Spine Health & Spinal Hygiene

Medical experts have seen how pain education and cognitive behavioral therapy or CBT classes effectively manage chronic back pain; even a one-time pain management class can help. Individuals experiencing back pain often try a variety of remedies to find relief. These include:

• Eliminating activities
• Over-the-counter medications
• Prescription pain medications
• Support devices and braces
• Pain specialists
• Surgery

All treatment options can help alleviate discomfort and pain, but sometimes taking a pain management class and getting educated on what is happening in the body has been shown to help individuals gain a better understanding helping them to find relief. A recent study suggests that a one-time class may be all that is needed. These quick classes can give more individuals immediate access to information and skill sets that can help reduce the pain and everything that comes with it.

Cognitive Behavioral Therapy Classes

Cognitive Behavioral Therapy for chronic pain provides individuals with information and pain management skills. Cognitive-behavioral therapy is handled by a therapist and can take multiple individual or group sessions that last one or two hours. A session can include:

• Education on pain and how it works.
• How thoughts and emotions influence pain.
• How pain affects mood.
• Sleep and pain.
• Activity and action plan development.

Chronic lower back pain or CLBP is considered a physical ailment; cognitive behavioral therapy can provide mental health strategies to manage symptoms better. For example, individuals with chronic pain begin to fear doing activities that could increase their pain level and begin to constantly worry about worsening the injury or creating a new injury. This can lead to severe stress that exacerbates the chronic symptoms and can lead to other health issues.

Single Session Vs. Multiple

Doctors and medical experts are trying to make pain education and relief skills more accessible. They do not require multiple sessions and instead consist of single-session, two-hour management classes. A randomized clinical trial of adults with chronic low back pain was compared to:

• 2-hour pain relief skills class known as Empowered Relief.
• 2-hour back pain health education class with no skill set training.
• 16-hour, 8-session cognitive behavioral therapy group class.

The study found that three months after treatment, the Empowered Relief group showed positive results. In the randomized trial, a single-session pain relief class was found to be non-inferior to an eight-session cognitive behavioral therapy class to:

• Reduce pain-related distress
• Pain intensity
• Pain interference

Benefits

The individuals that completed the one-time 2-hour class reported positive results after three months. They found that the course had significantly reduced:

• Pain intensity
• Pain interference
• Sleep disturbance
• Anxiety
• Fatigue
• Depression

However, doctors caution that the two-hour class does not replace comprehensive cognitive-behavioral therapy. This is to get individuals on a positive path of pain management that can further develop into a healthy lifestyle. The objective is to create a range of options that meets an individual's needs. The most significant advantage of a two-hour class is the convenience. Individuals can participate in these classes in person or online.

Body Composition

Supplements That Can Help Improve Lean Body Mass

A few dietary supplements that directly support body composition improvement.

Protein Powders

Protein powders are common nutritional/dietary supplements. Protein powders come in a variety of sources:

• Milk-based - whey and casein
• Egg-based
• Plant-based - rice, hemp, pea, pumpkin seed, and soy.

Rice Protein

Rice protein is a plant-based protein powder used by vegans, vegetarians, and individuals who can’t tolerate dairy products. Research has found that rice protein has similar effects on body composition as whey. Scientists found that individuals who took rice protein and individuals that took whey protein both experienced positive body composition changes.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Cochrane Database of Systematic Reviews. (Oct 2015) “Psychological therapies for the management of chronic neuropathic pain in adults.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485637/

Darnall BD, Roy A, Chen AL, et al. Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401

Future Neurology. (Nov 2014) “Neuroimaging chronic pain: what have we learned and where are we going?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289824/

HRB Open Research. (Aug 2020) “The relative effectiveness of psychotherapeutic techniques and delivery modalities for chronic pain: a protocol for a systematic review and network meta-analysis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459872/

Journal of Psychosomatic Research. (Jan 2010) “Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.”

National Institutes of Health. (March 2016) “Meditation and cognitive-behavioral therapy ease low back pain.” https://www.nih.gov/news-events/nih-research-matters/meditation-cognitive-behavioral-therapy-ease-low-back-pain

Pain. (Feb 2008). “Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254507/

Pain and Therapy. (Jun 2020) “Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/

Perhaps you bent the wrong way while lifting something heavy. Or you’re dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they’ve had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.

Sometimes, it’s clearly serious: You were injured, or you feel numbness, weakness, or tingling in the legs. Call the doctor, of course. But for routine and mild low back pain, here are a few simple tips to try at home.

CHILL IT 

Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. “Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes,” she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.

KEEP MOVING

“Our spines are like the rest of our body — they’re meant to move,” says Reicherter. Keep doing your daily activities. Make the beds, go to work, walk the dog. Once you’re feeling better, regular aerobic exercises like swimming, bicycling, and walking can keep you — and your back — more mobile. Just don’t overdo it. There’s no need to run a marathon when your back is sore.

STAY STRONG

Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. “They help you maintain the proper posture and alignment of your spine,” Reicherter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.

