Dr. Jeffrey I. Kennis,  D.C.
205 Commercial St.
Boston, MA 02109
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Posts for: October, 2019

October 22, 2019
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Daily stretching can be one of the best ways to alleviate radiating leg pain from a lumbar herniated disc. The following 3 stretches can help loosen your tight hamstring muscles for better lumbar spine support and reduce pressure on the sciatic nerve going down your leg. Just remember to stop if any exercise causes pain to worsen.

See Types of Sciatic Nerve Pain

Hamstring Stretch Seated

Seated hamstring stretch

This stretch is ideal for those with limited mobility or really tight hamstrings, as it is done in a seated position. To perform this stretch:

  • Sit at the front edge of a firm, straight-back chair with both feet on the ground, 3 to 6 inches apart.
  • Straighten one leg in front of you, with your heel on the ground and toes pointed at the ceiling.
  • Keeping your back straight, lean forward over the outstretched leg. You should feel the stretch in the back of your thighs.
  • Hold this position for 30 seconds, if possible. Then switch to the other leg.

Watch Seated Chair Hamstring Stretch for Sciatica Relief Video

To increase the stretch, prop your heel on a stool or second chair rather than the floor.

See Hamstring Stretching Exercises for Sciatica Pain Relief

 
Hamstring Stretch Towel

Towel hamstring stretch

If you prefer to stretch while lying down, the towel hamstring stretch may be a good option. To perform this stretch:

  • Lie on your back with your left leg flat on the ground and your right leg bent.
  • Tighten your abdominal muscles while slowly lifting your right leg.
  • Wrap a towel or yoga strap around the ball of your right foot. Hold the two ends of the strap with each hand.
  • Gently push your right heel toward the ceiling as you straighten out your right leg. Keep your left leg against the ground.
  • Once a stretch is felt, hold this position for 15 to 30 seconds.
  • Release your right leg back to its original position. Switch legs and repeat at least 3 times per leg.

Watch Supine Hamstring Stretch (Towel Hamstring Stretch) for Low Back Pain and Sciatica Relief Video

To make the stretch more comfortable, lie on a soft surface such as carpet or a yoga mat, or on a padded physical therapy table at your gym.

See Easy Exercise Program for Low Back Pain Relief

Standing Hamstring Stretch Video

A standing hamstring stretch can help alleviate radiating leg pain. Watch: Standing Hamstring Stretch for Low Back Pain Relief Video

Standing hamstring stretch

You can also stretch your hamstrings while standing.

  • Stand up straight with legs and feet together.
  • Engage your lower abdomen, drawing your belly button toward your spine.
  • Inhale to lengthen your spine, and as you exhale, fold forward from the hips, lowering down your torso. While folding forward, draw your shoulders away from your ears and keep your spine nice and long.
  • Place your hands at your hips or on the front of your thighs, avoiding pressing your hands into the tops of your knees. Keep your legs engaged to protect your knees.
  • Hold this stretch for 30 seconds.
  • Inhale and keep a flat back to come out of this stretch.

When doing any stretches, only go into the stretch as far as is comfortable for you—never stretch to the point of pain. Hamstrings can become quite stiff and tight over time, especially if you have pain secondary to a herniated disc. Start with gentle stretches, such as by holding for only 5 or 10 seconds, and gradually increase the stretches over time. For any pain that worsens or does not improve, see a doctor for an accurate diagnosis.

Learn more:

Specific Hamstring Stretches for Back Pain Relief

5 Little-Known Tips for Lumbar Herniated Disc Pain Relief


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October 22, 2019
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Massage therapy provides a promising way to help ease your sciatica pain1 through a combination of:

  • Relaxing tight muscles
  • Improving blood circulation2
  • Reducing stress2
  • Fostering a better healing environment2
Massage therapy is a commonly overlooked treatment for sciatic pain

Massage therapy is a commonly overlooked treatment for sciatic pain.
Learn more: Sciatica Treatment

The specific benefits of massage on the tissues of your lower back, guidance on finding a good massage therapist, and simple tips for self-administered massages are highlighted below.

