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When it comes to treating chronic pain, physicians have often turned to medication as a first resort for conditions such as headache, neck pain, low back pain, and pelvic pain. In recent years, it is becoming increasingly obvious that this has been a bad approach. The “opioid epidemic”, as it’s now called in local and national news, has claimed the lives and livelihoods of millions of Americans, and shows no signs of slowing down. Why do physicians so quickly turn to medication for treatment of chronic pain conditions? Is strong medication the only thing that can provide relief for headaches? Is there no other approach for treating neck and back pain?

An article in the New York Times discusses alternative therapies, including physical therapy, exercise, acupuncture, tai chi, yoga, progressive relaxation, cognitive behavioral therapy, and mindfulness-based stress reduction. It also discusses a frustration we physical therapists often express: Drugs are often prescribed as a first resort because American health insurance systems have been slow to pay for other forms of care. Physical therapy visits can be limited or associated with very high co-pays, making drugs a more affordable (but more dangerous) option. Other alternative therapies aren’t covered, so back, neck, and headache pain sufferers are forced to pay out of pocket…

Still, one should consider the pros and cons of medication vs. alternative therapies. Most people recover from severe pain without the need for surgery or long-term, potentially addictive medications. If you do not have a serious diagnosis requiring surgery, consider a visit or two to the physical therapists at Saunders Therapy Centers. We can consult with you and tell you if we can help. We are well-attuned to financial considerations and will make sure to not waste your money or time when determining what we have to offer for your particular case.

Conventional wisdom is that osteoarthritis of the knee results mostly from wear and tear, which is why, these days, it’s more common among older people and those whose excess body weight puts extra stress on those joints. BUT THAT’S NOT WHAT LATEST EVIDENCE SHOWS! 

Dr. Richard Loeser, a rheumatologist who directs the Thurston Arthritis Research Center at the University of North Carolina, Chapel Hill, was quoted in this article published by NPR,  “Your joints aren’t just like your automobile tires that wear out as you use them,” he says. In fact, exercise helps nutrients diffuse into cartilage in the knee and keep it strong and healthy.

If cartilage “is formed and more healthy when you’re younger, then your joints are more likely to be functioning better and have less osteoarthritis when you get older,” Loeser says. And exercise also helps fully grown people.

“By strengthening your muscles and by stimulating your cartilage you can still improve the health of your joint,” Loeser says. Read more in the original article HERE.

Let’s talk more about the power of positivity… Trying to be positive when you’re experiencing stress or pain is difficult, and do-gooders who spout trite advice can come off as annoying, at best!

New research by Dr. Barbara Fredrickson, a psychologist at the University of North Carolina, takes the pressure off of trying to be positive all the time. Her theory promotes “micro-moments” of positivity as a key to improving long-term well being. The concept is that repeated brief moments of positive feelings can provide a buffer against stress and depression and improve both physical and mental health.

After reading about this theory in Jane Brody’s April 3^rd New York Times article (Turning Negative Thinkers into Positive Ones), I spent a day trying to be hyper-aware of tiny moments that made me happy. Here are a few things I remember:

1. Discovering that birds moved into the new birdhouse I bought at the Uptown Art Fair.
2. Noticing the bright, lime-green color of fresh buds on these really cool trees in my neighborhood. 
3. Being charmed by the baby in the Target checkout line –she flashed me the BIGGEST toothless smile!

Try it out! Dr. Fredrickson’s research has shown that micro-moments of positivity are cumulative, and that we can train the circuitry in the brain to promote more positive responses with repeated practice.

By Robin Saunders Ryan, PT MS

Did you know? Many headaches are caused by neck problems. The term for these types of headaches is “cervicogenic.” The joints, discs, ligaments, and muscles contain nerve endings that can refer pain to the head. Although neck related headaches are most common at the base of the skull, your pain can also be felt in the face, forehead, eyes, temples, and even the upper back and shoulders.

If your headache is accompanied by a feeling of stiffness, tenseness, or decreased motion in your neck, upper back, or shoulders, there is probably a neck-related component to your headaches. You should see a physical therapist for an evaluation.

