Chronic Pain

Difference between a strain, sprain, or tear

John Naumann Acute Pain, Chronic Pain Comments Off on Difference between a strain, sprain, or tear

strain, sprain, or tearMost people don’t know what the difference is between a strain, sprain, or tear of a muscle.  But as a provider these are very important delineations in how we approach the care of an injury. So what is the difference?

A sprain is a ligament injury. A ligament is fibrous connective tissue that connect bones to each other and stabilize them.  Typically ligament injuries occur when a joints range of motion is pushed to an unnatural position.  Sprain injuries can vary in severity, which will contribute to the time for recovery

A strain injury is a muscle or tendon injury.  This is commonly caused when a muscle is overloaded and is over stretched.  There are two types of strain injuries, acute strains and chronic strain injuries.  Acute strains are instantaneous strain injuries and chronic strains are caused by repetitive motions over time that place stress on muscle or tendon.  Strain injuries, like sprain injuries, can vary in severity, which will contribute to the time for recovery.

A tear injury is a muscle, tendon or ligament injury that results in the tearing of the fibrous tissue.  These can be more serious than strain or sprain injuries.  They can result in the need for a surgical repair in order to restore proper function.

The rehabilitation process is strongly driven by identifying the type of injury that has occurred.  It is recommended that you seek a medical professional in order to identify that severity of the injury before beginning treatment.


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.


Can Osteoarthritis be prevented?

John Naumann Chronic Pain Comments Off on Can Osteoarthritis be prevented?

Can Osteoarthritis be prevented?  Researchers from the University of Surrey identified a link between metabolism and osteoarthritis. Metabolic changes, caused by a poor diet and a sedentary lifestyle, trigger’s the genetic reprogramming of cells in the body and joints.

Such metabolic changes impact upon the cells ability to produce energy, forcing it to generate alternative sources to function. The stress this places on cells leads to the overproduction of glucose, which when not used for energy transforms into lactic acid, which is difficult for the body to flush out. Abnormal levels of this acid in the body leads to the inflammation of the joint’s cartilage which impedes on movement and causes pain.

By identifying metabolic changes in cells, it is potentially possible to control or significantly slow down the symptoms of osteoarthritis, alleviating the suffering of millions of people.

This debilitating condition disproportionately affects post-menopausal women who are more pre-disposed to the condition because of biology, genetics and hormones. Currently there is no effective treatment for this painful ailment, with only painkillers available to treat symptoms and no known cure.

“It is important never to underestimate the significance of a healthy diet and lifestyle as not only does it impact upon our general well-being but can alter the metabolic behaviour of our cells, tissues and organs leading to serious illnesses.”

Credit:  Science Daily


Can exercise and diet affect Osteoarthritis?

John Naumann Chronic Pain Comments Off on Can exercise and diet affect Osteoarthritis?

During the expert review, researchers from the University of Surrey identified a crucial link between metabolism and osteoarthritis. Metabolic changes, caused by a poor diet and a sedentary lifestyle, trigger’s the genetic reprogramming of cells in the body and joints, according to an article in Science Daily.

It states that metabolic changes impact upon the cells ability to produce energy, forcing it to generate alternative sources to function. The stress this places on cells leads to the overproduction of glucose, which when not used for energy transforms into lactic acid, which is difficult for the body to flush out. Abnormal levels of this acid in the body leads to the inflammation of the joint’s cartilage which impedes on movement and causes pain.

This demonstrates that many conditions we experience are significantly influenced by our lifestyle choices and diet.  Placing importance on these things will help improve ones quality of life.


10 tips to reduce stress

John Naumann Acute Pain, Chronic Pain, Headaches Comments Off on 10 tips to reduce stress

Reducing stress in your life helps with your overall well-being and helps reduce pain. When we are stressed the body is at a continuous state of fight or flight through the release of cortisol which can inhibit our mind from returning to a state of calm.   Here are 10 tips to reduce stress that doesn’t involve a vacation or spa weekend.

  1. Meditate – This can take place anywhere at anytime.  Sit up straight with feet on floor, and think of something warm and relaxing and close your eyes.  Shut out the world around you and let your mind focus on this peaceful, serene place.  A few minutes of meditation can make a big difference in
  2. Deep breathing – This is excellent when you feel frantic and hot tempered.  Sitting calmly for about 5 minutes just taking slow deep breaths that go from your diaphragm to the upper part of your chest can reduce your heart rate and blood pressure.
  3. Be Present – Reduce the number of things you are thinking about and focus on one sense, like, taste, touch, hearing, smell, or sight.  Listen to nature or watch a pretty view.  Bring yourself to the now.
  4. Reach out to people – Reach out to your family or friends, do this face to face, not online.  Talk to them about what you are dealing with and invite a new perspective that may help you find solace.
  5. Tune into your body – Find a place to lay down flat on your back and start with your toes and go up, taking a moment to see how each body part feels.
  6. Decompress – Take a warm bath, lay on a heating pad, place a warm wash cloth on your face, or massage an area that is holding tension.
  7. Laugh out Loud – Think of something funny, listen to a comedian you like, but the act of smiling and laughing triggers the release of endorphins that helps suppress the release of cortisol.
  8. Listen to music – Listening to your favorite up-beat music and even singing along with it can do wonders in relieving your stress.
  9. Get moving – Exercise and activity can help release chemicals that help provide positive energy and emotions.
  10. Be grateful – Create a journal that you write in daily that documents what you did for yourself, work, family, and community.  Even if it is what you might consider a minor thing it triggers a positive emotional response in the brain.

