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MAX  HEALTH 

 Eight out of 10 people will

experience back pain in their

lives. Here is some important

information on why it happens

and what you can do about it! 

BY LINDA HEPLER, BSN, RN

ONE MINUTE you’re perfectly fine, and the

next minute, you’re lying on the floor, writhing

with back pain. None of us are immune to an

aching back. In fact, according to the National

Institutes of Health, this condition affects 8 out of

10 people at some point during their lives. It can

be either acute, developing suddenly and dissipating

after a few weeks, or chronic, meaning that it has lasted

for longer than three months.

  Most lower back pain is caused by mechanical

injury resulting from injured muscles or tendons due

to a strain or sprain, said Kaixuan Liu, MD, PhD, an

endoscopic spinal surgeon practicing in the New York

area. But for those older than 50, the normal aging

process can lead to degenerative changes that affectthe spine. “As we get older, our muscles become

Oh My Aching Back!

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HOW FUNCTIONALMOVEMENTSCREENING CANHELP WITH BACK PAINChris Tomshack, DC, founderand CEO of Health SourceChiropractic and Progressive

Rehabilitation, doesn’t use anold school technique – spinalmanipulation alone – to treathis patients with back painthese days. Instead, he said, “Iuse a progressive rehabilitationprogram that starts with functionalmovement screening.”  Functional movementscreening, or FMS, said Dr.Tomshack, is a diagnostic toolto identify muscle asymmetries,tightness and weakness that may

lead to (or already has led to)injury by examining the mobilityand stability of the hips, core,shoulders, knees, spine andankles. The FMS, administeredby a trained health professional,such as a chiropractor orphysical therapist, seeks outpoor movement patterns duringseven different exercises, suchas deep squats and in-linelunges. “It’s an objective way

to evaluate problems, and alsowhen repeated after treatment,provides a measure of progress,”said Dr.Tomshack.  After the FMS test, a treatmentplan is developed, he added,which involves functionalstretching and exercises toretrain faulty movement patterns,in addition to deep tissuemassage and chiropracticmanipulation. “When you

combine these treatments, theywork synergistically to reducepain and prevent re-injury,” saidDr. Tomshack.  The final step in backrehabilitation is to help peoplewith lifestyle changes, such asbetter nutrition and exercises todo at home to maintain spinalhealth, he added.  To find a certified FMSprovider in your area, check outFunctionalMovement.com.

weaker and can’t hold the bones tight

and in alignment,” he explained. The

resulting spinal instability may cause

abnormal curvatures of the spine.

Wear and tear of the structures that

support the spine can also cause a

gradual narrowing of the disc spaces

between the vertebrae as well as

narrowing of the space within the

spine that the nerves travel through,a condition known as spinal stenosis.

 And older persons are more prone to

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caused by arthritis and osteoporosis,

added Dr. Liu. All of these conditions

can cause lower back pain.

  While we can’t stop ourselves from

getting older – or our spine from

aging right along with us – we can

alter lifestyle habits that trigger the

pain or make it worse, according to

Dr. Liu. “Many every day activities we

do without thinking can make a hugedifference to our lower spine health,”

he said.

Back Pain TriggersHere are some common factors that

contribute to lower back pain:

LACK OF EXERCISE, especially

those that strengthen your core.

Developing strong core muscles in the

hips, back, abdomen and pelvis help to

support the spine, keep it straight and

prevent strains and sprains. Exercises

such as lunges, planks and squats andregimens such as yoga and Pilates help

to strengthen core muscle groups.

EXERCISING TOO MUCH.

While most people know that too

little exercise is detrimental to spine

health, many people don’t realize that

too many repetitions while exercising,

especially while lifting weights or

doing squats, can cause back pain.

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said Dr. Liu, “but be aware when your

body is crying out for a break.” 

BEING OVERWEIGHT. The lumbar

and sacral areas of the spine that are in

the lower back bear the largest share

of the body’s load, and even as few

as 10 extra pounds of weight in your

abdominal area can add to that load,

pulling the spine out of alignment.

SITTING TOO MUCH. Sitting is

worse on your spine than standing

or walking, said Dr. Liu, as it

places pressure on spinal discs and

vertebrae. And if you’re sitting in an

uncomfortable, unsupportive chair, itcan force the spine out of alignment.

