Back Surgery

Before Back Surgery – Try specialized physical therapy first

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Approximately 500,000 Americans undergo back surgery to relieve their pain every year.

But the American Society of Anesthesiologists estimates that 20 – 40% of those surgeries fail – leaving folks worse off than before they were considering back surgery in the first place. And what happens when your first back surgery fails? You get a second surgery – and maybe even a third – to try and repair the failure. Once you go down that rabbit hole – your chances of success after back surgery drop significantly – down to a mere 5-15% success rate.

Knowing this, why do so many doctors and medical specialists continue to recommend back surgery without first exhausting all possible non-invasive solutions?

Well, when back surgery works, it can be a highly effective form of pain relief. So it’s attractive. But it’s important to note that within 3-5 years, according to research, many patients find themselves feeling worse than before surgery, and reverting back to relying on daily pain medication. People assume back surgery is going to be a pain-removing procedure, when in actuality it’s only a pain-reducing procedure. This was concluded by a 2003 study in the European Spine Journal that investigated the long-term success of posterolateral spinal fusion. They found only 20% of the subjects continued to be pain free after 5 years, and warned against patients relying on surgery as a long-term fix.

Given the list of potential complications from back surgery – including infection, blood clots, nerve damage, adverse reactions to anesthesia, and incomplete pain relief – it’s imperative you consider all other non-invasive treatment options first. It may take longer for you to experience pain-relief, but the results will be longer-lasting and you can avoid putting yourself at risk for irreversible complications.

Examples of non-invasive treatment options include chiropractic treatment, acupuncture, massage, shockwave therapy, therapeutic exercise, and of course, physical therapy. But the biggest objection I hear from folks against trying some of these non-invasive solutions – often for a second or third round – is that they’ve “tried it all” and it didn’t work. But more often than not, after diving in further, I find that patients have “cherry-picked” their treatment choices over the years without any real strategy – or they’re trying way too many things and all at once.

Not only does this get exhausting, but it’s ineffective. 

Passive modalities (acupuncture, massage, chiropractic treatment, etc) are great at reducing pain but you need to match them up with specialized and corrective movement strategies to make the effects last. Traditional physical therapy, Pilates, and personal trainers can all help you to feel better as well, but if the exercises aren’t specialized enough, they won’t have any effect or could even make you feel worse. Without a strategic plan, and putting all of these things together and in the right order, you’ll have  a hard time getting rid of your back pain naturally. 

Over my 22 years of working with patients suffering from back pain and sciatica, I say all of this from experience. For the first 10 years of my career I was what I call a “generalist”. I worked in traditional physical therapy settings where I followed doctor’s orders, relied on insurance to dictate what I could and couldn’t do, and I used many of the passive modalities already mentioned above along with (what I thought at the time) were the best core training and back stabilizing exercises.

It wasn’t until I went on to learn specialist techniques and truly understand how back pain actually manifested, that I was finally able to help people not only get rid of back pain – but keep it gone for good and avoid surgery. It is entirely possible to treat back pain on your own and get rid of it naturally – and then maintain and prevent it with the right types of exercise – but you really need to work with a specialist who can guide you through this process.

So what’s the difference between a physical therapy specialist who treats back pain versus a generalist?

They’ll do their own examination and come up with their own diagnosis, they won’t rely on just passive modalities to help you, and you’ll have an extremely precise and customized exercise prescription instead of a bunch of general exercises (that you could honestly learn from YouTube). If you’re suffering from a back problem and want to avoid procedures and surgery at all costs – it’s really important that you don’t just stop with general physical therapy or chiropractic treatment and assume you’ve exhausted all of your options.  Look for someone who specializes in back pain in the way I’ve just described, and has a proven track record for coming up with strategic treatment plans that last. 

Eighty percent of all back problems are mechanical in nature and come on slowly over time from repeatedly moving poorly or from your lifestyle (even when your back pain seems to have come on suddenly and out of nowhere). Because of this, all of the passive modalities, including back surgery, and general exercises in the world will not correct these problems – and your back pain and associated symptoms will continue to return until you have a full understanding of what’s going on and can correct them. When you find a specialist who can do this for you – it’s life changing. Before you consider back surgery, consider working with a specialized physical therapist, especially if you’re already tried regular physical therapy and it failed. They do exist – and if you need help finding one – please reach out. I’m happy to help you locate one in your area.

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].

5 Expert Tips to Treat Back Pain Naturally and on your Own

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Back pain impacts approximately 31 Million Americans at any given time, and our health care system spends $50 Billion per year on low back pain treatment.

It’s the single leading cause of disability keeping people out of work, and it’s the second most common reason for doctor’s visits. Back pain is a big problem in this country. But the even bigger problem, in my opinion, is how the traditional medical system treats and manages those suffering from back pain.

Despite what you may have been told, getting rid of back pain on your own is entirely possible and preventing it can be even easier.

But it starts with understanding what the true cause of back pain is for most people. Eighty percent of back pain is “mechanical” in origin, which means it’s not due to any serious pathology like cancer, infection, or fracture. Mechanical back pain is the result of abnormal or unusual forces occurring in the structures of your spine – like your ligaments, muscles, discs, and vertebrae. These abnormal forces can accumulate slowly over your lifetime or happen quickly in a single event – such as picking something up the wrong way. The good news is that if abnormal forces can cause your back pain, then reversing those forces can get rid of your back pain. Surgery and other medical procedures won’t do that. They only impact the structure or irritant that is aggravated, like when you remove a piece of your bulging disc. The goal for true back pain recovery is to eliminate what is causing those structures to be aggravated in the first place – and the best way to do that is with healthy movement you can do on your own!

