Back Pain

Back Pain


>>>ON “HEALTH MATTERS” TELEVISION FOR LIFE, COPING WITH BACK PAIN.>>MORE THAN 80% OF PEOPLE WILL SUFFER FROM LOWER BACK PAIN AT SOME POINT IN THEIR LIFE.>>AND THEN YOU’D WAKE UP IN THE MIDDLE OF NIGHT WITH SOME BACK PAIN, BUT YOU JUST DEALT WITH IT BECAUSE YOU’VE GOT LIFE TO LIVE, RIGHT?>>OFF-AND-ON BACK PAIN PLAGUED THIS MAN FOR NEARLY 30 YEARS. HIS JOURNEY TO FIND RELIEF. AND HOW DIET AND EXERCISE MADE ALL THE DIFFERENCE. WHETHER THE PAIN IS MINOR OR MAJOR, OUR PANEL IS HERE TO HELP YOU FIND RELIEF FOR YOUR ACHING BACK.>>”HEALTH MATTERS” IS MADE POSSIBLE BY OUR VIEWERS, THE FRIENDS OF KSPS. AND BY PROVIDENCE HEALTH CARE.>>I’M DR. ANDREW BOULET, AND MY WIFE HAD A CARDIAC ARREST. I CHOSE PROVIDENCE BECAUSE I KNEW THAT EVERYTHING WE NEEDED FOR HER COMPLEX CARE WAS AVAILABLE FROM THE EMERGENCY ROOM, TO RADIOLOGY, TO THE NURSING STAFF, TO THE SPECIALISTS WE NEED FOR HER CARE.>>I’M ARNIE PETERSON. I’M AN ORTHOPAEDIC SURGEON. AND I WORK IN THE SACRED HEART PROVIDENCE MEDICAL GROUP. WHEN I NEEDED MY HIP REPLACED, I CHOSE PROVIDENCE BECAUSE OF THE PROFESSIONALISM AND THE CARE I KNEW I WOULD RECEIVE. I NEVER THOUGHT TWICE ABOUT GOING ANYWHERE ELSE. >>WELCOME TO ANOTHER EDITION OF “HEALTH MATTER.” I’M TERESA LUKENS. CHANCES ARE YOU’VE HAD BACK PAIN AT ONE POINT OR ANOTHER IN YOUR LIFE. IT’S ONE OF THE MOST COMMON REASONS THAT PEOPLE GO TO THE DOCTOR. THERE ARE LOTS OF REMEDIES THAT PROMISE RELIEF, BUT WHAT WORKS? OUR PANEL IS HERE TO ANSWER THAT QUESTION AND MUCH MORE. LET’S MEET THEM. DR. BENJAMIN HOWIE IS WITH PROVIDENCE ORTHOPEDICS. HE SPECIALIZES IN ORTHOPEDIC SPORTS MEDICINE. DR. JAMIE GORE IS A CHIROPRACTOR WITH PEARSON & WEARY CHIROPRACTIC, ORTHOPEDICS AND REHABILITATION. DR. NATHANIEL WHITNEY IS WITH INLAND NEUROSURGERY AND SPINE ASSOCIATES. HIS SPECIALTY IS NEUROSURGERY. DR. RYAN BARNES IS WITH MULITCARE HEALTH SYSTEM. HE WORKS IN PAIN MANAGEMENT, PHYSICAL MEDICINE AND REHABILITATION. THANK YOU ALL FOR BEING HERE TONIGHT. WELCOME. YOU CAN EMAIL US YOUR QUESTIONS OR EMAIL THE SHOW AND ASK OUR PANEL. ALSO, WE ARE STREAMING LIVE ON FACEBOOK TONIGHT. LET’S BEGIN TONIGHT BY TALKING ABOUT HOW THE PATIENTS THAT YOU SEE IN EACH OF YOUR PRACTICES, AND THE TYPE OF BACK ISSUES THAT YOU EACH SEE AND WHAT ARE SOME OF THE THOSE MOST COMMON ISSUES? DR. HOWIE, LET’S START WITH YOU.>>SURE. SO MY PRACTICE IS PRIMARY CARE SPORTS MEDICINE. SO THE NONOPERATIVE SPORTS MEDICINE. THE BIG GOAL IS TO KEEP PEOPLE MOVING, PEOPLE IN ATHLETICS REPORT RECREATIONAL ACTIVITIS THAT THEY ENJOY. I DON’T SEE A LOT OF BACK PAIN IN ALL HONESTY. WHEN I DO, IT’S A LOT OF TIMES MUSCULAR. PEOPLE GET A STRAIN OUT THERE DOING THEIR ACTIVITY OR SPORT OR THEY HAVE IT AND IT’S INHIBITING THEM FROM DOING WHAT THEY WANT TO DO. THAT’S MOSTLY WHAT I SEE IS THE MUSCULAR PART OF IT. WHEN IT GETS TO THE FRACTURES AND DISPLACEMENT, THINGS LIKE, THAT THEN I GET THEM ON TO THESE GUYS.>>YES. IN FACT, WE WILL TALK ABOUT THAT TEAM APPROACH TONIGHT, A LOT, I THINK. DR. BARNES?>>SO I SEE A LARGE NUMBER OF PEOPLE WITH BACK PAIN OF ALL SORTS FROM SUBACUTE, FROM FOUR WEEKS AND CHRONIC BACK PAIN, SOMETIMES FOR DECADES. ONE THING I ENJOY ABOUT BACK PAIN, IT’S A CHALLENGING DISEASE TO TREAT BECAUSE IT’S VERY HETEROGENEOUS. THERE ARE SO MANY DIFFERENT CONTRIBUTORS TO BACK PAIN AND WE JUST SEE ALL TYPES AND TRY TO SORT IT OUT. AND PHYSICAL MEDICINE, REHAB, YOU KNOW, ARE BIG FOCUSES IN IMPROVING PEOPLE’S QUALITY OF LIFE AND FUNCTION AFTER ESTABLISHING A DIAGNOSIS.>>AND DR. WHITNEY, THE SURGEON ON THE PANEL TONIGHT.>>I APPRECIATE WHAT YOU SAID ABOUT TEAM APPROACH, BECAUSE I’M OFTEN KIND OF AT THEN OF THAT TEAM WHEN PEOPLE HOPEFULLY TRIED EVERYTHING AND NOTHING ELSE IS WORKING AND THEY COME TO A SURGEON. BUT WHAT I ACTUALLY DO IN MY PRACTICE IS MOSTLY SPINE. SO A LOT OF PEOPLE WITH, YOU KNOW, BACK PAIN, HOPEFULLY HAVE TRIED A LOT OF OTHER THINGS FIRST. WE ENDED UP DOING A LOT OF SURGERY FOR PEOPLE WHO HAVE FAILED THE OTHER THERAPIES. SO VERY SURGICAL, BUT ALSO VERY NICHE AND A LAST RESORT FOR PEOPLE.>>MM-HMM. AND DR. GORE AS A CHIROPRACTOR.>>THAT’S MY BREAD AND BUTTER, BACK PAIN. WE ARE USUALLY ONE OF THE FIRST LINE OF DEFENSES AND THEN WE SEND THEM OFF TO DR. WHITNEY. BUT THE MAIN THING WE SEE ARE PEOPLE WHO SIT A LOT DURING THEIR DAY, HIKE WAS NOTED BEFORE. MOVEMENT IS KEY. AND SO GETTING THEIR JOINTS MOVING IS VERY IMPORTANT FOR US AND THEIR MUSCLES, GETTING THEM MOVING AND STRETCHED OUT AND STRENGTHENED.>>IS THAT BECAUSE WE ARE SITTING SO MUCH MORE THAN WE EVER USED TO?>>YES, OUR BODIES ARE MADE TO MOVE AND WE ARE NOT MADE TO BE SO STATIONARY AND WE ARE AND NOW WE ARE COMBATTING THAT.>>WHAT ARE SOME OF THE SIGNS AND SYMPTOMS THAT PEOPLE SHOULD BE CONCERNED ABOUT OTHER THAN JUST AN ACHE? THOSE PROLONGED CONDITIONS OR SOMETHING THAT MAY SEE FOR MORE THAN A FEW DAYS?>>SO THE THINGS TO LOOK FOR, OF COURSE, WOULD BE LOSS OF BOWEL OR BLADDER FUNCTION, NUMBNESS OR TINGLING, OR PAIN THAT’S GETTING WORSE OR JUST NOT GETTING BETTER. THOSE WOULD BE REASONS TO COME ON IN AND BE EVALUATED. THOSE ARE SOME OF THE BIG ONES.>>ANYONE ELSE LIKE TO ADD TO THAT?>>FOR ME AS WELL, FUNCTION. IF THEY ARE ABLE TO HOLD THEIR GRANDCHILDREN OR PERFORM THEIR WORK AND THEIR DAILY ACTIVITIES OF LIVING. THAT’S A BIG ONE FOR CHIROPRACTORS. WE’VE GOT TO GET THEM MOVING.>>IS THERE A CERTAIN TYPE OF PAIN TO WATCH FOR? FOR INSTANCE, STABBING OR DULL PAIN THAT MAY BE DIFFERENT, AND THAT MAY BE A RED FLAG THAT I NEED TO SEE SOMEBODY. THIS IS MORE THAN JUST A SLIGHT STRAIN THAT I MAY BE ABLE TO WORK OUT?>>ALONG WITH WHAT WAS MENTIONING, THE NUMBNESS OR TINGLING, IT MAY SIGNIFY NEUROLOGICAL INVOLVEMENT. THERE’S A LOT OF DESCRIPTION OF PAPE AND THE DESCRIPTION OF PAIN MAY CLUE US IN TO WHAT’S GOING ON. PAIN THAT’S SHARP AND REALLY INTENSE AND WORSE WITH BENDING FORWARD, SOMETIMES SUGGESTS INSTABILITY. AND IF WE SEE THAT, WE TRY TO TREAT IT, AND MOSTLY BECAUSE IF WE SEE THAT, WHAT WE KNOW IS THAT THAT PERSON HAS INCREASED RISK OF FUTURE BACK PAIN. WE TRY TO COME ONE A TREATMENT MAN TO IDENTIFY THAT AND HELP PREVENT BACK PAIN RECURRENCES.