Vancouver Spine Care Centre

08/05/2020

Back pain: Four ways to fix bad lockdown posture – by copying astronauts

June 19, 2020

Authors

Andrew Winnard
Lead for the Aerospace Medicine Systematic Review Group and Lecturer, Northumbria University, Newcastle

Nick Caplan
Professor of Aerospace Medicine and Rehabilitation

The advice we give to astronauts can be helpful to people working from home.

Lockdown could be bad for you back. Thanks to measures to tackle the coronavirus pandemic, many of us are now working from home. This means you might not be moving around as much, and your home desk setup (and the posture you adopt while working) might not be as good as it should be. These are all things that can lead to back pain.

Common poor desk posture is actually very similar to the posture astronauts adopt during spaceflight in zero-gravity. Usually this is a forward leaning posture with a forward head position and the loss of normal spinal curves. Being in space also has similar effects to staying in bed all day.

At the Aerospace Medicine and Rehabilitation Laboratory at Northumbria University, our team of researchers look into ways of keeping the spine healthy in astronauts during space missions. But this research can also be used to help those of us on Earth keep our spines healthy when working from home.

At a very basic level, the spine is a stack of 33 bones called vertebrae. In between the vertebrae are thick jelly-like discs that provide space for the bones to move across the whole spine when we rotate or bend.

Alongside the vertebrae are many small and large muscles that either help stabilise the spine or help it generate movement. All these muscles are in a complex conversation with the brain in order to work together and maintain your upright posture and stability when sitting and moving. When even one of these vertebrae, discs or muscles becomes irritated, it can lead to back pain.

When you lean forward a lot you stop using the small postural muscles that control the spine’s normal curve. Over time, they become smaller, weaker, and don’t activate properly when needed. So if you’re working at home, you might find our advice to astronauts helpful.

Four tips to help you keep your spine healthy

1. Move. Try to take a few moments to move around every one to two hours during the work day. For your spine this means gently rotating, leaning forwards, backwards and sideways. Avoid extreme ranges, and don’t use weights or resistance to do this. Think of it like oiling the joints and moving that oil around by gently moving them. Make sure to stretch gently.

2. Sort out your setup. While on the International Space Station, astronauts float rather than sitting. So they’re encouraged to keep a normal, upright position as much as possible, as well as exercising to maintain back strength. To keep good posture on Earth, making sure you set up your desk, chair and home office equipment correctly is key.

Ensure your screen is directly in front of you, with the middle of your screen at eye level. Be sure to sit back in a good chair that is upright and not reclined. Have your keyboard level, right in front of you, with your elbows by your side and at 90 degrees, ideally with wrists supported too. Make sure your feet are also flat on the floor in front of you.

3. Aim for a “neutral” upright posture. Try to avoid leaning forwards. Maybe even get someone to check your posture from the side. If you look hunched over, are leaning forwards, or craning your neck back to see your screen, then you have a high chance of developing spinal pain. You can reset to good posture by:
Aim to have your ear in line with your shoulder, and that this is in line over your hip.

Try to make sure your head is over your torso not sticking forwards, and that your head isn’t tilted up or down.
Ideally have a slightly inwards arch in your lower back – but only a small one, as over doing it can hurt too.
If you’re experiencing back pain, a small pillow being placed behind your lower back may help, or lying on your back, on the floor, once or twice a day may help move your spine into a better position.

4. Exercise. If, like our astronauts, you have some weak spinal stability muscles from poor posture – or not enough exercise from lockdown (or in their case, spaceflight) – some spinal exercises might help. Things like beginner level pilates exercises can help strengthen your spine.

But remember to gently suck in your belly button towards your spine (to about 30-40% of your max power but not 100%) during your exercise as this can help engage the right muscles. Remember to move around every hour or two. At the end of the day, a walk may also help minimise back pain and build strength.

Of course, being in gravity is ultimately different to floating in space. If you find your spinal problems aren’t improving, seeing a professional may be useful to getting specific exercises or treatment tailored to you.

Providing first class standards of chiropractic and orthopedic health care for people in Vancouver and of the lower mainland of British Columbia.

07/06/2020

Back Braces Help!

Back pain patients fear moving, concerned that they may trigger pain. Back braces reduce pain and fear of pain and allow a return to normal activities of life.(1) For spinal stenosis patients with back pain, back belts improved walking distance.(2) And for acute compression fractures, a back brace is usually used. A soft brace is just as effective as a rigid brace to prevent spinal deformity, improve quality of life and lessen back pain.(3) Back braces aren't necessary forever, but for short term and for certain conditions, they help!

