6 Quick Stretches to Protect Your Back at Work

Are you spending most of your workday sitting down? Left unchecked, this positioning leads to muscular imbalances and skeletal malalignment, all of which can worsen back pain.

While seated, your hip flexors, hamstrings, and—if you're wearing high heels—calf muscles are all in a shortened position. As the years go by, this position will lead to a shortening of these soft tissues overall, which ultimately predispose you to developing pain and discomfort.

The discomfort could range from a simple ache to a problem that limits function and requires medical treatment and possibly even surgery. 

Poor posture takes a toll on your back

Your posture while sitting for long periods could also have an impact. As people sit, they have a tendency to slump down in their chairs, allowing their shoulders to round forward and their neck to look relatively upward.

This posture has a significant impact over time, because whenever you look upward, you are decreasing the amount of space your nerves have to exit the spinal cord. If you are someone who already has a condition called stenosis (a narrowing of the joint space in which a spinal nerve travels through), this posture exaggerates the problem.

Thankfully there are a few simple exercises to combat the imbalances commonly associated with too much sitting. 

To avoid common problem muscular shortness and stiffness, don’t overdo it. People often stretch too aggressively. Make the stretch mild, or you’ll waste your time. 

For maximum benefit, perform five to 10 of each of the following stretches, holding each stretch for 10 seconds. Don’t do the stretches more than twice a day.

1. Stretch those tight hamstrings.

Having tight hamstrings—the large muscles in the back of your thighs—is a common result of too much sitting in the workplace. To stretch these muscles, lie down on the floor near a doorway, straightening the leg you will not be stretching through the doorway. 

Next, place the leg you will stretch up along the doorframe, starting with the knee slightly bent. Straighten the knee completely, and depending on the level of stretch felt, either move closer or farther away. The closer you get to the wall, the more intense the stretch.

2. Focus on the hip flexors.

A second important muscle group is the hip flexors, located in the front of the hip. Begin with one knee on the ground. I would suggest putting something soft, such as a pillow, under your knee to make it more comfortable. 

The leg that is not being stretched will reach out in front, foot flat on the floor, with the hip and knee both bending approximately 90 degrees. Now, shift your weight forward allowing the leg that is behind to feel the stretch at the front of the hip. 

Two tips. If you’re feeling the stretch more in the opposite hamstring, you probably need to extend your foot farther forward at the beginning of the stretch. Second, make sure you don’t arch your back in an effort to stretch the hip. Arching could lead to low-back irritation.

3. Try a neck stretch.

To stretch your neck, tuck your chin down toward your throat, rotating the head toward each ear. Next, place your hand on the back of your head, providing a gentle downward force. 

4. Sit up tall for the head tilt.

A second stretch for your neck is to sit up tall, then allow your head to tilt toward the right or left shoulder. Again, use your hand as added weight to assist in stretching. The stretch sensation should occur on the side opposite of the way you are tilting. 

For example, a left-sided neck stretch should use a right-sided tilt, and vice versa. If you are feeling the stretch in the same side, discontinue the stretch. It could be a sign of something else going on.

5. Stretch out those arms.

Quite a few people who work in an office suffer from wrist and elbow pain. An easy way to prevent this from developing is to avoid getting stiff in your wrist flexors or extensors. 

• A good stretch begins with extending one arm straight out in front of your body. 
• Make sure your elbow is straight and your palm is facing down. Bend the wrist so the fingers are pointing down. 
• With the opposite hand, reach out to the extended hand from below, and pull the extended hand toward you. 

A stretch should be felt in the top of the forearm or back of the wrist. 

6. Stretch palms to the ceiling.

The second wrist stretch would be once again straightening your elbow, but this time the palm faces up toward the ceiling. You will once again use the opposite hand to bend your wrist back so the fingers point down towards the floor once again. This stretch should be felt in the front of your forearm. 

These 6 stretches are a simple way to help prevent pain associated with a typical sedentary work environment. If you already have pain, these exercises are not a substitute for a thorough medical evaluation to ensure no other maladies are present.

Call ABChiropractic Family & Wellness in St. Charles Missouri 63303 at 636-916-0660 to schedule your appointment with Dr. Mario Awwad to discuss more ways to prevent back pain and to correct any issues that you may have regarding your health.

