How to Avoid Back Surgery

According to the Washington Post, spinal fusion surgeries increased from 56,000 in 1994 to 465,000 in 2011. That is an 8 times increase in the rate of back surgery in 7 years! In Europe and other countries, back surgery rates are more than 4 times lower than those rates in the U.S. Why the difference?

The Washington Post surveyed 125,000 patient charts in 2013 and found the vast majority of people were having surgery, before trying more appropriate conservative measures, especially physical therapy. Physical therapy is far less costly than spinal fusion surgeries, which can typically cost more than $80,000, while the average therapy treatments for 4 weeks runs $1100.

What you can do to help your back?

Most back pain is mechanical back pain, which is the term used to describe the abnormal movement, or lack of movement in certain parts of the spine. This happens due to poor posture, lifting injuries, accidents and wear of the joints in the spine. The vast majority of people suffering from mechanical low back pain, can have significant improvement, and in most cases, complete relief.

Simply do the following to eliminate your back pain:

  • Improve your spinal joint mobility
  • Improve your spinal, pelvic and leg strength (core muscle groups)
  • Improve your spinal muscle coordination
  • Improve your balance and proprioception (your body’s ability to know where it is in space)
  • Improve your health (no smoking, proper nutrition, manage your weight and hydration)

Why pain pills make back pain worse

Many people take over the counter medication, such as Advil or Tylenol to get through their day with back pain. Millions of people nationwide take stronger prescription pain medicine, which has strong side effects. However, what most people do not understand is that pain pills only mask the pain; they don’t fix the underlying mechanical problem. It’s like turning the radio up in your car to drown out the squeaking noise from a bad car part that needs fixing.

With pain medication many people actually have worsening pain over time, because their mechanical problem gets worse. In fact, it is very common to increase injury to the spine, because you do not feel the pain. Pain is your body’s natural way of telling you to stop stressing the area.

What to do to relieve back pain

  • See a specialist physical therapist, ideally one that does hands on therapy and has a spine program, like our practice.
  • Work with your doctor and physical therapist to restore your normal spinal motion, strength, coordination and balance.
  • Follow the recommendations after your pain is better to maintain a healthy spine.
  • Improve your workstations and home ergonomics to protect your spine, moving properly to do everyday tasks. Physical therapists teach you how to do this.
  • Finally, with the right physical therapy, you can eliminate or reduce your dependency on medication.

While in some cases, surgery is absolutely needed, the vast majority of people just need physical therapy to get rid of their low back pain and start an active, healthy lifestyle. If you are concerned about your back pain, give us a call to schedule a time to speak with one of our therapists. If you know someone who is suffering, forward this article to him or her. It’s time to ditch the pills and get back to an active, pain free, flexible and strong spine. Call us today!

The 5 Natural Ways to Relieve Sciatica

Have you ever experienced aching pain in the back / buttock area that radiates down your leg? You may have sciatica. Sciatica is a common condition that affects up to 1 out of 10 people, typically between ages 25-45.

Sciatica is typically felt as a dull aching pain to the low back / buttock area, that can at times be sharp, depending upon movement. It is generally on one side, but at times can be on both sides. Other symptoms can include numbness and / or tingling, radiating down to certain areas of the leg.

Sciatica is an entrapment and irritation to the sciatica nerve, which passes from the lower spine, down through the buttock and supplies the back of the leg down to the foot. Typically, sciatica is caused by poor mechanical movement of the hips, pelvis or lower back. This causes abnormal strain and stress to the gluteus and hip rotator muscles. Certain people are more predisposed to sciatica, because their sciatica nerve pierces through the piriformis muscle in the buttock, which makes it more susceptible to irritation.

Pain Relief
The good news is that over 90% of those suffering with sciatica will get better with conservative treatment, especially physical therapy. Physical therapy focuses on improving the mechanical movement of the hip joints, pelvis and spinal joints to relieve pressure on the sciatica nerve. Furthermore, since many muscles are impacted and often weakened, physical therapy helps to restore normal muscle function. This balances the spinal, gluteal and leg muscles.

