Your Weight and your Low Back pain

What factor does your weight play in your low back pain?  Putting on a few pounds really doesn’t have a significant impact on your low back complaint.  Of course, the more weight you add the greater risk you have of developing a low back issue.  One thing that seems to go hand in hand with weight gain is a decrease in activity.  This is also a factor in developing a low back injury.  Your chiropractor in the Woodbridge, Dale City VA area wants to help you understand the links between low back pain and weight gain.

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese.  The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.

Some of the most common obesity-related problems include musculoskeletal and joint related pain.  For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the back.  In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.

In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain.

Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back.

In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area.

Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis.

The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese. For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the Need for Weight Loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.  Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight.

It is also important to evaluate where excess fat is carried on the patient’s body. Patients who carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Back pain facts

I guess this is the reason I see so many back complaints as your Woodbridge, Dale City VA Chiropractor. 31 million Americans experience low-back pain at any given time.1   Even though it is so common there is a lot people don’t know about it.  I must confess when my back has a problem and I call a chiropractic friend of mine I seem to forget the causes of back pain too.  Naturally my back complaint is different than the rest of the worlds.    Here are some pretty interesting facts about back pain and if you ever get back pain be sure to call.

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

One-half of all working Americans admit to having back pain symptoms each year.2

Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.

Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7

More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8

A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

 

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

 

  1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

 

  1. Ibid.
  2. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  3. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

 

  1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  2. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  3. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  4. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Avoiding low back pain while sleeping

It isn’t as if we have tons of opportunity to sleep, so when we do let’s make the most of it.    The biggest complaint I see as your chiropractor in the Woodbridge, Dale City VA area is low back pain while sleeping.  There are some ways o minimize this complaint if not take it away all together.

Back pain can make it tough to get a good night’s sleep. At the same time, how you sleep may make things worse — while certain sleep positions put strain on an already aching back, others may help you find relief.

Although back pain and sleep problems are linked, the connection isn’t well understood. “There is not a lot of science behind sleep as a major cause of back pain,” says Santhosh Thomas, DO, MBA, a spine specialist with the Cleveland Clinic and associate medical director of the Richard E. Jacobs Medical Center in Avon, Ohio.

Experts do believe, however, that people with sleep problems experience more problems with back pain. “Sleep deprivation is known to affect mood and functional ability and negatively impacts perception of pain,” Dr. Thomas says. Pain in turn can affect the quality of your sleep, according to the National Sleep Foundation, leading to a lighter sleep state and more frequent waking throughout the night.

What’s more, there’s a relationship between the severity of pain, overall mood, and the ability to function — and a good night of sleep can improve all these symptoms, at least temporarily, according to a study published in the November 2016 issue of the Annals of Behavioral Medicine.

Worst Sleep Positions for Back Pain

Some sleep positions can put added pressure on your neck, shoulders, hips, lower back, knees, and even your heels, all of which can lead to pain, Thomas says. There’s no one-size-fits-all sleep position to kick back pain, but you can try a few tricks to get it under control so that you can sleep more soundly.

The most common offender? Sleeping on your stomach. “Typically, sleeping on your stomach can flatten the natural curve of your spine, putting some additional strain on your back muscles,” Thomas says.

Plus, stomach sleeping means that your neck is rotated, which can actually result in neck pain or back pain between your shoulders, says Paul Grous,  a physical therapist and spine specialist with Penn Therapy & Fitness in Woodbury Heights, New Jersey.

Don’t worry about keeping your body in the same position all night. It’s normal for you to move around a bit while you sleep, and that’s a good thing because a little movement can help ease pressure on your back. “Any sleeping position has the potential to amplify back pain if you maintain it for too long,” Thomas says.

Grous adds that the real culprit may not be sleep position but your daily activity — or a lack of it.

“My opinion of the biggest causative factor for back pain in our population is the amount of time we spend sitting during waking hours,” he says. “We sit too long and we don’t sit properly — we sit slouched with our backs rounded.”

During daylight hours, try to vary your posture as much as possible, and practice good posture when standing and sitting to help ease back pain at night.

Sleep Positions That Help Relieve Back Pain

First, you’ve got to be comfortable to get a good night’s sleep. Thomas suggests making a few simple modifications to your regular sleep position to help take a load off your back:

 

If you’re a back sleeper: Put a pillow under your knees to allow your spine to maintain its natural curve.

If you’re a stomach sleeper: Put a pillow under your lower abdomen and pelvis to ease back strain.

If you’re a side sleeper: Draw your legs up slightly toward your chest and sleep with a pillow (a full body pillow can be comfortable) between your knees.

