Physio ball for back pain relief

The cause of back pain and the potential treatments for back injury are diverse. Back pain can be the result of a range of conditions that affect muscles, tendons, ligaments, discs, nerves, other soft tissues or joints. Most back pain does not have one simple cause, but may be due to a range of factors, such as poor posture, repetitive activity or trauma. A staple piece of equipment for rehabilitating a back injury is the physio ball.

No matter what the particular cause of back injury, it is well documented that the resulting low back pain inhibits the deep abdominal muscles whose job it is to support the spine. A vicious downward spiral is created where injury causes back pain, which causes the muscles that support the spine to weaken which in turn leaves that back more vulnerable to further injury. It is possible to break free from this cycle and specific lower abdominal stabilization training is a key component to winning the battle. This is where the physio ball comes in, it can also be referred to as an exercise ball, gym ball, stability ball or therapy ball. It is effective in rehabilitation of the back because it helps strengthen and develop the core body muscles that help to stabilize the spine.

It has been shown that the muscle activity required to perform a simple curl-up exercise is almost doubled when using a physio ball compared to the same exercise on a stable surface. Using equipment like the physio ball to perform abdominal exercises changes both the level of muscle activity and the way the muscles work together to stabilize the spine and whole body, this effect is exactly that which is required to counteract the negative effects that back pain has on the muscles.

The physio ball does not simply provide a method to restore the spinal stability that is lost in an episode of back pain. The range of exercises that can be performed when using it allows for expansive program progression, making it suitable for use in very early remedial exercises to end stage functional rehabilitation. It is also possible to perform a range of mobility exercises to promote increased range of motion about the spine as well as improve stability.

The use of a physio ball is an excellent conservative back exercise treatment option for back pain sufferers. It is a readily available, inexpensive and versatile piece of equipment that can be used under the supervision of a health professional and/or as part of an independent management plan for back pain. Not only will its use help to resolve the presenting complaint, it will also help prevent further episodes of low back pain when used as part of a rehabilitation program.

Reference: Exercises on a "swiss ball" for chronic low back pain. Stankovic, A, Lazovic, M and Kocic, M. 2008, Proceedings of the 7th Mediterranean congress of physical an rehabilitation medicine, pp. 58-60.

Dr. David P. Chen
Chiropractor in Laurel, MD 20708

Is Asymptomatic Lumbar Spine Pathology Predictive of Future Low Back Pain?

This study investigated whether the findings on the scans of the lumbar spine that had been made in 1989 predicted the development of low-back pain in a group of 67 asymptomatic individuals with no history of back pain. In 1989, 21 subjects (31%) had an identifiable abnormality of a disc or of the spinal canal.

A questionnaire concerning the development and duration of low-back pain over a 7 year period was sent to the 67 asymptomatic individuals from the 1989 study. A total of 50 subjects completed and returned the questionnaire. A repeat magnetic resonance scan was made for 31 of these subjects.

Of the 50 subjects who returned the questionnaire, 29 (58%) had no back pain. Low-back pain developed in 21 subjects during the 7 year study period. The 1989 scans of these subjects demonstrated normal findings in twelve, a herniated disc in five, stenosis in three, and moderate disc degeneration in one. Eight individuals had radiating leg pain; four of them had had normal findings on the original scans, two had had spinal stenosis, one had had a disc protrusion, and one had had a disc extrusion. In general, repeat magnetic resonance imaging scans revealed a greater frequency of disc herniation, bulging, degeneration, and spinal stenosis than did the original scans.

The findings on magnetic resonance scans were not predictive of the development or duration of low-back pain. Individuals with the longest duration of low-back pain did not have the greatest degree of anatomical abnormality on the original 1989 scans. Clinical correlation is essential to determine the importance of abnormalities on magnetic resonance images.

