Out of the blue, your back starts to hurt. At first, it's just an annoyance. You can live with it. You've had lower back pain before and it went away on its own.
Now it's a few weeks later. You've got a low-grade pain that's not getting any better. You're actually worse, in fact, because your back hurts most of the time.
What to do?
You don't want to run to a doctor. After all, it's just back pain. Everybody has back pain. So you begin to solicit advice from your friends. And, of course, your friends have plenty of advice. "Do these exercises my doctor gave me." "Do these stretches - they worked for me." "Go to yoga class." "I know a great Pilates instructor. She'll get you in shape and your back will stop hurting." "Take vitamins and drink more water." "Meditate."
Your friends mean well and it's all very good advice. But none of it seems to work. Another month goes by and now the pain is increasing. It's even affecting your sleep.
It's time to see a doctor. But which one? For the most part, medical physicians are not experts on back pain. Typical recommendations include rest, moist heat, and anti-inflammatory medication.1,2 But, really, you've done all that. You need more specific advice.
Choices might include doctors of chiropractic, orthopedic surgeons, and physical therapists.
Many orthopedic surgeons are spinal specialists, but what they do is surgery. This would be a last resort, typically, after other treatment options have failed.
Physical therapists are highly skilled practitioners who focus on exercise, rehabilitation, and re-training. They are not primary care providers, and typically patients are referred to physical therapists by family physicians, chiropractors, and orthopedic surgeons.
Doctors of chiropractic are spinal specialists, too, and what chiropractors have to offer is expert conservative therapy.3 Chiropractors treat back-related problems all day, every day, and are the right doctor to see first.
As spinal specialists, chiropractors receive extensive training in evaluating patients with back pain. Chiropractors consider all aspects of the problem, and develop sound treatment plans based on the facts. If a person does not respond as anticipated, their chiropractor has a "Plan B" in place for further evaluation and possible referral.
When choosing a doctor, you're allowed to ask questions and participate in the process. The strategy for follow-up is critically important.
First, if you're improving and doing well, how will can you help keep the problem from recurring? Will your chiropractor prescribe stretches, exercises, and other self-care action steps to help you keep yourself well?
And, what steps will be taken if your problem and pain are not improving? Where might you be referred for further tests and evaluation? Chiropractic treatment is a powerful tool in most cases of back pain. Symptoms should begin to improve quickly. Have your chiropractor outline the "Plan B" if you are, in fact, not getting better.
Your doctor of chiropractic will be able to answer these questions.
1Zuhosky JP, et al: Industrial medicine and acute musculoskeletal rehabilitation. Arch Phys Med Rehabil 88(3 Suppl 1):S34-39, 2007.
2Cayea D, et al: Chronic low back pain in older adults. What physicians know, what they think they know, and what they should be taught. J Am Geriatr Soc 54(11):1772-1777, 2006.
3DeVocht JW: History and overview of theories and methods of chiropractic. Clin Orthop Relat Res 444:243-249, 2006.
What's going on? Is this mechanical failure people seem to be experiencing in their joints a new phenomenon? Or are more diagnoses being made now owing to the ready availability of CAT scans and MRI units? Are more surgeries being done owing to the abundance (at least in urban areas) of surgeons wanting to perform these procedures?
Regardless, deeper questions point to lifestyle patterns that may predispose a person to developing knee osteoarthritis. A comparison with earlier times may be useful in this context. For example, it's not well-known that people in the Middle Ages - the 11th and 12th centuries - lived into their 80s. They managed to get along without ibuprofen, without arthroscopy, and without major surgical procedures. But we live in the 21st century. What is our problem?
Mindfulness techniques can assist a person substantially in achieving improved levels of health and well-being. These methods, including meditation and guided imagery, are gaining prominence as more traditional medicine group practices, hospitals, and teaching institutions 1,2 are embracing an integrated approach.
Learning the basics of mindfulness methods is easy and straightforward. Success in applying these techniques requires attention and discipline, and one's capabilities in these areas increase with time and practice.