Here are 5 tips to help you minimize abnormal forces on your spine so you can avoid procedures and surgery!

 

1. Stop sitting so much

Compressive forces on your spine increase by 40% when you sit – and it goes up even more if you’re slouched! Over time, these compressive forces will start to aggravate the ligaments and discs in your spine. Because it happens slowly, you may not notice right away, so one of the best things you can do is interrupt your sitting at least every 30 min. This minimizes the accumulation of abnormal forces on your spine throughout the day.

2. Walk more

Our spines were designed to be upright and moving. Walking is one of the best and easiest ways to promote this. When you walk regularly, it helps to promote good mobility and blood flow, which can act like lubricant for the structures in your spine. Walking also helps to keep your hips from getting tight. Tight hips can cause abnormal forces to occur at your pelvis, which in turn, will create abnormal forces on your spine.

3. Vary your posture

You might be wondering why I didn’t say “maintain good posture”. To be honest, perfect posture all the time is kind of a myth when it comes to back pain. The truth is your spine is quite resilient and should be able to tolerate lots of different postures – even bad posture for a short period of time – without pain. The problem is when we assume the same posture all the time. Imagine if you never straightened your knee, eventually it would get stiff and be difficult to move in that direction. The same thing happens in our spines. One of the best things you can do is choose activities (like Yoga or Pilates) that work your spine through lots of different postures and range of motion. This helps keep your spine happy and healthy and it minimizes abnormal forces from the same repeated postures or activities day after day.

4. Strengthen your core

The stronger you are, the more resilient your body is going to be – period. When it comes to back health, having a good strong core is going to minimize stress on ligaments and even discs. When the muscles around your spine are strong, it’s going to be easier for you to lift and carry things, which is one of the most common ways people injure their backs. If your abdominals, glutes, and hips aren’t doing their job, your spine ends up taking more of the stress – and this can lead to both pain and injury. Pilates is my favorite way to strengthen your core because the exercises are designed to target your abdominals.

5. Educate yourself

There is a lot of misinformation out there when it comes to both diagnosing and treating back pain. You should never let an MRI or X-ray alone dictate what your treatment should be. Remember, the structures in your back don’t get spontaneously irritated. Irritation typically occurs due to abnormal forces on your spine. If you only address the irritated structure – like with an injection, procedure, or surgery – you’re not actually fixing the problem. The best way to address abnormal forces in your spine is with movement – movement that is designed to even out the forces in your spine and relieve pressure from those structures that have become aggravated.

If you’re currently suffering from back pain and want to avoid having to resort to medication, procedures or surgery – then give these tips a try. But if you’ve tried these tips and you continue to struggle – then consider consulting with a mechanical back pain expert who can help you get rid of back pain naturally – and with corrective movement and lifestyle strategies.

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 Red Flags Your Hamstring Strain is Probably Something Else

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A hamstring strain is a common injury I see in active patients aged 40 and above. But sadly – it’s also one of the most common mis-diagnoses I see as well. 

First, what does a true hamstring strain or injury look like?

A true hamstring strain typically presents with a sudden, sharp pain in the back of your thigh. Usually during activities such as sprinting, jumping, or sudden changes in direction. The injury often occurs due to overstretching or overloading the muscles beyond their capacity. Thus, leading to microscopic tears within the muscle fibers. Symptoms typically include tenderness, swelling, and bruising in the affected area, along with difficulty walking or bending the knee. To recover from a hamstring strain, you first need to heal the injured muscle/tissue. Then properly strengthen it so it can handle all the activities you want to do. This involves some combination of rest and therapeutic movement at first, followed by carefully prescribed strengthening and loading of the damaged tissue so that it heals back strong and resilient. When a hamstring injury is accurately diagnosed, and properly rehabbed, you can return to all the activities you love and it shouldn’t bother you again.

If you’ve recently suffered an injury to your hamstring – and it doesn’t sound like what I’ve just described – then you’ll want to keep reading – because there’s a good chance it was mis-diagnosed and your treatment is all wrong.

Here are 3 red flags that indicate your hamstring strain is probably something else – and usually a back problem instead:

1. You have chronic hamstring pain

A true hamstring strain is simply an injury to your soft tissue (muscle) and it should heal with time. Now, sometimes you don’t rehab it properly, and it can result in chronic problems, but it shouldn’t be chronic pain. There’s a difference – let me explain. A poorly rehabbed hamstring is likely to cause problems elsewhere in your body (namely your hip and knee), but the hamstring itself won’t remain chronically painful. You might trigger a poorly rehabbed hamstring when you do activities that bother it, but at rest, it will be for the most part “healed”. If you experience chronic achiness, especially at rest or when you’ve been sitting for a long time, this is likely something else. Signs like this often point to an undiagnosed back problem. This is especially true if when you first hurt your hamstring it seemed to have come out of nowhere – for example – you just woke up with it one day or it came on gradually. True hamstring injuries are painful where you hurt it, and go away with time and certainly with proper rehab. A chronic pain in your hamstring that lingers for months or years, especially when you’re at rest, is probably something else.

