Dr Davis' Back & Wrist Pain Blog

Exercise is a MUST for treating and preventing Back Pain

San Francisco Chiropractor Comments:

A primary complaint of many back pain patients is the inability to exercise. They want to exercise, but the exercise makes the pain worse. This is not good, because exercise is exactly what the spine needs to stay strong and healthy.

Many back pain patients that are unable to exercise over extended periods of time put on extra weight that further worsens the problem. Throw prescription or OTC pain medications into the pot and now you have a powerful mix of ingredients that can effect your home and work life and send you on a downward spiral, physically and emotionally.  

What I described above is not that uncommon. It can become a viscous cycle that is hard to break. The longer this "back pain-no exercise-weight gain-pain pill-emotional downer" cycle continues, the worse the problem becomes, making in even more difficult to break the cycle.

Obviously, the best approach is to prevent this ugly back pain cycle from happening in the first place by keeping the spine healthy with regular active spinal exercises and stretches, as well as aerobic conditioning (and chiropractic care).

Here is an excerpt from an article I found on Spine-health.com entitled Exercise is Essential For Back Pain Relief:

A natural stimulus for the healing process is active exercise - in a controlled, gradual and progressive manner. Movement keeps the discs, muscles, ligaments and joints in the spine healthy. Physical activity also allows diffusion of nutrients into the disc space and helps it stay healthy. For more information see Back Exercise and Abdominal Exercise Recommendations.

Too much rest worsens pain

Pain often prevents us from getting enough exercise, but lack of exercise can worsen the pain by leading to stiffness, weakness and de-conditioning. In the case of a disc injury, significant inactivity deprives the injured disc of the nutrition it needs and this can lead to further degeneration and pain. Additionally, exercise and activity is needed to maintain the exchange of fluids in spinal structures and reduce swelling that naturally occurs in the tissues surrounding an injured disc. This swelling can further irritate nerves that are already affected by the highly inflammatory herniated disc material. See also Exercise and Fitness Help Your Back.

Stretching, strengthening and aerobic conditioning exercises are important

It may take weeks or months of stretching, but you will find that the increase in motion provided by stretching leads to significant, sustained pain relief. Stretching your hamstrings regularly is essential therapy for lower back pain and sciatica. If an episode of low back pain has lasted two weeks or more, a strengthening program (such as McKenzie exercises, lumbar stabilization training and/or facilitation exercises) is critical to long-term recovery.

Click here for full article

My Take: Sure, exercise is great for preventing back pain and treating back pain. Hey...exercise is good for everything...Life is Motion. But some people just can't do it because of the back pain cycle they are caught-up in. This is where you need a doctor that is experienced in helping patients break the back pain cycle without (potentially addicting) drugs or surgery.

Nonsurgical spinal decompression is our treatment of choice as it is very safe and gentle and can help to re-hydrate the spinal discs, reduce inflammation and muscle spasms, and re-position the injured spinal discs, so that exercise can be implemented without making the problem worse.

Deep tissue laser or cold laser therapy (both are painless) can also help reduce inflammation levels so that more motion can be introduced into the spine, muscles, ligaments, and tendons.

  Trying to force exercise on a patient as a treatment when the spine is inflamed can backfire. So be careful, and make sure your doctor has plenty of experience treating severe back pain (and the tools to reduce inflammation first before exercise) and incorporates exercise into their back pain protocols (when the time is right).

To find out if you are a candidate for care at Executive Express Chiropractic in San Francisco, call 415-392-2225. 

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What's the best exercise for low back pain?

San Francisco Chiropractor Comments:

I have been practicing chiropractic in downtown San Francisco for 18 years now. One of the things I have learned is...there really is no "best exercise" when it comes to low back pain. It's more a matter of your overall fitness level, age, and specific spinal condition.

In general...staying fit from things like lifting weights, Pilate's, cycling, running, aerobics, and cross-training, all make sense if the conditions are right and you can handle it.

However, if the conditions are not right...say your back is inflamed and you can't even think about exercise...well, we have to get the inflammation down first (chiropractic care is great for this), then start real easy with exercise, and go from there. 

At Executive Express Chiropractic the exercises we prescribe are all based on the individual, and are very specific in nature.   But at the same time, we want to teach our patients common sense thought processes that they can use throughout their lives as they relate to back pain exercises and exercise in general.

