Archive for March, 2010

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B.T.T.o.D: A great start to a back friendly home: Declutter TODAY!

Monday, March 29th, 2010

Here is a fantastic post from Terri Trespicio’s blog. Terri is a writer/editor for Martha Stewart’s WholeLiving magazine, as well as the host of the Body & Soul show on Martha Stewart Radio. You should definitely check out her excellent blog and radio show.

Here is a recent post Terri did on decluttering your home. She offers some great tips and suggestions for using/reusing different common items in your home to help cut down the clutter. I know this isn’t a ‘back pain’ piece strictly speaking- but is a great entree into the concept of a back friendly home.

Look for some excellent ways to make your home more back friendly here on BackWords- The Back Together Blog.

Be Well,

Andy

One of the many, beautiful murals you may run into while strolling through Old Quebec City.

One of the many, beautiful murals you may run into while strolling through Old Quebec City.

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Video: Viewer Question about Spinal Decompression and Not gonna get dragged into nastiness about Health Care Reform.

Friday, March 26th, 2010

So after careful consideration, I have opted not to get swept into the discussion regarding Health Care Reform beyond what I have already said. Some of the letters I received were so nasty, and came from both sides of the debate. I figure, I posted a non-partisan piece, and I am going to remain non-partisan here on BackWords. I thank you all for your letters, and please feel free to submit questions and comments which are non-political in nature.

Here is a video post which says pretty much as much, and also answers a viewer question regarding spinal decompression therapy. I have seen adds for this popping up pretty much all over the place for the past several years. See a photo of one of the devices below (I did not take this photograph, it was emailed to me, so please forgive me for using it if it is yours!)

drs9000-HCR

staff_picture_2006_001

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Posted in politics, Videos, Viewer Question | No Comments »

Health Care Reform: Holy CRAP! Responses galore!

Wednesday, March 24th, 2010

So, on Monday I published what I was pretty sure was the most non-partisan piece on the health care debate ever written- and in spite of every possible effort I made to keep it in the realm of peaceful commentary, I received more letters on this post than on any other post I have ever written- and lots of it nasty. I would say about half of the comments were positive thoughts about my post, but the other half? Well, let’s just say I am kind of surprised how much vitriol I got from both liberals and conservatives alike.

I will be sorting through some of these comments today, and will post a summary some time tomorrow. If you did not have a chance to review the original post, check it out here.

Please feel free to send additional comments in the mean time. This is arguably one of the most important topics facing our nation, and it warrants discussion. Please try to keep your comments civilized, and thoughtful.

Thanks for stopping by. Look for the tip of the day later this afternoon!

-Andy

Random Contest: Copy of my book, Back Together to the first person who can identify the character in this photo:

The first person to identify the character in this photo, and win a copy of my book, Back Together.

The first person to identify the character in this photo, and win a copy of my book, Back Together.

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Posted in Announcements, politics | No Comments »

Fitness Challenge: Top 10 Dieting Tips from Dietician/Nutritionist Sarah Barts

Tuesday, March 23rd, 2010

I am so pleased to hear everyone’s stories as we are going through the fitness challenge. This past week, I did not lose or gain anything, but I am not discouraged- this isn’t about week to week. It’s about the rest of our lives!

I have been working with an outstanding nutritionist, Sarah Barts for some time now. Her approach to weight control is based on simple, common sense principles which help you not to just lose weight, but to maintain a nutritionally healthy lifestyle which will help you for the rest of your life. Recently, she has been doing some additional work as a personal chef. You should definitely check out her website here.

I asked her to contribute her top ten list of tips for helping to lose weight and maintain it. Check it out…..

Top 10 ways to eat healthier and lose weight.

As a registered dietitian certified in weight management and a personal chef, I’ve worked with multiple individuals wanting to eat healthier, enjoy food, and lose or maintain a healthy comfortable weight.  Through the years of working with multiple weight loss programs and countless hours of research, I have been able to see what works best for people.  Below is what I would consider the top 10 ways to eat healthier for prevention of chronic disease, help with weight loss, and overall improve relationships with food.

