Tag Archive for: spine

Do You Really Need an MRI?

Do you really need an MRI for that?

This is probably the number one question we get from clients  – especially those who suffer from back or neck pain.  Believe me, I get it! When you have pain that won’t go away, and it’s shooting down your arm or leg, often causing numbness and tingling – it’s scary! Why wouldn’t you want an MRI?  An MRI tells you everything and then you know exactly what to do to fix the problem, right?

Not necessarily….

Don’t get me wrong – MRI’s are an amazing advancement in medical technology.

MRIs can easily detect abnormalities in your brain and spinal cord. They can find tumors, cysts and other abnormal growths in various parts of your body. They can even detect certain heart problems and liver disease.  When you don’t know exactly what’s wrong, but you are showing signs that something is not right, an MRI is an amazing tool to help doctors detect the source of the problem.

The problem isn’t with MRI’s – they do their job magnificently.  The problem is with the way they are being used and prescribed.

Let me explain.

When it comes to neck and back problems, for example, 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 – because it takes a while for bad movement patterns or bad postural habits to take their toll.  The best way to figure out a movement problem is with… well… movement!

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 (we’ll get to that later). But the most common sign is that the problem comes and goes.  Some days you feel great, and then other days you’ll be experiencing severe pain that interferes with your routine and activities.  When the pain comes and goes like that, it is usually NOT due to something serious.  A tumor, or a growth, or a broken bone doesn’t go away. If you feel the pain or discomfort constantly and nothing – not even medication – changes your symptoms very much, that’s an indicator that you should see a doctor and may need an MRI.  But remember what I said – 70-80% of all musculoskeletal problems are mechanical in nature and NOT the result of a significant injury or dangerous growth. To sum it all up – MRIs are not needed as often as they are prescribed.

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, such as arthritis, stenosis, degeneration of joints, and even bulging discs. These typical and often unrelated imperfections show up in the MRI and are frequently blamed for the movement problem.

So back to our original question:  Do I really need an MRI?

If you’ve had a bad accident, fall, or trauma – then you’ll want to seek immediate medical attention and an MRI is probably 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.  A professional and specially trained movement expert (like a specialist physical therapist) knows how to tell if the issue is NOT a movement problem and can send you to a doctor 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 often get prescribed unnecessary surgery or procedures for those normal effects of aging that show up in the MRI and get blamed for your problem.

If this story sounds all too familiar, or you’ve been told that you have to get an MRI, get in touch!  We are a specialized physical therapy practice that is well-known for helping people with this exact dilemma and we know how to tell if you need an MRI or not.

Or – download our FREE guide to back pain, written by Dr. Carrie Jose, Portsmouth’s leading back pain specialist and physical therapist. This guide contains her BEST tips – the ones she gives to clients – that will help you get rid of back pain WITHOUT things like pain pills, procedures, and of course MRI’s.

Setting Goals for the New Year: Part One – What to address FIRST?

New Year’s may still seem pretty far away, but if you plan on setting any resolutions or goals for 2019, you should start now. The earlier you set your goals, the more likely you are to achieve them. But choosing meaningful and positive goals is a process. That’s why we’re launching this four-part blog series to be your guide as we head into the end of 2018!

The first step is identifying what you want to change – FIRST.

A typical New Year’s resolution might be to lose weight or be more active. But before you can address those goals, it’s important to take a quick inventory of your body and identify obstacles that might get in the way.  The last thing you want is to get all excited about a goal, only to have those aspirations quickly deflated because you neglected to see the whole picture.

Let’s take the weight loss goal for example. Coming from a physical therapist’s point of view, that might mean asking yourself, “what hurts?” or “what has physically been bothering me?”  What are one or two things that could possibly get in your way of completing this goal?  Maybe your body is feeling great, you could still be struggling on other levels. It’s important to be honest with yourself and identify anything and everything that could be an obstacle to your goal. Once you can recognize and become aware of this issue, you have the opportunity to resolve it!

But how do you do that?  First, you have to get specific. For example, if you want to address your back pain in the New Year, so that you can be more active and lose weight in 2019, it’s not enough to simply say “I have a problem with back pain.”  When we get specific, we are able to take what may seem like a big, overwhelming problem – and turn it into bit size actionable chunks….

Start with focusing on the what, when, where, and why of the problem.

