Archive for the ‘Tips’ Category
Tuesday, November 29th, 2011
Sometimes, things happen for a reason. Last week, I was working with a patient who had been dealing with low back pain for over a year. She had been to 2 physicians and a chiropractor before coming to my office, and had found no relief. It took me about 5 minutes to figure out what was wrong with her, and about 10 minutes to fix it. Now, it’s not always that easy, but this woman’s pain was from an obvious, easy source.
I mention that things happen for a reason because for the past several months, I’ve been increasing the use of stretching in my practice, and I have been generally pleased with the results, as have my patients, and as such, I had planned to do a post on stretching. This patient was a perfect example for me to start this series: In spite of all types of complex interventions which failed to produce results, this woman’s pain was alleviated by giving her a simple self-stretch- and I got to look like a superhero..
It was not the previous physicians fault that they could not diagnose this pain- the truth is this: we use what we know, and stretching is just not one of the modalities doctors frequently use (although, I was a little surprised that her chiropractor didn’t catch this- but in the end, it just made me look smarter!!)
From time to time, studies come out which either validate or invalidate the value of stretching as it pertains to injury prevention or performance- and while I generally give value to studies, I often look to what my own clinical experience tells me, and that is this: stretching helps.
For several years, I’ve had the good fortune to work with several folks who are gifted in the area of stretching. My good friend, Jorden Gold, founder of The Stretch Zone in Miami, has been working with professional athletes and the general public for about a dozen years- and his experience mirrors my own. A good stretching routine will improve performance, prevent workout related soreness, improve range-of-motion, improve general body awareness, and yes- most likely prevent injury and reduce pain.
Tip o’ the Day: Even if you have no pain at all, take five to ten minutes at the beginning of your day to stretch!
Enjoy,
Andy
Tags: Andrew Kirschner, Back Pain, back together, backtogether, kirschner, muscle pain, Neck Pain, stretching
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Tuesday, March 15th, 2011
Earlier today, one of my patients without prescription drug coverage related she was filling a prescription I had written for her. The first pharmacy quoted her a price of $175.00. She was about to forgo the prescription, but decided to check with a competing pharmacy, who sold her the prescription for $46.00.
The moral of the story is this: Different pharmacies can have different relationships with manufacturers and distributors, so it pays to comparison shop. Money is tight for most of us these days, so it is clearly worth the work.
Best,
Andy
It pays to comparison shop.
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, drugs, kirschner, Low Back Pain, money, Neck Pain, pharmacy, pricing, Tips
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Monday, March 14th, 2011
Viewer Question from Jim:
‘I’ve recently gotten back into working out after a few years- with school and my new job, I just didn’t have the time to work out like I did when I was in college. I’m a little older now, and I’m finding that even regular workouts are leaving me sore- particularly in my low back. It seems to wear off after a couple of days, but I am a little worried I may be hurting my back. What do you think?’
First, thank you so much for your question Jim.
Post workout soreness is often a normal consequence of hard exercise. If you have not been exercising regularly for some time you may notice more soreness than you used to. I am a little concerned that you seem to be feeling it mostly in your low back. There may be several possible reasons for this. First consider these three questions:
-Are you doing a disproportionate number of exercises that involve your back?
-Are you providing sufficient recovery time following your workouts?
-Have you exposed a possible weak area in your musculoskeletal system?
Look at your workout regimen. The first and second questions sort of go together. How have you broken up your lifting routine? Are you putting too much stress on your low back with your workouts, and conversely are you sufficiently working your abs to balance out the exercises you are doing? A good rule of thumb is this, and it’s and oldie but goodie: divide your sessions into ‘push’ muscle groups (Chest, triceps, quads, etc…) and ‘pull’ muscle groups (Back, biceps, glutes, etc…) By dividing them this way you will prevent overworking any group too much- including recovery time in your program, and ensure that you are getting balance in your workout. If you are finding yourself still getting sore, you can do ‘push’ on day 1, ‘pull’ on day 2, and take off day 3 before resuming. Three quick additional points- you can do cardio on pretty much any day, and ab crunches whether you are doing push or pull groups. Lastly, it goes without saying that you need to maintain adequate hydration and nutrition as you reintroduce your exercise routine- your body will require more of both as you burn more.
Now, if you’ve tried splitting up your routine, and you feel that your soreness is not improving, or is more than you think it should be, you should consider visiting with your physician to be certain that there are not underlying physiological conditions causing your back pain.
