Sciatica

Suffering from Sciatica? The Do’s and Dont’s

Four out of five people will experience a debilitating back pain and Sciatica episode at one point during their lives. Sometimes this looks like severe back pain that lasts a few days and eventually goes away on its own.

But for some – especially those that have experienced more than one debilitating back pain episode over the course of their lifetime – they experience searing pain down their leg that may or may not persist over a period of time.

When you experience back pain followed by radiating leg pain – this is known as “sciatica”.

Sometimes the pain will only go to your knee, or be a dull ache in the side of your hip and leg. But other times it can manifest all the way down to your foot and be accompanied by numbness, tingling and a loss of strength.

The good news is that there is plenty you can do on your own to help yourself recover from sciatica naturally. But there’s just as much you can do – unknowingly – to make your situation worse.

Here are some Do’s and Don’ts when it comes to sciatica.

The Dont’s:

1. Avoid resting in bed or on the couch.

While it may feel better in the moment – lying in bed or on the couch will ultimately aggravate your sciatica. Sciatica is caused by pinching or irritation of the nerves in your lower back. When you lie in a slouched posture (such as in bed or on the couch) you will put unwanted pressure on these nerves, thus aggravating your symptoms.

The trickiest part about this is that you typically won’t notice the aggravation when you’re resting. You’ll notice it after the fact when you stand up or try to move around, and mistakenly assume the movement is what’s aggravating you instead of the relaxed posture you were just in.

2. Avoid child’s pose and stretching forward.

This is another big misconception about sciatica because it tends to feel really good when you’re “in the moment” and stretching your back forward. Not always, but often, sciatica is caused by a bulging or herniated disc that is pinching your nerve.

The position of bending forward does temporarily relieve pressure on your nerves – which is why it feels good at first – but it doesn’t last.

Stretching forward also opens up the space between your vertebrae. This can influence the protrusion (bulging) of your disc. If you allow your disc bulge to protrude more onto that nerve – your nerve will become more angry and aggravated – as will your sciatica.

3. Don’t let your MRI decide treatment.

As I mentioned in our first two examples, sciatica often involves bulging discs and irritated nerves. And an MRI will typically confirm this. But here’s the thing – tons of people out there have bulging discs showing up on their MRI’s and no symptoms at all.

What matters is whether or not your bulging disc is interacting negatively with your nerve – and that is typically influenced by poor movement strategies.In other words, if you learn how to move better, you can actually make your bulging disc inconsequential and your sciatica will dissipate.

So you should never let your MRI, alone, determine your treatment protocol when you’re suffering from sciatica. What’s more important is how your sciatica symptoms behave during movement. Research has shown this to be more reliable than imaging alone because it tells us in real time what’s happening to your nerves.

The Do’s:

1. Keep moving.

While it may seem counterintuitive to move when you’ve got pain running down your leg – it’s one of the best things you can do.

Try to stand and walk upright as much as you can and pay close attention to what happens in your leg. If the symptoms in your leg start to subside, then you’ll know that your body is enjoying that particular movement and that it’s helping your sciatica.

But here’s the catch – make sure the relief lasts. Lasting relief (vs temporary) is what we’re looking for and it tells us if the movement you’re doing is a good thing for your sciatica.

2. Watch your Posture.

This may seem trivial – but maintaining good posture is critical when you’re suffering from sciatica. Remember that sciatica typically involves a pinched or irritated nerve – and irritated nerves are highly sensitive to postural changes in your lower back (especially slouched postures).

Whether you’re standing, sitting, or lying down – be sure to maintain a small curve in your lower back to minimize your slouch. This helps to keep pressure off your discs and already aggravated nerves.

3. Talk to a Movement Specialist.

While it’s entirely possible to rid yourself of debilitating sciatica without pain pills, procedures, or surgery, you’ll find it easier to do so under the guidance of a movement specialist who specializes in understanding back pain and sciatica.

Yes – you can get an MRI and go see a surgeon – but they aren’t movement specialists. They are surgical specialists. In order to get rid of your sciatica the natural way (with corrective movement strategies) – you need to work with someone who’s an expert in this.

Have you been dealing with back pain or sciatica? Or do you know someone who is?

If you”re local Portsmouth, NH, and you want help NOW for your back pain – Request a Free Discovery Session from one of my specialists. They’ll tell you if we can help and get you set up on a treatment plan right away!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

Back Surgery

Back Surgery: Why it fails and do you need it

Approximately 500,000 Americans undergo back surgery to relieve their pain every year, and according to the Agency for Healthcare Research and Quality (AHTQ), this costs approximately $11 billion annually.

But what if I told you that only 5% of people undergoing back surgery actually need it – and worse – for many folks the pain ends up coming back. The American Society of Anesthesiologists estimates that 20-40% of back surgeries fail. If you’ve had repeated back surgery your risk of failure increases. Failed back surgery is so common that it’s gotten its own name – “Failed Back Surgery Syndrome” – which occurs when you experience continued pain in your neck, back, or limbs following any spine surgery meant to reduce pain.

