Back Supports Are Not Always The Answer!

Spinal Lumbar or Lower Back Supports cannot really do anything to prevent pain in the lower back, a new review has reported.
The review, published in the latest issue of The Cochrane Library, found that the large belts which can be worn around the waist when picking up or carrying heavy objects are as effective in reducing pain as education about lifting.
The researchers looked at 15 studies which involved over 15,000 people and looked at both the prevention and treatment of low back pain. They found that patients who did not use such supports reported the same levels of pain or reduced disability as those who had.

Lead author Ingrid van Duijvenbode said that the findings of the review indicate that lumbar supports should not be recommended for patients looking to treat or manage their low back pain.
She said: "There is moderate evidence that lumbar supports do not prevent low back pain or sick leave more effectively than no intervention or education on lifting techniques in preventing long-term low back pain. There is conflicting evidence on the effectiveness of lumbar supports as treatment compared to no intervention or other interventions."

A spokesman for the Arthritis Research Campaign, which funds a great deal of research into alleviating low back pain, said that in most cases, patients benefited from maintaining everyday activities and keeping as mobile as possible, rather than resting.
Unfortunately back pain tends to deter exercise, but medical opinion is now firmly in favour of movement and exercise as part of back care.

Top Tips:
DO & DON'T
Select a form of exercise suitable for your fitness level - if you are a beginner, work up gradually. Don't do much in your first few days. Your tolerance will be very low at first, and if you do too much you won't be able to do anything the next day. Also, you will be put off.


Find an exercise that you enjoy. You will be more likely to continue. Don't do impact sports like running, at least to start with.


Learn to stretch. Stretches should be done slowly and gently, without jerks or excessive force. Don't just copy others, especially athletes! To get it really right, book a session with a physiotherapist. Don't do sports which make you bend your back, or move suddenly, like cycling or squash, until your back is fully recovered.



Stop if an activity creates increasing pain in your back. Find a different sport until you are fitter. Don't waste money on a home workout machine. Most people quickly stop using them because they are so boring.


Wear good quality trainers. These are excellent for reducing impact forces with the ground, which otherwise generate a shockwave up the back. Don't avoid lifting altogether. Moderate loads on your back are needed to build up fitness in the back muscles. But lift correctly.


Don't play competitive team games to start with - you may be tempted to overdo it, or you might hurt your back in a collision.


The best type and intensity of exercise is different according to your condition, your fitness and the state of your back. You need some exercise, but not too much. That's why you may be given conflicting advice by different experts. If that happens, learn the broad principles and then go your own way - it's your body and only you can feel it.


The key is to start gently, choose your sports carefully, and gradually develop into a more strenuous regime. Getting fit is a stress/recovery process, while most bad backs result from too much or too prolonged stress, with incomplete recovery. Your exercise "sweet spot" will be unique to you, and will change as you get fitter and your back heals.


Find something that you enjoy and that can be easily incorporated into your daily life. This can be easy to achieve, for instance: if you normally get the bus to work, try getting an earlier one and getting off a few stops earlier. Park your car further away from your destination and walk.



When going out to lunch, try to find a restaurant that is within walking distance. Walk up or down stairs instead of taking the lift.


Why exercise is good for your back:
When abdominal and back muscles are toned, they work together like a natural corset for your back, providing support and improving posture.
Fit muscles have better fine control and more power in reserve, giving smoother motion during lifting and moving.
Fitness postpones fatigue, helping you avoid tired habits like not lifting correctly.
Exercise makes bones denser and stronger.
With stretching, exercise increases flexibility, helps you use good postures for lifting and sitting.
Helps you lose weight and stop smoking! Excess body weight and smoking are bad for backs.
Exercise improves blood circulation, and so enhances nutrition and recovery processes in your back.

Terry O’Brien
BackTrouble.co.uk

Bio-Mechanics and Back Pain Relief.

When our body is in the standing position it is in a state of unsteady equilibrium because the base is small and the centre of gravity is a long way above it. That is why it has to be balanced by keeping the centre of gravity over the base, otherwise the body would fall over.Equilibrium: The steadiness of the body depends on the size of its base and the distance of the centre of gravity from that base. An object having a large base and a low centre of gravity is not easily upset.The first thing necessary in order to accomplish good posture is to straighten the neck, keep the chin down and back.

The second important thing is correct deep breathing. The line of gravity in the fundamental standing position falls in front of the ears, and in front of the cervical and dorsal vertebrae, through the lumbar vertebrae, through the hip joint, and slightly in front of the ankle joint. But this probably varies in individuals according to their build and height."Biomechanics is that branch of science concerned with the understanding of the interrelationships of structure and function of living beings with respect to the kinematics and kinetics of motion"Poor Posture associated by the following:

Genetic disorders, Familial association, Irregular/no exercise, Bad habits when sitting or standing, Carrying excess loads, (School/shopping) Underweight/Overweight (Inadequate diet)Mental Attitude towards oneself.

Biomechanics is our way of describing how each bit of your body moves in relation to another bit.
Our bodies are fantastic at compensating when things are not quite perfect but unfortunately when we run out of compensations we usually end up with pain and stiffness.

