By Mayo Clinic staff

Most whiplash symptoms develop within 24 hours of the injury and may include:

• Neck pain and stiffness
• Headaches, most commonly at the base of the skull
• Dizziness
• Blurred vision
• Fatigue

Some people also experience:

• Difficulty concentrating
• Memory problems
• Ringing in the ears
• Sleep disturbances
• Irritability

Main Category: Back Pain
Also Included In: Clinical Trials / Drug Trials;  Heart Disease
Article Date: 10 Feb 2009 - 2:00 PDT

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The proportion of people suffering from long term, impairing low back pain has more than doubled in North Carolina since the early 1990s, according to a new study.

What's more, researchers believe the increase may be indicative of a similar trend across the country.

In the study, published in the Feb. 9, 2009, issue of the Archives of Internal Medicine, researchers from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill found that the prevalence of chronic, impairing low back pain in the state increased from 3.9 percent in 1992 to 10.2 percent in 2006. Increases were seen in both men and women, and across all ages and racial and ethnic groups.

"Considering the social and economic costs of chronic low back pain, these findings are alarming," said the study's principal investigator Timothy S. Carey, M.D., director of the Sheps Center and Sarah Graham Kenan Professor in the departments of medicine and social medicine in the UNC School of Medicine. "Low back pain is the second most common cause of disability in the United States and a common reason for missing work."

"People with chronic low back pain also use an enormous amount of health care," said the study's lead author, Janet K. Freburger, Ph.D., a research associate and fellow at the Sheps Center and a research scientist at the UNC Institute on Aging.

Carey and Freburger noted that more than 80 percent of Americans will experience an episode of low back pain at some time in their lives and that total costs of the condition are estimated at greater than $100 billion annually, with two-thirds of that due to decreased wages and productivity.

"Since the costs of back pain are rising, along with the number of cases, current treatments overall do not seem to be very effective," Carey said.

The study is thought to be the first in the United States to use similar methods and a consistent definition of chronic low back pain to examine trends in the condition's prevalence over time.

The new findings also provide a possible explanation for rising health-care costs associated with back problems.

Some researchers have concluded that increases in the use of health-care services for low back pain are due to people with low back pain seeking more care nowadays than in the past.

But the UNC researchers said their data suggests that increased prevalence may be the primary factor driving those increases in service use and costs. That's because the proportion of people in North Carolina who sought healthcare for chronic low back pain rose only moderately between 1992 and 2006 (from 73.1 percent to 84 percent), and the average number of visits to all providers remained similar.

The paper notes that until now, studies examining trends in the prevalence of chronic low back pain have been "severely lacking."

"Discerning whether the prevalence of this condition is increasing and contributing to the increase in the use of health care services is vital for developing strategies to contain costs and improve care," Freburger said.

Reasons for the increase in chronic low back pain are unclear, although possible causes include increasing rates of obesity, depression and awareness of the condition, the study said. The changing nature of the state's workforce - with a decline in the percentage of manufacturing jobs and an increase in construction and service industry jobs over the time span concerned - may be another possible factor.

###

The study was conducted using a telephone survey of about 4,400 households in 1992 and 5,300 households in 2006. Individuals were considered to have chronic low back pain if they reported pain and activity limitations nearly every day for the past three months or if they reported more than 24 episodes of pain that limited their activity for one or more days in the past year.

The study was funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Study co-authors are George M. Holmes, Ph.D., senior research fellow, Anne M. Jackman, research fellow, and Jane D. Darter, applications analyst, all with the UNC Sheps Center; William D. Kalsbeek, Ph.D., professor, and Robert P. Agans, Ph.D., research associate, from the UNC Gillings School of Global Public Health's biostatistics department; Andrea S. Wallace, Ph.D. from the University of New Mexico-Albuquerque College of Nursing; and Liana D. Castel, Ph.D., from the department of general internal medicine at Vanderbilt University Medical Center, Nashville, Tenn.

Carey and Freburger also recently published another study showing that health-care providers appear to be underutilizing exercise as a treatment for chronic back and neck pain. The research, published in the February issue of the journal Arthritis Care & Research, found that less than 50 percent of people in the study were prescribed exercise, despite the fact that numerous randomized trials and clinical practice guidelines support the practice. That study can be found at http://www3.interscience.wiley.com/journal/77005015/home.

Source: Patric Lane
University of North Carolina School of Medicine

In this study, 353 patients exposed to rear impacts were followed for 2 years. 53% initially had LBP. At 2 years, 40.5% sill have LBP.

A Prospective Study of Acceleration-Extension Injuries Following Rear-End Motor Vehicle Collisions

2000, Vol. 8, No. 1-2 , Pages 97-113

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Robert J. BrisonAssociate Professor¹†, Lisa Hartling² and William Pickett³

¹Department of Emergency Medicine, Department of Community Health and Epidemiology, Queen's University

²Department of Emergency Medicine, Queen's University

³Department of Community Health and Epidemiology, Department of Emergency Medicine, Queen's University

^†Correspondence: Dr.Robert J. BrisonAssociate Professor, Department of Emergency Medicine, Kingston General Hospital, 76 Stuart Street, Kingston, ON, Canada, K7L 2V7 brisonrj@kos.net

Objectives: To describe pain syndromes among individuals involved in rear-end motor vehicle collisions [MVCs] for up to two years post-injury. To describe rear-end MVCs by: characteristics of individuals, vehicles, and circumstances surrounding collisions.

