Low back pain - Doroski Chiropractic Neurology, Woodbridge, VA

What is SI pain?

in Chiropractor by Doroski May 5, 2017 0 comments

Low back pain is one of the most common things I see in my Woodbridge, Dale City VA Chiropractic office. The problem with the diagnosis of low back pain is most of the pain isn’t in the low back, it is in the SI. SI pain is that pain along your pant line which is worse on either the right or the left. It can sometimes shoot into the butt or leg.

Pain in and around the sacroiliac joint is one of the more common causes of low-back pain. With approximately 80 percent of the population suffering from low-back pain at some point in their lives, the sacroiliac joint dysfunction likely represents about 15-25 percent of those cases.

The following points will help you educate your patients about the sacroiliac joint dysfunction.

What Is Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction (SJD) is a broad term often applied to pain in the sacroiliac joint region—the largest joints at the base of the spine.

SJD can be painful and debilitating, but it is rarely life-threatening.

SJD rarely requires invasive types of treatment such as surgery.

Symptoms and Causes

SJD symptoms include low-back pain, typically at the belt line, and pain radiating into the buttock or thigh.

These symptoms are hard to distinguish from other causes of low-back pain, such as disc herniations or facet joints disease.

Most often, SJD is caused by trauma. For example, rotation of the joint when lifting or participating in some vigorous activity may cause tears in small ligaments surrounding the joint, resulting in pain and dysfunction.

While more serious conditions such as fracture or dislocation, infection and inflammatory arthritis can cause sacroiliac joint pain, minor trauma is considered a much more common cause.

The risk of SJD may also increase with true and apparent leg-length inequality, abnormalities in gait and prolonged exercise.

Pregnant women may suffer from SJD because of hormone-induced relaxation of the pelvic ligaments during the third trimester, weight gain and increased curvature of the lumbar spine.

Evaluation

Because SJD pain resembles other types of low-back pain, it is often difficult to isolate it as the actual cause of the patient’s discomfort and disability.

Diagnostic imaging procedures, such as X-ray or MRI, aren’t very helpful in evaluating SJD.

The mostcommonly used diagnostic procedures are physical examination and anesthetic blocks of the sacroiliac joint.

Physical examination involves stressing the joint in various body positions and movements.

During anesthetic blocks, a procedure with unproven validity for SJD diagnosis, the anesthetic solution often creeps outside the sacroiliac joint and may relieve pain from other structures.

Treatment

Because it is often difficult to isolate SJD as the source of pain, an appropriate management strategy is hard to implement. Once SJD is determined as the cause of the problem, many therapies are available.

Chiropractic manipulation and mobilization of the sacroiliac joint has been shown to be beneficial.

Exercise focusing on strengthening the core stabilizer muscles of the spine and trunk and on maintaining mobility of the sacroiliac joints can also be helpful.

Patients with a leg-length inequality may benefit from a shoe inserts helping to properly distribute weight borne by your lower back and sacroiliac joints.

For those with abnormal gait biomechanics, gait training may be needed.

To reduce the excess rotation that sometimes occurs with SJD, a pelvic belt can help stabilize the sacroiliac joints.

In cases of fractures and dislocations of the sacroiliac joints, surgery is needed.

Prevention

Use proper lifting techniques and ergonomics during your daily activities.

Maintain a regular exercise program and a healthy diet to help you function at peak capacity and prevent injuries

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Low Back Stretches

in Chiropractor by Doroski January 27, 2017 0 comments

Low back pain is one of the most common health related injuries. The thing I hear a lot in my Woodbridge, Dale City VA Chiropractic office is “I didn’t even do anything”! Some of the types of injuries are even hard for me to believe and I have been a chiropractor in the Woodbridge, Dale City VA area for over 20 years. The thing I try to tell people is it is almost never that one thing that hurt your back it is the last two or three weeks that lead up to the injury. For the most part it is long standing tightness. All your back muscles attach to your spine and pelvis. As they continue to tighten over the course of weeks they increase the load on the joints until you sneeze, pick up a piece of paper, stretch, go to the bathroom…. Yes, the list goes on but it is rarely the actual cause.

