Archive for November, 2009

Heat Verses Ice: The Verdict

November 24, 2009

One of the most common misconceptions when dealing with pain, is at figuring out when to use heat verses ice.  Many patients come into the office with a new, very acute pain tell me that they are using heat.  PLEASE DON”T!!! For a new pain or a re-exacerbation (re-injury) of an old pain, ALWAYS USE ICE!

The Mechanism:  Their is an easy explanation for when to use ice and when to use heat.  The reason is simple science.  It how ice and heat affect the body differently affect the human body.  Heat increased blood flow, therefore, increasing the inflammatory response at the location where the heat was applied.  If you are already inflammed (due to an acute injury), you will only increase pain, swelling, and stiffness to the area if you apply heat.

Ice, on the other hand, temporarily decreases blood flow.  Decreased blood flow = Decrease Inflammation = Decreased pressure on pain receptors (nociceptors) = Decreased Pain.  Therefore using ice on an acute injury will reduce pain and inflammation.

Dr. Misty Funk’s Advice:  For the first 3-5 days after a new injury or re-injury of a chronic pain, use ice for 15-20 minutes several times a day to reduce the inflammatory response and pain. After 3-5 days, start experimenting with heat.  If you feel the area is more swollen or more painful after the heat, then continue to use ice for another day or two. Heat is best used on chronic pain or chronic muscle soreness.

Simply put, always think  ICE for acute pain and  HEAT for chronic pain or muscle soreness/tension (pain or tension that is always there).


Mid Back (Thoracic) Pain

November 9, 2009

Mid Back or Thoracic Pain occurs a lot less frequently than lower back or neck pain.  It’s my theory that it occurs less often because the mid back is protected by the ribs, as well as, because it has less range of motion than other areas of the spine.  More protection, less motion, less risk of injury.  (The Dr. Funk theory…lol!)

Mid Back pain can usually be one of four things.

  1. Simple back pain
  2. Rib pain
  3. Spinal nerve root pain
  4. Serious Red Flag pain

Simple Back Pain

Simple Back Pain means that pain is occuring due to relatively minor problems with the muscles, ligaments and joints of the thoracic spine.  There is no spinal nerve root  or vertebral disc involvement (pinched nerves or disc bluges or herniations).

Simple back pain can take up to six to eight weeks to heal and usually involves healing of the soft tissues around the thoracic spine.  You can expect your chiropractor to perform spinal manipulation in the area, as well as other modalities, such as myofascial tissue therapy or deep tissue massage, stretching, and rehabilitation.

In some cases, your chiropractor may refer you to your medical doctor to get a muscle relaxant or pain med so you will be more comfortable during treatment.

Rib Pain

Rib pain can be extremely painful.  If a rib head has moved or “popped” out of place, you will find that taking a deep breathe is extremely painful.  This is also (but not always) a sure sign of rib involvement, when your mid back is hurting.  Rib pain can be classified as sharp pain radiating along the rib to the front of the chest.  In some cases, you may have fractured a rib, so depending on the mechanism of injury, your chiropractor may get an x-ray to rule this out.

You can also expect about a six to eight week full recovery time with a rib.  You also want to avoid sleep on the side of pain, as to take pressure off the area while it is healing.

Spinal Nerve Root Pain

Spinal nerve root pain is much more serious and the signs and symptoms are different than simple mid back pain.  Nerve root  irritation or compression is always associated with signs of radiating pain, tingling, numbness, and weakness.

Serious Red Flags

If you are experiencing any of these signs and syptoms, you should have more concern.  You will want to see a specialist (your chiropractor can give you a referral, if needed) to help solve the problem.

  • Acute trauma (IE.  car accident or fall)
  • Constant progressive pain
  • Previous history of cancer
  • History of drug abuse or HIV
  • Past history of a Spinal Inflammatory Disease
  • Recent unexplained weight loss
  • Severe restriction of bending forward
  • Widespread neurological changes such as
    • Recent inability to urinate
    • Loss of anal tone that make defecate impossible or difficult
    • Numbness affecting the anus, perineum and/or genitals
    • Widespread or progressive loss of strength in the legs making walking difficult
    • The appearance of a sensory level on pinprick testing in the buttock or leg area.
  • Structural deformity noted in your spine

Most thoracic pain is benign in nature, but you will want to visit your chiropractor to rule out more serious conditions if pain is persistent and does not go away in a few days.

Exercises for Low Back Pain

November 5, 2009

Most everyone experiences low back pain at some point in their lives, and if you have, you know it’s no fun!  This blog post although titled “Exercises for Low Back Pain” may as well be called “Exercises to Prevent Low Back Pain”, as you need not wait until you have pain to perform them.  In fact, I prescribe these exercises to patients who are prone to low back pain.  The exercises listed below are easy to perform and will create lumbar (low back) stability and improved posture.

Lumbar Rehab Program

Perform these exercises once or twice a day for best results.

