Posts Tagged ‘osteopathic’

B.T.T.o.D: For the bodyworkers and therapists out there- Change the height of your table!

Thursday, May 20th, 2010

My mentor was a the Yoda of Osteopathic medicine, and to his detriment, was also a gentleman. I say this not because it is a bad thing to be a gentleman, but because he was too good a guy to ask the nurses and OR staff to stand on steps when he did surgery. Instead at 6 foot 4 inches, he would lower the table, and do surgery hunched over to accommodate them. The result was that he spent the later part of his life shaped like a question mark.

If you are an Osteopathic Physician, Chiropractor, Massage Therapist, or other type of body work specialist- purchase an adjustable height table (well worth the investment), and vary the height throughout your work day. Certainly there is a range of height appropriate for the patient you have on your table, but by moving it around, you will prevent yourself from structural compromise over time.

Stop back tomorrow for tips on making commuting a back friendly endeavor!

-AndyL1010348

Talking medical insurance reform with colleagues, Osteopaths being Osteopaths…

Thursday, April 29th, 2010

Well, today through Saturday I am at the convention of the Pennsylvania Osteopathic Medical Association getting some continuing medical education credits. It is always nice having the chance to catch up with some friends from medical school, internship, and residency and hear about their adventures in practice.

Talk About Insurance Reform…

This year the conversations were particularly interesting in light of the medical insurance reform. Some docs are elated by it, and others are terrified. The interesting thing is that again, I am dealing with a whole lot of folks who just spew back the talking points that their respective sides feed them. To date, I am the only physician I know who has actually taken the time to read the bill.

Do I like all of it? No- of course not. It would be impossible to create a bill which would ultimately satisfy everyone. As it stands, I like about 80% of what we got. I think the insurance & pharmaceutical industries got off easy with this legislation- I would have like to have seen accountability for how our premium dollars are being spent- but by and large I think the bill does more good than not, and at least it’s a start.

One of the things I see people focusing on more than any other aspect of the bill is the concept of mandatory health insurance. I don’t have as much as a problem with this as some of my colleagues do, in as much as we are already responsible for purchasing auto insurance- so I don’t see this as being very different. Some opponents say that rationale doesn’t hold up because you can choose not to drive. My response to that is that in most cities there is a federally subsidized mass transit system for those who choose not to drive- or simply cannot afford a car or insurance, so there is a safety net.

Look, I know a lot of you don’t like the idea of the Federal Government getting involved in health insurance, but the alternative would be to hyper-regulate the insurance industry (which has largely chosen to not self-regulate in any meaningful way) and that would not make free-enterprise folks happy either. I don’t know what the correct answer is, but it was interesting to speak with so many people on the front lines, and hear their opinions.

Osteopaths being Osteopaths…

On a slight side note, one of the most discouraging things about this convention was hearing about how many of my fellow Osteopathic physicians have given up Osteopathic Manual Medicine (manipulation) altogether. They all know it works wonderfully- they have other reasons. Many of them site the poor insurance reimbursement, or the commitment of time as reasons for forsaking this fantastic modality.

I became a physician because of my exposure to some wonderful Osteopathic physicians (my father being one of them,) and I had the opportunity to see hands-on medicine at work from a very young age. It saddens me that in this time when Americans are literally clamoring for all sorts of alternative approaches to medicine, that we have this long-tested modality at our disposal, and yet it is fading out of existence. D.O.s should be experiencing a renaissance, but instead are settling for assimilation.

Thankfully, not all of us are going that route. I maintain my commitment to Manual Medicine- and tomorrow’s ‘One Thing’ segment will be by a wonderful friend and physician, Matthew Dubrow, D.O.

I have known Matt for many years. His father was an extraordinary Opthalmologist in the hospital where I did my residency, and Matt is truly gifted at Osteopathic technique. I know his ‘One Thing’ will be a good one!

Thanks for stopping by, and I look forward to catching up with you here tomorrow.

Best,

Andy

Really, what could be more fun than a medical conference??

Really, what could be more fun than a medical conference??

Drug companies showing you the latest pill for whatever ails you.

Drug companies showing you the latest pill for whatever ails you.

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

Partner or Spouse as a Resource for relief from Back Pain

Wednesday, February 24th, 2010

I recently  had an encounter in my office which reminded me why I started to develop my couples-based approach to back pain in the first place…

About three months ago, I was working with a new patient who had been suffering with low back pain & sciatica. She had started to have issues with her blood pressure, and her internist wanted her to stop using anti-inflammatory medications- which were really the only drugs which had been providing her relief. He was concerned about the effect they were having on her kidney function, and consequently, her blood pressure.

I really gave some thought to her situation- she was in pain, she couldn’t take the only meds which were really helping her, and she had blood pressure problems.

From the back pain standpoint, her issues seemed pretty straight forward- she had some problems with the movement of her sacrum, which were surprisingly easy to treat. In about four visits, I had restored normal function to her sacrum and reduced her sciatica & back pain symptoms. I then invited  her husband to join us for her next visit, and taught him some simple sacral mobilization techniques which I asked him to do daily. He had some trepidation about trying to do these techniques, but he left my office pretty much convinced.