(1)Shahvarpour A, Preuss R, Sullivan MJL, Negrini A, Larivière C: The effect of wearing a lumbar belt on biomechanical and psychological outcomes related to maximal flexion-extension motion and manual material handling. Appl Ergon. 2018 May;69:17-24. doi: 10.1016/j.apergo.2018.01.001. Epub 2018 Jan 6.
(2)Ammendolia C, Rampersaud R, Southerst D, Ahmed A, Schneider M, et al: Effect of a prototype lumbar spinal stenosis belt versus a lumbar support on walking capacity in lumbar spinal stenosis: a randomized controlled trial.The Spine Journal 2019 (March); 19(3):386-394
(3)Kato T, Inose H, Ichimura S, Tokuhashi Y, et al: Comparison of Rigid and Soft-Brace Treatments for Acute Osteoporotic Vertebral Compression Fracture: A Prospective, Randomized, Multicenter Study. J Clin Med 2019 Feb 6;8(2). pii: E198. doi: 10.3390/jcm8020198.

07/03/2020

GIVE IT TIME... AND CHIROPRACTIC!

Leg pain (lumbosacral radiculopathy or sciatica) and loss of motor strength naturally concern patients. "When will it come back?" is a typical question. Keep in mind that studies show that treatment outcomes are quite similar for surgical and non-surgical care of disc herniation patients with leg radiculopathy.(1) One classic study reported that loss of motor strength due to sciatic nerve damage returned over 3 years with 10% in 6 months, 30% at 1 year, 50% at 2 years and 75% at 3 years.(2) A brand-new article concurs: Improvement comes over time regardless of treatment (surgery or non-surgery). Most patients in this new study did not choose surgery. Almost all of them regained full strength at 1 year with it typically occurring in the first 3 months though ongoing recovery took a year.(3) Don't hold back! Ask us the tough questions. We'll share with you the research-based answers.

1)Hanne A, Manniche C: The Efficacy of Systematic Active Conservative Treatment for Patients With Severe Sciatica: A Single-Blind, Randomized, Clinical, Controlled Trial. Spine 2012;37(7):531-542.
2)Yuen E, Olney R, So Y: Sciatic neuropathy: clinical and prognostic features in 73 patients. Neurology 1994;44(9):1669-74.
3)Akuthota V, Marshall B, Boimbo S, Osborne MC, Garvan CS, Garvan GJ, et al: Clinical Course of Motor Deficits from Lumbosacral Radiculopathy Due to Disc Herniation. PM R 2019 [Epub ahead of print]

06/29/2020

Maybe you are thinking of seeing a chiropractor and have some questions? Here is a link to our Canadian Association. If you have more questions, see our website; www.vancouverspinecarecentre.com

The chiropractic profession and others have invested significant resources to build a robust body of evidence studying the impact of manual therapies on spine, muscle, and nervous system conditions. For example, spinal and joint manipulation has been shown to be effective treatment for acute and chronic conditions like back pain. Learn more: http://bit.ly/2VZZuol

06/27/2020

Exercise Just a Little Each Week; It Helps!

It doesn't take much to improve your health, reduce your back pain, and lessen your experience of cervical spine disability. It really doesn't! A new report states that just 60 minutes of progressive exercise once a week makes a difference. Such exercise improves overall physical health and decreases the occurrence of cervical spine disability and low back pain in patients with musculoskeletal pain. (1) Let's talk about how you might fill those 60 minutes with effective, do-able exercises just for you! www.vancouverspinecarecentre.com

1) Satpute K, Hall T, Bisen R, Lokhande P: The Effect Of Spinal Mobilization With Leg Movement In Patients With Lumbar Radiculopathy - A Double Blind Randomized Controlled Trial. Arch J Phys Med Rehabil 2018 [Epub ahead of print]

06/25/2020

WALKING AND BACK PAIN

Walking is important. How often do you think about walking? How often are you thankful for the ability to put one foot in front of the other? Most of us don't give walking a second thought until we can't do it or can't do it as easily as we once did. Chronic non-specific low back pain tends to affect patients' motor control while walking. It's suspected that the erector spinae are working overtime in these patients, leading to a stiff lumbar-pelvic region and a more difficult time of walking. (1) A new report shows that spinal manipulation in combination with individualized exercise improves the walking ability in back pain patients suffering with lumbar spinal stenosis better than medical care (medications/epidural steroid injections) and/or group exercise in the short term. (2) Further, spinal manipulation for patients with lumbar radiculopathy (leg pain) also benefits the relief of leg and back pain, disability, range of motion and patient satisfaction. (3) Our chiropractic care incorporates one or all these approaches as needed to get you the relief you want from back pain and keep you walking without a second thought.