  1. Eat more vegetables, the more colors the better.  Dietary guidelines suggest 2 ½ cups of vegetables per day.  Fill half of your plate at lunch and dinner with vegetables of multiple colors, and you will fulfill these recommendations.  Not only are they high in antioxidants and phytochemicals to help prevent cancer, they are also a good source of fiber
  2. Limit drinks with calories, water is the best option.  4 ounces of 100% juice can have approximately 60 calories; 20 ounces of soda can have up to 17 teaspoons of sugar and close to 240 calories per bottle.
  3. Eat healthy 90% of the time, leaving 10% of the time to choose what you want.  There is no reason to feel guilty if you have always adored a food that may not be as healthy.  Portion control and frequency is key.  Realistic healthy eating includes small amounts of the not so healthy, but delicious foods.
  4. Eat slowly and enjoy.  Who doesn’t like to eat?  Why not enjoy it?  Slow down and distinguish what tastes good about your food.  This will give you time to evaluate what your likes and dislikes are, and check-in to your hunger or fullness levels.  (no need to clean your plate)
  5. Stop eating when you are satisfied.  Yes – the food tastes are great!  It will not be the last time you eat it and you can always save the leftovers for later.  No negative feelings needed for not cleaning your plate – - “it’s either a waste or a waist”
  6. Eat more whole grains and fiber.  Not only is fiber filling, which keeps you feeling satisfied longer, but it also keeps blood sugar in control, helps prevent colon cancer, and can reduce cholesterol.
  7. Move more.  You might have a sedentary job, and work out at the gym for an hour a day, which is ok.  But, you will burn more calories if you are physically active throughout the day in addition to your gym visit.  Walk whenever possible, e.g. pace whenever talking on the phone, use a pedometer and shoot for 10,000 steps per day, park further from the store or your work, walk for 10 minutes at lunchtime.  Include an activity that you enjoy 1-2x/week.
  8. Eat less processed foods.  If you can’t pronounce many ingredients on the label, your body is going to have a hard time with it too.  Eating foods with natural ingredients and less processing makes your body work the way it’s meant to, giving you more energy.
  9. Eat small frequent meals.  This will take some planning on your part, but eating smaller meals and nutritious snacks between them not only keeps your metabolism working throughout the day, but it helps to prevent over-eating.  When meals are skipped and you get extremely hungry, there is more tendency to eat whatever kind of food is available and eat fast, thus increasing calories consumed.
  10. Get rid of your diet rules.  If you have dieted multiple times, more than likely you have acquired the “good food/bad food” mentality and recite the multiple rules that you have learned over time.  The problem with diet rules, is they are most often accompanied by negative and guilty feelings when they can’t be followed perfectly.  Negative and guilty feelings are sometimes associated with an all or nothing way of thinking and sometimes the nothing can lead to over indulging.

Focus on eating foods that are nutritious, enjoy meals, eat slowly and moving more.

Brought to you by: Sarah Barts, RD, LDN

Certified in Weight Management

Personal Chef for Mindful Gourmet

sarah@mindfulgourmet.com

www.mindfulgourmet.com

484-744-1429

Old growth banyan tree, Key Largo.

Old growth banyan tree, Key Largo.


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Posted in Fitness & Exercise, fitness challenge, General Health Information, Nutrition | No Comments »

Health Care Reform: A few thoughts from a doctor in the trenches…

Monday, March 22nd, 2010

So yesterday, the House passed the most sweeping overhaul of America’s health care system since the enactment of Medicare in 1965. I am sure you have heard the pundits from both sides of the aisles. With everything you’ve heard, it can be easy to become overwhelmed with the huge amounts of information and disinformation out there. Now I am not here to give you an opinion one way or the other on this legislation (there are things I like about it, and things I really don’t) but regardless of where you fall on the political spectrum, the debate has forced us to consider some uncomfortable issues as a whole- Issues which I as a solo family practitioner, am faced with almost daily. These are topics which warrant attention regardless of your political leanings, and these issues are finally the topic of conversation- and frankly, I am glad to hear the discourse:

-The United States is WAY behind the curve when it comes to preventive care. An unbelievable amount of savings could be found in simply facilitating early screenings and preventive measures for a whole host of disease- from heart disease to Type II diabetes. For the first time ever I am hearing discussion of this issue.