Source: http://thepainsource.com/archives/399

Dr. David P. Chen
Chiropractor in Laurel, MD 20708
Laurel Regional Chiropractic

Chiropractic had the highest perceived benefit for back pain

A study published in the Journal of the American Board of Family Medicine reports on interviews with 31,044 individuals who used complementary and alternative medicine (CAM) for low back pain (LBP). The results are as follows:

The top 6 CAM therapies for LBP, starting with the most-used approaches are: chiropractic, massage, herbal therapy, acupuncture, yoga/tai chi/qi gong, and relaxation techniques.

Chiropractic use (76% of respondents) was larger than all the other 5 therapies combined.

Of those who used CAM modalities for back pain, 27% used it because conventional medicine did not help, 53% used it in conjunction with medical care, and 24% used it because their medical provider recommended it.

Chiropractic users scored the highest on their satisfaction and clinical benefits out of all 6 approaches. This reconfirms earlier findings from the Archives of Physical Medicine & Rehabilitation 2005, which reported that spinal manupulative therapy (SMT) provided the greatest pain relief scoring higher than nerve blocks, opioid analgesics, muscle relaxants, acupuncture, or NSAIDs.

Reference: Kanodia AK, Legedza ATR, Davis RB, et al. Perceived benefit of complementary and alternative medicine (CAM) for back pain: a national survey. J Am Board Fam Med. 2010;23(3):354–362.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Exercise at work to prevent low back pain

More jobs now require prolonged sitting which has been associated with loss of the lumbar lordosis, intervertebral disc (IVD) compression, and height loss, possibly increasing the risk of lower back pain. There are numerous studies suggest that exercise can play an important role in preventing occupational and non-occupational low back pain. An innovative approach was published in the April issue of The Spine Journal that used an office chair exercise that is performed while seated. The exercise provides a brief decompression of the lumbar spine by moving forward on the chair seat, placing the hands on the seat of the chair, pressing downward with the arms to take pressure off the lumbar spine, and arching the back and shoulders backward at the same time. This decompression maneuver held for 5 seconds followed by 3 seconds of reloading (sitting normally) and was repeated 4 times. Sequential MRI demonstrated a marked increase in vertical height of the lumbar spine using this decompression strategy. The authors concluded that “Seated upright MRI and stadiometry, as performed in this study, appear to be feasible methods for detecting compressive and decompressive spinal changes associated with normal sitting and, alternately, seated unloading exercises. Larger studies are encouraged to determine normative values of our study measurements and to determine if morphological changes induced by seated unloading predict treatment response and/or reductions in the incidence of sitting-related LBP.”

There are numerous quality evidence that post-treatment exercise programs can prevent recurrences of back pain. There have been many studies published this past decade that support the value of exercise in primary, secondary as well as tertiary prevention of low back pain. These studies have been conducted with multiple age groups and multiple settings including sports venues and the workplace.

Source:
http://www.chiroaccess.com/Articles/Exercise-and-the-Prevention-of-Low-Back-Pain.aspx?id=0000162

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Spinal manipulation is more effective for chronic low back pain

A randomized trial by researchers at an outpatient rehabilitation department in Italy involving 210 patients with chronic, nonspecific low back pain compared the effects of spinal manipulation, physiotherapy and back school. The participants were 210 patients (140 women and 70 men) with chronic, non-specific low back pain, average age 59. Back school and individual physiotherapy were scheduled as 15 1-hour-sessions for 3 weeks. Back school included group exercise and education/ergonomics. Individual physiotherapy included exercise, passive mobilization and soft-tissue treatment. Spinal manipulation included 4-6 20-minute sessions once-a-week.

Outcome measures were the Roland Morris Disability Questionnaire (scoring 0-24) and Pain Rating Scale (scoring 0-6), assessed at baseline, discharge, and at 3, 6, and 12months. 205 patients completed the study. At discharge, the results showed that spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups; pain recurrences and drug intake were also reduced compared to back school or individual physiotherapy.

Reference: Cecchi F, Molino-Lova R, Chiti M, Pasquini G, Paperini A, Conti AA, Macchi C. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil 2010; 24: 26-36.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic

Effects of Biofreeze and chiropractic adjustments on acute low back pain: a pilot study.

