Archive for the ‘General Health Information’ Category
Monday, July 5th, 2010
I don’t do a whole lot of book reviews here on BackWords. The truth is, if you were going to buy a book about back pain, I would prefer if you bought mine. However, occasionally I come across a book that covers things in an interesting or fun way differently from my own approach. In this case, the book focuses on a topic I don’t usually address in my couples-based approach.
Be the Boss of Your Pain by Timothy Culbert, M.D., and Rebecca Kajander, C.P.N.P. is an wonderful book that gives kids really wonderful tips and strategies for helping to reduce the effect of pain on their lives. With information on the physiology and psychology of pain, the book never panders, and is written in a comfortable, accessible style. The book lays out a mission statement in the first few pages, explaining that the goal is to help kids get rid of pain, make fewer visits to the doctor’s office, take less medicine, and basically how to get back into their lives.
With an approach that covers body, mind , and spirit- the authors include information on breathing and visualization exercises, as well as information about other modalities such as aromatherapy and acupressure- all in a way which is presented in a way children can understand and get excited about.
Children suffering with painful conditions often face difficult circumstances- frequent doctor’s visits, and dependency on adults for relief can leave kids feeling helpless and out of control of their lives. Be the Boss of Your Pain gives kids an opportunity to regain some of that control. For those of you familiar with my work, you know that is the goal of much of what I do. I have a copy of it in my treatment room, and virtually every patient has picked it up, and commented on what a fantastic concept it is- offering tips which are also applicable for adults. Check it out.
Thanks for visiting!
-Andy
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, be the boss of your pain, children, culbert, Kids, kirschner, Low Back Pain, Neck Pain, rebecca kajander, tmothy culbert
Posted in Announcements, General Health Information, Tips | 1 Comment »
Monday, June 28th, 2010
nyt
So, here is the link to an article in the New York Times this AM. Actually, this article was about the new show ‘Huge’ – a socially interesting concept for a show about the efforts of overweight teenagers to find dignity in their efforts towards transformation. However, the article also references the ‘gainer blog’ phenomenon (blogs devoted to finding ways to more efficiently gain weight. These blogs are not typically geared towards people who are ‘too thin’ trying to gain weight, but more towards overweight individuals celebrating and augmenting their obesity.) This was enough to get me doing some research. I have seen some of the people who proclaim that they are healthy in spite of being morbidly obese on some of the talk shows, and while they may be able to demonstrate good blood work- you simply cannot change the laws of physics. Your musculoskeletal system was just not designed to support tremendous amounts of weight, and even if one were to not exhibit any of the cardiovascular and endocrine issues associated with obesity, their feet, knees, hips, and yes- their spine- all are subject to greater wear and tear, potentially leading to pain, and surgical intervention. There are numerous studies out there which support this assertion.
The line in the article that caught me off guard was this notion that there is a conspiracy, and that this gainer phenomenon is ‘an outcry against the manipulations of a diet-industrial complex.’ If anything, the food industry is doing exactly the opposite thing- producing food products which promote obesity, and the media which provides advertising for these products puts all of them in our faces ALL THE TIME. This topic is poignant to me as I continue on my own fitness challenge, and try to get myself into the shape I know I should be. There are definitely social forces compelling many of us to get thin- particularly teenage girls- who are bombarded with images from all sides, so I don’t want to discount this notion completely- but I feel the greater force emerges from the food industry which continues to churn out numerous processed, fat laden, inexpensive, and apparently enticing foods. My suspicion here is born out by the disproportionate rates of obesity here in the U.S. relative to much of the world.
I don’t want to come across as against overweight people, but more in favor of a balanced healthy lifestyle. As someone who has battled with weight issues for much of my life, I can definitely feel empathy for those embroiled in the struggle to get fit.
Check back tomorrow for the Fitness Challenge update, and a book review of a really fantastic book for kids with pain syndromes.
Thanks for checking in!
-Andy
Be sure to check out the blog regularly for tips on how to prevent and relieve back pain. Back Together book and DVD programs available from Amazon.com. ORDER TODAY!
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, diet, dieting, gainer, Huge, kirschner, Low Back Pain, Neck Pain, obesity
Posted in General Health Information, Nutrition, Videos | No Comments »
Wednesday, May 5th, 2010
At least a few times a day, patients ask me about whether they should be using ice or heat to help relieve their back pain. It’s a good question, and unfortunately, if you asked 10 doctors, you might get 10 different explanations for why one is better than the other.
There is only one steadfast rule regarding ice & heat: For the first 48 hours immediately following an injury, ice is better. Ice causes some vasoconstriction (the reduction in the diameter of the blood vessels) in the area being treated, helping to reduce swelling and promote healing. It also can partially numb the area for a short time, providing some pain relief.
