Sunday, April 28, 2013

Intelligent Design of the Human Back spines and low backs were very intelligently designed. The functional anatomical design of your spine is truly a marvel of nature. Our spines are meant to be incredibly strong, and highly bendable in all directions. That being said, the stresses of daily living exert incredible forces on the human frame. Unforeseen accidents, poor ergonomics, carrying groceries, putting kids in car seat, recreational activities and working in chairs rather than in the field, are all factors that subject our back to destructive forces capable of damaging our neck and back.

What are the most common causes of back pain?

  • Working in a seated position, especially when exhibiting a slumping posture over many years
  • Imbalance between the flexors and extensors of the torso (we do everything in a flexed or sitting position, but do very little extension of our spine during our normal routine).
  • Lifting with tight hamstring muscles
  • Weakness and inflexibility of the core muscles of the torso (abdominals, gluteal, hamstrings, hip flexors, TFL, rectus femoris). This requires abdominal compression back braces with mechanical advantage until strength to the core muscles is restored.
  • Old soft tissue injuries or sprains/strains that have led to immobility and/or generative arthritis
  • "Weekend Warrior Syndrome"
What are the 4 regions of the spine?

The first 3 segments are made up of 24 moveable vertebrae as follows:
  1. Cervical Spine (neck) - consisting of 7 vertebral segments, with the majority of rotation occurring in the upper two segments known as C1 and C2 while flexion/extension is most prevalent in the lower five known as C3-C7. 
  2. Thoracic Spine (upper/mid-back/rib cage) - consisting of twelve vertebral segments and more limited motion due to the organ protection and support of the rib cage.  Interestingly enough, more folks suffer pain in between their shoulders or in the thoracic area than anywhere else in the spine.  One reason for such is because ribs fasten to the spinal vertebrae via a synovial joint and these joints become easily inflamed through postural stress, emotional tension or fast rotational movements of the spine (e.g. pushing a vacuum, swinging a golf club or tennis racket). Pain in this region is more often misdiagnosed than in other spinal regions and although maybe not as debilitating, the pain can be quite nagging, sharp and bothersome.
  3. Lumbar Spine (lower back) - consists of five vertebral segments that run from the lower thoracic spine to the sacrum. The majority of pain is sourced from the discs at the L4 and L5  because they are angled and form a major pivot or stress point with the less mobile spinal base. Fifty percent of forward bending (flexion) occurs in our hip joints while the rest occurs in the lumbar spine. The majority of motion is focused at the bottom two segments (L4/L5), and that is another reason the discs wear out more here than anywhere else.
  4. Sacral Region (base of spine) - this region consists of 5 fused or semi-fused vertebral segments that form a heart-shaped spinal base that is wedged between and forms a synovial joint with the pelvic bones. These are known as the "S/I Joints" and are the source of a great majority of lower back pain. The bottom of the sacral region (sacrum) joins with your coccyx or tail bone.
The 24 moveable vertebral bodies are stacked upon one another with a disc between each pair. The main bodies of these vertebrae function to support the human frame and the discs act as hydraulic shock absorbers. Did you know that only half of your body weight is supported by your muscles and the other half is supported by the stacked vertebral bodies? Another note of interest is the fact that 80% of energy we expend every day is simply just to maintain posture against the forces of gravity. That is why ergonomics and good posture is so important -- it conserves energy and prevents us from getting fatigued.

Common Areas of Spinal Failure

  • Spinal Discs -- our spinal discs function as shock absorbers and space occupiers to allow room for spinal nerves. They are composed of (1) a tough outer material, and (2) a soft, gelatinous (jelly-filled) inner core. This is very similar to the design of a hydraulic shock absorber for your car.

    Our hydraulic discs are made up of 75% water. Often, the discs may dehydrate, leading to dessication or degeneration; becoming inflexible or stiff. This, in itself can become what some describe as their typical morning stiffness. A logical progression of this degenerative process can lead to breaks in the outer tough fibers and actual leakage of the soft inner core. This is often referred to as a slipped or herniated disc because this herniated portion can apply pressure to sensitive nerve roots.

    Sometimes a twisting injury damages the disc and can subsequently cause degenerative spondylosis (this is a special name given to arthritis when it involves the spinal disc) in this area. Much of the pain in these cases is the subsequent swelling that compresses the nerve root. Over much time, the body's amazing ability to heal lessens the amount of inflammatory proteins in the area, especially after age 60. Therefore swelling goes down and many of these low back conditions that had been chronic can sometimes subside on their own. This is nature's normal course, but assumes a lifestyle consisting of: a healthy weight, consumption of lots of water,  a nutritionally sound diet and performance of a sound, regular exercise routine.

  • Muscles, Tendons, Ligaments and how they affect your back:
    Injuries to back muscles and soft tissues can cause spasm, immobility and pain.

    If the pain lasts for more than two weeks, and proper treatment methods are not instituted,  muscle weakness and tightness may occur; leading to chronic, recurring bouts of back pain.

    HAMSTRING MUSCLE TIGHTNESS: I want draw particular attention to this most common instigator of low back injury. Not only do low back pain suffers often develop tight hamstrings leading to a chronic backache, but those folks with tight hamstrings will almost always eventually develop lower back pain. This is even true of young athletes who do not properly obtain and maintain good flexibility of these muscles. Remember, I said earlier that 50% of our flexing forward occurs at the hip joints. This CANNOT happen if the hamstrings are tight because they must release their hold on the pelvis, allowing it to rotate forward at the hip joints. If this motion is limited, then the slack is taken up at the L4-L5 vertebral levels, often discs and/or ligaments at that level.

