Dr. Jeffrey I. Kennis,  D.C.
205 Commercial St.
Boston, MA 02109
NORTH END

( 617)720-2329


 

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Posts for: April, 2019

Our Sciatica Video Helps You Visualize the Pain

If you think sciatica is a confusing topic, you are not alone. So we're here with a video walk-through to help you better understand both the causes of sciatica and the associated symptoms:

See What You Need to Know About Sciatica


Sciatica is a symptom of an underlying medical condition, not a medical diagnosis.
Watch:
Sciatica Animated Video

Video highlights

As you can see in the image above, your sciatic nerve is quite long. It stretches from your lower back down through the back of both legs and into your feet; making it the longest nerve in your body.

While sciatica symptoms are often felt through your leg, the source of the problem is actually in your lower back (where your sciatic nerve roots originate).

Causes of sciatica

Often, the underlying cause of sciatica is a spinal disc problem. This may be a herniated disc or a degenerated disc (caused by degenerative disc disease) that affects a sciatic nerve root adjacent to your disc.

See Lumbar Degenerative Disc Disease (DDD)

Degenerative disc disease occurs when one of your discs start to break down, dry out, and flatten. This process usually occurs over time due to ordinary wear and tear.

See The "Degenerative Cascade" of a Degenerating Disc

Disc degeneration can release proteins (pictured above as small white dots) that may irritate the nearby nerve root.

Sciatica symptoms

Typically, sciatica symptoms are felt on only one side of your body.

You may experience numbness, tingling, or radiating pain through your buttocks, leg, or foot. Which symptoms you experience depends in part on your unique anatomy and which of your nerve roots is affected.

Sciatica may also be referred to as lumbar radiculopathy, which is the same thing.

See Radiculopathy, Radiculitis and Radicular Pain

Sciatica treatments

While treatments can vary based on the specific underlying condition causing your sciatica, most people can benefit from the following treatments:

See Sciatica Treatment

It is important to note that certain kinds of stretches and exercises can make your symptoms worse. So the first step in treating your symptoms is to have your doctor accurately diagnose the underlying cause of your symptoms.

After you uncover the underlying cause, your doctor can help you create a treatment program that is tailored to your specific needs.

The good news is that surgery is rarely needed to treat sciatica symptoms, and symptoms typically subside within 6 to 12 weeks.

 

Learn more:

Types of Sciatic Nerve Pain
When Sciatica Pain Is a Medical Emergency


Back Extension Exercises for Osteoporosis

People affected by osteoporosis face a heightened risk for small compression fractures in the spine. But you may be able to lower your risk of sustaining them. A study by the Mayo Clinic has shown that people who regularly strengthen their back extensor muscles experience significantly less osteoporosis-related fractures than people who don’t.1 Here are 3 exercises to help you strengthen these muscles and manage your osteoporosis:

Beginner back extension exercise


Strengthening the back muscles can help significantly decrease the occurrence of osteoporosis-related compression fractures. Read When Back Pain Is a Spine Compression Fracture

This exercise calls for you to bend your spine backward.

  1. Lie flat on your stomach with your forearms on the ground next to you, tucked in close to your sides.
  2. Raise your chest off the ground while keeping your hips, legs, and feet relaxed and in contact with the ground. Your elbows should be directly under your shoulders.
  3. Hold this position for 5 seconds before gently lowering yourself back to the ground
  4. Work gradually up to 30 seconds per repetition.

Aim to complete 10 repetitions.
See Pain Relief from McKenzie Treatment

 

Intermediate back extension exercise

Here’s a slightly more advanced form of the previous press-up exercise:

 

  1. Lie face down on your stomach and place your hands on the ground next to you, about level with the bottom of your ribcage (push-up position).
  2. Push through your arms, straightening your elbows. Lift the top half of your body off the ground while your lower body remains pressed against the ground.
  3. Arch or sag your back and try to relax your lower body.

This position is typically held for 1 to 2 seconds and repeated 10 times.
See Back Strengthening Exercises

 

Advanced back extension exercise

Here’s an advanced extension exercise that targets your upper back muscles:

 

  1. Lie face down on your stomach with a pillow tucked under your hips.
  2. Extend your arms back. You may want to clasp together your hands behind your lower back.
  3. Raise your head and chest off the ground.
  4. Hold this position for 5 seconds while looking at the ground.
  5. Gradually work up to 20 seconds at a time. Aim to complete 8 to 10 repetitions of this exercise.

