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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!

Is Pilates the missing link in your fitness?

Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method.

It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates — or enjoy the benefits.

I’ve been incorporating Pilates into my physical therapy practice for the last 10 years and it’s been transformational for both my clients AND my practice. Every March, we join participants from all across the globe to share the love for the original work of Joseph Pilates. Over the years, much of Pilates has turned contemporary, but for one month – the Pilates community pays respect to his traditional, classical Mat exercises. This movement is known as March MATness, and anyone can join!

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength — and it helps my clients connect to their bodies in a way that they haven’t been able to achieve with traditional strengthening methods.

Most of my clients are well into their 50’s and 60’s, and they love Pilates because it helps them have more energy, better balance, and improved strength and mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases the likelihood that their injury will come back.

Here are five reasons why Pilates was a missing link in my physical therapy practice, and why it might be the missing link to YOUR life-long fitness as well.

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We see a lot of folks with recurring back pain in our office. They’ve seen traditional physical therapists or chiropractors who get rid of their pain in the short term, but they aren’t able to keep it gone. Regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but also is a well-balanced exercise system — so it keeps your back feeling mobile in all directions — a missing link in most “back strengthening programs.”

2. Pilates strengthens your whole body, not just your core.

One of the keys to lifelong fitness is what I call “balanced strength.” That’s when each part of your body works together to produce the right amount of force, at the right time, to do your favorite activity in the most efficient way possible. Efficiency means you’ll be able to do it for a lot longer. I see lots of strong people in my office, but often certain muscles are working harder than others. And this can cause problems down the line. Pilates emphasizes full body strength that is coordinated — and this leads to a balanced body.

3. Pilates helps you get flexibility the right way.

Do you stretch your hamstrings every single day and find they just never get more flexible? It’s probably because you’re not stretching the right way — or maybe you don’t even need to be stretching them at all! What I love about Pilates is that it stretches your body in a dynamic way — with movement — so that muscles lengthen the right way and where they are supposed to. “Mobility before stability” is a phrase you will hear me say often, and it’s one of the keys to lifelong fitness.

4. Pilates puts very little stress on your joints.

Aging is a real thing and along with it comes arthritis. But it’s not a death sentence like most people are led to believe! The key to combating arthritis is maintaining a mobile and well balanced joint. When you optimize everything that surrounds your arthritic joints, your symptoms decrease. Pilates helps with all this and doesn’t cause any added stress. When your joints are happier, it becomes much easier to do your favorite activities – hopefully for life!

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is — and it’s almost ALWAYS a missing link that I see for people who’ve been at a certain activity for a really long time and then suddenly things start breaking down. They start experiencing pain when they never have before. If you don’t train your nervous system, it gets lazy, and that is how compensations develop in your body. Pilates helps with this because it is a mind-body exercise that emphasizes balanced strength and coordination. Your nervous system can’t get lazy when you do Pilates!

If you’re not yet incorporating Pilates into your fitness or rehab routine — what are you waiting for?

March MATness is the perfect time to get started with Pilates. We’re celebrating by sending the Pilates exercise of the day right to your inbox, modeled by our expert Pilates instructors! Just follow this link to sign up for our challenge and gain access to daily videos, exclusive offers, and promos!  The fun starts on March 1st!!

syringe

Steroid injections may do more harm than good, research shows

Have you been told you need to get a cortisone injection? Have you already tried them more than once? 

Research is now showing that cortisone injections may hurt more than help in the long run! 

The results of a recent study from Radiology has raised concerns in the medical community about potentially adverse effects on joints following corticosteroid injections. These injections are commonly used to treat arthritis, especially osteoarthritis of the hip and knee. The researchers in this study observed patients who had previously received steroid injections and found that some of the patients exhibited further joint damage on medical imaging tests. According to the original article, these patients presented with “accelerated OA [osteoarthritis] progression, subchondral insufficiency fracture, complications of osteonecrosis, and rapid joint destruction, including bone loss.” 

The joint issues that can be triggered by cortisone injections don’t just show up right after the procedure — which makes it easy to see the steroid shot as a quick fix with no drawbacks.

And it’s true that there are usually no short-term side effects. However, when it comes to your joints, it’s all about the long game. And it’s worth noting that an analysis from the Cochrane Review in 2015 found that the benefits of steroid injections usually wear off after about six months…  meaning it’s a temporary “band-aid” solution to a bigger problem — a band-aid with the potential to result in permanent degradation of your joints!  

