Fatty Liver: The Surprising Health Risk of a Sedentary Lifestyle
Fatty Liver: The Surprising Health Risk of a Sedentary Lifestyle
Fatty liver, also known as hepatic steatosis, is a condition in which excess fat accumulates in the liver. The liver is responsible for filtering toxins and producing essential substances such as bile, which helps in the digestion of fats. However, when there is too much fat in the liver, it can lead to inflammation and damage, ultimately affecting the liver's ability to function properly.
Fatty liver is becoming increasingly prevalent, with recent studies suggesting that it affects up to 25% of the global population. The condition is often associated with other health problems such as obesity, type 2 diabetes, and metabolic syndrome. In fact, fatty liver is often considered a manifestation of metabolic syndrome, which is a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.
The impact of fatty liver on overall health cannot be overstated. The liver plays a vital role in many bodily functions, and its impairment can lead to serious complications. Fatty liver is often asymptomatic, but it can progress to more severe forms such as nonalcoholic steatohepatitis (NASH), which is characterized by inflammation and scarring of the liver. NASH can eventually lead to cirrhosis, liver failure, and liver cancer.
In addition to the liver-related complications, fatty liver has been associated with an increased risk of cardiovascular disease. This is because fatty liver is often accompanied by other risk factors such as high blood pressure, high cholesterol, and insulin resistance
II. Causes of Fatty LiverThere are several factors that contribute to the development of fatty liver. These factors can be broadly categorized into lifestyle factors, genetic and metabolic factors, and underlying medical conditions.
Lifestyle Factors:
Diet, exercise, and alcohol consumption are all significant contributors to the development of fatty liver.
Diet: A diet high in fat and sugar can lead to an increase in fat accumulation in the liver. This is because excess calories from these foods are converted to triglycerides and stored in the liver.
Exercise: Physical activity helps to burn excess calories and reduce fat in the liver. A sedentary lifestyle, on the other hand, can increase the risk of developing fatty liver.
Alcohol Consumption: Excessive alcohol consumption is a well-known cause of fatty liver, and can lead to a more severe form of the condition known as alcoholic liver disease.
Genetic and Metabolic Factors:
Several genetic and metabolic factors can also contribute to the development of fatty liver.
Insulin Resistance: Insulin resistance is a condition in which the body's cells become resistant to the effects of insulin, a hormone that regulates blood sugar levels. This can lead to an increase in the production of triglycerides in the liver, which can contribute to the development of fatty liver.
Genetics: Some people may be more susceptible to developing fatty liver due to genetic factors. Certain genetic variations can affect the way the body processes and stores fat.
Link Between Obesity and Fatty Liver:
Obesity is a significant risk factor for fatty liver. Excess body fat, particularly around the abdomen, increases the risk of developing fatty liver. Obesity is also closely linked to insulin resistance and metabolic syndrome, both of which can contribute to the development of fatty liver.
III. Complications of Fatty LiverFatty liver can lead to several complications, some of which can be life-threatening. The most common complications include:
Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH):
NAFLD is the most common form of fatty liver disease and is often associated with obesity and insulin resistance. It is a relatively benign condition that does not typically cause significant liver damage. However, in some cases, NAFLD can progress to NASH, a more severe form of fatty liver disease. NASH is characterized by inflammation and scarring of the liver, and can eventually lead to cirrhosis, liver failure, and liver cancer.
Increased Risk of Liver Cancer and Liver Failure:
Fatty liver has been associated with an increased risk of liver cancer and liver failure. This is because chronic inflammation and scarring of the liver can lead to the development of cancerous cells and impair the liver's ability to function properly.
Association between Fatty Liver and Cardiovascular Disease:Fatty liver has been linked to an increased risk of cardiovascular disease. This is because fatty liver is often accompanied by other risk factors such as obesity, high blood pressure, high cholesterol, and insulin resistance. These risk factors can lead to the development of atherosclerosis, a condition in which fatty deposits build up inside the arteries and restrict blood flow to the heart.
IV. Diagnosis and Treatment:
Diagnosing and treating fatty liver is essential to prevent complications and improve overall health. The diagnosis of fatty liver is typically made through a combination of medical history, physical examination, and diagnostic tests. Treatment usually involves lifestyle changes, medication, and surgical intervention for more severe cases.
Lifestyle Changes:
Lifestyle changes are an essential part of managing fatty liver. These changes include:
Diet: A healthy diet low in fat, sugar, and calories can help reduce fat accumulation in the liver. A diet rich in fruits, vegetables, and whole grains can also help improve overall health.
Exercise: Regular exercise can help burn excess calories and reduce fat accumulation in the liver. Physical activity can also help improve insulin sensitivity and reduce the risk of other health conditions.
Weight loss: Losing weight, particularly around the abdomen, can help reduce fat accumulation in the liver and improve overall health. A weight loss of 5-10% can significantly improve liver health.
Medications and Surgical Interventions:In more severe cases, medication and surgical interventions may be required to manage fatty liver. Medications such as Vitamin E, pioglitazone, and obeticholic acid may be prescribed to help reduce liver inflammation and improve liver function. However, it's important to note that medication should only be prescribed by a medical professional.
In some cases, surgical intervention may be necessary. For example, if fatty liver is causing liver cirrhosis or liver failure, a liver transplant may be required. However, this is a complex and invasive procedure that is typically reserved for the most severe cases.
V. Overview of Recent Research on the Mechanisms of Fatty Liver:
Recent research has shed light on the mechanisms underlying fatty liver, which may lead to the development of new treatments and interventions. One area of focus is the role of the gut microbiome in fatty liver disease. Studies have shown that imbalances in the gut microbiome can contribute to the development of fatty liver by altering metabolism and increasing inflammation.
Other research has focused on the role of insulin resistance in fatty liver disease. Insulin resistance can lead to the accumulation of fat in the liver by increasing the production of fatty acids and impairing the breakdown of fat.
Additionally, recent studies have explored the link between fatty liver disease and cardiovascular disease, suggesting that the two conditions may share common risk factors and pathophysiological mechanisms.
VI. Discussion of Potential New Treatments and Interventions:
Based on the recent research, there are several potential new treatments and interventions for fatty liver disease. One approach is to target the gut microbiome with probiotics or prebiotics to restore balance and reduce inflammation. Another potential intervention is to target insulin resistance with medications that improve insulin sensitivity or reduce the production of fatty acids.
Other potential treatments include novel therapies that target specific cellular pathways involved in fatty liver disease, such as lipid metabolism and inflammation. For example, drugs that inhibit certain enzymes involved in lipid synthesis have shown promise in reducing liver fat accumulation.
VII. The Importance of Continued Research in the Field:
Fatty liver disease is a growing public health concern, and continued research in the field is essential for developing effective treatments and interventions. There is still much to learn about the underlying mechanisms of fatty liver disease and its relationship to other health conditions, such as diabetes and cardiovascular disease.
In addition, more research is needed to develop accurate and non-invasive diagnostic tools for fatty liver disease. Currently, liver biopsy is the gold standard for diagnosing fatty liver disease, but it is an invasive and potentially risky procedure.
Overall, continued research in the field of fatty liver disease has the potential to improve the lives of millions of people around the world who are affected by this condition.
VIII. Conclusion:
Fatty liver disease is a common and potentially serious condition that can lead to liver damage and other health complications. Lifestyle changes, such as diet and exercise, are essential for managing fatty liver, but in more severe cases, medication and surgical intervention may be required.
Recent research has shed light on the mechanisms underlying fatty liver disease, which may lead to the development of new treatments and interventions. However, continued research in the field is essential for developing accurate diagnostic tools and effective treatments for this growing public health concern.
Low Potassium Causes Diabetes! OMG Help Me Doc! Is That Really True?
Low Potassium Causes Diabetes! OMG Help Me Doc! Is That Really True?
Today we're going to talk about whether low potassium really causes diabetes. Now, I don't want to attack anyone personally, but seeing these various health gurus claiming that low potassium causes diabetes really gets my blood boiling. As someone with a background in nutrition, herbal medicine, and Western medicine, I believe in taking a holistic approach to managing medical conditions. However, I can't endorse claims that lack scientific basis. Unfortunately, some people profit from picking out rare correlations and presenting them as causation. Just because there may be links between potassium and diabetes, for example, it doesn't mean that a deficiency in potassium automatically causes diabetes. Statements like this are taken out of context and serve only to distract us from the real issue. It's frustrating to see these types of videos and articles circulating because they misinform the public and ultimately, they do more harm than good.
