Back pain

Steps to Treating Back Pain

back-pain-treatment

The first step is to have some form of cold/ice compress ready for your back. You can take a wet towel and place it in the freezer for an hour, or take ice and wrap it in a towel or use an ice pack.

The next step is to find a comfortable lying position for your back and spine. You can either lie directly on your back with your feet planted and your legs bent or your legs straight out in front of you. Another option is to lie on your less sensitive and painful side with a pillow for under your head and another pillow in between the knees. In this position you need to make sure your knees are close to your chest in order to have flection in the spine. A third option is to lie flat on your stomach and make a pillow for your head with your forearms and elbows and rest your forehead.

Once you have found a comfortable position for you, take your form of cold compress and place it on the sensitive/painful part of the spine. You should remain in pose and focus on breathing. The idea is to bring breath and air to the sensitive part of the spine and allow gravity to take over. Remain here for 15-20min.

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Discovering the Source of Pain and Connecting to the Body

body-pain

Pain in any part of the body is a sign that the body of out of “tune.” For instance one can complain of pain in the knee, but the x-ray, MRI and even manual testing show that there is nothing wrong with the knee.  So the question becomes why is this person complaining of knee pain? In this case we need to look at the body parts that are directly related to the knee such as the back, hip and ankle.  One must analyze the hip and ankle to understand what is occurring in the knee.

A person with a limited range of motion and flexibility in the back, hip and/or ankle requires the knee joint to work twice as hard, eventually causing discomfort, then tension and finally pain in the knee. If the issue is not addressed simultaneously in the back, hip, knee and ankle it can lead to inflammation of the tendons, sprained ligaments and inevitably major problems in the knee.

In order to resolve the problem in the knee, one should have a number of body tuning treatments on the back, hip and ankle as well as perform movement exercises at home.

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Surgeries to Avoid: Complex Spinal Fusion for Stenosis

Reasons to think twice before going under the knife

With spinal fusion, a surgeon places bone grafts that “weld” two or more vertebrae together to prevent motion and stop pain. The procedure is often used to treat back pain from spinal stenosis, which occurs when the soft tissues between the vertebrae flatten out, creating pressure on the spinal cord or nerves that go to the back, arms, neck, shoulders, and legs. There is little consensus on how best to relieve pain from stenosis, so doctors tend to develop their own preferences, says Richard Deyo, M.D., professor of medicine at Oregon Health and Science University.

Not all surgeries are worth the risk. — Getty Images/Uppercut RF

Not all surgeries are worth the risk. — Getty Images/Uppercut RF

Their top treatment choice increasingly seems to be fusion. Deyo recently studied the records of more than 30,000 Medicare patients who underwent surgery for stenosis of the lower back and found that complex fusion procedures (in which surgeons place bone grafts between multiple vertebrae) had increased an astounding 1,400 percent between 2002 and 2007.

The risks are significant: Those who underwent complex fusion were nearly three times more likely to suffer life-threatening complications than those who underwent less invasive surgery. Previous studies have also found that most fusion patients experience no more relief from their chronic back pain than those who had physical and behavioral therapy. “There is even some evidence that [complex fusion surgery] is worse than other surgeries,” says Floyd J. Fowler Jr., Ph.D., senior scientific advisor for the Foundation for Informed Medical Decision Making (FIMDM). “The vertebrae right above and below the fusion have to do a lot more bending, and it puts stress on your back above and below.”

Alternatives to Surgery

Before considering any type of back surgery, make sure you have exhausted more conservative measures, including physical therapy, cortisone injections, acupuncture, and medications. “Probably less than 5 percent of all back pain requires surgery,” says Arnold Weil, M.D., clinical assistant professor of rehabilitation medicine at Emory University School of Medicine in Atlanta.

by Karen Cheney, AARP The Magazine, July/August 2011

A Body Tuning Session with Shmuel Tatz

Peter Brook’s production of the Indian epic The Mahabharata was stunning. But for Tara, whose hip joint and upper back have been giving her problems, watching the drama was an excruciating ordeal. The play began at one in the afternoon and ended at midnight; to add to the effect of antiquity, the seats in the specially remodeled theater in Brooklyn had been converted to bleachers with only light padding.

