Posts

Opioid Addiction in Adults over 40: a Public Health Emergency

The COVID-19 pandemic has been top of mind for months. We’ve all experienced some major curveballs this year, and most people have learned a lot about public health and epidemiology along the way. But why now? Why are we finally learning how viruses attack the respiratory system, what it means to be immunocompromised, and the best practices for disinfecting? Maybe it’s because of the unpredictability and common threat associated with this virus. Although some demographics have an increased risk of serious outcomes, anyone can get this novel coronavirus and anyone can become ill. 

Unfortunately, Covid isn’t the only public health crisis facing Americans in 2020.

The opioid epidemic has been in the news for years, but many of us don’t bother to take precautions or educate ourselves because we don’t think opioid addiction can happen to us.   

That couldn’t be further from the truth!

Anyone can become addicted to opioids. Many of the Americans battling addiction right now don’t have a history of drug abuse. Instead, what they have in common is something relatively routine. They deal with chronic pain or they had a surgery, and a physician prescribed them opioids.

According to the US Department of Health and Human Services, “opioid overdoses accounted for more than 42,000 deaths in 2016” and “an estimated 40% of opioid overdose deaths involved a prescription opioid.” Between 2010 and 2016, opiate prescriptions from surgeons rose by over 18 percent (UCI Health). And according to the National Institute on Drug Abuse, approximately 21 to 29 percent of patients who are prescribed opioids by physicians end up misusing them. Eight to 12 percent become addicted (NIDA). And the reality of opioid addiction is sobering. In 2017 alone, over 47,000 people in the United States overdosed on opioids and died. 

In 2017, the opioid epidemic was declared a public health emergency.

A public health emergency is just that — public! The emergent status of this crisis is not limited to one demographic or “type” of person. Although media attention through TV and movies tends to focus on heroin and young people getting high, data from the Substance Abuse and Mental Health Services Administration tells us that 63.4% of the adults who misused prescription opioids in 2015 did so to relieve legitimate physical pain. Chances are, we’ve all felt pain at one time or another that ibuprofen or tylenol alone couldn’t get rid of. Everyone is at risk for opioid addiction because anyone could get in a car accident, or require surgery, or develop arthritis. 

Pain-relieving drugs like Oxycodone, Oxycontin, Vicodin, Percocet, and others can be extremely helpful in some circumstances. But unfortunately, they are often overprescribed thanks to aggressive incentivising and pressure from drug manufacturers. The fact that opioids are so often prescribed after surgery and for patients with chronic pain means that middle aged and older adults are at a higher risk for drug addiction than ever before. In 2016, 14.4 million adults on Medicare (age  65+) had at least one opioid prescription (Consumer Voice). Older adults are also more sensitive to the physical effects of opioids. Side effects such as respiratory depression and cognitive impairment increase in severity as the patient’s age increases, often leading to hospitalizations and even deaths

So many clients in our practice fall into this at-risk demographic.

We have countless clients coming to us with severe chronic pain. Some have already had surgeries or been told that surgery is their only route to a pain-free life. Many have considered opioids to treat their back pain. And we are so grateful that we’ve been able to help hundreds of individuals recover from their injuries AND chronic pain without resorting to drugs, surgery, or both!

We promote both physical therapy and Pilates as alternatives to surgery and for preventing painful musculoskeletal problems because they truly work.

We recognize that most knee, back, and other injuries occur because the surrounding muscles are too weak to support those joints and systems properly — and we have the expertise to retrain your body in correct movement. You may think that your regular exercise and stretching is enough, but oftentimes working specific muscle groups leaves others underdeveloped and your body unbalanced as a whole. Our team of specialists is trained to create individualized solutions for your particular needs, because we believe that movement is medicine — when it’s prescribed properly! The idea of a quick fix is tempting — but a quick fix can easily turn into long term opioid addiction, illness, and even death. Taking the time to teach your body how to heal itself is so much more rewarding in the long run.

