Back Pain

What does a stiff back mean?

John Naumann Back Pain Comments Off on What does a stiff back mean?

“My back feels so stiff!” We often hear our friends say.

Well, that doesn’t mean your friend’s back is actually stiff, according to a new study at the University of Alberta’s Faculty of Rehabilitation Medicine.

“A conscious experience of feeling stiff does not reflect true biomechanical back stiffness,” explained Greg Kawchuk, professor and back and spine expert in the Department of Physical Therapy. “When we use the same word, stiffness, to describe a feeling and how we measure actual stiffness, we assume these words are describing the same thing. But that is not always the case.”

In the study, Kawchuk and his team asked participants how stiff their backs felt to them. After that, using a customized device, they measured just how stiff the back actually was.

“There was no relation between biomechanical stiffness and the reported feeling of stiffness,” he said. “What people describe as stiffness is something different than the measurement of stiffness.”

Tasha Stanton, lead author and senior research fellow of pain neuroscience at the University of South Australia, said that the feeling of stiffness may be a protective construct that is created by our nervous system.

“It’s our body’s way of protecting ourselves, possibly from strain, further injury or more pain,” she said.

With lower back pain being the leading cause of disability worldwide affecting approximately 632 million people, it is important to examine mechanisms associated with lower back pain and its symptoms, including stiffness.

“Words are important. The words patients use to describe a problem in the clinic may not be the same thing we as clinicians measure in the clinic,” said Kawchuk. “We need to find out what it means exactly when someone says they have a stiff back. We now know it might not mean that their back is mechanically stiff.

It could mean they feel their movements are slower and more painful.”

Materials provided by University of Alberta. Original written by Laurie Wang. Note: Content may be edited for style and length.

How to properly set up a computer task chair

John Naumann Back Pain, Uncategorized Comments Off on How to properly set up a computer task chair

Most of us work at computer workstations today which can lead to neck and back discomfort.  Having properly set up a computer task chair can go a long way in helping support a proper posture, which in turn leads to less neck and back pain.  Here are some tips if you are experiencing discomfort in your work chair.

Set the proper chair height – If the seat is too high or too low, it can lead to increased pressure in the spine leading to increased back pain.  Most people have the seat too high, because desk heights are designed for clearance for very tall people.  So most people shorter than 6’4″, have to make some form of accommodation.  The proper height encourage a 90-95 degree bend at the knee with feet flat on the floor.





Adjust Seat Pan Depth – Some chairs have a seat pan that can be adjusted to provide proper leg clearance so that the person can sit all the way back in the chair to be able to properly use the lumbar support. The proper distance between the front edge of the seat pan and back of the leg (just below the knee) should be about 2 finger widths deep.  If seat pan doesn’t adjust and the clearance is not enough, purchasing a separate lumbar cushion can help make up the difference.






Adjust Lumbar Support – Most people set the lumbar support too low.  The lumbar support should be high enough that you feel it just under the lower part of the rib-cage in the back.  The back rest should be upright and locked to encourage about a 95 degree angle at the hip.






Adjust the Armrests – The armrests on the chair should lightly support the forearms when in proper seated posture.  It is important to avoid direct contact with the elbow as this can lead to ulnar nerve irritation.  Also make sure to not have to slouch or shrug your shoulders in order to use the armrests.






If you are working 80% of your day in front of a computer during the day and your chair cannot be set up to support a proper seated posture, look for a computer task chair that can be adjusted to meet your needs.

Are Back Braces Bad For You?

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on Are Back Braces Bad For You?

back braces bad for youThe most common injury in the work place was a back injury.  Back Braces were the big “safety” feature in the late 1990’s and early 2000’s in helping protect workers backs when lifting objects.  The problem arose when people would wear back braces for any lifting activities and gradually their abdominal core muscles became weaker and weaker because of lack of use.  This led to people becoming more susceptible to having a back injury from performing even the most basic of movements.   The question arose, “Are back braces bad for you?”