>>CATCH IT EARLY?>>EXACTLY.>>LET’S TALK ABOUT THE DIAGNOSIS. I GUESS THEY WOULD SEE THEIR GENERAL PRACTITIONER FIRST, AND GENERAL PRACTITIONER FIRST, AND THEN BE RECOMMENDED BEYOND THAT?>>YEAH, USUALLY THE FIRST LINE OF DEFENSE IS EITHER THEIR — YEAH, GENERAL DOCTOR, OR CHIROPRACTOR OR PHYSICAL THERAPIST. OFTEN IN MY WORLD IT’S THE PHYSICAL TRAINER THAT SEES THEM FIRST AND THEN WE START WITH THE BASIC STUFF, LIKE DR. GORE WAS SAYING, GETTING PEOPLE MOVING AND DOING THE BASIC AMOUNT OF THINGS WITH SHORT AMOUNT OF TIME OFF AND SLOWLY GETTING THEM MOVING. AND THAT’S USUALLY WHERE THEY START AND IF THEY ARE NOT CONTINUING TO IMPROVE, THEN THEY KIND OF GET SENT OPEN.>>TALK ABOUT THE PROCESS OF BEING DIAGNOSED. I GUESS HOW DO YOU LOOK FOR THOSE PROBLEMS? ARE THERE TESTS THAT PEOPLE CAN GO THROUGH? WHAT ARE WE WATCHING FOR?>>WELL, LIKE I SAID EARLIER, I’M KIND OF AT THE END OF THE ROPE. SO WHEN I SEE PEOPLE IN MY CLINIC, YOU KNOW, PEOPLE HAVE TAKEN VARIOUS PATHS TO GET THERE. THEY MIGHT HAVE GONE THROUGH SEVERAL STEPS. THEY MIGHT HAVE NOT. ONE OF THE BASIC QUESTIONS I ASK PEOPLE IS WHAT HAVE YOU DONE AND WHAT HAVE YOU TRIED.>>THEY HAD AN IMAGING STUDY, AN MRI OR SOMETHING OF THEIR BACK, AND THEN WE CAN CORRELATE THE SYMPTOMS S.SYMPTOMS. IS IT SOMETHING, NUMBNESS, TINGLING, NERVE ROOT, WHICH CAN BE CONCERNING AND WE CORRELATE THAT WITH A PICTURE. I’M USUAL LOOKING FOR THAT HISTORY. OVER TIME, WHAT HAVE THEY TRIED AND WHO HAVE THEY SEEN? AND CAN WE CORRELATE THAT TO A PHYSICAL ABNORMALITY ON A PICTURE TO PUT THE STORY TOGETHER?>>BRIAN, WHAT TYPE OF TESTS OTHER THAN MRI WOULD A PATIENT GO THROUGH?>>WELL, LIKE, FOR ME, THE MOST IMPORTANT PART IS THE HISTORY AND THE EXAM, DOING A GOOD THOROUGH MUSCULOSKELETAL EXAM. IT’S BASED ON A HISTORY AND EXAMINATION. OCCASIONALLY PATIENTS HAVE NERVE SYMPTOMS WHICH MAY NOT BE QUITE HERE. AND I DO ELECTRODIAGNOSTIC TESTING WHICH TESTS THE NERVES AND THE LIMBS TO GIVE US MORE INFORMATION ABOUT THE NERVE FUNCTION.>>SO WHAT’S THAT PROCESS LIKE?>>WELL, NERVE — THE NERVE TESTS, IT DOESN’T SOUND PLEASANT. IT’S NOT AS BAD AS IT SOUNDS. WE APPLY AESTHETIC SHOCK TO THE NERVES AND RECORD HOW FAST IT TRAVELS AND THEN WE PUT A NEEDLE IN THERE AND LISTEN THE NERVES TO COMMUNICATE WITH THE MUSCLE AND IT GIVES US AN IDEA WHETHER THE NERVES –>>IS THAT A FAIRLY NEW TECHNIQUE?>>NO, IT’S BEEN AROUND FOR QUITE A WHILE. YEAH.>>AND WHAT ELSE MIGHT BE AVAILABLE?>>FOR ME, FOR A COMPREHENSIVE BACK PAIN, ESPECIALLY CHRONIC BACK PAIN THAT’S NOT NECESSARILY MECHANICAL IN NATURE, WE EXPLORE @OTHER OPTIONS SUCH AS INFLAMMATORY PAIN AND CERTAIN HORMONAL DEFICIENCIES AND VITAMIN D CAN BE ASSOCIATED WITH BACK PAIN AND WE’LL DO AN OCCASIONAL WORKUP ON THAT.>>WE ARE HARD ON OUR BACKS.>>YES, DEFINITELY.>>OTHER THAN SITTING ISSUES WHAT TYPES OF INJURIES OR CONDITIONS WOULD CONTRIBUTE TO HAVING BACK PAIN?>>BACK PAIN, IT CAN BE ANYTHING FROM A FALL, A SLIP ON THE ICE AND FALL, SHOVELING SNOW. THAT WAS THE RECENT THING, CAR ACCIDENTS. I SEE A LOT OF THOSE. WORK INJURIES, WHETHER IT BE SOMETHING TRAUMATIC OR WHETHER IT BE A REPETITIVE OVERSTRAIN TYPE THING OF, YOU KNOW, TYPING ALL DAY AND NOW YOU HAVE CARPAL TUNNEL TYPE SYMPTOMS. SO THERE’S — YEAH. IT RUNS THE GAMUT.>>MM-HMM. SO THE BEST THING WOULD PROBABLY BE TO START WITH PREVENTATIVE MEASURES?>>YEAH.>>MM-HMM. AND WHAT KIND OF THINGS CAN WE DO?>>SO I THINK — AND I THINK THAT’S VERY IMPORTANT TO TALK ABOUT, BECAUSE THAT JUST KIND OF HIGHLIGHTS THE IMPORTANCE OF PEOPLE TAKING, YOU KNOW, KIND OF DRIVER’S SEAT WITH THEIR HEALTH AND SAYING ALREADY, SAYING ALL
RIGHT, WHAT CAN I DO TO PREVENT IT BEFOREHAND. THE THINGS I LIKE TO FOCUS ON ARE PHYSICAL ACTIVITY. A LOT OF BACK PAIN NOWADAYS IS FROM INACTIVITY. FROM INACTIVITY. IF WE GET PEOPLE MOVING, EVEN JUST LITTLE AMOUNTS. SO GETTING UP AND WALKING A LITTLE MORE THAN YOU USED TO. JUST BECOMING MORE ACTIVE IN GENERAL. SO THAT’S THE FIRST THING. SO JUST PHYSICAL ACTIVITY. AND THAT’S NEAR AND DEAR TO MY HEART IN SPORTS MEDICINE. I FEEL THAT’S GOOD — I THINK EXEREXERCISE IS THE BEST
MEDICINE. THE NEXT THING IS GENERAL HEALTH. THAT’S SOMETHING THAT WE FORGET ABOUT. WE THINK ABOUT A HEALTHY, WELL-BALANCED DIET AND ADEQUATE WATER INSTAY AND APPROPRIATE SLEEP, MAINTAINING HEALTHY WEIGHT. QUITTING SMOKING. THESE KIND OF BIG TICKET THINGS. WE OFTEN JUST FORGET ABOUT, BUT IF OUR BODIES AREN’T GETTING WHAT THEY NEED, THEY ARE GOING TO START BREAKING DOWN AND THEY ARE NOT GOING TO REPAIR AS QUICK. AND SO THE BASIC HEALTH IS REALLY IMPORTANT TOO, AND THEN THE LAST THING, WHICH IS YOUR DAY-TO-DAY POSTURE WITH WHAT YOU ARE DOING.>>AS SOON AS YOU SAY POSTURE, WE WANT TO SIT UP STRAIGHT.>>THIS COULD LOOK DIFFERENT FOR PEOPLE. PEOPLE SITTING AT A DESK ALL DAY. THAT MATTERS. WHAT IS YOUR BODY POSITIONING THROUGHOUT THE DAY? AND THAT COULD SET YOU UP. AND THE SAME THING FOR SOMEBODY DOING A LOT OF HEAVY LABOR, IF YOU ARE LIFTING, ARE YOU DOING THAT RIGHT? ARE YOU USING YOUR LEGS AND NOT YOUR BACK. OR FOR AN ATHLETE. SO ARE YOU — DO YOU HAVE APPROPRIATELY FITTING EQUIPMENT OR IS YOUR FORM GOOD WHEN YOU ARE DOING YOUR SPORT? ALL OF THOSE THINGS MAY INTO THE PREVENTION WHICH IS OUR GOAL THAT THIS NEVER HAPPENS EVEN THOUGH IT PROBABLY WILL SOMETIME IN YOUR LIFE. IN YOUR LIFE.>>IS IT TRUE THAT LOWER BACK PAIN IS ONE OF THE MOST SELF-TREATABLE CONDITIONS? SOMETHING I READ RECENTLY?>>I THINK SO. YEAH.>>YEAH? AND BECAUSE OF THE STRAIN ISSUES AND SITTING ISSUES THAT WE CAN PROBABLY TAKE THAT INTO OUR OWN HANDS AND REALLY STRENGTHEN THOSE MUSCLES.>>FOR SURE. IT’S ONE OF THESE THINGS THAT WE KNOW THAT THE BODY USUALLY GETS BETTER ON ITS OWN, WITH TIME AND SOME OF THE BASIC THINGS. AND SO THAT CERTAINLY IS SOMETHING THAT PEOPLE CAN TREAT BY THEMSELVES.>>YEP.>>DEFINITELY. AT LEAST IN MY PRACTICE, A LOT OF THE TIME I TRY TO ADDRESS NUTRITION AND GIVE THEM SUPPLEMENTS THAT CAN HELP REDUCE THE INFLAMMATION WHICH CAN CAUSE SOME OF YOUR PAIN. INFLAMMATION, WHETHER IT’S VITAMIN D, FISH OIL, THE VITAMIN C OR THE WHATTER HE WAS — WATER