So why don't I believe that low potassium causes diabetes?First things first, believing these claims is like sitting in a room with a huge elephant in the middle, but completely ignoring it. It's just not accurate. Diabetes is a metabolic disorder characterized by high blood sugar levels due to a lack of insulin production or the body's inability to use insulin effectively.
While low potassium levels can cause a range of symptoms like muscle weakness, fatigue, and irregular heartbeats, it is not a known cause of diabetes. What these gurus are referring to is the results of several studies that suggest that increasing potassium intake may help improve insulin sensitivity and lower the risk of developing type 2 diabetes.
But that's not only because of potassium by itself. Its largely because potassium is found in foods like fruits, vegetables, and legumes which by themselves can help improve overall quality of someone’s diet by substituting them for junk food which is loaded with sugar and promoting a healthy weight, which are the most important factors in preventing diabetes.
In fact, a holistic approach is needed to manage any medical condition, and diabetes is no exception. Diabetes is a complex disease that involves a combination of genetic, environmental, and lifestyle factors.
So, what are the major causes of diabetes?
There are many reasons why someone can develop diabetes, but today let's focus on the four most significant ones.
First up, obesity. Several studies have found that excess body weight, especially abdominal fat, increases the risk of developing type 2 diabetes. Each 5-kg increase in body weight was associated with a 31% higher risk of type 2 diabetes. That's a huge number!
Secondly, a sedentary lifestyle is another significant risk factor for type 2 diabetes. Physical inactivity leads to decreased insulin sensitivity and impaired glucose metabolism. Each 2.5 hours per week increase in moderate-intensity physical activity was associated with a 9% lower risk of developing type 2 diabetes.
Thirdly, an unhealthy diet high in refined carbohydrates, added sugars, and saturated fats can increase the risk of developing type 2 diabetes. Each additional daily serving of sugar-sweetened beverages was associated with a 13% higher risk of developing type 2 diabetes.
Finally, genetics also play a role. Certain genetic variants can increase the risk of developing type 2 diabetes. However, lifestyle factors, such as diet and physical activity, still play a more significant role in the development of type 2 diabetes than genetics.
So how do I look at the genetic risks that can make people more prone to certain diseases, such as diabetes? Think of genetics like carrying a loaded gun - just because you possess the genetic predisposition for a disease, it doesn't mean that the genes will automatically trigger it. You still have a significant amount of control over your genetic risks. It's like having a loaded gun in your pocket - you have the choice not to pull the trigger. So don't use your genes as an excuse for giving up. Yes, fighting genetic risks may require more effort, but it's still possible to overcome them. Don't let the fear of genetics hold you back - you have the power to take control of your health and well-being."
So, there you have it, guys. Low potassium does not cause diabetes, but a combination of genetic, environmental, and lifestyle factors do. Remember to take care of your body by exercising regularly, eating a healthy diet, and maintaining a healthy weight.
Eggs: Increasing Good Cholesterol or Raise Bad Cholesterol?
Eggs: Increasing Good Cholesterol or Raise Bad Cholesterol?
In today’s nutrition corner we will talk about eggs. Have you ever questioned whether consuming eggs really increases your cholesterol levels? Is it possible that eggs can be actually increasing good cholesterol ? How many eggs can you safely eat? Moreover, have you considered how our body regulates cholesterol and whether eggs have any benefits for our overall health? In this article you will find answers to all of these questions.
Why are eggs so special?You might be surprised to learn that eggs are actually one of the most nutrient-dense foods on the planet. They contain one of the highest quality protein, healthy fats, and a variety of vitamins and minerals that are essential for our bodies to function properly.
Many people particularly like eggs for their high protein content. However, the protein content in an egg is not equally distributed between the egg white and the egg yolk.
Approximately 60% of the protein in an egg is found in the egg white, while the remaining 40% is in the egg yolk. Specifically, one large egg white contains about 3.6 grams of protein, while the yolk contains about 2.7 grams of protein.
It is also important to understand that all the cholesterol in the egg is present in the egg yolk and there is no cholesterol in the egg white.
What is cholesterol and how our body self regulate the level of cholesterol in the blood Cholesterol is a type of fat that is found in our bloodstream and cells, and our bodies need it to function properly. We need cholesterol since it is a building block of cell membranes, helping to maintain their structural integrity.
It is also a precursor for the synthesis of important hormones. For example without cholesterol we could not make the important hormones estrogen and testosterone.
Additionally, cholesterol plays a role in the production of bile acids that are important for the digestion and absorption of fats in the intestines. However, too much cholesterol in the blood can increase the risk of heart disease and stroke.
This is where eggs come in, as they are one of the foods that are high in cholesterol. A single large egg contains around 186 milligrams of cholesterol, which is more than half of the recommended daily intake.
But here's the catch - eating cholesterol doesn't necessarily raise cholesterol levels in the blood. Our liver produces cholesterol every day, and it adjusts its production based on how much cholesterol we consume through our diet. In other words, if we eat more cholesterol, our liver will make less of it.
Additionally research has shown that the body can decrease the absorption of dietary cholesterol from the intestine back to the body if the blood level of cholesterol is already high. This is because the body has a mechanism to regulate cholesterol levels called the enterohepatic circulation.
This mechanism involves the liver secreting cholesterol into bile, which is then released into the small intestine to help with the digestion of fats. Once the fats are digested, the cholesterol is either absorbed back into the bloodstream or eliminated from the body.
However, when the blood cholesterol levels are already high, the body can decrease the absorption of dietary cholesterol by reducing the amount of cholesterol that is absorbed from the small intestine back into the bloodstream.
This is because the liver produces less cholesterol in response to high blood cholesterol levels, which in turn reduces the amount of cholesterol that is secreted into bile.
Can body regulate the level of cholesterol that it makes and reabsorbs from the intestines based on the level of cholesterol in our blood? While it is more complicated, in general this applies to roughly 75% of people as their liver compensates by reducing its own production. Moreover, research has shown that the way we prepare eggs and other food we eat can also significantly affect the impact on cholesterol levels.
Frying eggs or using them in dishes that require added butter or oil can increase the amount of saturated fats and trans fatty acids, which are known to raise cholesterol levels. On the other hand, boiling or poaching eggs, or using them in dishes that require minimal added fat, can have a neutral or even positive effect on cholesterol levels.
It is also worthwhile to say that eggs contain a type of fat called lecithin that can help to lower cholesterol levels by preventing the absorption of dietary cholesterol into the bloodstream. In fact, studies have shown that eating whole eggs, including the yolk, can increase levels of good cholesterol (HDL) in the body, which is important for heart health.
The specific mechanism by which eggs raise HDL cholesterol levels is not fully understood, but it is thought to be related to the presence of certain nutrients in eggs, including choline and betaine. These nutrients may help to support liver function, which in turn can lead to an increase in HDL cholesterol production.
Additionally, eggs are a rich source of choline. Choline is a nutrient that is important for brain function, as well as liver and muscle health. Eggs are an excellent source of choline, with one large egg containing around 147mg of choline.
It is also important to note that different types of eggs may have different nutrient profiles. For example, free-range eggs may contain higher levels of omega-3 fatty acids, while organic eggs may contain higher levels of vitamin E.
So what is the verdict? Do eggs raise cholesterol?Ok so now that we have all the important background info it will be easy for you to understand the answer to this question. The answer is actually not as straightforward as you might think. Studies have shown that eating eggs in moderation (up to one egg per day) does not significantly raise cholesterol levels in healthy individuals thanks to their liver's ability to regulate its own production. However, if you have high cholesterol or a family history of heart disease, it may be best to limit your egg intake or talk to your health care provider or a registered dietitian for personalized advice. Additionally, choosing healthy preparation methods, such as boiling or poaching, can help minimize any potential negative effects on cholesterol levels. And don't forget about the egg whites, which are a great source of protein without the cholesterol.
In conclusion, while eggs do contain cholesterol, they may not necessarily raise cholesterol levels in the majority of people. It's important to take individual factors, such as personal health history and preparation methods, into consideration when deciding on your egg intake. As with any food, moderation and balance are key to a healthy and varied diet.
Trans fats: The Silent Killer Lurking in Your Pantry
Trans fats: The Silent Killer Lurking in Your Pantry
Lets talk about trans fatty acids AKA trans fats. I like to tell my patients that for the most part there is no food that one cannot eat occasionally even though it may not be the best for you. However, there is one food that I believe no one needs to be eating at all. It’s not sugar or chocolates if that’s what you think. Its trans fats. Some of you may have heard about trans fats, some of you my not, but I promise you that everyone is going to learn something new today.
Why are trans fats bad?Trans fats are a type of unsaturated fat that can be found in many processed foods. They have been linked to a number of health problems and are considered to be one of the most harmful types of dietary fats. Trans fats are actually worst than saturated fats that most people know as the main culprit for clogging our arteries.