 

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Upper Cross Syndrome

Upper back burning and pain is a common complaint I see as your Chiropractor in the Dale City, Woodbridge, VA area.  I am very familiar with this complaint myself.  About half through the New Jersey Turnpike, on my way to Long Island, I can be seen digging into my upper shoulder.  By the Long Island express I have my arm wedged behind the passenger’s seat trying to stretch my chest.  That is the point I swear I am going to stretch my chest everyday and get the muscle fixed.  Than I do the same thing the next trip…  Here is some great information from Kenneth Miller MS on upper cross syndrome.

If you’re like the millions of people who use electronic tools such as a cell phone, tablet, laptop or desk computer, you’ve probably spent hours upon hours looking at the screen with your head jutted forward. Other situations that might have you holding your head forward of your shoulders include reading books, significant time behind the steering wheel or watching TV. Whatever the cause, the migration of your head to this forward position can ultimately lead to overactive muscles and a complementing set of underactive muscles. This postural distortion pattern, known as upper crossed syndrome (UCS), can result in imbalances of muscle tone or timing, often leading to poor movement patterns, and in this tech heavy society, increased stress on the head, neck and shoulder joints.

Poor posture at any level may lead to muscle imbalances. This can have a trickle-down effect into the rest of the body, not just in the local areas of the neck and shoulders. An associated sequence of muscle imbalances in the hip region, referred to as lower crossed syndrome, can oftentimes be observed in conjunction with upper crossed syndrome. When looking for long-term success in relieving UCS, identifying and addressing postural issues that could exist elsewhere in the body will also be needed. This total-body approach will relieve tensions through the entire kinetic chain, while also enhancing desired results.

Crossed and Countercrossed

The “crossed” in upper crossed syndrome refers to the crossing pattern of the overactive muscles with the countercrossing of the underactive muscles. When viewed from the side, an X pattern can be drawn for these two sets of muscles. The overactive muscles form a diagonal pattern from the posterior neck with the upper trapezius and levators down and across to the anterior neck and shoulder with the sternocleidomastoid (SCM) and pectoralis major. The other side of the X now depicts the underactive muscles, with the deep cervical flexors down toward the mid/lower trapezius, rhomboids and serratus anterior. As we continually assume the seated, forward head postures driven by electronic devices or poor exercise selection and technique, this X pattern of muscle imbalances will increase.

Identify Imbalances

When working with clients or performing your own workout routine, attaining and maintaining ideal posture is paramount to a safe and effective program. In order to address postural or movement imbalances, the less-than-ideal posture has to be identified and a corrective exercise strategy developed. This corrective program can have two applications. First, it can serve as a stand-alone phase of training that will help the client achieve better postural control and endurance. Second, it can be applied as the movement preparation for a workout. In the first application, the client may be in a post-rehabilitation situation and need a program that incorporates flexibility with local and integrated strengthening. The second application will most likely be for the client looking to move better and improve coordination before applying speed and increased force during their workout session.

The first step to improving any postural distortion pattern is being able to identify the condition. Upper crossed syndrome can be observed from different vantage points with different motions. Some basic assessments that can be implemented to identify distortion patterns are gait observations, overhead squat, pushing and pulling motions, and static posture analysis. With any postural assessment—static, dynamic or transitional—UCS can be observed by watching head position relative to the shoulders, and the arms and shoulder blades relative to the ribs.

By using the landmarks of the ears, shoulders and the glenohumeral (GH) joint, a static posture assessment can identify UCS by observing if the ears are forward of the shoulder. You might even say that this person is slouching.

Observations for the shoulder blade and the upper arm can be seen from the front and side views with the overhead squat, pushing (pushup) and pulling (cable row) motions. The movements to note during an overhead squat assessment for possible signs of UCS include

  • Arms falling forward or to side during the descent
  • Head migrating forward
  • Elevating or elevated shoulder blades
  • Elbows flexed or challenged in keeping arms straight

Depending on the extent of the distortion, someone may exhibit one or more of the listed movement compensations. Combining the different assessments can also confirm findings. This helps in prioritizing the corrective strategies during program design.  Call Doroski Chiropractic to have this problem evaluated and to get some possible home exercises to help it go away.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Is my weight causing my Low Back Pain

Does my weight cause my low back pain?  I hear this a lot as a Chiropractor in the Woodbridge, Dale City VA area.  Many aren’t aware that the weight can be causing the low back pain.  Although there haven’t been any direct studies that show excess weight cause low back pain we do know that the excess weight puts you at a higher risk for joint pain and muscle strain.  Excess weight can also cause fatigue and shortness of breath.  This can lead to a decreased exercise level which can weaken the low back leading to pain as well.

