Health September 14, 2016

Active Life and Spine Health

Common causes of back pain and preventive strategies

An epic powder day in the bowls; up and over Baldy on your mountain bike; 18 holes of golf; a backpacking trip in the Sawtooths. Sound like a list of your favorite Valley pastimes? It’s also a highlight reel of activities that can lead to back pain.

“The things we love to do here keep us fit, but they also put strain on our backs,” said physical therapist Jill Pardini-Morse, P.T. “Patients under 45 most often have muscular injuries from overuse; older patients experience pain related to degenerative changes that come with age, which may have advanced more quickly through high levels of activity.”

While the active lifestyle in our community might be unique, back pain is not: 80 percent of adults will experience back pain in their lifetime, and it’s the leading health-related reason people miss work.

But it’s not only getting out and getting fit that sends locals to seek relief.

“I consistently see patients with back pain resulting from postural and lifestyle habits—sitting at a desk, hunching over a phone,” said acupuncturist Joan Scheingraber, L.Ac. “It’s often a combination of these daily habits and physical activity that bring people in for treatment.”

Why So Common?

From the base of the skull to the tailbone, or coccyx, the spine is made up of 33 vertebrae, stacked atop one another and separated by gel-filled discs that keep the bones from rubbing together.  The spine protects the spinal cord and is supported by ligaments and by the muscles of your back and abdominals.

This complex puzzle supports our body weight and allows us to stand, bend and twist—and each piece is vulnerable to injury.

“In the summer and fall, we see acute injuries in people who fall off a mountain bike or trip during a hike; in the winter, injuries tend to be related to compression—from higher speed falls while skiing or from time in the bumps,” said doctor of chiropractic Aaron Stern, D.C., C.S.C.S.

The most frequent causes of back pain in the Valley, however, tend to be related to long-term wear and tear.

“The most common reason for a patient to visit me is pain caused by degeneration of a disc, or arthritic low-back pain,” said orthopedic surgeon David Verst, M.D., former chairman of orthopedic surgery at St. Luke’s Wood River Medical Center.  “Ninety percent of us will experience a degenerative disc by the time we’re 45.”

The Road to Relief

For those who experience back pain, a vibrant community of integrative practitioners and healthcare providers offers a variety of treatment and maintenance strategies in the Valley, including:

Acupuncture: “Acupuncture moves energy. When you put an acupuncture needle in, it increases circulation—of energy, blood, and lymphatic fluid,” Scheingraber said. “It also works to relieve pain by changing the neurotransmitters and by altering the way your body processes pain; so it’s working on an energetic level, a cellular level, and a muscular level.”

Physical therapy: “Our goal is to relieve pain and restore function,” Pardini-Morse said. To that end, patients will be evaluated and prescribed strengthening and flexibility exercises so they can resume a full range of pain-free activity.

Chiropractic: “The primary goal of chiropractic is to allow the body to heal itself without pharmaceuticals or surgery,” Dr. Stern said.  “We identify restrictions in the flow of energy moving through the spine and use movement and manipulation to allow free flow of neurologic impulse.”

Orthopedic surgery: “Because back pain so often resolves with time—most acute instances within six weeks—I always promote the idea that back pain should first be treated by a primary care physician, physical therapy, chiropractic, acupuncture, or other modality that provides relief,” Dr. Verst said. In some cases, deformity, spinal cord compression, injury or degeneration may ultimately require surgery, in which case a variety of approaches, including minimally invasive spine surgery, are available depending on a patient’s diagnosis and risk factors.

Pain Prevention

Whether you’ve had cause to seek treatment through any of the above means
or you’re looking to avoid a first episode of back pain, there are many preventive steps
you can take.

Strength and Flexibility

“The most important thing you can do to prevent back pain is to develop a strong core—abdominals as well as the posterior chain (including glutes, hamstrings and calves), as it’s is essential to provide stabilization,” Dr. Verst said.

As you strengthen, don’t forget to lengthen, as well:  “If your hamstrings and hip flexors are tight, that will create strain on the low back,” Pardini-Morse said. The good news: “You can always gain flexibility, you just need to work at it consistently,” she noted.

Get quality sleep—on the right surface

“Aim for seven to eight hours of sleep, as that’s when neurotransmitters are replenished,” Dr. Verst said. And, invest in a good mattress: “A high-quality, firm mattress allows the spine to be stable throughout the night,” he added.

Move Consistently

“Keep your weight in check by moving more and sitting less,” Dr. Stern said. “Get up and do something—it doesn’t have to be an intense workout. Even 15 minutes of movement a day can be really beneficial.”

As you consider exercise, be mindful of integrating different types of movement. “Aim for a variety of activities with a reasonable number of rest days,” Scheingraber said. “A lot of overuse syndromes come because people do the same thing over and over at a vigorous level.”

Don’t Smoke

“Smoking affects discs even more than it does coronary arteries; it impedes nourishment reaching the discs,” Dr. Verst said.

Red Flag Warning!

Most episodes of back pain, while very uncomfortable and potentially life altering for a time, are not life threatening. However, according to Dr. Verst, there are a few symptoms that should warrant immediate medical attention: “If you experience progressive numbness or weakness down the legs, and loss of sensation or function around the bladder or bowel, that’s an emergency,” he said. “It could be a sign of a condition called cauda equina, which can result in paralysis and other serious complications.”

This article appears in the Fall 2016 Issue of Sun Valley Magazine.