How Commuting Effects Your Neck and Back Pain

Unless you're a work-at-home member of the labor force (which has its own health risks, by the way), most of us commute from home to work and back again at least five days a week. From a health perspective, research suggests commuting is bad news, and it goes beyond the stress associated with those bumper-to-bumper, road-rage meltdowns you find yourself experiencing ... but somehow think you can handle day after day, week after week, year after year.
 
According to several recent studies, commuting – particularly longer times spent commuting – has a negative impact on weight, blood pressure, sleep quality / amount and heart disease. One study suggested the longer the commute, the higher the commuter's body-mass index, waist circumference, diastolic and systolic blood pressure, and metabolic risk factors. Another study found that high blood pressure, stress and heart disease were more likely in people who commuted more than 30 miles a day. And in a third study, researchers concluded: "Commuting long distances negatively impacts one's ability to capture adequate sleep."

The Telecommuting Age isn't necessarily solving the commuting health crisis, either; after all, even as more people work from home, the population at large continues to do more driving and less transportation by other means (bikes, foot, etc.). More time in cars, less time exercising - another recipe for health disaster.

The solution, if there is one, is to find ways to make your commutes as short, stress-free and infrequent as possible. Here are a few suggestions:

• Map it out: If there are multiple routes to your job, try some trial and error to determine which one gets you to and from work in the shortest – and least painful – amount of time.
• Try 40 in 4: If your employer / state allows, ask about a possible four-day, 10-hour-a-day workweek option. You'll find that the 10 hours aren't a major drain, and you'll appreciate the extra day away from work – and out of the traffic jams.
• Carpool: Yes, you're still spending time in a car, but at least you aren't always the one driving (and dealing with other drivers); and you're also not alone with your traffic frustrations, all of which contribute to stress.
• Schedule it & stick to it: A likely explanation for why longer commutes lead to higher weight, etc., is not only that commuters sit in a car too long, but also that by the time they get home, they have little time – or perhaps interest – in exercising. Schedule in exercise before or after work and stick to the routine. It will help counter some of the effects of your commute, including stress.

For many people, commuting is a reality, and depending on the job opportunity and living situation, they can't change the distance to and from work. But that doesn't mean you're destined to a life in the slow lane and its debilitating health effects.

DC or MD: What's The Difference For Back Pain?

When you're suffering low back pain, shoulder pain or any number of similar musculoskeletal conditions, who gets the call: your medical doctor or your doctor of chiropractic? Your choice of health care provider in those situations could make a big difference, and research is continuing to prove it. According to the latest study, chiropractic care is at least as effective as medical care for certain musculoskeletal conditions, while reducing health care costs and leaving patients more satisfied with the results.

The authors of the study, published in the Journal of Manipulative and Physiological Therapeutics (JMPT), went so far as to state that for certain musculoskeletal conditions, visiting an MD first instead of a DC may actually be a mistake:

"The findings of this study support first-contact care provided by DCs as an alternative to first-contact care provided by MDs for a select number of musculoskeletal conditions. Restrictive models of care in which patients are required to contact a medical provider before consulting a chiropractic provider may be counterproductive for patients experiencing the musculoskeletal conditions investigated and possibly others."

The study sample included 403 patients who saw medical doctors and 316 patients who saw doctors of chiropractic as the initial health care providers for their spinal, hip or shoulder pain complaint. Four months following care, all patients completed a questionnaire that evaluated pain on that day and four months earlier (11-point scale); satisfaction with care received and the results of that care (5-point scale from "very satisfied" to "very unsatisfied"); and other variables. The researchers evaluated related costs of care by reviewing an insurance claims database.

"Patients initially consulting MDs had significantly less reduction in their numerical pain rating score and were significantly less likely to be satisfied with the care received and the outcome of care." What's more average per-patient costs over the four-month period were significantly lower in patients who initially consulted DCs ($368 difference compared to MD care).

JMPT Editor-in-Chief Claire Johnson, DC, MEd, emphasized the importance of the latest findings: "Comparative studies – in other words, research that compares the outcomes between two different providers or modalities – are rare for chiropractic care," she said. "Thus, this study ... is especially important if payers and policy-makers are to better understand the ‘triple aim' as it relates to chiropractic. Specifically, this study helps us better understand what type of care provides better patient satisfaction, is more cost effective, and improves population health."

The answer, suggests an increasing body of research, is chiropractic care.

How To Help Prevent Back & Neck Pain

Your spine is the backbone of your entire body – literally and figuratively. That means poor spine health can negatively impact you from head to toe. How can you keep your spine in shape? Let's learn more about this critical anatomical structure and take a look at some of the simple strategies you can employ to ensure a healthy spine and a healthy body.

Exercises (to Do and Not to Do):
 Since we're talking shape here, let's start with a few exercises that help promote spinal health in the form of proper posture – along with a few that promote poor posture and put the spine at risk. First, a strong core supports the spine, whereas a weak core can lead to pain and injury. To build the core, think planks, bent-leg knee raises, stability ball exercises, ab curls, medicine ball slams and other exercises that strengthen the core muscles (remembering to keep your spine protected at all times by avoiding rounding the back / neck). On the other hand, avoid exercises / movements that unduly stress the spine: slumping while sitting and bending forward immediately after sitting come to mind, as do exercises that make you prone to rounding your back (traditional sit-ups, toe-touches, etc.).

Sleep Matters:
 Your sleep position and the overall quality of your sleep play a big role in spinal health. The ideal position for the spine during sleep places you on your back with a pillow between your legs. As you might imagine, lying on your stomach is the worse position. Your pillow and mattress also matter, so make sure you choose the right ones for you, or your spine will let you know with neck and/or back pain. (Talk to your chiropractor for suggestions.)

Nutrition Essentials:
 Believe it or not, certain foods promote a healthy spine (and vice versa). For example, adequate water intake is necessary to nourish not only the body's cells, but also the spinal intervertebral discs, which consist primarily of water at birth. As you might imagine, water helps keep the discs (and thus the spine) from getting stiff and subject to injury.  In addition, an anti-inflammatory diet is key to preventing back pain and other spine problems due to inflammation. Think foods such as omega-3 fish and lean proteins, fresh produce, avocado, olive oil, and various spices while reducing intake of pro-inflammatory foods (most fast foods and processed foods, sugar-laden sweets, etc.).

