The Latest on Lower Back Pain

The Latest on Lower Back Pain

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The Latest on Lower Back Pain

With all of this mild weather we have been experiencing in the Okanagan it really does feel like spring is just around the corner. I’m sure many of you have started to do some work in your yards in preparation for the gardening season. Each year during the start of spring there is something that comes along with the longer days and warmer temperatures: lower back injuries.

So what can we do to avoid hurting our backs?

A recent study published in the Journal of Arthritis Care and Research looked at just shy of a thousand patients over the age of 18. They found 8 different risk factors for lower back pain. In order of highest to lowest risk the 8 factors were: distraction during a task, manual tasks involving awkward postures, manual tasks involving objects not close to the body, manual tasks involving people or animals, manual tasks involving unstable or unbalanced objects, manual tasks involving heavy loads, moderate or vigorous physical activity, fatigue/tiredness. Being fatigued tripled the odds of suffering a lower back injury, while distraction increased the risk by 25 times! So based on this recent information when you are getting outside to do your yard work or gardening this spring make sure to remember this list and try to avoid these risk factors. Take frequent breaks during your day to avoid fatigue. When lifting, bring objects close to your body and focus on what you are doing to avoid distraction. When lifting, bend at your hips and knees (sticking the butt out) while keeping a straight spine to minimize dangerous pressure on the spinal discs and joints. As well, a recent study done at the University of Sydney in Australia found that almost half of the lower back injuries they looked at occurred in the morning between 8 and 11 am. The cause is yet unknown but it is thought that it may be due to the fact that your spinal discs fill with fluid overnight, making them more susceptible to pressure in the first few hours of your day. It makes sense then to take your time in the morning when possible and make sure your muscles and joints are warmed up before jumping right into your ‘spring cleaning’. Of course we don’t live in a perfect world where we can always completely avoid risk of injury. But keeping some of these latest study results in mind I hope that you can stay healthy during this upcoming spring season.

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
reception_dt@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
reception_gm@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
reception_wf@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
reception_lm@suncityphysiotherapy.com
more info

Bladder Incontinence

Womens Health

This one’s for the ladies.

Ladies, have you notice the increase in the number of bladder leakage commercials on TV these days? Brands like Poise and Always have caught on that there are a large number of women who experience bladder leakage on a daily basis. These commercials are great in one aspect because they open up doors for women to have conversations. This is important because these issues may be embarrassing to discuss with friends and therefore are often sealed behind tight lips or talked about only in doctors’ offices. The downside to these commercials is that they make you feel like a pad is the best way your bladder leakage can be addressed. Many women who have bladder leakage do not seek information regarding the underlying cause, the type of bladder leakage they have or additions ways it can be addressed.

To fill in some of the gaps – there are essentially three types of bladder leakage. First there is stress incontinence (loss of bladder control). This type usually occurs because the pressure exerted on the pelvic floor is too forceful for weakened muscles during a cough, sneeze, laugh or any event that increases intra-abdominal pressure.

The second type of incontinence is called urge incontinence. This type of leakage is usually behaviour driven and occurs because of toileting cues and conditioning surrounding your learned habits. For example, you just pulled into your drive way – before you pulled up there was no urge to go to the bathroom. However, now that you are in the driveway you are frantically rummaging through your purse to grab your keys, you found them. Now, to make it to the front door you waddle the whole way there because all you can think about is emptying your bladder and by the time you get the lock open you may have already leaked before you made it to the toilet.

The final type of incontinence is called mixed and is a combination of stress and urge. In addition to using these products there are other ways to treat bladder leakage. One of the treatments for stress incontinence comes from gaining body awareness and control of your pelvic floor muscles and retraining them to turn on before a cough and sneeze. The treatment for urge incontinence involves behavioural retraining surrounding your current toileting habits.

Now that you are aware there are more options, perhaps it’s time for you to take control of your leakage and contact a physiotherapist who treats women’s health in an effort to reduce or eliminate leakage.

Intramuscular Stimulation (IMS)

Intramuscular Stimulation (IMS)

IMS

Intramuscular Stimulation (IMS)

Intramuscular Stimulation (IMS): What is it and how can it help get rid of your chronic pain?

In this article I am going to focus on the treatment of chronic muscle and nerve pain and why it can be so difficult to find a solution for this type of pain. It is estimated that over one third of the adult population in North America suffers from chronic pain. That is a staggering statistic! This means that 1 of out of every third person out on the street is dealing with ongoing daily pain. Research shows that suicide is nine times more prevalent in people with chronic pain than with depression and it is estimated that in the United States, chronic pain affects more people than diabetes, cancer and heart disease combined.

So is chronic muscle and nerve pain so common? To understand this question we have to look at the gradual process that happens to all of our bodies to some degree over many years. As harsh as it sounds, the reality is that as we age our bodies are slowly ‘rotting’. By the time we reach our 50’s and 60’s we will all get some amount of arthritis in our spine. How fast we ‘rot‘ depends on a variety of factors including our overall fitness levels, nutrition, the types of jobs we do, family genetics and any traumatic injuries we sustain along the way ie. motor vehicle accidents. As the arthritis in the spine progresses, the nerves that exit the small spaces between each spinal bone (vertebrae) start to become irritated. In response to this irritation, the muscles that these nerves supply then start to form tight bands. These bands are the ‘knots’ you feel when you rub sore muscles. The muscle bands not only cause pain but they also begin to pull at joints and tendons as well as compress the already sensitive nerves at the spine. These tight bands often do not respond to traditional treatment approaches such as stretching, massage and spinal manipulation.