So why then do we continue spending so much money on back surgery when the majority of people don’t actually need it – and when half the surgeries fail?

Back pain can be excruciating, debilitating, and have a significant impact on your quality of life and happiness.

If you’re in this situation, and told by a well-respected surgeon that surgery is your best option of taking your pain away and getting you back to living your life again, odds are good you will take that opportunity. And most of the time – surgery does take your pain away – initially that is.

But what surgeons don’t tell you is that your pain has a high likelihood of returning.

If you’ve had one “successful surgery” – you assume the next will go the same. But as mentioned above – the more back surgeries you have – the more likely they are to fail – and the vicious cycle begins.

So when should you get back surgery?

If you’ve had an accident or trauma that has resulted in major damage to your spine – you need surgery.

If you have urgent compromise to one of your spinal nerves you also need surgery. But let me preface “urgent”.

Your symptoms will be progressive and severe.

Signs might include problems with your bowel and bladder, sudden and worsening foot drop (loss of strength and ability to lift your foot and toes), walking will be difficult and progressively worsen, and nothing will take your pain away – medication and rest will barely touch your symptoms.

These cases are rare – but do require surgery to quickly decompress your nerve before permanent damage ensues.

But 70-80% of the time, back pain is what we call non-specific or mechanical.

And surgery is not recommended – and rarely works for this type or back pain.

Mechanical back pain can be acute and last for a few days, or can be chronic and come and go. You might have nerve pain with numbness and shooting pain down your leg, but it won’t be urgent like the situation described previously. The pain you feel is typically caused by irritation to soft tissue structures, discs, muscles, and joints. But the root cause of this irritation is from something different – and that is what we need to care about.

It’s why 50% of back surgeries fail.

Let me explain…

When you get an MRI to see “what’s causing” your back pain – it will typically show some form of bulging disc, degenerative discs, or lumbar stenosis. You will likely be told that these findings are what’s causing compression and irritation to your nerves.

They might try injections and medication first, but when that doesn’t work, they’ll recommend surgery. But here’s the catch. These findings show up in 60-80% of all MRI’s when you’re over the age of 50. But not everyone with these “abnormalities” has back pain.

In other words, you can have two people of the same age, with equal-looking MRI’s, and one will have pain while the other doesn’t.

How does that happen?

What research has shown over the years is that what shows up in your images rarely correlates with what’s causing your back pain.It’s why so many back surgeries fail – because we are messing with “abnormal” findings that are in fact – quite normal for your age. So if the structures aren’t the problem – then what is?

Most back pain comes from poor movement habits and lifestyle.

Over time, repeated, unbalanced movements will exacerbate or cause irritation to these structures that are considered “findings”. But you can’t fix your back problem by only addressing where the symptoms are.

You have to address the root cause. This is typically some combination of restoring full and free mobility in your spinal joints and balancing out flexibility and strength. When you move correctly – these structures are no longer bothered – and neither is your back.

I know what you’re thinking – this sounds way too simple and perhaps you’ve already tried physical therapy or something similar and it didn’t work. Sadly, not everyone understands – or even agrees – with the concept of mechanical back pain in the way I’ve just explained it.

But trust me, when you find someone who does, you’ll be amazed at how easy it is to fix your own back. You can then keep the pain gone – without ever having to see the inside an operating room.

Back surgery can be costly – both to your bank account and mental well being.

That’s a lot of money to risk when there’s only a 50% chance of the surgery working. There’s an even better chance that your pain will come back. If there’s a complication of any kind, then you’re looking at more surgeries. This is an almost certain loss in quality of life.

It’s worth it to do your due diligence. Find a movement specialist who understands mechanical back pain and can keep you out of the operating room.

If you’re dealing with back pain now and want to learn more…

We will be talking all about this and more in our upcoming Masterclass for Back Pain & Sciatica Sufferers.

The Masterclass is free – and happening on January 24th from 6-7 pm via zoom. Reserve your seat HERE – spaces are limited – and there’s a limited number of spots left.

2 Reasons People Over the Age of 50 Avoid Exercises

Three Reasons Back Pain Sufferers Avoid Exercise (and what you can do)

80% of the population suffers from what we call “non-specific low back pain”. Low back pain is typically chronic, comes out of nowhere, you have good days and bad days, and it’s not usually due to any recent or major accident or fall. If you’ve got back pain and you’re reading this – odds are pretty good that you suffer from non-specific low back pain. Research shows that exercise is the best treatment for non-specific low back pain.

But what do you do when your back pain keeps you from the thing that’s supposed to help you?

Here are three of the most common reasons I see that keep people low back pain from exercising – and some tips for what you can do:

1. Fear

Let’s face it – back pain is scary.