Chiropractic Care:
 No conversation about spine health would be complete without mentioning chiropractic, an entire health care profession founded on the principle that a healthy, properly aligned spine has far-reaching effects on the entire body. Research asserts chiropractic's effectiveness in treating back pain, neck pain and various other musculoskeletal conditions, and the goal of periodic chiropractic care is to maintain spinal health, optimize the body's self-healing capacities, and thus prevent pain from returning. If you haven't been to a chiropractor yet, what are you waiting for? If you've visited one, but haven't returned in awhile, remember: your spine – and your entire body – deserve it.

5 Common Causes of Neck Pain (and How Chiropractic Can Help)

Neck pain can be acute (short term) or chronic (recurring or persisting for months and even years), but regardless, when you're in pain, relief is the first thing on your mind. Just as important as relief, of course, is finding the cause and ensuring you avoid the behavior / action that brought the pain on in the first place. Here are five common causes of neck pain – and why doctors of chiropractic are well-suited to relieve the pain and determine the underlying cause.

1. Poor Posture: Leaning over a desk all day or slouching in your office chair? You're bound to develop neck pain eventually, if you haven't already. Do this quick test: In an upright or seated position, round your shoulders and back (poor posture). Does it impact your neck as well? Exactly!

2. Monitor Madness: Staring at the computer screen for hours at a time? That's not good for your health (or sanity), but from a neck pain perspective, it's madness, particularly if the screen height forces you to crane your neck up (too high) or extend it down (too low).

3. Sleep Issues: Ideally, we spend a third of our day sleeping, so your sleep habits – for better or worse – can have a dramatic effect on your health. With regard to neck pain, anytime you sleep in an uncomfortable position, particularly one that stresses your neck musculature (think about side-sleeping while grabbing your pillow tightly, sleeping on your stomach with your arms out in front of you, or even sleeping on your back, but with a pillow that doesn't adequately support your neck), you risk neck pain.

4. Technology Overload: We may spend a third of our day sleeping, but we increasingly spend the other 16 hours typing, texting, tapping and otherwise interacting with our smartphones, tablets, etc. Bottom line: bad for your neck. One doctor has even coined the phrase, "text neck," to describe the neck pain that can result from this constant technology interaction.

5. The Wrong Movement: Twisting, turning, stretching and stressing your neck is an easy way to cause neck pain. While the muscles in the neck are strong, they can be strained, sprained and even torn, just like any other muscle.

It's important to note that beyond these common causes, various other health issues can also contribute to or directly cause neck pain, including fibromyalgia, cervical arthritis or spondylosis (essentially spinal arthritis), spinal stenosis (narrowing of the spinal canal), infection of the spine, and even cancer. The good news is that a doctor of chiropractic can help identify which of these or the above causes is to blame.

When neck pain strikes, most people turn to a temporary solution first: pain-relieving medication. But that's not a permanent solution, of course, and it doesn't address the cause of the pain at all, which could be something relatively minor – or more serious. What's more, research suggests chiropractic spinal manipulation is actually more effective than over-the-counter and prescription medication for relieving both acute and subacute neck pain.

The Burden of Back Pain: #1 Cause of Disability

More people may be living longer, but they're not enjoying it, particularly when it comes to musculoskeletal health, according to the latest Global Burden of Disease (GBD) study.¹ The largest analysis of global disability data to date, GBD 2013 reveals that "the burden of musculoskeletal disorders [is] much larger than previously appreciated," accounting for nearly 21 percent of global years lived with disability as of 2013.

 Back pain remains the No. 1 cause of years lived with disability worldwide; neck pain is also a common contributor to years lived with disability.

Led by the Institute for Health Metrics and Evaluation and funded by the Bill and Melinda Gates Foundation, GBD 2013 represents a massive analysis of global disability data, with 35,000 data sources spanning 188 countries.² Here are a few of the key findings from the latest analysis, published in Lancet in June, highlighting the global musculoskeletal disability burden

The Musculoskeletal Burden

• "In this analysis, we show that musculoskeletal disorders ranged from 9.6% of YLDs [years living with disability] to 28.9% of YLDs between 188 countries. Low back pain was the leading cause of YLDs in 86 countries and the second or third leading cause in 67 countries."
• "Musculoskeletal disorders combined with fractures and soft tissue injuries reached a total of 20.8% of global YLDs in 2013 ... Our analysis of time trends showed that this category of disorders was an important driver of rising YLD rates per person. Increases were driven by ageing of the population in most countries with trends in obesity and physical inactivity likely exacerbating the problem. Musculoskeletal disorders were not only an important contributor to the burden of disease but were also a crucial component of health expenditure in many high-income and middle-income countries."

Nonmusculoskeletal Burden
While back pain maintains the No. 1 position in terms of its impact on years living with disability, diabetes now occupies the No. 7 spot, moving up three positions from 1990 to 2013. In the U.S. alone, diabetes prevalence increased 71 percent over that time period.² What's more, almost a quarter of the global population suffers from tension headaches, while one in eight suffers migraines.³

From Analysis to Action?
Will data drive health-care decision-making? Comments by the GBD 2013 collaborators and other health policy experts suggest something has to give:
The GBD 2013 authors emphasize, "Although the GBD 2010 analysis brought more attention to these disorders, there remains little policy discussion of the options available to prevent and address these disorders."¹

Rifat Atun, professor of global health systems and director of the Global Health Systems Cluster at Harvard University's T.H. Chan School of Public Health, authored a commentary to the latest Lancet report and urges adoption of a prevention and wellness model to as a vital step to address the chronic disease burden:
"Don't wait for illness, invest in the maintenance of health," he said. "We can't manage these chronic conditions in hospitals, so there needs to be an emphasis on maintaining good health, preventing disease and slowing progression of disease when it does happen. There's no choice; it has to happen."⁴