Ultimately, your workouts will pay off- it is always my feeling that if you rest, you rust- so I’m glad you’re back at it. Keep us posted on your progress.
Best,
Andy
Montego Bay, Jamaica- The weather is always better somewhere else…
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, exercise, kirschner, Low Back Pain, Neck Pain, workout
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Tuesday, March 1st, 2011
Here is the link to my most recent post on Martha Stewart’s Whole Living Daily Blog. This weeks post is on the 3 mistakes many back pain sufferers make when recovering from pain which keep them from ever really feeling great.
Are you making any of these mistakes? Do you know someone who has?
Tomorrow: Viewer Question and iPad app update.
Thanks for stopping by,
Andy
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, kirschner, Low Back Pain, martha, Martha Stewart, Neck Pain, tip, Tips
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Monday, February 28th, 2011
Last week, I worked with a woman who had been experiencing low back pain for over a year. She had been to two M.D.s, a D.O., and a chiropractor with no relief. Upon examining her and reviewing her history, it took me all of 5 minutes to figure out what was wrong with her and about 10 more to treat it. Her pain is gone. GONE.
Now it isn’t that I’m so smart- her problem was pretty straight forward. The other doctors should have seen what was wrong with her, but it boils down to the fact that people know what they know, and they do what they do. This is true for physicians and patients.
I am working on my second book, which is largely about the lifestyle factors which can either cause or relieve back pain, and in researching what has worked and what hasn’t worked for patients it has become really clear that for all of this rhetoric about ‘thinking outside the box’, no one really does. We learn things throughout all of our lives which cause us to behave and respond in certain ways- and those are the things we stick with. They become part of our identiy.
The woman I told you about only needed a pretty simple stretch to fix her problem. In medical school, we talked about stretching for about 15 minutes- so it clearly wasn’t a priority. Stretching wasn’t to become part of what we as physicians know. I probably wouldn’t have understood how straight forward this patient’s pain was had I not been open to understanding the role of stretching in helping to relieve back pain. This only came about because a friend of mine, Jorden Gold, is a stretching coach- really rammed it down my throat. Now, stretching is a regular part of my treatment plans. I increased my knowledge base, and expanded what I know, and what I do- and I am a better physician as a result.
I truly believe that most back pain is the cumulative effect of a ton of lifestyle factors- many of which are based upon things we know- and behaviors we may have been doing for a really long time. As you take your journey through recovery- try to be ok with the fact that you know what you know, and sometimes what you know may be wrong, or simply not enough. Be open to new ideas methods- who knows what you might learn?
Tomorrow- the three mistakes most back pain sufferers make.
Thanks for stopping by,
Andy
Spring is coming soon!
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, kirschner, Low Back Pain, Neck Pain, stretching, Tips
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Tuesday, January 18th, 2011
Viewer Question Regarding Anti-inflammatory Medications…
“My doctor recently prescribed an anti-inflammatory for a sprained back. It does seem to take some of the edge off, but I feel like I am just putting a band-aid on the pain, without really helping things to heal. Shouldn’t I be doing physical therapy or something to help get myself out of pain?”
-Jason
Jason, thanks so much for your great question.
It can often feel like pain medications are just, as you put it, a band-aid, but anti-inflammatories are an interesting sub group of pain medications. You see, while drugs like Motrin do reduce pain, they may actually help you to heal faster as well. Sprains and strains of muscles and other tissues result in inflammation which occurs in the form of swelling or edema. What this swelling can do is inhibit blood flow to the areas which are healing, and actually prolong the length of time it may take for you to feel better. While sometimes additional treatment like physical therapy may be helpful, it is important to note that every injury is different- and this may not be right for you. Additionally, some injuries require time to become less acute before implementing more physically intensive approaches. If you have questions or concerns, you should really speak to your physician, and tell them what you are thinking- they should be willing to discuss your treatment options, and the thoughts behind their treatment decisions.
I hope this helps.
Updates…
I have been working furiously to finish up the Back Together iPad application, and it is getting much closer to being finished. The other programmer, Jessie, and I have been going to great lengths to make this a truly great program. Check back here for more updates.
Next week, I will be headed to Miami to do the final shooting for my next book, ‘Back Pain: The One Thing.’ I am really proud of how this is all turning out, and I know you will really love the book.
As everyone embarks upon living up to their new years resolutions, you might have noticed that I haven’t posted a Fitness Challenge update in some time- check back later in the week for the latest news. In the mean time, why not let me know how you are doing with your own fitness goals.