Arthritis is an issue we see all the time in our physical therapy practice, and that’s why patient and physician concerns with steroid injections are so relevant to us. Many of our clients have had injections suggested to them or have gone through with the procedure but not experienced any long-term healing. In many cases, this can be an overly simplified answer to the very complicated question of individual pain. Physical therapy, on the other hand, isn’t a one-size-fits-all solution. Our treatment model is entirely based around addressing the root cause of your pain instead of just providing temporary relief. Plus, we’re all about keeping your treatment non-invasive, movement-based, and entirely customized to YOU. 

If you’ve been told that you need a cortisone injection in your back, knee, or shoulder, think twice and get informed about other options!

If you’d like a NATURAL route to pain relief — and one that will make you more mobile and active at the same time — come talk with us! You can even schedule a FREE 30 minute Discovery Session with our specialists right now — no strings attached. 

What is Dry Needling?

At CJ Physical Therapy and Pilates, our goal is to help you live a pain-free life without pain pills or invasive procedures.

Trigger Point Dry Needling is one of several strategies we use to treat muscles that are extremely tense and in spasm. The spasm causes the muscle to be in constant tension which reduces blood flow, decreases oxygen, and can produce fibrotic unhealthy tissue over time (scarring). When a physical therapist inserts the very thin acupuncture needle (dry needle) into a knotted up muscle, it creates a local twitch reflex. Research shows that this not only relaxes the muscle, it breaks up the pain cycle by improving blood flow and oxygen to the muscle. This whole process helps to reduce and normalize inflammation in the area to promote healing. However, dry needling is not necessary for everyone, so it’s important that you know what it is and when it can be used to improve your health! Here’s our advice when it comes to pursuing dry needling treatment.

Work with a physical therapist to use dry needling in conjunction with movement based rehabilitation.

Dry needling can work wonders to relax your muscles. However, they’re just going to get tense and damaged again if you don’t learn how to use them properly and address any movement dysfunction that may be occurring. You don’t want to think of it as a quick fix! Dry needling is just the first step for some individuals who aren’t able to begin a physical therapy or movement regimen without first breaking up the pain cycles in the muscles that are prohibiting healthy movement. Dry needling serves as a “helper” to relax those muscles – and should be integrated with physical therapy treatment and strengthening activities such as Pilates.

Don’t be afraid of trying dry needling!

It can be uncomfortable for some people, but others say they feel no pain at all. It’s not dangerous and has lasting positive effects when used in conjunction with hands-on physical therapy under the direction of a specialist. Furthermore, our clients love it:

“After two back surgeries in my 20s and a new hip at 58, I figured I was lucky just to be walking. Dry needling has transformed the way I move. I’m more flexible. My walking stride has more length and I can stand longer.” – John

Do you have questions about dry needling? Want to see what a specialty physical therapy practice can do for you? We offer FREE Discovery Sessions right here in Portsmouth that give you the opportunity to ask any questions you may have! It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health. All you have to do is fill out this quick form, and we’ll be in touch!

How to NOT let Aches and Pains Ruin your New Year’s Goals

It’s that time of year, when we start looking ahead and setting goals for ourselves. It’s especially exciting now because we aren’t only entering a new year – but a new DECADE!

Exercising more and losing weight are the top New Year’s resolutions on everyone’s lists year after year. But what if you’re suffering from back or knee pain?  One of the worst things you can do is ignore pain and assume that by simply exercising more or losing weight, your ailments will just go away. It’s certainly a reasonable expectation, however, I typically see an influx of people calling my office right around March because these aches and pains have not only worsened — but derailed their New Year’s goals completely.

I don’t want to see that happen for you. So here are my top tips to NOT let aches and pains ruin your New Year’s goals:

1. Get assessed by an expert:

 

Your first thought might be to go see your doctor if you’re suffering from something like back or knee pain. But most medical doctors are trained to screen you for problems like broken bones or serious pathologies – not to actually assess your movement. You need to know how your pain behaves during everyday functional movements to truly fix it – and to avoid unnecessary procedures and surgery.  X-rays, MRI’s, or simply moving your limbs around on a treatment table won’t do that… but that is what a medical doctor is trained to do. A specialty physical therapy practice will be able to assess your movement in detail, through various movement tests, which will tell a much better story about how your pain may or may not impact the new exercise or weight loss program you’re about to start. Plus, we’ll be able to give you customized modifications so that you can embark on your new goal while decreasing your risk of injury.

