Recent Article in JAMA Highlights Spinal Manipulation for Low Back Pain
“Patients should stay active as tolerated and begin with nondrug treatments, including superficial heat, massage…and spinal manipulation.”
This JAMA patient page provides some great information for both acute and chronic sufferers of low back pain. It reiterates some things chiropractors have been saying for decades. However, it is always nice to see recommendations from the broader medical community. Such as highlighting the importance of conservative care before drugs or surgery. Spinal manipulation, also known as the chiropractic adjustment, is again touted. A great first line treatment option for both acute and chronic cases of low back pain. Combined with exercise and other non-drug treatment options, spinal manipulation is safe and effective.
There are many options to choose from when picking a treatment for your lower back pain. You can easily take a supermarket approach. But, you don’t need to waste your time and money down the aisle trying the latest fads, creams, lotions, potions, and miracle cures. The tried and true combination of time, early return to activity, exercise therapy, and chiropractic spinal manipulation remain at the forefront of first line intervention for lower back pain.
Dr. Erik Reich, Meriden chiropractor, and his son.
Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, and desk jockeys. Dr. Reich enjoys staying active through a variety of sports, time at the gym, and finding new vegetarian food spots. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
If you have aches and pains or an injury, you have a lot of options. The marketplace for treatment of injuries and insult to the human frame is large. If you think of this marketplace like a real supermarket you might look at the aisles and see shelves stocked with medication, patches, doctors visits, massage therapy, homeopathic remedies, acupuncture, chiropractic treatment, physical therapy, vitamins and supplements, yoga, and the list goes on.
But let us take two items off of the shelf and unpack them a bit. Narrowing the choice down between massage and chiropractic care for your problem, which do you choose?
Which type of practice is better suited to help relieve pain or other symptoms?
Similarities
Massage and chiropractic care are both interventions where the practitioner uses their hands to affect positive changes to irritated or injured tissue. Also, both treatments are conservative in that they do not rely on drugs or surgery to make these changes. Furthermore, massage and chiropractic are both considered very safe and non-invasive, with the most common side effect typically reported being temporary soreness following treatment.
Differences
Chiropractic care is performed by a doctor of chiropractic and often entails a full history, physical examination, diagnoses, and treatment planning before any adjustment or treatment is started. The doctor may order special tests such as x-rays or blood panels as well, depending on the history and exam findings.
Treatment in a chiropractor’s office typically involves an adjustment (spinal manipulation) or a series of adjustments. This is what chiropractors are chiefly known for prescribing as the therapeutic intervention. However, many chiropractors are also knowledgeable about and prescribe physiotherapy, nutrition, heat, cold, or electric therapies, exercises, and other modalities which can fall within a chiropractor’s scope of practice.
The Adjustment
The adjustment is the most well known aspect of chiropractic care though. So what is the adjustment, and how is it different from massage therapy? An adjustment is a fast impulse delivered to a joint, typically in the spine but also useful in the extremities at times, which stretches the joint past it’s normal end range of motion and results in a cavitation (the popping sound you may be familiar with hearing when you crack your knuckles). This fast release of joint tension often improves feelings of stiffness in a joint, pain surrounding the joint or adjacent soft tissues, and may relax tight muscles or reduce muscular spasm.
So an adjustment is most often delivered to joints in the spine or extremities, whereas massage therapy typically involves the soft tissues of muscle and fascia.
Massage therapists are licensed professionals trained to manipulate soft tissue. There are many benefits to massage therapy including increased circulation, lymphatic drainage, stress reduction, and more. However, massage therapists are not doctors and cannot diagnose or order special tests. You should still make sure to inform your massage therapist of any medical conditions you are experiencing before receiving a massage.
Massage and Chiropractic – Chocolate and Peanut Butter
As a chiropractor I have referred many patients to massage therapists for treatment. I have also personally utilized massage services for my own health. I do not believe that chiropractic is intrinsically better than massage (despite myself being a chiropractor) and will admit that for certain people and conditions massage is clearly a better tool to address some injuries and patient concerns. In fact, many chiropractors employ massage therapists in their offices and it is one of the chief adjuncts to chiropractic treatment in the United States. This is because massage and chiropractic care are so complementary.
For example, a patient may present with a bad ankle sprain with decreased range of motion and pain at the ankle. A chiropractic adjustment to the ankle resolves much of the pain and improves the available motion, but there is still much swelling and some discomfort about the joint.