Methods: Between 1 October 1995 and 31 March 1998, 446 adults involved in rear-end MVCs presented to the emergency departments serving Kingston, Ontario, Canada. Eligible subjects [N = 380] were contacted by telephone following the collisions then at 1, 2, 3, 6, 9, 12, 18 and 24 months post-MVC. Data were collected regarding: symptoms, treatments, work and leisure activities, the collision, and compensation sought and/or received.

Results: Ninety-three percent of eligible subjects participated in the study. Sixty-one percent experienced whiplash associated disorder [WAD] [with neck pain] of important severity and frequency following the collision. This declined to 37%, 35%, 34% and 36% at 3, 6, 12 and 24 months post-injury. Common associated symptoms accompanying WAD at six months included: low back pain [44%], neck stiffness [44%], headaches [43%], upper extremity numbness/weakness [26%], and visual complaints [14%]. Sixty percent missed less than one week of work after the collision. At six months, 36% continued to modify their work activities and 35% their leisure activities. Many of the collisions [46%] occurred at an intersection with the majority of vehicles [77%] stopped when hit from behind. The majority of the sample was female [63%] mean age 37 years. Few persons [7.7%] sought financial compensation, and none received any for pain and suffering.

Conclusions: This study provides new data about factors associated with WAD following rear-end collisions. Substantial proportions were affected for up to two years post-injury. Repercussions of WAD are reflected in the actual number of individuals with persistent pain, and in the complex array of associated symptoms, treatments sought, and impact on work and leisure activities. These findings exist in an environment where compensation is infrequent.

Here is another study in which LBP is considered a common injury with prolonged recovery: (Cassidy et al. Low back pain after traffic collisions: a population cohort study. Spine 2003;28(10):1002-9)

-Dr. McKnight

Don’t just sit there ... move!

Physical activity — which includes an active lifestyle and routine exercise — plus eating well, is the best way to stay healthy. An effective exercise program needs to be fun and keep you motivated. It helps to have a goal.
Your goal might be to:

✔    Manage a health condition

✔ Reduce stress

✔    Improve your stamina

✔    Buy clothes in a smaller size
Once you begin increasing your activity level, you’ll probably begin to notice other benefits:
✔    Better control of your weight and ap- petite
✔    Improved fitness, making it easier to do everyday activities
✔    Improved sleep

✔    More confidence in yourself

✔    Lower risk for heart disease, diabetes,
and high blood pressure

Getting started
Before beginning any exercise program, it’s best to talk with your doctor of chiropractic, who may be able to help you develop a routine best suited to your health situation.
If you haven’t exercised or been active in a long time, start slowly to prevent injuries. Taking a brisk 10-minute walk twice a week is a good start. Try joining a dance, yoga, or karate class if they appeal to you. You could also join a baseball or bowling team, or even a mall-walking group. The social aspects of these groups can be rewarding and motivating.
Don’t forget: Simple lifestyle changes can make a big difference over time.
✔    At work, try taking the stairs instead
of the elevator, walking down the hall to talk with a co-worker instead of sending an e-mail, or adding a 10- to 20-minute walk during lunch.
✔ When running errands, park at the far end of the parking lot, or even down the street.
✔    At home, do chores such as vacuum- ing, washing the car, gardening, raking leaves, or shoveling snow.
✔    If you ride the bus, get off one stop be- fore your usual stop and walk the rest of the way.
✔ Reduce screen time. Whether it’s your TV or your computer monitor, break up screen sessions with movement. Take frequent breaks, even if it’s just to stand and stretch.
How much exercise do you need?
Aim to exercise about 2.5 hours a week. Do moderate-intensity aerobic and muscle strengthening activities. Depending on your schedule, you could exercise for 30 minutes, 5 days a week or 45 to 60 minutes, 3 days a week.
You don’t have to do your total daily exercise all at once. If your goal is to exercise for 30 minutes, you can break that up into shorter time periods that add up to 30 minutes. As you become more fit, you can challenge yourself by increasing the intensity of your exercise by going from light to moderate activity. You can also increase the amount of time you exercise.
[Some suggestions based on the US Department of Health and Human Services. Physical Activity Guidelines for Americans: Recommendation statement.]

What does this mean?

There is no good relationship between the speed of the collision and neck pain or injury.

In many cases insurance companies make the argument that people who are involved in low speed collisions cannot be injured. Well...research shows, it just isn't so!

-Dr. McKnight

So what is a person to do?

The first thing you will need to do is to change your workout routines. We all fall in love with doing certain exercises and there is nothing wrong with that at all. One thing you must know is that your body becomes used to doing the same exercises over and over.

After time these exercises won’t be as effective as they used to be and you will reach that dreaded weight loss plateau. Increasing the intensity of your current exercises and also adding some new workout routines will help you get over the hump.

Doing this will keep your body off balanced and you will be much closer to reaching your weight loss goals. If you are a jogger…pick up the pace for about 30 to 40 yards and run that pace at different intervals.

You may also need to check your diet

Sometimes we get into the rut of thinking we can eat “anything” just because we workout. It’s OK to eat you favorite junk foods every now and then, but you really have to watch it over time. It only takes on average about a week for habits to form…good or bad.

If you think this may be keeping you from reaching your weight loss goals it’s good to keep a journal on hand to jot everything down than you are putting in your body. You have to be very careful because one bad week of eating can easily turn to a couple very fast!

