By Linda Pearce

Do you dread getting out of bed in the morning?

Does your back feel like someone’s inserted a steel rod into your spine overnight?

Do you have to wait a few minutes before standing up and getting out of your bed in the morning?

I hear that story nearly every week from patients. So what causes your back to feel so stiff in the mornings and feel so much better within an hour or two of waking?

The answer is one of two posiibilities:

1. You have wear & tear in the joints of your back
2. You have inflammation and swelling around the joints or disc in your spine

Let’s have a look at the first cause. Wear & tear of the spinal joints. This is usually caused by age or overuse. As we age the spinal joints wear. In particular, the joint surfaces become worn and not so smooth. They rub against each other and don’t move as well. This causes the stiffness in the lower back as well as other spinal joints. This stiffness becomes worse with rest. The more you rest the more stiffness there is. So you can imagine if you rest for 8 hours overnight, you’re going to wake up feeling stiff in the morning. You generally start to feel better after an hour or two, once you start moving and lubricating the spinal joints.

The other common cause of morning back stiffness is inflammation and swelling due to injury. Most inflammatory conditions are worse in the mornings and even during the night. When you’ve got a disc problem the inflammation causes swelling in the lower back joints, muscles, ligaments and other sensitive tissues. This swelling builds up overnight and if it is significant, it can compress pain sensitive structures, causing you pain that disturbs your sleep. The swelling builds up because you are lying still. So it’s at it’s worst when you wake up in the morning after you’ve been ling still for a long period. It will start to improve once you start to move around. This is because the swelling gets dispersed by the body. As you move, the swelling moves. However, be careful, the more you move the more your swelling could develop, causing you more pain and stiffness.

Either way, whatever the reason for your back stiffness, sleeping on a poor bed will make it worse. Read about choosing the right bed in this article.

Dr Wayne

In this post I’m going to answer 2 questions that patients ask me as an Osteopath.

By answering these questions you’re going to stop worrying about things you thought were true but in fact are not. You’re also going to learn more about how your muscles, bones & joints work together to help you move and function throughout the day.

So let’s start with a question about your joint health.

1. Will cracking my knuckles give me arthritis?

No. Cracking your knuckles will not cause arthritis. Cracking your knuckles will cause a popping sound that’s caused by a release of gas from the joint space. The joint might move better after you  crack your knuckles but it won’t cause any damage. For more information about what “cracking” or manipulation does, please read my last post.

2.   Are there any bad side effects of cracking my back?

Yes. If you’re one of these people who loves cracking your back, neck or spine you’ll need to read this article. Repetitive manipulation or cracking of your joints causes them to move more. So if  your joints move more, why would that be bad?

Well, the thing is that if a joint was stiff in the first place then you manipulate that joint, it would be beneficial. But the problem is that people who habitually crack their backs are not actually loosening up joints that are stiff in the first place. They’re most likely manipulating the joints that are already quite mobile.

This is the real nub of the problem: You cracking your back is unspecific, you don’t know which joints you’re cracking, you don’t know which joints are stiff and which ones need cracking and you don’t know what effect cracking your back is having on those joints.

What you may end up doing is cracking the joints that move a lot anyway. This will create a very undesirable situation. You end up with joints that move a lot, in fact too much, and joints that are stiff. The stiff joints are the ones that need moving but you can’t get them to crack because of the hit & miss nature of cracking your own back.

Ironically you end up with the same situation you had before you’re compelled to crack your own back. This is exactly why you keep having to crack your back, because the problem you’re trying to fix is still there.

The other problem with repetitive cracking your own joints is that you can end up with very mobile joints. Very mobile joints or hypermobile ones can cause instability which is harder to treat than hypomobility or stiffness in a joint.

On the other hand, if a professional manipulates your spine, they’ll assess your joints before manipulating. They will feel what’s happening at each joint and how that movement affects the surrounding muscles, tendons and other joints in the area. By feeling the movements available at each joint level and the tension of the surrounding muscles, a skilled therapist can distinguish the available movement between individual joints.

The outcome of having a skilled professional manipulate your spine is discrimination between the joints that need treatment and ones that don’t. This means that you feel better and stay feeling better for longer. You’ll also loose that desire to keep manipulating your spine and stop setting up a viscous cycle of crack-feel good for a short time-need to crack again-crack…. .

So, in summary, cracking won’t cause arthritis but don’t crack your own joints.

Dr Wayne

Last week we had a look at what causes the grinding or clicking sounds that come from a joint when you move. Keeping with that theme, this week I’m going to explain what makes the noise that you hear and feel when you have your spine manipulated.

The sound I’m talking about is the popping sound that you can hear when your joints are stretched using a technique we call a High Velocity Low Amplitude manipulation or HVLA. HVLA is a very safe technique that we use to loosen the joints in your spine as well as other joints including the elbow, knee, foot & ankle. It’s very effective and is an important tool that we have to help you feel more mobile.

Understanding what makes the popping sound requires a bit of high school physics & human anatomy.  The popping sound comes from the joint that’s manipulated. The joint is an enclosed space containing the two bony surfaces that glide over each other and the fluid that allows that gliding to occur, smoothly and easily.

When we manipulate a joint we  introduce a local force to that joint designed to stretch the joint space, that’s the space between the two bony surfaces within that joint. By stretching that joint we increase the volume within the joint space. By increasing the volume within the joint space, the pressure within the joint decreases. By causing a decrease in pressure within the joint, fluid inside the joint is able to escape the joint space as a gas bubble. The gas bubble leaving the joint space is what causes the popping sound.

The gas bubble is thought to be either carbon dioxide or nitrogen gas. Don’t worry, the gas bubble doesn’t float around in your blood stream or anything, it simply gets reabsorbed in the surrounding joint tissues.