The doctor prescribes some stretching and exercises for the patient to perform at home, and gives a referral to a massage therapist to address the soft tissue component of her injury. A referral for massage helps reduce the swelling and eliminates the remaining pain, and the patient is able to perform her home exercise with more ease, and is happy with her outcome and the collaboration because she knows a team is working together to resolve her presenting complaint.
I hope this post helps illustrate how massage and chiropractic are similar but different, and how they can often complement each other. Thanks you reading!
About the Author
Dr. Erik Reich, Meriden chiropractor, and his son.
Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
A lot more people are working at home lately thanks to the global pandemic Covid-19. This new situation can lead to challenges in setting up a work station which will be both comfortable and reduce the chances for strain and injury. So in this article I will outline several tips to improve ergonomics. Ergonomics means fitting the job to the person, which is important to consider while you work from home.
Working from home can be stressful. Your work space shouldn’t be.
1. Practice Good Posture
Many tasks you will likely be performing at home while working will be done with your arms and hands outstretched to the front of your body. For example, typing, checking your phone, writing, using a laptop, and reading are all activities which place your shoulders and arms in a forward position. This posture is chest and shoulder dominant. This means your chest and shoulder muscles are contracted more frequently to position your arms forward and closer to center. This can lead to shoulder irritation and poor breathing patterns.
In order to counteract this predominance of the chest muscles and forward rounding of the shoulders, you should be mindful of sitting and working with your chest forward. Think of someone tying a string to your breast bone and pulling you up. In this way your chest leads in front of your shoulders and places you in a more “open” posture.
Furthermore, if you are sitting at a desk, be sure to adjust your chair so that you are at a comfortable height and your thighs are parallel or slightly higher than parallel to the floor. Your keyboard and computer should be directly in front of you, not off to the side. Also, the computer screen should be at least 18″ from your face and the top 1/3 of the screen should be at eye level.
2. Don’t Forget to Move
Even while you are sitting or standing to work at home, movement is important. If your work requires you to spend long hours at a desk, small movements such as tapping your feet, rolling your neck and shoulders, and fidgeting with your hands and fingers, can help stimulate blood flow and decrease stiffness. Short breaks to stand, pace, performs some air squats, calf raises, or desk push-ups can also be very helpful.
3. Set a Timer
If you are like me, sitting to write or type, or finish computer work, you may be prone to stay put for long stretches of time to complete the task at hand. What can be helpful is to use your phone’s clock timer or another inexpensive timer to set micro-breaks for every 20 minutes. This way when the timer goes of you have an auditory cue to get up and move for a few minutes, without becoming overly distracted.
4. Your Breathing is Important
When working from home you may be sitting a lot. Sitting places the hips in flexion and can impede full expansion of the lungs while breathing. Naturally while sitting you will tend to take shallower breaths.
Take some time to focus on deep breathing and you may notice your posture improves, your back feels less tight, and you don’t fatigue as easily. Keeping your shoulders behind your chest as previously discussed can help.
Furthermore, placing one hand on your chest and one hand on your stomach and taking a deep breath, you should feel the hand over your belly move. Shallow chest breathing where your diaphragm doesn’t expand into your abdomen limits rib expansion and decreases circulation. So make sure both hands are moving well when you breath, get your diaphragm involved!
With improved rib expansion while breathing your blood will carry more oxygen, your joints will circulate their fluid to provide nutrition to the joint cartilage, and your stress levels will reduce. Good breathing has many health benefits.
5. Take Walking Meetings
Many meetings these days are being conducted remotely. There are many apps which make this possible, and when working from home it may seem convenient of comfy to sit on the couch at your chair for the duration. I would suggest if possible that you walk or pace comfortably around your house while on these calls. You may have already been sitting for some time before the meeting starts, and getting back to more work following the meeting. So if possible try and use this time to move around.
So there are 5 tips which I hope you will find helpful during these times when you are working from home, whether by choice or due to the recent coronavirus pandemic.
About the Author:
Dr. Reich, Meriden chiropractor, and his son.
Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
You may have had one of these experiences. A family member or friend may have told you about their awful experience at the chiropractor’s office. Maybe they were told they need to be seen three times a week for a year. Perhaps a treatment plan was offered but they would need to pay for the care all in advance. Or maybe the doctor advised them that they had a terrible condition that would need multiple x-rays and only that chiropractor’s secret/special/unique/proprietary technique was able to fix what was wrong.