If you're interested in reviewing the complete report, GBD 2013 provides the latest trends in disease and injury incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries – but be prepared. Reporter John Ross perhaps sums up the grim findings best:
"A focus on cheating death rather than keeping people healthy has transformed the planet's population into a world of walking wounded, a massive inventory of global illness levels has found. ... Premature death rates are in decline. But the death toll has been replaced by a colossal disability burden, with hundreds of millions of years of productive life lost each year to pain and disease."⁵

Are you suffering back or other pain that's reducing your quality of life? If so, you're obviously not alone. Fortunately, doctors of chiropractic can help relieve your back pain – and help prevent its return – in addition to managing a host of other musculoskeletal and nonmusculoskeletal health issues without drugs or surgery.
References

1. Vos T, Barber RM, Bell B, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, epub ahead of print June 8, 2015.
2. Tavernise S. "Global Diabetes Rates Are Rising as Obesity Spreads." New York Times, June 8, 2015.
3. Macrae F. "Back Pain Is the Biggest Cause of Ill Health in the World: Issues Cause More "Years Lived With Disability" Than Any Other Condition." Daily Mail, June 8, 2015.
4. Coghlan A. "Defying Death Is Causing Back Pain, Bad Teeth and Depression." New Scientist, June 8, 2015.
5. Ross J. "Illness Study a 'Call to Arms.'" The Australian, June 9, 2015.

Technology and Neck Pain (Text Neck)

Fast Facts: The Consequences of Forward Head Posture 1. Long-term forward neck posture leads to "long-term muscle strain, disc herniations and pinched nerves." (Mayo Clinic Health Letter, March 2000) 2. In regard to respiratory dysfunction in chronic neck pain patients, a recent study "demonstrated a strong association between an increased forward head posture and decreased respiratory muscle strength in neck patients." (Cephalgia, February 2009) 3. "For every inch of forward head posture, it can increase the weight of the head on the spine by an additional 10 pounds." (Kapandji, Physiology of the Joints, Volume 3) 4. "Loss of the cervical curve stretches the spinal cord 5-7 cm and causes disease." (Dr. Alf Breig, neurosurgeon and Nobel Prize recipient) 5. "90% of the stimulation and nutrition to the brain is generated by the movement of the spine," says Dr. Roger Sperry, Nobel Prize recipient for brain research. Dr. Sperry demonstrated that 90 percent of the energy output of the brain is used in relating the physical body to gravity. Only 10 percent has to do with thinking, metabolism, and healing, so when you have forward head posture, your brain will rob energy from your thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. 6. According to Rene Cailliet MD, director of the Department of Physical Medicine and Rehabilitation at the University of Southern California, forward head posture can add up to 30 pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. FHP results in loss of vital capacity of the lungs by as much as 30 percent. This shortness of breath can lead to heart and blood vascular disease. The entire gastrointestinal system is affected; particularly the large intestine. Loss of good bowel peristaltic function and evacuation is a common effect of FHP. It causes an increase in discomfort and pain because proprioceptive signals from the first four cervical vertebrae are a major source of the stimuli which create the body's pain controlling chemicals (endorphins). With inadequate endorphin production, many otherwise non-painful sensations are experienced as pain. FHP dramatically reduces endorphin production. 7. FHP has been shown to flatten the normal neck curve, resulting in disc compression, damage and early arthritis. Spine, 1986)

A few years ago, I started to notice that more and more young people were coming to my office with similar complaints. They all had neck pain, headaches, shoulder pain, and/or numbness and tingling into the upper extremity. While discussing my findings with one of these young patients, her mother asked me, "Well, what does she have?" I looked over at the patient and noticed that she was buried in her cell phone with her head flexed forward - texting. With that, I replied, "It's simple. She has text neck." I pointed out to the patient's mother that at 16 years old, her daughter had a reversed cervical curve with mild degenerative changes, and that she was too young to be experiencing these bony changes. I then asked the patient how often or how much she texts. She replied that she texts all day long, and that it is her primary mode of communication.

Technology Overload
These days, people are constantly "connected" to their hand-held devices, whether it is their cellular phones, portable video games like Nintendo DS, e-readers such as Amazon Kindle, or they are just using apps on an iPhone. A Kaiser Family Foundation survey found that young people 8-18 years old spend in excess of seven-and-a-half hours a day using some form of mobile media. As a result, this younger demographic will surely be developing a condition known as forward head posture (FHP), which can cause the above symptoms and more.
As technology advances in the market of hand-held mobile devices, it's important to understand that where the head goes, the body will follow. If you have forward head posture, then you will have rolled shoulders. With rolled shoulders, a concave chest can follow, and often a pelvic tuck, all of which can contribute to progressive pain and dysfunction over time.

Text messaging was reported to have addictive tendencies in the Global Messaging Survey by Nokia in 2001, and was confirmed to be addictive in a study conducted at the Catholic University of Leuven in Belgium in 2004. Since then, a study at the University of Queensland in Australia has found that text messaging is the most addictive digital service. It has been compared to being as addictive as cigarette smoking. The text reception habit introduces a need to remain connected, called "reachability."

Because the demographic of people ages 13-27 is one of the largest groups of texters, we can expect to see a large increase of medical and chiropractic conditions within the next decade. The amount of time spent in a forward head tilt while texting or gaming, surfing or browsing the Web has increased as hand-held mobile devices such as cell phones, video games, and MP3 players have become smaller, mobile and essentially a direct extension of the person. Look around you and you will see people with FHP using hand-held mobile device at tables in restaurants, at red lights in their cars, walking through the mall, in line at the grocery store, and even sitting in doctors' reception areas. We are a society that is "connected," now more than ever before, and we are suffering the health consequences.

The problem is getting worse each year. According to data released Dec. 15, 2009, by the Census Bureau, Americans sent 110 billion text messages in December 2008. In the same month in 2007, Americans sent 48 billion messages. Amanda Lenhart, a senior research specialist for the Pew Internet and American Life Project, is not surprised that the trend is especially prevalent among teenagers. In a Los Angeles Times article (Dec. 16, 2009), she stated: "Teens are still developing their communication habits. Adults have preset ones already."