Try these 5 natural ways to relieve your sciatica:

  • Improve your posture – One of the long-term causes of sciatica is poor posture. Make sure that you have a lumbar support in your work chair and in your car that you can take with you to different places. Look at the way your computer and desk area is setup. Avoid soft couches and recliners. Physical therapists are experts in ergonomics and can teach you the proper posture setup for workstations and home activities.
  • Change your position frequently – Sitting puts direct pressure on the sciatic nerve. Therefore, it is important to change positions frequently. Consider getting an adjustable standing desk if you have to spend most of your day sitting at a computer. If you are suffering from sciatica, try lying down for 10 minutes, standing for 10 minutes and sitting for 10 minutes. Rotate this throughout the day as much as you can.
  • Try magnesium – magnesium is thought to sooth irritated nerves and many of us have magnesium deficiencies. Try a good magnesium and calcium supplement to soothe pain. However, if you are on medications, consult your physician first.
  • Improve your hip strength and flexibility – The gluteal muscles support the normal walking motions we perform everyday. They become weak and tight with prolonged sitting, especially at a desk job. This causes severe strain on the smaller hip muscles around the sciatic nerve, when walking or standing.
  • Get your body mechanics checked – Most of us do not realize that we have made an adaptation in our normal movements, because of limited joint motion or muscle weakness. Our body is amazing at adapting to problems, however, it can only do this for so long, until abnormal strain and stress occurs. Having a thorough biomechanical movement analysis by one of our trained physical therapists, will pinpoint the exact problem that is causing your sciatica. This allows us to formulate a treatment plan that will help you naturally restore your movement, function and quickly relieve your pain.

For more information on how you can avoid low back pain and sciatica, call us today to speak with one of our Fellowship-Trained, physical therapy experts. We can put the spring back in your step and restore your ability to move pain free.

spinal stenosis

Physical Therapy Just as Effective for Spinal Stenosis as Surgery

A new study published in the Annals of Internal Medicine that followed 169 participants showed that physical therapy was just as effective for people suffering from spinal stenosis as surgery (1). In fact, the results point to what physical therapists have known for decades, people suffering with back pain should try physical therapy first, before considering more invasive procedures.

Spinal stenosis is a common back pain condition that affects people mostly as they age. In the spine there are canals that are formed by the vertebrae in which the spinal cord passes through the nerves branching off it. With arthritis, wear and tear, disc problems, fractures and injuries, the canals can become smaller. In fact, many of the vertebrae will change shape and even grow bone spurs into the canals due to abnormal stresses and strain on the spine. Spinal stenosis can be a very serious condition as the spinal cord and peripheral nerves can be irritated and even compressed.

Common symptoms with spinal stenosis are back pain, radiating pain to the shoulders, arms, buttocks or legs. Often numbness, severe pain and burning sensations can occur with compression. Furthermore, balance can be compromised leading to a greater tendency for falls. Many people with spinal stenosis also find it difficult to walk for 15-30 minutes without increased fatigue to the legs and even pain.

The good news is that there is a lot that can be done to support the vertebrae by building up the muscle support around the spine with the right physical therapy. In addition, by improving motion in areas of the spine with stiffness, the normal loads on the spine can be distributed better.

Tips for helping spinal stenosis back pain:

  • Avoid activities that cause prolonged or repetitive extension of the spine, such as reaching behind you or overhead.
  • Begin a walking program, trying to increase your distance a little more each day.
  • Keep your hips strong. The gluteus muscles help to control the movement of the pelvis, which ties to your low back. Strengthening these improves postural control with walking and movement.
  • Have regular physical therapy checkups with our physical therapists to analyze your spinal movement and strength. We then formulate a plan to improve both.
  • Avoid prolonged sitting, especially in slouched positions such as a soft couch or reading in a recliner.
  • Change positions and move when symptoms occur to alleviate irritation and pressure on the nerves.