Unfortunately in chiropractic, as well as the other healthcare fields, there are some bad actors. Furthermore, these practitioners may not even be aware that their actions are harmful, or without evidence, and essentially scamming people. No one wants to be duped, or the recipient of unethical practices. Evidence based doctors also don’t want patients exposed to bad actors, who then come away with the impression that all of chiropractic is a scam. If you receive a bad haircut, you don’t swear off all barbers and stylists. But if you have a bad experience at the chiropractor’s office, you may say “I tried chiropractic, what a joke”. To be clear, most chiropractors are ethical and do take their responsibilities to their patients very seriously. But no profession is without some bad apples.
Below I will list five signs your chiropractor may not be acting in your best interest. This list is by no means exhaustive, and context is important as well. Because some practices listed below may be reasonable depending on individual circumstances.
Red flags that you may need a new chiropractor.
5 Signs You Need A New Chiropractor
No Diagnosis or Treatment Plan is Given
Excessive Number of Visits are Recommended
The Doctor Refuses to Work with Other Providers
The Doctor has Secret Treatment Knowledge Only They Possess
Payment Must be Made Before Care is Delivered
Treatment Plans and Diagnosis
First sign, no diagnosis is given and no treatment plan is prescribed. Be wary of any health care provider who does not explain what diagnosis or hypothesis they are thinking of with regards to your symptoms. Also, clinicians should be able to lay out a treatment plan to address your concerns. If no diagnosis is offered or no treatment plan is laid out, that could be a sign your chiropractor doesn’t actually know what is going on with your symptoms or concerns. Generic non-specific statements like “sciatica” or “neck pain” are not diagnoses, they are symptoms. Likewise, your chiropractor should have some idea of how long it will take to improve or relieve your presenting symptoms.
Second, and this goes along with the first sign, chiropractic care should be individualized to each patient. Blanket plans of care where everyone is told to come in three times a week for two months is not patient centered. You may indeed need two months of care at that frequency, but most people who respond to chiropractic treatment feel better much sooner than that, especially if your symptoms have not been caused by trauma. Treatment plans where the doctor prescribes six months of visits at a time, and may ask you to pay up front, are especially dubious.
Working as a Team
Beware of any health care provider in the 21st Century who refuses to collaborate with your other providers. There is a history of animosity between the medical and chiropractic professions dating back to the 20th Century. This mistrust is still prevalent to a lesser degree, with some chiropractors skeptical of medicine and surgery. Also, some medical doctors, physical therapists, and surgeons view chiropractors with distrust and skepticism. Neither of these outlooks serve you, the patient, very well. Inter-professional cooperation improves health outcomes. Doctors refusing to deal with one another leads to worse outcomes, confusion, and mistakes being made. Find a healthcare team willing to collaborate on your behalf and cut loose any member of that team who refuses to deal with other members of YOUR team.
Secret Knowledge
In the chiropractic profession there are many named techniques. Of course, this is also true with the other manual therapy practitioners, such as massage therapists and physical therapy. Diversified adjusting, ART, Cox, Gonstead, Graston, McKenzie, and the list goes on.
However, claims that one technique is superior to another or a cure-all are unfounded and not backed by science. Be cautious of any provider who tells you they have secret knowledge. All of these techniques can be learned, but an unscrupulous provider may twist or re-brand a common technique, slap a label or their name on it, and all of a sudden they are out practicing like a guru who possesses the secret wisdom to heal what ails you. They’re also probably marketing themselves to other providers with $999 courses to spread their new superior methods. Don’t be conned by these charlatans.
By and large, we know what works to get people out of pain. Patient education, therapeutic exercise, return to activity, lifestyle advice…mix in some first aid care such as heat, stretching, or adjustments to bring pain levels down, and reassurance. None of this is secret knowledge.
Payment is Expected in Advance of Care
As a patient with a health concern you should expect your chiropractor to provide excellent care. A thorough history and exam, diagnosis, plan of care, and any treatments delivered should be appropriate and well explained. This is pretty standard stuff. What is also unfortunately encountered are excessive cookie cutter treatment plans that go on for months, with an expectation that you pay up front.
This is wrong for a couple of reasons. First, every patient should be treated as an individual. When an unscrupulous chiropractor hands you a piece of paper outlining the next six months of visits with a 20% discount if you pre-pay in one lump sum, they are more focused on their office’s cash flow than your health. Don’t believe for a second that you’re the only person in that office being given such a great “deal” on their care.