The world is becoming more mobile. Children are getting mobile phones at younger and younger ages due to affordable prices and parents wanting to stay in touch. Hand-held mobile devices are performing more daily functions and are more portable than ever. Google's vice president of engineering and mobile applications, Vic Gundotra, has noted: "We are seeing a very fundamental shift where increasingly, particularly among the young demographic and in Asian countries, the primary access to the Internet is not through the PC but through mobile devices."

The Problem's Not Going Away
Research performed by Informa Telecoms & Media reported that in 2008, almost 162 million smartphones were sold, surpassing laptop sales for the first time. The research also suggests that smartphone sales will continue to be immune to the global economic downturn. With technology advancing, sales of the hand-held mobile device staying strong and people's desire to stay connected, FHP will be more prevalent than ever.
Of course, forward head posture is not a new condition. Chiropractors have been treating and educating patients on the dangers of FHP for years, and the health conditions that FHP or anterior head carriage contribute to are well-researched and documented. [See "Fast Facts" table}

With all this said, it's important to understand the negative effects of a repetitive stress syndrome and appreciate how many hours you are using your hand-held mobile devices and how many hours your children are using these devices. Talk to your doctor about forward head posture, the dangers of text messaging and other behaviors that put your body in stressful positions, and how you can avoid the pain before it starts.

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When Texting Turns Deadly
Can't stop texting? If forward head posture doesn't concern you (even though it should), the Federal Motor Carrier Safety Administration has found that of 17 activities that can drawn a driver's attention from the road, texting puts you at greatest risk for suffering a serious car crash. According to the National Safety Council, an estimated 28 percent of crashes (1.6 million annually) are attributable to talking and/or texting on cell phones while driving.
According to Dr. John Callaghan, president of the American Academy of Orthopedic Surgeons, "The problem with the use of 24/7 communications devices is that every driver believes he or she is immune to slip ups, but isn't. Orthopaedic surgeons want to prevent the pain and suffering associated with texting-and-driving accidents. To say this habit can be deadly is the truth; it is an outcome we unfortunately see every day."

Where Does Back and Neck Pain Come From? (And What Can be Done About It)

PAIN is a significant problem in our society, and the way too many of us deal with it, either by taking medication to temporarily relieve the pain or ignoring the pain altogether, foolishly hoping it will go away, is an even bigger problem, contributing to long-term disability and reduced quality of life. Here are a few important pieces to the puzzle that can help you deal with pain now and prevent future episodes - chronic pain- from ruining your life.

 

How do you feel at this very moment? You can do a easy self-check just by moving your neck, shoulders, arms and legs around. Do you have any aches and pains anywhere? If your response is, "Don't most people have pain somewhere in their body?" or "Doesn't pain come with old age?" keep in mind that while that's true, it doesn't mean you have to accept it. And remember, pain isn't just physical. The emotional stress it creates can be as hard on you as the pain itself. Let's talk about ways you can find relief from your physical pain, which will undoubtedly lighten your emotional load at the same time.

Pain Defined
Pain is defined as an unpleasant sensation that can range from mild, localized discomfort to sheer agony. Pain has physical and emotional components. The physical part of pain results from nerves being stimulated. Pain may be confined to a specific area, as in an injury, or it can be spread throughout the body. Around the world, millions of people live with pain in some form or another, involving many different body parts, on a daily basis.
One of the most interesting things about pain is how each human being deals with it. Some learn to live with pain. Others can't stand to feel even an ounce of it. The most common types of pain include arthritis, lower back, bone/joint pain, muscle pain and fibromyalgia (widespread pain, tenderness and fatigue in muscles,tendons and ligaments). Back pain is the most frequent cause of limited activities for people younger than 45 years old.

Acute vs. Chronic Pain
Acute pain is a normal sensation triggered in the nervous system to alert you to possible injury and the need to take care of yourself. This type of pain comes on quickly and can be severe, but it lasts a relatively short period of time. In general, acute pain is in response to an event that happens to the body. It may be a result of surgery or an accident.
Chronic pain is different. Chronic pain tends to stay around or progress over longer periods of time. Pain signals keep firing in the nervous system for weeks, months or even years. Oftentimes, chronic pain is resistant to traditional medical treatments. The emotional component of pain often comes into play in a chronic situation.

The Consequences of Pain
The loss of productivity and daily activity due to pain is substantial. Americans spend at least $50 billion per year on back pain, and that's just for the more easily identified costs. Pain has a negative impact on an individual's quality of life. It diminishes one's ability to concentrate, do their job, exercise, socialize, perform daily tasks and sleep. Over time, this can lead to depression, isolation and loss of self-esteem. Researchers have found that depression is the most frequent psychological reaction to chronic pain.

If you hurt an area of your body and do not restore proper, healthy movement patterns, you will end up with problems later down the road. I can't tell you how many patients I have seen who got in car accidents and hurt their neck and back, but waited to get treatment and used pain as the indicator for how they feel. Eventually, the pain went down or even away, but they were often left with problems in their bones and joints.

Common Causes and Sources of Chronic Pain
An initial injury like a trauma, fracture, sprain/strain, or serious infection may be the cause of the chronic pain. There could also be an ongoing cause like arthritis, cancer, an ear infection or injuries that never healed properly. Some people even suffer chronic pain in the absence of any past injury or evidence of body damage. Many chronic pain conditions affect older adults. Common chronic pain complaints include headache, low back pain, cancer pain, arthritis pain, neurogenic pain (pain resulting from damage to the peripheral nerves or to the central nervous system itself), and psychogenic pain (pain not due to past disease or injury or any visible sign of damage inside or outside the nervous system).

Quite simply, pain can come from anywhere in the body. The source can be the neck, shoulders, low back, hips and everywhere else. Many times, the location of the pain depends on how the injury happened. Perhaps someone injured their shoulder while throwing a ball. Maybe someone sprained their ankle while running. How about the person who falls down the stairs and hurts multiple parts of their body simultaneously?

