Tag Archive for 'Low Back Pain'

Pain at Work

Published
by
Dr. Gould
on March 30, 2008
in Carpal Tunnel Syndrome, Headaches and Repetitive Stress Injuries
. 0 Comments

ergo2.bmp

Since opening my practice in 1988, I have had the privilege of teaching many local companies both big and small, the importance of Work-Station-Fit. What do I mean by Work-Station-Fit? I teach people how to make adjustments to their work environment so that the work environment fits their body, instead of their body trying to fit their work environment. By making a few simple changes comfort and fatigue are greatly reduced. This is what Ergonomics is all about.

Regardless of what you do for a living, having a simple understanding of Ergonomics can prevent a lot of pain syndromes and health problems. Improper ergonomics can lead to a variety of problems. Here are the most common problems: headaches, neck pain, shoulder and arm pain, carpal tunnel syndrome, upper back and lower back pain, varicose veins in the lower legs.

I’d like to give you a brief simple lesson in body mechanics.

First of all, our body is very efficient when it comes to energy consumption when we maintain an ideal posture. This ideal posture has a name, it is called the Neutral Position. Our body is said to be in a neutral position when all the weight of our body is balanced on the boney structures of our body, allowing it to be transferred into the seat pan of a chair (if we are sitting) or into the floor (if we are standing).

However, when we deviate from this neutral position our energy consumption goes up due to our weight being transferred away from our bone to the muscle. Going from the sitting position to the standing position requires us to get out of the neutral position. Imagine trying to stand in a position that is halfway between sitting and standing. I can tell you you would not last long. Why? Your muscles are now primarially responsible for holding all of your body weight up, not your bones. The load gets transferred from the boney structures of your body to the muscles.

So now you understand why you should try to obtain this neutral postition. So what does the neutral position look like? Here are a few guidelines:

If you are standing…

Stand straight up. Legs and feet symmetrical. Your head is looking straight ahead. Your arms are at your sides or if you are working at a table your elbows can be bent at a 70 to 90 degree angle. If you are working with your hands and eyes the table top should be elevated.

If you are sitting…

As you sit down push your bottom all the way back into the back of the chair, that way when you straighten up a natural curve will form in your lower back. Your head should be looking straight ahead. Not looking up or looking down. Now position your monitor, so that if you brought it to your face the center of the screen would touch your chin. Remember the 90 degree rule, elbows and knees should be at 90 degrees. Your feet should be flat on the floor. The edge of the seat pan (the part directly underneath your knees) should not be putting pressure on the back of your legs. Pressure on this area prevents the blood from returning from the lower leg, this can cause varicose veins. If your chair allows you to make and adjustment, make the adjustment. If not, put something under your feet to eliminate the pressure on the back side of the knee. If you use a keyboard keep your hands and wrists straight. Any deviation from this can lead to carpal tunnel issues.

Below is a humorous example of both good and bad ergonomics. Pay attention and learn.

I hope this has been helpful.

Yours in Health!

Dr. Gould

Antalgic Spine

Published
by
Dr. Gould
on February 27, 2008
in Cincinnati Chiropractors and Low Back Pain
. 0 Comments

antalgic.bmpAntalgia! We have all seen this and some of us unfortunately have experienced it. So what exactly is an antalgic spine and what causes it? As the picture demonstrates, the spine takes on an abnormal curve. There are a variety of things that can initiate this, ranging from trying to lift something heavy to simply rolling over in bed. To say the least, it can be very frustrating. Not only is it unsightly but also very painful.

So what causes our spine to become antalgic? The simple explanation for this is weakness of the spinal muscles. Specifically the (paravertebral) muscles located on either side of the spine. This weakness allows more of the load of your body weight to be transferred away from the boney structures of the spine to the soft tissues around the spine. Specifically the disc.

A disc is made up of two parts. The ball like center is called the nucleus. Wrapping around the nucleus, in concentric rings, is a ligamentous structure called the annulus. By design, the disc allows the vertebra to tip on one another. This tipping allows us to bend in all directions.

Imagine watching two kids on a teeter-totter. When one goes up the other goes down. What allows this to occur is a center pivot point or fulcrum. The nucleus does the exact same thing, it allows the vertebra to tip or teeter on the other. When you bend to the right the nucleus actually shifts to the left in each disc. This causes a wedging of the disc. When you straighten back up the nucleus migrates back to the center.

The spine becomes antalgic when the nucleus does not migrate back to the center position. Within a short period of time the muscles that surround that area go into spasm which inturn causes more pain.

Correcting the problem requires isolating where it is occurring and then a series of spinal adjustments to reposition or center the nucleus. Once recentered, exercises are provided to strengthen the paravertebral musculature to prevent future occurrance.

I hope this has been helpful. If you should have a question or would like to make a comment please do so at the bottom of the page.

Yours in Health!

Dr. Gould

Is Your Mattress Causing Back Pain

Published
by
Dr. Gould
on February 24, 2008
in Cincinnati Chiropractors and Wellness 101
. 0 Comments

hammock.bmpMany people sleep on older mattresses. By definition, your mattress is older if it is between 8 and 10 years old. Over time your mattress loses its ability to properly support your body. Like many things, this happens slowly over time, so we rarely notice it. What we do notice however, is we are not sleeping soundly or we wake up feeling stiff and in some cases in pain.

