Edgemont Chiropractic Blog
When a patient comes into the office seeking a solution to an episode of back or neck pain, I always ask about previous episodes. Often there is denial from the patient when I ask them if they have had any trouble in their back or neck before. “Oh no, I’ve been fine”, they reply. After a few more probing questions about their past, “ Well, just normal _______. “. You can fill in the blank with: stiffness, tightness, pulled muscles, tweaks, twinges, niggles, cricks, stiff back and hips and/or neck and shoulders. Further questioning reveals the patient may go for massage sessions regularly, all while denying they have any back or neck trouble!
Let me say clearly that after 40 years of experience, occasional stiffness, pulled back muscles, tightness, tweaks, twinges and niggles in your back or neck are not normal. Waking up with a stiff back or a crick in your neck is not normal. Your tight neck, shoulders, back and hips may be very common in our society, but that doesn’t make them normal.
And, just because these little irritants feel better after a while doesn’t mean they’ve gone away either.
Frequently, a few office visits later, the patient admits to having had a few twinges of back or neck pain, some persistent stiffness in their back or neck or the occasional niggle in the previous 1 – 3 months that they ignored before the big episode occurred. In my experience, this happens up to 90% of the time.
There are often early warning signs of a painful and disabling back or neck problem.
If I’ve just described your situation, you should be taking more action to investigate the cause and seek a solution before things get out of hand. This is one example in life when maybe you should sweat the small stuff, because in the world of back and neck pain, without taking care of the small stuff, big stuff usually follows.
Those little episodes or niggles are telling you something. Don’t discount them, massage them or wait them out. Get them attended to with a proper and thorough examination and treatment plan. The progression of back and neck trouble is accumulative. Your previous episodes and recurring niggles can result in a significant flare up of pain and disability. And the longer your suffer from your “normal” stiffness, twinges and neck cricks, the longer and harder it will be to find a solution to the underlying cause and the longer and more costly it will be to get you moving and feeling better again.
So yes, those occasional nagging little symptoms in your back or neck may be a cause for concern. Give us a call, and we’ll help you sort out these “normal” niggles before they catch up with you.
“Life can only be understood backwards; but it must be lived forwards” – Kierkegaard
Back and neck pain is extremely common in our society, causing pain and costing billions of dollars in treatment and disability costs per year.
In fact, lower back pain is the number one cause of years lived with disability in the world. Neck pain is number four.
Patients search for answers. They get confused over what’s wrong with them and what treatments will help. They start to think they must need an x-ray, CT scan or MRI scan of their spine to “see what’s wrong”.
While scans are good for detecting serious causes of pain, serious conditions actually make up less than 1% of all spinal pain. And these serious conditions may also be revealed in a good physical examination and blood tests.
Here’s the problem with scans. Typical findings on scans of the spine in anyone over 25 years old are:
1) Disc degeneration
3) Bone spurs
4) Stenosis (narrowing)
5) Disc bulges
And guess what? These findings are present in people with spine pain and without spine pain. That’s right, these finding are frequently present in people without any back or neck pain!
In fact, a recent study found that having a CT or MRI scan of your spine may actually increase the chance of having a worse outcome as you wait months in pain for specialist appointments that are often disappointing to most patients. Surgery is rarely the answer.
In my 40 years of experience, it is infrequent that a scan has altered the treatment, improved patient symptoms and very infrequent that it diagnosed some unforeseen serious condition.
Scans show your anatomy, not your pain. And pain is a very complex process mainly involving your spine, nervous system and brain. You can’t take a picture of it, at least not yet.
What’s Often The Real Issue?
Studies repeatedly show that in up to 95% of scans, neck and back pain is accompanied by profound changes in some of the stabilizing muscles of the spine. MRI scans do show things like fatty infiltration of muscles and muscle degeneration, but unfortunately are not usually mentioned in your scan report. Yet it’s probably the most important finding and the one thing you can do something about.
There’s a concept we discuss in the clinic called “Load-Tolerance”. If your load exceeds your tolerance, pain may result. It may be micro-injury, or it may be your sensitized nervous system on the lookout for possible injury and giving you a warning sign. Pain does not always mean tissue injury or damage.
In daily life, you are placing a load on your spine that it sometimes can’t tolerate or scares your nervous system and brain. The brain creates a pain response to get your attention.
For many people, just sitting all day is putting more load on their back that it can tolerate, and that creates pain. Your brain is yelling at you to get up and get moving.
For others, it’s doing their 1-2 hour walk on the weekend after having only minimal exercise or activity during the week. For some, it’s standing or walking slowly that overloads their muscle capacity. Standing and slow walking place more load on the spine that brisk walking.