2. Mobility before Stability:

This is a saying you hear me say all the time in my office. Your muscles won’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a stiff joint, or you’ll encourage compensation. Full and free mobility requires adequate flexibility in your joints as well as your muscles. Most people don’t think – or even know – how to assess their joint mobility. If you’re suffering from chronically stiff joints, you’ll want to get them checked before you start a new exercise program. I recommend seeing a movement expert, like those employed in our office, to make sure you’re ready and able to start on that new exercise program you’re so excited about!

3. Stay Hydrated:

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 and improve your daily hydration intake is to begin with 10 oz of water first thing upon waking. Add a squeeze of lemon for extra vitamin C and supported weight loss.

4. Pace yourself:

It’s very appealing and motivating to go “all in” on your new exercise or weight loss goal and 10x it… and I applaud you for it. But remember, you have 12 months, and really, the rest of your life to accomplish your goal in any way that you see fit. In other words, take pleasure and pat yourself on the back for simply setting a goal. That’s a first step that many don’t even get to. Be proud of yourself for setting an intention and envisioning a better quality of life. To give yourself the best odds of staying on that path, I encourage you to listen to your body and take your time in acclimating to a new exercise program. Don’t fight your body if it’s talking to you.  Our bodies talk to us for a reason. If you need help figuring out what your body is trying to say to you – click here to schedule a FREE Discovery Session with us in Portsmouth. We’re happy to translate for you!

Happy New Year – and Happy New Decade! 

Setting Goals for the New Year? We can help!

A new decade is on the horizon, and so are new health and wellness goals for many of us!

Are you already discussing resolutions or considering ways to make 2020 your best yet? The new year is a great opportunity to form new habits that will help us become our healthiest, happiest selves. Setting detailed goals is a constructive way to approach the 2020’s that can help you feel more motivated and hopeful about the future.

The idea of New Year’s resolutions is great, but most people only stick to them for a couple weeks.

Resolutions are so often left unfulfilled in part because they’re usually pretty general statements that are made without much forethought, intention, or planning. At some point we’ve probably all resolved to “get healthy” or “eat more vegetables” or “spend less money.” All worthy ideas, but can you see why people don’t follow through?! There’s WAY too much wiggle room, and nowhere near enough specificity. That’s why oftentimes, setting goals with distinct processes will help you accomplish much more than a run-of-the-mill resolution.

There are two essential factors in goal setting. First, the goal must be attainable. Secondly, you must define concrete steps that you intend to take towards reaching that goal.

Most of us want to be healthier, but what does that actually look like? One person’s journey to becoming healthy could be totally different from another’s. These goals can be made in conjunction with a health professional such as a physical therapist, especially if they relate to mobility, strength, and physical activity. Many of us have intended to “exercise more,” but those two words rarely yield results. A more effective goal might be to enroll in a Pilates class, take a half hour walk outside five days a week, drink the recommended 64 ounces of water each day, or to do ten minutes of stretching every morning after getting out of bed.

A group program such as Pilates can be especially helpful because it gives you a sense of accountability and camaraderie. In fact, our signature Pilates 101 program is relaunching in January, and we are so excited about it! Pilates 101: Get [Your] Back to Health is a one-of-a-kind 8-week program that delivers safe, yet highly effective Pilates-based core strengthening exercises that are easy on the joints, designed to lessen back pain, and help improve your flexibility and posture.

If you can track, schedule, or measure the steps of your goal, you’ll know when you’re making progress. If those steps happen alongside people who share similar goals and under the direction of a movement expert who can support you for two whole months — even better!

So, let’s finish off this decade strong — and don’t miss out on Pilates 101! These spots go fast, so apply now to make sure you don’t miss your chance.

5 Reasons People over 40 should do Pilates

Pilates is good for anyone and everyone… but especially for middle aged and older adults. Here are just some of the reasons to take Pilates classes if you’re in your 40s, 50s, 60s and beyond!