Exercise 1: Bridging

Lie on your back with your knees bent and feet shoulder width apart.  Slowly raise your hips off the ground.  Return to the start position.  Repeat for a total of 10 times.

Exercise 2: Bridging with Ball

Lie on your back with your ankles on the ball.  Raise your bottom off the floor, maintain a neural spine (don’t bend it).  Return to start position.  Repeat- 10 times.

Exercise 3: Land Swim

Lie face down and stretch your arms over head (place a towel roll under your forehead if your neck needs support).  Raise one arm and the opposite leg. Repeat with the other arm and the other leg.  Perform 10 reps.

Exercise 4: Land Swim with Ball

Lie on your top on top of the ball.  Balance on your hands and toes.  Be sure and keep your head neutral for support.  Raise one arm and the opposite leg.  Relax and repeat on the other side.  Continue alternating sides until you’ve completed a total of 10 reps.

Exercise 5: Chest Lift with Ball

Lie on stomach with ball and balance on your hands and toes.  Keep your head in a neutral position.  Raise one arm and the opposite leg.  Relax and repeat on the other side.  Continue alternating until 10 reps are complete.

Exercise 6: Crunches on the Ball

Lie with your back on the ball and spread your feet to balance your body.  Cross your hands over your chest (or for more difficulty place your hands behind your head).  Pick a spot on the ceiling and raise up toward it.  Slowly lower to the start position.  10 reps.

Exercise 7: Obliques with the Ball

Lie on your on top of the exercise ball and spread your feet to balance your body.  Place your hands behind your head and then take one elbow and reach toward the opposite knee.  Repeat on the other side.  10 reps, alternating side to side.

Exercise 8: Squat with Ball (You’re almost done….)

Place an exercise ball between the wall and the small of your back.  Stand with your feet shoulder distance apart then bend your knees and lower your body down until your knees make a 90 degree angle.  Hold for 3 seconds then go back to the start position.  10 Reps.

Exercise 9: Ball Pass

Lie on your back holding an exercise ball in your hands above your head.  Lift your hands, neck and upper body up as your lower body raises up and pass the ball from your hands to between your ankles.  Press the ball with your ankles to contract the inner thigh.  Lower your body down, return your hands above your head and feet down (now the ball is touching the floor.  Then lift up again and pass the ball back to your hands and lower your body down to the start position.  Repeat 10 times.

Wow!  Great job!  And great way to maintain or build a healthy spine that will never have back pain (again).

Disclaimer- If you are experiencing low back pain, check with your chiropractor, physical therapist, or medical doctor to make sure these are safe for your body to perform.

What About My Pillow?

November 3, 2009

Pillow FlowerOne of the most common concerns I get from patients is that they believe their pillow is contributing to their neck pain or headaches. “What is the best pillow for me, Dr. Funk?”, I hear all the time.

I have to be honest. I didn’t learn this in chiropractic school, although you would think that it would be taught. I actually had to do some research on my own to find the answers. And the answer is that you have to choose the right pillow for the way you sleep.

A pillow is designed to support the neck at night while we sleep. Proper alignment of our neck is a must to prevent or eliminate neck pain and stiffness.

Back Sleepers

For individuals who sleep on their back, their pillow should be medium sized so that the head is not at an upward angle.  A pillow that maintains the natural “C” shaped curve of the neck is a bonus, and placing a pillow under the knees will reduce pressure on the low back at night.  One caveat of back sleepers, is that they tend to snore more.  The good thing is that back sleepers develop less wrinkles on their faces over time.  (Hmmm…Snoring or wrinkles…got to weight the!)

Side Sleepers

Side sleepers need more firm and higher pillows.  Again, you want the head to be parallel with the bed, so no pillows that are super high or doubling pillows.  Since your shoulder is in the way when you sleep on your side, a firmer pillow will not only support the head but protect your shoulder as well.  I also suggest a flat pillow in between your knees to keep the pelvis in alignment.  Side sleepers snore less, so if you struggle with snoring, try sleeping on your side.

Stomach Sleepers

If you sleep on your stomach, you may not need a pillow.  If you feel you need one, use a flat pillow, so your neck can maintain it’s proper alignment.  This is the position that I recommend the least.  I think it is the hardest to maintain proper posture.  Many of my stomach sleepers come in complaining of tingling in one or both of their hands when they wake.  This typically happens because your body is not well supported during sleep in this position, and your pectoralis minor muscles can be overstretched.  Tight pec minor muscles will compress the brachial plexus causing a tingling sensation in the hands.

Pillow Types

  • The body pillow is good for pregnant women and the side sleeper.
  • The Memory Foam contour pillow is good for people with neck or spine pain and can be used for back or side sleepers.
  • The four position pillow works well in any position.
  • The U-neck pillow is designed for traveling and supports the neck.
  • Create your own perfect pillow with Select Comfort- Pillow[ology]

If you have any other questions, please feel free to e-mail or comment.

Tranquility Chiropractic Studio