My good friend Dr. Ron Spallone, a chiropractor in Denver, Colorado just posted an excellent article on his blog entitled Guidelines For Choosing The Best Low Back Pain Exercises. Here is an excerpt:  

1. If it hurts, don’t do it
This rule simply means that pain is bad. When you are trying a new exercise, or performing one you know, the exercise should be helping to relieve pain, not increase it. Some things to consider when implementing this rule are: (1) change the resistance (i.e. decrease or increase the weight), (2) change the speed (i.e. slow down or speed up), (3) change the range of motion (i.e. make your movement smaller or bigger). If none of these things helps to decrease the pain you are experiencing as a result of the exercise itself, stop the exercise.

2. If it helps, do it as often as you feel is necessary
Exercise is movement-movement is health. When you find a movement that results in an immediate reduction in your pain, do it for as long as you are able and as frequently as you are able. The only reason to ignore this rule is if increased frequency increases the pain (see #1 above).

Good stuff. It's really a lot of common sense. But if you get it down, you can avoid injuring your low back by only doing the back exercises that make sense for you and avoiding the ones that don't.

If you live or work in San Francisco and would like to find out what low back exercises make sense for you, give Executive Express Chiropractic a call at 415-392-2225.

In Denver, you can reach Dr. Ron  Spallone at 303-980-5699.

Chronic Low Back Pain Relieved by Frequent Exercise

San Francisco Chiropractor Comments:

One of the most common conditions we treat at Executive Express Chiropractic in downtown San Francisco is chronic low back pain. Chronic means the patient has had the back pain for over 3 months.

Many chronic back pain patients tell us they have gained weight (further aggravating the problem)during this period because they have been unable to exercise...which as it turns out, may be what they should have been doing more of.

According to a University of Alberta back pain study, those chronic low back pain patients that worked out 4 days per week, had a better quality of life, with less pain, and less disability than those who exercised less...say 2 days per week.

So, it's not just exercise that benefits chronic low back pain...it's frequent exercise...with weights.

The article talks about how these findings go against the grain in the sense that most would consider frequent exercise an activity that would make chronic back pain worse.

The findings were presented at the American College of Sports Medicine conference in Seattle, WA.

I have been working out with weights for over 30 years...typically I hold back when I have back pain (which is rare)...but I do not have chronic back pain. For acute back pain (a new episode) I would not recommend frequent exercise with weights...which would mos likely make the pain worse.  But for chronic back pain...the findings speak for themselves. However, I would do this under the guidance of a doctor and a personal trainer to make sure the exercise program makes sense.

If you would like to find out if you are a candidate for care at Executive Express Chiropractic at the SF Embarcadero Center, please call 415-392-2225 or request an appointment online.

San Francisco Chiropractor

Executive Express Chiropractic (formerly Front Street Chiropractic) is located at the downtown SF Embarcadero Center near the Ferry building. We offer walk-in, no-waiting, no hassles service.

Dr. Eben Davis is the clinic director. Dr. Davis has 18 years experience running one of the most successful chiropractic clinics in the country and writes daily on his award winning Back & Wrist Pain blog. 

Some of the conditions that Executive Express Chiropractic can help are:

• Low back pain
• Neck Pain
• Headaches
• Shoulder, arm and wrist pain
• Sports Injuries
• Whiplash
• Carpal Tunnel Syndrome
• Herniated cervical and lumbar discs

Clinic supervisor Dr. Adam Jacobs, DC is full body certified in Active Release Techniques (ART)...which is a high-tech method of isloted deep tissue massage with active participation by the patient.

 Executive Express also has a DRX9000 (lumbar decompression) and DRX9000c (cervical decompression) combo-machine which costs around $150,000. The DRX machines are used to help treat conditions such as herniated discs, bulging discs, spinal stenosis and degenerative disc disease (DDD).

This San Francisco Chiropractor clearly has an eye for flair (Executive Express Chiropractic photos) . The clinic is a remarkable combination of 100% eco-friendly building materials such as real leather scraps from shoes and furniture used for the curved leather entry wall, recycled marble chips for the countertop and shelves, and recycled resin materials (and silkworms from families in Nepal) for the dramatic privacy dividers between the chiropractic tables. 

Dr. Davis said "no expense was spared...we wanted to create a masterpiece that patients would talk about to their friends...but at the same time would be healthy for them, our staff...and our planet...even our patient processing, appointment making,  and record keeping systems are paperless.  And...our architects are the best in San Francisco...Martinkovic Milford Architects." 