What are the most significant health problems associated with trans fats?
According to recent studies, trans fats have been linked to an increased risk of heart disease, stroke, and type 2 diabetes. They have also been shown to raise levels of "bad" LDL cholesterol and lower levels of "good" HDL cholesterol in the blood.
The most significant health problem associated with trans fats is their impact on heart health. A study published in the New England Journal of Medicine found that replacing just 1% of energy intake from trans fats with energy from other sources was associated with a 2-3% reduction in the risk of heart disease. Another study published in the Journal of the American College of Cardiology found that consuming trans fats increased the risk of heart disease by 21% compared to consuming the same amount of calories from other sources.
Trans fats have also been linked to an increased risk of stroke. A study published in the journal Stroke found that women who consumed the highest amount of trans fats had a 39% increased risk of stroke compared to those who consumed the least amount.
Trans Fats and Diabetes
In addition to their impact on heart health, trans fats have also been linked to an increased risk of type 2 diabetes. A study published in the American Journal of Clinical Nutrition found that consuming trans fats increased the risk of type 2 diabetes by 40%.
Now that we've discussed the risks associated with trans fatty acids, let's dive deeper into what they are and how they're formed.
So what are trans fats?
Trans fats are a type of unsaturated fat that are produced when liquid vegetable oils are partially hydrogenated, a process that involves adding hydrogen atoms to the oil to make it more solid and stable at room temperature. This process converts some of the unsaturated fats in the oil into trans fats, which have a longer shelf life than other types of fats and are therefore commonly used in processed foods.
How are these trans fatty acids formed?Trans fats can be naturally occurring or man-made. Naturally occurring trans fats are found in small amounts in some animal products, such as meat and dairy, but they are not considered to be as harmful as man-made trans fats.
Man-made trans fats, on the other hand, are created during the process of partial hydrogenation, which was originally developed to produce a cheaper and more stable alternative to animal fats such as lard and butter. This process became popular in the food industry in the mid-20th century, as it allowed manufacturers to extend the shelf life of their products and improve their texture and flavor.
However, as we've discussed earlier, the consumption of trans fats has been linked to a number of health problems, and in recent years there has been a push to reduce or eliminate trans fats from the food supply.
Food Labeling of Trans FatsIn addition to understanding how trans fatty acids are formed, it's also important to know how they are labeled on food products. Unfortunately, the food industry has found ways to get away with putting trans fats into food without having to disclose it on the food label.
In 2015, the U.S. Food and Drug Administration (FDA) ruled that partially hydrogenated oils (PHOs), the primary source of artificial trans fats, are no longer "generally recognized as safe" (GRAS) for use in human food. This ruling effectively banned the use of PHOs in food products, but it's important to note that there are still loopholes that allow food manufacturers to use trans fats without having to disclose it on the label.
How to detect trans fats on food labels
To detect trans fats on food labels, it's important to read the ingredient list carefully. Even if a product claims to be "trans fat-free," it may still contain trans fats if it contains partially hydrogenated oils or hydrogenated oils.
For example, let's take a look at the ingredient list of a popular brand of margarine:
Water, vegetable oil blend (soybean oil, palm oil, palm kernel oil), salt, whey protein concentrate, soy lecithin, vegetable monoglycerides, potassium sorbate (used to protect quality), citric acid, natural and artificial flavor, vitamin A palmitate, beta carotene (color).
At first glance, this product may seem trans fat-free, but if you look closely, you'll see that it contains vegetable monoglycerides, which are a form of partially hydrogenated oils. This means that even though the product claims to be trans fat-free, it actually contains trans fats.
Another example is a popular brand of crackers:
Enriched flour (wheat flour, niacin, reduced iron, vitamin B1 [thiamin mononitrate], vitamin B2 [riboflavin], folic acid), soybean oil (with TBHQ for freshness), sugar, contains 2% or less of salt, leavening (baking soda, sodium acid pyrophosphate, monocalcium phosphate), high fructose corn syrup, corn syrup, soy lecithin.
Again, this product may seem trans fat-free, but it contains soybean oil, which is often partially hydrogenated to increase its shelf life. This means that even though the product doesn't list trans fats on the label, it may still contain them.
Healthy Alternatives to Trans Fatty AcidsWhile trans fats are unhealthy and should be avoided, there are plenty of healthy alternatives that can be incorporated into our diets.
Monounsaturated Fats
Monounsaturated fats are a type of healthy fat found in foods such as nuts, seeds, avocados, and olive oil. These fats have been shown to improve cholesterol levels and reduce the risk of heart disease.
Polyunsaturated Fats
Polyunsaturated fats are another type of healthy fat found in foods such as fatty fish, flaxseeds, and walnuts. These fats are essential for brain function and have been shown to reduce inflammation and improve heart health. Example is omega 3 fatty acids.
Whole FoodsChoosing whole foods over processed foods is an easy way to reduce your intake of trans fats and improve your overall health. Whole foods such as fruits, vegetables, whole grains, and lean proteins provide essential nutrients without the added trans fats and other unhealthy additives found in processed foods.
Food Preparation
The way we prepare our food can also affect its nutritional value. Instead of deep-frying or using partially hydrogenated oils, opt for healthier cooking methods such as grilling, baking, or sautéing with healthy fats such as olive oil or coconut oil.
Conclusion
In conclusion, trans fatty acids are a type of unsaturated fat that have been linked to a number of health problems, including heart disease, stroke, and type 2 diabetes. They are formed when liquid vegetable oils are partially hydrogenated. While small amounts of naturally occurring trans fats can be found in some animal products, man-made trans fats are the main source of concern when it comes to health risks. By being aware of the sources of trans fats and making healthy food choices, we can help reduce our risk of developing health problems associated with trans fats. Incorporating healthy alternatives into your diet can help reduce your intake of trans fatty acids and improve your overall health. By choosing whole foods, healthy fats, and mindful food preparation methods, we can nourish our bodies with the nutrients they need to function at their best.
Optimizing Back Pain Recovery: Best Practices
Optimizing Back Pain Recovery : Best Practices
In this article we will look at the best practices for optimizing back pain recovery. Despite the fact that back pain can cause a significant amount of pain and discomfort, it usually recovers spontaneously on its own. The speed of recovery depends on many variables. There is no one single magic remedy to speed up the recovery process. However there are certain strategies that can be used for optimizing back pain recovery to help you recover faster. Understanding that you may not have control over certain aspects of your recovery process, will also allow you to create more realistic expectations and avoid undue frustrations.
Physical fitness and age Individuals who are more physically fit and do not have other major medical conditions, generally tend to recover much faster. The body can fully focus on the healing of the injury when there are no other chronic conditions that also require attention, energy, and resources.
The smaller the number of raging fires present at the time of injury, the faster and more efficient the recovery process can be. Since most chronic conditions tend to accumulate over the years, age becomes an important player in the recovery process.
For the most part, healing is much faster in younger and healthier individuals. That is not to say, however, that growing old is always plagued with long term recovery process. A healthy and active 60-year-old individual with back strain may recover much faster than a 30-year-old sedentary obese office worker.
Prior injuriesHistory of prior back pain or the presence of other chronic musculoskeletal injuries plays a significant role in the recovery process. Individuals who suffer from chronic pain which is not well controlled, have gone through a process of so-called sensitization.
In other words, their nervous system has become more sensitive to any pain stimulus. Any new injury will, therefore, cause a lot more intense pain and take much longer to subside, despite the fact that the area of injury may be already healed.
Importance of early mobilization
When significant acute injury develops, bed rest may be necessary. It should be, however, limited to no more than 24 - 48 hours. Numerous studies have demonstrated the detrimental effect of prolonged bed rest on the recovery process.
Motion is the lotion and muscles need to move to heal. While you should not push through the pain to further aggravate your condition, gentle exercises focused on a pain-free range of motion and stretching will allow the muscles to become less stiff and maintain their flexibility.
Muscles that are not used, start to deteriorate very rapidly. They lose flexibility, mass, strength and become stiff. Intense pain with even small movements may then result from any attempt to use the stiff muscle since it will be pulling on the injured area.
Movement also creates important muscle pump which helps to increase local blood circulation. Increased blood circulation helps to flush out the inflammatory chemicals present at the site of the injury. The accumulated inflammatory chemicals irritate the nerve endings at the site of the injured area.
These chemicals are the primary reason for sensation of pain. Increased blood circulation also helps to supply the injured area with nutrients, oxygen and white blood cells that help to heal the injured tissue. Getting an early referral to a physical therapist to start the rehabilitation from acute injury is important for fast recovery and preventing the development of chronic conditions.