“Back pain” in itself is a general term. It’s more likely that instead of your entire back hurting at the same level all the time, you have a specific area (or areas) that hurts during specific activities. For instance, your “what” (the specific problem at hand) could be low back pain. The “when” could be in the evening after a long day on your feet. “Where” could be your living room when you’re trying to get up off the couch, or the golf course after a swing. “Why” could be a combination of factors that are causing you to experience the pain. For example, your body mechanics might be off to the point where it’s causing degradation of your vertebrae. Learning to move properly (for instance, with a physical therapist) would be a logical way to address that “why.”

Next, write down your focused description of the problem.

The simple act of writing something down will clarify and solidify your intentions. In this example, we started with the general statement “I have a problem with back pain.” We broke that down into parts, so that now you might say:

“I am experiencing severe low back pain. It typically occurs in the evenings after I’ve spent a long day on my feet, particularly when I’m moving from sitting to standing. This is likely a result of poor body mechanics, as I have never been instructed in proper movement to relieve back pain. This is the issue I intend to resolve so that I can be more active in 2019 and lose 20 lbs.”

Our next blog post will consider this series and discuss how to set a specific long term goal.

Stay tuned for this post coming out on 11/20! In the meantime, you may want to consider how physical therapy could help you in improving your overall health this upcoming New Year. You may not have a specific physical complaint like the one we described in this post, but working with a physical therapist can actually help you PREVENT these issues from arising later on! As we continue to age, it becomes more likely that we will experience back pain and numerous other issues. The great thing about PT is that it strengthens your body in all the right ways to guard against joint degeneration, stiffness, achiness, muscular weakness, and loss of balance (just to name a few benefits).

If you want to know if one of our specialists can help you, apply for one of our FREE Discovery Visits right here in Portsmouth!

 

Would a Tech-Detox be Good for your Health?

Technology is a huge part of all of our lives, and there’s nothing wrong with that. We rely on digital technology to do our jobs, communicate with friends and family, find answers to our most pressing questions, and so much more. If you’re reading this right now, it’s because you have access to the internet via your computer, phone, or other device.A 2016 report published by CNN tells us that on average, Americans spend over 50 hours per week online. This “world at your fingertips” has so many great assets, and yet it can be damaging to your health if you never take a break.

Too much screen time can disrupt normal sleep patterns and cause insomnia, lead to increased feelings of isolation, and decrease your attention span over time. And from a physical therapist’s standpoint, walking around looking down at your phone or sitting hunched at your computer for hours on end is terrible for your spine!

There’s no need to give up technology altogether – smartphones and other devices are an important part of the world we live in. However, research shows it can be incredibly beneficial to engage in a sort of “detox” from your gadgets and take a break! This doesn’t have to be as extreme as locking up your phone for a week or quitting social media altogether. You can take small strides towards freeing up those hours that you would otherwise spend online. For example, you can turn your phone off in the evenings, for instance at 5 or 6:00, so that you are not staring at a screen for several hours before bed. This allows your brain to produce its natural levels of melatonin, which your body needs to both fall and stay asleep! Another option would be to delete certain apps off of your phone. Is Facebook a big time suck for you? Try eliminating it from your mobile devices so that you can only access it from a computer. That way, you can prevent distraction when you’re out and about this summer. You can also delete those games that you play out of boredom or habit- which will free up your storage as well as your time! It’s hard to put away the phone altogether, because many of us rely on it for things like its camera function and music. If you’re carrying your phone with you constantly, try putting it on airplane mode. You won’t get texts or social media alerts, but you’ll still have access to your camera, music, calendar, and clock (including timers, alarms, and the stopwatch). You’ll be less distracted, but still get to enjoy the versatile functionality of your smartphone.

If you spend a lot of time during the day on the computer for your job, or have other commitments that require screen time, consider incorporating timed breaks into your day every 25 minutes to stretch and/or walk around. Easy everyday movement and mobility exercises really help to invigorate the body, and taking these breaks will ease tension in your back. You can read more about how prolonged sitting is tough on your back here. If your job requires constant sitting, try to stay up and moving when you get home. It’s easy to flop onto the couch after a long day, but consider stretching or doing a simple in-home workout while watching TV. Or instead of devoting hours strictly to TV watching altogether, you can catch up on your shows while making dinner or folding laundry, for example. Pairing a mobile activity with a passive activity like watching TV will not only make you more productive, but it will also save your back from the pressure and imbalance of prolonged sitting!

Do you have a tech-detox tip to share? Let us know on Facebook! We love to hear your thoughts, and invite you to get in touch if you have any questions about your back pain, mobility, or activity level.