Here are some daily stretches you can do to keep your back stretched and relaxed so the muscles function correctly.

The Deep Squat

Stand up straight with your arms folded across your chest. Place your feet shoulder-width apart and toes pointing out slightly. Squat down as far as you can, keeping your heels on the floor. As you squat ensure your weight goes into your heels and not your toes. For a full range of movement, your bum should sit down by your heels and your head should be tall and looking forward. Perform the exercise slowly when lowering down, giving yourself time to keep control and lower all the way – or as far as your range of movement will allow. Pause for a count of two at the bottom of the squat, allowing your groin area to relax. Your knees should be directed slightly outwards in alignment with your feet. Keeping your knees out, squeeze your gluteals and stand up out of the squat. Only go as far as you can without any pain. As you perform the exercise regularly you will slowly but surely be able to achieve greater flexibility. Do this for 2 sets of 10.

Knee to Chest

Lie on your back, flex your knees up and do a pelvic tilt so you press your lower back flat to the floor. Slowly and gently pull your right knee to your chest at a slight angle towards your left shoulder. Hold for 5 seconds and release back to the bent position. Then repeat with the opposite leg. Do this 10 times in alternating fashion

Downward Dog

Place your hands and feet on the floor, shoulder-width apart, knees bent and hips high. Your heels should be off the floor at this point. Relax your head and neck so you are looking towards your knees. Do a pelvic tilt so your lower back is arched and your spine is straight. Now straighten your arms and pull your shoulder blades together. Straighten your knees as well. You may lose the arch in your low back but don’t allow your lumbar spine to flex. This will require a good abdominal squeeze to maintain the lumbar arch. Hold for 30 seconds and relax. Repeat 5 times.

Spine twists

Sit down with your legs loosely crossed. Pull your back up tall and stick your chest out so that you are sitting upright with perfect posture. Fold your arms across your chest. Tighten your abs so that your pelvis is stable. Then slowly turn your head and shoulders to one side. Turn as far as you can and you will feel the stretch in the rib area. Hold the end position for a count of two and then turn across to the other side and repeat. Perform two sets of 10 repetitions each side.

Do not force any of these exercises and if you feel any discomfort stop. Keeping your low back stretched will help you prevent some low back injuries but routine chiropractic visits with these stretches can help prevent the big injuries. Of course injuries are inevitable but if your try to prevent the preventable ones you can eliminate a lot of pain from your life.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Sacroiliac Pain

in Chiropractor by Doroski November 11, 2016 0 comments

There are several types of low back injuries. One of the most common that I see in my Woodbridge, Dale City VA chiropractic office is SI pain. This is the low back pain people get across the pant line and it is usually worse on one side. It makes getting out of a chair and long car rides a nightmare. The good thing is there are no discs in the area so it usually isn’t a surgical injury.

Pain in and around the sacroiliac joint is one of the more common causes of low-back pain. With approximately 80 percent of the population suffering from low-back pain at some point in their lives, the sacroiliac joint dysfunction likely represents about 15-25 percent of those cases.

The following points will help you educate your patients about the sacroiliac joint dysfunction.

What Is Sacroiliac Joint Dysfunction?

Sacroiliac joint dysfunction (SJD) is a broad term often applied to pain in the sacroiliac joint region—the largest joints at the base of the spine.

SJD can be painful and debilitating, but it is rarely life-threatening.

SJD rarely requires invasive types of treatment such as surgery.

Symptoms and Causes

SJD symptoms include low-back pain, typically at the belt line, and pain radiating into the buttock or thigh.

These symptoms are hard to distinguish from other causes of low-back pain, such as disc herniations or facet joints disease.

Most often, SJD is caused by trauma. For example, rotation of the joint when lifting or participating in some vigorous activity may cause tears in small ligaments surrounding the joint, resulting in pain and dysfunction.