Application of heat versus cold
Using cold compresses for the injured muscles may be soothing in the first 24 – 48 hrs. This should be, however, followed by the application of heat to promote local blood circulation and to relax the muscle spasm.
Moist heat is preferred over dry heat, and moist heating pads, hot showers or baths work great. Heating pads can be applied to the injured area several times a day, but no longer than 20 minutes at a time.
You should never sleep on the heating pad. Exposing the injured area to the heat longer than 20 minutes at the time leads to overheating. This will trigger a protective mechanism, which may cause changes in the local vasculature and eventually decrease blood circulation in the injured area.
If pain prevents you from getting good night restful sleep, talk to your provider about prescribing short course of pain medication that can decrease the intensity of pain at night, while at the same time help you get better sleep.
Taking a muscle relaxant 30 minutes to one hour before sleep is generally a good option. However, your medical provider will be able to make more specific recommendations based on your particular condition.
Sleep and DepressionGetting a sufficient amount of sleep is important for everybody, but it is critical when recovering from an acute injury. The body heals and tissue regenerates when we sleep.
Insufficient sleep promotes systemic inflammation within our body, which slows down the healing and contributes to more pain perception. A minimum of seven, but preferably eight hours of sleep is recommended for optimal functioning and recovery.
Additionally, an insufficient amount of sleep combined with new intense pain has a strong effect on mood and may lead to depression. Whether depression results from sleep deprivation and pain or the depression has been present prior to the injury, it’s presence further intensifies pain and interferes with sleep, thus creating downward spiral leading to worse outcomes.
Complementary medicine, pain medication, and acute painAn increasing number of patients do not wish to take any pain medication when they develop acute pain from fear of their side effects. There is an ongoing battle and numerous initiatives to fight the opioid crisis around the world.
Additionally, it is also true that every medication carries a risk of side effects. This, however, doesn’t mean that taking pain medication is bad and should be avoided by all means.
It is important to understand that there is a role for pain medication in particular when it comes to severe pain. Getting pain under control as soon as possible will prevent altering the way in which our brain deals with pain.
Any uncontrolled pain lasting longer than several days can sensitize the brain to pain and lower the pain threshold. This ultimately translates to experiencing painful sensation at much higher intensity with much lover stimulus. A simple gentle touch over the painful area could, therefore, lead to severe pain.
Complementary and alternative medicine modalities have been used successfully for the management of pain and injuries for hundreds of years. Many of them have been extensively studied and their effectiveness proven in rigorous trials.
Despite their popularity, however, their role is primarily in the management of chronic pain and injuries. This is largely because their main mechanism of action, by which they help to control pain and promote recovery, is through stimulating body own healing processes and pain control.
In other words, their primary role is to restore the body homeostasis. The subtle changes they produce over time are sufficient to create a noticeable difference when treating chronic pain or injuries.
It is, however, usually not enough to promote lasting pain relief in severe acute pain Click here to read more about the complementary medicine, pain medication and acute pain.
The role of NutritionThe importance of nutrition cannot be emphasized enough when it comes to recovery from an acute injury. Providing our body with a sufficient amount of lean protein which is important for building tissue, as well as getting enough vitamin C to promote formation of collagen, is the very minimum.
Minimizing the intake of vegetable oils by decreasing consumption of fried foods and pastries and replacing them with monounsaturated fats from olive oil, canola oil, and avocados helps to decrease inflammatory process in the body.
Eating a wild salmon or other fish high in omega 3 fatty acids at least 2-3 times a week, or taking 1000- 2000 mg of mercury-free omega 3 fatty acids daily in the form of a supplement, has been also shown to decrease systemic inflammation.
Having fresh vegetables at least two times a day and eating 2-3 pieces of seasonal fruits will add much-needed vitamins and phytochemicals to act as powerful antioxidants.
Topical analgesic creamsTopical analgesic creams, ointments, and plasters have been used in many traditions to treat injured muscles and bones for millenniums. They have been made from a variety of herbs and other natural substances.
Their use not only soothes the pain but also promotes healing. A number of topical analgesic creams have been developed by the pharmaceutical industry based on these old folk remedies.
Most of these products contain some combination of menthol, capsaicin and salicylic acid. While these products have been marketed primarily to help to soothe the pain and aches, they also promote local blood circulation by stimulating special receptors on the skin.
As mentioned throughout this article, increased blood circulation in the area of pain promotes healing. The use of these products should be therefore encouraged for any musculoskeletal injury where application of topical creams is not contraindicated.
Before rubbing any of these products to the skin, try to apply only a small amount to observe for any skin reaction. You should also never apply these creams right before or after hot shower to avoid intense burning sensation.
In summary
Recovering from an acute musculoskeletal injury is a complex process. There is no one single recipe since everybody has a unique combination of factors that may either promote or hinder the recovery process.
In this article, we have covered only few of the most important aspects that exert a major influence on the recovery process. Optimizing sleep, physical activity, nutrition, and appropriate use of heat/cold and topical creams, can have significant effect on the speed of your recovery.
To learn more about complementary therapies that can be used for recovery from acute back pain, visit National Center for Complementary and Integrative Health
Back Strain: Symptoms, Causes and Treatment Strategies
Back Strain: Symptoms, Causes and Treatment Strategies
Back strain is probably the most common form of acute back pain. It affects the muscles and their tendons which attach them to various structures in the back. In general, muscle strain refers to a small tear in the muscle or its tendon. Most muscle strains tend to develop in the lower back area where the muscle changes into the tendon, but they can develop anywhere.
SymptomsA strain of the back muscles mostly causes localized pain in the area of the muscle/tendon injury accompanied by stiffness, limited range of motion and difficulties maintaining straight posture. Timing is very important when it comes to muscle strain.
Most muscle strains usually happen while lifting something very heavy or doing a sudden movement. Many individuals experiencing back pain due to muscle strain may feel a popping sensation at the moment of the injury which usually prompts them to seek medical attention.
They may have difficulties straightening their back up after the onset of the pain and usually maintain a semi bent position to avoid severe pain. That is not to say that muscle strain cannot come gradually. Even in this case, however, the individual can usually remember the moment when he felt sudden uncomfortable pain in the back which became progressively worse with activities.
Most individuals will also complain of muscle cramps in the area of their lower back. Additionally, coughing and sneezing usually brings on bouts of severe pain during acute back strain. The back muscles which tend to be the most affected by muscle strain are those right next to the spine.
Frequently, however, the pain can also be felt around the base of the spine and in the buttock area. Occasionally, pain may radiate into the buttocks. Under normal circumstances, pain due to back strain does not radiate down to the legs.
Pain radiating down to the legs is usually associated with nerve compression, but it is also frequently seen as a result of trigger points in the gluteal (buttock) muscles. Back strain is not a serious condition and most individuals with acute back strain recover spontaneously within 1 to 2 weeks.
CausesWhen muscle strain is caused by a sudden movement, it is generally a result of preexisting tightness in the back muscles which has developed over a period of time. Tight muscles are less flexible. Decreased flexibility results in limited ability to respond to sudden demands for muscle extension beyond the normal daily activity.
Therefore when the muscle is required to suddenly extend beyond its limits, such as when catching a falling object or catching ourselves from falling down, a strain can develop in the muscle or the tendon. To prevent further injury, the body triggers protective mechanism which manifests as muscle spasm.
The final outcome is stiffness and significantly limited range of motion with great amount of pain when trying to move in any direction.
Back strain can, however, develop also due to muscle overuse. In this case, the muscles and/or their tendons become strained due to repetitive movements in absence of sufficient time for recovery and repair.
Activities involving excessive forward bending of the spine constitute one of the most common misuses of the back leading to increased vulnerability to a variety of injuries. The forward bend position stretches the muscles and tendons of the back to a point where very little control can be exercised over the spine’s position.
Therefore lifting objects in forward bend positions can easily strain these muscles and their tendons. Additionally, forward bend position creates an uneven pressure on the spinal discs making them significantly more prone to injury.
Poor posture
Poor posture is one of the main underlying causes for the development of back strain. It generally refers to either too large or too small curvature in the area of the lower back. Over a period of time, poor posture leads to muscle imbalance and strain of the muscles/tendons in the back.
Spending extensive period of time in uneven position such as being twisted sideways or bent forward, also puts great stress on the spinal discs predisposing them to injury.
Poor physical fitness
poor physical fitness, excessive weight, sedentary lifestyle and lack of flexibility are also among the leading factors predisposing individuals to back strain. The result is poorly conditioned back muscles that lack sufficient strength and endurance to respond to increased physical demand when called upon.