HE WAS TALKING ABOUT. AND THEN THE OTHER STUFF THAT THEY CAN DO IS EAT, ICE, STRETCHING AND THE MOVEMENT WE KEEP BRINGING UP. THAT’S IMPORTANT, BUT THERE’S SO MUCH THAT YOU CAN DO. THERE’S TOPICAL CREAMS THAT ARE MORE NATURAL TO START THERE. AND, YEAH. I GIVE MY PATIENTS AT LEAST ONE OF EACH OF THOSE BEFORE THEY LEAVE. I TRY TO GIVE THEM NUTRITIONAL ADVICE AND A MOVEMENT PIECE AND STRETCHING PIECE AND POSTURAL PIECE AND IT ALL TIES IN TOGETHER. IF WE CAN GET RID OF IT, WHY NOT START THERE.>>YOU ARE A FAN OF THE SUPPLEMENTS THAT ARE AVAILABLE?>>DEFINITELY. I THINK THEY SHOULD BE THE FIRST LINE OF DEFENSE. THE SECOND LINE OF DEFENSE ARE THE OVER-THE-COUNTER ANTI-INFLAMMATORIES AND PILLS OF THAT SENSE. AND THEN FROM THERE, I WOULD REFER OUT, BECAUSE THAT’S NOT IN MY SCOPE OF PRACTICE. THAT’S NOT WHAT I DEAL WITH. SO NUTRITION CAN BE VERY POWERFUL. FOOD IS FUEL FOR SURE, AND THAT’S WHAT IF USED TO BE BACK IN THE DAY. SO WHY NOT START THERE?>>MM-HMM. DR. BARNES?>>YES. I TOTALLY AGREE. YOU KNOW, THERE’S A LOT OF MISSING LITERATURE ON THE ROLE OF DIET AND PAIN. I THINK MOST PEOPLE WHO WORK IN THE FIELD ANECDOTALLY AND I SUSPECT THAT THERE’S REGULARSHIP. SO I’M INTERESTED TO SEE OVER TIME WHEN THERE’S MORE LITERATURE COMING OUT, WHAT EXACTLY IS THE ROLE OF DIET AND PAIN, BUT MOST PEOPLE NOW WOULD CONSIDER ANTIINFLAMMATORY DIET. LOW IN SUGAR AND LOW IN PROCESSED FOODS AND HIGH IN FRUITS AND VEGETABLES AND NUTS.>>WE ARE HEARING ABOUT TURMERIC AND CINNAMON COMING INTO PLAY. WOULD YOU RECOMMEND ANY OF THOSE?>>YES, IT’S PROBABLY NOT GOING TO BE HARMFUL, BUT I WOULD CAUTION PATIENTS THAT THE EVIDENCE IS NOT THERE YET. BUT, IT’S LOW RISK. QUESTIONABLE BENEFIT AND PROBABLY WOULDN’T HURT AND COULD BE BENEFICIAL.>>MM-HMM. THEIR WAY INTO YOUR OFFICE, DR. WHITNEY, WHAT IS NEW SURGERY-WISE BECAUSE THAT CAN BE VERY FRIGHTENING FOR A PATIENT.>>SO WE OBVIOUSLY — SURGERY HAS A LONG HISTORY AND WE LEARN ALONG THE WAY. I WILL KIND OF STEP BACK FOR JUST A SECOND AND SAY I THINK IT’S GOOD TO — I’M GLAD WE ARE TALKING ABOUT ALL OF THIS GOING BACK TO THAT TEAM EFFORT, BECAUSE AVOIDING SURGERY IS A LOT BETTER THAN ANYTHING ELSE. I TELL MY PATIENTS THAT I CAN NEVER TURN BACK THE BLOCK. I CAN’T MAKE YOU BETTER THAN — BACK THE CLOCK. I CAN’T MAKE YOU BETTER THAN YOU WERE. WE ARE TAKING A SUBOPTIMAL SOLUTION TO A PROBLEM. SO, YEAH, WE’LL TRY TO FIX SOMETHING BUT IT’S BETTER IF YOU CAN HAVE A GOOD ACTIVITY LEVEL THROUGHOUT YOUR LIFE AND A GOOD DIET AND PREVENT A PROBLEM. OR IF YOU NEED SURGERY EVENTUALLY ON YOUR BACK, IF YOU HAVE DONE THESE THINGS ALONG THE WAY, YOU WILL DO BETTER IN SURGERY AND RECOVER FASTER. SO, YES. BUT GETTING BACK TO YOUR QUESTION, A LOT OF THINGS THAT WE DO NOW THAT WE LEARNED FROM EXPERIENCE, ONE OF WHICH, TRYING TO HAVE SMALLER INCISIONS AND BE LESS INVASIVE OR LESS DISRUPTIVE TO THE TISSUE AROUND THE SPINE. OBVIOUSLY THE SPINE IS IN THE MIDDLE OF YOUR BODY. WE HAVE TO GET THERE SOMEHOW. OFTEN THAT’S GOING THROUGH MUSCLE OR SPREADING MUSCLE FIBER WHICH THEN CAUSES POST-OPERATIVE PAIN AND IT’S HARD TO RECOVER FROM. SO WE TRY TO FIND WAYS TO GET THE WORK DONE BUT CAUSE LESS OF THE COLLATERAL DAMAGE AROUND.>>MM-HMM. BUT IT HAS BECOME MUCH MORE SAFE IN RECENT YEARS.>>YES.>>AND THOSE TECHNIQUES ARE CERTAINLY HELPING WITH THAT.>>WELL, WE HAVE OUR FIRST PHONE CALL TONIGHT COMING IN FROM FRED IN CALGARY. HI, FRED.>>HELLO. THANK YOU FOR CALLING.>>WELL, THANK YOU FOR TAKING MY CALL. MY QUESTION IS PERTAINING TO MY BACK. IT ISN’T SO MUCH PAIN, PROBABLY INFLAMMATORY, BUT A NARROWING BETWEEN THE THIRD AND THE FOURTH VERTEBRAE PINCHING THE NERVE, WHICH AFFECTS MY THUMB, INDEX AND FOREFINGER ON BOTH HANDS SO I HAVE A NUMBING AND TINGLING ON A CONSTANT BASIS, AND A NUMBNESS IN THOSE FINGERS. IT’S ALMOST LIKE TUNNEL SYNDROME. I’M WONDERING WHAT COULD POSSIBLY BE DONE TO ALLEVIATE THE SITUATION.>>ALL RIGHT, THANK YOU, FRED. WHO WOULD LIKE TO TAKE FRED’S CALL?>>I WILL TACKLE THAT ONE. HI, FRED. I’M ASSUMING THAT YOU MEAN IN THE NECK, I THINK IS WHAT HE SAID, THE THIRD AND FOURTH VERTEBRAE IN THE NECK.>>MM-HMM.>>SO OBVIOUSLY I’M A SURGEON, SO I’M TRYING TO IMAGINE THE MRI SCAN, OR THE C.T. SCAN. THERE ARE A LOT OF THINGS TO THINK ABOUT SURGICALLY, ANATOMICALLY T. DEPENDS HOW BAD THE NARROWING IS. I WILL SAY THAT THINGS IN YOUR NECK AND DOWN YOUR ARMS CAN MIMIC EACH OTHER. LIKE FRED SAID, LIKE A CARPEL TUNNEL SYNDROME, IT’S MORE A PERIPHERAL NERVE ISSUE THAN IN THE SPINE. SO FRED, IF YOU WALKED INTO MY OFFICE, I MIGHT GET ONE OF THOSE NERVE STUDIES TO SEE WHERE IS THE PROBLEM. SOMETIMES A PICTURE WILL SHOW ONE THING BUT THE PROBLEM IS ACTUALLY SOMEWHERE ELSE. OFTEN IN MY PRACTICE, IN YOUR SITUATION, FRED, THAT WOULD END UP BEING A SURGERY IF THE NARROWING WAS BAD ENOUGH, JUST TO MAINTAIN FUNCTION. SO THERE’S LITTLE WARNING SIGNS THERE THAT MAKE ME THINK THAT SOMETHING SHOULD BE CONSIDERED, BUT SHORT OF THAT, I THINK A LOT OF THESE OTHER NONSURGICAL OPTIONS ARE USUALLY THE FIRST WAY TO START. AS LONG AS THERE’S NO DANGEROUS WARNING SIGNS OF PARALYSIS OR SOMETHING LIKE THAT. IF YOU CAN DO SOMETHING ELSE, YOU KNOW, THERAPY, POSTURE, SOMETHING ELSE, TO TRY TO TREAT THE SYMPTOMS FIRST.>>MM-HMM. DR. GORE, IS THAT SOMETHING, AN ADJUSTMENT YOU COULD MAKE?>>SO NOT SO MUCH A TYPICAL CHIROPRACTIC ADJUSTMENT. IF THE NERVE COMPRESSION IS COMING FROM WHAT IS CALLED A DISC HERNIATION AND THE DISC IS PUSHING OUT AND PUSHING ON THAT NERVE, WE CAN DO TRACTION THERAPY. WE ELONGATE THE SPINE TO RELIEVE SOME OF THE PRESSURE ON THE NERVE TEMPORARILY. IF WE DO THAT ENOUGH TIMES, SOMETIMES THAT HEALS ON ITS OWN AS SURGERY IS NOT WARRANTED. IF IT’S COMING FROM ARTHRITIS, THEN THE BONE CAN GROW OUT AND PUSH ON THE NERVE. THEN THERE’S NOT A WHOLE LOT I CAN DO FOR THAT, AND THEN I SEND HIM YOUR WAY.>>IS THIS ANY STRETCHING EXERCISE OR ANYTHING THAT MAY HELP?>>ESPECIALLY WITH HIS SYMPTOMS, IT SOUNDS PRETTY SIGNIFICANT. I THINK I WOULD PROBABLY JUST START WITH THE REALLY BASIC STUFF. I WOULDN’T GO TOO HARD BUT JUST SOME OF THE POSTURE THINGS AS FAR AS, YOU KNOW, NECK DOWN AND HEAD BACK A LITTLE MORE. OTHER BASIC STRETCHES, BUT I DON’T HAVE ANY OFFHAND, I GUESS I WOULD SHOW HIM.