Stress And Back Pain

Is stress contributing to your back pain? It’s becoming recognized that your state of mind has an effect upon your level of back pain and whether it eventually becomes chronic.. People who are unhappy, worried depressed, or miserable at work are more likely to develop chronic back pain, according to the latest findings. Several recent studies have shown that psychological distress has increased the risk of developing back pain and of experiencing a slow recovery. A study in Sweden found that anxiety and the practice of ‘catastrophizing’ – assuming that the worst will happen- increased the risk of back pain. In another study in the US, people who reported higher levels of anger and distress also reported higher levels of chronic back pain. These studies show that we must review the complete picture with back pain and recognize that it involves much more than just muscles and bones.

In citing the major causes of back pain, in addition to physiological and skeletal problems, the Mayo Clinic cites three Risk Factors:
• Stressful Job
• Depression
• Anxiety

The stresses that are experienced everyday by people are usually easily identified and can be dealt with. Some examples of stress causing situations are:
• Worry about being on time
• Missing a train or plane
• Worry about a job interview
These situations, while upsetting and tension causing, can be handled and, once dealt with, usually do not result in long-lasting problems.

Repressed Emotional Stress
The type of stress that can lead to troublesome back pain is called repressed emotional stress. The process is not logical but, then, many subconscious emotions are not logical or rational. Repressed emotional stress might be caused by:
• An unhappy relationship
• Hidden anger and resentment towards a spouse, children or parents
• Dissatisfaction with a job or career choice, or disillusionment and a poor self image.
• A rift in family relations
• Loss of a loved one
• Financial problems or disaster such as an impending foreclosure
• Physical abuse or threats

Repressed emotional stress may not be easily recognized as the subconscious mind may hide it, creating a smokescreen of back pain symptoms to keep your mind focused on the pain instead of looking for the underlying causes. Repressing (hiding) the real causes blocks any true healing and an effort must be made to recognize and deal with the factors behind the symptoms.

No one should ever discount the powerful effect of stress on the body and the mind.
Stress puts the body into a sustained ‘fight or flight’ mode. When confronted by a threat, whether physical or emotional, real or imagined, a gland in the brain, called the hypothalamus, releases noradrenaline and adrenaline. These hormones trigger a complex set of actions which lead to a physiological and psychological state of hyper-alertness. Problems arise when this hyper-alert state becomes the norm.

The fight or flight mechanism causes muscles to tense in preparation for action, and if this response is not deactivated, the muscles can go into painful spasms, causing severe back pain. As the muscles of the neck and back tighten and squeeze the blood vessels, just like a kink in a garden hose, the supply of nutrients and oxygen are decreased. This leads to pain and eventual weakening of the muscles, making them more susceptible to strain and injury.

Stress is a part of every day life but studies have shown that if we exist in a daily state of hyperawareness, due to all the stresses that confront us, that we are predisposed to develop a number of disorders including heart disease, hypertension, and depression.

Experts at Johns Hopkins Hospital say that a growing number of studies confirm that the mind-body connection plays a role in back pain, both in setting off an initial attack and in contributing to ongoing chronic back pain. These studies have also led to the development of stress-relaxation techniques that can be learned to help break this vicious cycle.

(Brought to you by Jupiter Chiropractor)

Sciatica During Pregnancy

Imagine the surprise a woman must feel while dealing with the physical symptoms and discomforts of pregnancy, to suddenly develop severe back pain. This is not the usual low back pain that is often experienced during pregnancy; it is sciatica. This sharp, shooting pain usually starts in the buttocks and radiates down the back or side of the thigh to the calf and possibly the heel. There may be paralyzing numbness, in addition to the pain, which can be severe enough to limit mobility.

Sciatica can occur at any time in a normal pregnancy but it is most common during the second and third trimester, when the baby is larger and carried lower in the abdomen. Known as Pregnancy-Related Sciatica, it is caused by the pressure of the baby on the sciatic nerve. This is the largest nerve in the body, about the diameter of a finger. Its fibers branch off the spinal cord at the 4^th and 5^th lumbar vertebra (L4, L5) and the first few segments of the sacrum.

As the pregnancy develops, the abdominal tendons and ligaments become looser to prepare for childbirth. The backs of some women become quite unstable and prone to injury. Medical evaluation should always be sought. In some cases, sciatic pain is due to pressure on the nerve that is caused by damage to the disc between the vertebrae of the spine. This creates inflammation and pain and requires specific treatment.

