Posts Tagged ‘Back Pain’

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kristin-mcgee-chair-yoga-cat-cowPhoto: Chris Fanning

Don’t let sitting all day leave you stiff and sore. Steal five minutes to stretch away tightness with these simple yoga poses.

Health Magazine reached out to AJGpr client, celebrity Yoga and Pilates instructor, Kristin McGee to share some best chair yoga moves to combat back pain from her new book Chair Yoga: Sit, Stretch, and Strengthen Your Way to a Happier, Healthier You  (HarperCollins 2017).

“Oh, my aching back!” I can’t tell you how many of my students have back issues. And it’s no wonder, considering most of us spend our days tied to our desk chairs and parked in the same position in front of our screens hour after hour. The problem: Sitting for prolonged periods can cause or exacerbate back issues. When we’re stuck in this position, our hip flexors shorten in front and pull on our lower back. Not to mention, constant slouching can lead, over time, to compressed disks. That’s why it’s crucial to stretch your back every day. Here, four moves you can do right in your office..

1. Backbend Arch

Start seated at edge of chair, placing hands behind you with fingers facing away from hips. Prop yourself up on fingertips, drawing sacrum in and up to lift lower back. Follow backbend all the way up chest to shoulder blades and open up entire front body. Hold and breathe for 8 to 10 breaths, then release.

2. Cat/Cow

Sit at edge of chair with feet flat on the floor. Place hands on knees and inhale, lifting chest and sticking hips out behind you. Lift gaze, open chest, and gently squeeze shoulder blades together (A). On an exhale, round chest, scoop in belly, and curl tailbone under as you drop head toward sternum (B). Repeat for a series of 10 cycles. 

3. Lower-Back Circles

Sit with feet hip-width apart and hands resting on knees (A). Inhale, then begin circling torso clockwise, making sure to initiate movement from base of spine (B). Complete 8 to 10 rotations. Stop and then repeat the motion, this time circling in a counterclockwise direction. Continue alternating for 2 to 3 minutes.

4. Roll-Downs

Sit with feet hip-width apart and hands hanging at sides (A). From head, start rounding down through spine (B). Exhale, letting forehead release forward and the weight of your head bring you over until top of head is by thighs (C). Inhale; slowly start stacking vertebrae as you round up to sit. Draw belly button to spine to protect back, and feel the articulation as you round up. Continue rolling down and up for 5 to 8 cycles. 

Adapted from Chair Yoga: Sit, Stretch, and Strengthen Your Way to a Happier, Healthier You by Kristin McGee ($19; amazon.com). Copyright 2017 by Kristin McGee. Reprinted by permission of William Morrow, an imprint of HarperCollins Publishers.

chair-yoga-back-pain-2

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AJGpr client, Dr. Norman Marcus, founder of the Norman Marcus Pain Institute, is a leading pain specialist who has revolutionized the how to diagnose and then eliminate the most common causes of pain, without surgical intervention. Today he posted a blog about Rafael Nadal’s recent announcement that he would undergo stem cell treatment to relieve his back pain.

Rafael Nadal will receive stem cell therapy for back-pain. Should-you?

Earlier in November, Rafael Nadal, the 14-time Grand Slam winner, announced he would receive stem cell treatment to help heal his ailing back, the same type of treatment he received for his knee. His doctor in Barcelona, Dr. Angel Ruiz-Cotorro, who has been treating Nadal for 14 years, said, “Nadal’s back pain is ‘typical of tennis’ players in that the treatment is meant to help repair his cartilage.” Stem cells were recently extracted from Nadal for a cultivation process to “produce the necessary quantities,” said Ruiz-Cotorro. Once cultivated, the stem cells will be placed into the joints of his spine with the goal of regeneration of cartilage as well as for an anti-inflammatory effect. Dr. Ruiz-Cotorro predicts that Nadal can return to training in early December.

Will stem cell treatment work for Nadal’s Back Pain?