Guided imagery involves picturing a peaceful, relaxing setting and may incorporate persons, animals, and other living beings in the imagined environment. The purpose of the exercise is to focus and immerse yourself in the quiet and soothing surround. The benefit derives from profoundly shifting one's habitual focus on stress and stressful circumstances onto positive images that help support health and healing.3
To begin, you seat yourself comfortably in a location where you won't be disturbed or distracted by others. You close your eyes, take a few relaxing breaths, and affirm to yourself that you're going to have a positive experience. You start the self-guided imagery session by picturing a favorite place, one that is enriching and uplifting, such as a beach, nature trail, or mountain habitat. The environment does not have to be one with which you have actual experience. The power of self-guided imagery is that your imagination is, in fact, your open-ended guide.
For example, if you're on a beach, you could first focus on the sensation of the warmth of the sun on your skin. Feel how it feels. Really focus on the aliveness that the sun's rays generate throughout your entire being. Picture yourself in your comfortable beach chair and experience the textures and tactile sensations of your casual, colorful beach attire.
After a while, you may choose to walk down to the shoreline. Feel the warmth of the sand on the soles of your feet. Experience the contours of the sand and how your balance has to adjust with each step to match the miniature hills and valleys of the sandy shore. Hear the deep rumble of the ocean and the gentle susurration of the waves. Focus on a sequence of waves. See them rise, crest, and crash on the shore. Experience the ebb and flow of your own heartbeat and your own breath, your personal internal rhythms that align with the rhythms of the ocean shore.
Your self-guided imagery sessions may last for five or ten minutes. You could do these sessions daily or one or two times a week. Essentially, you're telling yourself a wonderful story that you experience in your mind's eye. Your self-guided imagery sessions are filled with beautiful images, sounds, and even music that provide an experience of peace, fulfillment, and happiness. Over time, the results include reduced stress, greater awareness, a heightened sense of presence and being-in-the-world, and improved health.
Regular Chiropractic Care and Mindfulness Techniques
Whether you're engaged in meditation, guided imagery, awareness practice, or breathing exercises, musculoskeletal aches, pains, soreness, and tension can interfere with what you're attempting to accomplish. Unless you're an advanced mindfulness student, these physical ailments can easily become the focus of attention and drain energy from your healing process.
Regular chiropractic care can provide effective solutions to these daily musculoskeletal stresses and strains. By detecting and correcting sources of nerve interference and spinal biomechanical dysfunction, regular chiropractic care restores optimal functioning and structural integrity to your body's skeletal and muscular framework. As a result, you're able to breathe more easily and fully, get more oxygen into your system, and deliver more healing nutrients to the regions of your body that need them the most. In this way, by helping to resolve and heal stumbling blocks to your concentration, focus, and attention, regular chiropractic care provides great benefit to every mindfulness practice.
Since mid-Fall TV commercials have been trumpeting the horrors of the "flu season". "It's never too soon to begin fighting this year's bug" they blare. Public health announcements urge us to get our "yearly flu shot", as if this is something we've got permanently scheduled in our Blackberries. All the leading over-the-counter pain medications offer special seasonal "flu" mixtures, and their ads deluge daytime and prime-time broadcasting.
For the health consumer, namely us, it seems as if this annual "war on the flu" is received wisdom. We're just defenseless human beings at the mercy of the all-powerful flu virus.
What's wrong with this picture?
What's never mentioned in the "flu warning" marketing is the versatility and adaptability of our remarkable immune system. We're the lucky owners of a built-in state-of-the-art biowarfare system, on-the-job 24/7 to combat microscopic foreign invaders of our health and well-being. Once our immune system has detected a foreign protein it mounts an immediate defense, attacking and destroying the alien molecules. And, the memory of that particular invader is permanent, enabling a future immune response to be swift and effective.1
The big issue with influenza is that new strains appear each year. We've never encountered these germs before. But, the whole basis and strength of our immune system is flexibility. It is specially designed to respond quickly to new attackers. And, for the most part, it does this very, very well.
Of course, no one wants their dinner companion to sneeze in their plate of pasta, as Elaine did on an infamous episode of "Seinfeld". Through a typical cascade of unfortunate events, Jerry's and George's comedy pilot was almost scuttled because the network executive was Elaine's date, and he got violently ill by being on the receiving end of her blast of micro-bugs.