This is why sudden unexpected movement, or performance of new repetitive task requiring the use of back muscles, easily result in back strain.
More information is available on this page.
Summary
Main SymptomsSudden onset
Localized pain & stiffness
Limited range of motion
Difficulties maintaining straight posture
Muscle cramp in the area of the lower back
CausesSudden movement
Tight muscles and lack of flexibility
Muscle overuse
Activities involving excessive forward bending of the spine
Lifting objects in forward bend position
Poor posture
Working in uneven position - twisted sideways or bent forward
Poor physical fitness,
Excessive weight
Sedentary lifestyle
Back Strain: Accelerate Your Recovery with These Tips
Back Strain: Treatment Guidelines for Back Strain
Most back strains do not require specific treatment, because they usually recover spontaneously in relatively short period of time. There are, however, certain strategies that may help you recover faster and make the process less painful. For full list of detailed recommendations on optimizing your recovery process please follow this link.
Mobility: swimming and walkingOne of the most important things to keep in mind, is that during the acute phase, it is of outmost importance to stay mobile. While short term bed rest may help to relieve some of the pain initially, staying in the bed more than 24-48 hrs leads to worse outcomes and prolongs the recovery time.
While becoming more mobile is important, you will need to initially modify your daily routine to avoid high impact activities, lifting heavy objects and twisting movements. The best way start increasing physical activity is walking for few minutes several times a day and eventually transitioning to recreational swimming in a slow pace. Swimming is excellent exercise for recovery from back injuries. It’s weightless nature eliminates gravity and pressure on the spine and takes the muscles and joints through full range of motion. Both activities will keep the muscles engaged without additional strain, and get them slowly ready for more physically demanding exercises.
HeatHeat plays important role in the treatment of back pain. It improves local blood circulation which enables the injured tissue to heal faster while decreasing muscle stiffness and pain. Applying heat to the painful area after the initial 48 hrs from the onset of the injury also helps with stretching. Additionally, heat reduces pain and makes movement easier when getting out of the bed in the morning. Heating pad should not be applied directly on the skin. While it can be used several times a day, it should never be applied for longer than 20 minutes at a time. Never sleep on your heating pad!!
Stretching, Massage and AcupunctureGentle stretching of the back muscles after using heating pad is important to slowly start elongating the tight muscles. Never push beyond the level of gentle stretch. If stretching is painful, you need to pull back. Gentle massage around the painful area can be very relaxing and soothing. You do not need to spend money on massage therapist, but if you can afford it, this might be a good time to splurge on couple sessions. Getting a simple massage from your partner at least once a day for the first few days can be equally if not more effective. Alternately, you can try self-acupressure using a tennis ball while leaning against the wall and finding the tender spots in your back. Both massage and acupressure help to promote local blood circulation and loosen up the tight muscles which results in increased mobility and less pain. If acupuncture is available to you, getting few treatment sessions can be very helpful to promote relaxation of the tight muscles, increase local blood circulation and decrease pain. For more information about acupuncture please follow this link.
The role of pain medicationWhile pain medication will not help you to recover faster, they can help to make the process more bearable. Motrin, naproxen or Alleve can be used in mild to moderate pain, to take the edge off the pain. Stronger pain medication, prescribed by your provider, may be necessary when pain is more severe.
Goals for pain management
It is very important to understand, that complete pain relief is neither realistic, nor the goal of pain medication or any treatment modality discussed in this article. Pain is a protective mechanism. It makes us start paying attention to our body and prevents us from causing further damage. Additionally, there is no single best remedy. Patience in combination with several treatment strategies placed in the context of a comprehensive treatment protocol, has been shown to lead to the best and fastest recovery.
To learn more about complementary therapies, visit National Center for Complementary and Integrative Health
Sciatica, Symptoms, Causes and Treatment strategies
Sciatica
Sciatica is a type of back pain that affects the sciatic nerve. The sciatic nerve is a large nerve that exits from the spine in the area of the low back, travels down to the buttock and continues down along the back of the thighs into the feet. It is an important nerve that branches in several places in the legs and provides nerve innervation to the legs and feet. A disc in the spine can herniate and compress the sciatic nerve causing symptoms of sciatica.
SymptomsPatients with sciatica usually experience the familiar electric jolt like sensation propagating along the back of the thighs sometimes all the way to the feet. The sensation of pins and needles or ants crawling under the skin of the legs is also frequently described by patients experiencing sciatica. The intensity of the pain varies among the patients. Some individuals experience excruciating debilitating pain that causes them to become bedridden for a couple of days, while others have only mild pain in their back and legs. While the sciatic pain usually starts in the low back and continues down the leg along the path of the sciatic nerve, the pain is usually more intense in the legs than in the back. Sciatica generally affects only one leg at a time. It is rare to see the involvement of both legs at the same time. If this is the case, it is important to seek medical evaluation to rule out other causes for these symptoms.
Most patients complain of more significant pain when they sit down. Standing for extended periods of time is also very painful and most people prefer to lay down or slowly walk around to ease their pain. Numbness and weakness in the leg are also frequently associated with sciatica. If the sciatic nerve becomes compressed in the buttock by a muscle called piriformis, it is called piriformis syndrome. The main differentiating symptoms between sciatica and the piriformis syndrome is that painful sensation caused by piriformis syndrome propagates down the leg along the back of the thighs and only up to the knees and not past the knees. The quality of the pain is also different. Pain radiating down the legs due to the Piriformis Syndrome generally feels like a dull, achy sensation unlike the electric-like, burning sensation caused by a pinched nerve in the spine causing sciatica.
CausesThere are many reasons why someone may develop sciatica. The risk factors are similar to developing any back pain. The excessive weight which creates too much pressure on the spine, sedentary occupation with lack of movement or carrying heavy objects are some of the most important causes. Aging is an independent factor that compounds any of the above risk factors because most people become more sedentary as they get older, gain weight and become less flexible. Sciatica is however not exclusive of young healthy individuals. Many individuals in the 30s present to their health care provider’s office with symptoms of sciatica after sustaining injury from doing exercises at the gym. This is usually related to lifting heavy weights, not stretching before and after exercising, as well as not getting enough rest to allow body fully recover and regenerate. To prevent flare-ups of sciatica it is, therefore, crucial to maintaining healthy weight and stay mobile.
Treatment GuidelinesWhile sciatica can be rarely caused by a bone spur or a tumor, in most cases of sudden onset of sciatica, it is related to a disc herniation. The treatment for sciatica is therefore essentially the same as for disc herniation since both share the same underlying cause. Treatment guidelines for disc herniation can be found here.
Summary
SymptomsElectric jolt like sensation in the back & back of the leg
“Pins and needles” sensation
Numbness and weakness in the leg
Burning sensation
Affects usually only one leg
More pain with sitting or standing
Pain is better when laying down or walking slowly
CausesExcessive weight
Sedentary occupation & lack of movement
Carrying heavy objects
Advanced age
Lifting heavy weights
Spinal Stenosis: Causes, Symptoms and Treatment
Spinal Stenosis
Chronic back pain can be a result of spinal stenosis. Spinal stenosis is usually seen in individuals over the age of 50 who developed significant degenerative changes in their spine from wear and tear. The medical word for these degenerative changes is osteoarthritis. Spinal stenosis is a result of the narrowing of the spaces within the spine where the spinal nerve roots are located. When the spaces get too narrow, excessive pressure on the nerves in the area develops.
SymptomsPeople affected by spinal stenosis may experience a variety of symptoms. Some individuals may have no symptoms at all, especially in the initial stages, while others may experience significant amount of pain. It is not known why some people experience more or less pain. Spinal stenosis is a degenerative disease and therefore develops slowly over period of time with gradually worsening symptoms. Most individuals experience tingling and numbness in their buttocks, legs, and calves, especially after prolonged walking. Walking up the hill or up the stairs is particularly painful, but even walking down the stairs can lead to significant amount of pain. In more advanced cases, weakness of the legs, pain, and cramping in one or both legs and feet can present with prolonged standing or walking. In severe cases, an individual may not be able to walk more than few blocks before severe pain develops.
Urination and bowel movement can also be occasionally affected as a result of the pressure on the spinal nerves that control these two essential physiologic functions, and the individual may develop urinary urgency and incontinence. In general, the back pain from spinal stenosis gets better with sitting down for a few minutes. Sitting flexes the spine and this relieves some of the pressure on the nerves. Many individuals with severe spinal stenosis, therefore, walk stoop forward and keeping their torso slightly flexed to lessen the pain while walking.