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese.  The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.

Some of the most common obesity-related problems include musculoskeletal and joint related pain.  For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the back.  In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.

In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain.

Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back.

In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area.

Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis.

The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese. For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the Need for Weight Loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.  Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight.

It is also important to evaluate where excess fat is carried on the patient’s body. Patients who carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

What is the SI joint

Your (my) hip is out…  I say it all the time to patients and they say it all the time to me.  Than we both point to that area on the back along the waist line to the right or left of the spine.  Now I am pretty good with anatomy and it obviously isn’t your hip joint, it is your SI joint.  It is also the cause of a significant amount of low back complaints I see in my Woodbridge, Dale City VA Chiropractic office.

Chiropractic is all about expression of optimal health and living the best possible life for you. The focus, especially with doctors of chiropractic at The Joint, is about improving the overall quality of your daily life through regular spinal adjustments. An adjustment helps restore spinal movement, which allows the nervous system to function at its highest possible level. Because the nervous system controls everything we do (including breathing, blinking and swallowing), a system operating optimally is extremely valuable. One of the additional perks — the one that often brings people in — is that pain and joint dysfunction often go away. That’s like magic! Many times people are freed to return to activities they love but have struggled participating in, whether it’s skateboarding, surfing, or lifting a little one up over their head. One of the most common issues that chiropractors see is SI joint dysfunction. It’s common enough that many people know what the SI joint is, but if you don’t, don’t worry — just keep reading. I’ll go over a bit of the science and how chiropractic can play a role in resolving SI joint issues.

The Science

SI stands for sacroiliac. You have two SI joints. The joints are on either side of the sacrum and each ilium (you know this as your hip bone). They are at the bottom of the spine and connect the sacrum and ilium on each side. The main motion of the joint is a shearing motion (a sliding motion back and forth between two parallel surfaces, joint facets in this case).

Dysfunction

SI joint dysfunction means the SI joint is not moving the way it’s intended. Perhaps this means its range of motion is limited — either the sacrum or the ilium is literally mal-positioned and stuck — or there is too much motion. Each joint works to transfer weight from the upper body to the lower body; they are designed to allow minimal movement and they have strong ligaments and tendons that support them. The dysfunction can occur as a result of a variety of things. We live in a society in which the average person sits far too much and carries too much weight. This lack of movement doesn’t encourage proper SI joint health and function. Dysfunction can also be a result of stress from overcompensation after prior spinal surgeries. Too much SI joint movement commonly occurs in pregnant women due to ligament-stretching and laxity.

Symptoms and Treatment

As with most conditions, symptoms vary from person to person. It’s common for SI joint dysfunction to present with low back pain or pain in the buttocks. Pain can radiate down the leg or even into the front of the thigh, but generally not past the knee. SI joint pain can mimic many other causes of low back pain. Chiropractors are experts at determining the source of spine pain in patients — and caring for them, too!

Through an adjustment, chiropractors help restore motion in the SI joint and/or associated joints contributing to the problem. I’ve found that SI joint dysfunction typically responds well to chiropractic care and that pain relief can occur quickly after an adjustment. The exact treatment duration and intensity will depend on the person, their lifestyle and the degree of the subluxation.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

IT band pain

As your chiropractor in the Woodbridge, Dale City VA area I see lots of low back complaints.  When I hear the patient say the pain is on one side or the other with a leg referral my first thought is the SI joint.  It is usually that but there are the odd balls (simmer down it is not said in disrespect to the person) that have an IT band injury.   This injury tends to be more on the side of the leg.

Symptoms

Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee.

It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill.

Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh. A therapist or trainer may use Ober’s test to assess this. Weakness in hip abduction or moving the leg out sideways is another common sign. Tender trigger points in the gluteal muscles or buttocks area may also be present.

Causes

TFL muscleCertain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius  are also thought to be a significant factor.

Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.

Treatment

Below are outlined a number of treatment options for ITB friction syndrome. See rehabilitation for more details on how the various forms of treatment might be included in a full rehabilitation program.

Rest

Rest is important to allow the inflamed tendon to heal. Continuing to run with ITB syndrome will most likely make it worse. Initially complete rest is a good idea but later activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.

Cryotherapy

Apply cold therapy or ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea to ensure the pain does not return. Once the inflammation has gone then potential causes must be addressed such as a tight ITB or the pain will most likely return.

Medication

A doctor may prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen. This is useful in the early acute stage to reduce pain and inflammation. Long term it is not likely to be of benefit, particularly if it is just being used to mask in injury and not as part of the treatment. Always check with a doctor before taking medication in case you have contraindications which mean they could cause harm, for example asthmatics should not take Ibuprofen.