This is the number one reason back pain sufferers don’t exercise. Is the pain you’re feeling good or bad? Should you be feeling any pain at all? Pain is confusing. When you experience pain during exercise, it can be difficult to know if it’s normal or a warning sign. For many, the safest thing to do (as they see it) is avoid any exercise or movement altogether until the pain subsides.

The problem is – when you try to resume movement again – the pain comes right back – and then you’re caught in a vicious cycle.

What you need to figure out is which movements are “good” and which movements are “bad” – and the good news is your body is going to tell you. If you hurt a little at first – but feel better the more you do something – and aren’t worse after – you can consider that movement generally safe and be encouraged to keep trying it.

But if you hurt during – and feel worse after – then that’s a sign to stop and back off. Pain is not something to fear – it’s just information. What’s important is how your back pain behaves over a period of time with a certain activity.

Fear of pain comes from not knowing what it is or what to do – but when you figure out how to “speak pain” – the fear goes away and you can have control over your body again.

2. Bulging Discs

Most people who suffer from long-standing low back pain eventually find themselves getting an MRI. And 60-70% of the time, it will show one or more bulging discs.

If you’ve been following me for a while, you know that most people over the age of 40 walk around with bulging discs – and that 65% of them feel no pain at all. In other words, if you’ve got a bulging disc, you can’t be certain it’s the cause of your back pain. Research proves this. And being told you’ve got a bulging disc is not a reason alone to avoid exercise.

Movement is actually one of the best things you can do for a bulging disc.

It may require some customization of your current exercise routine, but a movement specialist can help you with this. Don’t just stop or avoid exercise altogether just because you’ve been told you have a bulging disc. Go back to the rules of pain I mentioned above and let that be your guide instead.

3. You Were Told to Rest

Well-meaning doctors and family members who aren’t up to date on the latest back pain research will advise you to rest every time you experience back pain.

This might be reasonable advice when you’re dealing with an acute (sudden) episode of back pain – but it’s terrible advice for chronic, non-specific low back pain sufferers.

Rest is one of the worst things someone with chronic back pain can do. Since most people don’t have a thorough understanding of this concept, they find themselves in a yo-yo effect.

They rest to “heal” their back pain. When it’s gone they return to exercise – only to hurt their back again. I’ve seen so many people fall victim to this perpetuating cycle and it’s a big reason why so many back pain sufferers just give up on exercise entirely.

If it’s been a long time since you’ve exercised – start with 10 min of daily walking.

Walking is generally known to be one of the best things you can do for back pain. If for some reason walking increases your back pain – then that’s a good reason to see a back pain specialist (ideally one who understands how to heal your back with movement versus pills and procedures).

If you’re suffering from chronic, non-specific low back pain – and you’ve stopped exercising – know that you’re not alone.

This is such a confusing topic and there are so many mixed messages out there about what the “right” and “wrong” thing to do is. Don’t try to go at it alone. Exercise is good for your back, but you may just need a little help and guidance to get there.

Need help with Back Pain now? Are you Local to Portsmouth, NH? CLICK HERE to speak with one of my specialists. We will see what’s been going on with you – and get you on a treatment plan right away.

We will be talking all about Back Pain in our upcoming Masterclass! Its free – via zoom – on January 24th. Reserve your seat here!   Learn how to manage your back pain on your own – and get back to doing the activities that you love – pain free!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

back pain

Ignoring Back Pain could Sabotage Your New Year’s Goals

Now that the Holiday’s are behind us – many people start to shift their focus to New Year resolutions.

According to statista.com – the three most popular New Year goals are:

  1. Doing more exercise and improving their fitness
  2. Losing weight
  3. Saving money

Would you be surprised to know that if you are currently suffering from back pain – and you continue to ignore it – it could significantly impact your chances of success at achieving any of these goals?

Let me explain.

Let’s start with doing more exercise and improving fitness…

Most people think that if they start exercising more – especially their core – it will solve their back problem. Not necessarily.

While the research studies show (overwhelmingly) that exercise is one of the best treatments for back pain – what they don’t reveal is that there are typically some key things that must be in place in order for exercise to be effective.

For example, you must have good mobility before you start focusing on stability (or strengthening). If you’ve got a stiff back, general exercise could be all you need, and you’ll notice improvement. But you won’t know until you get going and by then it could be too late.

What if your back is stiff because it’s compensating for something – say a bulging disc or muscle weakness? If that’s the case, and you go all in with an exercise program in January, it’s only a matter of time (usually about 3 months in) before your back becomes worse, forcing you to abort your grand plan for the new year. When stability is there for a compensatory reason, it’s important to figure that out before adding more exercise or strengthening to the mix. This is one way back pain could derail your New Year’s resolution of doing more exercise and improving your fitness.

Say you want to lose weight this New Year.

This is a fabulous goal. And if you’ve got back pain, losing weight will surely help. But once again, it’s critical to understand why you’ve got back pain in the first place.

