, like a combination of phenol and alcohol.
  • Severing the nerves with surgical instrumentation.

Surgery

When one or more facet joints are severely damaged, they can become nonfunctional and painful. Surgery may be recommended when symptoms are not relieved by other therapies. (Ali Fahir Ozer, et al., 2015)

Prognosis

Facet hypertrophy is a chronic condition that progresses with age and does not affect life expectancy. (Weill Cornell Medicine Brain & Spine Center. 2023) The disorder is incurable, but symptoms can be managed with conservative therapies

  • A healthcare provider can help develop a treatment plan based on the extent and location of the joint affected.
  • Early diagnosis and treatment can help individuals achieve the best results.

Maintaining an active lifestyle and healthy weight can help prevent further joint stress. Individuals may be recommended to do regular stretching and strengthening exercises to lower inflammation, reduce stress, and improve overall health.


Facet Syndrome Treatment


References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x

Weill Cornell Medicine Brain & Spine Center. (2023). Symptoms of facet syndrome.

Cedars Sinai. (2022). Facet joint syndrome.

The University of Toledo Medical Center. (N.D.). Spondylosis.

Weill Cornell Medicine Brain & Spine Center. (2023). Facet syndrome.

Weill Cornell Medicine Brain & Spine Center. (2023). Diagnosing and treating facet syndrome.

Brigham and Women’s Hospital. (2023). Facet and medial branch blocks.

Smuck, M., Crisostomo, R. A., Trivedi, K., & Agrawal, D. (2012). Success of initial and repeated medial branch neurotomy for zygapophysial joint pain: a systematic review. PM & R : the journal of injury, function, and rehabilitation, 4(9), 686–692. https://doi.org/10.1016/j.pmrj.2012.06.007

Ozer, A. F., Suzer, T., Sasani, M., Oktenoglu, T., Cezayirli, P., Marandi, H. J., & Erbulut, D. U. (2015). Simple facet joint repair with dynamic pedicular system: Technical note and case series. Journal of craniovertebral junction & spine, 6(2), 65–68. https://doi.org/10.4103/0974-8237.156049

Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

For individuals experiencing pelvis pain symptoms and associated problems, can integrating pelvic floor physical therapy exercises help with treatment and prevention?

Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

Pelvic Floor Physical Therapy

When the muscles fail to function correctly, individuals can experience symptoms like:

  1. Painful intercourse
  2. Prolapse – when an organ or tissue drops or shifts out of place.
  3. Urinary incontinence
  4. Constipation problems
  5. These conditions are common in pregnant individuals or older women.

These symptoms can be treated with pelvic floor physical therapy to alleviate discomfort. Pelvic floor physical therapy can help women and individuals with vaginas:

  • Alleviate issues like painful sex, urinary leakage, and prolapse.
  • In physical therapy, individuals work on breathing, relaxation, and lengthening and strengthening techniques to train their muscles to function optimally.

Causes of Pelvic Floor Issues

Pelvic floor dysfunction tends to happen with age, during pregnancy, or in combination with events like the postpartum period and menopause, which can lower hormone levels.

  • Individuals who are pregnant are especially prone to pelvic floor issues but might not know they have a problem.
  • The pregnancy weight of a uterus can pressure and strain the muscles.
  • Vaginal childbirth can also stretch or weaken the muscles. (Ilaria Soave, et al., 2019)

Symptoms

Symptoms can include: (Columbia Surgery. 2022)

  • Pain in the pelvis region
  • Back pain
  • Painful urination
  • Constipation
  • Urinary leakage or incontinence
  • Stool leakage or incontinence
  • Painful intercourse
  • If left untreated, these symptoms can worsen over time.

Pelvic Floor Physical Therapy

An individual will meet with a specialist to discuss symptoms and undergo a physical examination that includes:

  1. Pelvic floor exam.
  2. Evaluation of posture, mobility, and core strength.
  3. Once the initial exams and evaluation are complete, the practitioner will go over pelvic floor exercises and provide a treatment plan.
  4. Recommended exercises vary based on symptoms but focus on relaxing, stretching, and/or strengthening muscles.