Want to learn more about how we can work with you to determine the safest, strongest, most effective route to recovery? Just click here to sign up for a FREE Discovery Session with one of our specialists.

 

This article was authored by Katya Engalichev. Katya is a pharmacy technician, EMT, and graduate student who writes for CJ Physical Therapy & Pilates. 

exercise

Can you get rid of Back Pain with Exercise?

With small group fitness, Pilates studios such as our own, and many gyms reopening again on June 1st, people are itching to get back into their exercise routines. In our last post, we talked about tips and considerations on things you can do to ensure your body is ready to go back, especially after weeks of quarantine.

But many folks I speak with have had back pain for years, long before quarantine. So many people have tried weekly massage, daily stretching and foam rolling, and every exercise under the sun — only to find that their back pain ALWAYS comes back.

Research has confirmed many times over that exercise is the best “treatment” for back pain.

While prescription medication, steroid injections, and even surgery may be more successful at getting your back pain gone quickly — a proper exercise routine beats these things out every time. Outcomes are either the same, or better, when you choose exercise over those procedures. It’s why in our business, we focus on empowering you through movement — instead of pills or procedures! If a long-term solution is what you’re looking for, and you want to end the merry-go-round of your back pain always returning, then proper exercise is the best route hands down.

Sounds simple, right? Why then, do four out of five people continue to suffer from debilitating back pain?

It’s because not all back pain is created equal, and neither is exercise. The tricky part is that for most back pain, any kind of movement is going to make you feel better. Our bodies are designed to move and not sit still. It’s why you wake up feeling stiff and painful, and better after you’ve moved around for about an hour. Movement brings blood flow to our muscles and joints, and exercise spreads pain-reducing endorphins throughout our body. But more often than not, the pain comes back the next day, or in come cases, feels worse two or three days later. And the frustrating part is that you never know exactly what you did — so you just rinse and repeat — hoping the next day it finally “works”.

Exercise DOES work to help your back pain, just like the research says, but it needs to be specific.

Skill and coordination also matter. One exercise can act like a miracle for one person’s back pain, while it aggravates another’s. I see this all the time in my office. The nuances come down to cues, tiny little tweaks, or sometimes you need a different exercise all together for your particular body.

Back pain is not cookie-cutter, and your exercise prescription shouldn’t be either. You don’t want to go on for years just managing your back pain when you could actually get rid of it entirely with the right movement strategy.

As you enter back into the world of fitness, take note of how your body and especially your back is feeling. The correct exercise routine is going to make you feel better, and STAY better. You’ll notice continued progress, and you won’t have to foam roll and stretch every single day to manage your back pain. The wrong exercise routine will make you feel worse, often several days or months later, and the worst part is you won’t be sure where it came from.

If this sounds familiar, or you find this back pain cycle starts happening to you when you return to the gym, feel free to give us a call. You can talk to a specialist for free and find out if your exercise routine is sufficient for your type of back pain. We’ll also be going over all of this (and more) in our FREE back pain and sciatica workshop on Tuesday June 16th! It’s all online via Zoom, and you can sign up right here.

Pilates Class at CJPT & Pilates

When Gyms Reopen — Will Your Body be Ready?

The state of New Hampshire is slowly reopening, and we are so excited that small-group fitness classes can return to gyms and studios on June 1st! While many businesses, including ours, have adapted by offering online services — most clients we speak with can’t wait to get back in the studio again. 

The big question is — will your body be ready?

If you’ve stuck with your strength and mobility routine and have been working out regularly from home, then you have a better chance than most to bounce right back.

But not everyone has taken advantage of online virtual exercise services, and many I speak with have opted to do nothing and just wait. Many have resorted to more frequent walking, running, or biking as a substitute for their usual exercise routines.

Any physical activity is better than no physical activity, but daily cardio is not the same as strength training. It’s just not going to be enough to get you by if your plan is to jump right back into the same pre-Covid workout routine that you left behind.

It takes months to gain appreciable muscle strength and improve mobility… but it only takes two to three weeks to lose it all.