Let’s have a look at some of the more common biomechanical problems:

Problem 1.
It’s the fashion not to tie trainers and shoes up but this prevents the shoe from supporting the inside of the foot and allows the foot to roll or ‘pronate’ too much in standing and walking.
This means the knee and the hip rolls inwards too much which makes the inside calf and inside thigh muscle shorter. The iliotibial band can then rub against the outside knee giving pain.
Further up, the bottom muscles become too long and stop working as they should do which puts added stress on the pelvis and low back joints. Before you know it you have back pain, knee pain and ankle pain! And all because of fashion!

Problem 2.
Whether you drive 5 miles or 500 miles a day your car seat is really important. In many cars the base of the seat slopes backwards. In fact some of the more expensive cars are the worst because they want you to feel ‘snug’ and safe in the seat. However, this position forces your pelvis to sit too far backwards.

Once this happens your low back and upper back flex forward too much but then your neck muscles have to work really hard to stop your head from flexing too much and allow you to see where you are going. This position then forces your shoulder blades to stretch too far forwards and a large stress is placed on both the front and the back of the shoulder.
The result is neck pain and /or upper or low back pain. This position can exacerbate sciatica as it is a big stretch for the nerves.

The solution is to raise the back of the seat so it becomes more horizontal. Some cars allow you to alter this angle but if yours does not then sit on a small cushion or buy a special wedge shape cushion that fits into the seat.

Terry O’Brien
Back Trouble UK.

The Silent Disease

The Silent Disease is the name that is often given to Osteoporosis, as most people don't know they have osteoporosis until it has progressed often to the point of fracture, usually in the hip, wrist or spine. Even when undiagnosed osteoporosis results in a vertebral fracture, the pain is frequently dismissed as general back pain. This lack of awareness can lead to serious illness, deformity, even death.

Osteoporosis alone does not cause back pain. It can, however, weaken the spine to where it is no longer able to withstand normal stress or minor trauma, resulting in vertebral fracture. It is the ensuing fracture that causes pain.

Osteopenia is a condition where bone mineral density is lower than normal, but not low enough to be classified as osteoporosis. While often a precursor to osteoporosis, not everyone with osteopenia will develop osteoporosis. Since a diagnosis of osteopenia puts one at greater risk for osteoporosis, patients are encouraged to seek the advice of their physicians about implementing preventive measures.

Osteoporosis Causes and Risk Factors
Bones are made of complex, constantly changing, living tissue. They are able to grow and heal, and are also susceptible to changes in diet, body chemistry, and exercise levels.
Early in life, more bone is laid down than is removed by the body. People typically achieve peak bone mass by around age 30, after which more bone is lost than is replaced. Too much bone loss leads to osteoporosis.

Both of the two primary types of osteoporosis are far more common in women than men:

Type I osteoporosis (postmenopausal osteoporosis) —generally develops after menopause, when estrogen levels drop precipitously, leading to bone loss — usually in the trabecular (spongy) bone inside the hard cortical bone.


Type II osteoporosis (senile osteoporosis) — typically happens after age 70 and involves a thinning of both the trabecular (spongy) and cortical (hard) bone.

In addition, certain medications and medical conditions can damage bone and lead to what is known as “secondary osteoporosis”. Patients being treated for any of the following conditions should discuss the risk of osteoporosis with their physicians:

Endocrine disorders

Marrow disorders

Collagen disorders

Gastrointestinal disorders

Seizure disorders

Eating disorders (such as anorexia or bulimia)

It is important to distinguish between primary and secondary causes of osteoporosis because treatment is often different. To determine the cause, a thorough medical history, physical examination, and appropriate diagnostic tests need to be conducted (see Diagnosing Osteoporosis).

Key risk factors for developing osteoporosis include:

Advanced = age over age 65.

Gender = Women are four times more likely to develop osteoporosis than men.

Heredity = Family history of osteoporosis or fracture on the mother’s side.

Personal history = any type of fracture after age 45.

Race = Caucasian and Asian women are at greater risk.

Body type= small-boned women weighing less than 127 pounds.

Menstrual history = Normal menopause increases the risk of osteoporosis and early menopause can exacerbate this risk.

Lifestyle = calcium and/or vitamin D deficiency; little or no exercise (especially weight-bearing exercise); alcohol abuse; smoking; too much cola/soda.

Testosterone deficiency (hypgonadism) = in men.

Why women are at greater risk for developing osteoporosis

Estrogen plays an important part in maintaining bone strength. Starting at about age 30 through onset of menopause, women lose a small amount of bone every year as a natural part of the aging process. When women reach menopause and estrogen levels decrease, the rate of bone loss increases for approximately 8 to 10 years before returning to premenopausal rates.

Osteoporosis Symptoms

Osteoporosis can go undetected for years and fracture is typically the first outward sign. Advanced osteoporosis is potentially disabling, often leading to one or more of the following:
fractures of the spine, wrist or hip

spinal deformity (e.g., lost height, hunched back)

chronic or severe pain

limited function and reduced mobility

loss of independence

decreased lung capacity

difficulty sleeping

Osteoporosis is the leading cause of spine fractures, especially in women over age 50, but only about one third of all spine fractures are diagnosed.