For example, being overweight is rarely the cause of back pain. A few extra pounds can certainly exacerbate your back problem, but it doesn’t usually cause back pain all on it’s own. The most common causes of back pain are mechanical (movement) problems. In other words – bad movement habits such as sitting all the time, bending and rotating too much, or having terrible posture can all lead to back pain slowly over time.

If you lose weight, but never correct these mechanical/movement problems, your back pain isn’t going to improve. When it comes to the process of losing weight, in addition to watching your diet, more exercise is often incorporated into a weight loss plan. If you’ve got back pain, it’s more than likely due to poor movement habits. More exercise will not address these, and worse, could exacerbate the problem. If your back pain increases, not only will you not want to exercise, but you could be more inclined to sit at home and eat more – completely derailing your New Year’s resolution of losing weight.

Finally – we come to saving money in the New Year!

What on earth could back pain have to do with this?

Well, you’ve probably heard the saying: “If you think wellness is expensive, try illness”. And this couldn’t be truer. When you ignore back pain, it’s only going to get more expensive to address later. As back pain worsens, you’ll have less willpower to bear it, and you’ll be more likely to opt for expensive fixes such as outpatient procedures and surgery. Not to mention the rehab that needs to take place afterwards for an optimal recovery and the expensive tests that need to take place before-hand to ensure you’re ready for surgery.

When you ignore a back problem it’s only a matter of time before it becomes unbearable. And when we’re desperate, we make poor decisions, which often leads to more money spent than necessary. All that money (and more) that you set out to save as part of your New Year’s goals eventually goes to waste. Instead, get in front of your back pain.

For 80% of back pain cases, there is a natural, movement-based solution.

Natural solutions are far less expensive – and much safer long term compared to something like surgery. While the impact of ignoring back pain may seem indirect when it comes to a New Year’s resolution of saving money – it will impact you in some way – at some point – in a monetary way if you don’t address it now.

When you’ve got back pain (or any pain for that matter) that isn’t going away, it’s your body trying to tell you something. Don’t ignore it. It’s only a matter of time before it gets worse and starts to derail more than just your New Year’s goals.

If you want to stop ignoring your back pain and you’re ready for some help – talk to one of my specialists! They’ll let you know if we can help – and if you’re a good fit for what we do. CLICK HERE to request a Free Discovery Session with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

back pain

Want to lose weight in the New Year? Don’t let knee or back pain get in your way.

If you google “Top 3 New Year’s Resolutions” – you’re sure to find “losing weight” as one of them. While I’m not a dietician or nutritionist, I know that the majority of weight loss has to do with what you eat. However, exercise plays a role too, and that I am an expert in. 

Exercise stimulates endorphins and makes you feel better all around. The better you feel, the easier it will be to stay motivated about your weight loss goal. Exercise also helps you burn more calories – which certainly isn’t going to hurt your weight loss journey.

But if you’ve got unchecked knee or back pain, not only will you find it challenging to exercise, you are going to be more stressed about it. Stress increases cortisol which interferes with your ability to manage weight. And if you can’t exercise at all because of pain, that will make it even harder to manage stress, never mind your weight. You can see how this vicious cycle from unwanted knee and back pain could completely derail your New Year’s goals.

Here are four tips to help you not let knee or back pain get in the way of losing weight in the New Year:

1. Mobility Before Stability

Your muscles can’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a joint that isn’t moving at its best, or you’ll encourage compensation. If your nagging back or knee pain is due to inadequate mobility, you’ll run into problems (and more pain) if you suddenly increase your exercise or activity level. We saw this happen at the beginning of the pandemic. People started walking and exercising more and we saw a huge influx of unexpected back and knee pain as a result. Their joints weren’t accustomed to moving so much and it highlighted the lack of mobility and compensations. Don’t let the same thing happen to you. Make sure all of your joints, including your spine, can move fully and freely without any pain before you begin a new exercise program.

2. Pace Yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember… the tortoise (not the hare) won the race. It’s important to not beat yourself up if you’re not seeing immediate results. If you’ve been out of shape for a while and doing something completely new, expect to be sore. But if you’re limping around for days or experiencing sharp pain in your back or knee, there is a chance you overdid it or worse case injured yourself. My general rule of thumb is to monitor your soreness on a scale of 1 – 10. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise they haven’t tried in a while. If you find that your pain level goes above a 5, or persists at that level (or higher) for more than a day, there’s a chance you’re overdoing it and setting yourself up for an unwanted injury. When in doubt, listen to your body. And if you’re not sure what it’s saying – enlist the help of an expert.