Most physicians avoid prescribing medications for pregnant patients suffering from sciatica but there are several steps that can be taken to relieve or decrease the discomfort. This includes:

• Massage to reduce muscle tension. Some experts believe that tightness in the gluteus and psosas muscles contribute to sciatic pain. Treatment once or twice a week can help relieve stress on weight-bearing joints.
• Moist heat alternated with ice packs
• Chiropractic treatments may be helpful. Be sure to select a practitioner experienced in treating prenatal patients.

In addition, these helpful habits may decrease the chances of developing sciatica:

• Avoid hours of sitting slumped at a computer or standing with a baby on one hip. Both can contribute to lower back pain.
• Maintain proper posture and try to stand straight.
• Wear flat shoes or ones with a very low heel. Avoid shoes that throw your weight backwards.
• Williams Exercises have been developed specifically for use during pregnancy. They may temporarily relieve sciatica pain as they help strengthen the muscles of the pelvic floor, the back and abdomen.
• Swimming and walking are excellent exercises if not contra-indicated by the physician.
• Avoid walking on an incline as this can cause joint irritation and lead to problems.
• Try to avoid significant weight gain.
• Try sleeping on a firm mattress, lying on one side. A pillow rolled up under the knees may be helpful.
• When getting out of bed, try rolling onto your side first, letting the weight of your feet and legs dangling over the edge of the bed, pull your body into a sitting position. This puts less stress on the lower back, helping you to avoid triggering a painful muscle spasm.
• Bedrest may be necessary at times.
• See your physician if the pain becomes unmanageable.

Sciatica is unique to a pregnancy and may gradually disappear on its own. Just because you had sciatica in one pregnancy does not mean it will appear in a subsequent one.

(Brought to you by Deerfield Beach Spinal Decompression)

Facet Syndrome

We’ve all suffered from joint pain at one time or another. It not only is an uncomfortable experience but it can be debilitating and lead to emotional problems. The thought of struggling with such discomfort is a fear that can be difficult to face, but thousands of people every day have to deal with such an epidemic.

Facet syndrome, which occurs when the joints in your spinal vertebrae are injured, is one common problem that targets every age. Recognized as one of the more frequent illnesses, facet syndrome can be extremely painful. When the spine is irritated, one can experience a variety of symptoms. From pain in an isolated area to pinched nerves and a loss of motion, the pain usually gets worse when you bend backwards or straighten your posture. For gymnasts and other athletes, facet syndrome is common problem.

Given that they are constantly moving around and stretching their spines, it is no wonder why vertebrae may sustain injuries or get irritated. Facet syndrome may also be caused by whiplash or the aging process. No matter how you have contracted it, it is vital that you put an end to the pain. First and foremost, consult a physician. Creating your own rehabilitation plan is not only dangerous but could worsen the situation.

For this reason, seek a professional so that he/she can evaluate your back. In many cases, they may recommend that you see a physical therapist. While it depends on the severity of facet syndrome, many find that spinal decompression therapy works wonders. Recognized as a non-invasive and non-surgical procedure, spinal decompression therapy can significantly reduce symptoms. Surprisingly, the treatment itself is relaxing and normally pain-free. It consists of having a harness wrapped around you that is then hooked up to a computer. The machine sends pressure to your spine, enabling the discs to stretch apart.

As a result, lost nutrients such as blood supply and Oxygen flow back into this area, which promotes healing. In order to truly feel the effects of such a procedure, it is imperative that you undergo 4-5 sessions per week for a total of twenty five sessions. While this may sound like quite a time commitment, each session is only thirty minutes long. That’s right - you don’t have to worry about quitting your job or putting other plans on hold. You can get help and still live your life. For most patients, it finally gives them hope and an answer to their constant pain. If you feel that you need additional treatments, acupuncture may be another alternative.

Acupuncture, which consists of placing needles in your skin, is a great way to naturally alleviate the discomfort. With no medicine required, this technique balances your energy and ensures pain relief. It also is known to promote calmness, allowing you to de-stress at the same time. Chinese medicine can be a difficult topic to grasp, but it certainly is another way to get rid of facet syndrome.

(Brought to you by West Palm Beach Chiropractor)

Facet Joint Syndrome

The facet joints are the connections between the vertebrae of the spine. Just like the knee or elbow or any other joint in the body, they allow the spine to bend and twist. They are also stabilizing joints that prevent excessive motion and help hold the body upright.