The biggest mistake that I expect to see once gyms and even our own Pilates studio reopens is that people will assume their body is ready to pick back up exactly where it left off. And within about two to three weeks of that, injuries WILL start to happen.

What can you do?

If you’re not in any pain, but all you’ve been doing is cardio, then it’s a good idea to start incorporating strength and mobility back into your routine now. Your body will be much happier when it gets back into the gym or studio, and you’ll be less likely to experience some kind of injury. My best recommendation is to utilize the online services that your favorite gym or studio already offers — or find a facility that is offering them. In our studio, for example, we have online virtual Pilates classes daily. We guide you through the movements using precise cueing, and watch you while you’re moving. This allows us to give you in the moment corrections and make sure that you’re getting the most out of your workout. While it’s not exactly the same as your instructor being right there next to you, it’s the next best thing.

If you’re already experiencing pain or stiffness, perhaps because you’ve been walking or running more than you’re used to, you’ll want to talk to a movement specialist like us before you jump back into your previous exercise routine.

We know how to screen your muscles and joints properly, and can guide you toward not only getting rid of your pain, but we will also ensure that you’re set up to thrive in your workouts once we’re allowed to reopen again. Another big misconception I see is that people assume their pain will just go away once they start exercising again. While that may be true for some, most of the time it goes the other way, and your pain either gets worse or manifests itself somewhere else because your body starts to compensate for the problem.

I spoke with a gentleman earlier this week who was suffering from knee pain and stiffness because he went from walking 2-3 miles per week to walking 2-3 miles per DAY with his wife. He wants to get back on the golf course, and due to the restrictions on using golf carts, more walking is going to be necessary. His knee won’t be able to handle that in its current state, plus it will get worse if he pushes it. So I’m excited that he took us up on our offer to talk for free about what was going on with his knee. Now we’re going to get him the help he needs!

If you have any questions about pain that you might be experiencing, or want to ask about getting into a Pilates class this June, give us a call!

We are still offering FREE Zoom or in-person consultations to help people figure out what to do about their pain while they are stuck at home or slowly re-entering the world.

people walking with face masks

Beyond the Mask: Five Ways to Build Immunity and Stay Healthy

The COVID-19 pandemic has changed so much of how we live, work, communicate, and think about our health. While precautions like face masks can be helpful, the best way to avoid getting seriously ill is to have a strong, healthy immune system. In our office, we’re helping people’s immune systems by making sure they stay active, healthy, and mobile. We’ve been helping people with back and knee pain recover quickly and manage their conditions from home, so they can get back outside and keep moving and exercising.

Exercising regularly is just one way to keep your immune system strong. Here are five more ways to make sure you’re building immunity during  these strange times!

 

1. Hydrate

 

Staying hydrated is one of the best things you can do for your health in general, but it’s especially important when you’re trying to fight disease. Each individual cell in your body that works for your immune system needs to be fully hydrated to perform its job optimally — and that all depends on how much water you drink!

 

2. Stay Moving

 

In the era of working from home and passing time with friends or family on Zoom, it can be hard to get up from your computer and make sure you’re staying active. But it is so important that we interrupt our sitting and make time to exercise! Keeping your blood flowing allows pathogens to be filtered out more efficiently — plus, sweat can even kill pathogens on the surface of your skin. 

 

3. Get Good Sleep

 

Sleep deprivation has been proven to increase the risk of illness, as well as increasing the risk of more serious long term effects. Sleep is when your body’s cells get to repair themselves — including those immune cells! Plus, getting enough sleep at night can help lower your overall stress. 

 

4. Eat Well

 

Nutrition is key for building and maintaining immunity. You should try to avoid processed foods and integrate more clean alternatives like nuts, berries, eggs, and fish. 

 

5. Get Outside 

 

Scientists are telling us that the novel coronavirus thrives best indoors, and out of UV light. All the more reason to get outside! Soaking up that Vitamin D will boost your immune system and just make you feel better in general. Not to mention that going outside is the one of the best ways to get exercise right now with gyms being closed! 