Stem cell treatment may seem logical in certain situations – for example, if you have a mechanical problem where a knee has worn out cartilage, causing bone to rub against bone, it makes sense to use stem cells to grow new cartilage to have a cushion to protect the bone and cause the knee to be less painful. As much as we may want to see him back on the courtstennisgrabbing more grand slam titles, if Nadal’s stem cell treatment is being used to eliminate his pain by repairing his joints or discs, the actual cause of his back pain may not be addressed.

Where does back pain originate?

The number one reason for back pain is muscular and other soft tissue, yet muscles are rarely evaluated as the cause of back pain. The only way to determine if Nadal’s back pain is from soft tissue and similar to most people with back pain would be a physical examination of Nadal’s back that included identifying possible muscles as the cause of his pain.

Some doctors believe that the disc, the cushion between the bones of the spine (the vertebra), is a major cause of back pain. They believe that surgeries to correct the flattening or herniation of the disc will decrease or eliminate back pain. Sometimes they are right, but they are just as likely to be wrong. The truth is that there is as high as a 50% failure rate for spine surgeries that were done to eliminate back pain thought to be related to disc problems. There are other joints in the spine that are thought to cause pain; one of them is the facet joint, which could also be a target for stem cell treatments.

When doctors rely on an MRI or CT scan to determine the source of the pain, the information obtained is often confusing. If a surgeon sees an abnormality on an MRI, he will often point to that abnormality as the cause of the pain; in my experience the abnormality found on an MRI or CT scan frequently is not the cause. In fact, if you randomly selected 100 people off the street, and perform an imaging scan, 40 may present with a herniated disc and have no pain and absolutely no awareness of their herniated disc; 70 may have degenerated (worn) discs with no pain, and a large number will have facet joint abnormalities. Therefore, finding an “abnormality” is more common than not. One, then, can deduce that the abnormality is more likely NOT the source of the pain. So treating the abnormality (with steroid injections, surgery, or stem cells) may therefore not relieve the pain.

Stem Cell Treatment and Sports Stars

Nadal, currently ranked as the number 3 professional tennis player in the world, is not the first sports star to chase after a “miracle cure.” The Denver Bronco quarterback Payton Manning and Yankees pitcher Bartolo Colon both went abroad to seek out stem cell treatment as a quick fix to get back in the game. (They both seem to be doing better overall, but it is inconclusive if the stem cell treatment was the cause of their recovery).

Will it work?

In the laboratory, it has been possible to demonstrate the ability of stem cells (most commonly found in the developing embryo and newborn) to grow new tissue. These cells are like silly putty; they can turn into, or adapt, to become any type of tissue. For example, a stem cell in the right environment in the body could become bone, cartilage or some organ (for example, liver or pancreas). But, it hasn’t been as easy to grow tissue in an actual person. There are some early studies that show that stem cells “may” relieve back pain, but both the doctors who are testing the technique and outside experts say much more research is needed before they can say whether the treatment offers real relief.

The use of stem cell therapies continues to be a hot topic for debate in the sports medicine and orthopedic surgery worlds. There is no current evidence-based research to prove that it works.

Sir William Osler, a famous physician, once said: “Use every new treatment as quickly as possible before it stops working.” Stem cell treatment needs to be further investigated to determine if stem cell treatments indeed work, and if so, for what conditions?

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DID YOU KNOW THAT…

  • 4 out 5 Americans suffer from back pain.
  • Back pain, now the most common disability in the United States, is the number one reason people go to the doctor or miss work.
  • In fact, every year nearly 12 million Americans make new-patient visits to physicians for back pain and one hundred million visit chiropractors.

WELL…

A few weeks ago, The NewYork Times, published an article entitled,  Common Back and Leg Pain Treatment May Not Help Much, Study Says. Basically, the article talks about a study recently published in the New England Journal of Medicine that shows the common and widely used treatment for lower back and leg pain caused by stenosis — a stenosis injection which combines a steroid and a local anesthetic is INEFFECTIVE.  In fact, the article goes on to say doctors and patients should think twice about using the treatment at all.