Most osteoporotic spine fractures (vertebral compression fractures) start with sudden back pain, usually after routine activity (lifting or bending) that slightly strains or jars the back. After a month or two, this acute pain is usually replaced by an achy pain (see Diagnosing vertebral compression fractures).

Osteoporosis Prevention

Postmenopausal (Type I) osteoporosis can be significantly influenced by preventive measures. Most of these behaviors are up to the individual and should be started as early in life as possible. For those genetically predisposed to osteoporosis, the following practices are even more important:
Exercise regularly weight-bearing exercises (activities that work one’s bones and muscles against gravity) are essential to maintaining bone health.

Ensure adequate calcium intake, Calcium plays a key role in keeping bones strong. Vitamin D is also essential, as it helps ensure absorption and retention of calcium in bones. Calcium and vitamin D requirements vary depending on age and gender.

Eat a balanced, healthy diet Certain foods provide excellent sources of calcium, while diets high in protein and/or sodium increase calcium loss.

Quit smoking - Smoking has a detrimental effect on bone density, leading to greater risk of injury and longer recovery times.

Limit alcohol consumption - While the exact way alcohol affects bone isn’t entirely understood, excessive alcohol use has been proven to accelerate bone loss.

Limit intake of colas/sodas - recent research indicates that too much cola or soda can increase the risk of osteoporosis.

Undergo bone density testing - every 1-2 years if you are postmenopausal, over age 65, or have other risk factors. Bone mineral density (BMD) tests indicate normal, low or osteoporotic bone density levels, as well as any increased risk of fracture.

For more information, see How to prevent osteoporosis.

Osteoporosis Treatment

Once osteoporosis has been diagnosed, patient and physician should work together to develop a treatment plan where the goal is to slow bone loss and prevent fractures. Treatment may include:
Education on diet/nutrition - see Food for Thought: Diet and Nutrition for a Healthy Back.

Exercise (if no fracture) - to help maintain bone density and reduce the risk of falls.

Medication - to slow bone loss and prevent fractures. Osteoporosis medications fall into two categories:

medications that slow or stop bone resorption (loss);

medications that increase bone formation.

Treatment for vertebral fractures, which may include:

rest, though long-term rest accelerates bone loss;

rigid back braces to support the spine;

ice/heat and pain medications;

surgery (kyphoplasty or vertebroplasty), which may be necessary in certain situations where the fracture is causing severe pain and/or deformity, or has failed to respond to three months of non-surgical treatment.

Do be positive because even once osteoporosis has been diagnosed, it is possible to slow bone loss, build bone density and prevent fractures. Continually advancing osteoporosis and related fractures are not an inevitable outcome of being diagnosed with osteoporosis.



Terry O’Brien
Back Trouble UK.

Back Exercises

Many times individuals experience back pain because their body is not strong enough to support their bodies. The result of a weak body is often back pain. However, back pain exercises are a great way to strengthen the entire body and provide support for your back. When your back has support because your body is strong due to back pain exercises then you will not experience back pain like you did before. So, if you suffer from back pain consider back pain exercises to increase your back strength and decrease your pain.

Back Pain Exercises

Back pain exercises might sound as if they are exercises that only focus on the back; however this is not the case. In fact, back pain exercises are made up of exercises that strengthen the back, stomach, neck, hips and thighs. The reason back pain exercises focus on all of these muscles is because all of these muscles work together to provide support for your back. When all of these muscles are strong due to back pain exercises they will provide a sound support system for your spine and your back pain days will be over.

Back pain exercises should include cardiovascular exercises like biking, running, or swimming followed up by wall sits, lounges, leg raises, sit ups, and other similar back pain exercises. When these back pain exercises are performed on a regular basis the individual will gradually strengthen their body providing more support to their back and body. As the body becomes stronger and better supported back pain will subside.

The Alexander Technique

The Alexander Technique is used to help to teach people about how efficiently and effortlessly they can use their bodies in everyday life. Often, we develop bad posture and habits without being aware of this, and expend too much energy or muscle force to achieve a task. Alexander Technique teachers help to adjust the client's posture to recognise the difference between current habits and what it feels like to use muscles with minimum effort and in a relaxed, fluid way.

Posture:

The Technique teaches how to become more aware of your own posture, balance and movement in everyday life. The lessons usually last for between 30 and 45 minutes and are normally on a one-to-one basis. The teacher uses his/her hands to gently correct any muscular imbalances and encourages the body to a better alignment. This is a direct body experience, so the client becomes familiar with the sensation of correct alignment in his or her own body. This can feel strange initially, as the body is not used to using it's muscles in this way, and the new methods of movement need to be practised with constant awareness as to how we choose to use our bodies in everyday tasks. It is a process of re-educating the body by learning how to stand and move correctly. This leads to health benefits as often-poor spinal posture will lead to other symptoms like poor breathing due to restriction in the throat and diaphragm areas. Breathing and how we breathe is an important aspect of the Alexander Technique.

Successful remedy:

An Australian actor, Frederick Matthias Alexander (1869-1955), developed the Alexander Technique. He suffered from respiratory problems as a child, which later affected his voice and career in the theatre. He tried many remedies without success and eventually began a process of self-observation to try to find a way of curing himself. He realised that the voice problem was a result of muscular tension in his whole body and that his thought patterns also had a great part in contributing to the tension that had become an ingrained habit. Alexander studied his posture with the aid of mirrors to see how this was affected when he recited and as a result could see that his body alignment was incorrect. He gradually taught himself to correct his posture and found that he had cured his voice problem. He went on to pass the technique to others and eventually opened a clinic to help people to learn about their own use of posture.