While more serious conditions such as fracture or dislocation, infection and inflammatory arthritis can cause sacroiliac joint pain, minor trauma is considered a much more common cause.

The risk of SJD may also increase with true and apparent leg-length inequality, abnormalities in gait and prolonged exercise.

Pregnant women may suffer from SJD because of hormone-induced relaxation of the pelvic ligaments during the third trimester, weight gain and increased curvature of the lumbar spine.

Evaluation

Because SJD pain resembles other types of low-back pain, it is often difficult to isolate it as the actual cause of the patient’s discomfort and disability.

Diagnostic imaging procedures, such as X-ray or MRI, aren’t very helpful in evaluating SJD.

The mostcommonly used diagnostic procedures are physical examination and anesthetic blocks of the sacroiliac joint.

Physical examination involves stressing the joint in various body positions and movements.

During anesthetic blocks, a procedure with unproven validity for SJD diagnosis, the anesthetic solution often creeps outside the sacroiliac joint and may relieve pain from other structures.

Treatment

Because it is often difficult to isolate SJD as the source of pain, an appropriate management strategy is hard to implement. Once SJD is determined as the cause of the problem, many therapies are available.

Chiropractic manipulation and mobilization of the sacroiliac joint has been shown to be beneficial.

Exercise focusing on strengthening the core stabilizer muscles of the spine and trunk and on maintaining mobility of the sacroiliac joints can also be helpful.

Patients with a leg-length inequality may benefit from a shoe inserts helping to properly distribute weight borne by your lower back and sacroiliac joints.

For those with abnormal gait biomechanics, gait training may be needed.

To reduce the excess rotation that sometimes occurs with SJD, a pelvic belt can help stabilize the sacroiliac joints.

In cases of fractures and dislocations of the sacroiliac joints, surgery is needed.

Prevention

Use proper lifting techniques and ergonomics during your daily activities.

Maintain a regular exercise program and a healthy diet to help you function at peak capacity and prevent injuries

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Back pain stats

in Chiropractor by Doroski February 19, 2016 0 comments

As a chiropractor in the Woodbridge, Dale City VA area I see patients for all sorts of reasons. Of course one of the main reasons people seek out a chiropractor is for back/neck pain. In fact, 31 million Americans experience low-back pain at any given time.1

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:

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.

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

Ibid.
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.
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.

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.
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.
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.
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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Hip pain may be your SI joint

in Chiropractor by Doroski January 22, 2016 0 comments

I see sacroiliac injuries in my Woodbridge, Dale City Virginia Chiropractic office almost as frequently as any other spinal injury. People often come in complaining of what they consider hip pain. Once the injury is examined it is more often than not the SI joint. It is also the cause of unilateral low back pain. Patients will complain of lower left or right side low back pain. Same thing, once you examine the area it is the SI joint. Doroski Chiropractic Neurology in the Woodbridge, Dale City Virginia area has some helpful information for you on the SI joint.

When the hip joint is spoken of, it is typically thought of as a vague area that may encompass anywhere from the iliac crest, the sacroiliac joint or the point at which the femur articulates with the acetabulum. The latter is the actual hip joint. Lower back pain that radiates more laterally to the pelvic area over the acetabulum, groin, and upper lateral thigh is not necessarily definitive of an L4/L5 disc syndrome. Pain in this region may also be secondary to a facet syndrome. Sometimes, pain to the lower abdominal and groin region may be a part of the symptomatology presented by a patient. The differentiation between the L/4/L5 disc and facet syndrome is that the disc with the radiculopathy will generally follow a known dermatome, while a facet syndrome follows a dermatomal pain pattern. Doctors of chiropractic usually find and treat articular lesions of the sacrum, ilium or lumbar spine, for a period of time, without cessation of symptoms or improvement of these complaints. One other consideration would be for a tear of the labrum in the hip, which may result in pain in the SI joint, gluteus area and even anterially into the groin.