Objective
The specific aims of the study were to study the effectiveness of Biofreeze combined with chiropractic adjustments on acute low back pain (LBP) compared with chiropractic care only. The hypothesis was that Biofreeze enhances the effect of chiropractic adjustments on acute LBP.

Methods
The data were collected at the baseline, 2 weeks after treatment, and 4 weeks after treatment for final analyses. Diversified manual adjustments were provided by licensed chiropractors twice a week for 4 weeks to both control and experimental groups. Biofreeze was applied to the lower back area 3 times a day for 4 weeks in the experimental group. For at-home care, subjects were instructed to apply Biofreeze 3 times a day as follows: Using a 5-g sample pack, subjects were instructed to apply Biofreeze to the low back once in the morning and 2 times in the afternoon. For evening application, subjects were instructed to apply once in the late afternoon, once in the evening, and once at bedtime. Outcome assessments included visual analog scale, Roland Morris Disability Questionnaire, heart rate variability for stress, and electromyography for low back muscle activity.

Results
A total of 36 subjects were recruited in the study (25 male). The average age was 34 years. Significant pain reduction was found after each week of treatment in the experimental group (P < .05). The Roland Morris Disability Questionnaire did not show significant changes in both groups. There were no significant differences for pain reduction in the control group. Heart rate variability analysis showed no significant change (P > .05) in the experimental group after 4 weeks of Biofreeze and chiropractic adjustments. There were no statistically significant changes in the electromyography readings between the 2 groups.

Conclusion
Biofreeze combined with chiropractic adjustment showed significant reduction in LBP. Biofreeze cooling gel gives rise to the cooling sensation without lower skin temperature because of the unique characteristic of menthol, which is one of the main ingredients. It is clear that the cooling effect of Biofreeze is different from the application of cold. It is possible that menthol stimulates the peripheral sensory receptors to inhibit pain through the gate control mechanisms.

Original article by: Zhang J, Enix D, Snyder B, Giggey K, Tepe R. J Chiropr Med. 2008 Jun;7(2):59-65.

Dr. David P. Chen
Chiropractor at Laurel Regional Chiropractic
Laurel, Maryland

Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain

The lumbar fascia is an often overlooked source of lower back pain. I agree with the author's conclusions that poor movement patterns and chronic inflammation can lead to abnormal fascial structure. As a chiropractor in Greenbelt, I pay special attention to spinal movement patterns as well as fascial tone. With nutrition, I also help each and every patient to decrease the chronic inflammation that seems to be all too common these days.

Background

Although the connective tissues forming the fascial planes of the back have been hypothesized to play a role in the pathogenesis of chronic LBP, there have been no previous studies quantitatively evaluating connective tissue structure in this condition. The goal of this study was to perform an ultrasound-based comparison of perimuscular connective tissue structure in the lumbar region in a group of human subjects with chronic or recurrent low back pain (LBP) for more than 12 months, compared with a group of subjects without LBP.

Methods

In each of 107 human subjects (60 with LBP and 47 without LBP), parasagittal ultrasound images were acquired bilaterally centered on a point 2 cm lateral to the midpoint of the L2-3 interspinous ligament. The outcome measures based on these images were subcutaneous and perimuscular connective tissue thickness and echogenicity measured by ultrasound.

Results

There were no significant differences in age, sex, body mass index (BMI) or activity levels between LBP and No-LBP groups. Perimuscular thickness and echogenicity were not correlated with age but were positively correlated with BMI. The LBP group had ~25% greater perimuscular thickness and echogenicity compared with the No-LBP group (ANCOVA adjusted for BMI, p<0.01>

Conclusion

This is the first report of abnormal connective tissue structure in the lumbar region in a group of subjects with chronic or recurrent LBP. This finding was not attributable to differences in age, sex, BMI or activity level between groups. Possible causes include genetic factors, abnormal movement patterns and chronic inflammation.

Dr. Louis S. Crivelli II

Chiropractor

Greenbelt, MD