Health Update: Low Back Pain

 

 Low Back Pain: Where Is My Pain Coming From?

        Low back pain can emanate from many anatomical locations (as well as a combination of locations), which always makes it interesting when a patient asks, "...doc, where in my back is my pain coming from?"  In context of an office visit, we take an accurate history and perform our physical exam to try to reproduce symptoms to give us clues as to what tissue(s) may be the primary pain generators. In spite of our strong intent to be accurate, did you know, regardless of the doctor type, there is only about a 45% accuracy rate when making a low back pain diagnosis?  This is partially because there are many tissues that can be damaged or injured that are innervated by the same nerve fibers and hence, clinically they look very similar to each other. In order to improve this rather sad statistic, in 1995 the Quebec Task Force published research reporting that accuracy could be improved to over 90% if we utilize a classification approach where low back conditions are divided into 1 of 3 broad categories:

1. Red flags - These include dangerous conditions such as cancer, infection, fracture, cauda equina syndrome (which is a severe neurological condition where bowel and bladder function is impaired). These conditions generally require emergency care due to the life threatening and/or surgical potential.
2. Mechanical back pain - These diagnoses include facet syndromes, ligament and joint capsule sprains, muscle strains, degenerative joint disease (also called osteoarthritis), and spondylolisthesis.
3. Nerve Root compression - These conditions include pinching of the nerve roots, most frequently from herniated disks. This category can include spinal stenosis (SS) or, combinations of both, but if severe enough where the spinal cord is compromised (more commonly in the neck), SS might then be placed in the 1st of the 3 categories described above.

        The most common category is mechanical back pain of which "facet syndrome" is the most common condition. This is the classic patient who over did it ("The Weekend Warrior") and can hardly get out of bed the next day. These conditions can include tearing or stretching of the capsule surrounding the facet joint due to performing too many bending, lifting, or twisting related activities. The back pain is usually localized to the area of injury but can radiate down into the buttocks or back of the thigh and can be mild to very severe.

        We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Tip of the Month

        By the time you read this, if you have children, they are already back in school. If they are, then you know what it's like to try to pack a healthy and safe lunch every day. Not too long ago officials from the Oklahoma State Department of Health offered some great tips to help parents out:

    Keep everything clean when packing the lunch. Use hot, soapy water to clean hands, clean preparation surfaces, and clean utensils. Wash your hands before you prepare or eat food. Wash insulated lunch bags with warm soapy water after each use.

    Use an insulated lunch box to help keep foods cold. Insulated, soft-sided lunch totes are best for keeping perishable foods chilled. You can also use a thermos to keep milk or juice cold until lunchtime. Perishable foods should not be out of refrigeration for more than two hours.

    Use freezer gel packs that are widely available in stores. If you cannot get freezer gel packs, freeze a juice box or plastic water bottle overnight and put that into the lunch box next to the sandwich.

    Keep your lunch in the coolest place possible! If there is a refrigerator at school, put your lunch in there. If not, keep it out of the sun and away from the heat.

    Pack shelf-stable foods, especially if you have a brown paper bag lunch. These food items include fresh fruits and vegetables, crackers, peanut butter sandwiches, canned meats, shelf-stable cheeses, packaged pudding, and canned fruits and juices.

    Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Blot dry with a paper towel before packing them in your child's lunch.

    Use a thermos to keep soup, chili and stew hot. Use an insulated bottle stored in an insulated lunch box. Fill the bottle with boiling water, let stand for a few minutes, empty, and then put in the piping hot food. Keep the insulated bottle closed until lunch to keep the food hot.

    Make sure kids wash their hands before eating lunch. Encourage at least 20 seconds - about the time it takes to sing two choruses of the "Happy Birthday" song - of hand washing in warm soapy water.

    Discard perishable leftovers after lunch.  Discard all used food packaging since bacteria can grow on plastic bags, aluminum foil, and paper. If you're packing your child's lunch with reusable bags, be sure to wash them daily with soap and hot water.

Remember, we're always here to help your body heal

and maintain the health you deserve.

Did You Know?

        Nuts and seeds just might boost your brainpower and balance your moods. Everything from the most common nuts -- such as walnuts, hazelnuts, cashews and almonds -- to the more exotic seeds and nuts can clear up that "brain fog" and enable you to think clearer and be happier than you ever imagined. 