Talk to our physical therapists today about our SPINE program and how you can help alleviate your back pain quickly, improve your flexibility and your ability to perform everyday tasks! Call us today to learn more.


Annals of Internal Medicine

Source Reference: Delitto A, et al “Surgery versus nonsurgical treatment of lumbar spinal stenosis” Ann Intern Med 2015; DOI: 10.7326/M14-1420.

Aquatic Therapy Helps ALL Ages!

Copied from the Winchester Sun.  It has been our pleasure to work with DJ, Joan, and Steve.  This is truly an amazing family and and even more AMAZING young man!

For most of DJ’s life, doctors were unable to provide a definitive diagnosis, until at 11 years old, DJ was diagnosed with genetic mitochondrial disease, which stems from a carnitine deficiency that was not diagnosed at birth.

“When DJ was born doctors simply said he was developmentally delayed,” Joan said. “Mitochondrial disease was so rare they didn’t even know to test for it, and at the time he was born, carnitine screening was not required like it is today.”

Depending on which cells of the body are affected, symptoms of mitochondrial disease manifest in different ways.

In DJ’s case, his central nervous system, kidneys and digestive system are impaired by the disease. His most significant impairments are caused by scarring on the part of his brain that controls speech, so he communicates through body and sign language, sounds his family and friends understand and more recently through the use of an iPad app. He also has weak muscles, causing him to walk with bent legs and subluxation of his hips.

He works regularly with a variety of therapists in order to overcome hurdles he faces because of the disease.

He works with Cheri Rogers, an occupational therapist for Lifespan Therapy, and Danielle Eckman, speech and language pathologist with Core 4 Therapy Group, on a weekly basis. The two collaborate to make the most out of DJ’s therapy time. He also sees a physical therapist at Advantage Physical Therapy in Lexington.

Because the signal between DJ’s brain and his muscles is interrupted, he is unable to chew solid food, making it difficult for the family to eat out.

“When you have a special needs child, it’s difficult to go places,” Steve Graves said. “You have to take a lot of stuff with you. DJ has a hard time chewing regular foods, so he’s on a mostly blended diet. Because of this, we usually have to pack snacks that meet his needs, and it’s hard to find a (restaurant) with items on the menu for him.”

Joan said DJ is also easily “wired up” and has sensitive hearing, so crowded and loud places can become too much for him to handle.

“He’ll begin pulling his hair or biting his hands,” she said.

The couple have four other sons — Jacob, Nathan, Dalton and Colton— and for these reasons the Graves family typically can’t eat out often.

On a recent trip home from a physical therapy appointment, they were looking for a place to eat. Knowing DJ was a bit on edge that day, the couple decided to visit a Culver’s drive-thru.

“We noticed they had mashed potatoes and gravy on the menu,” Joan said. “We decided to order some for DJ and pulled over to feed him. He loved them and when he was done, he signed for more.”

After DJ’s next therapy appointment, the family decided to visit Culver’s again. This time, Joan took to social media to express her excitement over finding a suitable menu option for her son.

She tweeted a photo of DJ with a Culver’s wrapper and tagged the casual dining restaurant.

Soon, the photo was being shared and favorited like crazy, Joan said.

“About a week later, I got a tweet back from Culver’s asking for our name and contact information,” Joan said.

The family was told a Central Kentucky Culver’s franchisee was interested in throwing a party in DJ’s honor.

Charlie and Wendy Jordan own the Reynolds Road Culver’s franchise in Lexington and the Georgetown location. In honor of DJ’s 16th birthday, the couple threw him a party at their Georgetown operation complete with Culver’s gifts and a meal for the family.

“DJ has never been able to have a birthday out anywhere,” Joan said. “For him to be able to do that on his 16th birthday, which is such a milestone and a right of passage, was just beyond amazing. His birthday would have just been like any other day for him if it weren’t for the generosity of Charlie and Wendy and Culver’s. Thanks to them, it was an unforgettable day.”