Complaints in these more lateral areas are often due to a problem in an area that many doctors don’t check—the femoral head. The femoral head may need to be assessed for the need for manipulation or mobilization. This in turn may cause deep pelvic muscle spasms, which may become chronic. I believe that every day activities, from subtle movements like turning in bed to more repetitive activities like bearing more weight on a pronated foot time and time again, may cause misalignment to the femoral head. This area should be checked and adjusted for recovery, in my opinion.

Drawing upon an example from personal experience: I would open the car door and throw my right leg into the car and then sit down. I would experience a subtle “click” in the acetabulum area, followed by pain and irregular walking gait, pulling of the leg when weight bearing, causing deep spasms of the upper thigh and lower abdominal muscles, pulling the leg forward instead of pushing the leg forward, as in a normal walking gait. This caused a transition of weight-bearing muscle function to muscles not usually used in normal walking. (A compensatory walking gait is developed.) This caused me pain and spasm in adjacent muscles.

All too often, I believe that this problem is missed or misdiagnosed, resulting in unnecessary surgery, hip replacement, repetitive chiropractic adjustments, physical therapy and muscle massage, and none of them address the underlying cause of the condition.

Examination for Hip Joint Dysfunction

Place the patient in supine position, with your superior hand holding the ilium to the table with light A-P downward Force (near the ASIS) to ensure the ilium will not rise off the table during motion of the leg. Holding the ilium on the exam table, grasp the ankle and rotate the foot medially. The big toe should touch the table. Full rotation indicates no hip joint dysfunction. If the ilium rises off the table during this action, this indicates improper function of the femoral head/acetabular articulation.

Corrective Procedure

Ascertain (through the examination described above) the side of restriction. Place the patient in lateral Syms position (Syms is performed by having a patient lie on the left side, left leg extended and right leg flexed) as in a side roll. Place your superior hand under the armpit of the patient, holding the humerus and ribs, with your inferior hand reaching over the patient cupping the femoral head. Proceed with the side-roll-type procedure with this exception: The inferior hand (cupping the femoral head) is driven directly forward (anterior).

If correction has been obtained, the leg now should move freely in a medial direction smoothly and completely, with immediate Improvement of pain. Occasionally the patient may experience residual muscle soreness. Over the course of my practice, I have found that these patients have a tendency to walk around for a while with a displaced femoral head and a compensatory walk, the surrounding muscles are sprained and inflamed, and soreness may continue for days until the patient returns to a normal walking gait. Generally, I find the quicker the patient returns to a normal walking gait, the quicker the syndrome is alleviated. I feel it is important to re-address with the patient what is a normal walking gait and this may lengthen the post-correction period.

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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 and lumbar supports.

in Chiropractor by Doroski June 12, 2014 0 comments

We hear it all the time at Doroski Chiropractic Neurology in Woodbridge VA… “Don’t worry Doc I have a back brace I wear while I am at work.” Just because you are wearing one doesn’t mean you are free from harming your back and does wearing one incorrectly even help. No one really thinks about wearing one correctly you figure it is a belt how can I do it wrong. Well I can tell you from personal experience you can do a lot of things wrong that you figured there really is only one way to do it. Take running for example. A few years ago I got in to running and figured I have been doing this for years “I think I got this.” It always feels good busting your butt getting ready for your first half marathon and at mile two the person you signed up to do it with, but never ran with, who happens to be a track coach goes “wow you are doing it wrong.” I bet after each run your shins are killing you and your back is tight. Why yes it is. Yea try doing this this and this. Next thing you know you are running easier and faster. So trust me just being handed a back brace doesn’t mean “you got this.”

So let me give you some background on back braces and do they really help.

The truth is that wearing an elastic or other support around your waist to help your back may be both good and bad. And whether wearing such a back belt will prevent back problems is controversial. A new study that found workers who routinely wear these support belts while working at Wal-Mart, were just as likely to injure their backs as those who did not.(1) However, some previous studies have shown back belts to prevent injuries, such as the UCLA study conducted with Home Depot workers, which found a 1/3 decrease in back injuries due to wearing back belts.(2)

Let’s look at the scientific evidence about whether back belts might help to support the back, whether there are any risks associated with wearing them, and whether such belts should be recommended or not.

