back pain

UPPER CROSS AND LOWER CROSS SYNDROME

Upper cross syndrome and lower cross syndrome are terms referring to muscle weakness and tightness in certain areas of the body that may be contributing to pain and/or reduced functional level. Each “syndrome” entails two predominant areas of muscle tightness and two predominant areas of muscle weakness. Oftentimes, these limitations occur as a result of impaired posture and can lead to pain. Once identified, both upper cross and lower cross syndromes can be effectively treated and managed with physical therapy care.

UPPER CROSS SYNDROME

The upper cross syndrome refers to the “upper half” of the body; the waist up. The two zones of muscle tightness are the pectoralis (pec) muscles and the upper trapezius/levator scapulae muscles. The pec muscles (pec major and minor) are located on the anterior (front) aspect of the chest. The upper trapezius and levator scapulae muscles are both located on the lateral (side) aspect of the neck and connect into the back. At the end of a long workday at a desk, posture can become less than ideal which includes forward head posture and slouching of the shoulders. With poor posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain.

LOWER CROSS SYNDROME

The lower cross syndrome refers to the “lower half” of the body; the waist down. The two zones of muscle tightness are the lumbar (low back) paraspinal and the hip flexor muscles. The lumbar paraspinal is located in the lower back on either side of the spine. The hip flexor muscles are located on the front of each hip. Standing posture contributes to the prominence of the lower cross syndrome and includes increased curvature through the lower back and positioning of the abdomen in a more anterior (forward) position. Over time, standing with increased curvature through the lower back and can lead to increased tightness through the lumbar paraspinal and hip flexor muscles. These limitations form half of the “cross” of the lower cross syndrome. The second portion of the cross of lower cross syndrome involves weakness through the gluteal and abdominal muscles. With poor standing posture, these muscles become stretched and are unable to perform their jobs as effectively as needed and can lead to pain. https://www.nhs.uk/live-well/exercise/common-posture-mistakes-and-fixes/

back pain, Facet joint radiofrequency denervation, neck pain

FACET JOINT RADIOFREQUENCY DENERVATION FOR NECK PAIN AND BACK PAIN

FACET JOINT

The spine is a column of bones arranged one on top of the other. The bones are linked at the back by joints called facet joints, one on each side. The facet joints hold the bones together and stabilise the spine, while also allowing movement.

The facet joints may become painful either due to wear and tear (also called degenerative change), stress or injury, although the reason is not always clear. Pain is felt around the facet joints and in the surrounding area. For example, pain starting from the joints of the lower back will often be felt in the buttocks and upper legs.

WHEN IS DENERVATION USED?

The denervation procedure is usually considered after trying less invasive treatments, such as medication, physiotherapy, transcutaneous nerve stimulation (TENS).

Exercise, acupuncture, yoga/pilates and relaxation therapy may also help ease back pain. Spine surgery could be also considered in selected cases.

Denervation is usually only considered if you have responded well to local anaesthetic injections near the affected areas, and these have helped to reduce pain.

WHAT IS THE FACET JOINT RADIOFREQUENCY DENERVATION

Facet joint radiofrequency denervation is a procedure in which nerve fibres supplying the painful facet joints are selectively destroyed by heat produced by radio waves and delivered through a needle.

The treatment is usually performed after an injection of a local anaesthetic close to the affected joints has helped to reduce feeling and pain.

The denervation treatment involves placing a special needle (radiofrequency probe) near the nerve of the joint; when a radiofrequency current is passed down the probe, a very small area of heat is created that causes a break in the nerve. This procedure does not affect any other part of the body. https://www.nice.org.uk/researchrecommendation/radiofrequency-denervation-what-is-the-clinical-and-cost-effectiveness-of-radiofrequency-denervation-for-chronic-low-back-pain-in-the-long-term

back pain, Back pain after bending over, Back pain after exercise

5 REASONS FOR BACK PAIN AFTER BENDING OVER

(1) Muscle spasms

Muscle spasms or cramps are quite common. They can happen at any time of the day, but especially during exercise or in the days following a workout. They are commonly caused by muscle overuse, nerve compression, lack of blood flow, dehydration.

Muscle spasms in the lower back often occur when you are bent over and lifting something, but they can happen during any movement involving your lower body.

(2) Strained muscle

A strained or pulled muscle occurs when a muscle is overstretched or torn. It’s commonly caused by overuse, physical activity, lack of flexibility.

