Total Back Newsletter

The Placebo effect on Back Pain

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How does the placebo effect back pain?

People suffering from chronic back pain will often turn to medication to help ease the pain.  A recent study, researchers recruited 97 adult patients with low back pain lasting at least 3 months. Patients were randomly assigned to 3 weeks of treatment on their usual pain medications alone, or on their usual medications plus placebo.  Importantly, patients knew they were taking a placebo. The researchers explained to patients about the “potentially powerful” placebo effect, and how the body may automatically respond to placebo treatments.  Measures of back pain and disability were compared between groups. 83 patients completed the study. Researchers found greater reductions in pain for patients assigned to placebo. On a 0-to-10 scale, patients in the placebo group had a 1.5-point improvement in pain score, compared to no significant change for patients taking usual medications only. Overall, open placebo treatment reduced initial pain and disability scores by approximately 30%. Patients in the usual-treatment group had similar improvements after they started taking placebo pills.  Researchers suggest that open-label placebo can be a safe and effective adjunct to treatment for chronic low back pain. Patients have better improvement when placebo is added to pain medications.

How does this happen?  Well one theory would suggest that our minds have a greater impact on controlling pain impulses than just medications.  Being aware of the environment and mental factors that may contribute to the triggering of chronic back pain may help some people manage it better, along with addressing the functional deficiencies that may be causing the back pain.


Dr. Jolley Uncategorized Leave a comment  


Great Exercise Tips!

Consistent exercise requires focus, and focus requires a plan. Outline your workouts by day, week and month so when you hit the gym, you know what to do.

In the real world, you’re not competing on “The Biggest Loser.” Work out for five hours a day and you’ll end up burned out, injured or both. Try 45 minutes, 3-4 times a week.

We’re talking about the inevitable temptation to skip a workout. When you’re having a “bad day,” stay strong and get to the gym. Skip out and you’ll regret it; make it happen and you’ll feel great afterward.

Many people are afraid to stop working out once they start, but you need time to refresh yourself and allow your body to do the same. Schedule a consistent break (3-4 days or an entire week) every few months and then start right up again.

Your body and mind get bored after a certain amount of time doing the same thing. Mix things up every so often, whether it’s trying a few new exercises, changing the time of day you work out, or even changing up the setting (e.g., running outside versus on the treadmill).

When it comes to exercise, some people can fly solo, and that’s great; but for others, they need a friend or spouse to help keep them on track. If you can’t do it alone, don’t be afraid to ask for help.

Unless your goal is to look like a body-builder, you can put the heavy weights down. Body-weight, resistance bands and balls, and other basic equipment can get the job done just fine.

This is the most difficult tip to stay true to, but it’s also the most important. Every day isn’t sunshine and roses; that’s true in life and in your exercise routine. Some days or weeks, you won’t feel as if you’re making any progress. That’s the time to stay positive, fight through it and remember why you decided to start exercising in the first place.

Source: To Your Health



Dr. Jolley Back Pain, Uncategorized Leave a comment  

walking-for-health-logo_cmyk_highres1-250x250As we age, many of us find that our walking speed gets slower. Most of us assume that it’s inevitable. It’s not. Researchers compared natural walking speed and life expectancy and came to some startling conclusion.

They combined the results of nine different studies and followed 34,000 participants for up to 21 years. Each participant was age 65 or older, with an average age of 73 years. Their natural walking speed, from a standing start, was measured and timed for short distances.

The result of the studies: Those who naturally have an above average walking speed will generally also have a longer-than-average life expectancy. Researchers were able to correlate current age with walking speed and predict the likely survival ages. For those participants age 75 and older, the information was especially on target.

Additionally, researchers realized that the information was valuable enough to be used as a standard assessment, such as blood pressure, heart rate, weight and general mobility tests.

That’s not to say you should intentionally start walking faster. Your body picks it’s own natural speed. However, it wouldn’t hurt to have your doctor do a test to see how fast you normally walk. It can be done easily in a hallway of the doctor’s office by a nurse or practitioner.

If you walk slower than average, your doctor could look for the reasons why, as walking speed is an indication of the overall state of your health. If a problem is identified and then remedied, your normal walking speed may increase – which will put you in a category of those who have a longer life expectancy and better body functioning.

Wear your sneakers to the doctor’s office!