2. Numbness and Tingling in your butt or leg

This symptom is almost always a red flag that the problem is stemming for your lower back or sacrum (tail bone area of your spine). This is because the nerves responsible for sensation in both your butt and leg originate from your spine. Your hamstring, on the other hand, is a muscle. Anatomically speaking – it can’t directly refer numbness to anywhere in your leg. With a true hamstring strain, you’ll experience localized pain, tenderness, and even swelling – but not numbness. So if you’ve suddenly started experiencing pain in the area of your hamstring, and are also having numbness and tingling in your leg, then your hamstring strain is probably due to something else – most likely a problem in your spine.

3. You feel pain below your knee

Your hamstring is the big group of muscles in the back of your thigh (you have three of them). They are responsible for flexing your knee and extending your hip. They originate from a bone at the bottom of your pelvis, deep inside your butt, and attach into various areas behind your knee. Because of where your hamstring is located, it’s impossible to feel true hamstring pain below your knee. This is a big red flag to me that the problem is likely coming from your spine. Now, it’s possible that your lower leg has begun to compensate for a poorly rehabbed hamstring strain and it’s hurting due to that. However, if you feel pain radiating from the back of your thigh, past your knee, and into your lower leg – it’s likely a back problem. Fun fact: 38% of all lower leg pain comes from a source within your spine even if you don’t have any back pain at all. So it’s very possible that pain in the back of your thigh and lower leg could be originating from your lower back.

Keep an eye out for these three red flags next time you feel pain or strain in your hamstring.

Remember that in most cases, you’ll know when you’ve strained your hamstring. With a true hamstring strain, the pain occurs at the time of injury and it’s fairly obvious. But if your hamstring pain comes out of nowhere, becomes chronic, starts feeling numb and tingly, or you’re experiencing pain below your knee – then you must consider that it could be something else – and that it’s likely a back problem. Talk to a physical therapy specialist who understands how to diagnose this properly. If you don’t get the root cause right, you won’t get the treatment right, and it will only delay the time it takes to get back to doing all the activities you love.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists by booking a free discovery visit HERE. They’ll ask you what’s been going on and see if we would be a good fit to help you 🙂

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, email her at [email protected].

Is Exercising Hurting Your Back? 5 Reasons Why.

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Is Exercising Hurting Your Back? 5 Reasons Why.

The research continues to show that the best “treatment” for back pain is exercise. But what do you do when exercising hurts your back instead of helps? 

This is one of the most common frustrations I hear from my clients. The doctor looks at their back and takes an X-ray. He or she only sees something like arthritis or degenerative disc disease. Surgery doesn’t make sense – so the advice is to go exercise – and specifically to strengthen their core. But when it doesn’t work they are at a loss.

So why would exercise hurt your back – when the research overwhelmingly shows that it’s supposed to help?  

Here are 5 reasons why your exercise routine might be causing your back pain instead of helping it:


1. It’s the wrong type of exercise

While the research isn’t wrong about exercising and back pain – it doesn’t always reveal the specifics on the type of exercise that’s being done. For example, walking is considered one of the best activities for back pain sufferers, and for the majority it will help significantly. But I also have clients who get worse just walking to their mailbox at the end of the driveway. What the research is really saying is that movement – not necessarily “exercise” – is what’s really good for back pain – even acute back pain. But you need to make sure it’s the right type of movement for your specific type of back pain. If you get the type of exercise or movement wrong – you’ll feel worse – and it’s one reason why exercise will sometimes hurt your back instead of help.

2. Stability training is introduced too soon

Stability training is an important part of back pain recovery – but I often see it introduced too soon. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. You want to make sure you explore that fully and get the spine moving the way it should be before you begin stabilizing or strengthening it. Every now and then I stabilize first, but it’s rare. More often than not I see that people with long standing back pain are suffering from a mobility problem that was missed. When your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to get irritated. You want to figure that out first before jumping ahead to stability training of your core and spine.

3. Your aren’t activating your core

Knowing how to properly activate your core is different from having good core strength. You can have the strongest abs in the world – but if you don’t use them when they count – your 6-pack abs are useless.  Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or performing complicated movements that require good coordination, you’re setting yourself up for injury.

The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. Pilates (when done properly and with a well-trained instructor) is a type of exercise that can accomplish this quite well. If you’re constantly having back pain every time you exercise or try to strengthen your core, it could be that you lack the ability to activate it when it counts.

4. You aren’t breathing properly

Not breathing properly, or not breathing at all, can significantly impact the effectiveness of your exercise routine. This directly impedes your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise. In order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abdominals, your deep back muscles, your pelvic floor, and your diaphragm. Your diaphragm is what controls your breathing.

Let’s say you hold your breath when you exercise. When this happens it means your diaphragm isn’t expanding or contracting in the way it needs to for your deep core to be fully functional. Additionally, when your diaphragm doesn’t work like it should, it adds unnecessary strain and work to your back muscles. This is one reason why you might not be able to activate your core properly – and why exercise might be hurting your back.

5. You’re using improper form

The last and most common reason why exercising might be hurting your back is because you aren’t doing it right. There’s a lot of people out there who think posture and form don’t really matter. But they do. If you’re lifting weights – especially when frequently and repetitively – you want your spine to be in good alignment. It might not hurt the first time you lift with improper form, but it will hurt when you get to your 100th rep.

Same goes for body weight exercises. Just because you aren’t adding load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. That’s really where people get in trouble. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture or it’s going to catch up to you and cause you unnecessary back pain.