(3) Herniated disc

The spine is made up of many parts including spinal discs and vertebrae. If a disc slips, it means that the soft center of the disc has bulged out, which can irritate the nearby spinal nerves. A slipped disc may be accompanied by severe shooting pain.

(4) Spondylolisthesis

Spondylolisthesis is caused by an injured vertebra shifting or slipping forward on the vertebra directly below it. More likely in younger people who participate in sports like gymnastics and weightlifting, spondylolisthesis is often the result of untreated spondylolysis. Spondylolysis is a stress fracture or crack in the small, thin portion of the vertebra that connects the upper and lower facet joints.

(5) Arthritis

Lower back pain may be the result of arthritis. Your joints are protected by cartilage, and when your cartilage deteriorates, it can cause pain and stiffness. There are many different types of arthritis, including osteoarthritis, psoriatic arthritis, rheumatoid arthritis.

The back pain you are feeling when you bend over is likely due to a muscle pull or strain. It could, however, be something more serious such as a herniated disc. If you are experiencing severe back pain, blood in urine, changes in bowel or bladder habits, pain when you lie down, or fever, you should get medical help right away.
If your back pain does not go away or improve over time, schedule an appointment with your doctor for a full diagnosis. https://www.nhs.uk/conditions/back-pain/

back pain

5 SLEEPING TIPS FOR BACK PAIN

(1) FIND THE RIGHT POSITION
If you sleep on your side, put the pillow between your knees and draw them up slightly toward your chest. If you like to sleep on your back, try the pillow under your knees, or roll up a small towel and place it under the small of your back.

Avoid sleeping on your stomach because it puts a lot of strain on your back. If it’s the only position you can fall asleep in, put a pillow under your stomach to take some of the pressure off your back.

(2) GET A GOOD MATTRESS
The type of mattress you need depends on your body type. A soft mattress can be good if your hips are wider than your waist because it will let your spine stay straight while you sleep. If your hips and waist already line up straight, a harder mattress might feel better because it will give you more support.

(3) GET IN AND OUT OF BED CAREFULLY
Be extra careful when you get in and out of bed. Bending forward at your waist or making quick and jerking motions can cause you more back pain.

Take your time and roll over onto one side and use your arms to push your way up. You can then swing your legs out of bed to stand up slowly. Reverse the movements when it’s time to lie down at night.

(4) EXERCISE YOUR CORE
Getting regular physical activity is a great way to improve the quality of your sleep. But doing targeted exercises to strengthen your core, the muscles in your abdomen, hips, lower back, and pelvis can also help ease back pain.

(5) TRY GENTLE YOGA STRETCHES BEFORE BED
Talk to your doctor about which poses are safe for you to practice and which ones won’t make your pain worse. It might be helpful to start off using yoga props like blocks and bolsters for added support so that you can hold poses comfortably. https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/tips-to-reduce-stress/

back pain, physical therapy for back pain

WHEN YOU SUFFER FROM BACK PAIN, HOW LONG SHOULD YOUR PHYSICAL THERAPY LAST?

In general, you should attend physical therapy until you reach your physical therapy goals or until your therapist and you decide that your condition is severe enough that your goals need to be re-evaluated. Typically, it takes about 6 to 8 weeks for soft tissue to heal, so your course of physical therapy may last about that long. Of course, if you have a serious condition or a progressively worsening condition, your course of rehab may take longer.

Sometimes, your condition may rapidly get better, and you may notice an improvement in pain control, range of motion, and strength within a few sessions of physical therapy. In this case, you may only attend therapy two or three times, and then hopefully be discharged with a home exercise program that can help you prevent or manage future episodes of your condition. https://www.nhs.uk/conditions/physiotherapy/accessing/

back pain, Benefits of massage for Lower Back Pain

3 MAIN BENEFITS OF MASSAGE THERAPY FOR LOWER BACK PAIN

Lower back pain is one of the most common and costly musculoskeletal problems in modern society. The 3 main benefits of massage are as follows:

  • Massage improves blood circulation, which aids in the recovery of muscle soreness from physical activity.
  • Massage relaxes muscles for an improved range of motion. Muscle relaxation also helps with insomnia.
  • Massage leads to increased endorphin levels. The increase in endorphin levels is one of the greatest benefits of massage therapy. Endorphins are the chemicals the body produces that make you feel good, which is very effective in managing pain. https://www.evidence.nhs.uk/search?q=back+pain+massage
back pain

CAN SHOES YOU ARE WEARING INFLUENCE OR EXACERBATE BACK PAIN? 5 TIPS FOR BUYING RIGHT SHOES IF YOU HAVE ARTHRITIS.