To schedule an appointment at Executive Express Chiropractic...call 415-393-2225 or request an appointment online.    

   

    

What's The Best Exercise For Back Pain?

San Francisco Chiropractor Comments:

We treat hundreds of new cases of low back pain and sciatica every year at Executive Express Chiropractic in downtown SF. The conditions vary from simple sprains to degenerative disc disease and lumbar disc herniations. Some patients are new and acute...some are chronic. Some patients can still function normally...some are debilitated.

We incorporate chiropractic adjustments, Active Release Techniques (ART), Graston Technique, Massage, and Exercise into our treatment protocols. We are also the only clinic in the SF Financial District to offer nonsurgical spinal decompression with the DRX9000.

I spend a lot of time staying current on trends in health care...especially in regards to back pain. One thing for sure...there is an overwhelming amount of research that has been done lately in the area of back pain and exercise. I wrote a few weeks ago about how exercise is underutilized as a potential treatment for back and neck pain.

Only 14.4% of physicians prescribe exercise. I was really shocked to learn that only 33% of all chiropractors prescribe exercise...that's really low. Roughly 64% of physical therapist prescribe exercise...but then again...that's what they do...and they do it well. 

This new research seems to be telling us what I already knew...exercise is one of the best therapies for back pain prevention (and treatment)...we do it with ALL patients at Executive Express.

But here's the crazy thing about exercise and back pain...It appears that there is no particular exercise that is better than the other. Studies show that exercise programs with varied goals and methods achieve the same favorable outcomes (Back Letter, Volume 24, Number 3, 2009) if the patient sticks with the program.

Can this mean that maybe it's not the exercise itself...but the fact that exercising increases self-confidence in movement and activities...and reduces fears of injuries (you look better too)?  

These studies suggests that clearly there is more to exercise than increased strength, endurance, and flexibility. A lot of the benefit is in the head...are we underestimating the psychological component of chronic back pain?

I Think We Are.

To find out if you are a candidate for care at Executive Express Chiropractic at the San Francisco Embarcadero Center...please call 415-392-2225 or request an appointment online.

Study Shows Chronic Low Back Pain On The Rise

San Francisco Chiropractor Comments:

                                I just read an article on www.medicalnewstoday.com entitled:

'Alarming Increase' In Prevalence of Chronic Low-Back Pain: UNC Study

The article goes on to talk about how, according to research results, the proportion of people suffering with chronic, impairing low back pain has more than doubled from 3.9% of the population to 10.2% since the early 1990's (to 2006). This is staggering.

So, the question becomes...WHY?...maybe increased obesity rates (what I think is a major cause)......depression and awareness of the condition...and the decline in manufacturing and services jobs and increase in construction jobs (of course this has reversed of late).

Plus...more people are seeking treatment for back pain vs. ignoring it (more health awareness).

Low back pain is the #2 reason for disability in the US...and for missing work. The article talks about how treatments are mostly ineffective...but does not say what they are (I have ordered the actual study and will comment later). 

Considering low back pain is a $100 billion dollar per year industry...it does make sense to figure out what's going on here...and to certainly consider the benefits of chiropractic care and nonsurgical spinal decompression...both of which have excellent track records treating chronic low back pain. 

The article also comments on the Carey and Freburger study I wrote about recently showing that health care providers are under-utilizing back pain exercises.

Check out the story and let me know what you think.

To find out if you are a candidate for care at Executive Express Chiropractic at the SF Embarcadero Center...please call 415-392-2225 or request an appointment online. 

Osteoarthritis Exercises

San Francisco Chiropractor and Chronic Back Pain Doctor Comments:

Osteoarthritis is a form of arthritis (inflammation of a joint) that is caused by a breakdown of cartilage in the joints...including the joints of the spine.  Osteoarthritis is also know as degenerative joint disease, or DJD.

DJD usually occurs in weight bearing joints like the knees, hips, and spine...but can occur in other joints like the wrist and fingers.

The cartilage loses it's elasticity with DJD, which can cause the muscles, ligaments, and tendons to become stretched and overworked...a chain reaction. This can lead to chronic pain, inflammation, and loss of motion.

Chiropractic care can often times help DJD...but one of the best things you can do is exercise. Some exercises can make you worse, so you have to be careful. A good spine doctor or physical therapist will usually know the right exercises to prescribe.