This is something that will sabotage your effort fast. It’s all about keeping a balance when it comes to losing weight. Before you know it you will be back on track to reaching your weight loss goals.

Conclusion

You have worked way to hard to get to the point where you are at now. Are you ready to give up and let all of your hard work down the drain? Believe me..it’s much easier to get out of shape then it is to get in shape. Keep this in mind if it pertains to you.

These are the same steps that I took when I was in the same boat as you. Almost at the verge of quitting out of frustration. Don’t do it. You have too much heart for that. Let’s get it!

http://bcove.me/95vnfpsi

• Try not to slouch when sitting or standing.
• Sit up straight with your back against the back of your chair and your feet flat on the floor. Keep your knees slightly higher than your hips.
• Stand tall with your head up and shoulders back.

Often times if you have been undergoing chiropractic treatments for weeks and weeks and there is no appreciable change, maybe chiropractic care isn't the answer for you. If you have had 10-12 spinal adjustements and there has been no change in your condition, another 10-12 adjustments is probably not the answer to your spinal condition.

It may be time for you to have some special imaging done to find out why your back isn't making any progress. An MRI scan can give your doctor a good picture of the soft tissue structures in your spine like the discs and the facet joints. These may be the underlying cause of your back pain. While chiropractic manipulations can help some disc problems and some facet problems, there are other treatment options which may be more effective in eliminating your pain.

If you are in persistent pain and are not getting the relief you seek, give Dr. Mcknight a call at (435) 656-0234 to find out if more can be done to help you feel better.

Here's the link to Men's Health for the full article:

http://www.menshealth.com/fitness/spinal-injury-prevention?cm_mmc=Twitter-_-MensHealth-_-Content-Fitness-_-ProperLiftingForm

Spinal Injury Prevention

Save Your Spine

Fitness pros always tell you to brace your core, but they really mean this: Save your spine. Your spine consists of five sections; each can be damaged by poor form. Stiffening your core while doing almost any exercise helps keep your spine safe and allows you to use heavier weights. Keep these 6 tips in mind the next time you lift.

Correct

1 Squeeze your glutes
By contracting the butt muscles, you "lock" the hinge between your sacrum and lumbar regions, making your lower back and hips move as one unit. Do it during pushups and planks, or when you push your hips forward (like rising from a squat or deadlift).

2 Prepare to be punched
Any exercise can involve your core. Tense the muscles of your midsection, and then try to make yourself as tall and long as you can. This helps keep your highly flexible lumbar section stiff so that it's naturally arched, not rounded or overarched.

3 Lock your shoulders
Pull your shoulders down and back so your shoulder blades can't move around. (It's as if you're flexing your lats like a bodybuilder.) This helps brace your upper back, because the strong muscles that control your shoulder blades originate on your upper spine.

Incorrect

1 Raising your hips
Your lumbar spine is the most vulnerable structure in your back. That's because the disks are narrower and the ligaments are weaker. When your hips remain high, you overstretch the joints, which leads to muscle spasms and lower-back pain.

2 Rounding your back
Rounding your spine increases the pressure on the front of your disks. This moves them out of place, and makes them very susceptible to herniation. "It's like squeezing one side of a water ballon. Eventually it will pop," says Bill Hartman, P.T.

3 Hyperextending
Keep your core tight and your shoulders pulled back, or you risk hyperextension. Your lower back is designed to handle only a small load, and overarching can change the shape of your joints, says Hartman. The result: stiffness, pain, or even stress fractures.

Watch Your Form

It helps to have someone check your form, but if you're not at a gym, let a video-game console help out. Your Shape: Fitness Evolved ($50), a new game for the XBox Kinect, uses tracking technology to watch and correct your form as you perform Men's Health workouts in front of the TV. Bonus: Unlike your buddy, it isn't distracted when a woman in short gym shorts walks by.

From Spine

The Effects of Therapeutic Climbing in Patients with Chronic Low Back Pain

A Randomized Controlled Study

Kai Engbert, PhD; Michaela Weber, MSc

Authors and Disclosures

Posted: 06/14/2011; Spine. 2011;36(11):842-849. © 2011 Lippincott Williams & Wilkins

Abstract and Introduction

Abstract

Study Design. A randomized controlled study investigated the effects of therapeutic climbing in patients with chronic low back pain. Before and after 4 weeks of training, physical and mental well-being were measured by two questionnaires (36-Item Short Form Health Survey [SF-36]; Hannover Functional Ability Questionnaire for measuring back pain–related disability [FFbH-R]).
Objective. Therapeutic climbing has been suggested to increase muscular strength and perceived physical and mental well-being. This study focused on the psychological effects of therapeutic climbing and compared it with standard exercise therapy.
Summary of Background Data. Therapeutic climbing has become increasingly popular in rehabilitation and its effects on muscular strengthening have been shown. Therapeutic climbing has also been suggested to yield psychological effects such as changes in attentional focus from pain to physical capabilities. To date, no controlled clinical trial has investigated these psychological effects and it is unclear whether therapeutic climbing is comparable or superior to other forms of exercise.
Methods. Twenty-eight patients with chronic low back pain conducted either a therapeutic climbing or a standard exercise regime. Each program took 4 weeks, including four guided training sessions per week. Before and after the program, patients answered two questionnaires assessing their physical and mental well-being.
Results. For the Hannover Functional Ability Questionnaire for measuring back pain–related disability, there was no difference before versus after or between the treatments. For the SF-36, both treatments showed significant improvements in 3/8 subscales of the SF-36. In 2/8 subscales, only the participants of the therapeutic climbing improved and in 1/8 subscales the converse was true. Comparing both groups, significantly larger improvements were found after therapeutic climbing in two subscales of the SF-36: physical functioning and general health perception.
Conclusion. The benefits of therapeutic climbing were comparable with those of a standard exercise regime. In two subscales of the SF-36, the benefits of therapeutic climbing exceeded those of standard exercise therapy, primarily in perceived health and physical functioning of the patients. This finding demonstrates that therapeutic climbing is equivalent and partly superior to standard exercise therapy for patients with chronic low back pain.

