Total Back Newsletter

Reasons Your Neck Hurts

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Reasons Your Neck Hurts and what to do about it

There are many reasons you neck may hurt and the treatment of neck pain is never the same for everyone. Knowing some of the common cause can help you better treat your neck pain!

  • Degenerative Disk Disease (DDD) – As you get older you will inevitably get degenerative disk disease.  Thank gravity for this one.  Your spine experiences constant compression over your life and the discs between your neck bones act as shock absorbers.  These discs begin to wear out over time and become more compressed and less pliable.  This can result in stiffness in the neck and increasing the stress on muscles and ligaments that attach in the neck.  Worst case scenarios, are when the disc degenerates to a point that it allows the nerves in that area to become “pinched”.  Typically ice and heat can help, but if it doesn’t chiropractic and physical therapy can be very helpful.  In severe cases, steriod injections or surgery might be necessary.
  • Neck Strain Injury – The neck is one of the most mobile areas of our body.  It allows for the head to rotate, flex, extend, and side to side motion.  This ability also creates a greater ability for an individual to experience a neck strain injury.  A strain is related to the muscles and ligaments that attach in the neck. A strain occurs when this muscle or ligament become extended with load over a long period of time.  We also call this a static posture.  My neck is holding a static posture while I type.  If I didn’t take an ocassional break to stretch and move my neck.  I could experience a neck injury if hadn’t just paused and moved my head around into a new position.  Make sure to change your neck posture about every 30 minutes when you are in a more strained neck posture.
  • Herniated disk – Your disk is firmer on the outside and jelly filled in the middle.  If the outer layer ruptures and can let the jelly filled interior to push out and apply pressure on a nerve and cause neck pain.  Physical therapy and chiropractic care can help treat the area and allow for the herniation to heal.  In some instances the herniation might not heal and a surgical procedure may be necessary.
  • Tension Headaches – This can be a result of neck pain.  If your muscles in your neck get tight do to static posture or stress it can result in increased pressure in the suboccipital muscles at the base of your skull.  This is most common among people that sit in front of a computer all day.  An Ergonomist can help with setting up your work station to improve your posture and decrease the tension in your neck.  Physical therapy and stretches are also a good option to help relieve your neck tension.

These are some of the most common causes of your neck pain.  Proper posture and changing your posture often can have a significant impact on reducing your potential for neck pain.

Is your bed causing your back pain?

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bed causing your back painWith so many causes of back pain, many people forget to look at their bed as a potential source.  Considering you are spending about 1/3 of your life on one you should ask the question, is your bed causing your back pain?

So how do you evaluate if your bed is contributing to your back pain.

  1. When you wake up in the morning, do you feel refreshed and back relaxed?
    • Your bed should afford you a restful night sleep and your back should be relaxed.  If not, your mattress may be ill fitting and need to be changed
  2. Do you seem to toss and turn all night?
    • If you toss and turn at night, it may be your sleeping position.  Back sleeping is optimal, side sleeping is OK, and stomach sleeping should be avoided.
  3. If you share a bed, does your bed partner complain of restless sleep?
    • If both you and your partner are complaining of discomfort while sleeping, it is probably time to look for a new mattress.
  4. Do you sleep with children or pets in the bed?
    • Pets and children move around a lot and can limit the space you have on your bed.  This can result in awkward sleeping positions that contribute to back pain
  5. Is your bed over 10 years old?
    • Beds wear out over time, and you should consider replacing your mattress about ever 10 years.

If you answer yes to many of these questions, you may be wanting to change your sleeping environment.  Better sleep and bed can lead to reduced back pain.


Diet can reduce back pain

Totalback Acute Pain, Back Pain Comments Off on Diet can reduce back pain

As they say, “You are what you eat!”  What we eat can help us meet many health and fitness goals.  So you might think your diet can reduce back pain,and you would be right.  Check out these diet tips to help reduce back pain.

  1. Stay hydrated – The discs in your spine are primarily made up of water.  Well hydrated body tissues help cushion the body and help the healing process.  Make sure to drink plenty of liquids.
  2. Eat healthy proteins – Protein is an important building block to muscle repair. But not all high protein foods are the same.  Consider adding fish like, salmon or tuna, to your diet.  They are high in Omega-3 fatty acids, which is an anti-inflammatory.  Some meats, especially processed meats, can actually create an inflammatory response.
  3. Eat “bright” vegetables – Typically vegetables with deep colors, actually have anti-inflammatory properties.  Try adding foods like, carrots, beets, sweet potatoes, cherries, berries, grapes and red wine, pomegranate, and watermelon to your diet.
  4. Other foods – Other good food choices for an anti-pain diet: avocados; nuts (walnuts, almonds, pecans, and Brazil nuts); lean proteins, such as chicken and turkey; beans; and cocoa.