If exercising is currently hurting your back – it could be due to one of these five reasons. Get expert help to figure out which one it might be – because at the end of the day – exercise really is good for your back. You just might need some expert guidance from a back pain specialist who “gets” this stuff to get there.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists. We will ask you all about what’s been going on and see if we would be a good fit to help you. Book your free Discovery Visit here.

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].

Vestibular Therapy: The Safer, More Cost-Effective Treatment for Vertigo Sufferers

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If you’ve ever suffered from an episode of vertigo, then you know how debilitating and scary it can be: Room spinning, loss of balance, barely able to walk or move… The traditional route of treatment is to get yourself rushed to the emergency room (ER), undergo a myriad of diagnostic tests to rule out anything serious (like a stroke or heart attack), and then, if they can’t find a “cause”, you’re typically sent on your way with medication and a referral to a specialist. 

Medications typically don’t do anything to resolve your vertigo but they will mask your symptoms.

And it can often take months to get an appointment with either a neurologist or ears, nose, throat (ENT) doctor. If, after this whole ordeal, you’re still suffering from dizziness/vertigo – you’re not alone. ER’s are notoriously bad at diagnosing and managing dizziness. Not only that, but it’s expensive. According to Dr. Newman-Toker, researcher and professor of neurology at John Hopkins University, the cost of emergency room visits due to dizziness now exceeds $10 billion per year. And almost half (43%) of all dizziness-related ER diagnoses are wrong. They are corrected once you get to a specialist who knows how to properly diagnose you.

So… if going to the ER when you’re suffering from a debilitating episode of dizziness/vertigo is not the best or most cost-effective treatment option… then what should you do? Enter Vestibular Therapy. It’s safer, more cost-effective, and it leads to long-term solutions that help you resolve your dizziness without medications or procedures. It’s not something a lot of people know about or fully understand – so let’s go through it to see if this is a treatment option you need and/or what’s been missing for you.

First – what exactly is vertigo – and how do you know if it can be treated with vestibular therapy?

Vertigo is a collection of symptoms, and not its own diagnosis. The symptoms you experience (dizziness, room spinning, disorientation, loss of balance) are the result of disturbances within your vestibular system, which is responsible for helping you maintain balance and spatial orientation. There are two distinct categories of vertigo: peripheral and central. Peripheral vertigo occurs when the peripheral components (located in your inner ear) of your vestibular system are affected. It’s caused by conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere’s disease – and can lead to sudden episodes of dizziness, nausea, and imbalance. Central vertigo, on the other hand, arises from problems within your central nervous system (aka brain). Causes of central vertigo include things like stroke, multiple sclerosis, or tumors – and it manifests as a more sustained form of dizziness, typically accompanied by neurological symptoms. You need the correct diagnosis of vertigo in order for treatment to work. But the good news is that 80% of all vertigo is peripheral – and can be treated naturally with vestibular therapy. Plus, when you’re first examined by a vestibular therapy specialist, they will rule in or out any vertigo that could have a central cause, and you’ll be referred to the correct medical specialist immediately.

So what is vestibular therapy and how does it work?

Vestibular therapy is a specialized form of physical therapy designed to address specific components of peripheral vertigo within your inner ear , as well as enhance the communication between your brain and vestibular system to improve your overall balance. Vestibular therapy starts with an examination (by a trained vestibular physical therapy specialist) that includes various maneuvers and specialized vision and balance tests to determine the exact type of peripheral vertigo you’re dealing with. From there, the correct treatment plan can be developed. For those that are vaguely familiar with vestibular therapy, it’s often associated with full body maneuvers such as the Epley, Semont, or Foster – which can be scary and ineffective if you haven’t been examined properly. It’s important to note there are many more components to vestibular therapy – so if you’ve tried and failed at one of these in the past – there is still hope. A good vestibular therapy specialist will incorporate interventions to work on all three of your balance systems, as well as give you additional strategies for home, lifestyle, and diet – all aimed at improving the areas of your balance and coordination system that might not be working as well as they could be. 

Vertigo is a common condition that many people are forced to face alone and without proper treatment, primarily because the education and awareness around vertigo is so limited. If you or someone you know wants to avoid medications and procedures (that typically don’t work), and treat vertigo naturally and in a more holistic way – then vestibular therapy might be exactly what you’re looking for. If you need help finding a qualified vestibular therapy specialist, don’t hesitate to reach out.

If you are local to Portsmouth, NH – click here to speak with a vestibular specialist.

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, email her at [email protected].

Vertigo

Vertigo and Fall Risk: 5 Ways to Safeguard Yourself Against Unexpected Falls

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Vertigo is often described as a distressing sensation of spinning that makes you feel as if the world is moving around you – or that you are spinning yourself. It’s an unsettling experience – and can be dangerous – as it puts you at a greater risk for falling. Over 3 million older adults are treated in the emergency room every year due to fall-related injuries. One out of five of those falls causes serious injury – like a broken bone or head trauma. 