STRETCH

Don’t sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. “Because most of us spend a lot of time bending forward in our jobs, it’s important to stand up and stretch backward throughout the day,” Reicherter says. Don’t forget to also stretch your legs. Some people find relief from their back pain by doing a regular stretching routine, like yoga.

THINK ERGONOMICALLY

Design your workspace so you don’t have to hunch forward to see your computer monitor or reach way out for your mouse. Use a desk chair that supports your lower back and allows you to keep your feet planted firmly on the floor.

WATCH YOUR POSTURE

Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.

WEAR LOW HEELS

Exchange your four-inch pumps for flats or low heels (less than 1 inch). High heels may create a more unstable posture, and increase pressure on your lower spine.

KICK THE HABIT

Smoking can increase your risk for osteoporosis of the spine and other bone problems. Osteoporosis can in turn lead to compression fractures of the spine. Recent research found that smokers are more likely to have low back pain compared with nonsmokers.

WATCH YOUR WEIGHT

Use diet and exercise to keep your weight within a healthy range for your height. Being overweight puts excess stress on your spine.

TRY OVER-THE-COUNTER PAIN RELIEVERS

Anti-inflammatory drugs such as aspirin, ibuprofen (Advil, Motrin, Nuprin), and naproxen sodium (Aleve, Anaprox, Naprosyn) can help reduce back pain. Acetaminophen (Actamin, Panadol, Tylenol) is another over-the-counter option for pain management. Be sure to check with your doctor or pharmacist about any interactions over-the-counter pain relievers may have with other medications you are taking. People with a history of certain medical conditions (such as ulcers, kidney disease, and liver disease) should avoid some medicines.

Call your doctor if:

Your low back pain is severe, doesn’t go away after a few days, or it hurts even when you’re at rest or lying down.
You have weakness or numbness in your legs, or you have trouble standing or walking.
You lose control over your bowels or bladder.
These could be signs that you have a nerve problem or another underlying medical condition that needs to be treated.


ARE FUNCTIONAL ORTHOTICS PART OF YOUR WELLNESS PROTOCOL?

Most Chiropractors advertise pain relief without drugs and care for injuries. Recently, some doctors and practices have begun labeling and promoting themselves as Wellness Centers. A wellness practice is focused on both maintaining a pre-existing level of musculoskeletal balance and postural health and preventing conditions that might alter this state of health. The challenge is, how can healthy patients be protected from problems that might arise in the future? The answer is simple: custom-made orthotics. Custom orthotics may be traditionally seen as a preventative measure, but so are most treatments of old. They are the perfect, foundational support your patients will never want to go without.

Wellness is a great concept—one of those “win-win” situations for doctor and patient. Orthotics are the perfect way to implement this concept and help establish a “preventative” approach, in addition to the traditional reactive ones, if need be. Let’s take at a look at the foundation of the body, and see just how useful they can be.

LOOK TO THE FEET

The feet are the foundation of the body. By age 40, nearly everyone has a foot condition of some sort, many of which eventually contributing to health concerns farther up the Kinetic Chain (Figure 1). Therefore, it’s in the best interest of healthy patients to be offered a wellness program which stresses preventative care for normal, healthy feet, in order to prevent foot problems from occurring later in life.

While 99% of all feet are normal at birth, 8% develop troubles by the first year of age, 41% at age 5, and 80% by age 20. By age 40, nearly everyone has a foot condition of some sort.

HOW CAN ORTHOTICS HELP?

Patients who participate in Chiropractic wellness programs can benefit from custom-made orthotics nearly as much as patients who seek Chiropractic care for musculoskeletal injuries and conditions. Foot Levelers’ custom orthotics have been shown to effectively support the pedal foundation for both categories of patients, and can prevent problems well into the future with static and dynamic support.

Static support.Static support. A 1999 study using radiographic measurements found that custom-made, flexible orthotics can significantly improve the alignment of the arches when standing.2 In the wellness-practice concept of orthotic use, custom-made, flexible orthotics can be used to maintain a properly functioning arch alignment.

Dynamic support. During gait, the foot undergoes substantial changes and must permit a smooth transfer of the body’s center of mass over the leg in order to conserve energy and keep the work expenditure to a minimum.3 This requires a flexible, yet supportive orthotic that accommodates varying weights and forces and allows proper movement and function of the foot, while supporting all three arches—in order to prevent eventual arch collapse.

Postural benefits. Since the entire body structure is balanced on one foot at a time when walking and running, improving foot alignment can help maintain knee, hip, pelvic and even spinal postural alignment,4 and prevent joint degeneration (of the hip, knee, or spinal joints). A pelvic or spinal tilt or recurrent subluxations will often respond rapidly to orthotic support of the arches in the feet. 

ORTHOTICS FOR EVERYONE

Custom-made, flexible orthotics have long been recognized as a valid adjunct to Chiropractic care for many musculoskeletal conditions. In the wellness model of Chiropractic care, Foot Levelers’ custom-made, flexible orthotics (Fig. 2) can be utilized as a preventative modality for the preservation of optimal arch support and the postponement or prevention of joint imbalances in later years. Therefore, orthotics are appropriate for virtually all Chiropractic patients.