Sunday, April 21, 2013

Is Your Pillow Causing You Pain?

Buying Neck Pillows
Many folks scratch their heads, wondering why they wake up with so much neck pain, and yet they don't know how to solve the problem. It could be as simple as their choice of pillow. Here are solutions to the five pillow mistakes you may not know you're making:

Long Lifespan

If you can fold your pillow in half and it doesn't rebound within 10 seconds, it's time to say farewell and throw that old thing out. Dead skin flakes, dust and sweat fill pillows with extra weight and bacteria. Aim to replace your pillow every 12 to 18 months to best maintain firmness and support for a restful sleep. See this Interesting Pillow Choice Article for some thought provoking suggestions. I often recommend the Nimblepedic Pillow brand (contoured version) as one of the best all-around support pillows for the neck.

What's the Use?

If sleep quality is the only benefit you are receiving from your current pillow, you may be missing out on other benefits and therapeutic value over that eight hour period. Specialty pillows keep your face from wrinkling, acids from refluxing and snores from waking up the whole house. If you have sinus congestion, make sure your pillow is hypo-allergenic. Make sure your head is propped up so your nose is higher than your heart. If you fear wrinkles, find a memory foam pillow like Nimblepedic, so wrinkling pressure on your skin is reduced.

Neck Pillows Should Be Versatile

If you have a conventional, fairly thick, non-contoured pillow for side-sleeping; yet you spend a portion of time on your stomach or back, you may be doing yourself a disservice. To not cause neck or back pain you need a contoured pillow that adapts to all your positions, or you will need to change pillows for each sleeping position. Michael Breus, PhD, told WebMD that sleepers must find the right pillow to fit their specific needs.

Side sleepers should use a pillow that is firm enough to sufficiently accommodate the distance from the ear to the shoulder, so that your head rests parallel to the mattress. Back sleepers need neck-contour-orthopedic pillows. This ensures that their heads aren't pushed up too high or sunk down too low in relation to their shoulders and that they have support for the natural neck curvature (lordosis).

Sleeping prone (aka: face down) is for the most part not recommended. Such stomach sleeping notoriously wrecks havoc with the ligaments and spinal disks of the neck, leading to loss of normal curvature and arthritis over time. If you still choose to sleep on your stomach, use a thin pillow, and try to place a portion of it under your shoulder and chest on the pillow portion opposite the way you turn your chin. Ultimately, the proper pillow aligns the neck and spine, according to the Los Angeles Times.

Filling Material Matters

Pillows should provide comfort and support the same way a mattress should. It’s great if you think a down pillow is super comfortable, but if you are having constant neck pain it could be because you aren't getting enough neck support when you sleep. A  good orthopedic neck pillow can solve this problem, and so can occasionally switching your sleeping position. When you experience neck or back pain, choose a high-density foam or firm cotton pillow that offers more support. Feather pillows are pretty much a non-viable alternative unless you purely sleep on your back and don't really have neck problems.

Money Isn't Everything

Just because a pillow is expensive doesn't mean its less expensive counterpart won't work. sent 71 people home with expensive and inexpensive pillows and instructed them to sleep on each pillow for five consecutive nights. What were the results? Pillow quality relied mainly on each sleeper's personal preferences about pillow firmness, fluffiness, flatness and size, according to the site. When buying, don't just go for best price. Find the right pillow for you by testing its comfort and seeing if it offers you the right neck support.

Monday, April 15, 2013

Back Be Nimble Introduces HealthTap


HealthTap brings the Full Spectrum of Doctors’ Knowledge to Mobile Health
Leading mobile health platform unveils results of nationwide Top Doctor Competition, and announces new ways to interact with winning doctors and their insights. 

HealthTap is an Interactive Health Information company, backed by some of the top investors in the Silicon Valley. The unveiling of HealthTap will change the face of health information online and redefine how people connect with physicians.  On HealthTap:
  • Users can: find real answers to their questions from leading physicians, quickly discover what information other doctors agree with, and find the best physicians in their area
  • Users can also find ratings for doctors nationwide
HealthTap puts the relationship between people and doctors first. They offer mobile and internet access to relevant, reliable and trusted health knowledge that is kept current through daily contributions  from top physicians. Web and mobile apps connect  a vast Medical Expert Network of  U.S.-licensed doctors with people seeking answers to their health-related questions.

•  Concise doctor updates on the latest health findings
•  Daily health tips created by doctors in more than 100 topics
•  Quick, personalized doctor answers to health questions
•  Deep Health posts where doctor share their opinions and insights
•  Transparent doctor-doctor consults and dialogues

“HealthTap is putting care and trust back into healthcare by placing the doctor and patient relationship back at the center of the healthcare experience,” says HealthTap Founder and CEO Ron Gutman. “By giving top doctors a simple way to share their knowledge and opinions and get recognized by their colleagues for their expertise, and by users for their bedside manner and care, we’re creating a healthy competition that motivates the best doctors to stand out and help millions everywhere. In a world where we expect to get immediate, reliable and deep insights on movies and restaurants on our mobile devices anytime anywhere, it’s high time we have an easy way to get the same when it comes to our health and well being. With the new HealthTap Spectrum we’re leading the way to comprehensive, caring, trustworthy and high quality mobile health.”

About HealthTap
HealthTap is the best way to connect with trusted health information and doctors. With top-rated web and mobile apps, HealthTap offers immediate and free access to personalized, reliable, and trusted health answers and tips from a network of over 36,000 U.S.-licensed doctors. Sign up today and download HealthTap’s free app for iPhone, iPad or Android at