Second, pre-payment contracts can be illegal in some jurisdictions. They also often contain clauses which violate your rights to receive a refund if you don’t utilize all the visits. Furthermore, many of these arrangements are entered into under the rationale that such a long plan with so many visits is required to avoid catastrophic health conditions. Terms such as disc degeneration, arthritis, or spinal decay are used, and of course you had better pay all at once. This is called “scare care” and it’s a bunch of malarkey.
Don’t Get Scammed
There are many great chiropractors in the world. There are some shady ones out there too. Hopefully this article makes clear some of the actions a few chiropractors, and even some other healthcare providers, might take to inflate their bank account, or their egos. These doctors and practices rarely have the patient’s best interests in mind, as the patient is secondary to increasing revenue. The American healthcare system is a disaster which puts profits far ahead of people, and hopefully this post gives you some insight on practices to avoid when seeing a chiropractor or other health care provider.
About the Author:
Dr. Reich, Meriden chiropractor, and his son.
Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
Have you heard the term “lumbar stenosis” regarding back pain or leg pain you are experiencing? If you or a loved one suffer from lower back and leg pain, and have been told you have stenosis, you may have some questions. So, where can you find stenosis treatment in Meriden, CT? My name is Dr. Erik Reich and I am a chiropractor in Meriden, CT. As a chiropractic physician I have treated many people suffering from lumbar stenosis over the past 8 years of clinical practice. Many cases of stenosis respond incredibly well to conservative chiropractic treatment, which is both non-invasive and drug free.
Dr. Erik Reich is a chiropractor in Meriden who treats neuromusculoskeletal conditions including pain and disability arising from spinal stenosis.
What is Lumbar Stenosis?
Lumbar spinal stenosis is a condition where the spinal canal narrows. Then, the narrowing can cause pressure on the nerves resulting in pain or other symptoms travelling into the legs. Lumbar stenosis can have several causes. For example, it can be caused by bony changes such as osteoarthritis, or congenital narrowing of the spinal canal, and spinal ligament thickening. Also, disc derangement such as herniation can also lead to narrowing and stenosis symptoms.
Do I Need Surgery?
Recent studies comparing surgery for lumbar stenosis versus conservative treatment such as physical therapy show similar outcomes. However, surgery carries added risks. Granted, for certain people surgery is an absolute necessity. To rule out surgery, a thorough history and examination should always be performed.
The risks associated with surgery typically do not arise in non-invasive treatment options such as chiropractic care. Therefore, while outcomes may be similar, many patients opt for a conservative non-invasive approach before considering surgery.
How Can Chiropractic Treatment Help?
There are several key components to an effective chiropractic treatment plan for addressing lumbar stenosis symptoms.
First, patient education is a key component of any successful treatment plan. High quality, evidence informed education about the condition, expected outcomes, goals of treatment, and possible side effects should be relayed. With better information, the patient often experiences better results.
Second, pain needs to be addressed. However, pain is only one symptom of stenosis which must be dealt with. It is hard to accomplish the goals of treatment if you are in pain. So passive care such as heat, massage, joint manipulation or adjustments, flexion-distraction, and other interventions are warranted to reduce painful symptoms to the point where active treatment, like an exercise program, can commence.
Third, active treatment moves to the forefront. Once pain has been reduced or eliminated, active treatment should begin in earnest. You should expect guided exercises, home stretching, and nutrition counseling. Symptoms from lumbar stenosis typically respond well to active care. Positive changes can usually be felt within the first week or two of treatment. Although every patient is unique and “it depends.”
Dr. Erik Reich is a Chiropractor Providing Lumbar Stenosis Treatment in Meriden
Dr. Reich, Meriden chiropractor, and his son.
Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, and traumatic injuries such as work and car accidents. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.
So what 5 questions to ask your chiropractor in Meriden? Below are some common questions, but this list is by no means exhaustive.
1. How Often Do You Treat This Type Of Condition?
Most chiropractors have a lot of experience treating lower back pain and neck pain, as well as headaches and other body aches and pains. It is a good idea to ask the doctor how often they see the types of symptoms you are feeling. Also ask how comfortable the doctor is with managing your symptoms. If the doctor states that 30% of their practice is treating people experiencing symptoms similar to yours, it’s probably a sign they are comfortable managing that condition.