Here’s what you can do:
Increase your tolerance for load. Stress causes adaptation.
- You need a good functioning spine, that’s one of our jobs here at Edgemont Chiropractic Clinic.
- Then get strong.
You need at least 30 minutes a day of some exercise activity that you like to do.
Usually any exercise or activity will do, but tell us your exercise program to be sure there are not activities that may be stressful for your spine at this time.
You need at least one hour, twice a week of strength training. Not a day of back exercises, a day of chest, a day of arms and legs. It’s your whole body that needs the integrated strength training.
You need functional strength training. Farm boy / farm girl strength. Your exercise program should include these functional and fundamental movements:
3) Hip hinging
6) Loaded carries
8) A few specific spine exercises as required
9) And a fabulous exercise that puts it all together, the Turkish Get Up. You can learn about it here.
These are the movements you will use in your daily life. You don’t use a bench press or leg press motion too often in daily life. And quit spending all that time training your core. That might be part of your problem. Read about it here.
If you’re getting older, you’re losing muscle at an increasing rate year by year, and getting weaker year by year.
An additional benefit is that we now know that strength training is superior to aerobic exercise in providing some protection from cognitive decline associated with aging.
We also know that 20-30 years of muscle wasting can be reversed in 2-3 months of supervised weight training.
You need good sleep. Sleep helps the body heal and decreases our sensitivity to pain through repair processes in the muscle and the brain.
You should be sure to hydrate and eat well.
And finally, it’s now being suggested that degeneration of discs and arthritis in the spine is not just “wear and tear”, it’s due to the fact that you haven’t had enough “wear and repair” in your lifetime. Sedentary people get more disc degeneration than active people. Load, when appropriately applied, stimulates bone, disc, nerve and muscle cells to produce healthy strong tissue!
And it’s never too late to start.
The One Thing You Are Doing In The Gym ( Or At Home ) That May Be Keeping You In Pain.
“To me, if life boils down to one thing, it’s movement. To live is to keep moving” – Jerry Seinfeld
Most gym and non – gym people agree on one thing – they are either doing lots of core exercises or say they need to do more core exercises.
I see a whole lot of people in my practice with back pain who are doing “a ton of core exercises”.
If those core exercises were so good for you, why are you in my office today?
The Myth Of Needing a Strong Core
“Simply put, a solid core is sexy” – Dan Cohen
That may be, but…
There’s a myth that the core muscles need to be trained hard to prevent back pain. Actually, there’s little scientific evidence to support this notion. While being able to activate and engage your core muscles is important, it’s equally important to be able to release and relax your core muscles when needed and while moving about all day.
People who over-train their core put excessive strain on their back while they are doing their core exercises. That adds stress, excessive stiffness and compression to their back all day as they continue to “engage’ their core, ending up with a back ache.
The same applies to those who do the plank exercise when they hold it for 30 seconds or longer. Can you think of any activity in daily life that requires you to contract those muscles that hard for that long? And you’re probably breathing quite shallow during your 30 plus second plank, missing the opportunity to engage and exercise the most important core muscle of all, your diaphragm.
The real trick is learning how to quickly engage your core, and just as quickly relax your core when needed in sport activities and throughout the day.
Here’s How You Do It.
“If you want something you’ve never had, you have to do something you’ve never done” – Thomas Jefferson
Start with practicing your abdominal breathing. Lay on the floor, face down, forehead resting on your hands as shown. Take a full breath in and expand your abdomen and feel your belly push into the floor. Your lower back will rise up a little, and that’s good for it. Your chest and upper ribs should not rise up.
Once you’ve done 20-25 breathes in this position, it’s time for your 10-15 second planks, while maintaining an abdominal breathing pattern. Try it. Difficult isn’t it? But now you’re engaging your diaphragm, one of your most important muscles of your core!
Hold this plank position for 10-15 seconds, or for three to five abdominal breaths. Pull your elbows towards your feet, while maintaining the position above. Then relax your knees to the floor, take in another two or three breaths, and get into your plank position again. Repeat about 10 times. You don’t need a gym to do this.
This turning on and off of your core muscles will add to your athletic ability and help protect your back when you need to. It will also teach you how to relax your core when you need to. And how to breathe properly.
You don’t need to walk around all day like you’re about to do a 200 pound deadlift.
~ Dr. Olson
While Covid 19 is still around us, we are meeting and exceeding all health, safety and sanitation guidelines as provided to us by the provincial health authorities.
In order to keep us all safe, please review our operating procedures:
Booking Your Appointment. When you call to book an appointment, you will be screened for any Covid 19 symptoms. If you have any symptoms you suspect may be related to Covid 19, please use the BC Covid 19 Assessment Tool on-line or call 811. During this time, we are waiving all cancellation fees, so call and cancel if you feel unwell.