1. Relieve -and prevent- back pain

Many people who come to us with back pain think that their pain would prevent them from participating in an exercise program like Pilates – but the truth is, it’s the opposite! Guided, individualized Pilates combined with a physical therapy regimen is actually one of the best things you could do for your back. We even have an entire program – Pilates 101: Get [Your] Back to Health – designed specifically for people with back problems. Pilates strengthens your entire body, starting from your core, which naturally prevents future back issues stemming from muscular weakness or imbalance. Furthermore, Pilates (combined with PT) teaches correct movement – which is the number one way to relieve any current pain!

2. Increase balance

Since Pilates is all about core strength, it makes sense that continued practice can improve your balance by leaps and bounds! This is an especially important benefit for the older adults who do Pilates with us. As we age, our balance unfortunately deteriorates. However, those changes are not irreversible! Pilates retrains the balance and strength that makes falls less likely.

3. Improve flexibility

You don’t have to be flexible to start Pilates, but you will see your range of motion improve drastically after consistent practice! Improving flexibility is especially important as we age. The founder of the Pilates system himself, Joseph Pilates, once said,

 “if your spine is inflexibly stiff at 30, you are old; if it is completely flexible at 60, you are young.”

The years you’ve spent on earth is just a number… but it’s the condition of your body that dictates your age – not the other way around! And flexibility is the cornerstone to musculoskeletal health and resilience.

4. Reduce stress

We know that exercise in general is a great stress reliever, but Pilates is especially beneficial because it focuses on literally releasing that stress from your body through guided, intentional movement. Plus, having a regular Pilates class to attend can be a consistent fixture in your life that can serve as an outlet for all your day to day stresses!

5. Improve physique

“In 10 sessions you’ll feel the difference, in 20 sessions you’ll see a difference, and in 30 sessions you’ll have a whole new body.”

That’s another great quote from Joseph Pilates! Pilates is one of the best full body workouts out there, and it’s super effective for improving muscle tone overall and shedding excess body fat. If you practice Pilates regularly, you’ll continue to gain strength overall, which will improve your ability and performance in any other physical activity you enjoy!

Are you over the age of 40 and wondering if Pilates is a good fit for you?

Check out our new Pilates intro special. You can try three of our specialized small group Pilates training classes for HALF-OFF! Just follow this link to submit your info and see if it’s a good fit for you.

Not ready to commit to three classes? No worries. You can try Pilates with us for FREE by signing up for a Pilates Taster session right here. You’ll meet with one of our Pilates experts, get your core strength assessed, and we’ll help you figure out the best place in our Pilates program to get started!

knees

Happy Halloween! Spooky Noises coming from your Knees?

“What are those cracks and noises coming from my knees? Is there something wrong??”

Our clients come in with this question all the time. They usually feel nervous and fearful that the noises they hear may indicate something more serious is going on within the joint. Is there damage occurring whenever they hear this sound? Do they need to avoid activities that provoke these symptoms? Will they need to rely on pain pills and surgeries in order to maintain their mobility if their joints deteriorate? 

Crepitus refers to these clicking, popping, and creaking sounds that a large portion of the population experience on a regular basis.  This phenomenon can occur at any joint, but is most commonly reported in the knees, shoulders, ankles, hips, and spine. 

Although these noises often don’t produce any pain, they can cause anxiety. Individuals start to develop their own beliefs about what is going on, and ultimately alter their behavior to avoid these cracking or popping sensations.

What causes these noises?

Many structural factors can contribute to joint noises.  Some of the most common are:

  • Tendons rubbing along bony prominences (bumps on bones)
  • Nitrogen bubbles popping due to pressure changes within the joint
  • Small labral or meniscus tears that get caught or pinched as we move

However, we don’t have the luxury of utilizing x-ray goggles during our examinations.  This means that we often cannot be certain of exactly which structures are creating these sounds.  What we do know is they aren’t a reason to be highly concerned as long as they aren’t associated with pain or swelling in the affected joint.  

How can I prevent it from getting worse?

The best way  to prevent these symptoms is to keep moving!! Motion is lotion. Regular movement throughout the day allows our joints to lubricate themselves, kind of like applying WD-40 to a creaky door hinge.  Additionally, it’s important to keep the muscles surrounding your knees strong and balanced. This helps to offload the forces through the joint, which limits “typical” wear and tear on cartilage and bony structures.