-We are lacking when it comes to prenatal care, and have a caesarian rate far above those recommended by the World Health Organization and virtually every Ob/Gyn governing body in the world. I am hearing many of my Ob/Gyn colleagues talking about the importance of primary care, and preventive screenings to facilitate the reduction in C-section rates and birthing complications.

-I am seeing the discussion of nutrition finally becoming serious. Rather than just saying ‘we should eat healthier’, I am hearing about school districts facilitating healthy eating for kids, fast food restaurants actually giving considerations to the contents of their products- there is even a new reality TV show where a chef is trying to improve the eating habits of an entire town.

-The nations poorest individuals are also the least likely to have insurance and subsequently, routine care. This population is almost never part of the popular discussion on the topic of health care. Now they are.

The American lifestyle seems tailor made for a whole plethora of health problems, and for the first time we, as a culture, seem to be thinking about the factors which contribute to this deleterious lifestyle.  Regardless of whether you lean right or left,  you would be hard pressed to deem this line of thought as anything other than positive.

Be well, and thanks for stopping in.

-Andy

Display at the Welcome center in the Royal Victoria & Albert, London. All of the pills an individual took over the course of a lifetime.

Display at the Welcome center in the Royal Victoria & Albert, London. All of the pills an individual took over the course of a lifetime.

Posted in politics, Uncategorized | 2 Comments »

Genetic Link to Pain Tolerance- Why does your back hurt more than theirs??

Monday, March 22nd, 2010

If you have been dealing with back pain, have you ever spoken with someone who has a similar condition? If you have met with people with similar spinal issues, you may have noticed that many people experience pain in different ways, and that different folks have different pain tolerances.

An article in the Proceedings of the National Academy of Sciences describes a gene which has been identified as SCN9A which plays a role in how you tolerate pain. Researchers found this gene was ‘underrepresented’ in patients suffering from rare conditions where patients don’t sense pain, and that it was over active in patients who had hypersensitivity to pain.

Now this news is probably not real comfort to you if you are hurting at this very moment. But clearly, there need to be other factors which can influence how you experience pain, otherwise you wouldn’t have ‘good days’ and ‘bad days.’

Here are just a few thoughts on getting more ‘better days.’…

-If you stick around this blog long enough, you will know what a big role I feel psychology has in how you feel. More and more studies cite the importance of the mind-body connection. Knowing this, take a few minutes out of each day to improve your psychology- this can come from meditation, a hobby, reading- doesn’t matter what- JUST DO IT!

-Regular exercise will keep your body ‘lubricated’ and as close to peak as possible. Take a few moments out of your day to work on your fitness.

-Maximize the quality of your sleep. Good sleep gives your body a chance to recharge and recuperate- both physically and mentally.

-Give yourself time for good social interactions- both with your partner/spouse and with friends. These interactions help solidify your feelings of worth and participation in community- key positive emotions.

These are just a sampling of the things you can do. Check back here often for more tips, and if you have specific questions or comments about your personal situation send ‘em in- as always, your contributions are what keep this place interesting!

Be well!

-Andy

My father & I with the late, great Oscar Peterson- the greatest jazz pianist ever.

My father & I with the late, great Oscar Peterson- the greatest jazz pianist ever.

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Posted in General Health Information, Studies & Research, Tips | No Comments »

B.T.T.o.D: Using a laptop? Place a pillow on your lap UNDER your laptop.