 

The effects of massage on nerves and soft tissues

Depending on the type of massage, a therapist may work on your muscles, joints, nerves, and/or layers of connective tissue deep below your skin. A few examples of massage techniques include deep tissue massage, trigger-point therapy, and neuromuscular therapy.2

A massage can cause the following changes to occur in your body, easing the sciatica pain:

  • Loosen and relax muscles. When your trunk, core, and lower back muscles are tight, they can apply pressure on the sciatic nerve root(s) in your lower back. Tight muscles may also get knotted up into small painful nodules, causing trigger point pain. Massage therapy can effectively stretch, loosen, and elongate these muscles, improving pain and function in your lower back and legs.2
  • Facilitate the circulation of healing nutrients. Hands-on soft tissue manipulation from massage stimulates the blood vessels in your skin and deeper tissues. There is enhanced circulation of blood, oxygen, and other nutrients to the sore areas, promoting healing.2
  • Release endorphins. Massage stimulates specific pressure receptors in your brain, which are special nerve fibers. Stimulation of these pressure receptors helps reduce pain by releasing endorphins, the body’s natural feel-good hormone.2,3
  • Reduce stress. Stimulation of the pressure receptors also helps reduce the levels of cortisol in your body—the hormone that causes stress. Reduced stress helps provide a feeling of relaxation and relief, with a lesser perception of pain.2,3

Some therapists may use aromatic oils or essential oils to rub into your skin. Some of these oils may have a therapeutic effect on tissues and help reduce pain. The scent from these oils also helps provide an overall relaxed feeling. If certain types of scents bother you, inform your therapist before you start the massage.

Massages are usually safe when performed by a trained professional. Rarely, increased pain, soreness, stiffness, and/or damage to blood vessels and/or nerves may occur from the forceful application of pressure.2

Read more about Massage Therapy for Lower Back Pain

Finding the right massage therapist

Therapeutic massages are typically given by qualified, trained professionals, such as massage therapists, physical therapists, sports medicine professionals, occupational therapists, and other qualified health practitioners. You can enjoy a relaxation massage at a spa or a massage center. Massages can also be self-administered.

Here are a few pointers to help you identify the right type of massage technique and therapist for your sciatica pain:

  • Identify your goals. Figure out what you want to accomplish before you start your search for a massage therapist. For example, if you want to relieve lower back tension, look for someone who is trained in specific muscle-relaxation techniques, such as neuromuscular therapy. If your goal is simply to raise your endorphin levels, you can head to your local spa for a basic Swedish (deep tissue) massage.
  • Consult with your doctor. Your doctor may be able to recommend an appropriately qualified health professional who administers therapeutic massage in your area. If you have specific health conditions, such as high blood pressure or nerve problems (neuropathy) in your leg, a doctor can advise if massage is a safe option to consider for your sciatica pain.
  • Check with professional organizations. The American Massage Therapy Association provides a searchable list of licensed massage therapists in your area. The list is not exhaustive, but unlike internet search engines, it screens out individuals who are not legally allowed to practice.

For people who have difficulty with mobility or driving, consider an in-home massage in which the therapist will come to your home.

See Massage Therapy Considerations for Lower Back Pain

DIY Massage

You can also massage your back using tennis balls and topical medication or creams. A few simple tips include:

  • Secure two tennis balls next to each other with duct tape. Place the secured balls under your back, buttock, or upper thigh while you lie on the floor and gently move around to find sore muscle groups. When you identify a tender spot, focus and press the area gently.
  • Press a tennis ball between your chair and lower back to loosen up tight back muscles.
  • Use topical medicated creams or gels on your rear pelvic area and massage with firm pressure.

See How to Use Tennis Balls for DIY Lower Back Pain Massage

Massage therapy can be an important part of your treatment plan—providing temporary but effective pain relief, stimulating your body to produce natural pain-relieving hormones, and enhancing the body’s own healing abilities. A massage can also provide an overall relaxing and enjoyable experience.

Learn more:

Can Massage Help Your Back Problem?

Myths About Sciatica Treatment Options


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October 15, 2019
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5 Exercises for Upper and Middle Back Pain

Upper and middle back pain is less common than pain affecting the lower back or neck. But that doesn’t make it any less aggravating to deal with. Here are 5 common exercises that target the muscles surrounding the thoracic spine. It’s advised you try these exercises under the guidance of a health care professional.

See Early Treatments for Upper Back Pain

Cobra pose

This back extension exercise is referred to as the cobra pose in yoga. It targets your back extensor muscles, which are attached to the back of your spine.

  1. Lie down with your stomach on the floor, with your hands in a push-up position.
  2. Slowly push through your arms until you straighten your elbows, lifting the top half of your body off the ground.
  3. Keep your lower body relaxed against the ground. This position is typically held for 1 to 2 seconds and repeated 10 times.

If this exercise is difficult for you, try a modified version where you rest on your forearms.

See Exercise and Back Pain

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. Reach your hands straight back. You can clasp them together behind your 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.

See Back Strengthening Exercises

To increase the intensity slightly, you can lift your legs off the ground, too.

Cat-cow pose

The cat-cow pose is a gentle stretch that can help ease the pain in your middle back.