3. Stay Hydrated

Most people don’t drink enough water during their regular day, never mind when they increase their activity level. Drinking lots of water has two great benefits: It will give you the extra hydration you need if you’re planning to be more active; and it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day is to begin with 10 oz of water first thing upon waking. And a good rule of thumb when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

4. Get Assessed by a Mechanical Pain Expert

If you’ve already got some nagging back and knee pain, do yourself a favor and get assessed by a mechanical pain expert before you begin your new exercise routine. Your first thought might be to go see your medical doctor – but it’s important to understand how different medical professionals assess different problems. Medical doctors are trained to screen your whole body and typically rely on imaging to make their diagnosis. This is a great approach if you’ve had an accident, trauma, or are presenting with what could be a serious pathology. But for 80% of musculoskeletal pain – including knee and back pain – X-rays and MRI’s are overkill and you risk being led down a path of unnecessary referrals, treatments, and procedures – and you definitely risk being told not to exercise at all. A mechanical pain expert, on the other hand, is trained to assess your pain with movement tests – not imaging. This is going to reveal a much more realistic picture of what you can and can’t do – as well as what movements will make you better or worse. This allows you to go into a new exercise routine with a much more informed approach and ideally, a plan to exercise around your pain and eventually make it better.

If exercising more and losing weight is part of your New Year plan – I hope these tips help you go into 2023 with confidence. But if you’ve got lingering or unwanted knee or back pain that’s not going away on its own – get it checked.

 

Are you local to Portsmouth, NH? – CLICK HERE to speak with one of my specialists. We will ask you about what’s been going on – and see if we would be a good fit to help!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

avoid back pain when raking leaves

5 Tips to Avoid Back Pain when Raking Leaves

We are in peak leaf-raking season right now in New England.

Leaves are everywhere – and the daily sound of leaf blowers in my neighborhood has become somewhat meditative.

I love Fall – but I don’t love raking leaves. And raking leaves is even worse when you’re suffering from back pain.

The good news – it’s not as hard as you think to avoid back pain while doing this repetitive, monotonous activity…

Here are 5 tips to help you avoid back pain when you’re raking leaves:

1. Take a walk before you start.

Walking is a really great activity for your back in general, but it’s also a really easy way to warm-up your entire body ahead of an hour or more of repetitive raking. Personally, I love nothing more than taking a walk in the cool, crisp Fall air.

Why not take a quick walk around the block before you get into your raking?

This simple activity will bring blood flow to your arms, legs, and spine – and get all your joints moving and warm ahead of the full body activity that is raking.

2. Stretch every 30 minutes.

The biggest “danger” to your back when it comes to raking leaves is the repetitive nature of it – specifically the frequent bending and rotation of your spine.

Our spines were designed to hold us upright, not to bend and twist over and over again in the same direction. One of the simplest ways to protect your back while raking leaves, or any other repetitive activity, is to take quick and frequent rest periods to stretch. Every 30 min or so, stop what you’re doing, and give yourself a simple stretch backwards. This very simple action can go a long way in avoiding excessive back pain while raking.

3. Bend with your legs and hips.

As mentioned above – one of the worst activities for your lower back is repetitive bending and rotation – which is very easy to do if you’re not paying attention while raking leaves.

One way to avoid this is to use your hips and legs to bend and rotate. Using your legs and hips to bend and get lower to the ground when raking minimizes the bending at your spine – and pivoting at your pelvis to throw the leaves away minimizes the rotation to your spine.

Don’t get me wrong, your back will still likely be sore after taking even when “doing everything right” – but the stress will be significantly less and can help you avoid throwing out your back a day or two later – because yes – this is the timeframe when it will usually occur if you didn’t use good habits while raking your leaves.

4. Engage your core.

You don’t need six-pack abs to prevent back pain while raking leaves, but being mindful of your core can be super beneficial and it certainly won’t hurt you. Most back injuries occur when you least expect it… coughing, sneezing, picking something light off the floor.

These activities are so mindless and automatic that you’re typically not paying attention to what your core might be doing – or not doing. Raking leaves is an equally mindless activity. Each time you pull the rake toward you or lift it, think about drawing your belly in and engaging your abs. This will help keep your spine more supported and stable while raking.

5. Keep moving afterwards.

What you do after raking is equally as important as what you do during to help prevent back pain.

One of the biggest mistakes people make after a repetitive or strenuous activity (like raking) is to slump on the couch or recliner and rest. This is one of the worst things you can do to your spine because it’s more pliable and vulnerable after strenuous activity. When you put yourself in a relaxed and sustained bending position – after all that repetitive bending – it can be the icing on the cake.

You go to stand up and “boom” – there goes your back. I see it all the time. Do yourself a favor and go for another walk after raking to cool down, and be mindful of the posture you rest in after all that hard work.

Hopefully these tips give you a few things to think about before you go raking, and most importantly, avoid unwanted back pain so you can enjoy this beautiful fall season.

Are you local to Portsmouth, NH and looking for help with your back pain?

Consider speaking to one of my specialists.

You can tell us everything thats been going on and we’ll see if we’re fit to help you – and give you all of the information you need to make the best decisions for your health.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected]

Three Ways to Keep Your Back From "Going Out"

Three Ways to Keep your Back from “Going Out”

Four out of five people will experience a debilitating back pain episode at one point during their lives.