If you are suffering from vertigo, it’s critical that you take time and due diligence to get to the bottom of what’s causing it so that you can safeguard yourself against unexpected falls. The good news is this is entirely possible. But first, it’s important for you to know that vertigo is a symptom, and not a diagnosis. Vertigo is the result of a disturbance in your inner ear (vestibular system). It can be caused by various things, namely, Meniere’s disease, benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and cervicogenic dizziness… just to name a few. Once you’ve identified the root cause of your vertigo – the correct treatment approach is possible. I can’t tell you how many horror stories I’ve heard from people suffering from vertigo longer than they needed to – all because they didn’t get the right tests to diagnose the cause – or were prescribed medication they didn’t actually need. All the while, continuing to live with a constant fear of falling and never knowing when their next vertigo attack would occur.

The reason suffering from vertigo puts you at such risk for falling is because when it comes to balance, we rely on three bodily systems. One is your vestibular system, which vertigo disrupts. The other two systems are your vision and proprioception. All three systems are responsible for helping you orient and visualize yourself in space. When you have vertigo – you’re forced to rely on (and train) the other two. 

The good news is there are strategies you can employ to compensate for a mal-functioning vestibular system.

If you suffer from vertigo – here are five simple and effective strategies that can help minimize your fall risk and enhance your safety:

  1. Remove Hazards: Roll Up and Stow Away Rugs

In a home environment, even seemingly harmless elements like rugs can pose a significant risk. Rolling up and storing rugs minimizes the chance of tripping or slipping, providing a safer space to move around, especially during vertigo episodes. Smooth, obstacle-free floors reduce the likelihood of unexpected falls and help maintain stability.

  1. Illuminate Pathways: Install Night Lights for Nighttime Mobility

Navigating through the house at night, especially when experiencing vertigo, can be daunting. Installing night lights along hallways, staircases, and near the bathroom provides essential visibility and helps prevent accidental falls. With well-lit pathways, you can confidently move around during the night, reducing the risk of missteps or collisions with objects.

  1. Exercise Caution: Walk with a Companion and Use Hiking Poles

Engaging in physical activity is crucial for maintaining health, but doing so alone when experiencing vertigo can be risky. Pairing up with a friend for walks provides both companionship and an added layer of safety. Additionally, using hiking poles offers stability and support, especially when dizziness strikes unexpectedly, allowing for more secure movement during outdoor activities.

  1. Focus and Reorient: Lock Your Gaze on a Steady Object during Dizziness

During vertigo episodes, it’s common to feel disoriented and unsteady. A practical technique to regain stability is to lock your gaze on a stable and fixed object. This method helps recenter your focus and gradually reduces the sensation of spinning or imbalance, allowing you to regain control of your body and surroundings.

  1. Safe Driving Practices: Stabilize Focus and Minimize Distractions

When vertigo strikes while driving, it’s essential to prioritize safety. If feeling dizzy behind the wheel, fixate your gaze on a stationary object—such as the dashboard or the road ahead—to regain a sense of stability. Additionally, reduce all distractions by turning off the radio and refraining from engaging in conversations with passengers. Prioritizing focus and minimizing external stimuli can help mitigate the risks associated with vertigo while driving.

While these strategies can be helpful – please know that you don’t have to let vertigo keep running your life and stop you from doing what you love. With proper treatment, you can stay out of the hospital, stop taking medication and move out of the fall risk category with the support of a good vestibular specialist. Diagnosing vertigo is a step-by-step process that starts with a detailed medical history and extends to various physical examinations. Vestibular specialists will employ a range of tests, including specialized balance assessments for fall risk, to pinpoint your exact cause of vertigo. Navigating through these diagnostic tools is crucial for developing a treatment plan that works. Once the correct diagnosis is made, treatment can begin immediately to start retraining your brain. The key is to train your brain to stop relying on the damaged part of the inner ear (that leads to vertigo and dizziness) – and help it to rely on your other two balance systems instead so that you can stay safe and improve your balance.

Interested in learning more about Vertigo?

Join us for our Free Online Masterclass for Vertigo Sufferers! It’s happening January 23rd, from 6-7pm via zoom – click here to reserve your seat before they’re all out.

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 seat in her upcoming Masterclass for Vertigo Sufferers – visit www.cjphysicaltherapy.com – or call 603-380-7902

Vertigo

6 Tips for Managing Debilitating Vertigo at Work

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“Vertigo” is the sudden onset of dizziness, spinning and nausea that often stops you in your tracks without any visible signs or warning. If you’ve ever experienced vertigo, then you know the debilitating effects it can have on your daily life and ability to work. For those that haven’t experienced vertigo – it can be difficult to explain. Your co-worker will never understand why you missed that deadline. Your boss won’t understand why you had to miss work for the past three days.  All because for 72 hours, the room has been spinning on and off, and you couldn’t spend more than five minutes reading on your computer before you felt the vertigo coming back on. 

Perhaps the most challenging aspect of suffering from vertigo is the unknown. By definition, vertigo is a symptom that occurs due to a miscommunication between your vestibular system (responsible for balance and spatial orientation) and your brain’s interpretation of those signals. When the signals are mismatched – the result is vertigo – that awful, uncontrollable sensation of spinning or dizziness.

What does this look like in real life? 

You could turn your head slightly too far or slightly too fast and bam – here comes the dizziness. You could get up from a chair or out of bed too quickly and suddenly the room is spinning. Vertigo has the ability to quickly and without notice turn the ordinary, mundane parts of your day into the scariest parts of your day… Suddenly everything from driving, working at a computer, walking to lunch, or getting up to go to the bathroom become debilitating and unreliable. Every single one of these tasks not only becomes difficult – but often the scariest parts of your day as well.  becomes the scariest part of your day. Why? Because every single one of these tasks requires balance and coordination – and when your vestibular system and brain don’t cooperate – these things become extraordinarily difficult.