There are many different chiropractic techniques in use today, some with proprietary names such as the Gonstead and Maitland techniques. In general, most involve rapid (high-velocity) short (low-amplitude) thrusts. Manipulation may be purely manual or mechanically assisted. For example, some chiropractors use an "activator"—a small metal tool that applies a force directly to one vertebra.

In addition, some chiropractors use a related therapy called spinal mobilization. This method involves gentle, extended movements (low-velocity, high-amplitude), rather than the “back-cracking” of classic chiropractic spinal manipulation.

*

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* Goertz CH, Grimm RH, Svendsen K, et al. Treatment of hypertension with alternative therapies (THAT) study: a randomized clinical trial. J Hypertens . 2002;20:2063-2068.

* Hurwitz EL, Morgenstern H, Vassilaki M et al. Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study. Spine. 2005;30:1477-1484.

* Rowe DE, Feise RJ, Crowther ER, et al. Chiropractic Manipulation in Adolescent Idiopathic Scoliosis: A Pilot Study. Chiropr Osteopat . 2006 Aug 21. [Epub ahead of print]

* Koes BW, Malmivaara A, van Tulder MW, et al. Trend in methodological quality of randomised clinical trials in low back pain. Best Pract Res Clin Rheumatol. 2005;19:529-539.

* Bisset L, Paungmali A, Vicenzino B, et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med . 2005;39:411-422.

* Hayden JA, van Tulder MW, Malmivaara AV, et al. Meta-analysis: exercise therapy for nonspecific low back pain. Ann Intern Med. 2005;142:765-775.

* Santilli V, Beghi E, Finucci S. Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized double-blind clinical trial of active and simulated spinal manipulations. Spine J . 2006;6:131-137.

* Martinez-Segura R, Fernandez-de-Las-Penas C, Ruiz-Saez M, et al. Immediate effects on neck pain and active range of motion after a single cervical high-velocity low-amplitude manipulation in subjects presenting with mechanical neck pain: a randomized controlled trial. J Manipulative Physiol Ther. 2006;29:511-517.

* Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther. 2008 Mar 1. [Epub ahead of print]

* McHardy A, Hoskins W, Pollard H, et al. Chiropractic treatment of upper extremity conditions: a systematic review. J Manipulative Physiol Ther. 2008;31:146-159.

* Wilkey A, Gregory M, Byfield D, et al. A comparison between chiropractic management and pain clinic management for chronic low-back pain in a national health service outpatient clinic. J Altern Complement Med. 2008;14:465-1473.

* Juni P, Battaglia M, Nuesch E, et al. A randomised controlled trial of spinal manipulative therapy in acute low back pain. Ann Rheum Dis. 2008 Sep 5.

* Miller J, Gross A, D'Sylva J, et al. Manual therapy and exercise for neck pain: a systematic review. Man Ther. 2010;15(4):334-354.

*Martel J, Dugas C, Dubois JD, Descarreaux M. A randomised controlled trial of preventive spinal manipulation with and without a home exercise program for patients with chronic neck pain. BMC Musculoskelet Disord. 2011;12:41.

Last reviewed March 2011 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

http://www.ubciweek.com/health-tips/health-tips-key-exercises-for-lower-back-pain.html

The aim of these exercises is to help you overcome back discomfort and help in the prevention of back pain. Strong backs do not get injured nearly as often as weaker backs. Stretching alone will not help you if your back is not strong so it is important to do regular exercises for lower back pain.

If you purchase some weights all of these exercises can be done in the comfort of your own home. It is important that before you undertake any exercise programme however, that you get cleared by your doctor particularly if you suffer from chronic back pain or have recently undergone surgery. These exercises are aimed at making the spine stable and they will make it stronger if done regularly; generally it is recommended that you try to work out at least 3 times per week.

Start with 15 reps at a time for each exercise; you can build up the number of sets as you become stronger and more stable. When doing these exercises, in order to activate the transverse abdominal muscles you need to pull in your belly button to the spine. People have a tendency to distend or push out the belly button when they exert force, this has an adverse reaction to core stability, so remember pull in the belly button, suck in those abs and hold but don’t forget to breathe!

OK for the first exercise lie on the ground, keeping the pelvis relaxed, but exaggerating the curve in the lower back by bringing the belly up towards the ceiling, making the contraction nice and hard by exaggerating the curve however the opposite movement is where the exercise comes in to play. Tilt your pelvis back towards your head as you suck your belly button down towards your spine, then tilt back towards your knees and then back towards your head. Repeat. This is the key exercise to start with if you have an acute episode of back pain but only work to your pain tolerance. This exercise aims to increase the range of motion and also by bringing the pelvis back it will help to relax the muscles by taking the pressure off the discs.