Muscle Relaxation

  • To relax the muscles, a therapist may recommend breathing exercises.
  • For pregnant individuals, this means timing breaths with contractions.
  • For individuals experiencing constipation, breathing exercises can help the body relax and reduce strain.

Stretching Muscles

  • Stretching can help relieve muscle tightness and stiffness.
  • A therapist may help stretch the pelvic floor through various therapy modalities.
  • This type of physical therapy can help loosen tight muscles or help gently reset dislocated organs back into place.

Strengthening Muscles

  • After the pelvic floor is loose and relaxed, the focus typically switches to strengthening the muscles.
  • Strength work may target abdominal muscles or the pelvic floor muscles themselves.

With time, commitment, and targeted treatment, individuals can use pelvic floor physical therapy to loosen tissues, strengthen muscles, and restore function.


Spinal Decompression In Depth


References

U.S. Food and Drug Administration. (2019). Pelvic organ prolapse (pop).

Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and clinical urology, 62(1), 79–84. https://doi.org/10.4111/icu.20190248

Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493–vii. https://doi.org/10.1016/j.gtc.2008.06.003

Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives of gynecology and obstetrics, 299(3), 609–623. https://doi.org/10.1007/s00404-018-5036-6

Columbia Surgery. (2022). Pelvic floor disorders: frequently asked questions.

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing spondylitis is an inflammatory arthritis that causes changes in posture that occur over time. Can exercise and maintaining spinal alignment help improve posture problems?

Ankylosing Spondylitis: Improve Your Posture With These Tips

Ankylosing Spondylitis Posture Improvement

Ankylosing spondylitis/AS is an autoimmune arthritis that primarily affects the spine. It can also spread to other joints of the body and affect the internal organs. Back pain problems are a common side effect of the condition and depending on the severity of damage to the spine, it can have a serious impact on posture.

Affects Posture

The condition usually first affects the sacroiliac joints at the bottom of the spine where they attach to the pelvis. As the condition progresses it works its way to the upper spine. The spine consists of 26 vertebrae/bones stacked on top of each other.

  • Ankylosing spondylitis can cause the bones to fuse together. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
  • The condition causes kyphotic deformity – rounding of the upper back, and the lower back flattening.
  • As the disease progresses, the spine becomes immobilized in a stooped-over position and causes significant difficulty with daily tasks.
  • A stooped posture can place pressure on the internal organs and lead to breathing difficulties.
  • The condition leads to balance problems which increase the risk of falls. (Alessandro Marco De Nunzio, et al., 2015)

Posture Improvement Tips

Standing and Walking

When standing or walking try to remember to:

  • Maintain a straight spine.
  • Line up the ears, shoulders, hips, knees, and ankles in a straight line.
  • Squeeze the shoulder blades together and down toward the back pockets.
  • Relax the arms at the sides.
  • Look straight ahead.
  • Tuck the chin back slightly.

Sitting

The natural curves of the spine need support for proper posture when sitting. Try these tips when at a desk or at a table:

  • Position the height of the chair so the hips and knees are bent at 90-degree angles.
  • Place the feet flat on the floor or use a footstool based on chair height.
  • Place a lumbar support pillow or rolled-up towel behind the lower back.
  • Position the screen monitor at eye level to keep the upper back straight.
  • Keep the keyboard and mouse close to the body to prevent overreaching which can increase the rounding of the shoulders and upper back.

Lying Down

Ankylosing spondylitis can make lying down uncomfortable. To support the spine while lying down try to:

  • Sleep on a semi-firm mattress or type like memory foam to conform to the body.
  • Place a pillow between the knees to maintain a straight spine when lying on the side.
  • Use a specialized pillow to prevent placing the upper back in a rounded position.