While there are many underlying causes to vertigo, and only a vertigo specialist can determine this, there are some things you can do to mitigate the onset of vertigo so that it doesn’t continue to impact your work day. 

Here are tips for managing debilitation vertigo at work:

1. Utilize Blue Light Filter Glasses

Prolonged screen time can exacerbate vertigo symptoms, and these glasses work to block harmful blue light emitted by digital devices. By alleviating the eye strain associated with screen time, these specialized glasses create a more comfortable visual experience, potentially lessening the likelihood of triggering or worsening vertigo episodes during your work day – especially if your work involves extended use of the computer.

2. Wear Noise-Canceling Headphones

Noise sensitivity often accompanies vertigo. Using noise-canceling headphones can create a quieter work environment for you, minimizing any overstimulation that might trigger or worsen your vertigo episodes. When you reduce auditory input, you’ll find it easier to focus, and it will be a calmer sensory experience for you at work.

3. Opt for a Swiveling Computer Chair

A swiveling chair offers the flexibility to rotate your body when shifting between screens or tasks. This minimizes abrupt head movements, which can trigger vertigo. The ability to turn your body rather than constantly turning your head can significantly reduce the risk of a debilitating vertigo episode happening during your work hours.

4. Find a Stable Focus Point During Physical Activities

Engaging in physical tasks that might induce dizziness can be challenging. If you experience vertigo during physical movements, find a stable object or point in your surroundings and focus on it. This fixed reference point can help recalibrate your balance and reduce the sensation of dizziness.

5. Be Mindful or your Movement and Pace

Sudden and quick movements are known to trigger episodes of dizziness and spinning from those suffering from vertigo. When you mindfully and purposefully slow down – you alleviate the stress on your vestibular system. This can go a long way in helping to minimize triggers that may exacerbate your vertigo symptoms.

6. Ensure Adequate Lighting

Aside from your vestibular system, your vision also helps significantly with balance. By ensuring ample lighting in the workspace – you can help compensate for the disruptions caused by vertigo. Well-lit environments provide clearer visual cues, assisting in maintaining balance and reducing the risk of falls during a vertigo episode.

If you’re currently suffering from vertigo – or have been dealing with vertigo on and off for years – perhaps it’s time to consult with a physical therapy vertigo specialist. The right practitioner will perform specialized tests to identify if your root cause is movement based – and can determine if you need to see a neurologist or eye specialist instead or in conjunction. By going this route first, you can determine if the cause of vertigo can be successfully treated naturally , and avoid treatment approaches that involve medications or procedures that you might not need. But in the meantime, hopefully some of these strategies help you create a more manageable work environment if you suffer from vertigo on a regular basis.

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 seat in her upcoming Masterclass for Vertigo Sufferers – visit www.cjphysicaltherapy.com – or call 603-380-7902

4 Spine-saving tips for less pain during Holiday Travel

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For many, Holidays mean traveling to visit family and friends. Or perhaps you’re a New England resident and just want to get away from the cold for a few days. Either way, hours in the car, hours on a plane, and sleeping on mattresses you’re not used to can wreak havoc on your spine.

The good news is there are some simple and easy things you can do to help prevent this. Here are 5 of my top tips to save your spine during holiday travel:

Tip #1: Interrupt your sitting

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting. Our bodies are made to move continuously throughout the day. Too much sitting puts extra load and compression on your spine, and can trigger an underlying problem you weren’t even aware of. On road trips or long plane rides, getting out of your seat is critical for keeping your neck and back healthy. In a car, plan extra time in your trip to pull over at rest stops and walk around. On a plane, choose an aisle seat so it’s easy to get up and stretch. I recommend interrupting your sitting every 30 min for good neck and back health whenever you’re able. Keeping up with that frequency while traveling can be difficult, but something is better than nothing.

Tip #2: Use a lumbar pillow

While sitting, a proper lumbar pillow is not only essential for good lower back alignment, but also for proper neck alignment. We have natural curves in our spine that are designed to absorb shock and disperse load. Ever heard of the dreaded “forward head”? That’s the posture your neck assumes when it needs to compensate for lower back slouching. When your spinal curves are not maintained, such as when sitting or slouching for prolonged periods, you get abnormal and unwanted forces throughout your spine, resulting in pain and stiffness that can occur in both your neck and lower back. When purchasing or making your own lumbar pillow – you want to make sure the roll is thick enough to maintain the natural curve (lordosis) in your lower back without much effort while you sit. The built-in lumbar supports that you can adjust in your car are typically not adequate enough – so don’t rely on those. Have a small pillow or roll handy to compensate.

Tip #3: Maintain a neutral spine while you sleep

When traveling and facing various mattresses that might not align with your typical sleeping setup, there are ways to compensate to prevent neck and back pain. Start by packing a portable travel pillow that offers adequate support for your neck’s natural curve. If the mattress is too firm, consider using extra blankets or folded clothes strategically placed under specific body parts, like your hips or shoulders, to create a more cushioned surface. If the mattress is too soft, try placing a firm object, like a folded towel or a small pillow, beneath your lower back for added support. Sleeping on mattresses you’re not accustomed to while traveling can be challenging – and you’re never quite sure what you’ll be getting into. The name of the game is to position yourself in a way so that you’re sleeping in a neutral position – where your head, neck, and spine all align.. It might take a bit of trial and error, but adapting your sleeping setup while traveling can significantly reduce discomfort and ensure less pain and strain in your neck and back.