The typical older mattress causes what I call “hammocking” of your body. Imagine what your body would look like laying in a hammock. Your feet and head are higher than your bottom. Lying like this for several hours can cause a variety of things to happen to the spine. In your lower back it causes the forward curve of the spine to flatten out. This in-turn causes the spinal joints in your lower back to spread apart, in many cases causing muscle spasm to occur.

If you suffer from back pain it may be due to your mattress and box-springs. Check to see if your mattress has lost its ability to support your body weight. Have someone stand at the side of the bed while you lay in the center of the mattress on your back. Ask them if you are hammocking. If so, it’s time to shop for a new mattress and box-spring.

People always ask me what is the best type of mattress and box-spring. I always tell them that it is a very individual thing. You can spend several hundred, to several thousands of dollars on a mattress and box-springs and find yourself very dissatisfied after several nights of use. Just remember, all mattresses and box-springs have pros & cons.

What you are looking for is a mattress that is both comfortable and offers adequate spinal support. In the majority of cases, a medium to firm mattress with a pillow top usually does the trick.

When you are shopping go to a variety of stores. Don’t be in a hurry and do not allow the salesman to sell you, allow your spine to tell you. When you lay on a mattress and your body and spine go Ahhhhhhh! You know you have found a good one.

Let me know if this has been helpful?

Yours in Health,

Dr. Gould

Low Back Pain

Published
by
Dr. Gould
on February 8, 2008
in Low Back Pain
. 0 Comments

Low Back Pain

Low Back PainThe causes of low back pain are many. Finding the actual cause is very important. Typically, people do things that simply “numb” the problem. Numbing the problem however, with various medications only allows the problem to continue, ultimately causing more pain, disability and degeneration. A thorough history and examination with the appropriate diagnostic workup is necessary to find the actual cause of low back pain.

Below are several causes of low back pain:

• Poor Posture – Causes an improper loading of the spine. Improper spinal loading, forces weight to be placed on structures that were not designed to carry weight. This type of compensation ultimately causes pain. In the majority of cases, poor posture is a symptom of years of inadequate exercise and improper sitting postures both at home and at work. Watch your posture. Watch your children’s posture. I tell patients all the time that proper posture in children is critical. I have a saying I use all the time… As the twig is bent the tree shall grow.

• Disc problems – See Disc Problems

• Facet Syndrome – See Facet Syndrome

• Lumbar Subluxations – Misalignments or subluxations are the true enemy of the disc and spinal joints. When your spine becomes subluxated the disc’s normal pumping motion is reduced or in severe cases, completely eliminated due to loss of motion. This pumping motion is needed to pull in nutrients and eliminate waste in both the joints and the discs.

• Osteoarthritis - If the subluxation is not corrected, degenerative processes begin leading to osteoarthritis. This is a degeneration of both the disc and the spinal joints at that same level. Once this happens, the areas above and below the affected area have to compensate for the osteoarthritic area. Over time these areas will begin to become problematic also.

• Pelvic Problems – The pelvis is actually made up of three separate bones. Two side bones or iliums and a center bone called the sacrum. These bones come together and form joints. There are actually three joints in the pelvis. There is a single joint in the front of the pelvis and two in the rear. These joints allow motion to occur when we move and walk. On occasion these joints become misaligned or subluxated. When this happens the lower back can respond by tightening muscles, shifting vertebrae which in turn can cause a stretching of spinal joints. All produce pain.

Eight out of ten people in the Cincinnati area will experience back pain during their lifetime. There are really only two choices of treatment when it comes to back pain. 1) If you choose to treat the symptom you are allowing the problem to get worse. Remember… Eliminating the pain with drugs does not eliminate the problem. 2) If you choose to treat the cause you will be working on eliminating the problem for good. A large percentage of my practice is made up of people that have had low back pain.

Facet Syndrome

Published
by
Dr. Gould
on February 8, 2008
in Facet Syndrome
. 0 Comments

facet-2.jpgfacet-2.jpgFacet Syndrome occurs when the joints of the spine jam. Jamming of the spinal joints usually occurs with hyperextension (excessive backwards motion). Jamming can also be caused form congenital postural problems or obesity. The spinal joints are designed to allow a certain amount of extension, if this amount is exceeded; the spinal joints become damaged, inflamed and very painful. If you bend backwards and it hurts, that is usually an indication that you may have a facet syndrome.

Our spine has four curves. It is these curves that give us amazing flexibility. However, if the curve flattens out or increases problems can occur. Facet syndrome is usually seen in the lumbar spine or lower back. It happens when there is an increase or an accentuation of the lumbar curve. This increased curve is called a hyperlordosis. A hyperlordotic spine is predisposed to this type of syndrome due to the increased load it puts on the facets and joint capsule.

I have treated many people in the Cincinnati area that have had facet syndrome. Spinal adjustments coupled with home exercises are very effective at eliminating this syndrome. Like most neuromuscular problems, it is best to seek out treatment early. The longer you wait the more difficult your case becomes.