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A Look at Spinal Manipulation Therapy and Back Pain

If you’ve ever been to a chiropractor or had a professional “crack your back,” you may have been a recipient of spinal manipulation therapy (SMT). Spinal manipulation, also called spinal manipulative therapy or manual therapy, is used in both Western and traditional East Asian medicine; in North America, it’s typically performed by chiropractors, osteopathic physicians, and physical and occupational therapists. Over 100 types of adjustment techniques are known throughout the world, but typically chiropractors will focus on eight to 10 varying approaches within their practice. Spinal manipulation therapy uses force, while spinal mobilization therapy is gentler. Some conditions such as osteoporosis, the patient’s size, or simply patient comfort may require spinal mobilization therapy. Chiropractic treatment can be extremely effective for acute neck or back pain due to muscle spasm, strain or sprain, and inflammation. If you’ve never experienced it before, it can be surprising just how much force can go into the manipulation of different joints of the spine. The most frequently used technique in SMT is the high-velocity low-amplitude thrust, which often results in an audible “pop.” A more sophisticated technique relies on using a flexion distraction technique that is somewhat gentler and safer. The goal of these techniques

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Acupuncture and Back Pain

Does acupuncture work for pain relief? It’s a question that’s been debated by the medical community for some time, but of late, more and more physicians have come down on the side of supporting it, or at least maintaining that it does no harm. In 1998, the National Institutes of Health (NIH) stated that there was enough evidence to show that acupuncture has beneficial, pain-relieving qualities for adults suffering from postoperative dental pain, the nausea of chemotherapy, lower back pain, headache, myofascial pain, osteoarthritis, and carpal tunnel syndrome. There have been several important studies that report acupuncture is effective in reducing chronic pain. Most recently, a study in the Journal of Clinical Pain suggests that people being treated for lower back pain with acupuncture are less likely to gain benefit from treatment if they have low expectations for its effectiveness – an interesting twist to the earlier findings on pain relief. Emotion and attitude seem to have quite an impact on acupuncture’s efficacy. Dr. Felicity Bishop, author of the study, wrote: People who started out with very low expectations of acupuncture – who thought it probably would not help them – were more likely to report less benefit as treatment

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10 Years Later: James’ Patient Experience

Meet James, a former patient of mine. James’ story began when he was lifting paving stones and felt a sudden shooting pain in his back, eventually traveling to his legs and toes. Knowing something was wrong, he immediately consulted a physician, but doctor after doctor couldn’t figure it out. He had undergone prior surgery for a herniated disk about 15 years ago. After receiving five different opinions with no clear answer, James was left with more uncertainty: “Five different guys didn’t seem clear on where my problem was. They thought it was scar tissue from a previous surgery I had 15 years ago or a herniated disc. Three of the doctors consulted each other and thought some kind of implant would be best for me.” James continued to look for someone who could provide a better answer. He didn’t want rods put in his back. When a friend recommended my services, James did his research and made his appointment the next day. What I did differently from the previous doctors was to get a high quality MRI and special Xray views. Once I got the results back, I assured him that the pain was not due to scar tissue left

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Winter’s Effect on Back Pain

It’s no secret that this winter has been unbearably cold. With record lows this February in many cities along the Eastern Seaboard, including here in New York, you might be wondering: what exactly is this bitter cold doing to our backs? Winter in itself can make your joint pain worse – and in some cases it can be debilitating. In fact, some people with rheumatoid arthritis and psoriatic arthritis suffer from cold allodynia, which means they can predict approaching colder weather by how much pain they are in. In colder temperatures, the tissues in your body shrink, causing them to pull on nerve endings, which for many can result in joint pain. Also, cold weather can lead to muscle tightness, exacerbating lower back spasm. Additionally, many cold weather activities can cause back aches and pain – from the repetitive bending and twisting associated with shoveling snow to the chance of slipping on a sheet of ice, winter-related slips and falls are highly common. With Winter Storm Pandora on its way out and the potential for more still on the horizon before spring finally hits, protect yourself from extra pain with these helpful tips: Bundle up, including layers, hats, scarves, and

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Back on the Dance Floor: Kathryn’s Patient Experience

Kathryn is a former patient of mine who has left a lasting impression. Her back pain began when she hurt her L3/L4 disc after a spinning class, and she believes she aggravated the injury during a subsequent game of golf. Initially, Kathryn told me she didn’t think too much of it because she’s athletic and used to pushing herself outside her comfort zone. Kathryn thought this was something she could deal with – so she sought a massage treatment, iced her lower back area, and rested. Afterwards, she continued to play golf and attend spinning class. Unfortunately, what Kathryn didn’t do was listen to her body and get help when she needed it. I see this in a lot of patients; a good rule of thumb is if the pain persists, starts to travel down your arm or leg, and/or keeps you up at night, it’s time to see a physician. Unfortunately, the pain took a turn for the worse when Kathryn further exacerbated her injury lifting a mattress while vacuuming. Kathryn contacted my office and met with me to discuss different options that would work for her injury. Because she had severe nerve compression in her lower back due