Typically, we put more effort into caring for our backs during those times than when we’re feeling good. But it’s critical that we take good care of our backs all the time, not just when we’re in pain.

The real secret to keeping your back healthy is in your daily habits.

Here are three ways to take care of your back on a daily basis so that you can keep it from “going out”:

 

1. Avoid sitting for prolonged periods.

When we sit for too long, the burden of our weight is placed abnormally on our spine and can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution?

Limit your sitting to half-hour periods with a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. In other words, if you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. I give this advice to every single client I have who comes to see me with back problems, and it’s one of the easiest ways for the average person to prevent a debilitating back problem over the long term.

2. The curves in your spine matter

We have natural curves in our spine that help us handle stress and loads. Whether sitting or standing, it’s important to maintain these curves. When standing, our spinal curves occur more naturally and are usually easier to maintain. But when we sit, the protective curves in our spine are harder to maintain and often disappear, and you’re often completely unaware it’s happening.

While strong back and abdominal muscles are an important component to maintaining a healthy back, they do very little when it comes to sitting and maintaining those curves, which is a common misconception in the medical and fitness community.

Fortunately, the solution is simpler than you think. Using a lumbar roll every time you sit goes a long way in helping you maintain the natural curves in your spine – and with minimal effort or thought. The good news is you can craft one quite easily on your own using a small towel roll or pillow. Simply place it between the small of your back and the chair and it will help you to maintain the natural lordosis (or curve) of your lower back. Give it a try. You’ll be amazed at how effective this one simple tip is for helping to control and prevent back pain.

(Did you know we have Lumbar Rolls right here in our Portsmouth office? Email [email protected] if you’re local and want to get one)

3. Extend instead of bend.

Did you know that the average person bends or flexes forward between three and five thousand times per day?

That’s a lot of bending over time and eventually something will give – and it tends to be your lower back. Our spines crave balance, but unfortunately, our modern-day lives are designed to have us bending forward more than we should. Sitting in front of a computer, putting shoes and socks on, driving, house and yard work, even brushing our teeth are all daily activities that involve bending forward in some way.

To combat this, we need to make a concerted effort to extend instead of bend. A really simple exercise you can do every day is to stand and extend your spine. Place your hands on your lower back for support and then arch back as far as you can go. Repeat this 10 times, at least once per day. If you’ve never arched your back like this before, it may feel stiff or even hurt a little at first. But with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days. If it doesn’t, or becomes troublesome for you, then it’s important to speak with a specialist.

Getting rid of a back problem really isn’t as complicated as you think – and it could be as easy as starting with simple tips like these.

These tips are considered basic “back hygiene” that everyone should consider incorporating into their daily routine. But if you’ve had several back pain episodes year after year, or every few months, these tips may only take you so far and it’s important to enlist the help of an expert.

CLICK HERE to request a FREE Discovery Call with one of my specialists.

Someone from my client success team will call you right away and see if you are a good fit for what we do.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

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How MRI’s Lead Back Pain Sufferers to Unnecessary Procedures

Have you ever had back pain and wondered…

Do I need an MRI to figure it out? One of the most popular questions and concerns I get from clients is whether or not they need an MRI when they are experiencing back pain or sciatica. It’s pretty standard protocol when you go see a doctor – but is it necessary?

In most cases… NO.

About 70-80% of back problems, even sciatica, are considered mechanical in nature and quite normal. That means there isn’t anything “serious” causing your pain.

Serious causes of back pain include things like a tumor, infection, fracture, or severely compromised nerve. Your symptoms will be pretty specific and obvious to a back pain specialist – and will typically require advanced medical intervention. An MRI can be useful in these cases to get more clarity before medical intervention begins. But when your back pain is mechanical in nature, an MRI is more often than not misleading – and may lead to unnecessary procedures or surgery.

If you’ve had back pain for years, it comes and goes, or you’ve had relief in the past from things like physical therapy or chiropractic treatment…

You most likely have mechanical back pain.

The root cause of mechanical back pain can NOT be diagnosed by an MRI. And if your back pain falls into the mechanical category, and you get an MRI anyway, you can end up with treatments you don’t need. Over the years, I’ve seen SO many people with mechanical back pain get major medical procedures that were irreversible and made them worse.

Here’s the problem….

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. Everything from bulging discs, arthritis, stenosis, and degenerative discs, which are all considered normal as we age, but are usually NOT the root cause of your back pain.

What typically happens is the MRI finds them, and your back pain gets blamed on them.

But what we know from research is that all those common MRI findings I just mentioned rarely correlate with what’s actually causing your back pain. Research has shown consistently that you can have two people with identical MRI’s showing something like bulging discs and arthritis, but only one of them will be suffering in pain.

That’s how we know the root cause of your back pain is coming from something else!

