Patients guide to low back pain

Low back pain is one of the most common disorders in North America.  About 80% of people suffer from low back pain at least once in their lifetime.

There are a number of things that increase your risk of developing low back pain.  These include smoking, obesity, older age, female gender, physically strenuous work, sedentary work, stressful job, job dissatisfaction anxiety and depression.  This is not to say that these factors cause low back pain, however they are linked to it.

Low back pain can have many causes.  However, most people suffer from non-specific low back pain, which means that there is not a specific disease or abnormality in the spine clearly causing the pain.  Many people attribute their back pain to a degenerating disc or arthritis, although problems in the muscles, ligaments or joints may be equally responsible.  Many of these problems cannot be seen on imaging tests, such as X-rays, MRIs or CT scans, however it may be important to undergo these examiantions to rule out more significant pathology.

Rarely, back pain is caused by a potentially serious spinal condition, such as infection, fracture, tumor or cauda equina syndrome.  It is a health practitioner’s role to identify these conditions and manage it appropriately.

There are many forms of treatment for low back pain.  People who suffer from non-specific low back pain or mechanical low back pain can undergo many forms of formal or informal treatment.  These include heat or ice therapy, exercise, physical therapy, manipulation, mobilizations, acupuncture, massage, yoga and interferential current.

The risk for low back pain can be reduced from occurring or returning.  The most important factor is exercise and staying active. Regular exercise that improves cardiovascular fitness can be combined with specific exercises to strengthen the muscles of the hips, torso and core without putting additional strain on the back.  It is also important to avoid repetitive bending or twisting and high-impact activities that increases the stress in the spine.

People with low back pain should learn the right way to bend and lift.  As an example, lifting should always be done with the knees bent and the abdominal muscles tightened to avoid straining the weaker muscles in the lower back.

People who sit or stand for long periods of time should change positions often and use a chair with appropriate support for the back.  An office chair should be readjusted several times through the day to avoid sitting in the same position.  Taking brief but frequent breaks to walk around will also prevent pain due to prolonged sitting or standing.  People who stand in place for long periods can try placing a block of wood on the floor, stepping up and down every few minutes.

Your healthcare provider is the best source of information for questions and concerns related to your health related problems.  Chiropractors are specialists in treating back pain and are trained in identifying all back related problems, including serious conditions.  The providers at MOBO PHYSIO are more than happy to meet with you to review your case.

Dr. Justin Arseneau, DC

HEAT vs ICE

Every day, patients ask me “What’s better, heat or cold?”, to which I ask them “Which do you find feels better?”.  Almost every time their response correlated with the theoretical clinical choice.

Cold Therapy

Cold therapy increased vasoconstriction of the local blood vessels (decreased size of the blood vessels).  It decreases inflammation, edema, cellular metabolism and nutrition. Cold therapy also decreases muscle tone

Who would benefit from cold therapy? Cold therapy is best used in the acute phase of an injury.   This is when inflammation and edema are the greatest.

Heat Therapy

Heat therapy increases the local temperature of a tissue, which increased vasodilatation (increased size of blood vessels).  This is true only of more superficial structures in the body as deeper structures are insulated from this effect.  Heat also permits muscle relaxation, decreased sensitivity to nerve endings if the heat is mild, increased cell permeability and metabolism and possibly edema.

So who would benefit from these effects?  Patients who are passed the acute phase of injury.  In this stage of healing, tissue healing is promoted by increasing circulation and nutrients to the area.

These are not hard and fast rules to heat and cold therapy and your condition may not react in the same way.  For further information health care provider regarding heat or cold therapy for your specific condition.

Dr. Justin Arseneau, DC

Shoe Selection: Part 1

 

Wearing the appropriate shoe during a specific sporting activity can improve performance and comfort, and most importantly, prevent injuries.  Sports can place a lot of stress on your feet, ankles, kness, hips and low back.  For example, jumping can generate forces that are 3-5 times greater than a person’s body weight through their legs.

Tips for finding the right shoe:

  • Try shoes on at the end of the day or after a workout.  Your feet swell through the day and a shoe should be able to accommodate your feet.
  • When trying on shoes, wear the same type of sock that you would wear when participating in the sport or activity.
  • Tie the laces up as you would normally and check the following

    • The heel counter (the back of the shoe that holds the heel in place) should grip your heel to maintain stability
    • There should be at least 1/2 inch space between the tip of your toe and the end of te shoe
    • The toe box should be wide enough for you to wiggle your toes confortably

Try the shoes on to ensure they fit comfortably.  Also, inspect the shoe on a level surface to make sure they are free of defects.

All shoes should also pass the following tests:

  • Dish Rag Test

    Grab the rear and for foot of the shoe and twist.  If it twists, it fails!

  • Pinch Test

    Pinch the upper part of the heel counter (above the midsole area), then pushon the back of the heel to try and bucle the material.  If it buckles, it fails!

  • Fold Test

    Push the toe of the shoe in and try to fold the shoe in half.  If the shoe folds just below the toes it passes.  If it folds halfway down the shoe or in half it fails!

 

  • Shelf Test

    Rest the shoes on a shelf and look at them from behind.  Are they symmetrical and straight?  If not, they fail!

These are tests to help determine if shoes will provide you with enough support.  Although they are a good screen, there are exceptions to these rules.  If you are unsure if a shoe is appropriate or will provide adequate support, contact one of our health care professionals at MOBO PHYSIO for assistance.

Dr. Justin Arseneau, DC

UNDERSTANDING ARTHRITIS

The Osteoarthritis Society of Canada predicts that within the next generation one person will be diagnosed with osteoarthritis (OA) every 60 seconds. OA is a painful condition caused by a gradual loss of cartilage and inflammation in the joint. There are over 100 types of arthritis and OA is the most common. 1 in 10 Canadians are affected by OA. It is the leading cause of pain and disability worldwide. It affects predominantly the knees, hips, hands and spine and common symptoms include pain and stiffness in these joints. The prevalence of OA increases with age, and factors such as lifestyle, work and family history can contribute to this condition. What can you expect to determine a diagnosis of osteoarthritis? OA requires a combination of patient history, discussion of symptoms, manual examination and diagnostic imaging. The combination of imaging and a diagnostic examination leads to a better understanding of the patients symptoms. Based on the examination findings and your symptoms, your chiropractor will work with you to determine an appropriate course of treatment. How can we treat OA? Because OA is a multifactoral condition, a combination of treatments modalities and techniques is generally required to adequately treat it that is tailored to the patients specific condition. It is important to work with your healthcare provider to create an effective and acceptable long-term plan for managing with arthritis. Exercise has been proven to be beneficial and leads to an increase in quality of life of OA patients. This includes specific aquatic, stretching, aerobic and resistance exercises that are beneficial and effective for this condition. Spinal adjustments (SMT) have also been shown to be beneficial. Patients who undergo SMT report positive results, including pain relief and increased function. Acupuncture has also been show to be beneficial in controlling the symptoms of OA. Education and support is a major component of arthritis treatment. By learning more about arthritis you can better participate in your own care. It is important to discuss OA treatment options, the effects of OA on daily activities, and the strategies for coping with limitations imposed by OA with your chiropractor. Other treatments that are effective include weight loss, orthoses, certain assistive devices, heat and cold therapies and TENS treatment. There are many treatment options for OA patients and a customized balance of treatment options is generally required for maximum benefit. Patient commitment is a crucial component to establish an effective treatment plan. A working relationship between your chiropractor and other health care providers is also beneficial. Your healthcare provider is the best source of information for questions and concerns related to OA. Dr. Justin Arseneau, DC