Posture Exercises

For individuals with ankylosing spondylitis stretching and strengthening exercises can help improve body posture. Individuals are recommended to talk to their healthcare provider before beginning an exercise program.

Chin Tucks

  • Sit up straight.
  • Squeeze the shoulder blades together.
  • Rest the arms at your sides.
  • Look straight ahead, pull the chin back and in until the stretch is felt along the muscles of the neck.
  • Hold for three to five seconds and relax.
  • Repeat 10 times.

Corner Stretch

  • Stand facing a corner.
  • Raise the arms to shoulder height.
  • Place one forearm flat against each wall.
  • Stagger the feet.
  • Slowly shift weight over the front leg and lean in toward the corner.
  • Stop once the stretch is felt across the chest.
  • Hold for 10 to 20 seconds and relax.
  • Repeat three times.

Scapular Squeezes

  • Sit up straight with arms resting at the sides.
  • Squeeze the shoulder blades together like they are holding an object between them.
  • Hold for three seconds and relax.
  • Repeat 10 times.

Maintaining spinal alignment will help decrease back pain that occurs with AS.

  • Targeted exercises can help stretch tight muscles and strengthen the muscles responsible for maintaining spinal alignment.
  • Maintaining healthy posture when sitting, standing, and sleeping can help prevent deformities in the spine.
  • Regular physical activity can help combat stiffness and help maintain overall strength.

For an individualized exercise program, see a physical therapist or chiropractor on incorporating posture exercises to help prevent complications from developing.


Arthritis


References

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

De Nunzio, A. M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V., Peluso, R., Di Minno, M. N., & Pappone, N. (2015). Ankylosing spondylitis and posture control: the role of visual input. BioMed research international, 2015, 948674. https://doi.org/10.1155/2015/948674

How Non-Surgical Spinal Decompression Can Help with Pain Management

How Non-Surgical Spinal Decompression Can Help with Pain Management

Can healthcare professionals help individuals with spinal pain by incorporating non-surgical spinal decompression to restore mobility?

Introduction

Many individuals don’t realize that putting unwanted pressure on their spines can lead to chronic pain within their spinal discs that is affecting their spinal mobility. This usually happens with demanding jobs requiring individuals to carry heavy objects, step wrong, or be physically inactive, which causes the surrounding back muscles to be overstretched and leads to referred pain that affects the upper and lower body portions. This can cause individuals to go to their primary doctors to get treated for back pain. This leads to them missing out on their busy work schedules and paying a high price to get treated. Back pain correlating with spinal issues can be a huge problem and make them feel miserable. Fortunately, numerous clinical options are cost-effective and personalized to many individuals dealing with spinal pain that is causing them to find the relief they deserve. Today’s article focuses on why spinal pain affects many people and how spinal decompression can help reduce spinal pain and restore spinal mobility. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce spinal pain affecting their backs. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with spinal issues in the body. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

 

Why Spinal Pain Is Affecting Many People?

Have you often experienced pain from your back muscles that seem to ache after bending down constantly to pick up objects? Do you or your loved ones feel muscle stiffness in the back and experience numbness in your upper or lower body portions? Or are you experiencing temporary relief after stretching your back muscles, only for the pain to return? Many individuals with back pain never realize that their pain is within their spinal column. Since the spine is an S-curve shape with three different regions in the body, the spinal discs within each spinal segment can become compressed and become misaligned over time. This causes degenerative changes within the spine and can cause the three different spinal regions to develop pain-like issues in the body. When several environmental factors start to be the causes of degeneration of the spinal discs, it can affect the spinal structure. It can become a strong influence affecting their function, predisposing the disc to injuries. (Choi, 2009) At the same time, this can cause a significant impact when getting treated due to its high cost and can start normal age-related changes that cause pathophysiological issues to the vertebral body. (Gallucci et al., 2005)


When many individuals are dealing with spinal pain associated with herniated discs, it can not only cause discomfort but also mimic other musculoskeletal disorders that can cause radiating pain to different locations in the body. (Deyo et al., 1990) This, in turn, causes individuals to suffer constantly and research various treatments to reduce the pain they are experiencing. When spinal pain affects most individuals, many will seek cost-effective therapies to ease the pain they are experiencing and to be mindful of the daily habits they adopt over time and correct them.