        Walnuts are "brain food."  Walnuts are made up of 15 to 20 percent protein and contain linoleic (omega-6 fatty acids) and alpha-linoleic acids (omega-3 fatty acids), vitamin E and vitamin B6, making them an excellent source of nourishment for your nervous system.  A healthy nervous system means both clearer and happier thinking.  Under-consumption of omega-3-rich foods may actually lead to depression. The same walnuts that you can find in the baking aisle of just about any grocery store may also boost your mood. 

        Walnuts aren't the only nut with mood-boosting omega-3s, either. Flax seeds are an excellent source for omega-3s, making them a viable source for those who don't like to eat fish, the most common source of omega-3s. 

        Cashews are high in magnesium, which can "open up" the blood vessels in your body, including those in your brain. When more oxygen-rich blood nourishes your brain, like any organ, it operates better. By providing your body with phenylalanine, adding almonds to your diet can do wonders for your mental and neurological health. Additionally, almonds are high in riboflavin, which may boost your memory. Peanuts and pecans provide another important nutrient for optimal brain function, choline.  Choline aids in both memory and brain development.  Seeds and nuts are essential to a healthy, well-functioning brain.

Survey Says Chiropractic Outperforms Other Back Pain Treatments - Even Medication

        SURVEY SAYS!!!!  If you have back pain... you are probably old enough to remember Richard Dawson first yelling that phrase on the popular 70s and 80s game show, The Family Feud. If not - it doesn't matter - you just learned something interesting about American pop culture and game show history.

So, What Does The Survey Really Say?

        According to an August 9, 2011 article on chiroeco.com, "In a new survey, chiropractic outperformed all other back pain treatments including prescription and over-the-counter medications, deep-tissue massage, yoga, and Pilates. According to the American Chiropractic Association (ACA), this news reinforces the use of conservative care options as a first line of defense against pain.

        The survey, released by a leading consumer product rating and survey publisher in late July, found that 65 percent of those surveyed using chiropractic care for back pain said it helped a lot. Only 53 percent of respondents using prescription medications found them as helpful.

        "Additionally, about half of those surveyed who are using deep-tissue massage, yoga or Pilates said those treatments helped a lot and only 28 percent of respondents using over-the-counter medications reported that they helped a lot.

        "Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain."

        One serious eye-opener was that only 28% of respondents said over-the-counter medications helped a lot.

        It has been known for quite some time that common over-the-counter non-steroidal anti-inflammatory medications (NSAID) have serious side effects.  One of these side effects is that an estimated 16,500 people die every year.

        Natural, conservative options like Chiropractic, deep tissue massage, yoga, and Pilates are most likely better and safer choices when it comes to relieving back pain.

What About Neck Pain And Headaches?

       Neck pain is very common and it can make your life miserable. If you suffer from headaches... there is a very good chance you suffer from a common type of headache called "cervicogenic headache."  This type of headache is caused by a problem in your neck.

        One way to tell you might suffer from cervicogenic headaches is to identify if any neck motions cause the headaches or increase their severity.

        Also, take a good look at yourself in the mirror.  Does your head tilt to one side?  Is your head posture bad?  In other words, does your head stick out in front of you instead of sitting back over your torso?  You'll probably need a trained eye (like your Chiropractor's) to see that one.

Did Dr. Oz Really Say This Tiny Tibetan Fruit Is The "New Miracle Berry?"

DON'T BE FOOLED! Separate fact from miracle
claim fiction and discover why one fitness author says
Dr. Oz and Oprah have sued over 50 companies... 

        Miracle this!  Amazing that!  How many times have you heard about a "magical" plant that will instantly melt 50 pounds off your waistline - or cure you from any disease known to humankind?

        There is always "proof" that this magical plant works because some culture or tribe or group of people living in some far off mystical land has been using it for centuries and they are all skinny, healthy and live to be 165 years old!

        If this stuff is so good, why hasn't everyone already heard about it? Because... it's been hidden in that far off, mystical land!

        Ah... the magic of advertising.  You have to love how the magical cures are never found in someone's backyard in Ohio. It's always halfway across the world, usually in a rainforest.

        Well, now there is a tiny Tibetan fruit that is claimed to help people lose weight without any other kind of diet of exercise.

        The fruit is the sea buckthorn berry and advertisers are going crazy because it was mentioned on the Dr. Oz show.

        Here's what einnews.com had to say about the issue, "Sea buckthorn oil is a helpful antioxidant, but fitness author Rusty Moore warns us to be skeptical of some of the claims websites are making. Buzz was generated online after Dr Oz featured this 'super food' on his TV show. Dr Oz claims that sea buckthorn oil is a healthy supplement that aids in digestion and has antioxidant properties similar to Vitamin C.