Home Exercise Equipment for Low Impact Aerobic Exercise

Cardiovascular exercise can play a critical role in maintaining spine health and ensuring progress in recovery from back pain or surgery. Balancing aerobic (or cardiovascular) exercise, which works the heart, with anaerobic strengthening exercises and stretching can deliver both physical and mental benefits for back pain patients, allowing them to:

• Maintain a healthy weight or lose weight
• Relieve stress, anxiety, and depression
• Increase flexibility and mobility
• Improve strength of muscles and joints that support the spine
• Increase circulation throughout the spine and supporting structures, which is crucial to promote healing
• Improve quality and duration of sleep

More Exercise Info:

Sciatica Exercises

Exercise and Back Pain

Neck Pain Exercises

Abdominal Exercises

While the physical or mechanical benefits captured through exercise are important for spine health, the mental health benefits can also be substantial. Cardiovascular exercise in particular promotes the release of endorphins, biological chemicals that naturally help alleviate sensations of pain and produce overall positive feelings. Activity that leads to improved emotional well-being is particularly important for spine patients because depression and anxiety, as well as sleep problems, are common among those struggling with chronic back pain or recuperating from surgery or treatment. Cardiovascular exercise - whether in the form of walking, swimming, biking, or some other activity - can play a key role in helping decrease the pain one senses and increase positive feelings.

For many, ready access to home exercise equipment can make it easier to start and maintain an aerobic exercise program. Exercising in the comfort of one's own home is the preferred exercise option for many people because:

• Exercise can be done in private
• Workouts can be done at any time and don't require travel to another location during limited hours
• Unlike outdoor activities home exercise is not dependent on the weather, so staying with an exercise program may be easier

Nonetheless, it can be confusing to know which type of exercise equipment to buy, and making a mistake with cardiovascular equipment can be detrimental to both physical and financial health.

Back Exercise
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This article focuses on home equipment that is designed for a cardiovascular workout. Other types of exercise equipment for resistance training and exercise (e.g., Swiss Exercise Balls, a BOSU board, Dynadiscs, or body blades) are also important parts of an exercise program for back pain patients.

The types of cardiovascular home exercise equipment profiled in this article are:

• Elliptical trainer
• Stationary bike
• Treadmill

CALL ABChiropractic Family & Wellness in St Charles Missouri (63303, 63301, 63376) at 636-916-0660 to schedule an appointment with Dr Mario Awwad to discuss recommendations on exercise to see if it is safe to pursue such a program.  

A Modern Spine Ailment: Text Neck

You may have noticed a new buzzword in health news recently: Text neck.

Text neck is the term used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, or other wireless devices too frequently and for too long.

And it seems increasingly common. Recently, a patient came in to my practice complaining of severe upper back pain. He woke up and was experiencing severe, acute, upper back muscle strain. I told him I believe the pain is due to the hours he was spending hunched over his cell phone. Diagnosis: Text neck. 

Of course, this posture of bending your neck to look down does not occur only when texting. For years, we've all looked down to read. The problem with texting is that it adds one more activity that causes us to look down—and people tend to do it for much longer periods. It is especially concerning because young, growing children could possibly cause permanent damage to their cervical spines that could lead to lifelong neck pain.

What are the symptoms associated with text neck?

Text neck most commonly causes neck pain and soreness. In addition, looking down at your cell phone too much each day can lead to:

• Upper back pain ranging from a chronic, nagging pain to sharp, severe upper back muscle spasms.
• Shoulder pain and tightness, possibly resulting in painful shoulder muscle spasm.
• If a cervical nerve becomes pinched, pain and possibly neurological symptoms can radiate down your arm and into your hand.

I believe, as some studies suggest, text neck may possibly lead to chronic problems due to early onset of arthritis in the neck. 

How common is text neck? 

A recent study shows that 79% of the population between the ages 18 and 44 have their cell phones with them almost all the time—with only 2 hours of their waking day spent without their cell phone on hand.1

How is text neck treated? 

First, prevention is key. Here are several pieces of advice for preventing the development or advancement of text neck: 

• Hold your cell phone at eye level as much as possible. The same holds true for all screens—laptops and tablets should also be positioned so the screen is at eye level and you don't have to bend your head forward or look down to view it. 
• Take frequent breaks from your phone and laptop throughout the day. For example, set a timer or alarm that reminds you to get up and walk around every 20 to 30 minutes.
• If you work in an office, make sure your screen is set up so that when you look at it you are looking forward, with your head positioned squarely in line with your shoulders and spine. 