To take this exercise to the next level, as before make the contraction nice and hard by exaggerating the curve in the back, lift the pelvis off the ground towards the ceiling into the bridge position, supporting through your shoulders. When you are in this position it is important to keep your body nice and hard by contracting your abdominal muscles and your pelvic floor muscles as you move into the plank position by kicking the right leg straight out,the knee must be in the same plane as the knee of the balancing leg. Keep your stomach tight and avoid twisting or slouching. Maintain the plank for ten seconds keeping nice and strong then bring the extended leg back down, alternate and extend the other leg straight out. By taking the balance point away the small muscles of the lower back will have to contract hard in an effort to stabilise the spine.

Next, lying on the ground, engaging the core, arms outstretched to the side, palms up, lift both feet off the ground bending the knees at a 90 degree angle to the hips, keeping the core still and the knees and heels together, rotate first to the left side and then to the right. The idea is to keep your shoulders down and your head still looking straight up all the time.

To progress from this exercise, in a similar position, extend your knees away from your chest a little further and continue to rotate from side to side maintaining your core stability.

Now still lying flat on your back in the starting position, engaging the core, lift your head up off the ground as you extend your left hand diagonally to the right leg as that leg comes high off the ground to meet the hand, then head, hand and leg go back down to the starting position, then alternate opposite hand with opposite leg again lifting the head off the ground as the cross extension occurs. Alternate, repeat.

For the next exercise again in the starting position, lift the left leg high off the ground towards your chest assisting with your arms to pull all the way as you lift your head off the ground to meet your knee. Alternating right leg, left leg, this exercise will stretch out your hamstrings and lower back.

OK time to get up. Standing before a low bench or table if you are doing these exercises at home, gently squat by bending the knees keeping the head and chest up, rotate, extend arm and reach across to the opposite side of the bench and back up to the standing position, then squat, rotate and reach with the opposite arm to the opposite side of the bench. It is really important that we do not hunch over for this exercise, make sure to bend the knees but keep the body upright in the extension.

Next getting a dumbbell approx 8-10lbs in weight, standing upright, feet close together, dumbbell in left hand, elbow fully bent, tilt body down to the same side as the one you are holding the weight, then back up extending arm straight up above the head. Do not push the arm over the head or tilt to the opposite side; arm comes up and straight next to the head. Do 15 reps and then alternate weight to other side and repeat.

When using weights for some of the exercises,if it is too easy with the chosen weight, increase the weight 5lbs at a time until you get to the point that it is challenging on the last rep.

Next, holding weight in both hands above the head for the next exercise, tilt from side to side, keeping core engaged and head central to arms.Head moves with the tilt i.e. don’t let your arm fall on to your head. Head must be in the middle as you move from left to right. One rep equals left to right tilt.

For the next exercise holding a load in one hand only, core engaged, tilt again from left to right, you don’t need a load in each hand for this exercise, so tilt down to one side, back up and over to the other side, keep chest up and take your time. The aim of this exercise is to work your quadratus lumborum and your obliques. The QL connects the pelvis to the spine and it is a common source of lower back pain. The aim of this exercise is to make this area of the back nice and stable.

Finally an exercise for posture that you can do in the sitting position, sitting nice and tall, suck your belly button in, posture erect, bring your head back and down almost creating a double chin, roll your arms back, keep your shoulders down and pinch your shoulder blades together, hold for one minute. This exercise can be done during the day for one minute every half hour as part of your daily routine at the office or home.

By practising these general exercises over a period of time you will build up the strength necessary to live a normal life free of back pain. The key is though to focus on the core abdominal muscles as much as possible and get used to thinking about them and activating them before you go about your regular activities like gardening of vacuuming or lifting the children.

April 20, 2009 | Filed Under Uncategorized | No Comments

Does this sound like you? “I wake up, and I can barely move my neck far enough to look at the clock. After 10 minutes, it loosens up, but I still have pain aching into my neck and shoulder. Everything I do to fix the pain makes me feel better but only temporarily. Pills will help as long as I keep taking them every 3 hours for the rest of my life. No thank you. Massage will help for a day. Chiropractic will help for a week, but then the pain comes back. I tried physical therapy and alternative medicine with the same results. I’ve had injections, which unfortunately didn’t last very long either. I’m looking for something new!”

St. George’s spine clinic is excited to announce new technology for neck pain sufferers. Most people don’t realize that they have lost strength in their neck due to previous neck injuries, car accidents, surgeries, and years of wear and tear. Losing strength in the neck leads to many problems such as intense pain, headaches, and shoulder or arm symptoms. A new machine called the Multi-Cervical Unit enables doctors, with the aid of a computer, to evaluate the neck and pinpoint precise areas of weakness for therapy. The therapy follows American Medical Association standards and is proven to restore long-lasting range of motion and relief.

Advanced Spine and Rehabilitation is the first and only clinic in Utah to have this innovative technology.Individuals suitable for this therapy include those with previous whiplash injuries and acute or chronic neck pain. “With a computer, we test the strength and motion of the neck muscles, and from that determine if the individual does or does not have cervical weakness. We use the data generated from the computer to design an individualized strengthening program for the patient.” No referral is necessary, and no extra out-of-pocket expense is required above Medicare and insurance coverage.

This site has helped us a lot

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In a nut shell, if you hurt your low back at work, research shows you will recover more quickly and have fewer long lasting effects if you undergo chiropractic treatment.

Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence

Cifuentes, Manuel MD, PhD; Willetts, Joanna MS; Wasiak, Radoslaw PhD, MA, MSc

Abstract

Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP).

Method: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care.

Results: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8).

Conclusions: In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.

Many people go to chiropractors for relief of back pain. But there is reason for caution. Much of what chiropractors do is nonsense, and they often misinform their patients.

Do you need to see a chiropractor? Many people think they do. Just about everyone thinks of a chiropractor when back pain is mentioned. There is considerable evidence that spinal manipulation can help relieve some types of neck and back pain. But neck manipulation can be dangerous. And according to a study published in the October 8, 1998, New England Journal of Medicine, spinal manipulation may be no more effective than physical therapy in the treatment of back pain and only marginally more effective than following a self-help instruction booklet. So what about chiropractic treatment? [1] Should you—or any member of your family—ever go to a chiropractor?

There is no doubt that dramatic relief of back pain will occasionally occur when manipulation is used to unlock a binding spinal joint. Many people with acute or chronic back pain experience relief of symptoms when the spine is loosened by manipulation performed by a chiropractor, an osteopath, a physical therapist, or an orthopedist. Manipulation is most readily available from chiropractors, however, and a report issued by the RAND Corporation stated that 94% of all such manipulation in the United States is done by chiropractors [2]. For this reason, many people who have back pain will visit a chiropractic office where they will experience spinal manipulation for the first time.

A survey of Consumer Reports readers published in May 2000 found that 35% of 46,860 respondents had used alternative therapies for a variety of problems, 40% of whom had chiropractic treatment for back pain [3]. The back-pain patients rated deep-tissue massage, chiropractic treatment, exercise, and physical therapy (in that order) as more effective than prescription drugs, acupuncture, over-the-counter drugs, and other forms of treatment.

Obviously, many people with back pain are going to chiropractors, and most of them are satisfied with the care they receive. But many are unaware of the controversy and the nonsense associated with some forms of chiropractic treatment and often become victims of misinformation.

The Theory of Chiropractic

It is now generally accepted that spinal manipulation can relieve some types of back pain. Most chiropractors claim to do more than just treat back pain, however. Clinging to the scientifically rejected theory that misasligned or "subluxated" vertebrae cause "nerve interference" that results in disease or ill health, many chiropractors use "spinal adjustments" to treat disease and infection as well as back pain. The Association of Chiropractic Colleges bolstered support for this theory in 1996 when the presidents of all 16 North American chiropractic colleges reached a consensus and issued a position paper stating that "Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation." [4].

The chiropractic profession continues to define itself as a method of correcting subluxations to restore and maintain health, despite the fact that there are no scientific studies to indicate that vertebral misalignment or any other problem in the spine is a cause of disease or infection. Basing their treatment on the vertebral subluxation theory, many chiropractors claim to be primary care physicians capable of treating and preventing a broad scope of human (and animal) ailments.

Some chiropractors advise that spinal adjustments should begin at birth to correct subluxations caused by "birth trauma." The entire family may be advised to undergo regular life-long spinal adjustments in order to maintain optimum health by "keeping the spine in line." Some chiropractors specialize in chiropractic pediatrics. According to the American Chiropractic Association, 10% of patient visits to chiropractors are made by children and adolescents who are treated for such maladies as otitis media, asthma, allergies, infantile colic, and enuresis (bedwetting). [5] An article in the April 2000 Archives of Pediatric and Adolescent Medicine warned that chiropractic pediatric care is often inconsistent with recommended medical guidelines. [6] "When I contemplate a chiropractor treating a 2-week-old neonate with a fever," said the editor in a sidebar comment, "I get a gigantic headache."

Studies conducted by chiropractors and published in "peer reviewed" chiropractic journals often recommend treatment for such conditions as infantile colic and asthma. A study published in the Journal of Manipulative and Physiological Therapeutics for example, concluded that "Spinal manipulation is effective in relieving infantile colic" [7]—a conclusion not confirmed with reliable, unbiased research and recently refuted by a well designed study by a Norwegian research team [8].

When medical researchers tested chiropractic manipulation as a treatment of asthma in children, they reported that "the addition of chiropractic spinal manipulation to usual medical care provided no benefit." [9] Although chiropractic manipulation can be beneficial in the treatment of some types of neck and back pain, I always advise parents not to take their infants and children to a chiropractor, since the risk may outweigh any benefit.

Limitations of Chiropractic

Since chiropractors work on the back, most people think of the chiropractor as a back specialist. But when back-pain victims visit a chiropractic office, they may be given pamphlets suggesting that chiropractic treatment is also beneficial for asthma, infantile colic, ear infection, digestive disturbances, and a host of other organic or visceral problems. There are many good chiropractors who do a good job treating back pain, but few voluntarily limit their treatment to the care of back pain. Chiropractic colleges are still teaching the theory that using spinal adjustments to correct vertebral subluxations will restore and maintain health. Unless you see a chiropractor who has been recommended by an orthopedic specialist or who works with physicians in a back-pain clinic, your chances of finding a properly limited chiropractor are slim. Poorly informed consumers may not know where to draw the line when they visit a chiropractor.

"That spinal manipulation is somewhat effective symptomatic therapy for some patients with acute low back pain is, I believe, no longer in dispute," said the editorial in the New England Journal of Medicine [10]. But "there appears to be little evidence to support the value of spinal manipulation for non-musculoskeletal conditions. For this reason, I think it is currently inappropriate to consider chiropractic as a broad-based alternative to traditional medical care."