One notable study was the Lancet series – three published papers that investigated how MRI findings related to the treatment of back pain. Martin Underwood, MD, co-author of the Lancet series, and professor at Warwick Medical School, is quoted in The Guardian saying: “If you get into the business of treating disc degeneration because it has shown up on an MRI, the likelihood is that, in most of those people, it is not contributing to their back pain.”

If you notice that certain positions or movements relieve your back pain, or you feel better after walking and exercise, your back pain is likely mechanical in nature, and you don’t need an MRI to diagnose you. Mechanical back pain responds to specialized movement therapy and a selectively progressed exercise protocol. Mechanical back pain does NOT respond well in the long run to injections, procedures, or surgery, which is what you can end up with if you get an MRI and don’t really need one.

I can’t tell you how many people I’ve seen over the years get surgery for a bulging or herniated disc only to find that it didn’t help their problem – or it came back again with a vengeance. And once you have surgery, mechanical back pain can actually become more difficult to fix because your tissues and ligaments are now compromised from surgical scarring, no matter how minimally invasive they say your surgery will be.

If you’re confused, I don’t blame you.

We’ll be talking all about this and more in our upcoming Masterclass for Back Pain & Sciatica sufferers!

We’ll be going over why so many people suffer from back pain, how to tell if your back problem is mechanical or if you’ve got something more serious going on, why MRI’s are so confusing and may lead you to getting unnecessary procedures and surgery…

Spaces are limited – so be sure to reserve your seat today so you don’t miss out 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

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Failed Back Surgery Syndrome? You’re not alone.

Back pain impacts approximately 80% of the population and the response to that has been more and more back surgeries being performed each year. However, despite more surgeries being performed, people aren’t having any less back pain. In fact, those that do get back surgery only have success rates of 50%, and after a few years, their results are no less successful than those who chose to have conservative interventions such as physical therapy and exercise for the same problem.

The American Society of Anesthesiologists estimates that 20-40% of all back surgeries fail. That statistic gets worse for patients who have a second surgery, estimating that only 30% of second back surgeries are successful. Should you have a 3rd or 4th surgery your success rate plummets. Only 5-15% of 3rd and 4th back surgeries have successful outcomes. Despite these statistics, approximately 500,000 Americans are still undergoing back surgery every year to relieve their pain. The Agency for Healthcare Research and Quality estimates that back surgery costs us $11 billion annually. That’s a lot of money to spend on something that isn’t even guaranteed to work. 

So why are we spending so much money on back surgery when for almost half of these people (and in some cases more), it’s not even successful?

Well – problem number one is if you’re dealing with excruciating, debilitating back pain that is having a significant impact on your life and happiness – surgery is often a very attractive option. If you’re told surgery will take away your back pain, which it often does in the short-term, why wouldn’t you want to choose this approach?

The second major problem is with the way back pain is typically diagnosed. Nowadays, doctor’s rely on imaging (X-rays or MRI’s) to decide what’s wrong with you and to formulate a treatment plan. They rarely take the time to talk to you about the events that led to your back pain, examine the way you move, or make certain that what shows up in your images is actually responsible for your pain.

For example, if they see a bulging disc and you’ve got coinciding leg pain – they assume that’s the source of your problem and recommend you cut it out. If you’ve got severe degenerative changes or stenosis in your spine, they recommend fusion.

What’s the problem with this approach?

Well, things like bulging discs and degenerative changes, among many other findings that show up in MRI’s and X-rays, are quite normal. They occur naturally as you age. It’s no coincidence that before the invention of MRI’s – there were far less surgeries being performed. What we do know is that 50% of the time, back surgery fails. Could it be because we are going in and tampering with structures that have nothing to do with the source of our back problem?

Let me explain.

We now know from research that 70-80% of all back pain is considered “mechanical” in nature. Meaning, the root cause or your pain is due to restrictions in your joints or soft tissue that impact the way you move. This, in turn, can make surrounding structures very angry and lead to pain. Findings such as bulging discs, disc degeneration, and stenosis are all a normal part of aging and there are plenty of people out there who have these exact same findings on their images – yet have no pain at all. That’s because for some, their joints move fully and freely, and these (normal) abnormalities don’t give them any trouble. But for those whose joints do not move well, that bulging disc has a better chance of getting irritated or causing something else (like a nerve) to get irritated. Removing the disc, or fusing your spine, won’t take away your underlying mechanical movement problem. It will put a temporary band aid over it until the problem either re-occurs – or shows up in another section of your spine – often years later.

Does this help you to understand why so many back surgeries are unsuccessful? 

It’s such a common occurrence they even have a name for it – “Failed Back Surgery Syndrome”. When your back pain is due to a mechanical problem – such as an underlying movement or mobility issue – surgery will not fix this. Additionally, MRI’s and X-rays can’t accurately diagnose it. When you do have surgery, you end up prolonging your problem further. Because you think that just because your back pain is gone, your problem is gone.

It’s only a matter of time before your pain returns, and it’s usually worse. Plus, your mechanical problem becomes more challenging to address once you’ve had surgery. But the good news is that it’s still possible to address it without a second back surgery. And it’s possible to address debilitating back pain without a first surgery altogether.