The bottom line is to avoid looking down with your head bent forward for extended periods throughout the day. Spend a whole day being mindful of your posture—is your head bent forward when you drive? When you watch TV? Any prolonged period when your head is looking down is a time when you are putting excessive strain on your neck.

Next, rehabilitation is important. 

• Many people don't know this, but you need to have strong core muscles—the abdominal and lower back muscles—to support your upper body, including your neck. Your core muscles usually do not get enough exercise during normal daily activities, so you need to do specific exercises to target these muscles.
• You also need strong and flexible muscles the neck to minimize strain on your cervical spine and help support the weight of your head. Again, your neck will not get sufficient stretching and strengthening during normal daily activities, so it is best to learn specific neck exercises with the help of a health professional.

Some people will also benefit from a more comprehensive treatment plan, such as a combination of manual adjustments, massage therapy, and strengthening exercises.

Call ABChiropractic Family & Wellness, your St. Charles Pain Relief Center, at 636-916-0660 to check your kids and family members for "Text Neck".  Dr. Mario Awwad specializes in treating patients of all ages.

References

1. Always Connected: How Smartphones And Social Keep Us Engaged.

Considerations When Buying a New Mattress

When shopping for a mattress, it is important to be aware of the quality and value of each potential purchase. The following are things a patient should consider when purchasing a new mattress:

1. Shop for the best value and quality of the mattress rather than for price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.
2. Be aware of mattress advertising gimmicks. Claims that a mattress is “orthopedic” or “medically-approved” should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.
3. Give the mattress a test-run before buying. To sample mattresses, people can try sleeping on different makes and models in hotels or at other people’s homes before going to a mattress store. When shopping at the store, shoppers should lie on the mattress for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress. 
4. Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, and removal of old mattresses and the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).
To help preserve the quality of a new mattress, it should be repositioned every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises against putting a mattress on a box spring/foundation that is not made to go with the mattress, as this may decrease the life of the new mattress.

How to Evaluate a Mattress

Choosing a new mattress that is comfortable, supportive, and high quality is important to help people with low back pain get a sound night's sleep. And marketing messages, promotions and special features can make shopping for the right mattress a challenge.

By understanding the physical composition of a mattress and being prepared to ask questions about the interior of a mattress, individuals can accurately evaluate and compare mattresses. Some mattress stores will offer cutaway views of the interior; this is a good aid in understanding and gauging mattress quality.

Key Components of a Good Mattress

The following physical components are the important features of most high quality mattresses.

Mattress springs and coils provide back support. The wire in the coils comes in different thicknesses, where a lower gauge number denotes thicker, stiffer wire and a firmer mattress. A higher concentration of steel coils may indicate a higher quality mattress, but this does not mean that the highest number is best: patients should use their own judgment regarding which mattress is best suited to provide support and help alleviate their low back pain.
Mattress padding provides comfort. In addition to the spring coils in a mattress, the padding on top of the mattress can indicate quality. Mattress padding is usually made of materials such as polyurethane foam, puffed-up polyester or cotton batting. Extensive mattress padding is often more expensive, but many people find it more comfortable and worth the extra cost.
Middle padding in a mattress. This type of mattress padding is just below the quilted top layer and is usually made with foam. When looking at a cross-section of the mattress, softer foams feel almost moist to the touch while firmer foams won’t spring back as quickly. The next layer of mattress padding is made of cotton batting that may vary in thickness across different mattresses and even within one mattress. This causes the mattress to feel firmer in some areas rather than others, such as increased firmness in the middle of the mattress.
Insulation mattress padding. This padding lies on top of the coil springs so that they cannot be felt from the top of the mattress, and it also protects the coils from damaging the top layers of the mattress.
Mattress ticking and quilting. The outer layer of a mattress consists of ticking, which is usually a polyester or cotton-polyester blend in a good quality mattress. The mattress quilting attaches the ticking to the top layers of padding. It is a good idea to examine the quality of stitching on the mattress quilting, looking for consistent, unbroken stitches.
Mattress foundations. The mattress foundation or box spring adds another level of support to the mattress. Foundations usually consist of a wooden or metal frame with springs. A plain wooden frame may make mattresses feel harder than a frame with springs. A wood mattress foundation should only be purchased if the wood has no cracks and is straight. The Better Sleep Council recommends that purchasing a foundation and mattress as a set helps preserve the mattress.
Foam mattresses. As an alternative to traditional mattresses, some types of mattresses are constructed entirely or mostly from memory foam or latex foam. They can be purchased in different densities. Some foam mattresses are made of multiple layers of foam adhered together while others have a foam core in the center. Foam mattresses come in various degrees of firmness to give people greater selection for back support and comfort. Choosing between a foam mattress and a traditional mattress is based on personal preference.
Asking questions, requesting written product information and examining each mattress thoroughly will help patients become more educated consumers. By following the practical guidelines for selecting a new mattress, patients will be well equipped to find the best mattress for sleep comfort, back support and reducing low back pain.