Solving the Chronic Pain Puzzle
Pain is a complex puzzle. For certain cases, it takes complex solutions to help solve that puzzle. In some cases, the individual's pain is so debilitating that it requires the use of X-rays or other special imaging to visualize the problem that is occurring in the spine or extremities. It may be appropriate to use any of the following: Chiropractic, acupuncture, nutritional supplementation, massage/bodywork, yoga and psychological therapy. In some cases, it may even require over-the-counter or prescription medication (although the goal is to avoid relying on these because of the potential side effects). But there are definitely things you can do that can help you prevent and treat chronic pain. Let's explore these strategies that, as you might have guessed, are all related to one another.

1. Posture: You have probably been told at different times of your life about the importance of good posture. "Sit up straight" or "don't slouch" are probably familiar phrases to you. Proper posture is difficult to attain, so don't stress yourself out about it. When you are sitting, put a rolled-up towel or sweatshirt in the small of your back. Sit all the way back to the rear of the chair so you feel the support in your back. When you stand, stand against the wall or a post so you can maintain erect posture. It is important to strengthen your core muscles, the muscles along the spine. Yoga, Pilates or a specific workout program with weights will help you achieve this. You may want to find a personal trainer to help you focus on specific exercises to help you achieve your goals.

2. Balance: As you develop strength, you begin to develop balance. Many of the positions utilized in yoga, Pilates and weight training work specifically on balance. Would you believe that your feet also have a lot to do with balance? The three arches you have in your feet must all be supported in order for the rest of your body to have good support as well. If one or more of the arches is flat, it can significantly affect the stress to your joints and your ability to exercise efficiently. Ask your chiropractor about analyzing your feet to see if you need arch supports.

3. Spinal Load and Stability: Understanding how to exercise or perform any type of sporting activity is crucial to your health. How many people do you know who lift weights incorrectly? On a daily basis, I see patients who have hurt themselves with physical activity. By being careful and doing your exercises properly, you can reduce the amount of spinal load (stress) and instability you create for your body. I cannot tell you how important it is to make sure your feet and all of the joints above them are healthy and moving properly. When your joints move well, you can perform activities optimally and with minimal stress on your body.

4. Alignment: Exercising makes your muscles stronger, which also helps maintain structural and bony alignment. Chiropractic care is hopefully a regular part of your life. Visits to your chiropractor at a frequency you both find appropriate will help you maintain your alignment.

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Keep in mind that pain may be indicative of a serious underlying condition. Always talk to your doctor about any pain you are experiencing, particularly if it does not go away or worsens with time.

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Can Children Get Back Pain?

As adults, we get used to a variety of daily or near-daily aches and pains, particularly as we age. But what about our children? Don't they seem immune to many, if not all, of the pain complaints we have – despite the fact that for the most part, they're exponentially more active?

Maybe not. A study of schoolchildren ages 12-15 revealed a startling statistic: More than half (57 percent) reported experiencing back pain in the past year. As you might expect, "remaining seated at school" was a primary pain trigger, particularly for back pain lasting up to seven days.

These findings not only point to the universality of back pain – and the need for it to be addressed by qualified health care professionals such as doctors of chiropractic; but also the need to recognize and avoid situations that may increase the risk of experiencing an episode of back pain.

For example, evidence implicates ergonomic flaws both in the school and workplace (desk / chair height, etc.) in back pain, not to mention carpal tunnel syndrome, neck pain and other conditions. What's more, the act of sitting alone creates undue stress on the spinal column and encourages poor posture whether at school, work or home, a major initiator of back pain and related conditions.

For some children, lockers are no longer available at school. This forces our kids to carry books and school supplies in backpacks which can be very heavy, and add additional stress to the spine.

If anyone in your family is suffering from back pain, do something about it. Talk to your doctor about the potential causes and solutions.

What Your Spine Says About Your Health

You may have heard the saying, "the eyes are the window to the soul." There is another saying in the world of chiropractic, "your spine is the window to your health." How can the condition of your spine divulge so much information about overall health? Your spine is the central support column of your body and its primary role is to protect your spinal cord. Think of it like the foundational frame of a house holding everything together. If the frame becomes dysfunctional many problems will begin to manifest themselves. The house begins to develop cracks, shifts, and structural problems. When your spinal foundation becomes dysfunctional you develop aches, pains, injuries, and other health related issues. The good news is you can do a simple spinal health checklist to determine if you may benefit from the expert intervention of a chiropractor or other healthcare professional. Becoming familiar with simple spinal anatomy, structure and function will help empower you to take control of your health.

Your spine is composed of 24 bones (vertebrae); 7 in the neck (cervical spine), 12 in the middle back (thoracic spine), 5 in the lower back (lumbar spine) and the base tailbone (sacrum). Your soft spinal cord is encased inside these 24 moveable hard vertebrae to protect it from injury. Your spinal column has three natural curvatures making it much stronger and more resilient than a straight design. There are cervical, thoracic, and lumbar curves designed with precise angles for optimum function. However, these curves are different than the abnormal curves associated with scoliosis and postural distortions. You may remember getting screened in school or your doctor for scoliosis when they had you bend over and touch your toes. This was an early checklist for spinal abnormalities. Through life's stresses, genetics, trauma, injuries, and neglect the spine can develop dysfunctions in these curvatures and the body must compensate by changing posture as a protective mechanism.
What are some of the compensations your body develops and what can they tell you about spinal health?

Rounded Shoulders: This is a very common postural distortion resulting from more sedentary lifestyles. Hunching over in front of a computer screen hours on end simply feeds this dysfunction. This poor posture pattern adds increased stress to the upper back and neck because the head is improperly positioned relative to the shoulders. Common effects are headaches, shoulder, pain, neck pain and even tingling and numbness in the arms because of nerve compression by tight muscles.

Uneven shoulders: One shoulder higher than the other is indicative of a muscular imbalance or spinal curvature. You probably see this one on most people where one shoulder is migrating up towards the ear. Stand in front of a mirror and you can easily see if this asymmetry is present. You may also notice that one sleeve is longer than the other when you wear a shirt. This asymmetry is a common precursor for shoulder injuries, headaches, neck pain, elbow injuries and even carpal tunnel syndrome (tingling in the hands).