>>WE HAVE ELAINE HERE IN SPOKANE. HI, ELENA.>>HI.>>THANK YOU FOR CALLING.>>OH, THANK YOU GUYS FOR HAVING ACTUALLY SOMETHING ON HERE THAT I CAN ATTUNE TO.>>OKAY. YOU HAVE A QUESTION?>>YEAH. I WAS WONDERING WHY THERE’S NOT MORE PHYSICIANS IN THE SPOKANE AREA THAT DEAL WITH SCAPULA DISKINESIS, ESPECIALLY FOR THOSE WHO ARE HYPER STRETCHING.>>THAT’S A GREAT QUESTION. THAT’S ACTUALLY A POORLY UNDERSTOOD PHENOMENON. I GUESS BRIEFLY TO EXPLAIN WHAT SHE’S TALKING ABOUT IS SO YOUR SCAPULA, YOUR SHOULDER BLADE, WHEN YOUR ARM MOVES UP. SHOULDER BLADE HERE, AND YOUR ARM, YOUR HUMOROUS HERE. AND SO THE SCAPULA ROTATES 1 DEGREE FOR EVERY 2 DEGREES THAT YOUR ARM GOES UP. IF YOUR SCAPULA DIDN’T MOVE, YOU COULDN’T MOVE ABOVE YOUR HEAD. THE SCAPULAS JUST DON’T MOVE LIKE THEY SHOULD. AND THEY MOVE MORE CHOPPY. AND THIS CAN MANIFEST AS SHOULDER PAIN OR UPPER BACK PAIN. I THINK THIS IS BECOMING MORE UNDERSTOOD AND SO THERE ARE ACTUALLY A LOT OF PHYSICAL THERAPISTS IN SPOKANE WHO ACTUALLY UNDERSTAND THIS REALLY WELL AND CHIROPRACTORS AND PHYSICIANS. AND SO THANKFULLY, IT’S BECOMING MORE KNOWN, YOU KNOW, RATHER THAN JUST WHAT’S HAPPENING RIGHT AT THE SITE, BUT LOOKING MORE KIND OF UPSTREAM.>>SO WE SHOULD START TO SEE A FEW MORE DOCTORS, POSSIBLY, PRACTICING.>>I WOULD THINK SO. AND IT’S ONE OF THOSE PLACES WHERE OFTEN PEOPLE HAVE SHOULDER PAIN THAT’S JUST NOT GETTING BETTER AND THEN WHEN WE KIND OF FIX THAT, WHETHER IT’S A TRIGGER POINT UP IN THE BACK OR SOMETHING ELSE, THAT — WHERE THEIR MOTION IS JUST NOT CORRECT, THEN THE SHOULDER PAIN MAGICALLY GETS BETTER.>>I WOULD SUGGEST — I AGREE WITH THE PHYSICIAN FOR DIAGNOSING THE SHOULDER PAIN. THE PHYSICAL THERAPIST WOULD BE THE AVENUE TO FOCUS ON THE SCAPULAR DISCAN I DISKENESIA,
AND THEY COULD HELP WITH YOU THE SCAPULAR DISCAN I TEASIA.>>I WOULD LIKE TO TALK ABOUT THE FRACTURES AND THE HEALING THEREOF. I HAD TWO COMPRESSION FRACTURES DIAGNOSED IN EARLY SPRING THREE YEARS AGO AND HAVE BEEN THROUGH CHIROPRACTOR AND BEEN SEEING A NUMBER OF DIFFERENT DOCTORS. AND I’M WONDERING WHETHER THERE’S ANYTHING THAT WOULD — WOULD COUNTER THE ARGUMENT OR THE DIAGNOSIS THAT IT’S JUST SOMETHING THAT HAS TO HEAL OVER TIME? I BELIEVE IT’S CORRECT THAT THE PAIN THAT I’M STILL HAVING RIGHT NOW IS MOSTLY MUSCULAR PAIN, COMPENSATING FOR WHATEVER WEAKNESS THERE MIGHT BE IN THE COMPRESSIONS. THESE ARE IN THE REAL LOW, LIKE, 3 AND 5, SOMETHING LIKE THAT. SO I WOULD REALLY LIKE NO MARE SOME OBSERVATIONS ON HOW LONG I MUST — YOU KNOW, I WILL HAVE TO BE DEALING WITH THIS. I HAVE PLENTY OF MOBILITY. I CAN DO LOTS OF THINGS BUT THERE’S CERTAIN THINGS THAT I JUST AVOID, KNOWING THAT IT WILL JUST CREATE MORE PAIN.>>ALL RIGHT. THANK YOU, KEITH. DR. BARNES.>>SO YOU ARE RIGHT ABOUT COMPRESSION FRACTURES DO IMPROVE WITH TIME. SHOULDN’T BE THREE YEARS, THOUGH. MOST COMPRESSION FRACTURES, MOST PEOPLE EXPERIENCE SPONTANEOUS RELIEF OF PAIN, A LOT, LIKE 50%, SIX WEEKS, USUALLY THREE MONTHS MOST PEOPLE ARE BETTER. AND MY EXPERIENCE, YOU KNOW, THERE’S THE MANAGEMENT OF THE ACUTE COMPRESSION FRACTURES. THERE ARE A LOT OF THINGS WE CAN DO FOR THAT. THE RADIOLOGISTS CAN INJECT CEMENT AND IT DOES SEEM TO WORK PRETTY WELL FOR ACUTE PAIN. THE — IF YOU ARE HAVING PAIN THREE YEARS OUT, MY QUESTION WOULD BE, EXACT HISTORY WHAT YOU ARE SAYING, WHERE IS THE PAIN COMING FROM? IT’S UNLIKELY COMING FROM THE COMPRESSION FRACTURE, BUT WHAT HAPPENS WHEN THERE’S A COMPRESSION FRACTURE, IT CHANGES THE BIOMECHANICS AND CHANGES THE MECHANICS OF THE SPINE AND IT CAN CHANGE THE POSTURE CHANGES AND SO THAT CAN CAUSE SECONDARY PROBLEMS. SOMETIMESIT’S MUSCULAR. SOMETIMES IT CAN CAUSE INCREASED LOAD ON THE JOINTS. WHEN IT’S CLOSER HIGHER UP TO THE THORACIC SPINE, I SEE A LOT OF RIB PROBLEMS RELATED TO THAT. SO THOSE ARE — THE FIRST QUESTION WOULD BE THE DIAGNOSTIC QUESTION ABOUT WHERE THE PAIN IS COMING FROM. AND THEN WITH THAT ANSWER, YOU CAN PROCEED WITH SPECIFIC TREATMENT OPTIONS.>>CAN I JUST REAL QUICK?>>PLEASE.>>MY EARED PERKED UP WHEN HE SAID COMPRESSION FRACTURES. I DEAL WITH A LOT OF PEOPLE AT THE END OF THE ROAD. BASICALLY WHAT YOU ARE REFERRING TO IN MY MIND, I THINK OF THATS IS SPINAL BALANCE. SO JUST A 30,000-FOOT VIEW. WHEN I TALK TO PATIENTS, I KIND OF DESCRIBE YOUR SPINE KEEPS EVERYTHING BALANCED ABOVE YOUR PELVIS. WHEN YOU HAVE A COMPRESSION FRACTURE, IT DEPEND HOW BAD THE COMPRESSION FRACTURE IS, IS IT MILD OR MAJOR, IT WILL CHANGE THE ANGLE OF THE SPAIN PIPE, AND
THE FACET JOINTS BUT THAT CAN THROW OFF YOUR SPINAL BALANCE WHERE YOUR MUSCLES HAVE TO WORK HARDER. SO UNFORTUNATE HISTORY, YES, I THINK — I OFTEN TELL PEOPLE THAT YOU WILL DEAL WITH THIS AT SOME LEVEL FOR THE REST OF YOUR LIFE, ESPECIALLY IF THEY HAVE EXHAUSTED EVERYTHING AND THEY ARE TALKING TO ME NOW. IT’S OBVIOUSLY BAD ENOUGH, THREE YEARS. BUT I THINK JUST TO — I GUESS I WOULD JUST — PART OF IT IS MANAGING EXPECTATIONS AND KNOWING I’M NOT LOOKING FOR A MAGICAL CURE, ESPECIALLY IF IT’S GONE THIS LONG AND DIDN’T GO AWAY ON ITS OWN. THERE MIGHT BE SOMETHING ELSE. YOU ARE DOING WHAT YOU WANT TO DO. AND YOU ARE ABLE TO BE ACTIVE AND FLEXIBLE. THAT’S GOOD. JUST IN THE BACK OF YOUR MIND, THAT’S PROBABLY SOMETHING THAT’S REAL AND JUST TELL YOURSELF, I’M NOT THE SAME AS I WAS BEFORE AND THERE’S A GOOD REASON FOR IT. IT’S NORMAL. IT’S FINE. IT’S TO BE EXPECTED. IT’S A SPINAL BALANCE IDEA IS WHAT I THINK ABOUT.>>OKAY. WE HAVE DEBBIE IN MALOW WASHINGTON. HI, DEBBY.>>HI, THANK YOU FOR ALLOWING ME TO ASK MY QUESTION.>>ABSOLUTELY.>>I AM AN OLD BALLET DANCER, AND I HAVE, YOU KNOW — I’VE HAD HIP REPLACEMENTS AND MY ANKLES ARE BOTHER ME, BUT RIGHT NOW, MY BACK, I HAVE — I KNOW I HAVE ARTHRITIS IN THE VERY LOW SPINE. MY QUESTION IS: CAN PAIN IN YOUR BACK MISALIGNMENT, CAN IT WRAP AROUND INTO YOUR, LIKE, INTESTINE AREA? BECAUSE I HAVE — AND I HAVE BEEN TO DOCTORS AND THEY SAY, WELL, WE CAN’T FIND ANYTHING AND I HAD A COLONOSCOPY AND SO ON AND SO FORTH. SO I’M JUST TO ASK MY QUESTION, CAN IT COME FROM MY BACK.