1)Koch C, Hänsel F: Chronic Non-specific Low Back Pain and Motor Control During Gait. Front Psychol 2018;9:2236
2)Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton S, Smith C, Patterson C, Piva S: Comparative Clinical Effectiveness of Nonsurgical Treatment Methods in Patients With Lumbar Spinal Stenosis: A Randomized Clinical Trial. JAMA Netw Open. 2019;2(1):e186828. doi:10.1001/jamanetworkopen.2018.6828
3)Rodríguez-Romero B, Bello O, Vivas Costa J, Carballo-Costa L: A Therapeutic Exercise Program Improves Pain And Physical Dimension Of Health-Related Quality Of Life In Young Adults. A Randomized Controlled Trial. Am J Phys Med Rehabil 2018 [Epub ahead of print]

06/22/2020

SEE YOUR CHIROPRACTOR FIRST

You know seeing your chiropractor is beneficial. Your pain eases. You feel better. A benefit you may not realize since you are a chiropractic patient is that seeing a chiropractor reduces the chance of back surgery. A new report noted that there is a "very strong association" between back surgery and the first healthcare provider seen for the back pain issue. 42.7% of workers who first saw a surgeon first had surgery while only 1.5% of those who saw a chiropractor first had back surgery. (1) Plus, the chiropractic adjustment works wonders on the autonomic nervous system. This tie is described well in a new case report of a tension-type headache sufferer with major depression who found relief of both. (2) For a depressed back pain sufferer, relief from chiropractic care is most welcome!

(1) Keeney BJ, Fulton-Kehoe D, Turner JA, Wickizer TM, Chan KC, Franklin GM. Early Predictors Of Lumbar Spine Surgery After Occupational Back Injury: Results From A Prospective Study Of Workers In Washington State. Spine (Phila Pa 1976) 2013;38(11):953-64

(2)Chu ECP, Ng M. Long-term relief from tension-type headache and major depression following chiropractic treatment. J Family Med Prim Care. 2018 May-Jun;7(3):629-631. doi: 10.4103/jfmpc.jfmpc_68_18.

06/18/2020

Physical activity is a great way to prevent and treat back pain – but did you know that some exercises can do more harm than good?

06/11/2020

Best song for the current times. (It’s still OK to groove...but keep your distance, cause Dr. Henry says :)

This is a song inspired by Dr. Bonnie Henry. - Stay at Home

06/07/2020

To Your Health
June, 2017 (Vol. 11, Issue 06)

Your Heart Hates These Medications
By Editorial Staff

If you haven't figured it out yet, your heart is a big deal – a very big deal, and we're just talking about the health side of things. So let's keep figuring out ways to keep it as healthy as possible for as long as possible.

Avoiding use of nonsteroidal anti-inflammatory drugs (NSAIDs) for even a few days is one way, suggests research.

This finding is big because NSAIDs are so readily available and commonly used for everything from headaches to back pain. Think Advil, Motrin and similar over-the-counter medications. In this large study (nearly 500,000 participants ages 40-79), NSAID use for one to seven days increased the risk of suffering a heart attack by 24-53 percent: 24 percent for celecoxib (Celebrex), 48 percent for ibuprofen (Advil, Motrin), 50 percent for diclofenac (Voltaren) and 53 percent for naproxen (Aleve). Heart attack risk increased with higher doses and higher duration of use.

Does this mean if you take NSAIDs, you'll suffer a heart attack? It depends on your cardiovascular risk, general health and other factors. But you certainly don't want to take the chance, particularly if there are safer options available to deal with your pain. That's where chiropractic and other drug-free therapies can make a big difference.
By the way, this isn't the first time (and won't be the last) that over-the-counter medications have been linked to dangerous health outcomes. While the pharmaceutical industry, mainstream advertising and even your medical doctor have made NSAIDs seem like the first choice for managing pain, increasing research suggests they should be one of the last.

05/28/2020

PREVENT CHRONIC DISEASES BY TREATING MUSCULOSKELETAL DISEASES EARLY

Musculoskeletal conditions like back pain, neck pain and osteoarthritis of the hip or knee, may lead to chronic diseases like cardiovascular disease, cancer, diabetes, chronic respiratory disease or obesity. For example, those with osteoarthritis appear to have an elevated risk of developing cardiovascular disease. The latest study reports that those with musculoskeletal conditions have a 17% increased risk of developing a chronic disease. What do the study's researchers recommend? Manage musculoskeletal diseases early in their development. Preventing and treating these musculoskeletal conditions early may help prevent the development of chronic diseases later. Just what the connection is between musculoskeletal conditions and chronic disease risk is curious and yet unknown.(1) Your chiropractor manages musculoskeletal pain conditions all the time and encourages you to get a handle on your back pain and neck pain issues sooner than later!

1) Williams A, Kamper SJ, Wiggers JH, O'Brien KM, Lee H, Wolfenden L, Yoong SL, Robson E, McAuley JH, Hartvigsen J, Williams CM. Musculoskeletal conditions may increase the risk of chronic disease: a systematic review and meta-analysis of cohort studies. BMC Med. 2018 Sep 25;16(1):167. doi: 10.1186/s12916-018-1151-2.