How might back belts help to support the back? They do not hold the back in, as many presume. Back belts function primarily to hold the stomach in, thus increasing intra-abdominal pressure. This has led some to refer to these belts as abdominal belts rather than as back belts. But how does increasing intra-abdominal pressure support the spine? We will briefly review the intra-abdominal balloon theory and a more modern theory.

Intra-Abdominal Balloon Mechanism

It was originally proposed by Bartelink in 1957 that increased intra-abdominal pressure would decrease the compressive load on the spine through the intra-abdominal balloon mechanism.(3) To begin with, you must think of the abdominal cavity and the abdominal organs as a squishy liquid. Then realize that the abdominal cavity becomes a closed chamber when we bear down and hold our breath, which we instinctively do when we lift heavy things. This chamber is closed on the bottom by the anal sphincter and on the top by the diaphragm. When bearing down, the abdominal contents tend to push outwards. But if we contract our deep abdominal muscles—the obliques and the transverse abdominus muscles—or we wear a thick belt, the abdominal contents are forced upwards rather than outwards.(4 p.109) This theoretically provides a decompressive effect on the lumbar spine. Since the crura of the diaphragm is attached to the first 3 lumbar vertebrae, when the diaphragm is pushed upwards, it exerts a traction force on the lower lumbar spine (L4 and L5). It was also theorized that since this balloon mechanism makes the spine more rigid, it would decrease the amount of work required of the erector muscles to prevent us from falling forwards. Kapanji estimated that this abdominal support mechanism acts to reduce compression forces on the L5/S1 disc by 30% and reduces the force required by the erector spinae muscles by 55%. (4, p.198).

But more recent scientific evidence fails to support some of these theoretical assumptions. Such recent studies reveal that an increase in intra-abdominal pressure actually results in an increase (rather than a decrease) in compressive force on the lower spine.(5,6) And there is no decrease in the amount of work required of the lower back muscles.(7) However, by stiffening the trunk, increased intra-abdominal pressure may prevent the tissues in the spine from strain or failure from buckling. Such intra-abdominal pressure may also act to reduce anterior-posterior shear loads.(8) In other words, support for the spine is provided, without reducing compression to any appreciable degree.

Belts may also help to protect the spine by limiting the range of motion that occurs when bending or twisting, though this effect is less than expected.(9,10) However, since when the spine bends more, it is more vulnerable to injury, if these belts reduce extreme bending at all, they may be beneficial.

Are there any risks associated with wearing a back belt?

The main risk associated with wearing a back belt is that during the period of wearing it, the supportive spinal muscles—the deep abdominal and back muscles—that normally support your spine will become weaker. These muscles are less active while your spine is being artificially supported by the belt. Muscles need to be consistently exercised in order to stay strong. If these muscles become weaker, when you stop wearing the belt, you may be more likely to hurt your back. And at least one study seems to suggest this. In this study, there was an increase in the number and severity of back injuries following a period of belt wearing.(11)

Another risk associated with wearing a back belt is that it causes an increase in both blood pressure and heart rate.(12) This may pose a problem for those individuals with existing cardiovascular disease or risk factors, such as hypertension.

A third risk associated with wearing a back belt is that workers may be inclined to lift heavier objects while wearing them. These belts may be giving workers a false sense of security. This could result in an increased risk of injury.

REFERENCES:

Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM. A prospective study of back belts for prevention of back pain and injury. JAMA. 2000; 284(21): 2727-32.

McIntyre DR; Bolte KM; Pope MH. Study provides new evidence of back belts’ effectiveness. Occup Health Saf. 1996; 65(12): 39-41.

Bartelink DL, “The Role of Abdominal Pressure in Relieving Pressure on the Lumbar Intervertebral Discs,” J Bone Joint Surg, (Br) 1957, 39B: 718-725.