>>AND YOU ARE HAVING INTESTINAL PROBLEMS?>>NOT PROBLEMS, PAIN.>>PAIN. PAIN IN YOUR INTESTINE.>>YES.>>SO WHEN I HEAR THAT, A LOT OF TIMES WE HAVE WHAT IS CALLED OUR HIP FLEXORS AND THOSE MUSCLES ACTUALLY ATTACH TO THE FRONT OF OUR LUMBAR SPINE. SO THE FRONT OF THAT LOW SPINE AND YOUR HIPS. WHEN IT’S REALLY, REALLY TIGHT, PEOPLE COMPARE OF INTESTINAL PAIN AND UTERINE PAIN AND I GET INTO THOSE MUSCLES AND GET THEM TO RELAX AND IT RELIEVES A LOT OF PAIN. SOMETHING WHERE YOU HAVE A LOT OF WEAR AND TEAR AND ARTHRITIS THROUGHOUT THE LUMBAR SPINE, I WOULD TAKE A LOOK AT THE PELVIS TOO, TO MAKE SURE THE LARGE JOINTS, YOUR SACROILIAC JOINTS ARE WORKING. SOMETIMES THOSE JOINTS LOCK UP AND RESTRICT AND THEY ARE NOT MOVING QUITE AS WELL AS THEY SHOULD AND THE AREA ADJACENT OR ABOVE IT, HAS TO COMPENSATE AND MOVE A LOT BIT MORE AND THEN THE MUSCLES TIGHT UP TO TRY TO PROTECT AND SPLINT IT. GETTING THAT PELVIS BALANCED AND RELAXED AND STRENGTHENING SO THEY CAN SUPPORT.>>SO SHE MAY BENEFIT FROM A CHIROPRACTIC ADJUSTMENT?>>YES, DEFINITELY, YES.>>WELL, GETTING RELIEF FROM PACK PAINBACK PAIN ISN’T ALWAYS EASY, ESPECIALLY WHEN THE PAIN COMES AND GOES. A SPOKANE MAN BATTLED BACK PAIN FOR ALMOST 30 YEARS, BOUNCING FROM DOCTOR TO DOCTOR. TONIGHT HIS JOURNEY TO BETTER HEALTH AND HOW EXERCISE HELPED HIM FEEL BETTER. TO SEE DAVE FODE IN ACTION, YOU’D NEVER KNOW HE’S BATTLED BACK PAIN MOST OF HIS LIFE. DAVE’S A REGULAR AT GIORGIO’S FITNESS. HE’S ALSO AN AVID BIKER, WHO’S BEEN KNOWN TO PUT IN 100 MILES IN ONE DAY.>>I FEEL GOOD. I FEEL GREAT.>>HE SAYS HE FINALLY GOT REAL RELIEF FROM HIS BACK PAIN ABOUT A YEAR AGO.>>I CAN GO OUT AND WORK ON A CAR OR WORK ON MY HOUSE AND NOT WORRY ABOUT THINGS. THINGS ARE SOLID AND ALL THAT PAIN STUFF IS NOT HOLDING ME BACK ANYMORE.>>BUT GETTING THERE TOOK DECADES OF SEARCHING. IT STARTED WITH APRIL INJURY ON THE JOB.>>I WAS 23 YEARS OLD, AT WORK, AND LONG STORY SHORT, A TRUCK AND A BULLDOZER, AND I WAS IN BETWEEN AND I GOT SQUISHED RIGHT AT THE PELVIS.>>DAVE WAS RUSHED TO THE E.R. HIS BACK WASN’T BROKEN, AND WHILE SORE FOR A FEW WEEKS, HE WAS ABLE TO GO BACK TO WORK.>>I FELT I WAS LUCKY.>>IN THE YEARS TO COME, THE BACK PAIN WOULD RETURN. AND WHEN IT DID, DAVE FOUND RELIEF THROUGH CHIROPRACTIC.>>I WAS ABLE TO DEAL WITH THAT THROUGH LATE 20S AND EARLY 30S>>BUT IT NEVER REALLY WENT AWAY.>>YOU’D WAKE UP IN THE MIDDLE OF THE NIGHT WITH SOME BACK PAIN, BUT YOU JUST DEALT WITH IT BECAUSE YOU’VE GOT LIFE TO LIVE, RIGHT?>>STILL STRUGGLING, DAVE KNEW HE NEEDED TO MAKE A CHANGE.>>WELL, IT WAS SPRING 2013. I WAS KIND OF THAT SICK AND TIRED OF BEING SICK AND TIRED. SO I JUST TOLD MYSELF TO SUCK IT UP. I WAS ALMOST 240 POUNDS. SO I DECIDED THAT I’M GOING TO JUST START EXERCISING, START EATING BETTER, AND IT STARTED TO WORK. UNTIL A DAY OF GOLFING, TRIGGED THE BACK PAIN AGAIN, AND WORSE THAN EVER. AND THE MOTION OF GOLF, SWINGING THAT CLUB, SOMETHING LET LOOSE IN THERE.>>IN A MATTER OF DAYS, DAVE HAD X-RAYS, AN MRI AND SURGERY.>>I WOKE UP FEELING AMAZING, AMAZING. I HAD NO IDEA WHAT PAIN I WAS IN. IT WAS LIKE A NEW LEASE ON LIFE KIND OF THING.>>DAVE HAD SUFFERED A RUPTURED DISC. FEELING BETTER, HE WENT BACK TO EXERCISING. EVEN TRAINING FOR A HALF IRONMAN, BUT EVENTUALLY THE PAIN CAME BACK.>>I WAS GOING FOR LONGER 9-MILE, 10-MILE RUNS. AND NOW, I’M STARTING TO HAVE NUMBNESS IN MY FEET. A. I’M STARTING TO HAVE CRAMPING IN MY CALVES AGAIN. I’M LIKE, MAN, WHAT’S GOING ON HERE?>>A NEW ROUND X-RAYS AND MRIS BROUGHT A DIAGNOSIS OF DEGENERATIVE DISC DISEASE. STILL IN HEFTY PAIN, DAVE EXPLORED HIS OPTIONS. IT TOOK MONTHS AS DAVE INTERVIEWED DOCTORS AND BATTLED INSURANCE. IN MARCH 2017, HE FINALLY GOT THE SURGERY HE NEEDED, AND BEST OF ALL, REAL RELIEF, WHICH BRINGS US BACK TO DAVE’S PASSION FOR EXERCISING, SOMETHING THAT’S KEPT HIM GOING ALL THESE YEARS.>>STAY ACTIVE. THAT’S, I THINK, 75, 80% OF THE BATTLE RIGHT THERE.>>WELL, I THINK ALL OF CAN YOU SPEAK TO DAVE’S STORY. HE HAD A LITTLE PIECE OF EVERYTHING IN THERE WITH THAT 30-YEAR BATTLE AND EXERCISE PLAYING A ROLE.>>I THINK THAT’S A GREAT STORY AND IT HIGHLIGHTS THE FACT OF HOW IMPORTANT MOVEMENT IS AND OFTEN IT’S JUST GOING BACK TO THOSE SIMPLE THINGS. OF COURSE, WHEN NEEDED, JUST LIKE HE DID, TO SEEK OTHER TREATMENT, AND — BUT GREAT STORY.>>MM-HMM.>>IS IT A COMMON STORY? 30 YEARS IS A LONG TIME?>>YES, FOR THEM, IT’S A VERY LONG TIME. AND UNFORTUNATE HISTORY IT’S A BATTLE FOR PEOPLE TO TRY THIS AND TRY THAT.>>SO A COMMON THREAD RUNNING THROUGH THAT STORY. AND, AGAIN, HE HAD CHIROPRACTIC TREATMENT. HE HAD SURGERY AND HE WENT THROUGH THE FULL GAMUT. AND TWO DIFFERENT SURGERIES HE MENTIONED.>>YEAH.>>WELL, QUITE A STORY. WE HAVE AUDREY IN SPOKANE CALLING IN WITH A QUESTION. HI, AUDREY.>>HI. THANK YOU SO MUCH FOR ALLOWING ME TO SPEAK. I AM 87-YEAR-OLD LADY WHO HAS HAD BACK PROBLEMS ALL MY LIFE. AND IT STARTED WITH MY — IN MY NECK WHEN I WAS ABOUT 20 AND THEN EVERYTHING CALMED DOWN FOR A FEW YEARS AND IT’S GONE ON AND ON. I CAN’T GO INTO ANY REAL DIAGNOSIS OR TALK ABOUT IT, BECAUSE OF THE FACT THAT IT WOULD TAKE ME ALL NIGHT! BUT FOR THE MOST PART, I’M A VERY HEALTHY LADY STILL, BUT I’M BEGINNING TO HAVE PROBLEMS WITH WALKING, FEELING LIKE MY HIP IS BOTHERING ME. ALSO TEN YEARS AGO, I HAD MY RIGHT KNEE OPERATED ON AND HAD IT REPLACED OR WHATEVER THEY DID THEN AND THAT WAS FINE. THAT WAS GOOD UP UNTIL NOW, BUT IT’S STARTING TO HURT. ALSO IN MY GROIN IT HURTS. AND I — I JUST DON’T QUITE GET THE CONNECTION. I WAS IN THE MEDICAL FIELD A LITTLE BIT FOR ABOUT 25 YEARS BUT I WAS DOING TRANSCRIPTION. SO I’M ONLY KNEW WHAT THE DOCTORS WERE SAYING, NOT THAT I REALLY UNDERSTOOD ALL OF IT, BUT STILL I AM KIND OF — I’M VERY INTERESTED IN WHY THE GROIN IS INVOLVED IN THIS, AND IF — IF ALL OF THIS THAT I’M FEELING IN MY RIGHT LEG AND HIP IS CONNECTED. AND I WOULD LIKE TO KNOW ABOUT THAT.>>OKAY. ALL RIGHT. THANK YOU VERY MUCH FOR YOUR CALL, AUDREY. DR. BARNES?