Subsequent Facebook posts about DJ’s special day have garnered more than 600 shares and have been seen by more than 35,000 users, many of whom have reached out to the family to share their own stories of hope and inspiration.

The Graveses manage P3, a Facebook group dedicated parents of special needs children. It’s a place where parents can share their own struggles and successes with their children. Through the page, Joan discovered how powerful sharing her family’s stories could be.

“This is a whole different world for (special needs children),” she said. “Every day they have to confront a world that doesn’t understand them and find ways to adapt and get by in that atmosphere.”

Steve said its not only the parents of other special needs kids that needed to hear DJ’s story.

“People just need to hear some good news sometimes,” he said. “There’s so much bad news out there that people are hungry to hear some good news. That’s why we like to share stories like this.”

How to put the spring back in your step

Spring is just around the corner and that means a lot more outdoors time. However, if you suffer from knee pain, arthritis, low back pain or other aches and pains that keep you from being active, there are things you can easily do to become more active.

Change How You Sit
A lot of aches and pains relate to how we use our bodies in the day. Many back pain sufferers actually begin having back pain, because they sit too much. Here are some simple solutions to help you feel better:

  • Stand up and move around every 30 minutes, even for 1-2 minutes.
  • At work, vary your activities. Don’t sit for 4 hours in a row for example. Vary your activities so you can be walking, standing, sitting, squatting or other positions. The key is to mix up your positions and move throughout the day.
  • When you do work or play at a computer, make sure you have good posture. A good rule of thumb is that the top 1/3rd of the screen should be at eye level, your shoulders comfortably back and the keyboard / mouse a little lower than the height of your elbow.

Get active
Being active, doesn’t mean you have to go out and run a mile. Make it simple and something you enjoy, otherwise you won’t stick with it. Many studies show that to improve heart health and overall conditioning, you just need 30 minutes of walking a day. This can significantly make you healthier and stronger.

  • Start with an easy goal. If you tire after 10 minutes of walking, start with that, then slowly increase your time each day until you get to 20-30 minutes.
  • Make time for activity. In today’s busy world, if it doesn’t get planned, it won’t happen. Therefore, make a time where you can get out everyday or at least 3-4 days a week.
  • Do an activity you enjoy. For some, this is a group class and for others it is a sport. Whatever it is for you, !find local activities or just get out and walk.

Eat, Sleep, Drink
You are what you eat and do, so if you don’t feel well or are in pain, you can feel better rather quickly by simply eating well, drinking enough water and getting enough rest. This is different for everybody, but the bottom line is get enough vegetables and fruits in your diet, limit the intake of fried or processed foods and layoff the sugars. Did you know that a can of soda actually contains about 6 packets of sugar! It’s OK to treat yourself to goodies now and again, but make smart choices overall about what you eat.

Get enough rest! Sleep is the time your body needs to rebuild after using it all day. Instead of staying up late to watch TV or be on the computer, tape your favorite show and do something different before bed. More and more studies are showing that working on electronics before bed actually makes you sleep worse.

Drink enough water. Your body is almost 80% water, and you expel a lot through breathing and going to the bathroom. Make sure you replace this fluid. It is needed to make everything in your body run. Many common aches and pains, such as headaches, are attributed to being chronically dehydrated. You don’t have to be thirsty to be dehydrated. When you slurp down a soda, it quenches your thirst, but can actually make you lose water in your body.

Get help if you are in pain
If you suffer from low back pain, neck pain, headaches, joint pain or you aren’t happy with the way you feel, physical therapy can help. Our physical therapists have years of training in analyzing and treating pain with movement. Not only do we quickly relieve your pain, but we improve your strength, movement and ability to do the activities you love. We also teach you how to maintain your results and keep progressing toward your goals.

Where Your Pain Is Coming From

If you are suffering from aches or pains, here are some important questions that can help you determine the root cause of the problem:

How long have you had your pain?