At least five guidelines and caveats should be observed when seeking chiropractic care for back pain.

1. Be on Guard

Look for a chiropractor who openly states that his or her practice is limited to the treatment of neuromusculoskeletal problems that have a mechanical origin. You might also find a suitable one in the directory posted at Chirobase.org.

If you cannot find a chiropractor who is a neuromusculoskeletal specialist or who works in a back-pain clinic as a member of a back-care team, you have to be on guard as an informed consumer if you are to protect yourself from the nonsense associated with chiropractic treatment. There are many chiropractic procedures and techniques you should avoid—some of which are dangerous as well as a waste of time and money.

2. Seek Appropriate Manipulation

Properly performed spinal manipulation is always done by hand. Chiropractors who believe that slightly misaligned vertebrae can cause disease often use machines or small hand-held spring-loaded mallets to tap misaligned vertebrae back into place. A 1998 survey by the National Board of Chiropractic Examiners found that 62.8% of survey respondents said they used an Activator mallet to adjust subluxations [11]. Such chiropractors might also use instruments to measure heat and electrical activity over skin surfaces in a search for subluxations. The only treatment they may offer is a spinal adjustment for whatever ails you.

A good chiropractor who specializes in the care of neuromusculoskeletal problems does not use instruments and machines to diagnose and treat subluxations. And his treatment is not limited to the spinal adjustment. Physical therapy, massage, exercise, rest, home treatment with hot or cold packs -or no treatment at all-are sometimes more appropriate than spinal manipulation.

3. Avoid Unnecessary Treatment

While an acute episode of back pain can be incapacitating and scary, remember that most back pains resolve in two to four weeks. After limiting bed rest to a couple of days, most back-pain victims can begin moving around and gradually resume normal activities over a period of a week or two. If you go to a chiropractor for relief of back pain, you should not continue with treatment if your pain worsens during the first week or if you are not any better after two weeks. If your symptoms persist after one month, see an orthopedic specialist for a definitive diagnosis.

A chiropractor who is reasonably competent in making a diagnosis might immediately refer you to a specialist if certain red flags are present, such as: fever; a history of cancer; prolonged back pain unrelieved by rest; the possibility of a fracture resulting from advanced age, long-term use of steroids, or severe injury; and so on. In the case of a simple strain, you might be advised that rest and time are the 'best treatment. But you cannot always rely on the diagnostic ability of a chiropractor. Some chiropractors "analyze" the spine in a search for subluxations rather than make a diagnosis. They always find subluxations that require spinal adjustments. Such chiropractors are less likely to offer appropriate advice and are more likely to subject you to prolonged and unnecessary treatment.

Be wary if your chiropractor's diagnosis is "subluxated vertebrae." Be even more wary if you are given a treatment plan that recommends daily visits that are gradually reduced in frequency over a period of several months. Such plans usually lead into "maintenance care" that requires one or two treatments a month for the rest of your life!

4. Popping Normal Backs

As a general rule, chiropractic treatment, or manipulative treatment for back pain, should be discontinued when symptoms disappear and you are feeling well. It is not necessary to continue with occasional spinal adjustments unless you have a structural problem that causes chronic back pain that can be temporarily relieved with manipulation. Frequent and unnecessary manipulation may do more harm than good, causing you to seek treatment for symptoms caused by the manipulation.

Normal spinal joints often make popping sounds when the joint surfaces are forcefully separated by manipulation.

Chiropractic patients often interpret these sounds as movement of vertebrae that are out of place. Some chiropractors use the popping sound to encourage patients to return for regular spinal adjustments in order to "maintain vertebral alignment." While such treatment has a strong placebo effect, it is misleading and tends to perpetuate illness or fear of illness.

5. "Neck Specialists"

Some subluxation-based chiropractors believe that most ailments, including low-back pain, are related to misaligned vertebrae in the neck. These "upper cervical specialists" always adjust the neck, usually the top two vertebrae at the base of the skull. This can be dangerous, since excessive rotation of the head and upper cervical spine places a strain on the vertebral arteries and can result in vascular injury or stroke.

There are special cases in which cervical manipulation can be beneficial when vascular problems have been ruled out and head rotation during manipulation does not exceed 50 degrees. But cervical manipulation should never be done routinely, especially as a preventive-maintenance measure. Most of us will never need cervical manipulation. Upper cervical chiropractors who manipulate the neck of every patient they see should be avoided. Elderly persons, especially those who have vascular disease or who might be taking blood thinners, should not submit to neck manipulation of any kind.

The Dangers of Neck Manipulation

A 1996 RAND report on The Appropriateness of Manipulation and Mobilization of the Cervical Spine estimated that stroke and other injuries resulting from cervical spine manipulation occurred about 1.46 times per 1,000,000 manipulations [12]. It also concluded that only 11.1% of reported indications for cervical manipulation could be labeled appropriate. A patient who receives regular, frequent, and totally unnecessary neck manipulation is subjected to greater risk. Since many cases of stroke caused by cervical manipulation have not been recognized as such, studies are being done to determine how many stroke victims had neck manipulation prior to their stroke. The incidence of stroke from cervical manipulation might be much higher than indicated in past studies. A study by the Canadian Stroke Consortium, published in the July 18, 2000, Canadian Medical Association Journal, for example, reported that stroke resulting from neck manipulation occurred in 28% of 74 cases studied [13]. Other causes were sudden neck movement of various types. The most common finding was vertebral artery dissection (splitting or tearing of arterial walls with clot formation and embolism) caused by sudden movement or rotation of the top two cervical vertebrae.