Kapanji, IA. The Physiology of the Joints, Vol. III.

McGill SM, Norman RW. Reassessment of the role of intra-abdominal pressure in spinal compression. Ergonomics. 1987; 30: 1565-1588.

Nachemson AL, Anderson GBJ, Schultz AB. Valsalva maneuver biomechanics. Effects on lumbar spine trunk loads of elevated intrabdominal pressures. Spine. 1986; 11: 476-479.

McGill S, Norman RW, Sharatt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990; 33:147-160.

McGill S. Abdominal belts in industry: A position paper on their assets, liabilities and use. Am Ind. Hyg. Assoc. J. 1993; 54(12): 752-754.

Lantz SA, Schultz AB. Lumbar spine orthosis wearing I. Restriction of gross body motion. Spine. 1986; 11: 834-837.

McGill SM, Sequin JP, Bennett G. Passive stiffness of the lumbar torso in flexion, extension, lateral bend and axial twist: The effect of belt wearing and breath holding. Spine. 1994; 19(19): 2190-2196.

Reddell CR, Congleton JJ, Huchinson RD, Mongomery JF. An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers. Appl. Ergonomics. 1992; 23: 319-329.

Hunter GR, McGuirk J, Mitrano N, et al. The effects of a weight training belt on blood pressure during exercise. J Appl Sport Sci Res. 1989; 3: 13-18.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Maplink

Low back pain can be prevented.

in Chiropractor by Doroski June 5, 2014 0 comments

Low Back Pain can be prevented. Here are some of the things we do at Doroski Chiropractic Neurology in Woodbridge VA that can help. These tips should help you prevent some general low back issues that lots of people experience. Visit us at Doroskichiropractic.com for other blog tips and to schedule an appointment.

Low back pain is very common and I see it all the time in my office. One of the common things I hear is something completely benign caused it. Granted we see a lot of traumatic injuries that you would assume would cause low back pain. Such as digging a hole, falling off the roof, working doing repetitive twisting or anything strenuous. People don’t generally think twice when they hurt their back doing those activities. They may wish they hadn’t but to have back pain following those things isn’t unusual. It is the injuries associated with sneezing, that big morning stretch, bending over to grab an empty dog food bowl… These are the injuries that always make the patient scratch their head. Unfortunately, it is not the event that really caused the injury. It is the 4 weeks of back stiffness that they ignored before the injury. Usually when I ask they go yea it was stiff, or yea I just had a long car ride, or I put in new baseboards BUT it was ok after that. Odds are it really wasn’t but you were just dealing with it.

When your low back is tight for a long period of time it is a ticking time bomb. The muscles are continually pulling on the pelvis and lumbar joints until that one weird movement and the entire thing falls apart. Unfortunately, this injury is harder to fix then the guy who fell off the roof, mainly because the rest of his back hasn’t had a few weeks to compensate for the low back tightness. I always stress to my patients that spending a few minutes in the morning and at the end of the day stretching their low back will make a world of difference. That and staying hydrated will help keep the muscle from tightening up.

Here are some daily stretches you can do to keep your back stretched and relaxed so the muscles function correctly.

1. The Deep Squat

Stand up straight with your arms folded across your chest. Place your feet shoulder-width apart and toes pointing out slightly. Squat down as far as you can, keeping your heels on the floor. As you squat ensure your weight goes into your heels and not your toes. For a full range of movement, your bum should sit down by your heels and your head should be tall and looking forward. Perform the exercise slowly when lowering down, giving yourself time to keep control and lower all the way – or as far as your range of movement will allow. Pause for a count of two at the bottom of the squat, allowing your groin area to relax. Your knees should be directed slightly outwards in alignment with your feet. Keeping your knees out, squeeze your gluteals and stand up out of the squat. Only go as far as you can without any pain. As you perform the exercise regularly you will slowly but surely be able to achieve greater flexibility. Do this for 2 sets of 10.