If you’re currently suffering from back, knee, or any other kind of pain that is preventing you from moving and exercising, give us a call.

We’re currently offering free consultations, both in-person and virtually, to help you figure out what’s going on and give you all the information you need to make the best decision about what to do next.

 

Noticing More Knee Pain during Quarantine?

Aside from back pain, the second most common complaint bringing people into our office these days is knee pain, and lately, I’ve seen a little surge.

Here’s why…

People are sitting a lot more, which leads to increased stiffness in your knees. And a lot of us are doing different kinds of activities than we did 6 weeks ago, which for some, is exposing knee problems they never knew they had.

I spoke to one gentleman last week (we’ll call him “Jack”) who had started walking every day, and running a little bit, because his gym had closed. After about 4 weeks of this, he began experiencing pain in the front of his knee. He put some ice on it, took a break from his daily walks and running, and also resumed some stretches that a former physical therapist had told him to do. This seemed to help, so he resumed his walks and running again. Three days into it… bam… his knee pain returned.

Our specialist team has opened up our schedules to answer people’s questions about what they can do at home right now to take care of any aches or pains.

So Jack took us up on that, because he wanted to know if his knee pain was something to worry about. Did he need to see a doctor? Did he need to let it rest some more? Were there specific exercises he could do?

He did NOT want to stop his walking and running routine, but he definitely didn’t want his knee to get so bad that it would keep him from returning to the gym when it opened back up. He’s 55 years old and staying active and mobile is VERY important to him. We spoke for about 20 minutes and I knew immediately that rest wasn’t going to work, and that X-rays or medication from a doctor wouldn’t do anything either. Those things would only mask the problem. They would take care of the pain in his knee – but wouldn’t correct the source of his problem.

Ironically, the truth about knee problems is that they’re often not actually knee problems!  

With most knee pain, we can trace the underlying issues to a locality directly below the knee (the ankle or foot) or directly above it (the pelvis, hips, core, and low back). If you don’t engage your core throughout your daily movement, it actually puts a huge amount of strain on your knees. As your legs swing and rotate, the torque that should be occurring through your pelvis and hips gets overloaded onto your knees. So as we age, we may start feeling a sense of wear and tear or weakness in our knees that actually comes from a lifetime of improper movement.

The mainstream medical model is focused largely on treating symptoms rather than identifying the root cause of WHY the problem is occuring in the first place.

Pain pills, injections, and even surgery are often recommended before more conservative and natural treatments! And because these quick fixes are merely addressing the symptoms, the physical problems return for the majority of affected individuals. That’s because those knee issues actually stemmed from a different part of the body, and the knee will continue to be overloaded until those biomechanical problems are addressed directly!

Yes – we were able to figure ALL of this out from a FREE phone session.

The next step for Jack was an evaluation with our knee specialist. We scheduled a virtual session over Zoom, she was able to confirm the source of the problem. Turns out the muscles in his hips weren’t firing like they should and it was causing his knees to compensate and work harder than they needed to, which resulted in pain. So we got him doing the correct stretches and specific exercises that would train his hip and pelvis to work like they are supposed to.

In no time, Jack will be back to his walking and running routine, but he will ALSO be in better shape to return to the gym. One of his frustrations before was not being able to do as many squats as he wanted – because they hurt his knees. He had no idea that the problem was actually coming from his hips! So he is pretty excited to try his squats again once his gym opens back up.

If Jack’s story sounds familiar to you, schedule a call with us.

There is no point in sitting at home worrying, or scouring Google for what you should do to fix your pain. We can figure out what’s going on with you over the phone and I’ll let you know if you need to schedule a session with us, see a doctor, or if it’s something you can take care of on your own.

You could also join us for our FREE Virtual Knee Pain Webinar on Thur May 14th from 6-7p!

Is Quarantine Turning Into a (Literal) Pain in Your Butt?