Back Pain Treatment without Drugs!

C’mon there is a standard "cure" for most causes of back and neck pain?

Fact: Compared to other medical conditions, there are relatively few standardised approaches to diagnosis and treatment of back problems. Spine specialists from various areas of expertise (such as physical medicine and rehabilitation, chiropractic, osteopathic medicine, physical therapy and surgery) will often disagree on the diagnosis and most appropriate treatment plan for back pain and back problems, and specialists within a discipline will also frequently have different opinions.

A few diagnoses for back pain as a result of back a back problem are relatively straightforward (such as a spinal tumour, infection, or fracture) and there is generally more consensus for diagnosis and treatment of these back problems.

Myth:
Rest is the key to recovery from back pain and back problems
Fact: The two main reasons bed rest may be recommended for back pain are to reduce pressure on the discs in the spine and to stop the mechanical stresses that are irritating pain receptors. A short period of bed rest may help reduce acute back pain. However, in most instances, more than 1 or 2 days of rest can be detrimental to recovery from back pain, potentially leading to increased pain and other adverse results, such as:

muscle atrophy (1% to 1.5% per day)

cardiopulmonary reconditioning (15% loss in 10 days)

bone mineral loss

risk of blood clots

loss of wages

creating an "illness" mindset

Myth:

Heat and massage feel good so they must be helping back pain and back problems?

Fact: These therapies can reduce acute back pain in the short-term, but do not provide a long-term solution to back problems. They are used to manage pain during recovery, allowing patients to complete a rehabilitation program and participate in daily activities.

Myth:

Long-term pain indicates I need back surgery for my back problems?

Fact: If back pain has reached the chronic stage, spine surgery actually has a reduced likelihood of being successful. Typically, symptoms that suggest back surgery might be helpful occur early in the course of pain and are relatively apparent.

Let us Help?

Are you a candidate for treatment?

Our associated clinics treat both acute and chronic back conditions.

If your symptoms have appeared recently we can use the best manual physical

therapy techniques to facilitate the healing process and restore normal function as soon as possible.

If your symptoms are long-standing (more than 6 weeks) or recurrent you are likely to have developed weakness and instability in your spine and you may be a candidate for our specialised programme of intensive strengthening of the lumbar spine.

We are able to treat anyone between the ages of 18 to 80.
Treatment is as suitable for those with sedentary lives as it is for athletes - we have patients at both ends of the scale.

This list shows some of the the conditions that can be treated successfully using Natural Physical Therapy.

Lumbar strain

Herniated (prolapsed) disc

Sciatica

Degenerative disc (or joint) disease

Stenosis

Spondylolisthesis

Osteoporosis

Osteoarthritis

Hypermobility/instability

Scheuermann's disease

Many treatment methods help only with symptomatic relief but do not address the underlying cause of pain and therefore result in only a temporary solution.

That is why so many people with back pain find themselves in the "Pain Maze" confused over which therapy to undergo, or whether drugs, injections, manipulation or surgical procedures will indeed bring an end to the pain.

That’s why Back Trouble UK was formed, so that Back Pain sufferers could be both more informed and to be able to make a more informed choice of available therapies.

Possibly Dangerous Remedies!

Back pain occurs in many forms. It may be only an uncomfortable twinge in the lower back or so severe that it is disabling. The pain may persist for a week, or for months or years. Back pain is extremely common, and there are numerous methods and commercial products available to treat it.

One common misconception is that back pain is caused by activity and relieved by rest. Unless otherwise advised by a physician, however, you should not treat back pain with extended bed rest. The patient with low back pain should rest for no more than two days and may try nonprescription products. It is better to resume normal activities (even though there may be some pain) than to rest too long and get out of shape, which may increase the risk of future episodes of pain. In one-third of all cases, back pain will heal in a week or so.

Preventing Back Pain:

To prevent future episodes of back pain, ask your physician to refer you to a physical therapist who can teach you exercises to strengthen the muscles of the back. Sitting for extended periods is a primary factor in back pain. Regular exercise can allow the back to better support weight while sitting. If your job involves a great deal of sitting (such as working at a word processor), walking during break periods and after work is a good idea.

Using Non-prescription Analgesics:

A number of safe and effective non-prescription products are available, but they should not be used longer than 10 days. The products should not be used when pregnant or nursing a baby, and they should not be combined with prescription pain relievers unless you ask a physician or pharmacist. Also, you should not combine non-prescription products with each other (for example, ibuprofen plus naproxen) unless advised to do so by a physician or pharmacist. If you drink three or more alcoholic beverages daily, do not use any non-prescription pain reliever without asking your physician.

Choosing a Pain Reliever:

Acetaminophen (Tylenol) is a good first choice because it does not cause stomach problems and is safe with most prescription medications. Other products that may be effective include aspirin, ibuprofen, naproxen and ketoprofen. It is important to note, however, that these medications may irritate the stomach unless taken with food or milk. Aspirin may cause interactions with prescription medication, such as warfarin, other medications for thinning the blood, or medications for gout, arthritis, or diabetes.