        "Online marketers have been using the endorsement of Dr. Oz to distribute sea buckthorn oil. In the past 3 years, Dr. Oz and Oprah Winfrey have sued over 50 companies who were using their endorsement without permission. Unfortunately, several companies were making exaggerated weight loss claims when it came to supplements Dr. Oz simply mentioned on his program."

        The same thing happened several years ago when Dr. Oz mentioned the Acai Berry was a good antioxidant and a useful supplement.

        That mention was taken by advertisers and used as a personal endorsement for all kinds of wild claims.

        What's the bottom line with all this?

        Obviously, some foods are better than others.  Some are more nutrient dense with building blocks your body can use, while others are not. You want to eat as many positive nutrient dense foods as possible. Obviously, comparing Sea Buckthorn to a Chicken Nugget - the Sea Buckthorn is a relative miracle food. But, so is an apple given the same comparison.

        The reality check is this:  You must eat good food, exercise and reduce stress CONSISTENTLY TO ACHIEVE AND MAINTAIN REAL HEALTH.

        This includes losing weight and keeping it off.  There are right ways to do things that work better than others, but there are no shortcuts.There is no magical plant from a mythical far away land that will turn you into Superman or Superwoman.

        Both Acai and Sea Buckthorn are most likely good for you and can help your body get the nutrients it needs to function properly, but don't expect a miracle.  Miracles happen from doing the right thing long enough.

Tip of the Month

        It's extremely painful.  We're not talking about a root canal gone bad.  Not even close.  It's another visit to the gas pump... When it costs over $60 to fill up a Honda Accord - you know things are bad.  The price of gasoline is draining bank accounts and many experts say there is no relief in sight. Some say the answer is to get a new, fuel efficient car.  That sounds all fine and dandy, but you have to do a little math to see if it works. For example, one of the new high mileage economy cars will cost you $20,000 -  $25,000. How long is it going to take you to make your money back with your Miles Per Gallon (MPG) savings?  Probably years.

        So, here are some money saving tips from Popular Mechanics: (1) Coast to a stop - Popular mechanics tested and found the less you use your brakes, the better your fuel economy.  They said anticipating a red light and coasting vs. hitting the accelerator and then using your brakes at the last second made a huge difference. (2) Do not accelerate too slowly!  This goes against what most of us believe.  Cars get poor gas mileage in low gears and tests showed taking 15 seconds to get to 50 mph got better gas MPG than taking 30 seconds to reach the same speed. (3) Use your air conditioning!!!  Another urban myth gets destroyed.  When you drive on the highway,  roll up your windows and use the AC. The wind resistance caused by the open windows causes MPG to decrease and the faster you go, the worse it gets.
 

        There are 3 more tips waiting for you at: http://autos.yahoo.com/news/6-driving-tactics-to-save-gas-this-summer.html?page=all 

What To Do If Your Cell Phone Gets Wet...

        Do not turn it on.  Pull out the battery and SIM card.  If you dropped it in salt water, rinse it in fresh water.  Dry your phone using compressed air - the kind used to clean computer keyboards.  Cover your phone with uncooked rice for at least 24 hours (this draws out the moisture).  Turn your phone back on.  You might want to say a little prayer first :)

Remember, we're always here to help your body heal
and maintain the health you deserve.

 

Did You Know?

        One of the pitfalls of pursuing a healthy diet is that we can eat well and easily miss an important nutrient. In the world of healthy eating, one of the most common nutrient deficiencies is Vitamin B-12, a crucial nutrient for nerve health and the construction of red blood cells that carry oxygen throughout your body.  Vitamin B-12 deficiency is especially common among vegetarians and vegans, but it's also common in meat eaters, too. Why? Because Vitamin B-12 can only be absorbed in the small intestine, and due to common intestinal ailments, even many meat eaters who consume high levels of B-12 are unable to absorb it in their gut.

        This leads to a series of "mystery" health symptoms that actually have a simple common cause: Vitamin B-12 deficiency!

        Here are some of the most common symptoms of deficiency: *Chest pain or shortness of breath * Fatigue or unexplained weakness * Dizziness, trouble with balance, and fainting * Confusion, memory loss or dementia * Coldness, numbness or tingling in the hands and feet * Slow reflexes or diminished nervous system function * Pale skin or yellowing of the skin * Sore mouth and tongue.

        The proper form of Vitamin B-12 to supplement your diet is methylcobalamin. This is a form that exists in nature, and it is pre-methylated, meaning it's ready for your biochemistry to put to immediate use.