Take a comprehensive approach to treating your back pain by making sure your diet supports your back pain recovery.

10 Ways to Control Chronic Back Pain

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10 ways to control chronic back pain







Tips to help you deal with your chronic back pain

Chronic back pain can be one of the most frustrating conditions to deal with.  It affects every posture (laying, seated, standing) and every movement (especially walking and lifting).  Chronic back pain can wear you down and make you irritable and more sensitive to other stimuli and create an almost hopeless state of mind.  So managing your back pain not only do you need to address the physical but also the mental aspects of pain management.  Here are 10 tips for addressing the mental side of pain management.

  1. Positive imagery – Focus your attention on a pleasant place, like the beach, mountains, etc.
  2. Symbolic imagery – Envision a symbol that represents your chronic pain, such as a loud, irritating noise or a painfully bright light bulb. Gradually reduce the irritating qualities of this symbol, for example dim the light or reduce the volume of the noise, thereby reducing the pain.
  3. Transfer – Use your mind to produce altered sensations, such as heat, cold, anesthetic, in a non-painful hand, and then place the hand on the painful area. Envision transferring this pleasant, altered sensation into the painful area.
  4. Pain Movement – Move chronic back pain from one area of your body to another, where the pain is easier to cope with. For example, mentally move your chronic back pain slowly into your hand, or even out of your hand into the air.
  5. Dissociation – As the name implies, this chronic pain technique involves mentally separating the painful body part from the rest of the body, or imagining the body and mind as separate, with the chronic pain distant from one’s mind. For example, imagine your painful lower back sitting on a chair across the room and tell it to stay sitting there, far away from your mind.
  6. Alter your focus – This is a favorite technique for demonstrating how powerfully the mind can alter sensations in the body. Focus your attention on any specific non-painful part of the body (hand, foot, etc.) and alter sensation in that part of the body. For example, imagine your hand warming up. This will take the mind away from focusing on the source of your pain, such as your back pain.
  7. Sensory splitting – This technique involves dividing the sensation (pain, burning, pins and needles) into separate parts. For example, if back pain feels hot to you, focus just on the sensation of the heat and not on the hurting.
  8. Mental anesthesia – This involves imagining an injection of numbing anesthetic (like Novocain) into the painful area, such as imagining a numbing solution being injected into your low back. Similarly, you may then wish to imagine a soothing and cooling ice pack being placed onto the area of pain.
  9. Mental analgesia – Building on the mental anesthesia concept, this technique involves imagining an injection of a strong pain-killer, such as morphine, into the painful area. Alternatively, you can imagine your brain producing massive amount of endorphins, the natural pain relieving substance of the body, and having them flow to the painful parts of your body.
  10. Counting – Silent counting is a good way to deal with painful episodes. You might count breaths, count holes in an acoustic ceiling, count floor tiles, or simply conjure up mental images and count them.

Try some of these mental exercises, they will take practice but can help you limit the intensity of the pain you are feeling.

Treatment For A Bulging Disc

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treatment bulging disc

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Treatment For A Bulging Disc

In this post, you’ll learn about the definition, causes, symptoms, diagnosis and treatment of a bulging disc. But to thoroughly understand a bulging disc, it is important to learn some basic anatomy and physiology of the spine – specifically the disc which is the area affected by the condition.

Your spine is made up of 24 vertebrae. Between each vertebra are structures called intervertebral discs or spinal discs.  A spinal disc has two main parts. A fibrous exterior (annulus fibrosis) made of a several layers and a soft gel-like interior (nucleus pulposus). Each disc functions to cushion the spine, absorb shock, and maintain spacing between the vertebrae.

Now that you have a basic understanding of anatomy and physiology, let’s now talk about a bulging disc in more detail.

What Is A Bulging Disc?