Heat and Cold: Your doctor or physical therapist can tell you how to use heat or cold treatments and other products.

Be cautious about internet information:

Patients searching the Internet for information on back pain may be led to devices purported to relieve back pain, including Back Bars (delivering pressure point massage), portable pillows, seating systems, back supports, and driver’s cushions. One device allows the user to hang suspended from the ceiling, supported by an air-filled cushion worn around the waist.

An A-frame metallic device allows one to hang upside-down holding on to its bars.
Another company claims to have the solution for back pain (as well as stress, insomnia, migraine, and arthritis) with automatic Chinese ear acupuncture devices that do not use needles.

One company touts the benefits of proanthenols, which they claim are grape seed and pine bark extracts, for back pain. Since patients often purchase these products in lieu of a physician visit or safe and effective back treatment.

We would like to warn patients to avoid unproven and possibly dangerous remedies.

Sport & Low Back Pain:

About 80 per cent of the world's residents suffer from low back pain at one time or another, and an athletic lifestyle offers no warranty against the problem.

low back pain is a common ailment among runners, cyclists, and other athletes, and until now no one has been exactly sure what sports-minded people should do to alleviate - or prevent - the complaint. Now, thanks to research carried out at the University of Copenhagen in Denmark, it appears that special co-ordination exercises can help get athletes' backs 'back on track'.

The Copenhagen investigations add some clarity to what has been a muddled picture concerning the proper therapy for low back pain. Sports scientists have been pretty certain that inadequate strength and endurance of the back muscles increase the risk of low back pain, suggesting that back-strengthening exercises would be an ideal preventative.

However, it's been impossible to determine which back-muscle strengthening programme is optimal, and recent research has even called into question the validity of traditional back-strengthening therapy. For one thing, scientists have shown that some popular low back exercises actually magnify 'intradiscal pressure' in the spine, possibly INCREASING the risk of difficulties. In addition, other studies have suggested that back-strengthening exercises are no more effective than short-wave diathermy or ultrasound at ameliorating low back pain.

Developing smoother back movements:

So, the Copenhagen investigators decided to take a new tack. Instead of assuming, as almost all other researchers have done, that muscle-strengthening routines are the answer for low back pain. The Danish researchers reasoned that healthy functioning in the low back does not depend on muscle strength, endurance, and flexibility alone - but also on the CO-ORDINATION of movements involving the lower back.

They theorised that individuals who moved clumsily might put inordinate strains on their low back muscles, connective tissues, and spinal structures, even if their basic muscle strength was pretty decent, leading to the onset of pain. As a result, the Danes hypothesised that training to improve co-ordination - but not necessarily muscle strength - might help individuals develop smoother movements of the lower back, which would then decrease the risk of harmful stress on the low back and thereby reduce the risk of pain. Forty Copenhagenians aged 18 to 65 with chronic low back pain took part in the study.

The subjects had all experienced low back pain for at least three months in the preceding year, but none of the individuals suffered from serious problems such as osteoporosis, painful osteo-arthritis, inflammatory rheumatoid arthritis, or disc degeneration.The subjects were divided into two groups, each of which trained for one hour two times per week over a three-month period. One group carried out conventional endurance/strength training for the low back, while the other conducted the special co-ordination training. After a 10-minute warm-up, the endurance/ strength group completed four key exercises:

Leg Lifts, in which subjects stood by the end of a table, leaned over into a prone position with the hips against the edge of the table and the chest flat on the table, and then lifted both legs behind them to the greatest possible height.

Trunk lifts, in which subjects lay prone on a table with their hips at the edge and the upper part of the body extending out over the edge of the table face-down (a strap over the calves kept individuals from toppling off the table). With hands behind their heads, the participants lowered their trunks and then lifted their trunks upward to the greatest possible extent (very much like traditional 'Roman-Chair' exercise).

Abdominal contractions (sit-ups), in which individuals lay on their backs with their knees flexed, feet on the floor, and arms behind their heads and then slowly 'sat up' in a straight- forward direction; and
Lat pull-downs, in which participants sat on a seat, grasped a weight lever, and then pulled the lever down behind their necks and shoulders, lifting a weight stack which was attached to the lever.

During the strength/endurance workouts, subjects did as many repetitions of each exercise as possible (but no more than 100), with 30-second pauses after each set of 10 repetitions.

At the end of the workout, participants completed about 10 total minutes of stretching, using 30-second static stretches of the various muscle groupsLike the strength/endurance people, the co-ordination-trained subjects started their workouts with 10 minutes of jogging and warm-up activity. They then completed four co-ordination exercises, including 1) "Knee-elbow touches'' in which they started in an upright, standing position and then rotated their trunks to the right, lifted their right knees while standing on their left feet only, and touched their right knees with their left elbows. They then returned to the standing position, rotated their trunks to the left, lifted their left knees, and touched their left knees with their right elbows. This alternating pattern - left elbow touching right knee and right elbow touching left knee - continued for up to 40 repetitions. 2) 'Balancers,' in which subjects started out on all fours (hands and knees on the ground) and then extended their left legs straight back and their right arms straight ahead, while remaining in balance on their right knees and left hands.