Spinal Decompression In-Depth- Video

Do you often feel constant muscle aches and pains in your body that are your general areas of complaint? Do you feel your muscles pull uncomfortably after lifting or carrying a heavy object? Or do you feel constant stress in your neck, shoulders, or back? When many individuals are dealing with general pain, they often assume that it is just back pain when it could be a spinal issue that can be the root cause of the pain they are experiencing. When this happens, many individuals opt for non-surgical treatments due to its cost-effectiveness and how it can be personalized depending on the severity of the pain. One of the non-surgical treatments is spinal decompression/traction therapy. The video above gives an in-depth look at how spinal decompression can help reduce spinal pain associated with low back pain. Spinal pain can increase with age and be provoked by extreme lumbar extension, so incorporating spinal decompression can help reduce pain in the upper and lower extremities. (Katz et al., 2022)


How Spinal Decompression Can Reduce Spinal Pain


When individuals develop spinal issues, spinal decompression can help restore the spine to its original position and help the body naturally heal itself. When something is out of place within the spine, it is important to naturally restore it to its proper place to allow the affected muscles to heal. (Cyriax, 1950) Spinal decompression uses gentle traction to pull the spinal joints to let the spinal disc back in its original position and help increase fluid intake back in the spine. When people start incorporating spinal decompression into their health and wellness routine, they can reduce their spinal pain after a few consecutive treatments.

 

Spinal Decompression Restoring Spinal Mobility

Spinal decompression can also be incorporated with other non-surgical treatments to restore spinal mobility. When pain specialists utilize spinal decompression within their practices, they can help treat various musculoskeletal conditions, including spinal disorders, to allow the individual to regain spinal mobility. (Pettman, 2007) At the same time, pain specialists can use mechanical and manual manipulation to reduce the pain the individual feels. When spinal decompression starts to use gentle traction on the spine, it can help minimize radical pain correlated with nerve entrapment, create negative pressure within the spinal sections, and relieve musculoskeletal disorders causing pain. (Daniel, 2007) When people start thinking more about their health and wellness to reduce their pain, spinal decompression can be the answer through a personalized plan and can help many individuals find the relief they deserve.

 


References

Choi, Y. S. (2009). Pathophysiology of degenerative disc disease. Asian Spine Journal, 3(1), 39-44. https://doi.org/10.4184/asj.2009.3.1.39

 

Cyriax, J. (1950). The treatment of lumbar disk lesions. Br Med J, 2(4694), 1434-1438. https://doi.org/10.1136/bmj.2.4694.1434

 

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropr Osteopat, 15, 7. https://doi.org/10.1186/1746-1340-15-7

 

Deyo, R. A., Loeser, J. D., & Bigos, S. J. (1990). Herniated lumbar intervertebral disk. Ann Intern Med, 112(8), 598-603. https://doi.org/10.7326/0003-4819-112-8-598

 

Gallucci, M., Puglielli, E., Splendiani, A., Pistoia, F., & Spacca, G. (2005). Degenerative disorders of the spine. Eur Radiol, 15(3), 591-598. https://doi.org/10.1007/s00330-004-2618-4

 

Katz, J. N., Zimmerman, Z. E., Mass, H., & Makhni, M. C. (2022). Diagnosis and Management of Lumbar Spinal Stenosis: A Review. JAMA, 327(17), 1688-1699. https://doi.org/10.1001/jama.2022.5921

 

Pettman, E. (2007). A history of manipulative therapy. J Man Manip Ther, 15(3), 165-174. https://doi.org/10.1179/106698107790819873

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