Call ABChiropractic Family & Wellness in St. Charles MO at 636-916-0660 to schedule your no risk appointment.  Our chiropractors can help address your pain complaints and mattress concerns.  We offer a full range of different chiropractic adjustments, as well as decompression, traction, and massage therapy.

7 Sleeping Tips for Patients with Chronic Pain

Patients dealing with back and neck pain will often have trouble sleeping.

Consider these points:

• Various studies detail how chronic pain can make it difficult to sleep and how sleeping problems can exacerbate one's symptoms.

• A past Spine-health poll of nearly 1600 people found that 63.7 percent of people get less than or equal to 6 hours of sleep while only 29.9 percent of responders get the recommended 7-8 hours of sleep.

We've compiled some sleep tricks that seem to help many of our forum members:

1. Only go to bed when you are tired

Do not allow yourself to toss and turn in bed. This only makes things worse, and usually you'll end up stressing about everything you have to do the next day.

If you are not sleeping within 20 or 30 minutes, get out of bed and engage in something that makes you tired. One person suggested the iPhone app, "Words with Friends."

Once you figure out your optimum bed time, do your best to keep a regular sleep schedule.

2. Cool the room

Simply cracking the window in cold weather or cranking the air conditioner a little more in hot weather is a great way to make the room temperature colder and to have deeper and more restorative sleep.

3. Drink herbal tea

Make a conscious decision to avoid coffee after dinner and expand this to exclude/limit pop and even other stimulants like alcohol and nicotine.

Chamomile tea is an excellent choice to help you relax.

4. Work up a sweat

While many chronic back pain and neck pain sufferers worry that exercising will only exacerbate their pain, the opposite is actually true: remaining inactive is often worse for pain.

Engaging in regular exercise, stretching, and strengthening programs can promote the body's natural healing process and make you feel better both physically and mentally. And, as a bonus, it will make it easier to fall asleep at night.

5. Write down your worries

Why is it that when your head hits the pillow, all your worries become so intense? Try "forced worrying." Before you go to bed, take 15 minutes or so to write down your worries on a blank sheet of paper.

Remind yourself that you will have plenty of time to address these concerns the following day. If you find yourself in bed worrying about other things, keep a notebook and pen nearby and write these down as well.

6. Visualize something peaceful

With your mind free of worry, gently close your eyes and think of something tranquil and relaxing.

Consider incorporating a sound relaxation machine or even aromatherapy.

7. Check your "equipment"

Ask yourself these questions:

• Does my mattress provide me with enough lumbar support? Check out these mattress guidelines.
• How does my pillow support my neck? Is it too high or too firm? Remember these suggestions for pillow support and comfort.
• What position is most comfortable when sleeping? Am I relaxed on my back, side, or am I curled up? How do I feel when I wake up in the morning after having slept in these positions?

Certain sleeping positions are recommended for different types of pain.

For example, patients with pain from osteoarthritis are advised to sleep in the fetal position (on their sides, with knees curled up), while patients with degenerative disc disease may prefer to sleep on their stomach. Those with hip pain may achieve relief by placing a pillow between the knees.

Call Dr. Awwad, ABChiropractic Family & Wellness, your Pain Relief Center in St. Charles MO 63303 to schedule your new patient exam and consultation to see how we can help you with your pain complaints.  Call 636-916-0660 and speak to Karen or Rachel to schedule your life changing appointment.  Chiropractic is safe and effective for the detection and correction of pain symptoms.