They then went back to the starting position and moved their left arms ahead and right legs back before alternating this pattern for a total of up to 40 reps.
3) Modified sit-ups, like No. 3 from the strength/endurance training except that instead of sitting up straight ahead, subjects moved forward alternately to the left and then to the right as they did their 'crunches'; and
4) Proprioceptive training, in which the participants stood on a wooden disk with a sphere attached to its undersurface. Subjects tried to keep balanced on the sphere without letting the edges of the disk touch the floor - while twisting their bodies and bending at the knees.

Participants stood on both feet at the beginning of the study but progressed to one-footed balancing (alternating feet) after several weeks. Post-workout stretching was the same as for the strength/endurance group.

And the results?

After three months of training, both groups had less low back pain, better mobility of the low back, and less trouble carrying out their daily activities, and the co-ordination group improved just as much as the strength/endurance group. Consumption of drugs to control low back pain was reduced by about two-thirds in both groups as well. Notably, back-muscle strength increased in the strength/endurance group but not in the co-ordination subjects, yet each group made similar improvements in low back function, demonstrating that an upgrade in strength is not the only thing which can heal a 'bad back'. Supporting this idea is the fact that there was not a strong correlation between improved back strength and reduction in low back pain in the Copenhagen research.

What does the Danish research mean to you?

If you suffer from low back pain or want to minimise the risk of low back pain in the future, improving your back-muscle strength is a decent idea, but it's not the complete answer. You should also carry out the co-ordination drills completed by the Danish athletes to 'smooth' and co-ordinate the functioning of your lower-back muscles and spine, and you should probably also improve the flexibility of your low back by stretching out your low back muscles AFTER they are thoroughly warmed up.

With improved strength, co-ordination, and flexibility in your low back, you should be able to exercise more efficiently and with less fatigue in your low back area. In addition, the prevention of low back pain should allow you to train more consistently, leading to higher-quality performances.

Is Exercising Safe for Those with Back Pain?

Many people with back pain don't know whether it is safe to do exercises or if exercises will worsen their condition. It all depends on the cause of the back pain.

Exercising is beneficial for various conditions causing back pain, even osteoarthritis of the spine.

Always check with your GP or Chiropractic Doctor as to which exercises are appropriate for you to do.

When back pain is caused by an injury, maintaining day-to-day activities is usually recommended.

BED REST FOR A COUPLE OF DAYS ONLY: Muscles go into spasms at the site of an acute injury (triggered by inflammation). Muscle spasms restrict movement to protect the body from further injury.

Muscle spasms may cause intense pain. For the first couple of days after an acute back injury, lying on a firm surface may be helpful in relieving muscle spasms and pain.

After a couple of days, bed rest is counterproductive. Prolonged bed rest weakens the back and delays healing.

For the majority of people experiencing back pain from an injury, maintaining normal activity speeds up recovery. Maintaining normal activity is better than either bed rest or getting into an exercise program too quickly.

In the case of an acute back injury, back exercises (except for gentle stretching exercises) are best started after the majority of back pain has resolved. It is important to maintain day-to-day activities, as bed rest will not speed up recovery and prolonged bed rest causes wasting of the muscles. Weakened muscles make recovery more difficult.

If you are suffering from severe back pain caused by an acute injury, a couple days of bed rest may be necessary until inflammation and muscle spasms have subsided, but get up and get moving as soon as possible.

Increase activity slowly. Try to get up and walk around the house a little. Do a little more every day.
The muscles that support the back are activated during almost any activity - even while simply sitting or standing the core muscles support the weight of the body - so maintaining daily activities will maintain the muscles that support the back.

Walking and swimming are low impact activities that can be started before the back pain has totally resolved, as recommended by your physician. Stay away from high impact activities until you have completely recovered from a back injury.

Start with gentle stretching exercises only. Stretching exercises for the back increase circulation to the muscles to speed healing, relieve tight muscles and back pain, and help increase mobility. A warm shower or bath before exercising will loosen up tight muscles and ease pain, making the exercises easier to do.

Save the strengthening exercises until your back pain has gone or as recommended by your GP or Physical Therapist. Until back pain is gone (usually two weeks to two months for back muscle strain), avoid exercises that put pressure on the lower back, such as leg lifts done in a face down position.

You don't want to restrain injured muscles and cause a flare up of back pain. If you are unsure as to what exercises are safe, a Chiropractic Doctor can create a personalised exercise program for you to follow.

*Warm water exercises are particularly beneficial. Warm water increases circulation, speeds healing, relaxes tense muscles, and eases pain, which makes the exercises easier to perform. Many public swimming pools offer warm-water exercise classes.



When you have recovered from your back injury, begin strengthening exercises that target your core muscles. Strong back, abdominal, and buttocks muscles support the spine, take stress off the joints of the spine, are vital to good posture, and will reduce the chance of recurring back pain. Do strengthening exercises regularly to maintain strong muscles.

It’s a well proven fact that strengthening the muscles that support the back can prevent back pain from recurring.

Reduce Your Stress

Relieving stress can reduce pain that is aggravated or caused by tense muscles. Managing stress on an ongoing basis may also help prevent back pain from occurring in the first place.

