JustCare

Tag: Back pain

  • Got lower back pain? Exercise

    Got lower back pain? Exercise

    It’s extraordinarily common for people to have stiff and achy backs. Rachel Fairbank reports for The New York Times that four in five Americans have lower back pain at some point in their lives. The science suggests that exercise could prevent or reduce some lower back pain.

    In particular, aerobic and core work can help with lower back pain. The key is to strengthen core muscles around your spine. These muscles keep you stable and standing up. They can be found  deep in your back. They also include hip muscles, quadriceps and hamstrings.

    You want to ensure your spine can move in a variety of directions as well as hold you up. Pain generally comes from a muscle pull or strain because it is weak.

    What should you do to strengthen your core and become more flexible?

    • Move! All day long, however you can. Walk more steps. Regular exercise makes a huge difference. It doesn’t appear to matter what type of exercise you do, just that you do it. A side benefit of exercise is that it increases blood flow to the spine and makes your spine bones and cartilage stronger.
    • Exercise your deep core muscles. For example, do planks, ideally on your toes, but you can start on your knees. Squats, pushups and bridges are also good exercises for your deep core muscles. Crunches and sit-ups are great, but they don’t help strengthen those deep core muscles.
    • Do Pilates! You want muscular control along your spine.
    • Inject some instability into your exercise routine. This will help with coordination and control. For example, balance on something that is not level.

    At the end of the day, it’s less about having big muscles than about how well you can coordinate and control the muscles surrounding your spine. Reactive sports such as tennis or hiking are helpful for improving your coordination and control.

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  • Treating back pain: Often, hot and cold packs and time do the trick

    Treating back pain: Often, hot and cold packs and time do the trick

    Today I’m talking back pain, one of the biggest issues my patients face. Eight out of ten of you will experience back pain at some point in your lives.  Usually, the back pain will go away on its own, though it may take a while. For typical back pain, treatment is simply hot and cold packs and rest.

    A few times a day, rest your back on a cold pack for no more than 20 minutes.  Then, rest it on a hot pack for up to 20 minutes.  It will feel great, and generally your back will start feeling better fairly quickly. You can also help your pain by taking analgesics, such as aspirin or ibuprofen. Make sure you don’t have health problems that prevent you from taking these medications.

    There’s really no need for you to see a doctor at first.  You should call your doctor only if your pain does not go away after three days. Of course, if your back pain follows a fall or there are other neurological symptoms, such as numbness, you do need medical attention. And, if you have a medical history of cancer or osteoporosis, it is also good to see a doctor.

    One treatment that is probably overused for simple back pain is a Magnetic Resonance Imaging test or MRI. An MRI is almost always an unnecessary test. You might see an abnormality on your MRI, but except in the rarest of instances, the treatment will be the same: home care, hot and cold packs and rest.

    MRI tests are not therapeutic nor does it change my treatment plan for back pain. An MRI should be used as a diagnostic tool, which is helpful in certain circumstances, but many times should not be ordered. An MRI will not help your back and, generally, will not help your doctor to figure out the source of the pain or how to treat it. Of course, if pain persists, you should see your doctor again. But most often the pain will resolve and not getting tests will save you time and money.
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  • The value of integrative care

    The value of integrative care

    As much as we may believe that different health conditions from which we suffer can be treated independently of one another, there is ample evidence to suggest that they tend to be interconnected and often should be treated as such. Katherine Gergen Barnett, M.D. explains in a Health Affairs post the value of integrative care, doctors who look at the whole patient when providing treatment, not discrete conditions.

    In short, Barnett explains that a good doctor treats the person–understands the range of personal, social, medical and emotional issues his or her patient is facing–in order to heal the patient. Put differently, as Hippocrates is believed to have said, “It is more important to know what sort of person has a disease than to know what sort of disease that person has.” In turn, it’s generally helpful for the millions of people who suffer from chronic conditions to have peer support as well as lifestyle support, in addition to medical support, to promote better health.

    Dr. Barnett, along with her colleagues at the Boston Medical Center, have created an integrative medicine group to better treat patients with multiple conditions. Their patients, all of whom suffer from chronic pain–as do some 100 million Americans–benefit from group medical visits, the principles of mindfulness-based stress reduction (MBSR), and evidenced-based complementary medicine.

    • Group medical visits: In this care model, as many as 12 patients with a shared condition–e.g., diabetes, back pain, high blood pressure, arthritis–see the doctor at the same time. These visits allow for peer-to-peer support–a type of buddy system–as well as more time for the medical visit. The social aspect of the visit also can promote better health.  The research suggests that these group visits can improve quality of life for patients.
    • Mindfulness-based stress reduction (MBSR): Research further shows that mindful meditation and purpose promote better health. They can ease stress, improve mental health and reduce pain.
    • Integrative medicine: With integrative medicine, doctors see and understand the whole person requiring treatment and recognize that treatment can include help with lifestyle changes. Patients may be offered evidence-based complementary medicine, such as tai chi to improve balance, yoga to promote calm, or acupuncture, all of which can help reduce pain.

    Integrative care is still a relatively new concept. To see if it’s available in your community, contact your local hospital. And, if it is, and you’re suffering from pain and other chronic conditions, you might consider learning more about it. You might also want to learn more about good incremental care, another evidence-based approach to alleviating pain that treats the whole person.

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