Stretching exercises

Stretching exercises for the muscles on the outside of the hip in particular are important. The tensor fascia latae muscle is the muscle at the top of the IT band and if this is tight then it can cause the band to be tight increasing the friction on the side of the knee.

Foam roller exercises

Using a foam roller on the IT band and gluteal muscles can help stretch the iliotibial band and remove any tight knots or lumps in the tendon. therefore friction on the side of the knee.

Strengthening exercises

Improving the strength of the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the ITB tendon at the knee. In particular strengthening exercises for the tensor fascia latae muscle and gluteus medius such as heel drops, clam exercise and hip abduction are important.

Sports massage

A professional therapist may perform sports massage to help relax and loosen the tissues and use myofascial release techniques which have been shown to be highly effective. Self massage techniques can also be very helpful in correcting excessive ITB tightness, especially where access to a massage therapist on a regular basis is not possible.

Electrotherapy

Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

Acupunture

Dry-needling techniques or acupuncture may be beneficial also. Acupuncture is performed by inserting needles of various lengths and diameters into specific points over the body and in this case around the knee joint. The needle is usually inserted, rotated and then either removed immediately or left in place for several minutes. It is thought to be beneficial in reduce chronic or long term pain.

 

Training modification

Errors in training should be identified and corrected. These can include over training or increasing running mileage too quickly. As a general rule a runner should not increase mileage by more than 10% per week. Running across a slope or camber in the road for long periods or poor foot biomechanics should be considered. When training starts again avoid too much downhill running.

A rehabilitation strategy which includes stretches and exercises to strengthen the hip abductors is important. In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

A common cause of Low Back Pain

Summer is here and based on vanity alone it is time to lose some weight.  That being said there is another reason to drop those extra pounds.  Low back pain is one of the most common reasons people go to the doctors.  As a chiropractor in the Woodbridge, Dale City VA area I obviously see lots of low back pain.  Not all of it is weight related but it is a major factor in the cause of low back pain.

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese.2  The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.1

Some of the most common obesity-related problems include musculoskeletal and joint related pain.1 For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the back.  In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.

In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain.1

Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back.

In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area.3

Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis.2

The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese.2 For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the Need for Weight Loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.  Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight.4

It is also important to evaluate where excess fat is carried on the patient’s body. Patients who carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist measurement of more than 35 inches or men with a waist measurement of more than 40 inches.4

 

References

 

1  American Obesity Association. “Health effects of obesity.” AOA Fact Sheets. 2002.

2  American Obesity Association. “What is obesity?” AOA Fact Sheets. 2002.

3  Fishman L., Ardman C. Back Pain: How to Relieve Low Back Pain and Sciatica. New York: W.W. Norton & Company, 1997: 248.

4  National Institutes of Health. National Institute of Diabetes & Digestive & Kidney Diseases. “Understanding adult obesity.” 2001. http://win.niddk.nih.gov.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Back pain facts

There are many reasons people come to my Woodbridge, Dale City VA chiropractic office.  One of the biggest reasons they come is back pain.  In fact, 31 million Americans experience low-back pain at any given time.1  As common as back pain is there are many things people don’t know about it.  Here are some pretty interesting facts about back pain and if you ever get back pain be sure to call.

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

One-half of all working Americans admit to having back pain symptoms each year.2

Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.

Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7

More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8

A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

 

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

 

  1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

 

  1. Ibid.
  2. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  3. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

 

  1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  2. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  3. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  4. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Low back pain prevention

There are several things you can do to prevent back pain.  One of the biggest things is core strength.  Lots of jobs involve sitting for long periods of time and this can lead to a weakening of the core.  Your Woodbridge, Dale City VA chiropractor has a few tips to help you strengthen your core and prevent injury.

 

Basic Core Exercises for Beginners

Supermans

Easy to learn and perform, Supermans strengthen the often-neglected lower back, a common source of pain. They also provide a great full-body stretch to finish up your workout.

Lie with stomach on ground, arms extended overhead and legs straight

Raise arms and legs as high as possible and hold for five to 10 seconds; keep arms straight and core tight

Slowly lower and repeat for specified reps

Sets/Reps: 3-4×20

 

Bird Dogs

Assume all-fours position with back flat; look straight ahead

Slowly raise right arm and left leg and hold for five to 10 seconds; keep core right

Slowly lower and perform on opposite site

Repeat for specified reps

Sets/Reps: 3-4×20 each side

 

Planks

Assume plank position with elbows under shoulders, back flat and eyes focused on ground

Keep core tight and hold position for specified time

Sets/Duration: 3-4×60-120 seconds

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link