CausesThere are several reasons why spinal stenosis may develop. The most common causes include osteoarthritis and bone spurs. Osteoarthritis is one of the forms of arthritis. It is a result of wear and tear that affect the protective cartilage on the ends of the bones. When osteoarthritis is present in the spine, it can cause over time narrowing of the spinal canal, which eventually results in spinal stenosis. When bone spurs develop as a result of long term wear and tear, the spurs may grow inside of the spinal canal and cause pressure on the spinal nerves. Less frequent causes of spinal stenosis include a spinal tumor and a car accident. In both of these cases, there are usually several other prominent symptoms that point out to that diagnosis.
Treatment guidelinesIn mild cases of spinal stenosis, a conservative treatment approach is recommended. This may consist of physical therapy and strength training, stretching, short term course of acupuncture, daily stretching, swimming, Tai Chi or Yoga exercises. The goal is to keep the back muscle flexible and relaxed as much as possible. Building core strength is also important to properly distribute the weight and decrease the load on the spine. Losing excessive weight is crucial for the successful management of back pain. Carrying less weight translates to less pressure on the lumbar area of the spine from the excessive forward pull of the abdomen.
In more severe cases when the benefits of conservative treatment have been maximized, but pain continues to significantly affect the quality of life, surgery may be necessary. This should be however the last resort since there are inherent risks to any surgical procedure. It has been recommended, that only when all other treatment options have been exhausted, and the individual’s quality of life as it is now is poor, surgery should be considered as a possibility to improve current quality of life.
For more information about spinal stenosis you can visit the Mayo Clinic Spinal Stenosis page
Acute Pain Management: A Guide to Complementary Therapies
Acute Pain Management: A Guide to Complementary Therapies
Increasing number of patients do not wish to take any pain medication when they develop acute pain from fear of side effect. There is an ongoing battle and numerous initiatives to fight the opioid crisis around the world. It is also true that every medication carries a risk of side effects.
Complementary medicine such as acupuncture, massage, yoga and meditation has been used to ease the pain and treat acute and chronic injuries long before contemporary medicine became the standard of care. The question arises, should we shy away from conventional pain medication for controlling acute pain and focus primarily on complementary modalities, because they are generally safer and mostly free of side effects?
In this post I will try to present unbiased view of both sides and attempt to come up with the answer that I have found in my practice most successful.
Conventional medicine and acute painConventional pain medication maintains a bad rap in minds of many people. This is especially true for those who are more in tuned with their body and look for complementary medicine as the primary treatment option for their daily maladies.
While managing daily aches and pains with stretching, massage, yoga or acupuncture is definitely very reasonable and preferred option, situation slightly changes in case of intense acute pain.
It is important to understand that there is a role for pain medication when it comes to severe pain. Getting your pain under control as soon as possible will prevent altering the way your brain deals with pain.
Any uncontrolled pain lasting longer than several days can sensitize your brain to pain and lower your pain threshold. This ultimately translates to experiencing pain from similar injury in the future at much lower level than before.
Complementary medicine and acute pain Complementary medical modalities have been used successfully for management of pain and injuries for hundreds of years. Many of them have been extensively studied and their effectiveness proven in rigorous trials.
Despite their popularity, however, their primary role is generally seen in management of chronic conditions. This is largely because their main mechanism of action, by which they help to promote recovery, is through stimulating body’s own healing processes and pain control.
In other words, their primary role is to restore the body homeostasis. The subtle changes they produce over time are sufficient to create a noticeable difference when treating chronic pain or injuries.
It is, however, usually not enough to promote lasting pain relief in severe acute pain. But that doesn’t mean these modalities cannot be used successfully even in cases of significantly severe pain.
There are many practitioners who are quite skillful and capable to accomplish “miraculous” results. This author has treated successfully many patients with significant amount of acute pain in his own private practice with acupuncture and herbal medicine.
The problem with using modalities such as acupuncture for treatment of severe acute pain, becomes with the access to these skillful practitioners and the associated cost. In case of acupuncture, it takes years of experience, and additional training in treatment of musculoskeletal injuries to treat patients with severe acute pain, to achieve reliable results.
When seeing an acupuncturist for treatment of chronic conditions, weekly sessions are generally sufficient to achieve great results. This is, however, not true in case of significant acute pain.
To successfully treat an acute pain, the practitioner will need to see the patient generally up to three times a week for the first two weeks and usually will also prescribe an herbal formula. At the average cost of $70 -$100 per office visit, this can easily add up to $300 - $400 a week x 2.
This also does not account for the travel time to and from the office and lost work. Compared to a small co-pay for an office visit with a primary care provider and pain medication if the patient has a medical insurance, this becomes a significant financial burden that majority of patients cannot afford. Just because it is possible, doesn’t therefore mean that it is always feasible and the right thing to do.
Eclectic Approach An eclectic approach to pain management is in this author’s opinion the best. In the eclectic approach, the patient uses combination of several modalities which complement each other to achieve the best result.
Combining one or several complementary modalities such as acupuncture, acupressure, massage, yoga, breathing exercises and meditation along with pain medication, will have much greater effectiveness than using any of them as a standalone modality.
This combined approach takes the best from both worlds so to speak. The complementary medical modalities slowly work on helping the body recover faster, while pain medication helps to control the acute pain and allows the patient to focus on the recovery process.
Getting sufficient amount of sleep, staying physically active and following an anti-inflammatory diet will further maximize the healing. For more details on how to optimize your recovery process follow this link.
To learn more about complementary therapies, visit National Center for Complementary and Integrative Health
Disc Herniation: Understanding Symptoms, Causes, and Treatments
Disc Herniation
Disc herniation is a result of a disc protruding out of the spine. The disks in the spine are important structures for providing space and cushioning between the individual bones (vertebras) in the spine. The disk is a round soft cushion which has a soft jelly-like consistency in the center and tougher outer part providing for the structural integrity. When too much pressure is generated on the disc, the tough outer part can break and small tear develops. The inner soft part can protrude outside of the disc and irritate or push against the nearby nerves causing pain and other symptoms. Herniated disc doesn’t always cause pain, and there are some individuals who only find out about disc herniation accidentally when imaging of their torso is done for other purposes. Studies indicate that 41% of disk protrusions and up 71% of more severe disk extrusions eventually resolve spontaneously.
SymptomsThe symptoms related to disc herniation can vary not only in intensity but also in presentation. The major differentiating factor is whether the herniated disc touches the spinal nerve or not. If the disc is not touching the nearby spinal nerve, the affected individual may only experience low-grade back pain which is worse with certain movements. If, however, the disc is touching a spinal nerve and causing impingement of the nerve, the pain is typically more intense. There will be also other associated symptoms based on the level of the spine where the herniation occurred. In most cases of disc herniation in the lower back, when the herniated disc is impinging on the spinal nerve, the pain will be mostly felt in the buttock and in the legs rather than in the low back. Radiating pain may, in some cases, reach all the way down into the foot. This is usually described as sciatic pain.
The symptoms of electric shooting pain radiating down the leg usually resolve fairly soon with or without any treatment, however, the numbness may be present for several months. In severe cases of herniation, the numbness can become permanent, and it may never completely resolve. Many individuals also develop weakness in the leg supplied by the affected nerve and may have difficulties maintaining a steady gate. It is important for the individual developing this type of back pain, to contact their provider immediately if they notice new changes in their bowel movement or urination. A condition called Cauda Equina can result from impingement of the nerves controlling bowel movement and emptying the urinary bladder. The affected individual may develop difficulty emptying their bladder and present with loss of sensation in the area of the buttock that would be in contact with a horse saddle- hence called saddle anesthesia. This is a serious complication of disc herniation that requires a surgical intervention to prevent permanent nerve damage.
CausesWhile the exact cause of disc herniation is usually hard to elicit, it is generally associated with more advanced age and activities involving heavy lifting and or twisting movements. As we age, the tough outer layer of the disc becomes more fragile as it undergoes degeneration. The disc also loses some of the inner soft cushioning jelly-like substance. This makes the disc more fragile and prone to rupture when it is exposed to sudden twisting movement or excessive load. Young individuals engaged in strenuous jobs or sports activities that require heavy lifting, especially when combined with twisting movements, are at great risk for disk herniation due to the instability that this combination of pressure and twisting movement creates in the spine. Additionally, having tight muscles that attach to the individual vertebras above and below the disc, can also predispose the individual to disc herniation by keeping the disc under constant pressure. In such cases, a small innocent movement such as picking up a pen from the floor can be the final hit for rupturing the disc and causing herniation.