Relieving Stress with Exercise:

Stress can be relieved through exercise. Aerobic exercise is a particularly effective form of exercise for relieving stress -aerobic exercise burns off stress hormones and increases the body's production of endorphins - naturally occurring chemicals that relieve pain and improve mood. Stretching exercises also can relieve stress and loosen tight muscles. Yoga incorporates poses that increase strength and flexibility with breathing techniques to relieve stress.

Relaxation Techniques:

Relaxation techniques invoke the "relaxation response." Muscles relax and blood pressure, heartbeat, and respiration decrease. This is the opposite of the "stress response" where muscles tense and blood pressure, heartbeat, and respiration increase.
There are many relaxation techniques, from simple deep breathing exercises that are easy to learn on one's own to self-hypnosis that must initially be taught by a qualified professional. Other relaxation techniques include meditation, progressive muscle relaxation, guided imagery, biofeedback. Special equipment is needed for biofeedback and it must be taught by a professional.

Though most relaxation techniques are not complicated, they still take time and practice to master.

Massage Therapy:

is very beneficial for relaxing muscles, increasing circulation, and relieving stress. Regular massage can help manage stress and back pain. Soaking in warm water relaxes the muscles and has a calming effect
Stress Management is an ongoing process - as is staying strong through exercise. Keeping fit through exercise and managing stress are both important in the treatment and prevention of back pain.

Chiropractic Therapy is regarded as being highly successful in both the treatment and management of stress related Back Pain. Visit http://www.backtrouble.co.uk/

Scoliosis

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Scoliosis is an abnormal curvature of the spine.

A certain degree of spinal curvature is often considered normal and usually requires no formal treatment. This may not be considered an abnormal finding in some cases.

Scoliosis has many causes and can be associated with:
• Neuromuscular disorders
• Bone disease
• Soft tissue disordersScoliosis can occur in infancy or during adolescence.
• Infantile scoliosis is rare and typically presents itself before the age of three.
• Adolescent idiopathic scoliosis is the most common type of scoliosis.

Females are affected eight times as frequent as males. School screening programs have provided for earlier detection and treatment of scoliosis, which has led to improved outcomes.

A careful spinal evaluation is a part of all chiropractic examinations. The examination should also include a thorough neurological examination and inspection for skin lesions to rule out non-idiopathic causes.

Diagnostic evaluation:

• X-rays of the cervical, thoracic and lumbar spine should be performed to measure the exact location and degree of curvature.
• Bone scans may be indicated
.Treatment varies based on criteria including:

• Location of curve
• Type of curve
• Degree of curvature
• Age
• Underlying condition(s)
• Skeletal maturityIn general, curves less than 20 degrees can be observed and followed every six months. Curves above 20 degrees typically require bracing.

Exercise is important for maintaining flexibility and strength of spinal muscles.
Surgery is performed if the curve continues to progress despite bracing, or if the curvature angle is too severe.

Curves above 50 degrees have been shown to progress over the years, and progression of a thoracic curve above 60 degrees can impair heart and lung function. Surgical fusion is important in these cases to prevent further medical problems.

www.backtrouble.co.uk

Live Life-Control Your Back Pain

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1. A back disorder can develop over a period of time or a patient may actually have a sudden onset of back pain. There may be one specific incident or known injury such as a fall, direct trauma, motor vehicle accident, or the back injury may be the cumulative result of one or all of the following:

*.Poor posture
*.Improper body mechanics
*.Stressful living situations and poor working habits
*.Limited flexibility and decreased strength

Poor posture is one of the leading causes of back pain. You can help prevent or even help cure a back disorder by trying to improve your postural awareness and by making changes in your activities of daily living.

Listed below are some useful tips to remember:
Correct sitting and standing postures are one and the same; head and shoulders erect and balanced, stand up straight and look straight ahead.

Do not sit or stand for long periods of time (take periodic rest breaks and change positions as needed).
Always position yourself close to your work and work at a comfortable height.

2. Always practice good posture and proper body mechanics.
Faulty Body Mechanics involves improper lifting techniques.
One must maintain proper posture and keep objects close to the body.

3. One must use the strong muscles of the lower extremities to perform the lift instead of bending at the waist and using the lower back.

4. Do not twist while lifting and obtain assistance if needed.

5. Stressful Living Conditions and Poor Work Habits.

This may aggravate the symptoms of back pain and may even create a flare-up of pain following periods of increased tension.

6. Utilising stress management is an important tool to help improve emotional factors in one's life.

Most individuals will cope better by understanding the nature of their injury and taking the appropriate steps necessary to eliminate back pain and provide for a healthy back.

7. Exercise:

Exercising aerobically 3 to 5 times weekly and maintaining good strength and flexibility are the keys to having a strong and healthy back. Generally, people in poor physical condition tend to be more vulnerable to back injuries than those who maintain a high level of physical fitness. One of the most important components of good health is to maintain a daily exercise program.