What if I’m noticing pain or inflammation in the joint that’s making these noises?

If you have a specifically noisy joint that’s also painful or swollen, it’s best to come in for a formal examination with a physical therapist – ideally someone who specializes in movement mechanics.  We train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.

If finding the solution to your problem is something you’re interested in, you can come in for a free Discovery Session at our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are great for people who want to talk with a specialist about what might be causing their problem, and we’ll help you figure out what the next best steps are.  Our goal is to give you all the information you need so that you can make the best decision for your health – without any obligation or commitment.

We also know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free health and posture classes!  These events are for people in our community who want really valuable, expert information about movement, pain, and overall wellness. We know it’s confusing out there with all of the information floating around on Google and Facebook, and this is a valuable first step towards getting some answers for your problem.

Hopefully you found this information helpful, and the only thing scaring you this Halloween will be haunted houses instead of the noises coming from your joints!

PS – If you found this information helpful, please share this with a friend or on your Facebook feed.

Research shows MRI’s not reliable for back pain

One of the most popular questions and concerns I get from clients is whether or not they need an MRI for their back or neck problem. When you have persistent pain that won’t go away, or shooting pain or numbness down your arm or leg, it’s scary. It makes sense to get a look inside with an MRI – right?

Not necessarily.

Here’s the problem. 

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine.  But what we now know from research is that all those findings on an MRI rarely correlate with what’s actually causing your pain. 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.”

Let me explain.

When it comes to neck and back problems, what most people don’t realize is that 70-80% of all spine and musculoskeletal problems are what we call “mechanical” in nature.  That means that your problem has to do with the way you move, bad postural habits learned over the years, or muscular and joint imbalances like weakness and poor flexibility. Many of these mechanical “wear and tear” problems don’t show up until your 40’s, 50’s or 60’s – which coincidentally is also the time that things like disc degeneration show up on an MRI. Disc degeneration and arthritis are normal parts of aging, but they often get blamed for problems they don’t actually cause. The best way to figure out a movement problem is with… well… movement! Not an MRI.

But how do you know that it’s a mechanical problem and not something more serious?

The easiest way to find out is to ask a physical therapist who specializes in the spine, and specifically in mechanical neck and back pain.  But one sign you can easily recognize on your own is to take note of how your pain behaves. Does your pain come and go? Do you have good days and bad days? Can you change positions and influence your pain? When your pain is variable, it’s the best sign that your neck or back problem is “mechanical” in nature and due to a movement dysfunction. And that also means you don’t need surgery or any kind of procedure to fix it! In fact, a procedure or surgery could leave you feeling worse off than before.

So what’s the big deal about getting an MRI?  Isn’t it good just to be extra-cautious?

In theory – yes.  But here’s what actually happens.  MRI’s are super powerful and amazing tools.  Because of this, they see everything – including normal age-related changes like I mentioned just a moment ago. They also pick up things like bulging discs.

Research has also shown that around 60-70% of the population walk around with bulging discs and have no symptoms. Why?

Because a bulging disc only gives you trouble if you are moving or positioning yourself in an unbalanced way.

If an MRI picks this up, the news is often more devastating than it needs to be and the typical advice is to get an injection or surgery.  Neither of these procedures will fix your movement problem. And what typically happens is the bulge comes back, or appears somewhere else. This is why being “extra-cautious”, and over-prescribing MRI’s when it comes to back and neck pain, is not a good idea. The outcome is usually that people end up dealing with invasive procedures and surgeries they didn’t even need.  

If you’ve had a bad accident, fall, or trauma – then an MRI is a good idea.  But if you are dealing with chronic, long-standing aches and pains that have come and gone over the years and have recently gotten worse – there is a 70-80% chance that it is a movement problem that has finally caught up to you.  It’s best to see a movement expert for this. We know how to tell if the issue is something more serious. We can also send you to a doctor right away if necessary. But when you automatically assume that you need an MRI first, you end up spending a lot of money (the average cost of an MRI is $150,000, and you have to pay a portion of this), and the likelihood of getting prescribed an unnecessary surgery or procedure is much higher.

If this story sounds all too familiar, or you’ve been told that you must get an MRI for your neck or back problem – feel free to reach out to us and we can help you sort through fact vs fiction.  You could also come to our next “Ask the PT Night” on October 23rd and ask your questions then!