For example, acute low back pain may be from a muscle strain. Chronic low back pain is typical of restricted joints, tight muscle tissue and weakened muscle strength.

How is the pain? Achy, sharp, tingling?

Achy pain is typically a problem with movement due to poor functioning of muscles and joints. Sharp pain can be a muscle spasm or even an impingement of a joint. Tingling sensations and pain can be irritation to a nerve either from compression or inflammation of that area.

Does the pain impact a specific area or does it spread over a wide area?

Wide-spread pain is typical of muscle strain, inflammation and weakness. People will experience this type of pain with prolonged standing, walking and other physical activities. This happens because the muscles cannot support the spine or hips and thus become strained. Specific pain to a part of the leg or arm could be nerve related. In either of these cases, it is important for you to seek out the right professional help.

Is the pain worse at a specific time of day?

Achy, stiff pain in the morning can be due to muscle and tissue stiffness. Severe radiating pain to the lower back, buttock and leg with bending in the morning is an indicator of a potential herniated disc. Wide-spread pain is typically related to the lack of flexibility and guarding in the spine. Whereas pain towards the end of the day after moving and activity is an indicator of spinal muscle weakness as the muscles fatigue during the day.

Do you have difficulty with prolonged sitting, standing or walking?

Pain with prolonged standing and walking is typical of muscle fatigue in the spine as well as the hip muscles. It is typical to complain of pain to the low back and buttocks as your muscles cannot tolerate the activity. Most people with low back pain have a lot of weakness with these muscles.

How we can help

The good news is that with the right physical therapy treatment, you can relieve your pain quickly and prevent it from returning. The fastest way to relieve your pain is to find the true source and treat it. Our physical therapists have years of medical training, specializing in muscles, joints and nerves, to determine where your pain is coming from. With specialized hands-on therapy we can relieve your pain, get you stronger and put you on the right path to return to your favorite activities.

Feeling Stiff, Achy? Physical Therapy Helps

Our bodies are made to move and rely on a finely-tuned balance of proper posture, strength, coordination, chemical levels, blood pressure and more. When you don’t move on a consistent basis or experience changes to your health, you may start to feel stiff and achy, especially in the mornings. Poor health, injury, a sedentary lifestyle and poor nutrition are also often to blame for the constant nagging aches or pains you may be experiencing.

Why do I ache in the morning?

Your tissues get irritated in the day and build up a chronic layer of inflammation. This may be subtle enough where you don’t notice it too much at the end of the day. However, overnight the inflammation thickens and makes your tissues inelastic, while also irritating the affected area further. The result is aching stiff joints or muscles in the morning, until you get moving. Then the inflammation becomes more liquid like, allowing the tissues to move better, thus hurting less.

If this cycle continues to happen, a chronic deterioration of the tissues can happen, often leading to severe problems down the road. Therefore, it is important to address your constant aches and pains, before they become severe.

Here are some tips for relieving common aches and pains

  • Stay hydrated and drink plenty of water. If not, your tissues can become drier, which slows down normal chemical processes in your body.
  • Get enough sleep. Too little sleep drastically affects the hormones in your body that are needed to maintain your delicate body chemistry. This can affect your muscles and other tissues normal functioning.
  • Exercise regularly. This makes your body more efficient at pumping blood around the body and removing normal metabolic wastes that are produced.
  • Improve your posture. If you sit at a desk or computer, get up every 30 minutes for a few seconds stretch. Move around and stand up to be straighter.
  • Eat bright colored fruit and vegetables. Fruits and vegetables with bright colors often have a higher concentration of antioxidants and vitamins that assist the body in repairing itself and normal functions.
  • Get a physical therapy consultation. If you have aches and pains that aren’t going away, or if you have a recent or past injury that keeps you from doing the things you love to do, you need to seek out the advice of our expert physical therapists. Physical therapy can really help you quickly relieve aches and pains for the long-term.