Tip #4: Stay Hydrated

Staying hydrated during holiday travel plays a crucial role in preventing neck and back pain due to its impact on overall bodily function. Adequate hydration supports the elasticity of spinal discs, which act as cushions between vertebrae, preventing them from becoming stiff and compressed. Dehydration can exacerbate muscle tension and reduce flexibility, increasing the likelihood of discomfort and stiffness in the neck and back. By drinking enough water, you help maintain proper circulation, delivering essential nutrients to muscles and tissues, promoting their relaxation, and reducing the risk of cramping or spasms that often contribute to neck and back pain during long journeys. Plus – hydration supports your body’s ability to recover and repair – so when you’ve got those travel-related strains on your spine that are ultimately inevitable no matter how careful you are – you’ll simply feel better faster.

Traveling any time of year, especially during the Holidays, comes with its own set of challenges and problems. There is no need to add unwanted neck and back pain to that list. Implementing even just one of these spine-saving tips next time you travel can make a real difference in alleviating neck and back pain – and allow you to focus on your destination instead.

Are you local to Portsmouth, NH and looking for help?

Request a free discovery visit by clicking here. We will ask you all about what’s been going on and see if we would be the best fit to help you 🙂

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]

6 Essential Habits that Build your Immunity

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Flu season is upon us – and it’s that time of year where a healthy immune system is more important than ever. Whether it’s more shopping or extra Holiday gatherings, you’re bound to be around more people than usual, which is a recipe for spreading and catching germs.

Here are 6 essential habits that will help build your immunity:

1. Stay Hydrated

Staying hydrated is one of the best things you can do for your health all of the time, but it’s especially important when you’re trying to fight disease. Water helps flush everything out, and your cells (especially those that fight germs) work better when fully hydrated. But water isn’t the only thing that helps you stay hydrated. Broth, tea, or anything without a lot of sugar counts. Personally, when I’m not feeling well, I love making myself a big thermos of hot water with lemon and tea. Not only is it soothing but it’s packed with vitamin C. So how much water should you drink? The U.S. National Academies of Sciences, Engineering, and Medicine says that men should aim for about 15.5 cups per day, while women should aim for 11.5 cups. Now keep in mind, how much you exercise and sweat each day will vary these numbers, but as a general rule, keep your favorite water bottle by your side at all times and make staying hydrated easy.

2. Exercise Regularly

Exercising regularly is well-known for improving cardiovascular health, lowering blood pressure, keeping muscles and bones strong, and helping control your body weight. But did you know that regular exercise also helps you boost your immune system? There are a certain amount of immune cells naturally circulating through your body at all times. But when you exercise, and increase your blood flow, you help push more immune cells from your lymph nodes and spleen into your bloodstream. Now if you’re already sick or feeling low energy, it’s important to listen to your body and modify where you need to. You don’t want to risk getting an injury for the sake of your immune system. There has to be a balance. But going for an easy walk – even when you’re sick – can help. And when you’re not sick – get moving – it’s going to help build a healthy immune system not to mention a healthy musculoskeletal system.

3. Get some Sleep

Good, quality sleep is essential for your health, and it helps keep your immune system functioning well. When we sleep, our bodies produce special proteins designed to target infection and inflammation, and T-cells (white blood cells) that play a critical role in fighting infectious diseases. So what happens when we don’t sleep? Lack of sleep has been proven to increase the risk of illness. Sleep researchers at several universities tested this theory by exposing 164 volunteers to the cold virus through nasal drops while monitoring their sleep and evaluating their health habits. The participants who slept less than five hours were four-and-a-half times more likely to catch a cold than those who slept for seven hours a night. So prioritizing sleep is crucial all of the time – but especially when you’re fighting off a cold or illness.

4. Eat Well

Eating a healthy, whole-food and varied diet is one of the best ways to boost your immune system. Incorporating vibrant fruits and vegetables bursting with vitamins and antioxidants, such as citrus fruits, bell peppers, spinach, and berries, will bolster your body’s ability to fight off infections. Lean proteins like poultry and fish, along with probiotic-rich foods such as yogurt and kimchi, support a healthy gut, which happens to be where a significant portion of your immune system resides. And don’t forget about whole grains and healthy fats – like those found in nuts and olive oil. They help strengthen your immune system also. Eating well is good for you all the time – but especially when you’re sick and trying to fight off germs and infection.

5. Be Social

Having positive interactions with people and meaningful relationships is not only linked to improved immunity, but it also happens to top the list of things that help us to live longer. Now, if you’re already sick, then you may want to stay away from your friends and loved ones physically. That doesn’t mean you can’t pick up the phone or hop on Zoom. But when you’re feeling good and healthy – prioritize these relationships and connections. Make time for group activities, or walks with a friend. Being social and interacting with others contributes positively to your emotional well-being – and turns out – will help keep you from getting sick as well.

6. Get Outside

Getting a regular dose of fresh air not only reduces stress, but it gives you vitamin D. You can get vitamin D from food and supplements – but the best place to get it is from the sun. The effectiveness of vitamin D on fighting colds and flus is still unclear and being studied, but vitamin D is believed to help facilitate a healthy and normal immune system. But regardless of the research, getting outside feels good and gets you away from all that circulated air indoors. I don’t think it’s a coincidence that we get more colds in the winter, so when you can, bundle up and get outside. Your immune system will actually thank you.