>>I THINK THAT’S A VERY GOOD QUESTION, AND SOMETIMES IT’S A DIAGNOSTIC CHALLENGE TO TEASE THIS OUT. THERE ARE A FEW THINGS THAT CAN CAUSE PAIN IN THE GROINS. THE HIP JOINT CAN DO IT, THE S.I. JOINT CAN DO IT. IT CAN BE REFERRED FROM THE BACK. AND I GUESS EVEN MORE COMPLICATED WHERE A LOT OF TIMES THERE MAY BE TWO DIFFERENT THINGS GOING ON AND ONE IS AGGRAVATING THE OTHER AND TRYING TO TEASE ALL OF THAT OUT TAKES A LITTLE BIT OF WORK. MY RECOMMENDATION WOULD BE, SEE EITHER A MUSCULOSKELETAL SPECIALIST AND PART OF THE EXAMINE IS TO LOOK AT THE DIFFERENT POTENTIAL CAUSES. SOMETIMES WE USE IMAGING, DIAGNOSTIC INJECTIONS TO HELP TEASE OUT THE PRIMARY PAIN PROBLEM ALONG WITH THE TREATMENT PLAN ONCE DIAGNOSIS IS ESTABLISHED.>>OKAY. WE WANT TO TAKE AN EMAIL NOW FROM OSCAR IN SPOKANE. AND OSCAR SAYS: AND OSCAR SAYS:>>MAYBE I WILL SPEAK TO THAT FIRST. SO RESEARCH HAS BEEN DONE ABOUT DISCS AND THE GIST OF IT IS — I WILL GO BACK TO ONE STUDY. I FORGET WHAT YEAR IT WAS. THEY HAD THOUSANDS OF THE PATIENTS ACROSS COUNTRY AND ANYONE WHO HAD A HERNIATED DISC AND PAIN AND MISSING WORK. PEOPLE WHO HAD SURGICAL TREATMENT AND NO SURGICAL TREATMENT. SO TWO YEARS AFTER THIS, IT THEY WERE AT THE SAME PLACE. OSCAR’S QUESTION ABOUT PATIENCE. NOT KNOWING THE EXACT DETAILS IF THIS WAS AN ACUTE NERVE PROBLEM, BARRING THAT, IT’S NOT AN EMERGENCY TO TAKE CARE OF AND I THINK PATIENCE IS A GOOD OPTION. NOW, DURING THAT TIME OF PATIENCE, A LOT OF THESE OTHER THINGS THAT WE HAVE BEEN TALKING ABOUT COULD ACTUALLY BE HELPFUL AND MIGHT GET OSCAR THROUGH THAT THROUGHOUT NEEDING SURGERY, ACTUALLY. SO I THINK — YOU KNOW, I’M NOT SECOND GUESSING ANY ONE SURGEON’S OPINION BECAUSE ALL OPINIONS ARE VALID BUT THERE’S NO HARM IN WAITING. THERE’S NO HARM IN PATIENCE.>>HOW LONG? I MEAN, HOW DO YOU GAUGE THAT?>>WELL, I’M GOING TO GET ONE OF MY BIASED, WHAT I TELL A LOT OF MY PATIENTS. SURGERY SHOULD NOT BE THOUGHT OF AS A CURING PAIN IN YOUR BACK. THAT’S MY BIAS. THERE’S A LOT OF PEOPLE DO GET COMPLETE RELIEF OF PAIN IF THEY HAVE SURGERY, IF THEY GET TO THAT POINT, BUT I THINK THAT’S NOT THE REASON TO DO SURGERY. SO, YOU KNOW, SURGERY IS MORE INDICATED FOR SOME — YOU KNOW, SOME ACUTE ISSUE, SOMETHING THAT CAN’T BE TREATED WITH THESE OTHER METHODS. SO I GUESS THAT’S JUST KIND OF MY BY AS GOING INTO IT, — BIAS GOING INTO IT, WHICH IS YOU KNOW AVOID SURGERY IF AT ALL POSSIBLE.>>THERE’S SO MUCH FEAR, IT SEEMS LIKE, ESPECIALLY WITH BACK ISSUES BECAUSE IT’S SUCH A TENDER AREA OF THE BODY. EVEN GOING TO CHIROPRACTORS, PEOPLE ARE AFRAID OF THAT. THERE’S SOME FEAR INVOLVED. I’M SURE YOU HAVE HEARD ALL OF IT. YOU KNOW, WHAT ARE YOU DOING TO MY BODY?>>MM-HMM.>>WHAT EXACTLY WHEN YOU ARE DOING AN ADJUSTMENT, ARE YOU PUTTING BONES BACK INTO PLACE? WHAT TAKES PLACE? WHAT ARE YOU DOING?>>YEAH. SO BONE OUT OF PLACE MODEL IS A LITTLE OLD. BASICALLY WHAT WE ARE DOING IS LIKE WE HAVE BEEN TALKING ABOUT ALL NIGHT, INDUCING MOTION. SO SOMETIMES PEOPLE WILL SAY, YOU ARE OUT OF ALIGNMENT.>>YEAH. YOU HEAR THIS A LOT.>>YOU HEAR THAT A LOT, BUT WHAT REALLY IS GOING ON AND THE WAY I THINK ABOUT IT IS SOME JOINTS ARE LOCKED UP. THEY ARE STUCK. THEY ARE KIND OF FUSED TEMPORARILY AND OTHER JOINTS ARE IMBALANCED AND THEY ARE MOVING TOO MUCH. AND SO WHAT WE DO IS WE KIND OF BALANCE THAT OUT. AND SO THROUGH THE CHIROPRACTIC ADJUSTMENT, I UNDERSTAND IT CAN BE SCARY FOR PEOPLE AND I DEAL WITH THAT EVERY DAY. IT’S HARD TO GIVE UP, ESPECIALLY YOUR HEAD AND NECK BUT A BODY PART TO SOMEONE ELSE, IT’S INSTINCTUAL NOT TO. WITH A CHIROPRACTIC ADJUSTMENT, AND WE APPLY HVLA IN THAT JOINT TO GET IT MOVING AGAIN TO TAKE IT OFF THE ABOVE OR BELOW LEVELS THAT ARE MOVING TOO MUCH TO BALANCE IT OUT. SOMETIMES YOU HEAR A POP, AND IT’S A CAVITATION. IT’S JUST WHEN THE FLUID TURNS TO GAS AND IT FORMS THIS BUBBLE AND IT MAKES THAT SOUND. SO IT’S JUST A BUBBLE. IT’S NOTHING TOO SCARY. THE CHIROPRACTIC ADJUSTMENT SHOULDN’T HURT. SOMETIMES IT CAN BE A LITTLE TENDER IF YOU HAVE SOME INFLAMMATION AROUND THERE, BUT USUALLY PEOPLE HAVE A BIG SIGH OF RELIEF AFTERWARDS.>>IS IT A MYTH? YOU HEAR ONCE YOU START GOING TO THE CHIROPRACTOR, YOU HAVE TO KEEP GOING. IS THAT TRUE?>>THE WAY I PRACTICE. I ALWAYS TELL MY PATIENTS, I LOVE SEEING YOU, BUT I WANT TO GET YOU BETTER AND SEE EVEN MORE PEOPLE. 80% OF THE POPULATION WILL HAVE BACK PAIN AT ONE POINT IN THEIR LIFE IF I CAN HELP MORE PEOPLE, THAT’S MY GOAL. I WANT TO SEE YOU A LITTLE MORE OFTEN IN THE BEGINNING AND TAPER OUT AND GIVE YOU THE TOOLS TO HEAL ON YOUR OWN. IT’S JUST LIKE WHEN YOU GO TO THE DENTIST, YOU ARE SUPPOSED TO BRUSH AND FLOSS WHEN YOU GO TO THE CAVITY. ONCE YOU GET A CAVITY, YOU CAN’T GET RID OF THAT, JUST LIKE THAT JOINT RESTRICTION OR IMBALANCE, YOU CAN’T USUALLY GET RID OF THAT WITH STRETCHING OR EXERCISE. EXERCISE. BUNT ONCE WE GET YOU GOING, YOU CAN RETAIN IT ON YOUR OWN.>>WE HAVE ANOTHER EMAIL FROM KEITH.>>I WILL SPEAK TO THAT, SINCE I ACTUALLY GET THAT QUESTION A LOT TOO IN THE CLINIC. I DO NOT DO LASER SPINE SURGERY. BUT I HAVE TALKED TO PEOPLE WHO HAVE HAD IT DONE. SO THIS — OBVIOUSLY I’M NOT THE BEST PERSON TO ANSWER THE QUESTION PER SE, BUT MY UNDERSTANDING OF WHAT LASER SPINE SURGERY IS, IS BASICALLY A MINIMALLY INVASIVE PROCEDURE, LIKE WE SAID EARLIER ABOUT KEEPING DAMAGE TO THE TISSUES AROUND IT MINIMAL. BUT IT’S FREQUENTLY TO DECOMPRESS A NERVE WITH A NERVE IS GETTING PINCHED IN THE BACK WHERE I MIGHT USE A KNIFE OR A DRILL TO DO THAT, THEY ARE USING A LASER TO DO THE SAME THING. THE ULTIMATE RESULT IS TO FREE UP SOME COMPRESSION AND OBVIOUSLY TO DO THAT AS MINIMALLY INVASIVE AS POSSIBLE.>>OKAY. ANYONE ELSE KNOW ANY DETAILS ABOUT LASER SURGERY?>>I KNOW — NOT A WHOLE BUNCH. I KNOW THERE’S VERY LITTLE LITERATURE OUT ON IT, WHEREAS THERE’S DECADES AND DECADES OF RESEARCH FROM THE NEUROSURGICAL FIELD. AND SO I HAVE RESERVATIONS, CONCERNS ABOUT IT, ESPECIALLY WHEN A LOT OF SURGEONS ARE ALREADY USING MINIMALLY INVASIVE TECHNOLOGY.