2. Knee to Chest

Lie on your back, flex your knees up and do a pelvic tilt so you press your lower back flat to the floor. Slowly and gently pull your right knee to your chest at a slight angle towards your left shoulder. Hold for 5 seconds and release back to the bent position. Then repeat with the opposite leg. Do this 10 times in alternating fashion

3. Downward Dog

Place your hands and feet on the floor, shoulder-width apart, knees bent and hips high. Your heels should be off the floor at this point. Relax your head and neck so you are looking towards your knees. Do a pelvic tilt so your lower back is arched and your spine is straight. Now straighten your arms and pull your shoulder blades together. Straighten your knees as well. You may lose the arch in your low back but don’t allow your lumbar spine to flex. This will require a good abdominal squeeze to maintain the lumbar arch. Hold for 30 seconds and relax. Repeat 5 times.

4. Spine twists

Sit down with your legs loosely crossed. Pull your back up tall and stick your chest out so that you are sitting upright with perfect posture. Fold your arms across your chest. Tighten your abs so that your pelvis is stable. Then slowly turn your head and shoulders to one side. Turn as far as you can and you will feel the stretch in the rib area. Hold the end position for a count of two and then turn across to the other side and repeat. Perform two sets of 10 repetitions each side.

Do not force any of these exercises and if you feel any discomfort stop. Keeping your low back stretched will help you prevent some low back injuries but routine chiropractic visits with these stretches can help prevent the big injuries. Of course injuries are inevitable but if your try to prevent the preventable ones you can eliminate a lot of pain from your life.

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Some ways to prevent Low Back injuries

in Chiropractor by Doroski April 29, 2014 0 comments

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Preventing back injuries is a major challenge for employers. According to the Bureau of Labor Statistics (BLS), more than one million workers suffer back injuries each year. Typically, back injuries account for one out of every five workplace injuries and illnesses, and one-fourth of all compensation indemnity claims are a result of back injuries. The pain and discomfort of back injuries can have a dramatic change in employee productivity.

A BLS survey shows that four out of five back injuries were to the lower back, and that three out of four occurred while lifting. This survey shows the importance of reducing back injuries caused by lifting. Although no approach has completely eliminated such injuries, a substantial portion could be prevented by incorporating an effective control program along with an ergonomics analysis and design of work tasks.

OSHA has evaluated ways to help prevent lifting injuries. They specify two types of controls: engineering and administrative.

Engineering controls are used to redesign the workstation to minimize lifting hazards. Administrative controls include carefully selecting and training workers, so that they can perform their jobs safely.

Suggested administrative controls include:

Strength testing of existing workers: Studies have shown strength testing can prevent up to one-third of all work-related injuries. Through the strength-testing process, employers can discourage employees from performing tasks that exceed their strength capacities.

Physical conditioning or stretching programs: These programs are implemented to reduce the risk of muscle strain.Training: Employees should be trained to utilize proper lifting techniques that place minimum stress on the lower back.

How to Lift Safely

Before lifting, take a moment to think about what you are about to do. Examine the object for sharp corners, slippery spots or other potential hazards. Know your limit and do not try to exceed it. Ask for help if needed. Or if possible, divide the load to make it lighter. Know where you are going to set the item down and make sure the destination and your path are free of obstructions. Then follow these steps.

	1. Stand close to the load with your feet spread shoulder width apart. One foot should be slightly in front of the other for balance.
	2. Squat down bending at the knees (not your waist). Tuck your chin while keeping your back as vertical as possible.
	3. Get a firm grasp of the object before beginning the lift.
	4. Slowly begin straightening your legs, lifting slowly. Never twist your body during this step.
	5. Once the lift is complete, keep the object as close to the body as possible. If the load’s center of gravity moves away from your body, there is a dramatic increase in stress to the lumbar region of the back.

If you must turn while carrying the load, turn using your feet, not your torso.

To place the object below the level of your waist, follow the same procedures in reverse order. Remember to keep your back as vertical as possible, and bend at the knees.

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