Uneven hips: Hips that are not level are like the foundation of a house that is not level. You begin to develop compensations further up the body so you remain balanced when walking. You develop altered spinal curvatures, shoulder positions, and head tilts. Your body has one primary purpose of maintaining symmetry and balance and it will do it whatever way is necessary. Signs of unbalanced hips may manifest in abnormal shoe wear typically on the outside edges and pants will fit unevenly in the leg length.

When you visit a chiropractor for a spinal evaluation some of the things they will search for during your evaluation are underlying signs of spinal damage that you can't see. Spinal x-rays are a safe and effective way to get look at your spine for damage or potential problems. Just like a dentist takes an x-ray of your teeth to see if you have cavities or problems with the bones below gum line. If problems are detected, corrective or preventive measures can be implemented to help your body function at optimum.

Degenerative Disc Disease (DDD): This is not a real disease in the terms of how we think of them. DDD is term used to describe degeneration and excessive wear on the soft tissue disc structures between the spinal bones. It may come with age or from biomechanical asymmetries in movement causing excessive wear from overuse. Sort of like uneven treads on a car with imbalanced tires, one may be worse than the other. Although the degeneration cannot be reversed, once discovered there are strategies your chiropractor can implement rebalancing exercises and therapies to help prevent further damage.

Osteoarthritis: The breakdown of the tissue (cartilage) that protects and cushions joints. Arthritis often leads to painful swelling and inflammation from joints rubbing together. The increase in friction causes a protective pain response and excessive swelling where the body attempt to add artificial cushioning via swelling.

Herniated disc: A herniated disc is an abnormal bulge or breaking open of a protective spinal disc or cushioning between spinal bones. Patient's may or may not experience symptoms with a herniated disc. Disc diagnosis is conformed via a special imaging study called an MRI (Magnetic Resonance Imaging) which observes soft and hard tissue structures. You cannot see or confirm a suspected disc herniation via normal spinal x-rays.

Spinal stenosis: The narrowing of the spinal canal the open space in the spine that holds the spinal cord. Stenosis is a more severe form of arthritis that typically causes radiating (referred pain down the arms or legs) from an irritated or compressed spinal nerve.

If you experience spinal pain, tingling, numbness, weakness, muscles spasms or swelling near your spine or arms and legs consult a healthcare professional. These are all warning signal signs from your body that something is wrong and needs your attention. Pain is how your body communicates its function with you. A car has dashboard warning lights that tell you when the car has a problem. If you chose to ignore the signals bad things are going to happen. Your body has its own warning light system. Start checking for the warning lights. Ignore them at your own risk.

Tylenol: A Poor Choice for Relieving Your Low Back Pain

Acetaminophen (Tylenol) is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately. In fact, improper use, coupled with the drug's narrow safety margin, means "a large fraction of users [are] close to a toxic dose in the ordinary course of use," according to the Food and Drug Administration.

But for the sake of discussion, let's ignore the safety issues for a moment. Is acetaminophen an effective pain reliever in the first place? Not for low back pain and pain attributable to knee / hip osteoarthritis, conclude the authors of a recent meta-analysis. The just-published review of 13 randomized trials has yielded "high-quality evidence" that paracetamol (acetaminophen) does not reduce pain intensity or disability, and does not improve quality of life, in the short term for people experiencing LBP; and provides only "minimal, short-term benefit" for people suffering from hip or knee pain caused by OA, stating that "the small effects ... are not likely to be meaningful for clinicians or patients."

Back to the safety issues surrounding acetaminophen, which the meta-analysis did little to dilute. According to the review researchers, "high-quality" evidence suggests paracetamol use results in a fourfold risk of an abnormal liver function test. Not surprising, since acetaminophen misuse (overdose) is now the most common cause of acute liver failure (exceeding all other medications combined) and the second most common cause of liver failure requiring transplantation.
In fact, the FDA has mandated that all acetaminophen-containing prescription products feature a "black box" warning (the administration's strongest safety statement) noting an overdose can cause liver failure and even death; and have been urged to place similar language on OTC acetaminophen products.

How often do you use acetaminophen-containing over-the-counter and/or prescription medications for you LBP and OA pain, even as you pursue relief through chiropractic care? How often do you take these drugs for your spinal / OA pain instead of visiting a chiropractor? As this meta-analysis suggests, acetaminophen is ineffective for these types of pain. So give chiropractic a try – a proven natural pain reliever.

How To Help Neck and Back Pain With Posture

One hundred and thirty thousand years ago, when residents of the planet possessed complete Neanderthalic characteristics, posture wasn't really that high on the list of health priorities, to say the least At the time, we assume finding food, surviving the seasons and avoiding death by all manner of creatures were considerably more important. But this is 2011 and we can stand upright, walk upright and consider our health a precious asset. And yet, like the Neanderthals, our apparent disinterest in good posture remains.

Why is good posture so important? It's pretty simple. When the spine is properly aligned with its natural curvature and the entire body – from the ears to the shoulders to the hips, knees and down to the ankles and feet – is in balance, we maximize spine health and avoid poor posture-related pain and dysfunction. Ideal posture creates ideal balance; it also optimizes breathing and circulation. And shouldn't we all want to achieve that?

May is National Correct Posture Month, so we thought it was high time to get you out of your slumped, bent-back, round-shoulders position that is likely all too common if you work at a computer, spend considerable time texting or checking e-mail on your cell phone (who doesn't these days?), or engage in any of the countless activities that put your back, neck and spine at risk courtesy of poor posture. It's time to stand tall, walk tall and improve your spinal health, all at the same time!

For tips on the best ways to perfect your posture, look no further than Straighten Up America, a health promotion initiative developed in 2005 with an admirable vision: to educate the public about the importance of good posture and spinal health, to the point that "every American will take two or three minutes every day to care for their spinal health, just as they care for their dental health." Straighten Up, which partners in promoting the nation's health with the President's Council on Physical Fitness and Sports, is designed to get children and adults up and moving while they improve their posture and spinal health. The Straighten Up program also includes healthy lifestyle recommendations congruent with the goals and objectives of Healthy People 2010, America on the Move, Steps to a Healthier US and the 5 A Day programs.