One modification of this exercise instructs you to lift your legs off the ground as well. A doctor or physical therapist can help you find the variation that works best for you.

See Exercise and Back Pain

These exercises may not only help to increase your bone mass but also strengthen your muscles, which can better protect you from a fall or other trauma. It is recommended you perform these exercises with the guidance of a health care provider.

See Physical Therapy Benefits For Back Pain

 

Learn more:

Vertebral Fracture Symptoms
Osteoporosis Treatment


5 Tips for Flying Back Pain Free

If you're like most people with back pain, you dread the thought of a long flight.
But sometimes plane trips are unavoidable, so here are 5 tips for flying back pain free:
See Lower Back Pain Symptoms, Diagnosis, and Treatment


Sitting can cause pain from lower back muscle strain to flare-up.
Read:
Pulled Back Muscle and Lower Back Strain

1. Move around regularly

Sitting in the same position for a prolonged period puts a great deal of stress on your lumbar spine (lower back). To minimize the impact of this stress, get up to walk and stretch your back every 20 to 30 minutes.

See Stretching for Back Pain Relief

To avoid any confusion, bring a doctor's note and alert the crew prior to boarding that you have a back condition and will need to move around. It is also helpful to make your way to the back of the plane to minimize disruptions.

See Diagnosing Lower Back Pain

2. Schedule smart

Booking a flight at a time of day when the plane is less likely to be full will make it easier for you to get up and move around regularly. Additionally, with no one sitting next to you it will be easier to move and stretch while remaining in a sitting position, and to change sitting positions as needed.

Watch: Seated Chair Hamstring Stretch for Low Back Pain Relief Video

It will also be easier to retrieve your belongings from under the seat in front of you without twisting and straining your lower back.

Watch: Lower Back Strain Video

As a general rule, flights that arrive between 6 and 7 a.m., as well as 1 and 2 p.m., are likely to be less full.

3. Support your spine

Bring a back roll or ask for extra pillows to put behind your back to help minimize slouching. Over the course of several hours, this can prevent significant pressure on your lumbar spine and associated pain.

See Different Types of Pillows

If you are on the shorter side, bring something to prop up your feet to keep your knees at a right angle. You may also want to splurge for a first-class or business-class seat.
 

4. Bring heat and/or cold therapy

When you first sit down in your seat, applying heat therapy can help help loosen up your muscles and minimize stiffness. After a few hours, applying cold therapy can help cool pain and inflammation provoked by excessive sitting.

See Heat Therapy Cold Therapy

To help avoid issues with security, you can bring small plastic bags to fill with ice at the airport. Additionally, you can purchase disposable heat wraps that deliver low-level heat over the course of several hours.

See Benefits of Heat Therapy for Lower Back Pain

5. Engage your mind

It seems too simple, but specific imagery techniques can help reduce your experience of lower back pain while flying.

See 11 Chronic Pain Control Techniques

One simple technique you can try is mental anesthesia. All you need to do is picture an injection of numbing anesthetic (like Novocain) going into your lower back. Additionally, you can imagine a soothing and cooling ice pack being placed onto your lower back.

See Chronic Pain Coping Techniques - Pain Managemen

I hope all of the above advice will help keep your back healthy and happy on your next flight.

Learn more:

Ice Massage for Back Pain Relief
Easy Exercise Program for Low Back Pain Relief


If you’re dealing with back pain, you might benefit from online resources that offer additional treatment options and increased engagement. A study published in the journal Nature found that participants who completed a 12-week internet-app-based care program reported less lower back pain and interest in surgery than before.1

Image of a couple looking at a cell phone on their couch.

A recent study found that participation in an internet-app-based care program may help improve lower back pain. Read Lower Back Pain Symptoms, Diagnosis, and Treatment

App-based program improves lower back pain

All study participants had lower back pain and were divided into two groups:

  1. Participants in the first group were given tablet computers with an app that provides remote access to sensor-guided exercise therapy, education articles, cognitive behavioral therapy, team discussions, symptom tracking, and personalized coaching.
  2. Participants in the control group received only three education articles.