A bulging disc occurs when the inner layers of the annulus fibrosis begin to deteriorate allowing the soft gel-like material inside the spinal disc to bulge out to the outer layers of the annulus fibrosis.  This is not like a herniated disc where the soft gel-like material completely leaks out of the outer material.  Imagine stepping on a balloon without popping it – that is how a bulging disc looks

What Are The Causes Of A Bulging Disc?

A bulging disc can result from several different causes. Any of the following scenarios may cause a bulging disc:

  • Spine trauma or blow

The most common situations are car accidents and sports-related injuries.

  • Repetitive Trauma
  • Most bulging discs are a result of repetitive movements done improperly over a period of time rather than one specific injury this micro trauma causes early degeneration changes in the spine and specifically the disc.
  • Aging
  • As you age your spine starts to degenerate causing the spinal disc, which functions as a cushion, to degenerate or dry out making it more susceptible to injury.


What Are The Symptoms Of A Bulging Disc?

A bulging disc causes no symptoms unless it leads to irritation or compression to nearby or adjacent areas which can result to localized pain. The location of pain caused by a bulging disc varies depending on the affected region of the spine.

  • Pain in the neck, upper back, shoulders, and/or arms.
  • Pain in the middle back, ribs or torso
  • Pain in the lower back, groin, hips, buttocks and/or legs

How Is It Diagnosed?

The diagnosis of a bulging disc involves a combination of the following:

  • History
  • Careful physical examination
  • MRI


What Is The Treatment For Bulging Disc?

Most bulging discs do not present with symptoms unless there is active inflammation in the disc. A program of progressive resistance exercises utilizing the MedX Medical Spinal Testing and Rehabilitation equipment is usually sufficient to treat a bulging disc.  Another effective treatment is non-surgical spinal decompression. At the Center for Total Back Care, we offer this procedure using the finest technology called VAX-D. VAX-D, which stands for Vertebral Axial Decompression, is a nonsurgical treatment for bulging, herniated or degenerative discs. Videos of both the MedX and VAX-D treatments can be found below.

At the Center for Total Back Care, we will assist you in returning to your normal activities of daily living in the fastest time possible. You can get back to living a pain-free life once again by scheduling a free consultation at the Center for Total Back Care today. Don’t suffer another day, call us at 480-633-8293 right now!



Healthy Holiday Tips!

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The holiday season is upon us and so are busy schedules and poor eating habits.  Here are a few tips on how to have a healthy holiday season!

  1. Plan for holiday events that involve a lot of sweet and high calorie food
    1. Eat healthy before the holiday event so that you don’t overeat
    2. Limit sampling to bite size, not serving size
    3. Avoid high calorie drinks, go for the one for one strategy.  For every high calorie drink, follow with the same volume of water
  2. Get plenty of sleep
    1. Stick to your normal sleep schedule.  People who sleep less eat more, exercise less, and have less energy
  3. Stick to an exercise regime
    1. You may not be able to maintain your normal workout schedule but plan your exercise schedule in advance so you can keep to it.
    2. Lower your workout expectations.  If you are in a time crunch, try HIIT (High Intensity Interval Training) for an effective shorter workout.
  4. Don’t overbook yourself
    1. Make time for yourself to decompress and relax.

Most importantly, remember the goal of the holiday season is to celebrate and enjoy friends and family.  Happy holiday’s from The Center for Total Back Care Team!

What does a stiff back mean?

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“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.

Arms fall asleep at night? Check the Scalenes!

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The numbness in your arms, could be your scalenes

Have you ever woken up in the middle of the night and one or both of your arms are asleep? This can be not only uncomfortable, but also very scary.

What might be causing this?

While there are many potential issues that might be contributing to this, the problem can be located in your neck. In particular, this may be an issue with your scalene muscles.

Scalenes and nerves

What are the scalenes?

The scalene muscles are a pair of muscles located in the front of your neck on either side down to your first two ribs. Each side is divided into three separate sections, anterior, posterior and middle, that perform different functions. They bend the head side to side, flex the neck forwards and lift the first two ribs when breathing. The picture above represents the brachial plexus, which includes the subclavian artery and ulnar and medial nerve, in which innervates the scalene muscles. The subclavian artery provides the blood supply for the entire arm. The ulnar and medial nerves are major nerves for the arm.

How do the scalenes cause arm pain when I sleep?

There are a couple of causes for the arm pain related to the scalenes. First, everyone’s physical makeup can be a little different and the position the nerves innervate the scalenes can increase the potential for impingement on the nerves and blood supply. For the purpose of this topic we focus our attention on your sleeping posture but work posture, and overuse injuries.