One of the earliest tests of this program proved quite encouraging: After five weeks of daily practice of "Straighten Up" exercises, more than 80 percent of participants reported improved posture; just under 80 percent said they had strengthened their core muscles; and 80 percent reported that after performing the exercises, they now sat and stood more upright, and their backs felt more comfortable in that position.

Are you and your family ready to perfect your posture? Here are a few Straighten Up exercises; to download the complete list and for more information, visit www.straightenupamerica.org.

The Butterfly: Standing and with head held high, belly button in, place your arms behind your head and gently pull your elbows backward. Slowly and gently press your head against your hands while counting to two. Relax, breathe, and repeat three times.

Tilting Star: With head high and belly button in, spread your arms and legs into a star. Breathe in and slowly stretch one arm over your head and slide your opposite arm down your leg. Slowly tilt your star to the opposite side. Relax. Repeat two times.

Twirling Star: In the star position (hands and legs forming a star; see Tilting Star description), turn your head to look at one hand. Slowly twist your entire spine to watch your hand as it goes behind you. Relax and repeat (each side) two times. Keep your head high, belly button in.


The Hummingbird: With head high and belly button in, put your arms out to the sides with your hands up and pull your shoulders together in the back. Now make small, backward circles with your  hands and arms. Bend at your waist from side to side, keeping the circles going as you count to 10.

Lower Back Pain is the #1 Cause of Disability Worldwide!

Are you suffering from back or neck pain?

 You're definitely not alone, and we mean on a global scale. A series of studies emerging from the Global Burden of Disease 2010 Project, a massive collaboration between the World Health Organization, the Institute for Health Metrics and Evaluation, the University of Queensland School of Population Health, Harvard School of Public Health, Johns Hopkins Bloomberg School of Public Health, and the University of Tokyo, Imperial College London, clarifies the worldwide health burden of musculoskeletal conditions, particularly back and neck pain, in crystal-clear fashion, with low back pain identified as the number-one cause of disability worldwide and neck pain the number-four cause. Overall, musculoskeletal conditions represent the second leading cause of global disability.

Findings emphasize the shift in global health that has resulted from disability making an increasingly larger footprint on the burden of disease compared to a mere 20-30 years ago. In addition, while more people are living longer, the flip side is that they do so with an increasing risk of living with the burden of pain, disability and disease compared to generations past.

Dr. Scott Haldeman, a neurologist and doctor of chiropractic, provides a summary of the project's findings that should make it abundantly clear that conditions many people may consider relatively harmless actually have tremendous potential for long-term health consequences:

• Musculoskeletal conditions such as low back pain, neck pain and arthritis affect more than 1.7 billion people worldwide and have a greater impact on the health of the world population (death and disability) than HIV/AIDS, tropical diseases including malaria, the forces of war and nature, and all neurological conditions combined. 
• When considering death and disability in the health equation, musculoskeletal disorders cause 21.3 percent of all years lived with disability (YLDs), second only to mental and behavioral disorders, which account for 22.7 percent of YLDs.
• Musculoskeletal conditions represent the sixth leading cause of death and disability, with only cardiovascular and circulatory diseases, neonatal diseases, neoplasms, and mental and behavorial disorders accounting for more death and disability worldwide.
• Low back pain is the most dominant musculoskeletal condition, accounting for nearly one-half of all musculoskeletal YLDs. Neck pain accounts for one-fifth of musculoskeletal YLDs.
• Low back pain is the sixth most important contributor to the global disease burden (death and disability), and has a greater impact on global health than malaria, preterm birth complications, COPD, tuberculosis, diabetes or lung cancer.
• When combined with neck pain (21st most important contributor to the global disease burden – death and disability), painful spinal disorders are second only to ischemic heart disease in terms of their impact on the global burden of disease. Spinal disorders have a greater impact than HIV/AIDS, malaria, lower respiratory infections, stroke, breast and lung cancer combined, Alzheimer's disease, diabetes, depression or traffic injuries.
• Current estimates suggest that 632.045 million people worldwide suffer from low back pain and 332.049 million people worldwide suffer from neck pain.

"The Global Burden of Disease Study provides indisputable evidence that musculoskeletal conditions are an enormous and emerging problem in all parts of the world and need to be given the same priority for policy and resources as other major conditions like cancer, mental health and cardiovascular disease," said Dr. Haldeman.

Sit Up Straight To Reduce Stress and Back Pain

What do you feel when you're stressed? If you're experiencing a high level of stress right now, this may be an easy exercise for you. For many people, the physical reaction can include a sense of painful, stiff weight on the neck and shoulders; as if some mysterious force is pulling you down, urging you to curl up into a little ball and avoid the stress triggers. That's stress in a nutshell, and one of the consequences, as you might imagine from the above picture, is poor posture.

According to a recent study, stress might not only cause poor posture; the opposite might actually be the case. The study compared upright, seated posture to slumped seated posture to evaluate how different postures affected emotions / mood, particularly in the face of stress. Results showed that "upright participants reported higher self-esteem, more arousal, better mood, and lower fear, compared to slumped participants."

The researchers' concluding remarks were even more revealing: "Adopting an upright seated posture in the face of stress can maintain self-esteem, reduce negative mood, and increase positive mood compared to a slumped posture. Furthermore, sitting upright increases rate of speech and reduces self-focus. Sitting upright may be a simple behavioral strategy to help build resilience to stress."

The take-home message: Sit up straight and reduce your stress! By the way, proper posture is also a great way to prevent spine-related aches and pains.

Why Chiropractic Can Relieve Your Low Back Pain

Doctors of chiropractic are known for treating low back pain – and preventing its recurrence – and recent research emphasizes the science underlying their effectiveness. A recent study suggests chiropractic care (spinal manipulation) can reduce LBP, but it also suggests chiropractic can increase spinal disc height.

Why is that important?

 Well, loss of intervertebral disc height is one of the traits of low back pain. Discs are the ligaments between the bony vertebrae that act as shock absorbers for the spine. As we get older, our discs have a tendency to get smaller, which can lead to all kinds of problems, including pain. Fortunately, as this study suggests, chiropractic can help.