>>YOU KNOW, WE SPEND SO MUCH TIME SLEEPING, HOW IMPORTANT IS A GOOD BED, OR A SPECIFIC KIND OF BED, AND SLEEP POSITION AND THAT SORT OF THING TO MAKE SURE WE KEEP FROM HAVING BACK PAIN? I THINK IT’S SOMETHING TO BE CAREFUL ABOUT, IF YOU’VE BEEN TO A MATRESS STORE IT’S LIKE BUYING A NEW CAR, IT CAN BE VERY EXPENSIVE. THERE IS A VERY WIDE RANGE. THE BIG THING FINDING SOMETHING THAT IS COMFORTABLE AND YOU CAN AFFORD. AS FAR AS SLEEPING POSITIONS EVERYONE IS DIFFERENT BUT USUALLY IT’S GONNA BE SOMETHING ON YOUR SIDE, WITH YOUR BODY IN ALIGNMENT. OFTEN SLEEPING ON YOUR FRONT CAN CAUSE PROBLEMS. I THINK IT’S COMFORT-YOU KNOW IT FOR YOURSELF.>>>YOU’RE NOT LOOKING FOR THAT LOWER BACK SUPPORT?>>I THINK IT’S GOING TO BE A COMFORT ISSUE.>>THERE’S SOME RESEARCH BUT VERY LIMITED EVIDENCE, BUT IN GENERAL, MEDIUM FIRM, MAYBE FIRM FOR SOME PEOPLE. SOME PEOPLE HAVE INCREASED PAIN FROM THE PRESSURE IN FIRM. BUT THE MEDIUM FIRM BEDS. I WOULD ECHO THE PRICING. I DID SOME MATTRESS SHOPPING YEARS AGO AND, YOU KNOW, $800 MATTRESS IS JUST AS GOOD AS THE $5,000 AS FAR AS THE FIRMNESS AND THE QUALITY. AND — BUT OTHER THAN THAT, THERE’S NO GREAT — I WOULD SAY IF YOU HAVE AN OLD MATTRESS AND I HAVE PERSONAL EXPERIENCE WITH THIS, MEDICAL SCHOOL, WE HAD — YOU KNOW, LITTLE MONEY AND HAD OLD MATTRESS AND MY CURRENT WIFE AND I, WE HAD –>>HAD A DIP IN THE MIDDLE.>>AND WE WOKE UP IN THE MORNING WITH BACK ACHES HASN’T THAT WENT AWAY WITH A DECENT MATTRESS. SO THERE’S NO REALLY GREAT GUIDANCE OTHER THAN IF YOU HAVE PAIN IN THE MORNING AND YOUR MATTRESS IS PRETTY OLD, IT’S REASONABLE TO CHANGE THIS, IT’S SOFT MATTRESSES, THEY DON’T PROVIDE THE SAME TYPE OF SUPPORT AS A MEDIUM FIRM OR FIRM MATTRESS.>>MM-HMM. YES, WHAT I TELL MY PATIENTS IS, YOU KNOW, TEST IT OUT, LAY ON THE BED AND IF YOU LAY ON YOUR BACK, IF YOU FEEL THAT IT FILLS UP THE CURVE IN YOUR SMALL BACK THERE, AND IS SUPPORTIVE BUT STILL COMFORTABLE ENOUGH TO SLEEP, THAT WILL BE GOOD. IF YOU ARE ON YOUR SIDE, SAME THING. MAKE SURE THE CURVES ARE SUPPORTED AND MAYBE PUTTING A PILLOW BETWEEN YOUR KNEES SO YOUR HIPS ARE LINED UP WITH YOUR PELVIS EASIER. AND MAKING SURE YOU HAVE A GOOD SUPPORTIVE PILLOW UNDER YOUR HEAD. A LOT OF TIMES I SEE EVERY DAY, I WOKE UP WITH THIS PAIN AND IT’S BECAUSE THEIR PILLOW IS NOT SUPPORTIVE. SO THEIR NECK IS CRUNCHED OVER. THEY ARE FOLDED OVER FORWARD AND THAT PRODUCES SOME PAIN. SO MAKING SURE YOU ARE — BASICALLY, LIKE DR. BARNES WAS SAYING IS THAT YOUR SPINE IS IN ALIGNMENT.>>IT JUST AS IMPORTANT TO HAVE A GOOD PILLOW AS GOOD MATTRESS.>>WE HAVE A CALL FROM JEREMY IN ELK. HI, JEREMY?>>HI.>>YOU HAVE A QUESTION?>>>YES, I HAVE A QUESTION. I WONDERED IF MY LEFT SCIATIC NERVE HAS ANYTHING NO DO WITH MY LOWER BACK PAIN ON MY LEFT SIDE.>>OKAY. — JUST THAT SIMPLE? ANYTHING ELSE?>>MY WIFE HAS SOMETHING WRONG WITH HER NECK. USUALLY AT C3. I’M WONDERING IF YOU KNOW ANYTHING ABOUT THAT AND THE VESTIBULAR SYSTEM.>>OKAY. SO WE HAVE TWOFOLD QUESTION FROM JEREMY. FIRST THE SCIATICA.>>I CAN ANSWER THE SCIATICA QUESTION. FOR ME WHEN PEOPLE COME IN WITH A COMPLAINT OF SCIATICA, THAT MEANS LEG TO PAIN ME. AND THAT’S ALL IT MEANS. SO THE DIFFERENTIAL FOR LEG PAIN IS FAIRLY BROAD. MOST PEOPLE ASSUME IT’S FROM A NERVE, BUT THERE’S A VARIETY OF THINGS THAT CAN MIMIC NERVE PAIN DOWN THE LEG. SO SOMETIMES THE MUSCLES THAT ATTACH TO THE SIDE OF HIP, IF IT’S PAINFUL THERE, IT CAN LOOK LIKE AN L5 NERVE ROOT PROBLEM. AND HIP PAIN MIMICS — IT CAN DEFER DOWN THE LEG, AND S.I. JOINTS AND A LOT OF THINGS TO ASSESS FOR. AND SO THE ANSWER TO YOUR QUESTION, YES, IT COULD BE FROM A NERVE PROBLEM, BUT THEN THERE’S A VARIETY OF OTHER POTENTIAL PROBLEMS THAT YOU NEED TO SEE A PHYSICIAN TO KIND OF SORT OF TEASE OUT.>>OKAY. WE HAVEN’T TALKED ABOUT MEDICATIONS AVAILABLE, IF YOU DO PERSISTANT PAIN OTHER THAN GOING THROUGH REHAB OR SURGERY. WHAT IS RECOMMENDED AS FAR AS OVER THE COUNTER OR PRESCRIBED MEDICATIONS? FORTUNATELY IF YOU LOOK AT THE OVERALL BENEFIT OF MEDICATIONS IT’S REALLY MODEST, IT CAN SOMETIMES BE HELPFUL GUIDELINES RECOMMEND OVER THE COUNTER TYLENOL, NSAIDS FOR A PERIOD OF TIME, I HAVE A THING AGAINST NSAIDS-IBUPROPHYN, ALEVE -OVER THE COUNTER SEEM HARMLESS BUT ACTUALLY CAN BE QUITE DANGEROUS, THERE ARE ALOT OF DEATHS EVERY YEAR FROM COMPLICATIONS FROM NSAIDS, YOU NEED TO BE VERY CAREFUL WITH THOSE MEDICATIONS. FOR — YOU KNOW, WE TALK ABOUT MEDICATION MATTERS. WE DISTINGUISH FROM ACUTE PAIN VERSUS CHRONIC. WE NEED TWO, OR THREE WEEKS OF SOMETHING FOR ACUTE. WE HAVE A WIDE VARIETY OF OPTIONS OF MUSCLE RELAXERS. WE CAN USE STRONGER PAINKILLERS, THE OPIOIDS WHICH CARRY HIGHER RISK. CHRONIC, CHRONIC PAIN, A LITTLE DIFFERENT. THE BENEFITS START BECOMING A LITTLE LESS BUT THERE ARE CERTAIN OPTIONS I USE THAT WORK ON THE NERVOUS SYSTEM. WHICH IS THOUGHT TO PLAY A LARGER ROLE IN CHRONIC PAIN WHAT WE EVERY ASSUMED. BEFORE WE THOUGHT IT WAS SOMETHING WITH THE MUSCLE OR THE SPINE OR S.I. JOINT, BUT IF WE LOOK A LITTLE MORE THERE’S A SENSITISATION OF THE NERVOUSE SYTEM INVOLVING LOTS OF FORMS OF CHRONIC PAIN. SO THE MEDICATIONS THAT HAVE BEEN HELPFUL FOR CHRONIC PAIN USUALLY WORK ON THE NERVOUS SYSTEM IN SOME WAY TRYING TO REVERSE SOME OF THE SENSITIVITY.>>WHAT ABOUT BIOLOGICS?>>WHAT YOU DO YOU MEAN BY BIOLOGICS? THAT GOES ALL OVER THE PLACE.>>I KNOW.>>I THINK JUST TO PIGGYBACK ON WHAT HE WAS SAYING, MEDICATION IS GREAT ON THE SHORT TERM, AND THEN BEYOND THAT, THEN YOU START TO WONDER, ARE WE JUST MASKING SOMETHING THAT SHOULD BE TREATED SOME OTHER WAY? SOME PEOPLE NEED TO BE ON CHRONIC MEDICATION. THERE’S A ROLE FOR THAT. BUT I THINK BEFORE YOU START JUMPING TO, THAT YOU JUST NEED TO REALLY LOOK AT THE UNDERLYING PROBLEM, HAVE WE DIAGNOSED THE CORRECT THING? ARE WE CHASING THE RIGHT PROBLEM? AND BEFORE WE START MASKING IT. BIOLOGICS ARE NEWER AND KIND OF ALL OVER THE PLACE. AND KIND OF LIKE WE WERE SAYING EARLIER LIKE LASERS AND THINGS LIKE THIS. IT’S GOOD TO BE CAREFUL AND TO LOOK AT THE RESEARCH UNDERNEATH THEM.>>OKAY. OKAY. WE HAVE AN EMAIL FROM LYNN. AND LYNN SAYS:>>FIRST OF ALL, EXPLAIN WHAT SHE’S TALKING ABOUT.>>I WOULD BE CAREFUL NOT TO GET STUCK ON ONE OF THOSE.>>IT’S WHERE YOU FLIP UPSIDE DOWN.