There is an interesting phenomena which occurs whenever you manipulate the sacrum- you can stimulate the parasympathetic  portion of your autonomic nervous system, and the result can be lower blood pressure.

Well, after a few weeks of working with her husband, her pain had improved significantly, and when she went to her internist he found that her blood pressure had improved, and he wouldn’t need to add any additional medications. As a bonus, her husband, who had felt helpless to provide his suffering wife with any relief, now felt empowered by his ability to help- and they felt closer than they had in several years.

Donna & I drank the bottle of wine they gave me as a thank you gift last night.

I love when I am able to help my patients with their pain, but there is something so gratifying about being able to pass on this ability to a patients loved one. Ongoing pain can have such an adverse effect on a couple, and sometimes giving a partner or spouse the ability to provide relief can help their pain as well as their relationship. And in this instance, there were even greater reaching benefits.

Sometimes, I really love my work.

Thanks for visiting, and be well!

-Andy

I-Technique 7 Prone Thoracic Release 2

Your are wasting your money going to your Chiropractor, Osteopath, Physical Therapist, etc…

Monday, February 22nd, 2010

I knew this tagline would get someone’s attention. I am not above being a little provocative if it will help me to make a point. So now that you are here, let me tell you a short story, which I was reminded of when editing this weeks ‘The One Thing’….

I was seeing a 32 year old mother of 3 for her back pain- let’s call her ‘Sue’- and after seeing her weekly for about 8 weeks, I managed to get her essentially pain free. We discussed her workout regimen, some home exercises I wanted her to do, some ergonomic things she could do around the house, and a few other things before I sent her home.

When I get someone to the point they are feeling pretty good, my goal is to see them for occasional maintenance, perhaps every 6-9 months- with the option of them coming in sooner if they ever had an exacerbation. I never got into the whole ‘I need to see you every week for the rest of your life’ thing (the exception being some of the professional athletes I work with who put themselves in harms way pretty regularly.) I booked Sue for six months, and she was so happy for her relief.

I came into my office one morning about 3 weeks later, and there was Sue- looking none-too-happy with me.

I asked Sue what brought her in. She had full return of her pain, and was incredibly frustrated by her setback. I didn’t want to discuss this in the waiting room, and scare off other patients, so we went back into the treatment room.

Had she fallen, been injured, over did it in the gym?  No- none of the above- her pain was back and she was pissed.

She got up on my treatment table and I began to palpate her spine. Lo and behold, her spine was right back where we had started. It was as though I had done nothing at all. It was at this point, I pursued a different line of questions….

Had Sue taken any of the ergonomic suggestions we discussed for her house? No.

Had Sue been doing any of the specific exercises I had prescribed to help keep her back moving? No.

Had Sue changed her child care situation to involve her husband a little more, so she wouldn’t be the only one picking them up? Nope.

Basically, she left my office the previous visit feeling great- did none of the things we discussed to help maintain her wellness, and was really annoyed when her pain came back.

Here’s the bottom line: If you are going to a Chiropractor, Osteopath  -or anyone else who does manual medicine or body work- you are wasting your time and money if you don’t address the lifestyle issues which caused your back pain in the first place. Back pain is not just a structural  thing. I talk about the pain triad with many of my patients- that is the essential 3 things which I feel contribute to back pain. They are as follows:

Structural issues: These are what they sound like- problems associated with basic structure and function. These things can usually be measured or imaged with x-rays or MRIs, and they can usually be fixed with manual medicine, therapy, and addressing underlying ergonomic concerns.

Psychological Amplifier: This is the part of your mind which gets frustrated or annoyed with the effect back pain has on your life, and can actually make it worse.

The Learned Neurological Response: This is the part of your central nervous system which controls modification of your normal body mechanics in order to find less painful ways of functioning following an injury or compromise, and sometimes has a difficult time resetting once the structural cause of pain has been addressed.

Almost all of my patients have each of these factors contributing to their discomfort- perhaps to different degrees, but they are all there.

For you to really control your back pain, rather than having it control you- you need to look into each of the components of your back & neck pain, otherwise you will forever be at the mercy of physicians and therapists to find relief from your discomfort- and throwing money out the window. Really- give this some thought the next time you experience an exacerbation. Take your practitioners suggestions and information- and use them!! This is the only way you will find lasting relief.

Best,

Andy

One week to the Philadelphia Flower Show- Spring is four weeks away!

One week to the Philadelphia Flower Show- Spring is four weeks away!

Back pain odds & ends- the Olympics, Chiropractors & Osteopaths wasting your money treating your back pain, viewer fitness updates…

Sunday, February 21st, 2010

Following the Olympics:

I subscribe to google alerts for different stories relating to back and neck pain. This week, I have read about a hundred stories about olympic athletes and their back and neck injuries. If I hear one more interviewer ask the question ‘why do you think so many olympic athletes are having injuries?’ I will blow a cork! Aren’t there better questions they could ask? How about questions about their love lives? What kind of car are they drivin’?