Like other doctors, some chiropractors specialize or have a preference to treating certain conditions or groups of symptoms versus other types of pain. For example, I feel very competent and knowledgeable about lower back, neck, and shoulder pain. I do not feel as knowledgeable about some types of knee pain. So it doesn’t hurt to ask. Because every provider is different and some prefer to focus their time and practice on certain conditions or regions of the human body. Be wary of a doctor who states they only treat one area of the body and claims to be able to effect distant symptoms. While not unheard of, a chiropractor who only treats the first three joints of your neck, even if you are calling about elbow pain, should be approached with caution.
Meriden Chiropractor Dr. Erik Reich answers common questions new patients often ask when seeing a chiropractor.
2. Do You Take X-Rays?
In some cases x-rays are invaluable. However, routine x-rays for uncomplicated back pain are not recommended. With mounting evidence and guidelines being published regularly which advise doctors away from the over-utilization of imaging for most types of back pain.
Therefore, regular use of x-rays, especially for non-traumatic neck or back pain, should be avoided according to most researchers. Part of the reason for this change is the number of false positives which are seen in otherwise healthy individuals. X-ray imaging reports with scary sounding terms like degeneration, bone spurring, and spondylolisthesis can imply that something is very wrong with your spine, when in fact these are often found in healthy people with no history of pain or disability. What’s more, when a patient gets a scan and sees these findings, they are more likely to undergo more expensive tests, begin medications such as opioids, and have worse health outcomes overall due to the stigmatization of otherwise non-contributory imaging findings.
This is not to discount the legitimate usage of imaging, but in America, patients by and large are over imaged, over medicated, and have worse outcomes because of it. You can read more about the use of imaging in modern chiropractic practice here.
3. How Long Do Treatments Take?
Treatment plans should be tailored to the individual. Cookie cutter plans where every patient gets the exact same treatment are not your best interest. When asking how long a treatment will take be sure to exclude any time for history taking and examination. As these will make your visit longer, typically at your first appointment and any re-exams. Typically a treatment session can last anywhere from 10 minutes up to 30 minutes. However, a complicated case can take longer to evaluate and treat. Most patients in my office get a combination of hands on treatment and other modalities. Which may include adjustment to the spine or other soft tissue therapy. As well as guided exercise, and some passive modality such as a cold pack or electric muscle stimulation if warranted. A treatment session of this type would run around thirty minutes.
4. Will You Respect My Treatment Preferences?
The answer better be a loud “Yes”. Because patients are individuals with their own biological, social, and psychological make-up, treatment should be tailored to the individual. If a patient presents with a strong preference not to be adjusted, the chiropractor should respect this and not try to sell or trick the patient into accepting an adjustment, even if it is the doctor’s strong opinion that an adjustment is what is best for the patient. The pillars of evidence based practice are relevant clinical research, patient values, and clinical expertise. If my expertise and research backs a treatment, but that treatment violates the patients values, then a competent clinician should be able to come up with an alternative. This is important to honor the patient’s values, while making the best effort to make a positive change to the patient’s presenting health concern.
5. Do I Need A Referral?
In general you do not need to be referred to see a chiropractor. However, there are rare instances where insurance plans do require a referral for chiropractic services. If you are unsure about whether or not a referral is required by your insurance, check with your plan. If you do not have insurance, no referral is necessary.
ABOUT THE AUTHOR
Dr. Erik Reich with his son Leif.
Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, to seniors, and traumatic injuries such as work and car accidents. He also enjoys spending time with his wife and son, and their Boston terrier Jarvis.
If you’ve recently been in a car accident, you are no doubt under a lot of stress. Dealing with repairs, police reports, attorneys, and insurance companies can make you want to crawl in a hole. Because so many factors are involved after a crash, it is important not to neglect taking care of yourself. So, even if you don’t feel immediate pain or discomfort, seeking a professional evaluation and whiplash treatment following a car accident should be a priority.
Many people feel pain or other symptoms right at the time of the accident, still others don’t feel pain until a day or more after being injured. If you are in a state of shock or feeling no pain due to an adrenaline rush after a collision, symptoms may not develop for several hours or even days later. Especially if neck pain does develop or becomes worse in the 24-48 hours after a crash.
Dr. Erik Reich Meriden Chiropractor specializes in gentle treatment of whiplash injuries.
Seek Treatment for Whiplash Promptly
Whiplash injuries are very common following car accidents and other accidents. Whiplash occurs where the neck is moved extremely rapidly. The speed and force involved with this rapid movement is often enough to stretch muscles, tendons, and ligaments beyond their limits. This can cause these tissues to tear or become overstretched. Which in turn results in pain, inflammation, muscle spasms, swelling, or cramping.