Thursday, March 18th, 2010

This will do several things for you: 1) It will raise the laptop, alleviating some of the flexion in your neck while trying to look down at the screen. 2) It will allow you to nudge the computer into a level position so your head isn’t cocked to the left or right while viewing. 3) It will get the hot surface of the laptop off of your lap, allowing you to work in more comfort.

I know it isn’t easy to carry around a pillow with you all the time, but you can likely leave one in the space you work in at home, and one in your workplace. Give it a try- you WILL notice a difference.

Be well!

-Andy

Howard Jones with his copy of Back Together!

Howard Jones with his copy of Back Together!

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Posted in Ergonomics, Tip o' the Day/ B.T.T.o.D., Tips | No Comments »

Letters: Yoga, prayer, Dead Sea- and all pertaining to back pain!

Wednesday, March 17th, 2010

Thank You!

I am so grateful for the nice responses I’ve been getting from viewers. This past week, between the FB fanpage, Twitter, You Tube and directly from right here on the blog, I have gotten more letters than in any previous week. So really, thank you for stopping by and contributing. When I end a video with ‘your cards & letters are what keep this place interesting’- it is the honest truth.

Viewer Letters

DR. KIRSCHNER–DO YOU FEEL THAT DOING YOGA IS A GOOD ALTERNATIVE EXCERCISE FOR SOMEONE WITH SERIOUS BACK PAIN?  I HAVE VERY LITTLE KNOWLEDGE OF YOGA.  WILL IT HURT ME?

-M

Well M, without knowing the specific mechanism or type of back pain you have, I can only make a few statements about Yoga in general…

As a rule, I love Yoga both for exercise and as a modality for helping with back pain. Gentle range of motion exercises and stretches, as found in various types of yoga can be useful for reducing back pain- I’ve personally only done ‘hot’ Yoga a few times, but it was really great for loosening up the muscles of the spine, and restoring some lost range of motion. It also helps with core stability, which is critical for long term reduction of back pain. If you are experimenting with different types of exercise, I would also give a well structured Pilates program a shot as well. As I mentioned before- I don’t know your specific circumstances, so be sure to consult your physician before trying anything. Hope this helps!

In response to the piece on prayer from last week:

Dr. Kirschner, prayer is such an integral part of my health & wellness. I have constant back pain, resulting from a fall off a bicycle. I had a compression fracture in L4, and I have never really had a pain free day since. My faith in God is really one of the only things that keeps me going. My family doctor understands how helpful this is to me, but none of the specialists I see really get it. Thank you for acknowledging the value of prayer.

-Teri

You will always see me stress the connection between body and mind, and for many people, faith is the best way they have of accessing the ‘mind’ component of back pain. I am glad you have found a way to find relief!

In response to the intro to the Alternative Medicine pieces starting next week, Live from the Dead Sea:

Andy- each year me and my boyfriend travel to the Dead Sea and soak in both the sea, and the mud baths around it. When I leave there, I get improvement in my neck pain which lasts 3-4 months. Your readers should really know about this- I get relief without medicine, and it lasts for a long time. I’ve been told the Dead Sea has properties which help lots of people.

-Shawn

As I related in the intro to that video- tens of thousands of people flock to the shores of the Dead Sea each year to float in the salty water, and get themselves covered in the mineral rich mud. I have patients who go there for pain relief, psoriasis, and other conditions. I have seen enough anecdotal evidence that people are getting relief, so I cannot simply write it off as some ‘crunchy’ pseudo-holisitc medicine- but conversely, I cannot explain why these folks are getting these results. I enjoy the sensation of floating in the Dead Sea- but it left me with my skin feeling kind of weird for a few days- and I didn’t particularly care for the sensation. As for a recommendation: if you have people close to you who have gotten results, and it is not too much of a hardship- give it a try! At the very least you will have an amazing trip to one of the most beautiful countries in the world.

Back Together is now available on Amazon.

