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

( 617)720-2329




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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.

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.
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

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

1 Hour to Ease Your Back Ache and Boost Your Mood

Using a stand-up desk for 1 hour per day may help alleviate your back pain and boost your mood.
See Lower Back Pain Symptoms, Diagnosis, and Treatment

Back pain is the most common work-related injury. But there are several ergonomic changes that can be made to prevent back pain in the workplace. Read Ergonomics of the Office and Workplace: An Overview

Sound too good to be true? Read on to learn more:
See Back Pain and Ergonomics

The risks associated with excessive sitting

Before we look at the possible benefits of a stand-up desk, let's talk about the risks associated with excessive sitting. Complications may include:

  • Neck pain from hunching forward
  • Increased risk for developing heart disease
  • Tight hips and hamstrings
  • Increased back pain

See The New Health Epidemic: Sitting Disease

It is important to note that good posture can help minimize some of the risks associated with excessive sitting, but it is not a cure-all.

See Good Posture Helps Reduce Back Pain

Recent evidence promotes more standing

In a 2011 study, participants experienced less upper back pain, less neck pain, and an improved mood by simply sitting 66 minutes less per day.1

See Workplace Ergonomics and Neck Pain

Participants in the study held sedentary office jobs. Researchers provided the participants with a device that allowed them to sit or stand at their desks throughout the course of the study.

See Work Ergonomics: Minimize Back Injuries

The participants were given the choice to sit or stand as much, or as little, as they pleased. On average, the group ended up sitting around 1 hour less each day—but this was enough to realize statistically significant health benefits.

Improved emotional well-being

As mentioned previously, the benefits of less sitting were not only physical. Participants reported decreased fatigue, tension, confusion, and depression—all gained by sitting 66 minutes less per day.

See Depression and Chronic Back Pain

Moreover, the following benefits were reported:

  • 75% felt healthier
  • 71% felt more focused
  • 66% felt more productive
  • 62% felt happier
  • 33% felt less stressed.
See Stress-Related Back Pain

Toward the end of the study, the office workers’ sit-to-stand desks were removed, and their moods and pain levels went back to baseline.

What does this mean for you?

One clear takeaway from this study is that you may benefit from the daily use of a stand-up desk. Here are some tips to help get you started:

  • Height adjustable stand-up desks that are placed on top of your regular desk are available at a fraction of the cost of a full stand-up desk.
  • Ensure that your monitor is placed at eye level to reduce strain on your neck.
  • Place your foot up on some kind of rest so you can easily shift your body weight from one leg to the other.
  • Consider purchasing an adjustable stool so you can sit, or partially sit, for periods of time.
See Ergonomics of the Office and Workplace: An Overview

As a bonus, you may only need to use a stand-up desk for 1 or 2 hours per day to reap significant health benefits.

Learn more:

Early Treatments for Lower Back Pain
Office Chair, Posture, and Driving Ergonomics


  1. Pronk NP, Katz AS, Lowry M, Payfer JR, "Reducing Occupational Sitting Time and Improving Worker Health: The Take-a-Stand Project," 2011. Prev Chronic Dis 2012;9:110323

2 Neck Pain Symptoms That Require Immediate Medical Attention

Neck pain is not typically a cause for panic, as you can treat many symptoms with simple measures such as rest, stretching, ice/heat therapy, over-the-counter medications, and ergonomics. However, there are some instances of neck pain when you should seek medical attention immediately. Here are two: See Chronic Neck Pain: What Condition Is Causing My Neck Pain?

1. Stiff neck with a severe headache or fever

Having a stiff neck and flu-like symptoms could be a sign of meningitis, a serious condition that occurs when the protective membranes covering the brain and spinal cord become infected and inflamed.
If your neck is stiff, and you also have a fever and/or an especially painful headache, you could have meningitis.

See When Neck Stiffness May Mean Meningitis

Meningitis, in its most dangerous form, is a bacterial infection that causes inflammation in the brain and spinal cord. Early warning signs of meningitis may include a fever (high body temperature, chills, body aches), an intense headache, and an inability to flex the neck forward. A stiff neck doesn’t always occur when meningitis is present, so look for other possible symptoms, such as nausea, vomiting, and increased sensitivity to sound or light.

See How Meningitis Causes Neck Pain and Stiffness

Meningitis symptoms usually develop within a few days of exposure. Getting meningitis treated early is critical; delaying treatment poses a severe risk for hearing loss, brain damage, and even death.

Experiencing a stiff neck, fever, and bad headache all at once doesn’t always signal meningitis, but if you display these symptoms, it is recommended you visit a doctor right away.

See When Is a Stiff Neck Serious?

2. Neck pain with persistent arm/hand numbness or weakness

Cervical radiculopathy occurs when a nerve root in the cervical spine is compressed, inflamed, or damaged. Symptoms of cervical radiculopathy include tingling, numbness, and/or weakness in the areas served by the affected nerve root.
Do you have neck pain that radiates to your shoulder, arm, or finger with a pins-and-needles, weakening, or numbing sensation? These symptoms may suggest cervical radiculopathy.

See What Is Cervical Radiculopathy?

Cervical radiculopathy means that a nerve root in your cervical spine is compressed, inflamed, or damaged. The issue most often occurs because of a nearby bone spur or herniated disc that is caused by degenerative changes in your neck. Less commonly, cervical radiculopathy indicates an infection or tumor.

See Cervical Radiculopathy Causes and Risk Factors

Cervical radiculopathy pain typically is felt in just one side of the body. The pain may also take on a burning or shock-like quality, and your grip may feel weaker. Your reflexes may also be affected.

See Cervical Radiculopathy Signs and Symptoms

If you show cervical radiculopathy symptoms, see your doctor. He or she may perform a physical examination, review your medical history, and possibly conduct imaging studies or other advanced diagnostic tests.

See Diagnosing Cervical Radiculopathy

These two examples don’t form a comprehensive list, as other neck pain symptoms may require immediate medical attention. You should also seek urgent care if your neck pain is accompanied by problems with coordination or bowel/bladder control.

See Neck Pain Symptoms

When in doubt, call your doctor to see if troubling signs or symptoms need to be checked. Getting an accurate diagnosis early may lead to more effective treatments and better outcomes.

See Diagnosing Neck Pain

Learn more:

Stiff Neck Causes, Symptoms, and Treatment
Video: What Causes a Stiff Neck?

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