AJGpr client, Dr. Norman Marcus, one of the nation’s leading specialists and a pioneer in the treatment and relief of chronic pain, and author of End Back Pain Forever: A Groundbreaking Approach to Eliminate Your Suffering, has been saying this for YEARS!

Dr. Marcus contends that, “One reason why this approach is ineffective is that the pain in the back and leg may not be the result of the narrowing or other supposed abnormalities seen on the MRI or CT scan. It is well known that very few (in one published article – less than 10%) scans of the low back in adults are read as normal; as many as 40% of adults with no back pain have herniated discs, and 70% have degenerated discs.”

Named one of the “Best Doctors in New York for pain management” by New York Magazine and founder of the Norman Marcus Pain Institute, Dr. Marcus responded to the The New York Times article and the New England Journal of Medicine study in his blog Epidural steroids are not effective for spinal stenosis.

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 Epidural steroids are not effective for spinal stenosis.

I have been suggesting for many years that there is an overuse of spinal injections and surgeries for low back and leg pain, so it was no surprise when I read an article in The New York Times (NYT) that reported on a study recently published in the New England Journal of Medicine[1] about patients with spinal stenosis who are frequently treated with a procedure that has been shown to be ineffective. Epidural steroid and lidocaine injections for patients found to have spinal stenosis were no better than epidural injections of lidocaine alone. In chapter 4 of my book End Back Pain Forever I discuss the many reasons for back pain. MRIs and CT scans of the low back will almost always find something such as spinal stenosis or a degenerated or herniated disc even in patients without pain. Therefore the US Institute of Medicine suggests that these imaging studies should not be done routinely since what you find in the study is frequently not the cause of your pain. The most common cause of back pain is muscles and other soft tissue. If you treat the diagnosis you got from the MRI or CT and the actual reason for the pain is muscle, it makes sense that the treatment will frequently fail, which it does!

The NYT report of this relatively large, randomized, double blind, controlled study clearly demonstrates the ineffectiveness of the use of steroids for symptoms attributable to spinal stenosis (narrowing of the canal in the spine which contains the spinal cord) which occurs frequently as we age. The treatments most often provided are epidural steroids to theoretically reduce the inflammation of the nerves being squeezed by the narrow canal, and surgery to widen the canal. Both approaches have a significant failure rate.

At the Norman Marcus Pain Institute we have shown in multiple published articles that one reason why these approaches are ineffective is that the pain in the back and leg may not be the result of the narrowing or other supposed abnormalities seen on the MRI or CT scan. It is well known that very few (in one published article- less than 10%) scans of the low back in adults are read as normal; as many as 40% of adults with no back pain have herniated discs, and 70% have degenerated discs. So it is “normal” to find an abnormality.

B_vertebrae_function_01

Our unique physical examination, utilizes an instrument I developed, reveals that many patients with back and leg pains have areas of muscle tenderness that are the source of their pain yet are overlooked. One study of more than 23,000 patients[2] found that 70-80% of patients with back pain were diagnosed with sprains and strains of muscle and other soft tissue. It’s hard to believe then, armed with this knowledge, that muscle examination and treatment is not part of the typical standard of care for back pain in the USA[3]. If we are to properly address the cause of most back pain, the evaluation and treatment of its muscular causes must be addressed.


 

[1] Friedly JL, Comstock BA, Turner JA, et al. A Randomized Trial of Epidural Glucocorticoid Injections for Spinal Stenosis. New England Journal of Medicine. 2014:374:11-21.

[2] Deyo RA, Weinstein JN. Primary care – low back pain. New England Journal of Medicine. 2001:5:363-70.

[3] Chou R, Qaseem A, Snow V, Casey D, Cross JT, Shekelle P, et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.