In this doctor’s opinion, after the first 48 hours, it boils down to a matter of personal preference. Ice provides some of the pain relieving benefits, but heat can help to relax tense muscles- so there are potential benefits to either. Personally, my muscles recoil from cold and send me right into spasm, so I cannot really tolerate ice- so for me it’s heat, but I hear the opposite from plenty of people as well.
The one recommendation I will make here is to limit the time of either. If you are using ice, wrap your bag of ice in a thin towel or napkin so the cold gets applied gradually, and without ’shock.’ Apply for 20 minutes on, 20 minutes off. With heat, the timing is not as critical, but prolonged heat can cause too much relaxation to the area, will cause vasodilation (an increase in the diameter of the blood vessels in the injured area,) and if there is still some underlying inflammation- could increase swelling. So 20 on and 20 off here is probably a good rule as well.
Hope this helps!
Insurance nightmares…
Last week, I asked you to share with me some of your health insurance nightmares. My wife and I have been dealing with a pretty complicated problem, which thankfully seems to be largely resolving. I am amazed by how many of you have had serious issues with your health insurance. I am preparing a piece or two on this topic- not strictly a back pain thing, but I felt important enough to discuss here on BackWords. Check back.
As always, thanks for visiting,
Andy
Coming soon: Back pain tips for riders of mass transit.
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, health insurance, health insurance nightmares, heat, ice, injuries, insurance, kirschner, Low Back Pain, muscle spasm, Neck Pain, Sciatica, trauma
Posted in General Health Information, Low Back Pain, Neck Pain, Sciatica, Tips | No Comments »
Wednesday, April 28th, 2010
When do you need to consult a physician?
You know the old adage about not assuming things? Well boy is it ever true when it comes to back pain.
The vast majority of back pain is musculoskeletal (originating in the bones & muscles of your back,) but there are some conditions which cause back pain which have little or nothing to do with the back itself. Kidney disease, pancreatic disease, several cancers, and other conditions have back pain as their hallmark symptom.
So what are you supposed to do to help differentiate between run of the mill back pain, and something more insidious? Here are a few pointers, which should only serve as a guideline:
-First of all, if you have back pain (in particular pain which has no clear cause, such as having moved a lot of heavy furniture) which lasts more than 72 hours, go see your physician.
-If your pain is excruciating, don’t wait it out- consult your physician as well.
-If you have ongoing back pain (from arthritis, disc disease- really any idenitfied cause, and the symptoms change in any significant way, for example you suddenly develop sciatica, or other new symptom, consult your physician.
-If you develop incontinence of bowel or bladder, go straight to the ER- do not pass go, do not collect $200. I don’t mean to be glib, but this one is serious, and requires immediate attention. It may seem obvious, but I have had more than one patient who waited several days before telling anyone about this symptom.
-If small movements cause a feeling of ‘electrical shocks’ in your extremities, consult a physician.
These are the big ones which come to mind right now- there are others, but the take home point here is than not all back pain IS back pain, and some is more serious than others. If you have new pain which came from out of nowhere, or you have ongoing pain which has changed in some significant way, you need to be seen by your physician.
Insurance Nightmares…
I am looking for some of your experiences with insurance- particularly those which went less than well. Have you had an insurance nightmare? Please share it with me here- I am preparing a piece on appealing your denial of coverage, based upon a recent horrible experience my family has gone through.
Beautiful sky over Philadelphia last night- Spring is kind of here!
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, doctor, health insurance, insurance, kirschner, Low Back Pain, Neck Pain, nightmare, nightmares, Sciatica, symptoms, warning signs
Posted in General Health Information, Low Back Pain, Tips | No Comments »
Monday, April 5th, 2010
Today, I answer one of the most frequently asked questions in my practice: After all of the treatments, adjustments, therapy- why am I still in pain?
Some helpful tips follow the video. Enjoy!
WhyIstillhavepain
Here are some things to pay attention to in your spine lifestyle. Addressing these few things may go a long way towards helping you to find relief. Take a look at these:
1) Make sure your workspace is as ergonomically optimized as possible. Good chair, good organization of work related materials, etc…
2) Get regular sleep. Optimize your sleep environment- supportive mattress, dark room, quiet. Don’t consume caffeine within several hours of your bedtime.
3) Get regular exercise, and exercise properly- maintaining an optimal body composition will help take the strain off of your back. Good form will ensure that you are working the correct muscle groups, and prevent you from harming yourself further.
4) Minimize the weight of the items you carry with your. Dump out the contents of your purse or briefcase and get rid of everything you don’t really need.
5) Make sure your car is as spine friendly as possible; Adjust seating and controls for easy, unstrained reach. Add a lumbar support (a rolled up t-shirt will do.) Set your mirrors so you aren’t cocking your head one way or another.
6) Consume plenty of water daily. This helps to eliminate cellular waste from your system, and allows you to heal and function more efficiently. Take a few minutes, several times a day to do some relaxing, restorative deep breathing exercises.