The popularity of back bracing has waned from this heyday, but we are beginning to see a resurgence of back bracing again.  This time around many of them are more compression based wraps versus the more rigid support provided by the older back braces.  The benefit of compression based wraps is they provide light support but encourage more abdominal muscle engagement to brace the back.  In acute cases this can help people get over the “hump” with back pain.  For people with chronic back pain, wearing a brace all the time could actually be exacerbating the injury.  The important thing is to focus on spending time strengthening you back and abdominal core muscles

Better Night Sleep with Back Pain

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on Better Night Sleep with Back Pain

One of the biggest challenges for people with back pain is getting a good night sleep.  Getting a better night sleep with back pain isn’t impossible if you do a few things.  Follow these tips to a better night sleep.

  1. Check your mattress – If your mattress is over 10 years old you will want to consider replacing it.  An old mattress doesn’t do a good job provide good back support.
  2. Check your pillows – Pillows break down quicker than mattresses and can reduce support for the head and neck.  Having the proper head and neck support will help provide a good nights sleep
  3. Stretch – Stretches like hamstring stretch, piriformis stretch, iliopsaos stretch, and back lying trunk rotations can help get muscles loosened up in the back encouraging better blood floor for recovery while you sleep
  4. Check your position – Laying flat on your back is the most decompressed position you can put your spine in.  Place a pillow under the knees to provide even better support.  Side-lying is sometimes more comfortable, especially if you place a body pillow between your arms and knees.  Avoid laying on your stomach.
  5. Give yourself time – Making sure you go to bed early enough to let your back get into a position to relax is important.  Often slight shifts in position may pull us from deep sleep, due to pain response.  If you normally sleep 7 hours, go to bed an extra hour earlier to help you hit your target.

Getting a good nights sleep will help with stress and irritability with back pain.  Before you go to bed tonight try these tips to get a better nights sleep.

How to treat back pain

John Naumann Acute Pain, Back Pain, Chronic Pain Comments Off on How to treat back pain

A recent article published on Harvard Health Publications cites how the approach to treat back pain has changed since the 1980’s.  Up until the 1980’s bed rest was the most prevelant way to treat back pain.  By the early 1990’s, use of anti-inflammatory medication and light activity where commonly prescribed.  Recent studies now state that use of any medication in the initial treatment of back pain is ineffective and possibly harmful.  The new way doctors are prescribing treatment is to try, massage, heat, accupuncture, and spinal manipulation for treating acute back pain.  For chronic back pain the recommendation is to prescribe physical therapy, accupuncture, and stress reduction programs.

The new approach to treating back pain is not using any new techniques, but by limiting, if not eliminating the prescription of non-steroidal anti-inflammatories is definitely a big change for many physicians.  Learn more:  Here’s something completely different for low back pain.

Yoga vs. Physical Therapy for Chronic Low Back Pain

John Naumann Back Pain, Chronic Pain Comments Off on Yoga vs. Physical Therapy for Chronic Low Back Pain

yoga vs. physical therapyMany people tout the benefits of Yoga for reducing chronic back pain and many studies have shown that physical therapy is more effective than taking pain medication.  So which is more effective, Yoga vs. Physical Therapy for Chronic Low Back Pain?

A recent study published in the Annals of Internal Medicine  finds that yoga was just as good as physical therapy for reducing pain and increasing mobility. While clinical guidelines and many large-scale randomized controlled trials endorse yoga as a reasonable first line approach, physical therapy still remains the most common reimbursable, evidence-based, non-pharmacologic therapy prescribed by doctors.

Yoga is a great way to maintain pain relief once the initial phase of back pain is addressed by a medical professional.  But caution needs to be addressed when considering Yoga as a primary method for treating chronic low back pain.  First, the cause of low back pain is different for everyone and needs to be addressed individually.  Secondly, Yoga instructors are not medical providers, so they aren’t trained to recognize potential risks when performing certain movements.

Physical Therapy is great to help address increased bouts of pain and help educate the patient about what precautions they should take with any exercise program, including Yoga.  Also Physical Therapy, is covered under most insurance plans, while Yoga is not.

Most people would benefit from practicing Yoga as a maintenance program between physical therapy services in treating chronic low back pain.

Hormone’s Effect on Back Pain

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Hormones effect Back PainAging is associated with an increased risk for low back pain caused by lumbar disc degeneration in both men and women. A recent study from China suggests that lower estrogen levels after menopause are associated with more severe disc degeneration in women and that hormone replacement therapy, also called HRT or HT, may help.

Several studies have shown a strong link between estrogen levels and disc generation. This study is the first to include men in the comparison group, according to an article published in Menopause, the journal of The North American Menopause Society (NAMS).