We are about 5 weeks into social distancing and doing our best to flatten the curve. Although we are all coming together as a country to do our moral duty and fight the spread of Covid-19, it doesn’t come without consequences.

More screen time and more couch time are wreaking havoc on our bodies.

Most people I speak with are making a concerted effort to be as active as they can during the day. But even the best efforts are not combatting the extra bending and sitting that is happening. It’s almost impossible to avoid it. Due to social distancing and more people working from home than ever before, our primary way of “gathering,” seeing loved ones, and communicating with co-workers is now totally digital.

Whether we like it or not, we are hunched over and leaning forward more than ever — and it’s becoming a pain in the butt, quite literally.

In our last blog post I talked about the difference between “good pain” and “bad pain.” Since then, I’ve spoken to many of you over the phone about your concerns. One of the most common questions that came across this week was about pain in your butt, and not the figurative kind!

Yes, too much sitting can cause pain in your butt, but not for the reasons you might think…

One person I spoke with thought it might be due to the hard kitchen chair he was sitting on. Makes sense, right? But when he added a cushion, and then tried moving to the recliner to do his work and online social gatherings, the pain in his butt got worse.

So he did what most of us do, and went straight to Google.

He thought that maybe he had “piriformis syndrome” and started doing the recommended stretches. The pain in his butt started to subside a little, but then spread to the back of his thigh. He thought the pain in his thigh might be due to the stretches and that it was a good thing. But after about a week of this, he woke up one morning unable to move his back! That is when he called me.

I explained that the pain in his butt was NOT due to piriformis syndrome like “Dr. Google” told him. It was actually coming from his lower back. All the extra sitting was putting pressure on his disc, which was putting pressure on his nerve, and the result was pain in his butt. Without realizing the true cause of his problem, he accidentally started doing stretches that made his problem worse. It’s very common to have a back problem and not experience any back pain. Back problems can manifest in your butt, thigh, or lower leg, and very often get confused with tight muscles that just need to be stretched. If you do the wrong stretches, you will make your problems worse and you WILL end up with back pain – often severe and seemingly out of nowhere.

Luckily, we were able to hop on a Zoom session and give him the correct stretches to do. Within a few weeks, he no longer had pain in his butt, and he knew what to do to keep it from coming back.

If quarantining is giving you a (literal) pain in your butt right now, don’t rely on Google to figure out your pain — talk to us!

We’ve been opening up extra slots on our schedules just to talk to people and help them figure out anything new or strange that might be going on.

All you have to do is fill out this quick form to request a call with one of our specialists.

5 Ways to Save your Back While Stuck at Home

Staying at home during the coronavirus pandemic doesn’t have to mean staying stationary. If you already have occasional or chronic back pain, it’s so important to take extra care of your spine during this time! Even people who rarely experience back pain may see new flare-ups due to increased time spent sitting at home.

For many, work stations at home are not ergonomically ideal or perhaps even nonexistent. On top of that, social-distancing and closed fitness facilities are likely to reduce our overall level of activity and mobility throughout the day. Combined, prolonged, poor posture and reduced mobility are the main ingredients for increasing back and neck pain. But have no fear! There are still many ways to prevent your back pain from kicking up, even while stuck at home!

1. Stand Up & Take a Load Off

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. Aside from participating in regular strengthening exercise, like Pilates, this is the easiest way for the average person to prevent back injury (and heal your back faster if you already have an injury).

2. Watch for Curves

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.  When we sit, the protective curves in our spine are harder to maintain and often disappear.  And while a healthy core and strong back muscles are important to back health, they won’t protect your back if you sit for long periods, or when the curve in your lumbar area disappears while you’re sitting.

Fortunately, the solution is as simple as rolling up a towel and placing it between your chair or car seat and the small of your back (just above the belt line). Using a purpose-designed lumbar roll is my favorite choice, and what I use for low-back support. You can use a lumbar roll in your office chair, car, and on the plane if you’re flying! If you want to learn where you can get on of your own contact us about them here. Or see in more detail how to use them in our free e-book!