Here’s what we will do:

• Assess the motion of each of your neck (cervical) joints – Your cervical spine has seven vertebrae – each “segment” has a disc and facet joints, along with the ligaments that hold it all together. We can often find a problem at one or two of these segments. The treatment for this type of problem involves mobilization of the stiff segment.
• Assess the muscles of your head, neck, and upper back. The muscles that control rotation, side bending, head tilting, looking up and down, etc… can get out of balance – especially when repetitive motion, static postures, or abnormal posture is involved. The treatment for muscle imbalance involves myofascial release, manual stretching, and very specific muscle exercises.
• Assess your posture and lifestyle – Good alignment of the head and neck will minimize the forces on your neck structures. Poor posture, especially when sitting for prolonged periods, is one of the most common causes of neck related headaches and The treatment for poor posture is exercise and education and, sometimes, assistive devices, or a change in your chair or work station.

Medication can help headache pain temporarily, but unless you get to the root cause of neck related headaches, you are only treating the symptoms. Our physical therapists are skilled at headache evaluation and treatment. We can help your physician assess whether neck treatment would be of benefit.

A common cause of back pain and sciatica is herniated disc. When our patients first hear that diagnosis, many of them are afraid, because they may know someone who had surgery or might have had a poor outcome. MRIs, CTs, and even drawings of herniated discs can be really frightening!

In fact, most people with a diagnosis of herniated disc do very well with conservative care. We use manual therapy, and teach you proper positioning and exercise to counteract the stressful forces that your work, hobbies and habits place on your back.

A 2016 study in the New England Journal of Medicine* followed a 29-year-old female with herniated disc and nerve compression causing right leg pain and numbness. Five months after epidural injection and physical therapy, an MRI showed that the herniation had disappeared.

Here’s another fun fact: Depending on age, up to 80% of people with NO SYMPTOMS have evidence of disc problems on MRI or CT scan**. This means that, even if you have a herniated disc, it might not be related to your pain. You might just need good, old-fashioned, back rehabilitation. It’s amazing what a handful of targeted exercises can do! Our therapists perform a very specific evaluation to determine which exercises you need to counteract any stability, weakness or range-of-motion problems.

Fear can be debilitating. Don’t let a diagnosis of herniated disc scare you away from doing the things you love. Try physical therapy!

*NEJM. 2016; 374:1564

**Am J Neuroradiol. 2015; 36(4):811-816

Smartphones help us in many ways, but they can be bad for your neck. An informal term for a relatively recent phenomenon in physical therapy is “text neck”. This refers to the neck and upper back pain, headaches, and even arm and hand symptoms that can be caused by excessive texting.

The human head weighs about twelve pounds. But when you bend your neck downward while texting, the weight and stress on the neck increases – a lot more than you’d imagine. For example, at a 45-degree angle, the force on your neck can approach 50 lbs! And if you’re texting as much as some of our patients do, that’s a lot of force for a long time.

Don’t worry – we won’t suggest that you stop texting – looking down at your phone is only half the problem. A sedentary lifestyle, poor posture, static positions, and muscle imbalances – these can all contribute to the syndrome. Learning exercises to strengthen certain muscles and counteract the texting position can significantly help. Physical therapists are movement specialists! If you’re having trouble with “text neck” or anything else, give us a call – we can help.

Stretching is something that we have been taught to do ever since our physical education classes growing up. Static stretching of holding a particular stretch for 30-60 seconds has been highly debated over the past few years. Research now shows that a static stretching prior to exercise can negatively affect your muscles power, strength, and overall performance.

Dynamic stretching consists of active movements that elicit a stretch, but are not held for any length of time. Through repetitive movements, it helps prepare your muscles and joints for your workout. By properly warming up your body prior to exercise, it can help decrease your risk of injury. One of the benefits to dynamic stretching, is that it can be individualized based on your activity. A runner’s dynamic stretching would look very different compared to a cyclist’s due to the different movements required for each sport. Talk to your physical therapist today about an appropriate dynamic stretching routine you can incorporate for your specific exercise goals.

by Lisa Martens, DPT

http://www.ncbi.nlm.nih.gov/pubmed/22316148