A form of treatment that has been gaining popularity in the last 5 to 10 years for chronic muscle and nerve pain is Intramuscular Stimulation (IMS). This treatment technique was developed by a Doctor in Vancouver by the name of Dr. Chan Gunn. Dr. Gunn developed this technique while working with people who were injured on the job and whose pain was not going away with traditional treatment approaches. What he found in these patients was that by stimulating their tight muscles with an acupuncture needle, the pain very often significantly improved or in many cases disappeared.

So the key to addressing this chronic pain process is to release the muscle tension. In an IMS treatment, when the needle enters the taut band the muscle will ‘grab’ the needle and a deep, cramping sensation is felt. Once the muscle grabs it then typically will ‘reset’ itself and begin to relax. When the tight muscle relaxes, a decrease in pain should follow. IMS is now being recognized and used by physiotherapists and doctors around the world to treat chronic pain of musculoskeletal origin. If you are suffering from ongoing muscle or nerve pain and haven’t had success with traditional types of treatment, IMS may be worth trying. For more information about IMS visit:www.istop.org

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
reception_dt@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
reception_gm@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
reception_wf@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
reception_lm@suncityphysiotherapy.com
more info

Know Pain or No Gain

Physio Articles

The phrase “no pain, no gain” would probably be the leading misconception about pain that I hear – live by this slogan at your own risk. Why? Because first and foremost, pain is a protector. Pain is a wonderful and fascinating perception that helps to keep us out of danger. I can certainly sympathise that when you’re experiencing persistent or intense pain, its hard to see it as “wonderful” or “fascinating” but it truly is a remarkable defence mechanism that we possess.
When you step on a nail, twist your knee or tweak your back, what comes to your defence first? The simple answer is pain. It’s your first warning of actual or even potential tissue damage. Yes, that’s correct – “potential” tissue damage, meaning your body is smart enough to tell you to withdraw from danger before the damage is done. Wow! When tissue damage does occur, such as a strained ligament, tendon or muscle, your body sends all its best healing products to the area in the form of ‘inflammation’. The brilliance of inflammation is that it increases the sensitivity of the danger detectors (receptors) in the damaged area, which send more danger messages to the brain where they are processed and a pain experience can result. What do you think of that? Essentially, your body doesn’t just heal you with inflammation but it also tells you about it through the feeling of pain as a way of changing your behavior, allowing the area to rest and heal more effectively.

If you understand that the experience of pain is a critical response when the body feels threatened or in danger, then you will see how the slogan “no pain, no gain” will quickly lead you astray. Instead, us ‘pain geeks’ like to encourage the slogan – “know pain or no gain”, meaning that if you understand why you are experiencing pain and what it means, you are more likely to adopt the appropriate behaviour to encourage recovery.

The story of pain can get rather complex but equally as fascinating. Like any of our body systems, our defence systems can sometimes get a bit carried away and malfunction. This is often the case in the event of persistent pain – a story that will have to wait for another time. Until then, remember “know pain or no gain”.

Swimmer’s Shoulder

Shoulders

With the May-long weekend marking the unofficial start of summer, and the weather quickly heating up, many people are hitting up the lake to take their swimming practices outdoors. Like any sport, aches and pains can occur in swimming, with shoulder pain being the most common complaint. The term swimmer’s shoulder is used to describe painful shoulder overuse conditions that occur in the sport.
The shoulder is a ball-and-socket type of joint, which allows for a large amount of motion. This excessive mobility is balanced by surrounding tissues to make it more stable. Included in the structures that help stabilize the shoulder is a fibrous capsule that surrounds the head of the humerus (the arm bone), as well as the rotator cuff. Four muscles make up the rotator cuff, and serve to keep the humerus properly placed in the joint. The bony structure that you can feel on the top of your shoulder is called the acromion, where impingement can occur.
Many movements occur at the shoulder during swimming, a lot of which is overhead. Different swimming strokes involve different patterns of motion, but all have some combination of rotation, circumduction and scapular movements. These positions can put the swimmer at risk of impingement, especially if the biomechanics are off.
Injuries to the shoulder complex from swimming are typically microtrauma: small injuries over time from the repetitive activity rather than a macrotrauma from a one-time incident. There are many factors that can contribute to injury, typically described as intrinsic and extrinsic.
Intrinsic factors can include the positioning of the joint itself; if the capsule surrounding the joint is tight at the back, it pushes the humerus forward, increasing the likelihood of impingement of the tissues under the acromion, and placing more stress on the tendons of surrounding muscles. Opposite of that would be if the joint is lax, which creates more demand on the rotator cuff muscles to provide stability. Another intrinsic factor is posture, with rounded shoulders and an increased forward bend in the upper back being common amongst swimmers. This lengthens and weakens muscles that stabilize the scapulae, can contribute to a tight posterior capsule in the shoulder, and decreased mobility in the spine.
Extrinsic factors are related to the use of your shoulder: overuse (your training schedule), misuse (swimming form), abuse (too strong of demand placed on your shoulder), and disuse (time off from training).
To maximize your season, it is worthwhile to assess your shoulder mechanics, preferably before injury occurs to be preventative. Any impairments should be addressed, which can include mobilizing stiff or tight structures, strengthening the rotator cuff and other supporting musculature, and improving technique. Be cautious of overtraining – don’t increase your distance, intensity or frequency of training too quickly. Give yourself adequate time to make strength and endurance gains, as well as time to recover.
Consulting your physiotherapists to address shoulder and posture impairments, and a coach to look at your form, can help keep you swimming strong this summer.