In the real world, our immune systems can be weakened due to life habits, circumstances, and stress. Stress is a notorious compromiser of immune defenses.2 And, of course, being human, there's plenty of stress from dawn to dusk. If worry and anxiety pile on top of not-enough-sleep or sub-optimal nutrition, getting sick is a pretty likely outcome. So, developing and maintaining healthy habits of living and successful strategies for managing stress is really the key.3
If you do the simple things that keep you healthy and well, in the winter months you can pretty much "let the flu go around you". You can be confident, knowing you've done the work to fight off the latest flu threat. Someone else's germs are their germs, not yours. If your immune system is on the job, you're far less likely to "catch" something.
And, even if you do succumb, you've got a much better chance of getting well again quickly.
1Sompayrac L: How the Immune System Works, 2nd ed. Blackwell, 2002.
2Wein H:Stress and disease - new perspectives. NIH Word on Health, October 2000.
3The Truth About Your Immune System - What You Need To Know. Harvard Health Publications, 2007.
We're in the middle of several deadly epidemics in the United States. Obesity, diabetes, and heart disease are affecting more and more people every year. Recent statistics show that two-thirds of Americans are overweight or obese. Thirty percent of American children are obese. Approximately 21 million Americans have diabetes. One child out of every 500 has type I diabetes. In America, 72 million adults have high blood pressure. These are shocking statistics, considering that U.S. health care expenditures totaled $2 trillion in 2006. That's 2 TRILLION dollars.
As Americans, we're getting less healthy by the day. The good news is there are many things we can do about these trends. There is real action that every American, young and old, can take to support and protect their health and well-being. These action steps all focus on lifestyle - the choices we make each and every day.
The first step is an honest self-assessment. When was the last time I exercised? Does my clothes size increase every couple of years? How many times during the week do I eat fast food? When was the last time I ate an apple instead of half a box of cookies?
Regardless of the answers, it is possible to become healthy and fit again, whatever your current circumstances. You CAN lose 10 or 20 or 30 or however many pounds. You CAN climb stairs without getting out of breath. You CAN regain the youthful glow of vitality. You CAN be vigorous and proud of your body, rather than worrying about what's going to be the next thing to break down.
Healthy eating and regular exercise are essential parts of the solution to combating obesity, diabetes, and heart disease.1,2 These practices have the magical effect of resetting your metabolic clock - your body shifts from a pattern of storing fat to a pattern of burning fat.3 Over time, with a nutritious food plan and consistent exercise, you even burn fat while you're resting! Your body is very smart. You just have to treat it right.
Your chiropractor is a wonderful asset - both as a health care practitioner and as a guide - on your journey toward fitness and wellness. Your chiropractor has extensive resources available on practical nutrition and how to design a supportive food plan. He or she has deep knowledge regarding the types of exercises and activities that will be right for you. You and your chiropractor can design an exercise program that will be both fun and rewarding. Working together, you'll be maximizing your health and vitality. You will begin to fulfill a way of living that will support you in being healthy and well for years to come.
1Lindstrom J, et al: Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 368(9548):1673-1679, 2006.
2Orchard TJ, et al: The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 142(8):611-619, 2005
3Yannakoulia M, et al: A dietary pattern characterized by high consumption of whole-grain cereals and low-fat dairy products and low consumption of refined cereals is positively associated with plasma adiponectin levels in healthy women. Metabolism 57(6):824-830, 2008
Most of us are procrastinators. We let things go until the last minute. Papers, magazines, and books pile up on the desk until the process of finding what we're looking for resembles an archeological dig. Our garages look like our desks. Stuff fills the garage just like stuff covers the desk. Eventually, finding things resembles exploring for treasure in a dark, long-abandoned cave. We're motivated to clean our desks and garages only by the impossibility of adding any more stuff to the clutter and the piles.
Sometimes it seems as if procrastinating is hard-wired into our DNA. This is particularly true when it comes to our health. No one wants to go to the doctor, so it becomes even easier to put off the needed checkup. Whether it's our chiropractor, our dentist, or our family physician, nobody seems to want to pick up the phone, go to the office, and take care of business. Of course, procrastination in relation to our health can lead to some big problems. Tooth pain that comes and goes doesn't seem like such a big deal. But if the coming and going is fairly consistent, then there's probably a cavity that needs filling. You keep putting it off and when you finally get around to going to our dentist, you learn you need an expensive root canal and a crown. That's not good.