My book, Back Together, has been available on Amazon since it’s launch. Last week my DVD program finally became available. They both make great gifts- so I hope you will give them a look. The links are below:

Back Together- Hands-on Healing for Couples (BOOK)

Back Together- Simple & Effective Relief from Back Pain- for Couples (DVD)

Thanks again for stopping by. Look for the wrap up on my spinal surgery pieces this week, and the alternative medicine series to begin next week.

Best, and be well!

-Andy

Performing an upper thoracic release on the great Jeremiah Trotter.

Performing an upper thoracic release on the great Jeremiah Trotter.

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Viewer Question: Is cracking your back (or your knuckles!!) a cause of arthritis?

Monday, March 15th, 2010

I’m actually kind of surprised it took this long for this topic to show up from someone:

I grew up hearing warnings about cracking your knuckles. “If you crack your knuckles, you’ll develop arthritis when you get older.” So, now that I suffer from back pain, I’ve found different ways to “crack” my spine. For example, I’ve discovered that if my husband hugs me pretty hard around my upper back, I hear a refreshing pop. If he moves up another half inch or inch, I hear another one. If I’m in my car, I can push on the steering wheel and stretch my back in such a way that it cracks. So, what I’m trying to ask is – is this harmful and can it actually lead to more pain or back problems in the future?

-Randi

Thank you for your question Randi.

I get asked this by patients pretty much every day, and I cannot believe it took this long for me to realize I should cover this here- and the answer has two parts:

First of all, let’s talk about the ‘crack.’ Patients have come to expect a loud crack or crunch associated with osteopathic or chiropractic treatment- I can’t tell you how many times a week I hear ‘Doc- I need you to crack my back!’ In fact- with the treatment style I’ve developed over the past decade or so I actually do very little ‘craking’ at all. Some patients actually voice disappointment when they don’t have the satisfaction of the noise announcing that yes, they are cured! Sorry.

That being said, the cracking sound that so many folks associate with treatment is an interesting thing. You can make virtually any moveable joint in your body crack, but that sound should by no means be the goal of treatment. There are lots of thoughts on what is actually making the sound (One of the leading theories is the shift of nitrogen bubbles occurring inside the joint space when a corrective ‘thrust’ is applied.) Anatomically, there really isn’t much of a difference between cracking your knuckles, and cracking your back.

I’ve been a pianist most of my life, and more than one piano teacher told me I would get arthritis from cracking my knuckles, which by that time had already become a habit. I’ve done some research, and there is no evidence that cracking your knuckles, or cracking your back will cause you arthritis or any other problems.

Now, let me qualify that with two provisos: Firstly- I wouldn’t ‘crack’ my back if I were in the middle of a severe flare up of pain- you could irritate an area which is already inflamed, and potentially make your acute condition worse. Secondly- There have been numerous studies that have shown that when you ‘self-correct’ or ‘crack’ your own spine, you are very unlikely to correct the segment which actually needs to be moved. You may get the one above or below it, but you probably won’t get the one causing you discomfort.

I hope this answers your concern. And again, thanks for your contribution.

Be well!

-Andy

The minerals of the Dead Sea, thought to be so good for your joints, are apparently not so good for your bike!

The minerals of the Dead Sea, thought to be so good for your joints, are apparently not so good for your bike!

Posted in General Health Information, Low Back Pain, Neck Pain, Viewer Question | No Comments »

B.T.T.o.D: Follow any bodywork with healthy intake of water!

Monday, March 15th, 2010

Any time you have bodywork done, be it Osteopathic treatment, Massage, Chiropractic- it doesn’t matter what- be sure to consume plenty of water that day. Manipulation of the soft tissue can stimulate areas of the lymphatic system, releasing all sorts of cellular waste.  A healthy amount of water will help flush those waste products out of your system.

Be well!

-Andy

BT Signature

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Posted in Tip o' the Day/ B.T.T.o.D. | 1 Comment »

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