Having a strong immune system keeps us healthy. And when we’re healthy, we can take that opportunity to work on and optimize other aspects of our health – such as strength, mobility, and cardiovascular health – that keep us feeling good and reduce our risk of injury. Getting sick puts a stop to life’s momentum, and can prevent you from getting into a routine altogether if you’re getting sick often. So don’t take your health for granted. If you haven’t already, start incorporating one or more of these habits into your life today.

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, email her at [email protected].

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Do Cortisone Shots Work on Herniated Discs?

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Do Cortisone Shots Work on Herniated Discs?

A recent conversation with someone regarding whether or not they should get a cortisone shot in their back to help a herniated disc inspired me to write this article. Why? Because in speaking with her, I realized how misinformed she was about when you should and shouldn’t get a cortisone shot, and what they are and aren’t good for. And I hate to see people getting procedures or injections when they don’t actually need one.

So when is a cortisone shot a good idea?

Cortisone shots work really well when the primary source of your pain in a targeted area is inflammatory or “chemical”. When you’ve got pain that is of chemical origin – then chemical drugs (like a cortisone shot) will work well to get rid of it. So what is “chemical pain” and how is it different? Chemical pain is the result of your body’s natural inflammatory response in response to injury – which produces an influx of chemicals and other nutrients in your blood to heal the injured area. Since this process creates inflammation and swelling – you feel pain. When the inflammatory process is working correctly, these chemicals naturally dissipate as the tissue heals. But on occasion, the process can get out of hand and get dysfunctional. The painful chemicals linger and create an almost constant state of pain that really doesn’t respond to any kind of movement or even rest.  In the case of back pain due to a herniated disc, typically you’ll find that you can relieve it temporarily by changing positions, moving, or going for a walk. But if it’s chemical pain – your back will hurt constantly – it will feel hot and inflamed – and nothing will seem to touch it. While rare, if your herniated disc is causing this type of pain response, then you’ll likely benefit from a cortisone shot. You need to get rid of those chemicals and the cortisone shot will do just that

But most cases of back pain – even those involving a herniated disc – are instead considered “mechanical” in origin.

Mechanical pain is responsible for 70-80% of all musculoskeletal injuries and it has to do with your mobility and movement patterns. Unlike chemical pain – mechanical pain does respond to changes in movement and position. It’s why most people suffering from herniated discs will feel better when they walk, move, or exercise. They can also temporarily relieve their back or leg pain by standing up (for example) after having been sat for a long time. The key recovery tool for mechanical pain is movement – identifying where your mobility restrictions are and where your faulty movement patterns or habits exist. Once you figure this out – the structural component (aka the herniated disc) is irrelevant and you can live with it for years to come without issue. If you’re suffering from back pain or sciatica, and have been told you have a herniated disc, and what I’ve just described is your typical pain pattern – you will likely not benefit from a cortisone shot and instead need a proper movement/mechanical assessment from someone who’s an expert in this sort of thing.

Now here’s where things get confusing…

If you’ve got a herniated disc – it has the ability to irritate the structures surrounding it – everything from muscles to nerves. I’ve seen people aggravate a herniated disc by simply sneezing or coughing. When your herniated disc gets “angry” and irritates the surrounding structures, you will experience localized inflammation. But it’s different from the dysfunctional inflammatory pattern I described previously. It’s still possible to make this inflammation go away on its own – without drugs – because it’s not in a permanent “chemical” state. But when you’ve got a highly sensitive and painful herniated disc it’s very tempting to get a cortisone shot to relieve the pain.

But here’s why I urge you to think twice… The cortisone shot may provide you with temporary relief – but it will be a bandaid.

Because at the end of the day – the cortisone shot will not address the root cause – the underlying mechanical problem that is causing that herniated disc to keep getting angry. What you risk is that during those periods of “pain relief” – you continue to do things that make that herniated disc worse – because you can’t feel what’s going on. If you keep masking the pain pattern with cortisone shots, and keep unknowingly making your herniated disc worse, you may get to the point where you can’t fix it naturally anymore and will be looking at a surgical fix instead.

Ok – so that was a lot of information and scientific terms thrown at you. But at the end of the day – here’s what I want you to remember and think about if you’re considering getting a cortisone shot for your herniated disc… 

If you can influence your back pain with any sort of movement or activity – then it’s not the type of pain that warrants a cortisone shot. Cortisone shots do nothing to affect a structure (aka herniated disc) – they only eliminate chemicals that are causing pain. And the short-term pain relief from the cortisone shot will not outweigh the potential long-term and harmful consequences you could experience by not addressing the root cause. But if you’re experiencing the sort of back pain that is hot, inflammatory, and not responsive at all to movement, activity, or positional changes – then you’ve got a situation where a cortisone shot might be beneficial – and could get you over the hump that is needed for movement and activity to actually help.

At the end of the day, before you consider any kind of injection or procedure, be sure you’re well-informed and have asked all the questions necessary to be sure that a natural alternative is not still available and worth trying.

If you are local to Portsmouth, NH – consider speaking to one of my specialists. We will ask you all about what’s been going on and see if we would be the best fit to help you. Click here to request to speak with a specialist.

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].