Thanks for stopping by,
Andy
OK- Let’s see how geeky my viewers really are. What’s wrong with this picture?
Tags: Andrew Kirschner, andy kirschner, app, Back Pain, back together, backtogether, iPad, kirschner, Low Back Pain, Medication, Neck Pain, NSAIDS, pain
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Wednesday, October 20th, 2010
My past several posts on the Whole Living Daily blog have been about ways to make your life more back-friendly. By identifying and eliminating the ‘anatomic bombs’- those lifestyle things which are likely to cause problems, you can significantly decrease your discomfort. Here is the wrap up for those posts, a list of some of the most common ones.
Enjoy!
-Andy
From the Series of 'Doors' by artist, Steve Tobin.
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, ergonomic, Ergonomics, kirschner, Low Back Pain, martha, Martha Stewart, Neck Pain, pain, whole living, whole living daily
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Wednesday, October 6th, 2010
I had several visits with a patient who had neck pain which she related to computer use. If you’ve checked out my recent posts on Martha Stewart’s Whole Living Daily, you’ve seen my suggestions on making your home and workspace more back friendly. This patient had taken all of my suggestions, and modified her desk space- altering the height and position of her monitor and keyboard, optimized her chair, etc… and she still had neck pain.
I did not identify any significant mechanical problems with her neck- so I sat her down in front of my computer and had her browse the internet for a few minutes (checking out some of her favorite posts here on BackWords!) Almost immediately, I was able to see what the problem was- she was squinting at the screen, and craning her neck forward to see it better. I quickly asked her when her last eye exam was, and she told me ‘more than 4 years ago.’
She had an eye exam, got her prescription changed, and her neck pain went away.
Get regular eye exams!
-Andy
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, eye, eye exam, eyes, kirschner, Low Back Pain, Neck Pain, pain, tip, tip o' the day, tip of, tip of the day, Tips
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Monday, September 27th, 2010
I’ve been doing a series of posts on the Martha Stewart Whole Living Daily blog about ways to make your home more ‘back friendly.’ Sometimes by simply rearranging a few things you can go a long way from preventing your home from causing or exacerbating back pain. The first two posts were on addressing the ergonomics of your kitchen and desk. This week’s post deals with your closet.
Do you have any thoughts or experiences with ‘anatomic bombs’ in your home? Please share them here.
Thanks for stopping by,
Andy
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, ergonomic, Ergonomics, kirschner, Low Back Pain, martha, Martha Stewart, Neck Pain, pain, whole living
Posted in Ergonomics, Tips | No Comments »
Wednesday, September 22nd, 2010
rosaquestion
Thank you so much for your question Rosa.
Sciatic injury is sort of an open ended definition. To best answer your question, I should first give you two definitions. First, the sciatic nerve is a thick nerve which runs down the back of your leg, and exits the spine between your 5th lumbar vertebra and your sacrum. Sciatic pain, or sciatica is a global term which relates to any pain associated with that nerve. Some people mistakenly call any pain radiating into the leg sciatica- it is really only pain going down the back of the thigh (The front and sides of your thigh are actually a different nerve.)
There are lots of ways in which a nerve can be injured, but sciatic pain is less often the result of nerve injury than it is due to irritation of the nerve by one of its adjacent structures. There are three common causes of sciatic pain. One is L5S1 disc herniation, where the disc has extended beyond its’ normal location, and encroached upon the space where the nerve travels. The second is stenosis, where arthritis, disc degeneration, or other anomaly has caused the hole through which the nerve travels to become reduced in diameter. The third, and in my practice the most common is when a short thick triangular muscle called the piriformis goes into spasm, causing it to thicken in its center and compress the pathway through which the nerve travels through the buttocks.
An actual injury to the nerve can be caused by a trauma, and prolonged compression from any one of the three sources above can cause damage as well resulting in pain, altered sensation, and in really bad cases loss of muscle strength associated with that nerve.
I hope that answers your question. There are some great posts here on how to reduce sciatic pain including this one which describes an effective piriformis stretch. Check back periodically for new tips & suggestions.
Again, thanks for your question.
-Andy
Stay tuned for a new "One Thing" tomorrow featuring an expert from the Ayengar Institute.
Tags: Andrew Kirschner, andy kirschner, Back Pain, back together, backtogether, injury, kirschner, Low Back Pain, nerve, piriformis, radiculopathy, sciatic, Sciatica
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