Source: SENIOR NEWS LINE –By: Matilda Charles

Myths about back pain

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myths about back pain

5 Myths about back pain

Any medical condition can have myths created around the causes.  We often have discussions with patients around the causes of back pain and we often hear myths about back pain.  Here are some of the most common myths around back pain.

  1. Heavy school back packs cause back pain – A recent study showed no direct correlation to heavy back packs and back pain.  Static postures have more correlation to a students back pain than back packs
  2. Moving will cause more back pain – When a person has back pain it can be very uncomfortable to move in any way, but the reality is that movement helps relax muscles in spasm. Smooth, mild movements, while uncomfortable at first, will help decrease back pain and helps speed up the healing process.
  3. Avoid weightlifting with back pain – This goes in conjunction with moving.  If you approach weightlifting with lighter loads and continue to build up the weight you will strengthen your body which will be more capable of handling stresses that can cause back pain
  4. MRI’s and X-rays will diagnose back pain –  As we age our back changes, discs narrow and bone spurring can occur.  This doesn’t mean that you are going to have back pain.  Most people have these conditions and rarely have back pain.
  5. Pain means you have damaged tissue – Pain can be related to many things that don’t necessarily mean you have damaged tissue.  Pain intensity is unique to each individual and the body responds differently for everyone.  People that have been on pain management pills can struggle with false pain when they aren’t taking them.  Sometimes just interrupting the pain impulse can alleviate back pain immediately.

How we lift in our youth has links to back pain in our mid-life

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back pain in mid-lifeA recent study out of Finland has shown links between how we lift and how we lift in our youth has links to back pain in our mid-life.  When we are younger we don’t care as much about how we lift or what we lift because we rarely experience significant back pain.

The study showed men, that reported heavy lifting in their youth, had double the chance of lower back pain.  Women that reported moderate lifting had double the chance to experience lower back pain.

People that start off learning and practicing how to lift correctly and maintain a good physical conditioning program can decrease this risk.  The important thing is that the habits we get in our youths can have a lasting effect later in life.

Yard Work and Back Pain

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Everyone loves a beautifully maintained yard, but most people don’t love the maintenance part of the beautiful yard.  Yard maintenance, especially in an Arizona summer, can be grueling work and people with back pain need to take special precautions.  Use these tips to help address yard work and back pain:

  1. Use the right tool – Using the right tool for whatever you are doing in the yard increases efficiency and decreases stress on the body, especially the back.
  2. Loosen up – Before you start doing heavy yard work, warm-up doing some of the lighter tasks to activate the muscles without putting a lot of load on them
  3. Hydrate –  Summertime is hot, make sure you are well hydrated before you start and take plenty of fluid breaks.  Dehydration can cause cramping, which can lead to muscle spasms and strain/sprain injuries.
  4. Mix up yard tasks –  If you have work that requires you to be bent over, mix it up with work that requires you to work over you head.  This uses different muscle groups and allows for muscle recovery.
  5. Take breaks – Working all day on the yard with no breaks is dangerous.  Take frequent breaks to rehydrate, rest, and recover.

If you are currently dealing with back pain, you may want to outsource the labor so you don’t aggravate your back condition.

What is Cupping?

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fire-glass-cupping-therapyEveryone watching the Olympics saw the large purple dots all over Michael Phelps and it started the buzz, what is cupping?  The interesting thing is that cupping is nothing new and is actually one of the oldest treatment modalities and has been used for almost 3,000 years! Like many therapeutic modalities its primary function is to increase blood flow to the treated area, speeding up the healing process.

Cupping essentially is a bowl or cup that is placed on the surface of the skin and the air is removed, creating a vacuum that encourages the skin and blood vessels in the area to expand.  The coloration on the skin is caused by some of the capillaries bursting and causing a mild bruising in the area.  This is why Michael Phelps has the purple dots on his shoulders and back.

While you may be interested in the potential healing aspects of cupping, most physical therapy and chiropractic practices offer therapeutic modalities that don’t leave the visible bruising and treatments that offer more empirical evidence of efficacy than cupping.  Cupping has not had many studies performed to verify its effectiveness in treating musculoskeletal ailments, and the studies that have been done have inconclusive findings.

School can be a pain in the back!

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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.

Best exercise programs for people with back pain

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What are the best exercise programs for people with back pain?