So if you’ve got back pain and are considering surgery, definitely think twice and be sure you’ve been fully examined by a mechanical back pain expert first. And if you’ve already had back surgery and it failed, still talk to a mechanical back pain expert. 

Remember that the odds of success for second and third back surgeries are very low. Even after a failed back surgery, it’s still possible to learn how to address back pain on your own and get back to doing everything you love. 

Did you know that we specialize in back pain – and have helped thousands of folks learn how to treat back pain completely on their own?

CLICK HERE to talk to someone from my team – especially if you’re considering back surgery and want to make sure you’ve explored ALL possible alternatives first.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

Three Ways You’re Getting Back Pain Treatment Wrong

If you’re over the age of 40 and reading this, odds are pretty good that you’ve experienced back pain at least once in your life. In fact, four out of five people are impacted by back pain, and for many, it’s a constant back-and-forth year after year.

The first thing you need to understand is that back pain is normal. It’s hard to combat the everyday stressors our modern-day lifestyles impose on our spine. We simply weren’t meant to sit for hours each day or be crouched over electronic devices. Rather than have unrealistic expectations about pain-free lifestyles, we should instead be focusing on ways to naturally manage our own back pain.

Now keep in mind, I make a living off helping people recover from debilitating back pain. But that doesn’t mean I want you to suffer. Here are three ways we’re getting back pain treatment wrong.

1. Quick fixes and passive modalities.

Reliance on quick fixes or passive modalities is how most people attempt to treat their back pain. It’s also the number one reason why back pain returns. A passive modality is something that is done to you vs something you actively do on your own. It’s where you walk in somewhere, lie on a table, and receive some kind of treatment. This could be chiropractic care, massage, acupuncture, or even injections and surgery. You have no active role in the process – it’s completely passive.

Now, I’m not saying there is anything wrong with these treatments. They are great for easing symptoms related to back pain – especially tight, spasmatic muscles. (I have back pain myself and get a massage once per month.) But they shouldn’t be used in isolation. They need to be part of a more comprehensive, movement-based approach to addressing back pain at its source. Plus – you’ll find the relief you get from passive modalities is almost always temporary. And when your pain keeps coming back – it’s a sure sign you’re missing something. Don’t get back pain treatment wrong by relying on passive modalities.

2. Letting MRI’s make the decision.

Traditionally, the medical community diagnoses your back pain with images. If you’ve had back pain for a while, and especially if you’ve already tried some physical therapy, doctors will prescribe an MRI to “see what’s going on” inside your spine. The problem is that what shows up in your MRI doesn’t always correlate with what’s causing your back pain. In fact, 60% of the time, what you see on your MRI has nothing to do with the root source of your problem.

For example, your MRI might show a bulging disc in your spine. Well, did you know that bulging discs are normal and occur naturally as you age? You could have two people with the same bulging disc on their MRI and one will have zero back pain.

Why? Because the root cause of back pain is more complicated than your anatomy. Evidence from research tells us that 70-80% of all back pain is primarily caused by restrictions in your mobility – which is influenced by your habits and the way you move – not by what’s going on structurally in your spine.

So if your doctor lets your MRI make the decision, and recommends surgery to cut out a bulging disc that isn’t even the source of your real back problem, you’ve not only wasted a surgery, but wasted even more time not addressing the real cause of your pain. Letting MRI’s dictate your treatment plan is one of the most overlooked ways we’re getting back pain treatment wrong.

3. The wrong exercises.

One of the biggest problems I see when it comes to treating back pain is non-specific, non-prescriptive, generalized exercises that are designed to make you strong and perhaps even target your core – but it’s before the real problem gets addressed.

Almost 90% of the time, back pain is due to immobility in your spinal joints (vertebrae) that causes irritation of surrounding structures in your spine – such as discs, nerves and ligaments. What we know to be true is that these mobility restrictions can be freed up with very specific movements, in very specific directions, using a very specific frequency during the day.

Once the restriction in your spine is free and you’re moving normally, you can do any exercise of your choosing. It’s at this point that strengthening your core, for example, is beneficial. Because a strong core helps prevent future back pain episodes (but it doesn’t cure a current back pain episode).

To figure out which specific move you need to address your back pain will require help from an expert. But the good news is once you know what movement gets rid of your back pain, you can use it time and again to manage it on your own. But generalized exercises, when done too soon, is another big way we’re getting back pain treatment wrong.

If you’ve been suffering from back pain longer than you should, I hope this information helps you figure out where you might have been steered wrong.

It’s worth getting help from a back pain specialist who emphasizes corrective, prescriptive movement as a means to recovery – vs quick fixes, MRI’s, and generalized exercises.

Want help from one of our specialists? Request a Free Discovery Call HERE to see if you’re a good fit for what we do.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or visit her website at cjphysicaltherapy.com.