3. Extend instead of Bend

The human spine (and entire body) craves balance, which means both extension and flexion.  But we spend the majority of our time in flexion, bending over to put shoes and socks on, brushing our teeth, driving, sitting at work and then driving home. At home we bend forward to cook, sit some more as we eat and then curl up on our couch or an easy chair. As long as we’re not gymnasts or circus performers, it’s safe to say we could all use a little more extension in our day.  A really good exercise is to stand and 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.  This is also a great activity to do when you are interrupting your sitting during the day.  If you’ve never arched you 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, stop and consult with a qualified physical therapist who specializes in back pain.

4. Stay Hydrated

We all know that drinking water is important, but don’t forget WHY! Water lubricates the joints, keeps the body’s soft tissues and fascia hydrated, and boosts exercise performance (yes, including at-home Pilates!). Water also improves skin health and elasticity — keeping you looking (and feeling) young! Water is also essential for digestion, flushing the body of waste and reducing unnecessary snacking. Water makes up 90% of our blood – which helps regulate the body temperature, deliver oxygen to all the cells in our body, and improve concentration and reasoning. Now more than ever, to stay healthy and mobile – make sure you are getting at least 7-8 cups of high quality H2O per day!

5. Build Stability

Mobility and then stability! Stability comes from a strong core. It can seem challenging to maintain strength with little equipment at home, but there are, in fact, plenty of ways to activate your muscles without any equipment at all! A basic strengthening flow daily can help keep our muscles active, blood flowing and reduce likelihood of pain. The flow you see below targets some of our most commonly weak muscle groups in a simple-to-do floor routine.

 

If you like these tips and want to learn even more ways to prevent debilitating back episodes, you can sign up for access to our FREE COVID-19 back pain survival guide right here!  And don’t forget to check out our Virtual Pilates programs if you’re looking for a way to exercise in your home that will target — and resolve — back pain. We have virtual small group classes at least once every day, Monday through Friday. We’re here for you through this quarantine and beyond!

work from home, coronavirus, back pain, quarantine

Back Pain Doesn’t Go Away for the Coronavirus!

The coronavirus (COVID-19) is forcing everyone to adapt to new routines — but many of us are still experiencing the same old chronic pain. In fact, your back pain may start acting up again now due to stress, decreased exercise, and more time spent at home on your computer. The important thing is that you don’t ignore it! Listen to your body and KEEP MOVING!  

Prior to seeing us, many of our clients who suffer from back pain were told that the best way to recover was to ice and lie down. They were advised to rest, relax, and limit their movement until the pain goes away. The problem with this model for treatment is that it goes against everything we know about the basic principles of joint and tissue healing.

Our modern health research suggests that early movement is actually the BEST way to head off chronic back pain!

Of course, if you’ve suffered a trauma like a car accident or a major fall, you should absolutely go get checked out by a medical professional and follow their advice based on your injuries. But if you are dealing with a chronically aching back or general soreness, stiffness, and pain, it turns out that movement is actually the best course of action!

But not ALL types of movement and exercise are safe or beneficial when you’ve hurt your back…

That’s where physical therapy comes in! A physical therapist is able to identify specific movements that actually work through and relieve that pain, based on your individual condition. We call these initial exercises “first aid movements” – and they are especially helpful because you can use them any time you might tweak your back in the future! If you’re experiencing acute back pain, of course it doesn’t make sense to continue with all of your activities as usual if they are just exacerbating your symptoms. But there is a middle ground between overdoing it and completely stopping the movement that your body craves. 

But how are we supposed to see a physical therapist, you ask, when everything is shutting down to contain this coronavirus? 

We have a plan! We’re offering live virtual options for both our FREE Back Pain & Sciatica class on Thursday, April 9th and our Pilates 101: Get Your Back to Health program starting Tuesday April 14th. So please don’t let the pandemic keep you from signing up or sharing this info with others you know who may need our help!