Anyway...I found a pretty good article on the excellent www.spine-health.com website, entitled:

Exercises for Osteoarthritis 

Check the exercises out...but check with your doctor before you do any.

If you would like to find out if you are a candidate for care at Executive Express Chiropractic at the SF Embarcadero Center...simply call 415-392-2225, press ext#1.

Regular Exercise: 10 Benefits

San Francisco Executive Express Chiropractor Comments:

Making time to exercise is probably the single best thing you can do for your physical and emotional well being. There are just so many great things that result from a regular exercise program. And...it really doesn't have to take up a whole lot of time either...you can get positive benefits from exercise in 20 minutes per day.    

I came across this article on the excellent www.revolutionhealth.com website...it is entitled:

Exercise: 7 benefits of regular physical activity, courtesy of www.TheMayoClinic.com

I am going to add 3 more of my own (benefits of regular exercise) to make 10...here they are:

1. Exercise helps prevent back pain by keeping extra bodyweight off the spinal joints, discs, and ligaments. It also helps keeps the spinal muscles tone and flexible.

2. Regular exercise helps you look young. I know when I go to high school reunions, I can sure tell who takes care of themselves with regular exercise...it just shows.

3. Exercise is a form of discipline...YOU have complete control over whether or not you exercise or not. Do you make excuses...or do you get the job done. You feel good about yourself when you get the job done...and this carries over into other areas of your life and makes you more productive.

Well...that's about it. If you are not exercising because it causes too much pain...we need to get that fixed...and that's where chiropractic can help. A good chiropractor can work with you to get you back on track with an exercise program, while at the same time fixing your spine. The combination of exercise and chiropractic care is very powerful...you should try it out. Chances are...you will be glad you did.

If you would like to find out if you are a candidate for care at Executive Express Chiropractic at the Embarcadero Center in San Francisco...simply call 415-392-2225, press 1 (24 hr live operator). Ask for a complimentary consultation with Dr. Eben Davis.      

Is Yoga Good for a Herniated Disc?

San Francisco Chiropractor and Herniated Disc Doctor Comments:

Yoga is very popular these days...and there are many different kinds. Some methods of Yoga are very gentle...some are advanced...and everything in between.

Anyway...I am often asked...Is it is OK to do Yoga with a herniated disc?

My answer is always...it depends. It depends on your particular condition.  There are Yoga postures that might be perfect for you and actually enhance the healing process...and there are Yoga postures that may hurt you.

This is where an experienced Yoga teacher comes in. I used to have an onsite Yoga instructor at my Financial District Chiropractic Center. Sometimes Yoga made sense for herniated disc repair...sometimes it didn't.

I did a little research online and came up with this article on the Yoga Journal website entitled:

Yoga With A Herniated Disc

It's an excellent read. Check it out. Let me know if you have any experience with Yoga and disc herniations and if you know any really good instructors here in downtown San Francisco that I can refer patients to.

For a complimentary consultation with Dr. Eben Davis at Executive Express Chiropractic at the Embarcadero Center...simply call 415-392-2225, press 1 (24 hr live operator). 

Weight Lifting with a Herniated Disc

San Francisco Chiropractor and Herniated Disc Doctor Comments:

I guess if you know you have a herniated disc in your low back...or in your neck...you had an MRI at some point. Actually, x-rays and positive orthopedic tests for disc pathology are usually a pretty reliable indicator also. Either way...you had some sort of episode of low back or neck pain, that was diagnosed as a herniated disc. So now what?

Well...most of the time the back pain or neck pain resolves with conservative treatment, such as chiropractic, physical therapy, or medications. We treat many patients (that lift weights) with herniated discs at Executive Express Chiropractic in downtown San Francisco. Most of the time we are successful with treatment outcomes.   

But what about the disc herniation...it's still there...can I lift weights?

Probably (see a good chiropractor)...as long as you are careful not to do exercises that could put too much stress on the herniated disc. If your disc herniation is in the low back...I would avoid squats, presses behind neck, and low back extensions...and I would be careful with everything else. avoid exercises that cause pain.

If you have a herniated disc in the neck...I would avoid presses behind neck, heavy shoulder presses, and neck extensions with weights. Go nice and easy with everything else. Use lots of dumbbells and cables.

Sit-ups are OK with really good form...no pulling on the neck...nice and slow...squeeze the abs on each rep.  A strong abdominal region and core will help stabilize the low back...and neck.