Treatment guidelinesPain due to acute disc herniation can be very debilitating. Unless there are, however, any so-called red flags, which your provider will rule out during his physical exam, there is no need for any invasive procedures to treat acute disc herniation. Most patients will feel significantly better in 4-6 weeks, and they will fully recover in 3-4 months. Conservative treatment is therefore recommended as first-line therapy. There are a number of treatment options and all of them help to some extent in the recovery process. Their selection depends on availability and personal preference. Making certain changes to your daily routine can also speed up the recovery process. You can read more about optimizing your recovery process here. During the acute onset of symptoms, bed rest can be helpful for one to two days. Being inactive and staying in bed longer than two days has been associated with worse outcomes. Motion is the lotion, therefore early referral to physical therapy to learn appropriate mobilization and stretching exercises is very important for successful rehabilitation. Pain medication such as Motrin or Naproxen can help ease some of the pain, but if this is not sufficient, talk to your provider about using additional pain medication for short period of time. After initial 24-48 hrs from the onset, hot baths or heating pads applied for no more than 20 minutes can also help loosen up the muscle spasm and relieve some pain. This should be followed by gentle stretching. Avoid sitting for extended periods of time and walk slowly avoiding any sudden movements. If heated pool or larger Jacuzzi tub is available, stretching for 15- 20 minutes in the warm water and doing gentle ranges of motion can also be very helpful.
Uncovering the Truth About Sore Throat: Separating Fact from Fiction
Uncovering the Truth About Sore Throat: Separating Fact from Fiction
Sore throat, also known as pharyngitis, is a common condition that most people will experience at some point in their lives. The question is, when is a sore throat just a normal occurrence and when should you be concerned? In this blog post, we will discuss the causes of sore throat and provide insights into how to determine if it is caused by a virus or bacteria. We will also delve into the topic of streptococcal infection and address some common misconceptions about the testing and treatment of strep throat.
How to Tell if You Have Strep Throat?
It can be difficult to differentiate between viral and streptococcal causes of sore throat without laboratory testing, as the clinical presentation is similar. Typically, 70-90% of sore throats are caused by viruses, while only 5-15% of children and 5-10% of adults have strep throat each year. Indicators that point towards a viral cause of sore throat include symptoms like a runny nose, cough, or hoarseness.
Strep throat with exudate over tonsils
Do We Need to Test Every Person with Sore Throat for Strep?
No, testing for strep is not necessary in most cases. Criteria like age, symptoms, and risk factors can help categorize patients with sore throat and determine the likelihood of streptococcal pharyngitis. Generally, younger children and adolescents have a higher risk of streptococcal pharyngitis, but most sore throats in this group and in adults are still caused by viruses.
Strep: Separating Fact from Fiction
Most people worry that if they have strep and don’t get the antibiotic to kill the bacteria, something bad will happen. However, most people with proven strep will recover normally even without antibiotics. It’s a common misconception that streptococcal pharyngitis must be treated with antibiotics or bad consequences will result, but it’s still important to make the diagnosis and treat it with antibiotics if found to be the cause of sore throat.
Serious Conditions that Present as Sore Throat
There are conditions that present as a sore throat but can be serious, such as Epiglottitis, Retropharyngeal abscess, Peritonsillar abscess, Mono (mononucleosis), and Covid-19. Symptoms such as breathing difficulties, severe pain when swallowing, neck pain, and difficulty swallowing, among others, can indicate a serious underlying condition. It is important to seek medical attention for proper diagnosis and treatment.
Viral Pharyngitis vs Strep
There are four signs and symptoms known as The Centor Criteria used to diagnose strep throat in adults. They are: tonsillar exudates (pus on the tonsils), swollen and tender neck glands, absence of cough, and fever or history of fever. These criteria are used in primary care to determine if a person with sore throat needs a strep test. A rapid strep test is done if the Centor criteria are positive, and if it’s positive, treatment with antibiotics is usually prescribed.
Rapid Strep and Throat Culture
If a patient meets the Centor criteria, a rapid strep test is done. This involves taking a swab of the throat and tonsils, and results are usually available within 15-20 minutes. If the test is positive, the patient likely has strep and is treated with antibiotics. However, a negative result is not always definitive, so the provider may conduct a throat culture to confirm the results. This depends on the patient’s risk factors and Centor score. The culture results take 2-3 days.
The Significance of White Exudate on Tonsils
Many patients come to our emergency department concerned about white spots on their tonsils. A little white spot on the tonsils is not considered exudate, but rather a small white material that can collect in the tonsil crypts. Exudate, however, refers to the white, creamy substance covering the tonsils, which may or may not be related to strep throat.
Why Do We Treat Strep Throat?
One of the most common reasons for treating strep throat with antibiotics is to prevent the spread of infection to others. Strep throat is highly contagious, and the bacteria can be spread through coughing, sneezing, or even just talking. By treating strep with antibiotics, you reduce the amount of bacteria in your body, making it less likely that you’ll spread the infection to others.
Another reason we treat strep with antibiotics is to reduce the risk of complications. While most people will recover from strep throat on their own, some may develop serious complications, such as rheumatic fever or kidney inflammation. Antibiotics can reduce the risk of these complications and help prevent the spread of infection to others.
Over-Treating Sore Throat: The Dangers
While treating strep throat with antibiotics is important, over-treating with antibiotics is also a problem. Overuse of antibiotics can lead to antibiotic resistance, which makes it harder to treat infections in the future. In addition, antibiotics can have side effects, such as nausea, diarrhea, and life threatening allergic reactions.
The myth of misdiagnosing strep throat also contributes to over-treating sore throat. Many people believe that missing the diagnosis of strep throat is dangerous, but this is not the case. In most cases, the symptoms of strep throat will go away on their own even without antibiotics. However, it’s still important to seek medical attention if you suspect you have strep throat or if you have other symptoms that indicate a more serious underlying condition.
In conclusion, sore throat is a common condition that most people will experience at some point in their lives. It’s important to differentiate between viral and bacterial causes, as this will determine the best course of treatment. While strep throat is a serious condition that should be treated with antibiotics, over-treating with antibiotics is also a problem. The Centor Criteria can help determine if a person with sore throat needs a strep test or antibiotics, and a rapid strep test or throat culture can confirm the diagnosis. If you’re experiencing symptoms of sore throat, seek medical attention to determine the best course of treatment.
While sore throat can occur at any time, strengthening your immune will allow you to have more resiliency to both viral and bacterial throat infections. Herbal remedies such se these three top immune boosters can be a great addition to overall holistic boost for your immune system. To learn more about complementary therapies, visit National Center for Complementary and Integrative Health
Sinusitis Nasal Rinse: how to prepare herbal nasal rinse
Sinusitis Nasal Rinse
A nasal rinse, also known as nasal irrigation or a sinus rinse, can help to clear out mucus and debris from the nasal passages. This can help to relieve symptoms of nasal congestion, runny nose, and sinus pressure. It may also help to reduce the risk of sinus infections and improve overall nasal and sinus health.
Follow the steps below to create a great homemade nasal rinse
Ingredients:
1/4 teaspoon of non-iodized salt
1/4 teaspoon of baking soda
8 ounces of warm water
Instructions:
Mix the salt and baking soda in a cup or small bowl.
Slowly pour the warm water into the cup or bowl and mix until the salt and baking soda are fully dissolved.
Fill a nasal irrigation bottle or neti pot with the saltwater solution.
Lean over a sink, and using the bottle or pot, gently pour the solution into one nostril, allowing it to flow out the other nostril.
Repeat the process on the other nostril.
Blow your nose gently to remove any remaining solution.
Note: It is important to use sterile water or saline solution, distilled, micro-filtered (through 0.2 microns), or commercially bottled water.
You can also use pre-made saline solutions which are easily available in the market.
To make a herbal nasal rinse follow the directions below:
Directions
We prefer to use a tea bags that prevents the bits of herbs to get into the solution or a tincture.
Chamomile, Echinacea and Goldenseal are three herbs that can be used in combination for effective herbal nasal rinse. Echinacea and Goldenseal are best used as a tincture. Mixture of both herbs is available from many retailers in a single bottle. Add tincture into prepared solution according to manufacturers recommendations.
Steep the herbs in the water in a covered heat-proof container for 10 to 15 minutes.
Strain the herbs out of the tea through a coffee filter to remove all the little bits of herbs from the solution.
Add the salt and optional baking soda and stir well to dissolve.
Once the liquid has cooled until just warm or at room temperature, use it in your neti pot to wash out your sinuses.
Make sure your neti pot is cleaned out and sanitized after each use.
If you are really stuffed up you may want to do steam inhalation before the nasal wash to loosen up mucus.