  1. Get on your hands and knees. Align your arms straight under your shoulders, your knees directly under your hips, and your head straight in line with your torso and spine.
  2. Round your back, lifting your spine toward the ceiling. Your eyes should face your belly. Hold this pose for a deep breath.
  3. Slowly lift your chest and tailbone toward the ceiling, letting your stomach sink toward the ground. Your eyes will look up toward the ceiling.
  4. After another breath, gently round your back and lift your spine toward the ceiling again.

Alternate between the two poses.

See Stretching for Back Pain Relief

Opposite arm/leg raise

This exercise, sometimes called the bird-dog pose in yoga, strengthens your abdominals and back muscles.

  1. Get on your hands and knees. Keep your spine straight, with your hands directly below your shoulders and your knees aligned directly under your hips.
  2. Slowly reach out with one arm while extending the leg on its opposite side. Keep both straight and level.
  3. Hold for a few deep breaths, then gently lower your arm and leg to starting position.
  4. Repeat this exercise with your other arm/leg.

Try for 10 to 15 repetitions on each side.

See Back Exercises and Abdominal Exercise Recommendations

Corner stretch

Upper back pain is often due to poor posture, which may be exacerbated by tight chest muscles. The corner stretch is an easy and effective way to open up the chest muscles and encourage healthy posture.

  1. Face a corner of a room or stand in a doorway. Place your forearms against each wall (or each door jamb) with your elbows slightly below shoulder level.
  2. Lean forward until you feel a stretch in your chest under your collarbone.

Hold this stretch for up to a minute.

See Easy Chest Stretches for Neck Pain

A health care professional can create for you an exercise plan specifically tailored to treat your underlying condition. Stop immediately if any of these exercises cause pain.

Learn more:

All About Upper Back Pain

Causes of Upper Back Pain


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October 15, 2019
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5 Ways Motion Causes Low Back Pain

Our spines are remarkable—they're made up of incredibly intricate systems of bones, ligaments, tendons, and muscles that work together to enable movement in all directions. While all of this movement is great, the potential downside is that it can contribute to injuries and wear-and-tear damage over time that may lead to back pain and stiffness.

The spine is made up of strong bones, flexible ligaments and tendons, large muscles, and highly sensitive nerves. Watch: Lumbar Spine Anatomy Video

Understanding how movement impacts your spine can help you better communicate with your physician and hopefully get an accurate diagnosis for faster treatment and pain relief. With this in mind, here are 5 common ways that motion can contribute to back pain:

1. Large spinal muscles are easily strained with twisting motions

The most common reason motion causes back or neck pain has little to do with the bones in your spine. Instead, it’s related to the muscles and ligaments that surround your spine.

When you twist your lower back, such as during a golf swing or while bending to unload grocery bags, you run the risk of overstretching or tearing any of the large muscles or supporting ligaments around your spine. In response to this damage, the surrounding area will usually become inflamed. This inflammation can lead to a back spasm , which can potentially lead to severe lower back pain.

See Pulled Back Muscle and Lower Back Strain

Strains and tears in the spinal muscles and ligaments are a common cause of lower back pain. Watch: Lower Back Strain Video

2. Lumbar spine motion can cause a disc herniation

Your lumbar spine (lower back) is constantly in motion, and it also carries the entire weight of your upper body. This makes your lumbar spine particularly prone to injuries.

See Causes of Pain in the Lumbar Spine

The motion in your lumbar spine is divided into 5 spinal motion segments. Each of these segments is made up of 2 cartilage-covered facet joints and a spinal disc that provides shock absorption and prevents adjacent vertebrae from grinding together.

Your two lowest discs (the L4-L5 and L5-S1) endure the most strain, and therefore are the most likely to become herniated.1 A herniation can lead to sciatic pain that radiates down your leg and to your foot.

Watch Sciatica Overview Video

Symptoms of a lumbar herniated disc vary widely. Watch: Lumbar Herniated Disc Video

3. Overuse and injuries can lead to cartilage breakdown

Repetitive motions and overuse injuries, especially for athletes, can lead to spinal osteoarthritis—or the mechanical breakdown of the cartilage between your aligning facet joints in the back portion of the spine.

See Causes of Osteoarthritis and Spinal Arthritis

When this happens, the facet joints become inflamed, and progressive joint degeneration creates more frictional pain. As your back pain progresses, the motion and flexibility of the spine decreases.

See Symptoms and Diagnosis of Facet Joint Problems

Typical symptoms include:

  • More stiffness and pain in the lower spine and sacroiliac joint in the mornings and later in the day.
  • Decreased pain during the day as normal movements stir the fluid lubricant of the joints.
  • Low back pain radiating to the pelvis, buttocks, or thighs—and sometimes to the groin.

While overuse and injuries can potentially accelerate the development of osteoarthritis later in life, it is important to remember that staying active is a key part of a healthy lifestyle. Check with your doctor as to which exercises are appropriate for you, and how to perform exercises safely.