Highly effective people lead stressful lives but have understand that stress doesn’t have to be contained in the body, but released in a way that can lead to a positive lifestyle.  It’s the harboring of stress in the body that does damage to it and can lead to more pain.


Sleep Soundly

Dr. Jolley Articles, Back Pain, Chronic Pain, Headaches Leave a comment  

Sleep Soundly

How to sleep soundly

Getting a good nights sleep is the best way for the body to recover after a busy day.  So, how do you sleep soundly?

1) Your Mattress
Most people buy a new mattress when their old one “wears out,” meaning that it’s tattered, torn, excessively stained and/or otherwise unappealing to sleep on. Generally, it is not a good idea to keep a mattress longer than 10-15 years due to the wear and tear you put it through. Depending on the quality, it may last longer or shorter. Going to a store and lying on a mattress for a few minutes is not enough time to make a decision on something you will have to lie on every night for years to come. You need to test it out in a real sleep environment to make sure you can experience rejuvenating sleep. After all, why pay good money to end up tossing and turning every night?

Choose a mattress that has a trial period so that if you do not like it, you can return it and get another. Most good mattresses come with trial periods of anywhere from 90 days to up to five years, depending on where you buy them. Do not buy a mattress if you have no ability to return it. They cost far too much money to have buyer’s remorse later.

Again, in terms of which specific mattress type/style to choose, it really boils down to how it makes you feel/sleep. Some people prefer a firm mattress, while others like a softer mattress. As long as it adequately supports your head, neck and back during sleep (meaning you don’t sink into it excessively or don’t hurt the next day from lying on something that feels like your hard floor), it’s what makes you sleep well that matters most.

2) Sleeping Position
Okay, so you’ve picked out your “perfect” mattress; now how do you sleep on it? From a health perspective, the best position for sleep is on your back with a pillow under your knees. The pillow should be comfortable for you and help take pressure off the small of your back. The second-best position is on your side with a pillow between your knees. The pillow between the knees must be thick enough to keep your thighs hip-width apart. On your side also means you need a supportive pillow (I’ll explain what kind of pillow in just a minute).

The most undesirable position for sleeping is on your stomach. This is because you need to turn your head to either side in order to breathe, which can cause neck pain. Often I notice that people who sleep on their stomachs also throw one or both arms over their head, which can lead to pain in the shoulders as well. Please try to avoid this position, as it is not healthy for your body.

3) Your Pillow
Think about how you like to sleep before you choose your pillow. People who sleep on their back need a thinner pillow than those who sleep on their side. There are so many pillows to choose from, but my best advice to you is to take your current pillow to your chiropractor and let them analyze it for you.

Your head should not be lifted so high that it cranes your neck. While on your side, your pillow should cradle your neck so that your spine forms a 90-degree angle with a line through the shoulders. Don’t be fooled! Just because you have an orthopedic or fancy memory foam pillow doesn’t mean it is right for you. In fact, it could be one of the causes of your sleep problems. Again, let your doctor evaluate your pillow and discuss the best option to maximize your sleep.

Source: To Your Health –By: Kevin Wong, DC


School can be a pain in the back!

John Naumann Back Pain, Chronic Pain Comments Off on School can be a pain in the back!

back to school

Student Back Packs may not be causing student back pain

Schools are heading back into session and everyone is hitting the local stores to get their kid’s school supplies.  A recent study done out of the University of Lisbon, showed that almost 60% of children experience some form of back pain related to their school environment.  Believe it our not, they found little correlation between overweight backpacks and back pain.  So what is causing students to have pain in the back.  They found it was more related to poor static posture and related to their desk and studying environment.  Here are some of the key factors that can contribute to student back pain.

  1. Lack of Activity – Prolonged static posture, good or bad is not good for body.  Our bodies were designed to move to stay healthy.  Many students will sit sedentary at school all day and then come home and sit either studying, watching TV, texting friends, or playing video games.  It is recommended that a student gets at least 60 minutes of physical activity a day.  This is a good idea whether you are a student or not!
  2. Desk not properly set up – This is a very difficult for the classroom to be able to accommodate so many different body types, but a student can definitely set up a good home study environment.  Make sure the desk, chair, and computer are set up to encourage the best possible posture.  For tips, see 5 tips to make sure your workstation is set-up properly.
  3. No break in class schedule – Creating a break in the class schedule encourages a change in posture.  If PE is required in the student’s school, try to have it take place more middle of the class day to refresh the body and posture.
  4. Tablets and phones – Technology improvements have made many things in our life easier, but they are also encouraging extra stress on our bodies.  Phone use as moved from talking to viewing, which encourages a lot of forward head posture.  Tablets encourage the same thing.  The forward head posture puts more stress and strain on the back.

Addressing this points can help the student avoid some of the main things that contribute to school being a pain in the back.


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