The sleeping position can be the most significant contributor to your arms falling asleep. Sleeping on your stomach is the worst position for your neck and arms. Laying on your stomach shortens the scalenes and increases pressure on the brachial plexus, leading to blood flow constriction and nerve impingement. Stomach sleeping encourages you to put your hands above your head and maintaining your neck in a static rotated position. Many stomach sleepers will experience numbness and pain in both arms at the same time. Side lying positions can cause the arm on the side you are sleeping on to fall asleep because you are putting all the pressure on one shoulder causing the scalene muscles to shorten on that side. Plus the weight of your body applies pressure on the brachial plexus. Typically side lying people will experience arm pain and numbness on the side they are laying on. Back sleeping is overall the best position to sleep, as long as your arms stay at chest level or lower. If you place your hands above your head you will potentially experience pain in both arms.

How do you reduce the occurrence of your arms going to sleep?

The first thing to do is to improve your sleeping posture. Laying on your back or side is preferable to stomach sleeping, which should be avoided. If you are a side sleeper, make sure your head is properly supported. Finding the right amount of pillow support will help keep the neck in better alignment, reducing side lying curvature. Using a body billow will help keep the arms separated and supported. For back sleeping the important thing is to keep your hands from going higher than the shoulder.

Make sure you perform the upper trapezius stretch and chin tuck periodically throughout the day to alleviate the tension built up in the scalenes.

Lastly, if the issues are persistent seek medical assistance. Chiropractic, physical therapy, and massage therapy helps target the specific issues and can help address the issues originating in the neck and help you get a better night sleep and alleviate your arm pain and numbness.

Types of Pain You Shouldn’t Ignore

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Everybody experiences pain at one time or another and we will often ignore it.  But there are certain types of pain you shouldn’t ignore.

Chest pain 

Heart attack pain can feel like pressure in the center of your chest, which may spread to the jaw, neck and arm. Other possible heart attack signs include pain that gets worse when you exert yourself, shortness of breath, nausea and sweating.


While most headaches are not a sign of a severe medical problem, there’s one exception: pain that comes on suddenly, particularly after exertion, and feels like the worst headache of your life. This could be a sign of an aneurysm, or bleeding in the brain. This type of headache needs immediate medical attention.

Abdominal pain

Stomach pain is one of the most common complaints seen in the ER. In as many as half of cases, there’s no specific diagnosis. Common causes of abdominal pain include appendicitis, gallstones (hardened deposits of digestive fluid that can form in your gallbladder), pancreatitis (an inflamed pancreas) and diverticulitis (when pouches in the wall of the colon get inflamed or infected).

Appendicitis is associated with pain in the right lower section of the abdomen and is often accompanied by fever, nausea and vomiting. Anyone with these symptoms should go directly to the ER. If the pain is caused by appendicitis, a quick diagnosis is important because if it’s caught before the appendix ruptures, the surgeon often can remove the appendix with laparoscopic surgery. If the surgery isn’t done until after the appendix ruptures, the surgery becomes more complicated, and the recovery is longer.

Gallstones cause pain in the right upper section of the abdomen, often after eating a fatty meal. The pain can be severe and is often associated with nausea. As with appendicitis, removing gallstones early makes surgery simpler, with a faster recovery.

Back pain

While most cases of back pain are caused by muscle strain, some types of back pain are a sign of a more serious problem. Back pain associated with weakness and numbness in the arms and legs, or accompanied by fever, should be evaluated immediately. This type of back pain could be a sign of a spinal cord infection, which should be treated right away to reduce the risk of permanent damage to the spinal cord.

Severe upper back pain, whether or not it’s accompanied by chest pain, could be a sign of a heart attack or aneurysm.

Leg pain

If you have leg pain along with swelling of the leg, it could be a sign of a blood clot. The risk of a blood clot is higher after a long period of immobility, such as a long plane ride or after a person has been in bed for a while following surgery. The pain caused by a blood clot feels more like throbbing or aching. A blood clot is diagnosed with an ultrasound.

You will want to identify and treat a blood clot as quickly as possible, because an untreated clot could get larger, break off and go to the lungs, where it can cause a life-threatening problem.

Difference between a strain, sprain, or tear

Totalback 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.

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