Total Back Newsletter

Overlooked Causes for Back Pain

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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

Totalback 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

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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.

So, what is Gluten?

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Gluten is very controversial these days.  Recently we are seeing more products with that are “certified” gluten-free logo on it.  There is even a Gluten Intolerance Group that certifies products that claim to be gluten-free.  Most health care providers claim that it is safe for everyone except those who have celiac disease. Some health experts believe that gluten is harmful for most people.   According to a recent survey, more than 30% of Americans actively try to avoid eating gluten.  So, what is gluten?

Gluten is a family of proteins found in grains like wheat, rye, spelt and barley.  When flour is mixed with water, the gluten proteins form a sticky network that has a glue-like consistency. This glue-like property makes the dough elastic, and gives bread the ability to rise when baked. It also provides a chewy, satisfying texture.

For the vast majority of people, avoiding gluten is unnecessary.  However, for people with certain health conditions, removing gluten from the diet can make a huge difference.  Furthermore, the diet is usually harmless to try.  There is no nutrient in gluten grains that you can’t get from other foods.  Just make sure to choose healthy foods.  A gluten-free label does not automatically mean that food is healthy.  Gluten-free junk food is still junk food.

10 tips to reduce stress

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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.

Drugs for Back Pain, nothing more than a placebo

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Drugs for back pain

Recent study finds using drugs for back pain provide little benefit

Using drugs for back pain, such as ibuprofen (Advil) are commonly used to cope with back pain, but research from The George Institute for Global Health found they offer little benefit but cause side effects. Researchers found that in 35 trials testing painkillers and back pain, only 1 in 6 reported significant benefit!

“Back pain is the leading cause of disability worldwide and is commonly managed by prescribing medicines such as anti-inflammatories,” said lead author Manuela Ferreira.  “But our results show anti-inflammatory drugs actually only provide very limited short term pain relief. They do reduce the level of pain, but only very slightly, and arguably not of any clinical significance.”

Many people also can experience significant side effects such as liver damage and gastro-intestinal bleeding that can negate any of the potential benefits the medication might have.

Last year, a study conducted at the University of North Texas Health Science Center found manipulative therapies reduced pain and improved function in patients suffering from chronic low back pain.

Top Low Back Stretches: Prone Press Up Stretch

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Top Low Back Stretches: Prone Press Up Stretch

The prone press up stretch focuses primarily on the spine itself.  Often when people sit with poor posture the back becomes rounded increasing spinal pressure and putting pressure on the disc.  If you have a bulge or herniation in this disc it can increase pressure on the nerves resulting in back and lower extremity pain.  By performing the prone press up stretch you counteract this spinal position.  People that have been diagnosed with spinal stenosis or spondylolisthesis, should consult with a medical provider before performing these exercises.

Prone Press Up Stretch

Prone Press Up-Begin stretch by laying face down on a flat surface

-Place hands/elbows on surface at shoulder height with elbows away from body

-Slowly raise your shoulders by pressing your hands/elbows into the surface.  Make sure to keep your hips and legs on the surface.

-Raise to a height that is comfortable

Elbow Prone Press Up      -Hold for 10 seconds and perform 10 times




When should I perform the prone press up stretch?

Perform this stretch when you have been in forward posture for long periods of time.  This includes sitting, working bent over, or exercising in a bent over position.

When should you not perform the prone press up stretch?

People with existing spinal conditions such as a fusion, stenosis, or spondylolisthesis should consult with their doctor before performing this stretch.  Also if you experience increased pain while performing or prolonged pain after stretch.

Top Neck and Shoulder Stretches: Chest Stretch

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You may be asking, “What does a chest stretch have to do with the neck and shoulders?”  The chest muscles are often neglected when it comes to stretching to maintain proper head and shoulder posture.  As people work with their hands in front of them, such as, when working on a computer, sewing, reading, etc., they often leave their shoulders in a forward rotated position due to the tension that builds up in the chest muscles.  The result is a slouching posture that leaves the head in a forward position and puts extra stress and strain on the neck and upper back.  By stretching the chest muscles throughout the day you counteract this tension and helps you position your shoulders in a neutral position supporting a proper posture.  When performing this stretch you should feel the stretch across the chest and front of the shoulders.   It is important that when performing stretches that the individual does not have pain or numbness, but a mild stretching sensation in the muscles of the targeted area.  Please consult with a doctor if you have any questions about this exercise.