The researchers documented disc degeneration measured by magnetic resonance imaging (MRI scan) in men and women as they age. They discovered that younger, age-matched men are more susceptible to disc degeneration than pre-menopausal women, but post-menopausal women have a significant tendency to develop more severe disc degeneration than men of the same age.

Overlooked Causes for Back Pain

John Naumann Back Pain Comments Off on Overlooked Causes for Back Pain

When we think of back pain, we often think it is caused by lifting something heavy, falling, or getting in some sort of accident.  We often overlook causes for back pain that are less obvious.  Here are a few less obvious causes for back pain:

  • Sitting to long – Sitting shortens your hip muscles that attach to your low back and can cause significant back pain when tight.
  • Carrying bags on one shoulder – Placing the weight of a backpack, purse, or carry bag on one shoulder can lead to putting excessive stress on the back and spine, leading to back pain
  • Smoking – Research has shown that people that smoke, have a higher risk of experiencing back pain.
  • Excessive phone or tablet use – The posture when using a phone or tablet encourages forward head posture which increase the risk of neck and back pain.

Being aware of some of the most overlooked causes of back pain can help you avoid unnecessary back pain.


Steroid Injections and Back Pain

John Naumann Acute Pain, Back Pain, Bulging Disc, Herniated Disc Comments Off on Steroid Injections and Back Pain

Chronic lower back pain affects millions of Americans. Many try steroid injections to ease their discomfort, but researchers now say this remedy provides only short-term relief.

A study performed in France recently found that people that had steroid injections to relieve back pain had no long term effects.  They found that a single injection had the most benefit, but follow up injections had only a limited effect.

Patients rated their pain severity before the injection and again one, three, six and 12 months after the treatment.

One month after treatment, 55 percent of those who got the steroid injection experienced less lower back pain, compared with 33 percent of those who weren’t treated.

“However, the groups did not differ for the assessed outcomes 12 months after the injection,” Nguyen said.

For example, patients who did or didn’t received a steroid injection ended up in similar circumstances, with the same incidence of disc inflammation, lower quality of life, more anxiety and depression and continued use of non-narcotic pain pills, she said.

Overall, most patients found the steroid injections tolerable, and would agree to have a second one if necessary, Nguyen said. “We had no specific safety concerns and found no cases of infection, destruction or calcification of the disc 12 months after the injection,” she added.

The results were published March 21 in the Annals of Internal Medicine.

The study doesn’t say that steroid injections should not be used to treat back pain.  In certain cases of acute back pain, it can be helpful in the recovery and addressing pain management.  People experiencing chronic back pain would be better served seeking alternative methods of treatment.

Worst Exercises for Back Pain

John Naumann Back Pain Comments Off on Worst Exercises for Back Pain

Having back pain doesn’t mean you should stop exercising.  In fact exercising is very important in the recovery and protection from back pain.   Certain exercises can be very bad for back pain.  Here is a list of the worst exercises for back pain:

  1. Avoid doing standing toe touches –  While stretching the hamstrings is very good for keeping the back healthy, standing toe touches can put extra stress on the spine and aggravate back pain. Try: back lying hamstring stretch
  2. Avoid sit- ups – Sit-ups put a lot of extra stress on the low back and focus more on hips than back.  Try: Partial Crunches which helps maintain good spinal support while engaging those core muscles.
  3. Avoid double leg lifts – This exercise is great with a healthy back, but can put extra stress especially when the core muscles are weak.  Try: Single leg lifts that have one knee straight and the other bent and supportive.  Move slowly through the lift and only to a height about 6″ off the ground
  4. Avoid back squat –  This is another great exercise when you don’t have back pain, but can really exacerbate back pain when you are dealing with it. Putting heavy loads on your back can dramatically increase the pressure and stress in the spine. Try:  Wall Sit – Sit against a wall with knees at 90 degree angle and a tight core will reduce stress on back and encourage strength in your legs and buttocks.
  5. Avoid burpees – This high intensity exercise can put significant stress on the back, especially as you become more fatigue.  Putting extra stress on the back from explosive jumping motion while getting up from the ground.  Try: Planks are great core strengthening exercises that encourage static strengthening, versus the dynamic aggressive movements of a burpee.

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