Upper Back Pain from a Thoracic Herniated Disc

A herniated disc in the upper back can occur when the inner gelatinous material of an intervertebral disc leaks out of the inside of the disc. A thoracic herniated disc can cause upper back pain and other symptoms, such as radiating pain or numbness.

Specific symptoms of a thoracic herniated disc are usually different depending on where the disc herniates, as the herniated disc material in the upper back can either impinge on an exiting nerve root or on the spinal cord itself.

Thoracic Degenerative Disc Disease

Thoracic disc disease is conceptually similar to disc disorders in the cervical and lumbar spine, but symptomatic lesions (anatomical problems related to the symptoms) are far less common.

The most common location for thoracic disc disorders is at the thoracolumbar (the thoracic and lumbar parts of the spinal column) junction (T8-T12) in the mid back. The true incidence is unknown because many thoracic disc disorders do not cause thoracic back pain or other symptoms, and they comprise only a very small percent of all herniated disc treatment surgeries.

In one study, 90 asymptomatic patients (with no pain or other symptoms) were evaluated with thoracic MRI scans. These were the findings:

• 73% of patients were found to have disc abnormalities in the upper back, such as a thoracic herniated disc or thoracic degenerative disc disease
• 37% specifically had a thoracic herniated disc
• 29% had radiographic evidence of spinal cord impingement identified on the MRI.

These patients were followed for 26 months and none of them developed thoracic back pain from their thoracic disc disorders.1

The fact that so many people had thoracic herniated discs but no pain or symptoms is important to mention, as it shows that people may have both upper back pain and a thoracic herniated disc, but that the disc disorder may not be the cause of the thoracic back pain – it may just be an incidental finding.

In fact, there are many causes of upper back pain that are much more common than a herniated disc, and a correct diagnosis of the cause of the patient’s pain is more important than whether or not an MRI scan shows a thoracic disc herniation.

References:

1. Wood KB, Garvey TA, Gundry C, Heithoff KB: Magnetic resonance imaging of the thoracic spine. J Bone Joint Surg Am. 77:1631-1638, 1995.

CALL ABChiropractic Family and Wellness at 636-916-0660 to see how chiropractic can help.  We are located in St. Charles MO, 63303.  We are your St. Charles Pain Relief Center.

Chiropractic Adjustment

A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain.18

A chiropractic adjustment refers to a chiropractor applying manipulation to the vertebrae that have abnormal movement patterns or fail to function normally.

The objective of this chiropractic treatment is to reduce the subluxation, with the goals of increasing range of motion, reducing nerve irritability and improving function.

Chiropractic Adjustment Description

A chiropractic adjustment typically involves:

• A high velocity, short lever arm thrust applied to a vertebra
• An accompanying, audible release of gas (joint cavitation) that is caused by the release of oxygen, nitrogen, and carbon dioxide, which releases joint pressure (cavitation)19
• A relieving sensation most of the time, although minor discomfort has been reported (that usually lasts for a short time duration) if the surrounding muscles are in spasm or the patient tenses up during this chiropractic care.

It should be known that joint cavitation or cracking does not occur at times, typically as a result of significant muscle splinting or the patient not being adequately relaxed during the chiropractic manipulation. At times like this, it is sometimes best for the chiropractor to apply ice, have the patient rest, or do electrical stimulation and massage prior to attempting the chiropractic adjustment.

Chiropractic Adjustment Techniques

There are many different manipulative techniques that can be utilized in chiropractic, and there is a certain skill level and "art" involved with high velocity, low amplitude adjustment or manipulation. It is perhaps more important for the chiropractor to determine when not to apply the adjustment.

Chiropractic Adjustment Side Effects

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The most common reaction to a chiropractic adjustment is aching or soreness in the spinal joints or muscles. If this aching or soreness occurs, it is usually within the first few hours post-treatment and does not last longer than 24 hours after the chiropractic adjustment. Application of an ice pack often reduces the symptoms relatively quickly.

Call our St. Charles, Missouri office at 636-916-0660 to schedule your new patient appointment for you and your family to see if Chiropractic treatments can help you.  ABChiropractic Family & Wellness in St. Charles MO offers a variety of chiropractic adjustments as well as decompression and massage therapy.  

Mario H Awwad D.C