Shoes you are wearing can influence and exacerbate back pain. The wrong shoes can even cause back pain. That is especially true of people fond of stiletto heels, which can throw their bodies out of alignment and stress the back. https://www.nhs.uk/conditions/foot-pain/heel-pain/

5 TIPS FOR BUYING RIGHT SHOES IF YOU HAVE ARTHRITIS

Make sure the shoe shape matches your foot shape

Whether you have inflammatory arthritis like rheumatoid arthritis (RA) or the more common osteoarthritis (OA), many people need a shoe with a roomy toe box to accommodate the bunions, hammertoes, and deformed joints that often accompany their disease. These pressure points can be excruciating for already tender arthritic feet.

Look for shoes that offer lots of support

You get support primarily from the sole of the shoe — it should be wide, rigid, and only bend where your foot bends (at the toes) — and a stable heel counter, the back of the shoe that cups your heel and keeps your foot in place, which helps to prevent friction and pain.

Consider rocker soles

These slightly curved soles gently propel you through the gait cycle, distributing your weight more evenly to reduce the strain of walking on the foot, ankle, and toes.

Get the right type of material

Pick a shoe made of a material that’s soft and accommodating especially if you have issues like bunions or hammertoes.

Look for shoes with removable insoles

Shoes with removable insoles allow you to put in your own customised or over-the-counter insoles without making the shoe too tight.

back pain

TREATMENT FOR HERNIATED DISK

A herniated disk can press on the nerves in your spine and cause pain, weakness and sometimes numbness. Sometimes these symptoms can be severe enough to disrupt your life.

Most of the time the problems from your herniated disk should start to improve on their own within a few weeks. In the meantime, try one or more of these treatments to help you feel better.

Rest

Take it easy for a few days. Rest can relieve swelling and give your back time to heal. While your back hurts, avoid exercise and other activities where you have to bend or lift.

Medications

Take an over-the-counter pain medicine like ibuprofen or naproxen. These medicines can help relieve your pain and bring down swelling. Just don’t use these for more than 10 days without talking to your doctor.

Physical Therapy

Some exercises can help improve the symptoms of a herniated disc. A physical therapist can teach you which exercise strengthen the muscles that support your back.
Physical therapy programs also include:

  • Aerobic exercises – such as walking or riding a stationary bicycle
  • Ice and heat
  • Stretching exercises to keep your muscles flexible
  • Electrical muscle stimulation
  • Ultrasound therapy

Injections

If rest, pain relievers, and physical therapy don’t help with your pain, your doctor can inject steroid medicine into space around your spinal nerve. This is called an epidural injection. The steroid can help bring down the swelling, help you move more easily, and ease pain from a herniated disk.

Surgery

Most people with a herniated disk don’t need surgery. Rest and other treatments should start to improve your symptoms within 4 to 6 weeks. But if your pain doesn’t improve, surgery might be an option.

Talk to your doctor about surgery if:

  • You’re not getting relief from pain relievers, injections, and physical therapy.
  • Your symptoms keep getting worse.
  • You have trouble standing or walking.
  • You can’t control your bowels or bladder. https://www.nhs.uk/conditions/slipped-disc/
back pain

CAUSES OF BACK PAIN

The average person is born with 33 individual bones in the back (the vertebrae) that interact and connect through flexible joints called facets. By the time a person becomes an adult most have only 24 vertebrae because some vertebrae at the bottom end of the spine fuse together during normal growth and development.

The back has more than 100 joints each with its cluster of tendons, ligaments and muscles. Yet we often subject this complex structure to heavy loads and stresses.

Poor posture, careless lifting and many everyday tasks from weeding the garden to carrying heavy shopping can cause painful strains and sprains on the back. Sometimes you simply may not know why back pain has appeared.

In most cases, the cause of back pain is ‘mechanical’ (that is, not caused by disease), which means the pain will usually get better over time. In other cases, the cause of back is diseases and old age in some cases. When the back pain does not get better over time, it will be a good idea to visit your doctor for advice. https://www.nhs.uk/conditions/back-pain/causes/