Or you're playing pickup basketball on the weekend. You go up for a rebound and get shoved in the back. The next day you have lower back pain. You keep thinking it'll go away, but it's now four weeks later and your back is still stiff and sore. Had you seen your chiropractor the first week, after the pain had persisted for four or five days, treatment might have been pretty straightforward. Now you learn it's going to take at least several weeks of treatment before you can play ball again. Not good. Diabetes is the same thing. 1High blood pressure is the same thing.2 Overweight is the same thing. 3Procrastination with your health always costs more time and more money in the end. Prevention and, if necessary, early detection, are the keys.
When it comes to your health, the opposite of procrastination is managing your symptoms. It's not necessary to run to your chiropractor for every ache and pain or to run to your family physician for every sniffle or low-grade fever. It is important and necessary to pay attention to what's going on with you. Symptoms that linger mean something is wrong and your body needs help in getting better. Once you begin paying attention a learning curve will kick in. You'll develop skill in identifying problems that need attention. The next step, of course, is to pick up the phone, make an appointment, and arrive at the appointment on time. Your chiropractor or family physician will be glad to be of service in identifying the problem and providing appropriate treatment.
1Bo S, et al: Prevalence of undiagnosed metabolic syndrome in a population of adult asymptomatic subjects. Diabetes Res Clin Pract 75(3):362-365, 2007
2Guyomard V, Myint PK: Optimum control of blood glucose for prevention and treatment of ischemic and hemorrhagic stroke. Curr Treat Options Cardiovasc Med 11(3):201-211, 2009
3Anderson AS, Caswell S: Obesity management--an opportunity for cancer prevention. Surgeon 7(5):282-285, 2009
Is it possible that ups and downs with respect to our health and well-being are yet another reflection of the ebb and flow of all things? Aren't ups and downs part of the natural process of life? If ups and downs are natural, should you really be concerned with the downs? Isn't disease merely the normal flip side to health? If you have a stretch of bad health, isn't that merely the luck of the draw, part of the price you pay for being alive? And if you can wait out the bad periods and expect that they'll eventually swing around to a period of feeling good, why should you exert yourself and spend time, money, and energy exercising and eating "healthy" if it's all going to even out anyway?
The answers to these deep questions have profound implications for everyone. First, there are no "right" answers. How you conduct your life is a personal choice. But in fact many people do not make active choices. They exist in a default state, floating along on the current of any random convenient stream. "Whatever" is the slogan and catch-phrase of these persons. Such individuals fail to recognize that we live in an entropy-seeking universe. Breakdown, disorder, and decay are the tendencies of all things.
Our health is no exception. If you do not proactively take steps to combat the inexorable progression to disorganization, your body will gradually fall apart. Literally. Understanding that the patterns of life are cyclical does not imply that you should just lie down and take it. The fact that downward trends are inevitable does not imply that doing good things for your health and well-being are useless and a waste of resources.
In fact, taking action on your own behalf makes the highs of the cycles higher and simultaneously decreases the depths of the lows.The result of such action is specific improvement of your health over time. Yes, improving your health takes effort. In this space-time continuum unless effort is exerted to maintain the organization of matter, disorganization will rapidly follow. Muscles don't stay hard and strong on their own. Without proper training, heart and lung efficiency and strength deteriorate over time. With a careless diet, digestive organs become sluggish and function poorly. And so on down the entire list of physiologic components and functions.
So, yes, it's a random universe. Stuff happens, so why not sit back and "go with the flow". Quality of life is the criterion. How much quality our lives have is based on our personal contribution. Our personal effort. Our personal commitment to healthier lives for ourselves and our families. And that requires effort.
1Stineman MG, Streim JE: The biopsycho-ecological paradigm: a foundational theory for medicine. PM R 2(11):1035-1045, 2010
2Pinto BM, Ciccolo JT: Physical activity motivation and cancer survivorship. Recent Results Cancer Res 186:367-387, 2011
3Brinkhaus B, et al: How to treat a patient with chronic low back pain - Methodology and results of the first international case conference of integrative medicine. Complement Ther Med 19(1):54-62, 2011