>>YES. YOU KNOW, FOR THAT — AS FAR AS THE EVIDENCE, SAYING DOES THIS HELP WITH ACUTE OR CHRONIC LOW BACK PAIN, IT’S NOT THERE. COULD IT HELP SOME PEOPLE? LIKE DR. GORE WAS TALKING ABOUT AS FAR AS LENGTHENING OUT THE SPINE, I THINK IN SOME CERTAIN CASES IT CERTAINLY COULD. I WOULD BE CAREFUL WITH THAT, THE AMOUNT OF TIME YOU ARE SPENDING ON IT. WE ARE MEANT TO BE UPRIGHT BEINGS AND WE SHOULD SPEND MOST OF OUR TIME THAT WAY.>>I BET YOU GET THAT QUESTION A LOT TOO.>>YES, I DEFINITELY WANT PEOPLE TO START OUT SLOW WITH IT. DEFINITELY GO INTO A PRACTITIONER, WHETHER IT BE A CHIROPRACTOR OR MUSCULOSKELETAL SPECIALIST AND LET THEM SAY IF IT’S SAFE FOR YOU. DON’T GO ALL THE WAY UPSIDE DOWN THE FIRST GO. DON’T GO THERE FOR AN HOUR. START WITH THREE MINUTES AND MAYBE JUST 60 DEGREES. EVERYONE IS A LITTLE DIFFERENT. BE DOWN THERE FOR 30 SECONDS AND BACK AND FORTH. SO START REALLY SLOW AND MAKE SURE IT’S RIGHT FOR YOU. GET CHECKED OUT FIRST.>>CAN IT BE DANGEROUS? I MEAN BEING UPSIDE DOWN? WITH BLOOD GOING INTO THE HEAD AND ALL OF THAT?>>IT DEPENDS ON EACH PERSON. THERE ARE CERTAIN THINGS WHERE IT CAN MAKE YOU FEEL A LITTLE WORSE. YES. SO THAT’S WHY I SAY GET CHECKED OUT FIRST.>>YES.>>PHONE CALL FROM JOSEPH IN CALGARY. HI, JOSEPH. ARE YOU THERE? WE MAY HAVE LOST JOSEPH. JOSEPH? OKAY. WE WILL MOVE ON. LET’S TALK ABOUT, AGAIN, SOMETHING WE OFTEN DO, WHICH IS DRIVING. WE SPENT A LOT OF TIME IN OUR CARS. LET’S TALK ABOUT, ARE THERE ANY SUPPORTS IN THE CAR THAT MAKE DID –THAT MAY TAKE THE STRAIN OFF OUR BACKS IN THE CAR.>>A COMFORTABLE POSITION. MAKING SURE THAT THE BACK IS STRAIGHT. SO PERHAPS A LUMBAR SUPPORT OR A TOWEL ROLL OR SOMETHING TO GIVE THAT LUMM BA ARE — LUMBAR SUPPORT. A LOT OF CARS HAVE IT NOW. MEN WITH BIG HUGE WALLETS STICKING RIGHT IN THE S.I. JOINT OR WHATEVER.>>THROW EVERYTHING OUT OF KILT. SO BEING CAREFUL WITH THAT. AND ALSO IF YOU ARE DEALING WITH LONG ROAD TRIP AND YOU CAN TAKE BREAKS, GET OUT AND WALK AROUND FOR A LITTLE BIT, AND GET OUT. OR JUST KEEP MOVING, ESPECIALLY IF YOU ARE A PASSENGER, KEEP YOUR LEGS MOVING. DO SOME STRETCHES. YEAH.>>MAKE THAT DRIVE PRODUCTIVE.>>EXACTLY. KEEP MOVING. YOU KNOW, IT’S THE SAME THING ON THE AN AIRPLANE. GET UP, STAND EVERY HOUR OR AT LEAST.>>I WILL ADD A LITTLE BIT TO THAT. I HAVE A LUMBAR SUPPORT IN MY CAR, BUT, YOU KNOW, SOMETHING NO KNOW ABOUT BACK PAIN — SOMETHING THAT YOU SEE FROM MOST PEOPLE, IS THAT STATIONARY POSITIONS AGGRAVATE THEIR PAIN. STANDING IN PLACE AND SITTING IN PLACE AND THE THEORY IS WHEN YOU GET IN THESE POSITIONS WHERE LOADING CERTAIN STRUCTURES AND THE STRUCTURES CAN HANDLE THAT LOAD FOR A PER OF TIME, BUT OVER A LONG PERIOD OF TIME, IT CREATES INJURY. SO I THINK EVEN IF YOU DON’T HAVE BACK PAIN, BUT ESPECIALLY IF YOU HAVE BACK PAIN, YOU SHOULD BE AWARE OF THAT. AND THERE’S A CONCEPT OF POSTURE AWARENESS AND HOW YOU ARE SITTING AND I AGREE WITH THE MOVING AROUND AND ANOTHER THING THAT CAN WORK REALLY WELL IS JUST SIMPLE PELVIC MOTION HERE. MOVING THE PELVIS FORWARD AND TO THE BACK AND TO THE SIDE, AND THAT THE ACTUALLY OFF-LOAD AND RESET SOME OF THOSE.>>JUST SO YOU ARE NOT IN THAT EXACT SAME POSITION ALL THE TIME.>>EXACTLY.>>MM-HMM.>>AND THAT MAKES ME THINK OF LIFTING TOO. AND BEING VERY CAREFUL WHEN WE ARE LIFTING. IS IT STILL THE LEGS. DOWN WITH THE KNEES AND LIFT.>>I ALWAYS TELL PEOPLE STICK YOUR BUM OUT FIRST. IT’S A BIG MUSCLE FOR A REASON. WE ARE SUPPOSED TO HINGE AT THE HIP AND NOT BEND OUR LUMBAR SPINE. WE ARE SUPPOSED TO USE THE BIG MUSCLES, NOT MUSCLES IN OUR BACK AND KEEP WHATEVER LOAD YOU ARE LIFTING CLOSE TO THE BODY, CLOSE TO THE CENTER OF YOUR GRAVITY WHICH IS YOUR BELLY BUTTON. YOU DON’T WANT TO BE HANGING OUT OUT HERE. THAT PUTS A LOT OF STRAIN ON YOUR BACK. SO KEEPING IT CLOSE IN, KEEPING YOUR POSTURE AND SHOULDERS DOWN AND BACK AND MAINTAINING THAT CORE BRACE AS WELL.>>AND THEN WE’LL START HITTING TRAINING FOR BLOOMSDAY, GOLF COURSES. WHAT DO WE NEED TO KEEP IN MIND.>>BACK PAIN, JUST LIKE THE GENERAL PUBLIC IS VERY COMMON IN ATHLETES AND SO, YOU KNOW, AS FAR AS THERE ARE SOME HIGH-RISK SPORTS, GOLF, GYMNASTICS, FIGURE SKATING OR LIKE WE WERE SAYING LIFTING. LIFTING HEAVY WEIGHTS, A WEIGHT LIFTER, ESPECIALLY FOOTBALL, OFFENSIVE LINEMEN, BELIEVE IT OR NOT. OVER 50% THEM HAVE SOME CHRONIC BACK ISSUE BECAUSE THEY ARE DOING A LOT OF THIS EXTENSION AND GETTING UP AND THEY ARE JUST BIG GUYS. IN GENERAL, I WOULD SAY THE SAME THINGS APPLY AS FAR AS, YOU KNOW, MAKING THE BASIC HEALTH TYPE THINGS WE TALKED ABOUT. AND THEN JUST KEEPING A CLOSE EYE ON HOW YOUR BACK FEELS, IN IT FEELS REALLY TIGHT AFTER A RUN OR AFTER SOMETHING WHERE YOU MAYBE TRAINED A LITTLE TOO HARD. AND THEN THINGS LIKE HEAT PACKS, MAYBE THAT NIGHT, OR SHORT COURSE OF ANTI-INFLAMMATORY MEDICATIONS MAYBE FOR A DAY OR TWO. BUT JUST TAKING CARE OF IT EARLY, I GUESS AND ALLOWING YOUR BODY THE APPROPRIATE TIME TO REST AND TAKE A DAY OFF BEFORE YOU TRY TO TRAIN AGAIN. AND THEN JUST GOING BACK TO SOME OF THE BASICS THAT WE TALKED ABOUT.>>ABSOLUTELY.>>TAKE IT SLOW AND KEEP MOVING. EXCELLENT ADVICE. AND THAT WAS ACTUALLY GOING TO WRAP IT UP FOR US. WE HAVE COME TO THE END OF OUR DISCUSSION AND THAT WILL DO IT FOR THIS SHOW. I WANT TO THANK THE PANEL FOR A GREAT DISCUSSION TONIGHT AND THANKS WHO CALLED IN OR EMAILS QUESTIONS. WE WILL BE BACK WITH WITH ANOTHER EDITION OF HEALTH MATTERS WHEN OUR TOPICS WILL BE ALZHEIMER’S DISEASE ON APRIL 19th. UNTIL THEN, I’M TERESA LUKENS. GOOD NIGHT.>>”HEALTH MATTERS” IS MADE POSSIBLE BY VIEWERS LIKE YOU, THE FRIENDS OF KSPS. AND BY PROVIDENCE HEALTH CARE.>>I’M DR. ANDREW BOULET, AND MY WIFE HAD A CARDIAC ARREST. I CHOSE PROVIDENCE BECAUSE I KNEW THAT EVERYTHING FOR HER COMPLEX CARE WAS AVAILABLE FROM THE EMERGENCY ROOM, TO RADIOLOGY, TO THE NURSING STAFF, TO THE SPECIALISTS WE NEED FOR HER CARE.>>I’M ARNIE PETERSON, I’M AN ORTHOPAEDIC SURGEON. AND I WORK IN THE SACRED HEART PROVIDENCE MEDICAL GROUP. WHEN I NEEDED MY HIP REPLACED, I CHOSE PROVIDENCE BECAUSE OF THE PROFESSIONALISM AND THE CARE I KNEW I WOULD RECEIVE. I NEVER THOUGHT TWICE ABOUT GOING ANYWHERE ELSE. ♪♪ ♪♪

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