Excessive motion in the spine can lead to cartilage breakdown. Watch: Lumbar Osteoarthritis Video

4. Disc degeneration may lead to pain from micro-motion

Disc degeneration in your spine can create excessive micro-motion at a vertebral level and lead to lower back pain, a condition termed lumbar degenerative disc disease.

Common symptoms of degenerative disc disease include:

  • Low back pain that generally worsens with prolonged sitting or holding stationary positions
  • Worsened pain with certain movements, such as bending, lifting, or twisting.

See Causes of Degenerative Disc Disease Pain

Potential pain relief may be experience when changing positions frequently, and lying day may be most comfortable.

Micro-motion from disc degeneration can lead to lower back pain. Watch: Lumbar Degenerative Disc Disease Video

5. Bone spurs can form to compensate for too much motion

Over time, excessive motion in your spine can lead to inflammation and enlarged spinal joints. When this happens, bone spurs—or small, irregular growths on the bone—typically form on your facet joints in response to joint instability from the degeneration. The bony overgrowths can eventually become big enough to reduce joint motion and cause more swelling and stiffness.

See Diagnosis of Bone Spurs

While spurs can be a normal part of aging and do not directly cause pain, they may become large enough to irritate or compress nerves passing through spinal structures. This may result in diminished room for the nerves to pass—which is referred to as spinal stenosis.

Over time, degeneration of the facet joints in your lower back can result in the formation of a fluid-filled sac called a synovial cyst. These cysts are benign, but if they put pressure on the spinal canal they can, like bone spurs, cause symptoms of spinal stenosis.

See Treatment Options for Bone Spurs

Bone spurs are a marker of spinal degeneration, and are quite common in people over the age of 60.

Watch: Lumbar Osteophytes (Bone Spurs) Video

When discussing your back pain with a doctor, try to remember which activities make the pain better or worse. Sharing this information with your doctor may help him or her more accurately identify the specific cause of your pain.

Learn more:

Back Care for Lower Back Pain

Causes of Lower Back Pain


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October 15, 2019
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Understanding Lower Back Strain

Most episodes of acute lower back pain are caused by damage to your soft tissues, or the muscles and ligaments that support your lumbar spine.

This type of injury is called a lower back strain, but it’s popularly referred to as a pulled muscle. The pain resulting from a lower back strain can be surprisingly severe, sending many patients to the emergency room.

See Pulled Back Muscle and Lower Back Strain

Your back is supported by a large, complex group of muscles that hold up the spine. Watch: Lower Back Strain Video

Our animated video on lower back strains can help you better understand this type of injury.

See Sport Injuries, Back Injuries, and Back Pain

Video highlights

Your spine is made for movement: lifting, bending, twisting, and arching. The discs between the vertebrae enable this movement, but your muscles surrounding your spine power the movement.

See Lumbar Spine Anatomy and Pain

The back muscles that power the movement of your spine, shown here in red, include the extensor, flexor, and oblique muscles.

See Back Muscles and Low Back Pain

These muscles are made up of individual fibers, seen here.

In This Article:

Movements that place stress on your back, such as lifting heavy objects, falling to the ground, or twisting while lifting can cause a fiber in one of your back muscles to become over-stretched or tear. This injury is called a lumbar muscle strain. When a ligament in your back tears it is referred to as a sprain.

Watch Back Strains and Sprains Video

Symptoms of muscle strain

Symptoms of a lumbar muscle strain may include tenderness in your lower back, the sudden onset of pain, and localized pain that does not radiate into your leg.

See Lower Back Muscle Strain Symptoms

Lumbar muscle strains may be accompanied by muscle spasms as your body works to stabilize your injury.

Watch Back Spasm Treatment Video

The good news is that the initial pain from your lower back strain typically subsides in a short amount of time. The bad news is that low levels of pain or periodic flare-ups may continue for weeks or months after your initial injury.

See Early Treatments for Lower Back Pain

After 2 weeks, back muscles can atrophy—shown here as a white area in the muscle—from lack of use. This may lead to additional pain.

Treatment options for lower back strain

Most back strain injuries heal on their own within 3 to 4 weeks. But to prevent your muscles from atrophying it’s best to engage in various stretches and strength building exercises after 1 or 2 days of initial rest.

See Exercise and Back Pain

Other treatment options for your pain include:

We hope this video helps you better understand lower back strain injuries. Keeping your back muscles well-conditioned and flexible with strengthening and stretching exercises will help you avoid this type of injury.

See Pulled Back Muscle Treatment

Learn More:

Causes and Diagnosis of Lower Back Strain

Exercises for Lower Back Muscle Strain


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