That's good to know no matter your age and the condition of your spine.

Can Stress Really Be Causing My Back or Neck Pain?

Stress is a part of life, and so is back pain. Ironically, stress is a leading cause of episodic back pain. Your body experiences a cascade of physiological responses during chronic stress setting the stage for injury.

The human body is genetically programmed to respond to stressful situations by stimulation in a survival part of your brain known as the limbic system. Otherwise known as the reptilian or primal brain, it is responsible for the emotional "flight or fight" (run or stand and fight) response to negative stimuli. Your brain response functions the same in stressful situations regardless of the source and extent of the threatening stimuli. The limbic brain does not recognize differences between types and degrees of stress. It simply reacts. Your body releases hormones (chemical messengers) which cause a physical reaction to stress; shortness of breath, sweating, increased heart rate, muscle tension, tightness or stiffness in joints, etc., in preparation for survival reaction. So whether you are about to be chased by a rabid dog, cut off in traffic, or had a tough day at work the same response occurs. The same negative physical impact also occurs on the body.

There are several different types of stress and learning how to control them can make all the difference. You have physical stress (lack of exercise, illness, sleep habits, etc), mental stress (how you deal emotionally with life) and chemical stress (nutritional and environmental).

Stress alters breathing patterns by causing you to breathe more from the chest/lungs than the diaphragm. This altered pattern increases tension in the neck and upper back leading to poor posture, muscle tightness and headaches. The diaphragm is a dome shaped muscle that sits in the lower part of the ribcage underneath the lungs. Optimal breathing patterns should occur from the diaphragm first, followed by the lungs. Most often people have dysfunctional patterns where this sequence is reversed. Breathing is the foundation for relaxation.

Learn to control your breathing and you will have discovered a secret weapon of relaxation and stress reduction. To check your breathing pattern lie on your back with knees bent. Close your eyes and place one hand on your abdomen and the other on your chest. Take a deep breath in through your nose. The lower hand should move first and the upper hand second. If the upper hand moves first you have an altered breathing pattern. Luckily it is fairly easy to learn how to breathe again properly. In our quick tip help guide below you will learn how to restore normal breathing patterns.

Stress increases tension in the body 24/7. It is like flipping the light switch on for self- protection, muscle tension and tightness. Think about how stiff and tight you feel when walking across ice. Your body tenses up in anticipation of falling and is trying to protect you from injury. Imagine how your muscles would feel if you were in this constant state of tension for weeks at a time. It would not feel good! That is what chronic stress is doing.

Stress increases production of specific hormones known as cortisol and adrenaline located in the adrenal glands. These are two small glands that rest on top of the kidneys, one on either side. Cortisol is nicknamed the "stress hormone" and it can cause many negative reactions in the body if it is unbalanced. Chronically elevated levels of cortisol and adrenaline will cause increased inflammation in the body. In essence, your own body begins to turn on itself.

So what are some simple and effective tips you can start doing today to help alleviate stress? Below are suggestions for helping physical, mental and environmental stress in your life.

Nutrition: Eat healthy and eat often to control blood sugar levels. When you wait long periods between meals, you have a spike of a hormone known as insulin. This hormone controls how fast sugar enters your bloodstream after eating. Big surges in insulin occur when you wait too long between meals which may increase stress on your body chemistry. You can get cravings and mood swings. Eating only three meals a day is insufficient in keeping this delicate balance of hormones in check. It is recommended to eat three meals a day, mixed in with 2-3 healthy snacks. You will notice a renewed sense of energy and vitality with regular feedings.

Mental: Take some "me" time every morning before you start the day. Use this time to reflect on yesterday and plan out today's events. With the craziness of non-stop information overload in today's society it's more important than ever to take quiet moments. Set your alarm 15-minutes early and wake up to silence. Do not turn on the television or open the newspaper. You may find that problems which have plagued you suddenly become more manageable and put into perspective. When was the last time you sat in a room without white noise all around? Try it and see what happens.

Physical: Learning how to breathe with your diaphragm takes some practice, but in time it will become second nature. Practice the following technique on a daily basis for 3-5minutes. Lie on your back, putting a pillow support under your knees to relax your lower back. Place one hand on your abdomen and the other on your chest. Slowly inhale through your nose and make sure the only hand to move is the one on your abdomen. Try to keep the hand on your chest as still as possible. Exhale through pursed lips and repeat. You may become temporarily lightheaded after your first few, but this is a normal response to the increase in oxygen uptake by the body. Do this before bed time and you will have a more restful sleep leading increased recovery and regeneration.

You do have power over your body. Simple changes in your life to help reduce stress can have a profound impact on your health. Take back control of your life from pain. Empower yourself to feel good again mentally and physically. Start with the simple strategies above and when you feel the positive difference you will want more for yourself.

To decrease the stress in your life, talk to your chiropractor about your concerns.

The Right Choice for Low Back Pain

Back pain is a major health issue, so much so that is was recently confirmed as the number-one cause of disability worldwide. Add to that the shocking statistic that the average person has only about a 20 percent chance of not experiencing back pain at some point during their lifetime, and you can appreciate that low back pain (LBP) has been described as "a common threat to medicine and a reasonable threat to all national health care systems."

The authors of that quote conducted a study recently, results of which suggest a simple, drug-free way to counter that "threat": spinal manipulation, a treatment technique commonly provided by doctors of chiropractic. According to the study, spinal manipulation was more effective than a nonsteroidal anti-inflammatory drug (NSAID) and placebo in patients with acute LBP. In fact, patients who received spinal manipulation showed improvement in terms of their disability due to the pain, their subjective estimation of pain and their perceived quality of life compared to patients receiving drug therapy only.

This isn't the first time we've touted the benefits of chiropractic care for back pain, and it won't be the last. That's because a growing body of evidence suggests chiropractic's effectiveness and health-care cost benefits compared to the traditional medical approach, which often involves drugs and may ultimately lead to surgery. Suffering from back pain? Then do something about it; something that doesn't involve popping pills.