CHRONIC PAIN Neck Pain, Back Pain, Leg Pain ROOT CAUSE – HOPE & HEALING

Pain is complicated, multi-system and elusive. We in the medical and dental professions are understanding the pain science in unprecedented ways. Pain is multi-system involving the brain and changes in the brain when pain is chronic (over 3 months). Pain involves the immune system to facilitate healing in chronic, acute and sub-acute conditions, and in all cases involves soft tissue. Healing chronic pain involves different treatment strategies than acute pain.

Pain is a symptom. We at NJPTA understand pain and movement science. People in pain do not move like people without pain, and we understand how to assess and how to address not only the source of the pain, but the root cause of the pain. For example, in a potential lower back pain / leg pain condition the MRI shows you have a L45 herniated disc as the source of the pain, but the ROOT cause of the pain is gravity and how you hold your spine to cause the disc to herniate. We also understand how the body heals and how the body adapts in order to function. This adaptation is invisible and unperceptive (cannot be felt) until a threshold or tipping point is reached and then pain ensues. Studies show 70% of people have herniated or bulging discs, but do not have any symptoms. The threshold / tipping point for acute injury / back pain from an activity that occurred last week is very different than back pain ongoing for 3 years that suddenly got aggravated last week. A pre-existing back pain history requires different treatment strategies than one time acute injury. Our expertise is the knowledge and applying the correct treatment tools in our toolbox to give you the knowledge and ability for your body to completely and permanently resolve your pain.

MAXIMIZING WORK STATION COMFORT

Do you have a job that requires you to sit for the majority of the day? Do you find yourself having aches and pains in your neck and back? If so, you may want to read on to find a few simple exercises to interject during your workday to combat the negative effects of prolonged sitting. As the day wears on, especially if you do not take enough rest breaks, gravity will cause you to slump down and acquire a rounded shoulder, forward head posture. This is especially true during computer use. Additionally, you will also want to make sure your work station is optimally set up to decrease the risk of eye and neck strain. A few pointers for proper posture at your desk include the following

  • When sitting, make sure your hips are slightly higher than your knees so your thigh is on a “down slope,” with your feet flat on the floor. This will help keep you in an upright position with the least amount of demand on your postural muscles. Your elbows should be supported by the arm rests and should not push your shoulders into a “shrugged” position.
  • Your upper arms should rest at your sides and elbows bent. You should be able to reach your keyboard in this position without reaching your arms much farther forward.
  • Everything you use often should be in your “frequent reach zone,” which is defined as the space you can reach in front and to the side, with your arms resting at your sides. Things used less frequently should be placed in your “occasional reach zone” which can be defined as an arm’s length in front or to the side which can be reached without requiring any additional bending or leaning.
  • While OSHA recommends the monitor be about an arm’s length away, we recommend placing your monitor as close as possible to improve ease of viewing and decreasing eye strain. Think of it as a similar distance to that you would hold a book or newspaper from your eyes. The top of your monitor should be placed slightly below eye level so it promotes a slightly downward gaze. If you are using a laptop, you will never be able to achieve an ideal ergonomic situation without utilizing either an external keyboard or monitor.

A few exercises you may want to try during the day:

A few exercises you may want to try during the day:

  • Shoulder Roll: up, back, down 5 x every hour
  • Neck rotation: turn your head side to side, 3 times each side, every hour
  • Seated hip hinge: scoot to the edge of your chair and place your hands on your knees. Keep your back very straight, and hinge forward from the hips. Hold 1 second, do 5 times every hour.
  • Try to get up and walk around every hour, even for a short walk to get some water or use the restroom.

2 times a day (this should take you 3.5 minutes)

  • Chin tucks: sitting up tall, gently tuck your chin about 5 degrees, hold 5 seconds, do 5 reps 2 times during your work day.
  • Wrist extensor stretch: With your R arm out in front of you, palp down, wrist bent, apply over pressure with left hand until a stretch is felt in the back of the R forearm Hold 30 seconds, do 1 times each side 2 x during your work day
  • Wrist flexor stretch: with your R arm out in front of you, palm down, bend your wrist up and apply over pressure to your fingers with your left hand until a stretch is felt in the front of your forearm do 1 time each side 2 x during your work day.
  • Seated figure 4 piriformis stretch: scoot to the edge of your chair and place your right leg over your left so to form a “figure 4.” Keep your back straight as in the previous exercise, and lean forward until you feel a stretch in your R buttock. Hold 30 seconds, do 1 time each side, 2 times during your work day.

MYOFASCIAL DECOMPRESSION

Myofascial decompression is a technique that uses dome shaped “cups” to create negative pressure (suction) combined with gentle, strategic movement to help release the tightness in an area of muscle and fascia, thereby improving quality of movement, and decreasing pain. The suction helps to create “space” in the tissues and restore fluidity to the fascia. Fascia is the support structure or “scaffolding” for tissues. It is fluid and has a high degree of plasticity. It encapsulates and connects multiple muscles allowing for the functional kinetic chain and plays a large role in the quality of our movement. Certain areas of our fascia can lose their fluidity and become a sort of “glue” that causes a restriction in the ability of the tissues to glide, changing the way the forces in the system are distributed and can contribute to pain and injury. We see this occur in common injuries such as shoulder impingement/tendonitis, tennis and golfer’s elbow, work or sport related repetitive overuse injuries, as well as neck and low back strains.

The negative pressure created through the use of myofascial decompression, combined with active and/or passive movement, releases the tonic, tight, facilitated muscles and decreases the density that has accumulated in specific myofascial layers. It helps to bring blood flow, and therefore oxygen, to the area and allows nutrient exchange and helps to release trigger points, or knots, in the muscles. Myofascial decompression can also help decrease scar tissue and improve the pliability of the tissue/muscle. We are experiencing some exciting results with the addition of myofascial decompression to our tool box here at North Jersey Physical Therapy Associates, call today to come in and see if this technique is appropriate for treatment of your pain/movement impairment.

COULD YOUR POSTURE BE CAUSING YOUR NECK PAIN and HEADACHES?

Do you have neck pain and/or headaches that get worse after sitting long periods, or after prolonged cell phone, laptop, or tablet use? The way you are holding your head up could be overworking the muscles of your head and neck, contributing to your pain. With the increasing use of hand held electronics, slouched posture has become more prevalent than ever. In neutral, upright posture (as depicted in diagram below), the head is positioned over the shoulders and should present as a 10-12 pound load for the spine and muscles to support. As we increase neck flexion and look further and further down, the weight of the head progressively increases. Notice at the far right of the diagram the head can begin to mimic a 60 pound load on the spine and neck muscles due to the slumped posture. When you think of your head as a 12 pound weight versus a 60 pound weight, it’s no wonder your neck and head begin to hurt with improper posture!

Neck and Head Pain Posture
DR. KENNETH HANSRAJ/SURGICAL TECHNOLOGY INTERNATIONAL

It is important to think about creating space by brining your lower ribs up and away from your pelvis, drawing your breast bone up, and imagine you are putting your head on the ceiling.  Be sure not to arch your lower back.  These are all cues that can help facilitate abdominal elongation and proper upright posture that will place your shoulders over your hips and your head over your shoulders.

The next time you sit down to read a book, use your tablet or cell phone, think about the way you are holding your head, and try to bring the reading material up towards eye level so you do not allow your head to bend down and pull on your spine and neck muscles.  Fixing your posture alone may not be enough to eliminate your head and neck pain, but it is certainly a great place to start.  If you have persistent head or neck pain, call today to come in for an evaluation and individualized treatment plan at North Jersey Physical Therapy.