The joints are on the back of each vertebrae and they link one vertebra to the vertebrae directly above and below to form a working unit that allows movement. The surfaces of the joints are covered with a tissue called the articular cartilage. The joint itself is lined with a membrane called the synovium and the joint is enclosed in a fibrous sac, the joint capsule. Synovial fluid, a thick liquid which acts like lubricating grease and surrounds the joint, allows the bones to move without friction.

When these joints become inflamed secondary to injury or arthritis, pain and stiffness occur. If the joints in the neck or cervical spine are affected, these symptoms develop:

• Headaches
• Pain in the neck, shoulders, and upper back.
• Difficulty rotating the head
• Patients often complain that they have to turn their entire body to look to the right or left.

When Facet Joint Syndrome affects the lower back, there is:

• Pain in the lumbar area
• There may be referred pain to the buttocks and thighs
• Stiffness of back
• Difficulty getting out of a chair
• Difficulty standing up
• Complaints that the patient must walk hunched over

An injury or changes associated with aging may cause the cartilage cushion that covers the bones to wear away, resulting in pain as the bones in the joint rub together. Also, small nerves that branch off the larger spinal nerves can become irritated or pinched, causing pain. Facet Joint Syndrome is more common in people over 50 and is usually associated with aging.

Causes of Facet Joint Syndrome

• Whiplash Injury can cause the syndrome in the cervical area.
• Sports activities,such as gymnastics, where neck is extended
• Arthritis
• Poor posture which pushes the spine out of alignment
• Inflammation
• Infection
• Degeneration of the joint
  

Diagnosing Facet Joint Syndrome

• History and Physical should be done
• An X-ray, CT (computerized tomography) scan of the spine or an MRI (magnetic resonance imaging) will rule out fracture or herniated disc.
• Facet joint block would determine if the joints are the source of pain.
• A local anesthetic is injected into or near the nerves that supply the joint. If there is a significant decrease in pain, the diagnosis is confirmed.
  

Treatment

• NSAIDs (Non-steroidal Anti-inflammatory Drugs) such as ibuprophen, Naproxyn
• Muscle relaxants and narcotic pain relievers might be prescribed for more severe pain.
• Physical therapy
• Exercise program to improve flexibility and increase pain free movement
• Posture correction
• Activity Modification to avoid excessive lifting, stretching, bending
  

Approximately 80% of the patients who follow an active rehabilitation program and take NSAIDs become pain free. This usually lasts several months.

When conservative treatment fails, a surgical procedure called, Raiofrequency Rhizotomy, uses an electrical current to destroy the sensory nerves to the joint, resulting in pain relief.

(Brought to you by Jupiter Spinal Decompression)

Discitis and Back Pain

Discitis is relatively uncommon but it usually affects children under the age of ten. It is a low grade infection, usually caused by staphylococcus or a virus. It affects the disc space between two vertebrae and develops very slowly. Medical experts say this should be viewed in the same category as vertebral oseomyelitis (infection within the vertebrae). It can lead to severe, debilitating, neurological damage.

Disease Process

The infection does not start primarily in the in disc space but migrates there from other sources in the body. Urinary tract infections, pneumonia, and soft tissue infections are believed to be the most common sources. Often, no site of infection is discovered. The lumbar (lower) back is affected most often, followed by the cervical spine (neck) and last is the thoracic spine (upper back). Some post-surgical patients have developed the disease weeks after their operation, and, in their case disease diagnosis is not delayed. They rarely develop neurological deficits.

The edges of the disc erode and the degree depends upon the amount of infection and destruction within the disc. These areas become calcified, once healing begins, and, eventually, there is an interbody fusion, when healing is completed

Disease in Adults

This infection has a slow, insidious onset which can result in diagnosis being delayed for months. Pain in the back and neck are the most common complaints and movement makes it worse. Because the symptoms are similar to those of back strain, there is usually a delay in seeking medical attention. A doctor is often not seen until the sufferer develops an elevated temperature and chills, with weight loss. This delay can lead to a severe condition and the mortality rate (death rate) ranges between 2% to 12%. It more commonly affects males, with a ratio of 2:1 that has gone as high as 5:1.

Disease in Children

The onset is often more sudden, acute, and the back pain is accompanied by a refusal to walk, sit up, and there is extreme irritability. There may be localized tenderness over the spine and decreased range of motion.