8. In conclusion Back problems can be prevented most of the time. It is certainly easier to prevent a back injury by taking the appropriate measures. Patient education is one of the most effective tools in preventing back injuries. Patients can be taught to understand what their back problems are, how to prevent them and what to do if they occur. Self-responsibility and a desire to have a healthy back is the first step to success!

www.backtrouble.co.uk/

Exercise For A Healthy Back

These recommendations are for people currently not experiencing back pain. Modifications are necessary if you have back pain. Do not continue to perform an exercise that produces pain. Seek the advice of a GP or Chiropractic Therapist or other medical professional.

Exercise is an important part of improving and maintaining normal, comfortable back function. It is important to practice these exercises regularly so you can maintain your fitness level.

What are the different types of exercise? Exercise can be divided into three basic groups:

1. Strengthening: repeated muscle contractions until the muscle becomes tired.
2. Stretching or Flexibility: slow, sustained lengthening of the muscle.
3. Aerobic: steady exercise using large muscle groups.

All exercises should be performed slowly and comfortably to avoid injury. When performing strengthening and flexibility exercises, remember to breathe naturally and do NOT hold your breath; exhale during exertion and inhale during relaxation.

A program of strengthening, stretching and aerobic exercises will improve your overall fitness level. Research has shown that people who are physically fit are more resistant to back injuries and pain, and recover quicker when they do have injuries than those who are less physically fit.

Strengthening exercises help increase muscle tone and improve the quality of muscles. Muscle strength and endurance provide energy and a feeling of wellness to help you perform daily, routine activities.

Adequate strength of abdominal and back muscles helps stabilise the spine, allows proper spinal movement and makes it easier to maintain correct posture. Strong hip and leg muscles are important to perform proper lifting techniques and body mechanics.

Stretching/Flexibility Exercise:

Flexibility is the ability to move your arms and legs through their full range of motion. Stretching will help improve your flexibility.

Adequate flexibility of tissues around the spine and pelvis allows full, normal spinal movement, prevents abnormal force on the joints and decreases the possibility of injury. Stretching also prepares muscles for activity; stretching should be done before and after each vigorous workout to prevent muscle strain and soreness and to help avoid injuries.

When performing flexibility exercises, stretch as far as you can and hold the stretch for 10 seconds and then ease back. Each stretching exercise should be performed slowly, with no sudden jerking or bouncing. Bouncing is more likely to injure or strain a muscle or joint.

Aerobic Exercise:

Aerobic exercise provides cardiovascular conditioning--it strengthens the heart and lungs and improves the body's ability to use oxygen. Some other benefits of aerobic exercise include increased energy levels, improved mood, better sleep habits and decreased blood pressure. Aerobic exercise also burns calories and improves your metabolism, helping with weight loss. Some examples of aerobic exercise include:
Jogging, Cycling, Skating , Rowing, Swimming , Walking, Cross-country skiing and Dancing.

In general, to achieve maximum benefits, you should gradually work up to an aerobic session lasting 15 to 60 minutes, 3 or 4 times a week. Please check with your doctor before starting any aerobic program.
Your exercise routine should consist of a 5-minute warm-up (including stretching exercises) before the aerobic activity and 5 to 10 minutes of a cool down (stretching and slower activity) after the activity.

Here are some precautions with aerobic exercise:

Skipping or Jumping rope , puts too much pressure on the discs and should be avoided. Running can be done as long as it doesn't increase lower back pain. When walking or running, wear supportive, well-cushioned shoes and walk or run on a level surface.

What should I know about pain during exercise?

Do not ignore pain--if you feel increased pain or pain spreading to the legs, do not continue the activity. If you continue to perform the activity while you are in pain, you may cause unnecessary stress or damage on your joints. Seek the advice of a GP or a Chiropractor. Fear of pain can cause unnecessary inactivity.

Learn to "read" your body and know when you need to stop an activity.

www.backtrouble.co.uk

Two forms of Chiropractic. Two different Chiropractors

A Chiropractor based in Canterbury Kent, UK sates on their web-site that Chiropractic, around the world, is divided. There is one half that practice in a way that is congruent with medicine, but not what chiropractic was founded upon. This small faction of chiropractic only provide palliative care and provide treatment to relieve symptoms. It is the purpose of this kind of chiropractor to see a patient for 6-8 visits for pain relief and possibly some kind of treatment regime to minimise pain. This kind of chiropractor is trained in the UK.

Unfortunately, training is limited to this one form of chiropractic. It is unfortunate for the profession but even more unfortunate for the community who miss out on the many benefits that the other, more prevalent faction of chiropractic, provide all around the world, from Australia, Canada, New Zealand, USA, Europe, South Africa and even Ireland.

They go on to state that the leading and most prevalent group of chiropractors are trained overseas in countries like Australia, New Zealand, Canada and the United States.
This Chiropractor graduated with a double degree as a Doctor of Chiropractic in Australia, where they practised as a Chiropractor until June 2000 when they decided to move to the UK. They now practice as a Spinal Specialist in Blean, near Canterbury in Kent in the UK.

I am personally dismayed and find it very frustrating that certain practitioners of such an established and accredited profession as Chiropractic. Find it necessary to seek a commercial advantage by decrying other established practices and aspects of their Profession.
Chiropractic needs to present a united front to the world, not this "I’m trained in this technique and they are not". The I’m better than you are approach to attracting potential patients is only undermining the Chiropractic Profession as a whole and its ability to establish itself as the treatment of choice for those suffering from back related disorders!