Appointment Times Are Staggered To Limit The Number Of Patients In The Clinic At Any One Time. We will be practicing social distancing.
Please Arrive Just A Few Minutes Early For Your Appointment. Please don’t arrive too early or too late.
When You Arrive. Please use our hand sanitizers and keep conversations to a minimum. If you can, please come alone to limit the number of people in our reception area.
Practice Social Distancing. Check in at the reception desk, then please take a seat.
During Your Treatment. We’d like you to wear a mask, but it’s not mandatory. Your doctor will be wearing one. Please keep conversations to a minimum so we can focus on your health and maximize your appointment time.
The Treatment Room Will Be Sanitized Before You Enter. We will meet and exceed all health, safety and sanitizing guidelines from our provincial health authorities throughout the clinic.
Please Book Your Next Appointment Before You Leave. This helps us control our schedule to keep everyone safe.
Our website and Facebook pages are continually updated with helpful health tips and exercises.
Dr. Olson and Dr. Caroon also co-created patient information webinars on neck pain, breathing techniques for core strength and lower back pain. These are available for you to view on our website here.
Thank you for reviewing our new clinic operating procedures.
We are looking forward to serving you and helping you reach your health goals.
Your health and safety is our number one priority.
Here’s the fourth installment in our Anti-Sitting Strategy series.
This exercise is a real get-down type of exercise. You have to get down on the floor and crawl around. Great exercise for core muscle control, shoulder stabilization and neck strength. Here’s how…
Get on your hands and knees. Starting position is on all fours, hands under shoulders and knees under hips. Keep your spine in a neutral position, a small dip in your lower back and keep your head and neck in line with the spine – don’t let your head drop down or look up too much. Keep your neck long.
Start by moving one hand forward at the same time as you move your opposite knee forward. Then bring your other hand and opposite knee forward as you start to crawl. Sounds easy, but some people have a great deal of trouble synchronizing the opposite hand/knee movement at the same time, and then switching to the other arm/leg.
Practice crawling up and down a hallway to get the hang of it. It helps if your hallway has carpet – easier on your knees!
Once you have the basic crawling motion down pat, place a small ball ( tennis or golf ball) in the small of your back. Keep it balanced there while you crawl forward. Try more challenge by crawling backwards. Don’t let that ball roll off your back.
A few minutes of crawling two or three times a day is all it takes. Dogs and kids love to crawl around with you. Cats, not so much.
Here’s the third instalment of our anti-sitting strategy exercises
This exercise has to do with muscle strength. Muscle weakness and atrophy can occur after about 7 days of inactivity. As muscles weaken they get tired and sore and weight-bearing loads are gradually transferred to the joints and ligament system of the body, adding joint pain and stiffness.
Anti-Sitting Strategy #3 – The Farmer’s Carry
While we can’t get to the gym these days, we can do a simple overall weight-bearing exercise in our homes. All you need are two weights, each weighing 15-20 pounds. Some suggestions for weights are two pails or buckets filled equally with water, rocks or dirt from the garden or two evenly filled re-usable grocery bags filled with tin cans. This exercise will strengthen your core, arms, legs and improve your posture all at the same time!
Start with your weights placed on a low surface, you don’t want to pick these up off the ground. Bend at the hips and use your glutes to stand tall with a weight in each hand.
Keeping a tall posture and your shoulders relaxed, walk up and down a hallway or anywhere around your house or apartment.
One or two minutes is enough and should be performed a few times during the day. A heavier weight actually makes the exercise feel better and more effective, but please be careful when you pick the weights up and put them back down.
And thanks to Sheila Hamilton at it’s time! Fitness Results for the photos!
We interrupt our series on Anti-Sitting Strategies to give you some advice for an acute attack of back or neck pain. Here’s a quick guide to some self help measures. Our Anti-Sitting Strategy exercises will resume next week.
- Keep moving. Too much rest will stiffen joints, weaken muscles, delay healing and disconnect some of the brain neuropathways to and from the muscles. Move your body in as many ways and directions you can think of.
- Limit sitting. Get up and move for a couple of minutes after every 20-30 minutes of sitting. Change your posture frequently.
- Don’t hold stretches. Your nervous system is tightening your muscles to protect you. Don’t rile them up and make them mad, they’ll tighten even more. Keep moving in all directions but don’t hold a stretch position for more than 5 seconds. You can repeat the 5 second hold up to ten times after a brief period ( 5 seconds ) of relaxation. Again, move in as many ways and positions you can think of. Be creative.
- Avoid prolonged massage over the area. A few minutes of gentle massage is helpful, but remember those muscles are tight to protect you, so don’t overdo it.