Though she loved the play, Tara’s hip and back ached as she left that night.

To add to the problem, Tara has just completed a five-day vipassana meditation retreat, a 14-hour-a-day regimen of hour-long sittings alternating with mindful walking. Despite her best attempts at yoga stretches and an ergonomic variation on a zafu for sitting, the course had left her hip and back in poor shape to endure the day-long play.

Luckily, Tara has an appointment with Shmuel Tatz at his Carnegie Hall studio.

At the session’s start, Tatz has Tara up on his bodywork table, lying on her left side. Tatz himself strikes a thoughtful pose before beginning to work.

“Before I touch anyone, I try to tune my own body,” says Tatz as he takes a comfortable t’ai chi stance, one leg a step ahead of the other, his body balanced between. Taking a moment to center, Tatz then gently places one hand on Tara’s back, the other on her ailing hip.

“I find the person’s rhythm of breathing, whether fast or slow,’ he says. “I breathe in tune with her.”

Then, pressing on Tara’s sacroiliac, he begins top massage her lower back with his left hand, checking to see if she is relaxed. Wherever he finds some tightness, he relaxes it with massage, then gently rocks Tara’s body side to side with his right fist.

The pressure at the sacroiliac releases tensions there and in the lower spine, while the rocking motion helps Tara’s tight muscles relax, at the same time letting Tatz see if they are indeed relaxing as they should.

Tatz himself rocks his legs in time with Tara’s rocking, simultaneously coordinating each press of the fist with her breath: pressing in as she breathes out, relieving the pressure as she breathes in.

This careful movement, finely tuned with Tara’s own natural rhythm of breath, typifies Tatz’s work as he moves his focus on her lower back, checking the motion of each vertebra with the fingertips of his left hand as he rocks her side to side with his right. As his fingers examine her spine, he stops between the third and fourth vertebrae. “Feel that?” he asks. “Yes, it’s painful there,” Tara answers. The diagnosis is right.

Trained as a physical therapist Tatz sometimes uses X rays to find the exact cause of compression between vertebrae – whether a disc problem, calcium deposits, or poor alignment, for instance. With Tara, he uses his fingertips to massage between the discs, softly forcing open space between them as he rocks her from side to side.

Shifting his attention to her legs, he lifts her right leg at the knee, working it through it’s natural range of motion. In doing this, he sees that the quadriceps is shortened, a mass of tightness in the quadriceps and tendons of the leg, each problem playing into the other. The back, too, is part of the same pattern; nerves running between the back and hip can cause a problem in one place to travel to the other.

In order to help free the hip, Tatz works with the leg, easing the muscles into relaxation through a combination of massage, guided movement, and acupressure. The body is so interrelated, he says, that working on a zone far from the central problem is all part of a holistic strategy aimed at the center. For instance, with Tara’s leg extended, he presses an acupressure point to the side of her ankle, tugs at the leg, extends it as though it were in traction, massages her abdomen, and tugs at her hands raised over he head – all to open the joint at the hip.

As she lifts her leg and waggles it, Tatz says, “Always I ask a question of the joint or muscles. As I lift the leg, I ask the hip joint, ‘How’s your internal rotation?’ If it’s okay, I go to the abductors and ask how they are. If they answer, ‘Very tight,’ I give some help.

The session ends with a touch of the Alexander technique, Tara walking around the room with Tatz holding her neck from behind in a balanced position where it is not fighting gravity. He explains that jutting the head forward, as most people do, creates constant tension in the neck and shoulders, as the muscles there struggle to counterbalance the 10 pound of the head.

The walk is just part of the re-education of Tara’s body. Tatz also gives her some homework, showing her a series of movements and easy stretches to help her body to hold the changes he has made in it.

After the session, Tara’s report is that she feels “great: free of pain, more balanced, and relaxed.”

Yoga Journal

By Daniel Goleman, PhD. – a psychologist and contributing writer on behavioral science for the New York Times.