One of the foundations we try to establish with our patients is the importance of proper exercise to keep your back healthy.  There are a lot of different programs out there, some are better suited with dealing with back pain.  We take a look at some of the more popular programs out there and provide some advice on which ones may be better for back pain conditions.

  • Yoga – Yoga is a great option for people with back pain.  It focuses on flexibility and core stability will working on breathing and relaxing.  Stress is strongly correlated to the intensity of back pain.  Yoga is not the best option for weight loss, cardiovascular conditioning, or building muscle mass, but is probably on of the best options for people returning to an exercise program right after a bout of back pain. Many local gyms offer Yoga to its members and exercises can be easily practiced at home with minimal equipment
  • Pilates – Pilates also ranks very high as a great option for people with back pain.  Pilates focus is flexibility, strength, stability and control and endurance for the whole body.  It will have some increased benefits for strength because it will use some resistance training.  Pilates strong foundation of improving core stability can definitely help improve spine instabilities that can lead to back pain.  Pilates requires some very specialized equipment, commonly known as a “Reformer”.  Classes are typically offered by certified Pilates instructors and are often provided one-on-one. Pilates is not something you can easily do at home.  Pilates, like Yoga, is not the best option for weight loss, cardiovascular conditioning, but may improve muscle mass due to the resistance element with the reformer.
  • Interval training – Interval training is a general term and includes many of the popular programs you see today, P90x, Orange Theory, Crossfit, etc.  These programs are very popular because they reduce exercise boredom, by constantly varying exercises.  Many people can experience weight loss, better cardiovascular health, increased endurance and more muscle mass with these programs.  There is not as much focus on flexibility, as compared to Yoga and Pilates.  Many of the programs involve a group setting, which for some people can be encouraging or create a competitive atmosphere.  This can be motivating but can also lead people to push beyond their bodies limits, which for people with back pain can exacerbate the condition.  These types of programs are widely available and can also vary widely in cost.  Having a properly trained coach/trainer is important when doing this type of program.  A properly trained individual can help make modifications to the program to better suit an individuals condition.  People with back pain should approach this type of program with caution and discipline to stay within their limits and listen to their body.


The important thing is to stay active!  People with sedentary lifestyles often experience more back pain than ones with active lifestyles.  Doing any activity within your body’s tolerance is better than doing nothing at all.  A structured, consistent program can help people with back pain experience a better quality of life.  So get out there and move!

Living with Series: Degenerative Disc Disease

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degenerative disc disease

What is Degenerative Disc Disease (DDD)?

Degenerative Disc Disease is the narrowing of the space between the vertebrae of the spine.  It sounds nasty, but is very common as we age and most people can be diagnosed with having this condition but don’t have some of the symptoms that come along with it.  The disc’s in our spine provide multiple functions in our torso, like, twisting, bending, and shock absorption.  As we get older these disc will naturally compress which narrows the space between the vertebrae and this begins to affect mobility and in some case encourage compression of the nerves leaving the spine.  Even though it is more common in older populations, people with disc injuries or genetic predispositions for the condition can develop degenerative disc disease at an earlier age.

Can you prevent Degenerative Disc Disease?

Prevention is not an option as this is a natural process as we age.  The good news is, many people already have the condition but experience very few symptoms that can be related to this condition.  There are some things you can do to reduce symptoms related to degenerative disc disease:

  • Stop smoking – Smoking is not a main cause to degenerative disc disease, but contributes to a lot of conditions that are related to DDD, such as, hypertension, obesity, cardiovascular issues.
  • Proper nutrition – Eating a healthy balanced diet helps maintain proper weight and decreases risk of cardiovascular problems, which significantly contribute to DDD.
  • Exercise – Exercise helps keep the back strong and provides extra support for the spine decreasing the risk of injury
  • Stretch – Proper flexibility and mobility in the spine decreases the risk of injury and can decrease symptoms related to DDD.


When should I seek medical attention?

Living with degenerative disc disease doesn’t mean you have to live in pain.  There are many treatment options that can help address pain related to DDD and improve overall quality of life. Physical therapy and chiropractic care can help by breaking the cycle of pain.  Some people call these “Flair-ups”.  Often people may experience a minor back injury and the result guarding (tightening) of the muscles around the spine activating the symptoms related to DDD.  While this is the way the body protects the injured area it is actually counterproductive to the healing process.  Effective treatment can include, spinal decompression, massage, stretching and strengthening.  Find a medical provider that specializes in this treatment in order to get the best results..

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