Common Symptoms in Adults And Children

• Elevated temperature
• Chills
• Sweating
• Feeling of fatigue
• Loss of appetite
• Localized tenderness of spine
• Pain may travel to other parts of the body, including abdomen, hip, leg, groin.
• Movement aggravates pain.

Diagnosis

• Laboratory studies
• Sputum cultures may be done to isolate bacteria for diagnosis.
• Blood Culture
• X-rays of spine may show narrowing of disc space.
• Nuclear scan of spine
• CT Scan (Computerized Tomography)
• MRI (Magnetic Resonance Imaging)
• Echocardiogram can identify bacterial endocarditis which is responsible for some cases of discitis.
• Needle Biopsy of painful area to obtain tissue for culture

Treatment

• Antibiotics specific to kill organism once it’s identified
• IVs for hydration and supportive care
• Immobilization is necessary.
• Usually 2 weeks of bedrest
• Back brace when patient is able to ambulate
• This allows vertebrae to fuse in an aligned position.
• Bracing may be necessary for 3 to 6 months following treatment to avoid collapse of vertebrae and development of kyphosis ( curvature of spine – ‘round back’)

Discitis occurrence in the US ranges from 1 in 100,000 to 1 in 250,000 but in less developed countries, it is more common. In some parts of Africa, 11% of all patients seen for back pain were diagnosed with discitis.

(Brought to you by Lake Worth Chiropractor)

Diagnosis and Treatment Of Coccydynia

Coccydynia is pain in the coccyx, the tailbone, which can cause a great amount of discomfort and limit mobility. Sometimes, this pain is not taken seriously by general practitioners but it is important to learn the cause if the pain persists. In some cases, the cause is obvious as pain develops after a fall or injury. A pilonidal cyst also creates pain in the coccyx and since there is often a visible abscess, diagnosing the problem is simple.

Other causes of coccydynia are more complex and require a thorough examination and diagnosis. One of the first goals is to rule out the possibility of cancer as a cause of the pain. Before deciding upon a plan of treatment, it is important to distinguish coccyx pain from low back pain or other causes not related to the coccyx.

Diagnosing Coccydynia

• History and Physical must be completed.
• CT Scan (Computerized Tomography)
• MRI ( Magnetic Resonance Imaging)
• Dynamic X-rays –this means x-rays taken when sitting and standing. A comparison may show a coccyx that dislocates when the patient sits, causing pain.
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Treatment Of Coccydynia

Falls

• Use a cushion or well padded seat to relieve pressure on the coccyx when sitting. Several new devices have been developed which are far superior to rubber donuts or foam pads. Many can be found on the internet when doing a search for ‘coccyx cushions’. This cushion may be necessary for an extended period of time.
• Rest and avoid re-injury.
• Anti-inflammatory medications, such as ibuprophen and naproxyn, are helpful.
• Corticosteroid or local anesthetic injections may dramatically relieve persistent pain.

Unstable Or Dislocating Coccyx

• Rest and avoid re-injury.
• Corticosteroid injections are helpful.
• If pain persists and corticosteroids are unsuccessful, the coccyx may be removed surgically.

Childbirth

• Rest often allows the coccyx to return to its normal position.
• If this fails, treatment as for Unstable or Dislocating Coccyx is appropriate.

Repetitive Strain

This is due usually to long periods of rowing or bicycle riding.

• Rest – avoid activities that caused the pain.
• Anti-inflammatory medications, such as ibuprophen or naproxyn relieve discomfort.

Misaligned or Long Coccyx

• Injections of corticosteroids are often helpful.
• Surgery is not recommended.

Boney Spur or Spicule On Coccyx

• Local injection of corticosteroids and/or local anesthetic have been helpful.
• Surgery has been successful.

Muscle Spasms Of Gluteus Maximus Muscle

• Physical therapy and massage have been effective in relieving spasm.

Piriformis Syndrome

• Physical therapy
• Stretching exercises
• Injections of Corticosteroids Locally

Pilondal Cyst

• Surgical removal is necessary as infection reoccurs repeatedly.

Coccyx pain and the associated difficulty with sitting and movement can be most miserable and memorable. Sufferers who gain relief are always anxious to avoid any reoccurrence whenever possible.

(Brought to you by Coral Springs Spinal Decompression)