Chiropractors commonly manipulate the upper cervical spine as a treatment for head and neck pain. But since such pain in itself can be a symptom of vertebral or carotid artery dissection, especially following injury, it may be wise to forego neck manipulation for sudden onset of head or neck pain until risk factors can be better identified. Informed consent should always be obtained from patients about to undergo cervical manipulation. In many cases, massage, traction, and other forms of therapy can be substituted for prescribed cervical manipulation. Tension headache, for example, is commonly treated with chiropractic neck manipulation. A study published in the Journal of the American Medical Association found that spinal manipulation was no more effective than massage in relieving episodic or recurring tension headache [14]. So be cautious. Until studies on cervical manipulation have been completed, don't submit to neck manipulation unless you have a problem that cannot be treated any other way. A chronic "cervicogenic" head pain, for example, in which pain is transferred from joints in the cervical spine, can often be relieved with appropriate cervical manipulation. But such manipulation should be done only after a correct diagnosis has been made and other forms of treatment have failed.

The Bottom Line

A good chiropractor can do a lot to help you when you have mechanical-type back pain and other musculoskeletal problems. But until the chiropractic profession cleans up its act, and its colleges uniformly graduate properly limited chiropractors who specialize in neuromusculoskeletal problems, you'll have to exercise caution and informed judgment when seeking chiropractic care.

References

1. Cherkin DC and others. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. New England Journal of Medicine 339:1021-1029, 1998.
2. Shekelle PG and others. The Appropriateness of Spinal Manipulation for Low-Back Pain: Project Overview and Literature Review. Santa Monica, Calif: RAND, 1991, p 3.
3. Consumer Reports Survey. The mainstrearning of alternative medicine. Consumer Reports, May: 17-25, 2000
4. Association of Chiropractic Colleges. A position paper on chiropractic. Journal of Manipulative and Physiological Therapeutics 19:633-637, 1997.
5. Goertz C. ACA annual statistical survey on chiropractic practice. Journal of the American Chiropractic Association 33:35-41, 1996.
6. Lee A and others. Chiropractic care for children. Archives of Pediatric and Adolescent Medicine 154:401-407, 2000.
7. Wilberg JM and others. The short-term effect of spinal manipulation in the treatment of infantile colic: A. randomized controlled clinical trial with a blinder observer. Journal of Manipulative and Physiological Therapeutics 22:517-522, 1999.
8. Olafsdottir E and others. Randomised controlled trial of infantile colic treated with chiropractic spinal manipulation. Archives of Diseases in Childhood 84:138-141, 2001.
9. Balon JP and others. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. New England Journal of Medicine 339:1013-1020, 1998.
10. Shekelle PG. Editorial: What role for chiropractic in healthcare? New England Journal of Medicine 339(15):1074-1075, 1998.
11. Christensen MG and others. Job Analysis of Chiropractic. Greeley, Colo.: National Board of Chiropractic Examiners, 2000, p 129.
12. Coulter IE and others. The Appropriateness of Manipulation and Mobilization of the Cervical Spine. Santa Monica, Calif: RAND, 1996, pp 18-43.
13. Norris W and others. Sudden neck movement and cervical artery dissection. Canadian Medical Journal 163:38-40, 2000. [PDF}
14. Bove G, Nilsson N. Spinal manipulation in the treatment of episodic tension-type headache: A randomized controlled trial. JAMA 280:1576-1579, 1998.

The iliotibial band (IT Band) is a fibrous sheath of connective tissue that runs down the outside of the
leg. It starts at the hip and ends just below the knee. Many runners and other athletes will experience
problems resulting from IT Band dysfunction including lateral knee pain and hip pain. In fact, 12% of all
runner injuries are from the IT Band. So what can be done to prevent these kinds of injuries?

One important thing is to change up running routines. If you always run the same courses, the same
stresses affect the same body parts. One suggestion would be to run routes in the opposite direction.
Proper warm up is key as well. However, avoid a STATIC IT Band stretch before you run, as this will
cause a reflexive tightness. Therapeutic ultrasound and electrical stimulation can help relax the
tissue. Foam rollers are a great method for self treatment to loosen the IT Band. Newer tissue release
techniques, such as ART® and Graston, have had fast results in treating IT Band issues. These can be
done by a certified health provider.

The most important thing in prevention of IT Band-related problems is proper muscle activation and
use. Just because a muscle is strong doesn’t always mean it is properly firing. A trained practitioner can
evaluate and find potential weakness and dysfunction through a thorough exam. IT Band issues often
can often be traced to Glut and Hip weakness and/or dysfunction. The important thing to know is if
ignored IT band issues can lead to hip and knee arthritis. However, treatment for this problem is easy
and effective.

You don’t need to suffer. Learn how chiropractic can help you recover from auto injuries.

Auto injuries are a common source of chronic pain. Getting the proper treatment early after your crash can be very important in recovering quickly.

Most auto injury pain originates in the spine, and that's why chiropractic can be beneficial: we get to the underlying trauma that you experienced and help your body heal.

Whether you need to see a chiropractor, a physical therapist, a massage therapist, a pain management physician, or a spine surgeon, we can help. At our facility our wide range of physicians specialize in auto accident treatment.

Call today, and start to get your life back.

(435) 656-0234