To learn more about complementary therapies, visit National Center for Complementary and Integrative Health
Facet Joint Syndrome: A Silent Cause of Chronic Pain
Facet Joint Syndrome
Back pain can be caused by degenerative changes and inflammation in the facet joints which is commonly referred to as a Facet Joint Syndrome. The spine is made up of individual vertebral bodies which are stacked one on top of another. On each side of the vertebral bodies are tiny joints called facet joints. Their primary role is to allow the spine to move and make twisting and bending movements. They also keep the individual vertebras from moving too far forward or twisting without limits. Most facet joint-related pain is seen among individuals over the age of 60 secondary to osteoarthritis. It is, however, not uncommon for younger very active individuals to experience the same pain after engaging for several years in exercises that put lots of stress on the facet joints.
SymptomsWhen the facet joints become inflamed because of injury or arthritis, they will generate pain. Acute presentation of facet joint pain may resemble those caused by a herniated disc and at this stage it may be difficult to differentiate between these two. In most case the individual can pinpoint the area of pain indicating involved facet joint. At time, however, the person may experience diffused poorly localized pain in the lower back, hips, and buttocks on both sides. Most patients presenting with pain due to facet joint inflammation have difficulty bending backward which may help to establish the diagnosis. In some cases, the facet joint pain may project pain down to the legs and mimic the sciatic pain. Unlike sciatica, where the pain may project all the way down to the feet, facet joint pain usually terminates at the level of the knees. Only in rare cases the pain may project all the way down to the feet. This is usually seen when osteophyte is causing pressure on the nerve root.
CausesThe major cause for the development of facet joint syndrome appears to be osteoarthritis of the facet joints. Osteoarthritis is generally a consequence of wear and tear. It is characterized by narrowing of joint spaces, loss of joint cartilage and local joint inflammation. This process is similar to the more familiar knee osteoarthritis which is a well-known cause of knee pain among the elderly population. It has been shown that younger individuals suffering from facet joint syndrome tend to have history of strenuous jobs prior to the age of 20 which puts them at high risk for early osteoarthritis of the facet joints.
Diagnosis & Treatment guidelinesInflammation of the facet joints is generally not well diagnosed by MRI or X-Rays. There is also a poor correlation between the findings on the images, physical exam by the provider and the symptoms that the patient experiences. In most cases injection of an anesthetic medication into the vicinity of the painful facet joint can help to make the diagnosis. If the patient experiences immediate pain relief after the injection, the condition can be diagnosed as facet joint syndrome and steroid injections can then be administered to decrease the local inflammation. The steroid injections are usually administered by pain specialists under fluoroscopy which helps to guide the needle placement. The patient may receive these injections every 3-6 months based on the duration of symptoms relief.
Acupuncture treatment can also be beneficial since needling the musculature in the affected area can improve local blood circulation and decrease the inflammation and muscle tension. Referral to physical therapy to learn appropriate core strengthening and stretching exercise is important in long term management and prevention of further exacerbation.
Avoiding activities that put undue stress on the spine is as important, if not the most important aspect of any long term management of facet joint syndrome. No treatment will be effective if these perpetuating factors are not effectively addressed and appropriate modifications incorporated into daily lifestyle.
Chronic Back Pain: Treatment Options for Chronic Back Pain
Chronic back pain continues to be one of the most common musculoskeletal complains seen in primary care. It is estimated that the incidents of chronic back pain will continue to rise given our increasingly more sedentary lifestyle. While research in the areas of pain management and safer surgical procedures continues, both should be viewed as the last resort.
Self-AcupressureSelf-acupressure can be applied to the specific trigger points in the affected musculature by the patient at home on daily bases. It can be used as a sole treatment for the management of mild to moderate back pain. Self-acupressure can be also used along with any other modality to reinforce the treatment effect and promote faster recovery. More information about acupressure can be found by clicking on the tab on the left-hand side of this page.
Physical Therapy
Physical therapy is frequently used as a part of an overall treatment protocol to treat acute or chronic back pain. The goal of physical therapy is to relieve pain, help the body in the healing process, and restore normal functional pain-free movement. A physical therapist can prescribe specific rehabilitation exercises alone or in combination with dry needling, TENS, heat application, soft tissue release or gentle manipulations. Physical therapy is generally initiated if the injury is not spontaneously recovering with conservative treatments within 2-6 weeks. In case of severe acute back pain, however, a referral to physical therapy can be initiated right away. For more information click on the tab on the left-hand side.
Acupuncture and Dry NeedlingAcupuncture and dry needling are both very safe therapeutic modalities. Dry needling is mostly available to the patients through the department of physical therapy. The carefully selected patients which may benefit from dry needling usually receive a series of dry needling sessions as part of their physical therapy treatment plan. There are some primary care providers who have been trained in dry needling. They may offer this treatment modality to their patients on limited bases given their busy schedule. Acupuncture is available to patients only from licensed acupuncturists or physicians with training in medical acupuncture. For more information about Acupuncture and Dry Needling please click on the tabs on the left-hand side of this page.
Pharmacologic management
Pain medications play an important role in the management of chronic back pain for many patients. Some patients rely on a daily dose of pain medication to control their pain and there is a definite role for pain medication in the management of chronic pain. It is important to point out, however, that the medication should not be relied on as the sole long term strategy to keep chronic pain under control. This passive approach generally leads to further deconditioning, the need for increasing the dosages of medication and inherently to more side effects associated with their daily use. Appropriate use of pain medication can be, however, an integral part of a comprehensive treatment plan when used under the guidance of a qualified health care provider. In general, the pain medication should be used at the minimal effective dose and for the shortest amount of time, unless directed otherwise by the health care provider.
Surgical procedureNo surgical procedure is risks free. Formation of scar tissue and the need for subsequent surgery are known complications. Surgery should be therefore reserved only for rare cases. These generally include instances where all other treatment options have been exhausted. In these cases either the pain cannot be successfully controlled by any other intervention or there is a significant functional deficit that can be improved by the surgical procedure.
The information provided on these pages is not intended to treat or diagnose any condition and should be viewed solely for the purpose of education. By no means is this information replacing evaluation by a qualified health care provider. For detailed Terms and Conditions, as well the use of cookies by this website, please see the sections “Terms and Conditions” and “Privacy.”
For more information on Acupuncture and other complementary therapies visit Alternative, Complementary & Integrative Therapies: Acupuncture/Acupressure
Chest Stretching Exercises
Chest Stretching Exercises
The videos on this page demonstrate several exercises that help with stretching chest muscles. Shortened chest muscles result in rounded shoulders and upper back AKA "hunching". Rounded shoulders lead to increased stress on the low back muscles due to excessive pull on the back muscles.
If you have tendencies to hunching, add a couple of these exercises to core stretching exercises for specific muscles involved in your back pain. Learn the proper technique as demonstrated in the videos and perform them daily as part of your regular routine.
Lower Back Stretching Exercises
Lower Back Stretching Exercises
The videos on this page demonstrate several exercises that help with lengthening lower back muscles. These exercises are a fantastic addition to core stretching exercises for specific muscles involved in your back pain. Pick several of these exercises, learn the proper technique as demonstrated in the videos and perform them daily as part of your regular routine.
Back Pain and Physical Therapy
Physical therapy is frequently used as a part of an overall treatment protocol to treat acute or chronic back pain. The goal of physical therapy is to relieve pain, help the body in the healing process, and restore normal functional pain-free movement. A physical therapist can prescribe specific rehabilitation exercises alone or in combination with dry needling, TENS, heat application, soft tissue release or gentle manipulations. Physical therapy is generally initiated if an injury is not spontaneously recovering with conservative treatments within 2-6 weeks. In case of severe acute back pain, however, a referral to physical therapy can be initiated right away.
Individualized treatment and workout plansPhysical therapists can review with patients their daily routine and help them identify the major aggravating factors that continue to flare up their back pain or prevent the maximal recovery. They will thoroughly asses the patient’s condition and create an individual exercise treatment plan. Physical therapists can help the patient tailor a specific work out routine that will help them achieve their personal fitness goals without aggravating their back pain. Additionally, physical therapists are the top authority to teach patients the correct execution of individual exercises to prevent future injuries. Incorrectly performed exercises continue to be the leading cause of many exercise-related injuries. Incorrectly performed exercises can lead to permanent joint or back injury.
Summary
Physical therapy is an integral part of any comprehensive treatment approach to chronic back pain. In some cases, physical therapy can be, however, beneficial also in acute cases of back pain. Physical therapists often incorporate variety of techniques and tools when designing their individual treatment plan. Imaging is usually not needed in most cases of uncomplicated chronic and acute back pain but imaging studies can be ordered by the physical therapist if it is indicated. Physical therapists are top experts in designing individual workout routines that will help patients achieve their fitness goals without risking further injuries. Lastly, physical therapy only works if patients become active participants.