7) And as always, use a headset while you are on the phone- Cradling your phone between your ear & shoulder is one sure way to wreck your neck!
A good place to start is to pay attention to those areas where you spend the most time. Invite your partner to pay attention as well- sometimes an objective second party set of eyes will notice things you will not.
Be well!
-Andy
Victoria & Albert Museum, Kensington, London
Tags: Andrew Kirschner, andy kirschner, back, back health, Back Pain, back together, backtogether, chronic pain, health, lifestyle, muscle spasm, neck, Neck Pain, pain, Sciatica, spine, Tips
Posted in Announcements, Ergonomics, Fitness & Exercise, General Health Information, Tips, Videos | No Comments »
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.
- 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
- 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.
- 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.
- 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)
- 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”
- 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.
- 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.
- 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.
- 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.
- 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.
Tags: andrew kirchner, andy kirschner, Back Pain, back together, backtogether, diet, dieting, fitness, fitness challenge, kirschner, Low Back Pain, Nutrition, Sciatica, weight, weight loss
Posted in Fitness & Exercise, General Health Information, Nutrition, fitness challenge | No Comments »
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.
Tags: Andrew Kirschner, andy kirschner, back, Back Pain, back together, backtogether, gene, genetics, kirschner, Low Back Pain, psychology, research, studies, study, Tips
Posted in General Health Information, Studies & Research, Tips | No Comments »
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!
Posted in General Health Information, Low Back Pain, Neck Pain, Viewer Question | No Comments »
Tuesday, March 9th, 2010
Some thoughts on prayer & spirituality as the relate to health…
Inevitably, I catch some flack from people whenever I touch upon the topic of prayer and its effects on your health. It seems many don’t feel there is a place for prayer in medicine because there is no hard science to support it.
If you’ve been visiting my site for a while, you probably already know that I don’t agree with that sentiment. While I am a physician, and I need empirical evidence to support the use of a specific medicine or treatment modality- you know what a role I feel psyche has on your overall well being, and there is a proven link between psychological well being and physiological health.
I bring this up here because of a few moments where I had the chance to reconnect with elements of my spiritual life last week while I was in Israel…
I have been dealing with some pretty serious personal issues recently, and honestly, I have found them to be somewhat overwhelming (I will be hopefully putting some of these issues to rest Monday, when I publish this post)- and the emotional weight I’ve been carrying as a result has been pretty hard to deal with. Furthermore, my family has had to deal with me, and since you know how much I value ‘couplehood’ as part of my overall view of wellness, I really didn’t want to drag my family down the well with me. As a result I internalized a lot of this stress, and the feelings got worse.
During my trip, I visited the Western Wall, and went to the very spot where I had my Bar Mitzvah nearly thirty years ago. This was an emotional experience for me, as the last time I stood there I was surrounded by all of my Grandparents (the last time they were all together.) My wife and kids stood on the other side of the barrier which separates the men from the women on the exact spot where my Mother, Sister, and Grandmothers watched the ceremony. It really brought forth a flood of emotion, and for the first time in a long while I felt really connected to my religion and with God. This catharsis left me feeling better, less stressed, and better equipped to cope with the stressful things I face in the coming weeks.
This experience, and the relief associated with it was a reminder to me of how psychology & physiology go hand in hand. I don’t know if you believe in God, or practice religion- what I do know is that you need to have real knowledge of your emotions and the things you internalize in order to get them out of your body, and feel relief from pain. It doesn’t matter if this knowledge comes about through meditation, exercise, martial arts, or some other route or combination of routes- but it has to happen for you to get the most out of your physical body and reduce your pain. If prayer helps you to do that- then clearly there is a role for prayer in your overall health.
Thanks for visiting,
Andy
Photo taken on the spot of my Bar Mitzvah almost 30 years ago- Donna took this photo from the spot my Mother, Sister, and Grandmothers stood during the ceremony.
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, kotel, Low Back Pain, pain, prayer, Spirituality, wellness, western wall
Posted in General Health Information, Spirituality, Tips | No Comments »
Saturday, March 6th, 2010
Osteoporosis is one leading cause of back pain as some people age. A diet high in calcium, vitamins C & D, combined with regular weight bearing exercise (something as simple as walking will do) will go a long way towards preventing the ravaging effects of osteoporosis. There are other factors involved, so before to get regular check ups with your family physician, internist or OBGYN.
Thanks for stopping by!
-Andy
Beautiful lake Kinneret, Jordan River Valley, Israel.
Tags: Andrew Kirschner, Back Pain, back pain tips, back together, backtogether, kirschner, Low Back Pain, Neck Pain, osteoporosis, tip o' the day, tip of the day
Posted in General Health Information, Nutrition, Tip o' the Day/ B.T.T.o.D. | No Comments »