Pain from whiplash injuries can be intense or dull. Dull neck pain following an injury or accident may heal on its own, or it may not. If you are experiencing neck pain following a car crash, seeking a medical opinion is important because pain may not resolve on its own. The natural course of many aches and pains is to go away on their own some time after onset. However, whiplash injuries can linger, and left untreated can become chronic pain.
Neck pain and instability of the tissues in the neck due to whiplash can lead your body to respond by creating stability where it is lacking. This process involves laying down connective tissue, excess scar tissue, and in the case of bone, more bone, which is termed osteoarthritis. Chronic whiplash therefore has been associated with long term pain. Studies also indicate a tendency for increased opioid medication use, arthritic changes, and poorer health outcomes.
What Type of Whiplash Treatment is Best?
At Omni Physical & Aquatic Therapy Center, Dr. Erik Reich employs a number of evidence based treatment strategies. These treatments address the components of whiplash injuries. Treatment begins with an in-depth history taking process and review of relevant medical history. Followed by a physical examination to identify the involved structures and injured tissues. Then, an individual treatment plan will be discussed based on your body’s needs. Your personal preferences, and the doctor’s best clinical judgement are also important.
Care plans typically include some combination of both passive and active care. Passive care can be thought of as first-aid care. Hot packs, electrical stimulation to damaged soft tissues, and ultrasound are types of passive care which might be employed to reduce pain. As pain reduces, more active treatments such as stretches and exercises are introduced. Therefore, your neck and spine have the best chance of returning to pain free motion. Then you can enjoy the movements and activities you did before the accident which resulted in your whiplash injury.
Whiplash can be caused by auto collisions, sports injuries, work accidents, or other trauma to the neck and spine. Dr. Erik Reich in Meriden, CT specializes in treating head and neck injuries, and other spinal and muscular pain and loss of function.
Seek Treatment if You’ve Been Injured
Whiplash injuries can be extremely painful immediately following trauma. Or they may show up as dull worsening pain one or more days after an accident. But what is important is that if you’ve been involved in a traumatic event such as a car accident, get a professional to evaluate you. Even if you are uncertain if you sustained a serious injury.
About the Author
Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, to seniors, and traumatic injuries such as work and car accidents. He also enjoys spending time with his wife and son, and their Boston terrier Jarvis.
2019 is coming to an end. As we embrace the new year, and you are making your New Year’s Resolutions to finally kick back pain to the curb, keep these points in mind. Because as a society approximately 80% of us have or will experience back pain, this is the perfect season to resolve to beat the odds. At an annual health care burden in the billions of dollars, lower back pain is a scourge felt worldwide. But these New Year’s Resolutions can help you overcome one of the leading causes of disability worldwide.
Exercise at least 20 minutes a day, 7 days a week.
Stop smoking.
Eat at least 6 servings of fruits and vegetables a day.
Get more and better sleep.
Seek help if your symptoms are not resolving.
Dr. Erik Reich is a chiropractor in Meriden, CT who treats all types of musculoskeletal back pain.
Exercise for Your Back Pain
It may seem counter intuitive to exercise a part of your body that may be injured or in pain but science regularly backs this up. Therefore, one of the best interventions for both acute (new) and chronic (old) pain is graded exposure to exercise. If you are unsure of where or how to begin an exercise program while in pain, see resolution #5 – Seek Help!
Stop Smoking
Needless to say this is old news for a variety of health reasons, but in terms of back pain, smoking is very bad for both pain intensity experienced, healing time, and outcomes overall. I recently wrote a blog on this very subject here.
Eat Your Fruits and Veggies
Increased fruit and vegetable intake is associated with better healing and pain reduction.
When you consume more fruits and vegetables your body heals better, this is well documented in the scientific literature. Vitamin A is required for cell and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen and connective tissue formation and as a tissue antioxidant. Fruits and vegetables also contain fiber which is filling and satiety will reduce cravings for more inflammatory foods (processed foods, sweets, chips, etc.) which should be avoided when healing.
Better Sleep, Better health
Two recent studies in just the past month or two have shed more light on the important role sleep plays in your health outcomes. In one study which was discussed in this article, lack of and poor quality sleep was shown to increase pain felt by up to 30%. Furthermore, in another recent example, a study showed how sleep helps to clean the brain and allow your body to remove toxins.