Olympic and professional athletes are training at a much higher level than most of us ever will. Now, I know you are saying to yourself  ”Aren’t they in peak condition? Shouldn’t they have less injuries?” Well, sure they are in peak condition- but if you look,  pretty much all competitive sports (save for maybe curling?) have become ‘extreme sports.’ The overall stats for lifting, jumping, running, endurance- most metrics used to rank athletic performance- have all jumped by leaps and bounds. There are records from Olympic games earlier in the 20th century, where commentators essentially declared that we were approaching the limits of human performance. WOW- how wrong they were! Virtually every major record has been beaten in the past 2 sets of Olympic games. The technology to make us all faster, stronger, better nourished for endurance, and with better performance psychology has advanced so far- but in the end we are all limited by the laws of physiology, and ultimately gravity. As you reach the higher echelons of performance, you are more likely to be injured, regardless of conditioning. Now that being said- the Olympic athletes have access to training and knowledge to help minimize their likelihood of injury- but there is only so much you can do.

Sports Illustrated photo from the Olympics- One of the few photos you will find here I didn't take myself. Please don't rat me out...

Chiropractors, Osteopaths, Physical Therapists, and all the rest- are all a waste of your money!

You may have read my ‘coming Monday’ post earlier in the week. I suppose the search engines latched onto the tag line- because I have gotten a ream of hate mail, primarily from Chiropractors and Physical Therapist. ‘How dare you call my work a waste of money- I help a hundred people a week with their back pain!’

Have you ever been on this blog before? If you read back a few posts and see what I am about you will know that I am not here to bash anybody. How about reading the post first? I am not calling any body a quack- and I am certainly not about to tout my work as any better than yours- wait and give it a read.

Fitness  Challenge Update

People must have thought I dropped the ball on the fitness challenge until they read the post yesterday. Thanks for the updates some of you sent in. I am so glad you are choosing to do this along with me, and hope we can all talk at the beginning of 2011 about how we met the challenge, and lived up to our New Years Resolutions!

Have a great remainder of your weekend.

Andy

B.T.T.o.D: For practitioners: Change the height of your treatment table regularly.

Thursday, February 18th, 2010

This one is geared largely towards Osteopaths, Chiropractors, Physical Therapists, Massage Therapists, etc…

Throughout your day, vary the height of your treatment table- not only to accommodate the size of your patients/clients, but also to keep your spine from getting acclimated to one position. There are many older practitioners out there with severe kyphosis due to the limited movement of their treatment tables- take advantage of the tools you have available, and change the height of your table throughout the day.

Best,

Andy

I-Technique 14-Sacral Circle 2

Greetings from Miami, some upcoming guests, and More…

Monday, December 28th, 2009

Welcome to Miami…

My family made the long drive down I95, from Philadelphia to Miami- 23 hours in the car- and it was rough. There is pretty much no way to make that kind of trip in a spine friendly way. However, in spite of being quite stiff and sore, I am grateful to be here. The weather is certainly a step up from what we had when I left Philadelphia, and I’ve heard it has only gotten worse since we left.

Lincoln Road Miami- The Van Dyke- home of the oldest elevator in Florida.

Lincoln Road Miami- The Van Dyke- home of the oldest elevator in Florida.

Upcoming Guests…

While I am here, I will be revisiting my friend Jorden Gold of the Stretch Zone to get his ‘One Thing’ segment and maybe some other goodies.

I am also really excited to announce that my wife Donna has agreed to occasionally contribute pieces here on BackWords. Donna has a PhD. in anthropology, and teaches natural childbirth as well. Much of her work with couples teaches them ways to help relax and work through the discomfort of childbirth. I am really looking forward to seeing what she brings to the table, as I know it will be interesting and useful. Look for her first piece on using the observation of beauty as a way of getting in touch with your pain-free self.

Prayer & Back Pain…

Now- I want to take a moment to address some of the feedback I received on the role of faith & prayer on recovery from back pain; Some people seemed to think that I was being dismissive of prayer as a pain relief modality when I suggested that meditation or deep breathing was a substitute for prayer.

Let me be very clear- I don’t think of it as a substitute per se- I was reminding folks that if religion is not part of their makeup, either because they are not religious, or because that do not feel that prayer has any role in recovery from pain- that the small part of their day which would otherwise be devoted to prayer might instead be used for meditation or ‘quiet time.’ There have been studies galore which demonstrate conclusively that meditation and focus can help reduce pain. I am a quietly religious person, and a small part of my day is devoted to prayer (right before bedtime, usually)- and when I have had to deal with pain- be it back pain resulting from a car accident, or from kidney stones- prayer did help.

Twitter Feed Coming Soon….

I am putting the final touches on our new Twitter feed- expanding on the ways for you to get tips and information from Back Together. As of January 1st- you will be able to get information here on backtogether.org, from the Back Together fan page on Facebook, via the direct link to the blog at thebacktogetherblog.com, backtogethertv on YouTube, and via Twitter. Basically, there will be no excuse for you to not be chock full of great pain relief ideas, suggestions, and news.

Thank you again for visiting,

-Andy