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3-D Printing in Spinal Surgery

In spinal surgery, advancements in technology and medicine have given doctors new ways to combat conditions affecting the human body. Minimally invasive procedures use small incision for less complex procedures; in robotics, surgeons use robotic arms to carry out a minimally invasive procedures with potentially more accuracy. So what about 3-D printing? Technically, it’s been around since the 1980s, but hasn’t been used in medicine until recent years. Commonly used to support or replace body parts that don’t enter the bloodstream, 3-D printing has the ability to fabricate prosthetic limbs, layer by layer, from the ground up. What is 3-D printing? What is 3-D printing? In medicine, 3-D printing, also referred as additive manufacturing, is the process of using plastic or metal gel to shape a replacement body part based on a patient’s MRI or CT scan. 3-D printing is allowing prosthetics to be produced and personalized in complex shapes including hands and fingers. No longer will these devices cost thousands of dollars, removing much of the financial burden patients and their families may face. “If a parent wanted to purchase a 3-D printer of their own and produce hands for their own child, the cost of the printer and

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Is Robotic Surgery Right For You?

What is Robotic Surgery? Robotic surgery is a term used for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery has the potential to help overcome the limitations of minimally-invasive surgery, and to enhance the capabilities of surgeons performing some types of open surgery. To date, robotic surgery has had its biggest impact in Urological (Prostate) surgery, and general surgery. The applications in Spine surgery have been very limited to date, but we continue to monitor and research this technology. With robotically assisted surgery, the surgeon uses a remote manipulator to control the robotic arms that carry out the movements of the surgery. The advantage of this is to allow for very fine and controlled movements in a tight and inaccessible space, and for potentially improved visualization with the miniature camera systems that accompany the robotic arms, examples of such systems include the DaVinci Robot platform. Robotic surgery has been criticized for its expense, by one estimate costing $1,500 to $2000 more per patient. [1] However, this advanced technology allows surgeons to perform general exams as well as complex gynecological, cardiothoracic, and urological procedures with a minimally invasive approach. Potential benefits of robotic surgery In general,

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Top Products for Easing Back Pain

It’s that time again:  the season of giving! It can be tough to give gifts that are both thoughtful and useful – no one wants to give something that’s going to get tossed the next day – but if you know the recipient well enough, a product that can help ease their back pain might just hit the spot. While the cause of back pain is different for everyone, we’ve spotlighted some of the top products that patients have said help them to prevent or calm existing back pain in their daily lives. And while you’re browsing, think about how these could help your own back pain, too.

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How to Find the Right Mattress

Your bed may be the most important piece of furniture in your home. After all, we spend roughly a third of our lives sleeping, recharging our bodies and minds for a new day. But when that sleep is interrupted by back pain, it’s time to start learning how to find the right mattress. Decide if it’s time to get rid of your mattress. How do you know when it’s time to get rid of your mattress? Good mattresses typically have a lifespan of 10 years, but if you’re experiencing back pain, you may want to consider replacing it sooner. Choose the proper firmness. Mattress experts say many customers mistakenly think a firmer bed is a better one for dealing with existing back pain or preventing it. Those suffering from degenerative disc disease often find that the firmer mattress alleviates pain, but if that’s not your particular challenge, you won’t need the firmest mattress in the store. Too-firm mattresses can lead to pain at pressure points like the hips. A mattress that’s too soft, on the other hand, may make it difficult for you to move, and also will not give enough support. It’s important to know the difference between a

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Feeling Back Pain at Night?

It’s hard enough experiencing back pain as you go through your day, but back pain at night when you want to sleep is especially grueling.  Many patients experiencing nighttime back pain aren’t even especially uncomfortable during the day, but find that once they climb into bed, the pain may be too much to bear. These people find themselves in a nasty cycle: insufficient or interrupted sleep can exacerbate the very same pain that keeps them up each night. Nighttime back pain can be caused by a number of issues. Disc degeneration and arthritic changes as the result of aging may be to blame for some patients. A bulging or herniated disk putting pressure on a nerve can cause  back and leg pain when lying flat. Sprains or fractures and conditions such as scoliosis, spinal stenosis, or even endometriosis may also cause pain at night. It’s possible that nighttime back pain may be an indicator of spinal tumors, though this is quite rare. Typically, mechanical causes of lower back pain will get better once you are in a comfortable position, but when you roll over in bed, may wake you up. Also they are often accompanied by morning pain or stiffness. Before turning in,

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