How Long ShouldI Be on Bed RestFor Back Pain?When your back hurts, it’s

normal to want to lie down.But according to the National

Institutes of Health, too muchrest can make back pain worse.

Instead of taking to your bedfor days, it’s recommended that you limit your rest to a day ortwo to help calm the symptomsand reduce inflammation. Afterthat, moving around by gentle

stretching and walking canhelp you get better. As

for your workout – wait fortwo or three weeks to resume

vigorous activities.

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SHOULD YOU HAVE SURGERY?You’ve done everything your doc recommended: the tests, physical therapy, exercisesand pain medications – and still, after six months, you’re experiencing back pain. Should you consider back surgery?  Not necessarily, according to David Hanscom, MD, a Seattle-based orthopedic spinesurgeon. “Spine surgery should only be considered for specific structural problems, andmost back pain is not related to a structural problem,” he saidInstead, explained Dr. Hanscom, author of “Back in Control, A spine surgeon’s roadmapout of chronic pain,” the pain is often either a result of injured soft tissue (muscles orligaments) supporting the spine, or, in the case of many chronic back pain sufferers, a

permanent neurological problem – Mind Body Syndrome – that has evolved from thepain itself.  To explain how pain can actually cause more pain, Dr. Hanscom likens it to learningto ride a bike or learning a new athletic skill. “When the brain is hammered with thesame pain impulses day after day, week after week, it becomes more and more efficientin processing them,” he said.  In other words, continuous pain impulses from your back eventually causes paincircuits to become imbedded in the nervous system, to the point that even if the pain itselfhas abated over time, you experience it as the same – or even greater – because yournervous system has memorized the pain circuit. An example of this, said Dr. Hanscom, is“phantom limb” pain, a condition in which a person whose limb that has been amputatedcontinues to feel the pain even after the damaged or diseased limb that was causingdiscomfort has been removed. It’s a reminder, he explained, that the brain is an extremely

complex and sophisticated computer which is programmable.  And it’s not only the pain that your brain programs, said Dr. Hanscom. It also programsnegative thoughts related to pain, which intensifies pain. Finally the situation is madeworse by the side effects of pain and negative thoughts: anxiety, sleep issues and anger.

The answer, according to Dr. Hanscom, is a “defined organized comprehensivecare” program that revolves around education about the problem, management of sleepand stress, short-term medications, physical conditioning and actively working on ahealthier life outlook. Through tackling all of these things at once, you can calm down aturbocharged nervous system, “reprogram” your brain – and make a full recovery.Hanscom’s program is a result of both having experienced debilitating back pain himself,along with years of working with patients having pain. “It continues to evolve over time,”said Dr. Hanscom, who has presented numerous seminars and workshops on the definedorganized comprehensive care program. To learn more, log on to Back-in-Control.com.

Try taking a break every half hour or

so and walking around for a minute or

two.

BEING STRESSED. Stress causes

muscular tension in the lower back,

which can trigger pain. And stress also

lowers your tolerance threshold to pain,

making it seem much worse. Managing

your stress through stress management

techniques, from walking to therapy,will help to control your back pain.

 What To Do?What to do if you have back pain? Most

often it resolves within a few weeks

using at-home remedies such as over-

the-counter pain medications and rest,

noted Dr. Liu. “But if it doesn’t go away,

if it keeps you up at night or if you

have weakness, numbness or pins and

needles in your extremities, it’s best to

see a medical professional.” 

  Techniques to diagnose the causeof your back pain, such as x-rays,

MRIs or CAT scans, can help guide the

doctor toward an individual treatment

plan. The good news? Most back

pain – more than 80 percent – can

be alleviated without surgery, said Dr.

Liu. “Even if you do need surgery for

a structural problem of your back,”

he added, “it can often be done with

advanced technology through a scope,

which causes less trauma and pain.”

MS&F

HOT OR COLD?It’s a continuous debate – should you use heat or cold to relievesymptoms of back pain? Most

experts say that it depends uponthe type of pain. If your back

pain is related to an injury likea strain or sprain, cold works

best for a day or two to reduceinflammation. After that, heat willhelp to relax and soothe muscletissue. For those experiencing

chronic pain, heat will work best.