Ask for Help
The human body is resilient. You are highly adaptable and given the right inputs the body will take care of the output. But garbage in = garbage out. So if you are experiencing back pain, make some simple (but not easy) lifestyle changes to give yourself the greatest chance to recover. Or if you are unsure of how to make these changes, don’t hesitate to reach out and get some help.
Dr. Erik Reich is available for appointments Monday – Friday and can be reached by phone at (203)235-0171.
If you want to get better faster and with less pain after a disc injury, don’t smoke.
Scientific studies routinely demonstrate that smokers have more pain, decreased healing ability, and longer recuperation times”, states Dr. Erik Reich, a chiropractor in Meriden, CT.
It’s no surprise that smoking is bad for you. If you are a smoker, you’ve most likely been told by friends, family members, and your doctor to quit the habit already a million times. However, as a chiropractor, let me be perhaps the first to state it this way: smoking is terrible for your health after a disc injury.
In this study by Tsarouhas A et al. the authors state, ” Smoking habits were found to have a negative dose-dependent effect on the transcript levels of MMP-3 and MMP-13 and a positive correlation with pain intensity, suggesting an unfavorable role for smoking in the regression process of herniated disc fragments. “
In other words, smokers take longer to heal after a disc injury. Smokers also experience more pain with disc injury than non-smokers. Anyone who has had a cervical or lumbar disc herniation can tell you, they can be extremely painful and debilitating. Therefore, you should give yourself every advantage when you are trying to heal after such an injury to your spine. If you are a smoker, be aware that continuing to smoke during the healing process has been demonstrated to slow recovery, increase pain intensity, and result in poor outcomes. So stop smoking for disc health!
In sharing this study and the information in it, it is my hope that if you are a smoker experiencing back pain, but especially back pain due to trauma or disc injury, you seriously consider quitting immediately. I know you’ve heard it before about the negative health consequences of smoking cigarettes, but this study makes the connection between smoking and back pain in a way most people are still unaware.
Significantly lower MMP-3 (c) and MMP-13 (d) mRNA levels were observed in discs removed from patients smoking more than 20 cigarettes per day compared to non-smoking patients
I have no doubt that studies coming out in the future will build on the negative relationship between smoking and back pain, but in the meantime if you want my clinical advice: stop smoking for disc health now to improve your outcomes from suffering a spine related injury. Of course this is in addition to eating a healthy diet and exercising regularly, and if you need help doing that call (203)2350171 today.
American Academy of Orthopaedic Manual Physical Therapists Releases Position Statement Opposing Use of ‘Degenerative Disc Disease’ as Diagnostic Term
“Degenerative disc disease is a term which is neither accurate or helpful, it should be abandoned.” states Dr. Erik Reich, Meriden Chiropractor.
The position statement released recently by AAOMPT is spot on. Few things are as upsetting to me as a clinician as when a patient presents to my office having been scared by this garbage terminology. Degenerative disc disease (DDD) is not degenerative or a disease.
As Professor Stu McGill, a world renowned spine researcher is oft quoted as having said, “A degenerative disc disease diagnosis is the equivalent of telling your wrinkled mother-in-law that she has degenerative face disease.”
AAOMPT says patients often react to the label ‘degenerative disc disease’ by losing hope and seeking more invasive and higher-risk treatments. They avoid beneficial physical activity for fear that exercise and movement will worsen their condition, possibly leading to chronic pain. The majority of spinal pain is self-limiting and can be managed appropriately without the need for medications or risky procedures such as injections or surgery. For those individuals who do need care, AAOMPT supports and encourages early physical therapy instead of high-risk procedures and medication. AAOMPT strongly recommends that clinicians avoid using the diagnosis of degenerative disc disease.
One of the key interventions a clinician can provide to a back pained patient is education about their condition. Telling someone who has had a diagnostic scan or imaging that they are suffering from a disease such as DDD, when in fact this process is a normal part of aging and not a disease at all, causes harm and creates a nocebo effect.
A nocebo in this case arises from a patient being told they have a disease where in fact no disease is present. This can lead to negative expectations of recovery, fear or avoidance of beneficial activities, and seeking more aggressive and invasive treatments when they are not indicated or necessary.
Unfortunately, use of this terminology is still prevalent. Hopefully that changes as more practitioners are made aware of the negative consequences to patients of using this type of poor diagnostic language.