Chest Stretch

chest stretch– First find a doorway or corner that you can place your forearms and hands in a vertical position

– Make sure that your elbows are not higher than shoulder height when forearms and hands are placed on doorway or wall.

– From this position gently lean into the doorway or corner until you feel a good stretch across the chest and shoulders, remember no pain

– Hold this position for 10 seconds and repeat 3 times




When should you perform the chest stretch?

If you have a slouching posture or anytime you work for a long period of time with your hands in front of you.  If you work in front of a computer this stretch should be performed about every hour.

When should I avoid performing the chest stretch?

If you experience pain in the shoulder or chest when performing the stretch.  Consult with a doctor if you experience any of these issues when performing the stretch.



How your footwear can affect back pain

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How your footwear can affect back pain

flip flop

Next time you experience back pain, consider your footwear.  Why? Well think of your footwear like tires on a car, when the tread wears on the tires it can cause an imbalance and the car will begin to perform poorly.  This is why auto mechanics recommend regular rotations, alignments, and service.  Our bodies are not much different when it comes to this.  Our feet are our foundation when walking and standing, how they perform can have a direct influence on how the rest of our body feels.  Here are some tips when it comes to footwear to help avoid back pain.

  1. If you have foot and ankle problems get it checked out or it can lead to back problems – Pain or dysfunction in your feet affect your gait and standing posture which directly affects your back.
  2. Replace the “tires” – Like the tires on the car your shoes should be replace between every 3-6 months, depending on how much you wear them.  Do not think that because the shoe shows no outward wear that they aren’t worn.  The pressure from your feet inside the shoe will apply wear to the inside support, which is hard to see.  If you wear you shoes often you may need to change them sooner due to wear on the soles.
  3. Make sure your shoes are a right fit – Even if you have worn a size 10 shoe for 20 years, your size may have changed.  As we age the arches in our feet begin to change and even though we are no longer growing, our feet can flatten increasing the length of our feet.  Make sure the shoes you are wearing have about 1/2″ space between the tip of the shoe and you big toe.
  4. Wear orthotics – Fitted orthotics can significantly improve joint alignment.  Most over the counter orthotics might provide temporary foot relief, many aren’t design to help improve posture which directly influences back pain.
  5. Go to a running shoe store to get fit for shoes – Even if you don’t run, the running shoe store has an amazing number of options for all kinds of feet.  The employees at running shoe stores are often trained to analyze foot strike patterns to help you find the shoe that fits your individual need.  Runners are the ultimate footwear users, learn from their experience.
  6. Form versus fashion – Telling a woman not to wear high heels is like telling them to jump off a tall building, you just don’t do it.  But there are considerations, high heels have a lot of potential negative effects on our feet and back.  Limit how long you wear high heels.  Carry a pair of flats with you to change out in when you are going to be on your feet for much of the day, and put the high heels on when it is “necessary”.
  7. Sandals – Limit sandal and flip-flop wear.  They provide little to no support for the foot and can lead to foot problems, resulting in back pain.  Flip flop and sandals should only be worn on a day that involves limited walking or standing.

While your back pain may have many different causes, having a good foundation and making sure you have proper footwear is a good place to start. Footwear and back pain often come together.

Can rest cause back pain?

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rest cause back painHow does rest cause back pain?

For years the common treatment was rest and lack of activity to help recover from back pain.  But that rest might be doing more harm than good.  So how does rest cause back pain?

When people rest and aren’t moving or using there back, there muscles in the back get weaker and weaker.  Consider a recent finding with astronauts.  About 30% of the astronauts that go into space experience moderate to severe back pain, even though they are in excellent physical condition. The findings have shown that while in space the astronauts body is weightless so there is very little pressure on the back and very little need for muscles that support the lumbar spine to be engaged.  The findings show weaker lumbar spine muscles can result in back pain, even when there is no pressure on the spine.

Reducing the risk of back pain whether here on earth or in space, requires keeping the muscles strong in you back.  The Center for Total Back Care, has always used the Med-X system, as part of our rehabilitation program because it does the best job in isolating and strengthening the muscles in the lumbar spine.  Maybe NASA should look into creating a similar program to help treat their astronauts?


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