- No yoga, Pilates or gym classes for a few days. ( you can’t go right now anyway)
- Be mindful of medication use. Over the counter medications for inflammation may be helpful. They work best when taken on a regular schedule ( a few times a day – check product instructions ) but only for a couple of days. Using them for too long may delay healing.
- Use ice for the first 48 hours. If you used heat, don’t worry, it won’t necessarily make you any worse. Research is still unclear regarding which is better, ice or heat. Use what feels best to you. Whichever you use, the 15 minutes on, 15 minutes off and 15 minutes on rule works well. Then repeat in about 2 hours. And remember, never put an ice pack directly on the skin – it can burn – wrap ice in a moist towel before applying.
- Walk. Maintain social distancing. Walk for 10 minutes, three times daily.
- Rest. Periodically lie on your back with a small pillow under your knees and a small pillow under your head. Don’t rest your neck on a thick pillow.
- Sleep on your side with a pillow between your knees. Now you can use a thicker pillow for under your neck.
- Use topical ointments. Most of these ointments act as a counter-irritant. In other words, they stimulate the nerves to feel the hot/cool sensations and may block some of the pain signals.
- Abdominal breathing. If you have lower back pain, lie on your stomach and perform deep breaths into your belly. Feel your stomach push down into the floor and your lower back rise up slightly. Try not to raise your upper chest and shoulders with each breath. If it’s your neck that’s sore, lie on your back with a small pillow under your neck. Relax and breathe! Do this for at least 5 minutes every hour.
- Keep hydrated.
- Email Dr. Olson or Dr. Caroon for advice if needed. Email addresses below.
“We should take comfort that while we may have more still to endure, better days will return. We will be with our friends again. We will be with our families again. We will meet again.”
Queen Elizabeth II
April 5, 2020
Furthering our series of Anti-Sitting Strategies, here’s another exercise for you.
Hips get very tight with sitting and inactivity. So much so that stress and strain gets loaded onto the lower back contributing to overall back pain, hip pain and sciatica. Keeping mobile hips during these challenging times is essential.
Anti-Sitting Strategy #2, The Frog Stretch:
Start on all fours with a neutral spine. Place a broom stick along your back ensuring that the back of your head, mid back and base of your spine contact the stick.
There must be a small gap between the stick and your lower back. You can remove the broomstick. Now you have a neutral spine position. Place your knees wide apart, wider than your hips.
If your knees are tender you can place a small folded towel under each knee.
Maintaining your neutral spine, rock your hips back towards your heels. Keep a slight arch in your lower back (arrow).
You should feel a nice stretch in the upper inner thigh area. Don’t over-force this stretch, but you do want to feel a mild to moderate stretch.
Hold for 6 seconds, then move forward back to your starting position.
Repeat 10-15 times, as often as you like during the day.
This will help get the rust out of tight hips and achy backs.
Well, I don’t know about you, but I’ve been sitting way too much. Here’s my antidote to sitting: The Bridge Exercise.
Raise hips up off floor, keeping your core engaged and using your glute muscles. Hold for a few seconds, then slowly lower back down. Repeat 10-15 times for maximum effect. Three times daily or as needed!
If you’ve become a couch – potato like me during these extraordinary times, you’ve probably finished Netflix by now and it’s time to get some exercise. We start to lose muscle after about a week of inactivity.
But we’re essentially confined to our homes and it’s sometimes hard to maintain social distancing when outdoors. What can we do from the safety of our couch?
Fortunately, there’s been some compelling research that suggests simply thinking about a specific exercise or activity can make us stronger.
Motor imagery is a technique often used by athletes and others in the performing arts. It requires you to vividly imagine performing a specific exercise or task over a period of time, just like physical exercise. Motor imagery exercises the part of the brain where the impulse to move the muscle originates. In one study, participants used 22% more of their muscles after using the motor imagery technique.
In 2014, researchers performed a study involving subjects whose arm was in a cast. Half of the subjects were told to imagine flexing their wrists for 15 minutes, 5 times a week for 4 weeks. At the end of 4 weeks, this group was twice as strong compared to the group that did not perform the motor imagery technique.
So, pick an exercise. Let’s use a squat as an example because I’m not too fond of doing squats in real life. Sit still and vividly imagine performing the up and down movement of the squat exercise. Do it for 15 minutes. You might get brain strain, but no muscle burn to suffer. Repeat 5 times a week for the next month. It will give you some get up and go when the time comes that we can all get up off our couches and go back to normal life again.
While motor imagery is not a substitute for real exercise, it can supplement physical exercise and improve muscle performance.
And you don’t have to move a muscle.