See Early Treatments for Lower Back Pain

Throughout the study, all participants maintained access to treatment as usual, such as doctor visits, medication, and diagnostic imaging.

Participants who completed the digital program on average logged 44.8 workouts, read 9.2 online education articles, completed 1.7 cognitive behavioral therapy sessions, and posted on the app’s feed 6.3 times. Here’s what the study revealed:

  • People who completed the program improved their pain outcomes by an average of 52% to 64%.
  • Participants reported a 52% decrease in average interest in surgery to treat their lower back pain, while the control group showed a 53% increase in average interest in surgery.

See Lower Back Pain Symptoms

At the end of 12 weeks, the people who consistently engaged with multiple non-invasive treatments through the app reported significantly less pain and interest in surgery than the people in the control group.

See Surgery for Lower Back Pain

Education, coaching, and community may help improve lower back pain

This study suggests that educational resources, group support, 1-on-1 coaching, and self-tracking—administered remotely through an app—may be helpful additions to standard lower back pain treatment protocol. However, this study was small and other studies have been inconclusive, so further research on the digital component of care is needed.

See Non-Surgical Treatments for Lower Back Pain

Actively engaging in your recovery, whether it’s through an app or not, can lead to health benefits. In addition to discussing your pain with a doctor, you may want to consider:

  • Reading peer-reviewed articles on back symptoms or treatments
  • Joining a forum and connecting with other people who have similar back pain experiences
  • Trying cognitive behavioral therapy with a therapist or on the internet
  • Performing exercises under the guidance of a health care provider

See Back Strengthening Exercises

If you have found limited or no success with non-invasive treatments for lower back pain, your doctor may discuss with you such options as injections, prolotherapyradiofrequency ablationspinal cord stimulators, or surgery.


The best office chair is largely based on personal preference, but there are several ergonomic features you may want to look for when making your selection. This quick guide will get you started.

Illustration of a man sitting at a desk in an ergonomic chair

When choosing an ergonomic office chair, consider features like lumbar support, adjustable armrests and height, high backrest and headrest, and a deep seat. Read Office Chair: Choosing the Right Ergonomic Office Chair

Office chair features to look for

Typically a comfortable, supportive office chair is designed with several ergonomic qualities, such as:

Lumbar support. Your lumbar spine (lower back) naturally curves inward. Without lower back support it’s easy to round your back and flatten this curve when you sit for a prolonged period of time, which can strain the lumbar spine. An ergonomic chair should offer adjustable lumbar support. For some chairs with mesh backrests, adjustable lumbar support looks like a piece of reinforced plastic that is built onto the backrest and can be raised up or down. For padded chairs, you should be able to adjust the height of the backrest, which is designed with a supportive curve.

See Types of Lumbar Support and Ergonomic Office Chairs

Adjustable armrests. Armrests can help to support your elbows and take some weight off your shoulders, reducing neck and shoulder strain. Your elbows should rest lightly on the armrests and bend at about a 90-degree angle when using a keyboard and mouse. Look for armrests that have adjustable heights and can slide inward, so you can keep your arms close to your body.

Watch Video: 6 Tips to Improve Posture While Sitting

Adjustable height. An office chair that encourages correct posture should allow you to scoot all the way to the back of the seat with your feet flat on the floor, thighs horizontal and arms even with the height of the desk. It is thought that a seat height ranging from 16 to 21 inches off the ground is suitable for most people. An office chair that comes with a pneumatic adjustment lever can help you find the right height.

See Types of Lumbar Support and Ergonomic Office Chairs

High backrest and headrest. Look for an office chair that has a backrest that supports the natural curve of your spine. A backrest high enough for your upper back to stay flush against can help to keep you from hunching your shoulders. A headrest can also encourage you to keep your head back rather than drooping your neck forward, a position that load dozens of extra pounds of pressure on your cervical spine.

See How Poor Posture Causes Neck Pain

Deep seat. The seat should be deep enough so that you can sit with your back against the backrest while leaving 2 to 4 inches between the back of the knees and the seat of the chair. For extra customization, keep an eye out for office chairs that allow you to adjust the forward or backward tilt of the seat.

See Office Chair Back Support

Test out a variety of office chairs before you make a purchase, and see which one offers you the most comfort and support. You may even find that you prefer an office chair solution with an alternative design.