So what’s the point of HVLA or manipulation?

Well, the reason manipulation is so useful is because it frees up the joints and gives you greater mobility and less pain or stiffness.

HVLA is not the only tool we have in our toolbox, but combined with massage, stretching, articulation as well as many other safe and very effective techniques, we have everything we need to help you recover from many common conditions that cause stiffness, pain and discomfort.

Dr Wayne

As an Osteo I get asked a lot of questions by patients. One of the most common questions I’ve ever had is “What’s that clicking sound”. Now I’m not talking about the clicking sound that comes from manipulating a joint. I’m talking about the clicking sounds that come from your shoulder joint, or neck when you move them around.

A lot of patients are worried about these noises because they think that they come from two bones rubbing against each other. This is not the case. There’s nothing to worry about. Don’t worry that these noises are coming from early arthritis or wear and tear in the joints. Your joints don’t need oiling!

So what is the clicking sound?

Well, there are a number of causes as to why you might hear a clicking sound coming from your joints. To explain one of these causes let’s have a look at the normal function of your shoulder joint and it’s surrounding muscles. The shoulder is the most mobile joint in the body. It’s very mobile because it has a ball & socket joint with a huge degree of freedom. It needs to be very mobile because of the what it’s required to do. Surrounding it are a lot of short muscles you might have heard of called the rotator cuff muscles. If these muscles become tight from overuse or injury, they become shorter in length. As they become shorter they can get closer to the bones that lie beneath them. As they get closer to the bones beneath them, they are more likely to rub against these bones and make not only an audible clicking sound but you’ll also feel the clicking sound.

If the noise was coming from two bones rubbing against each other, you’d be in agony. In fact that’s what happens when a patient has hip arthritis and all the protective cartilage wears away from the joint surfaces. The hip joint becomes worn and the ball & socket grinds against itself. Giving you pain and stiffness.

So don’t worry, the clicking sound is harmless unless it’s painful.

Dr Wayne

That’s right, who would think that sticking a needle into your skin is going to relieve your pain? Probably no one.

Well that’s unless you’ve experienced Dry Needling Therapy (DNT) before and you’ve benefited from it’s amazing healing powers. Originating from Acupuncture, DNT is a relative new comer to the scene in terms of age. Acupuncture is reported to have originated as far back as 5300 years ago during the Ice Age. DNT began around the early 1900′s but has developed very quickly as a useful and very safe treatment option for patients suffering from pain and looking for relief.

DNT is useful for relieving pain from many sources. It is mainly used to help patients suffering from painful muscles and in particular local trigger points in the muscle belly. These trigger points can be caused by fatigue, poor posture, trauma or strain of the muscle fibres.

You’ve probably got a few trigger points around your body lying dormant even as you read this post. These latent trigger points are very common. They can give you pain and become active if you do too much sitting at your computer, you have poor posture, you exercise a lot or you’ve overstretched the muscles by lifting or carrying heavy objects.

Placing a needle into the muscle relieves the pain that comes from these trigger points, it relaxes the muscles in the area, it sends more blood into the region of your pain and also sends your own body’s endorphins or natural pain killers into the site of pain. Sounds great doesn’t it?

The needles that we use at our clinic are all single use, sterile and of the highest quality possible. You’ll hardly feel a thing. Some of my patients even ask me if I’ve actually got the needle in yet as I’m about to place another just under the skin layer.

The reason we’re so confident that you’ll benefit from DNT is that we have a lot of experience treating patients just like you and our Dry Needling technique is unique. No one else is using this style of DNT. It’s safe, effective and very good at resolving pain.

If you’re suffering from a bad back, a sore & stiff neck, a recent sports injury or you’re just in pain call the clinic to find out how we can help you.

So what do patients say after having DNT? The most common thing I hear them say is, I couldn’t feel a thing, I can’t believe it! The other comments are about how they feel less pain, more relaxed, calmer, less stiff, less swelling and more movement.

Dr Wayne

NEW YORK (Reuters Health) – Men who want to keep their bones strong may want to add running to their exercise routine, new research suggests.

In a study of 42 athletic men ages 19 to 45, researchers found that running seemed to have even bigger benefits for bone mass than strength training did. Both runners and weight trainers had greater bone density in the spine compared with road cyclists, but much of the benefit in weight trainers seemed to stem from their greater muscle mass.

In contrast, running appeared to build bone density regardless of the men’s muscle mass.

“The results of the study confirm that both resistance training and high-impact endurance activities increase bone mineral density,” senior researcher Pamela S. Hinton, an assistant professor at the University of Missouri in Columbia, said in a news release from the university.

“However,” she added, “high-impact sports, like running, appear to have a greater beneficial effect.”

Hinton and her colleagues report the findings in the Journal of Strength and Conditioning Research.

Bone is living tissue that reacts to exercise by becoming stronger.

Exercise that forces the body to work against gravity — like running, jumping and weight training — is most effective. In contrast, low- impact activities, such as cycling or swimming, put relatively little stress on the bones.

In this study, cyclists generally had the lowest bone density at all body sites measured. That sports-related difference did diminish once Hinton’s team factored in the men’s muscle mass; in general, as muscle mass — or body weight — increases, bone mass does as well.

However, even with muscle mass considered, weight trainers and runners still had greater bone density in the spine. And the effects of running appeared to be independent of muscle mass.

Hinton recommended that athletes involved in low-impact sports like swimming, cycling and rowing add weight training or high-impact activities to their workouts. It is key, she noted, to target muscles throughout the body.

“Exercise programs to increase bone strength should be designed using what is known about how bones respond to exercise,” Hinton said. “Only the skeletal sites that experience increased stress from exercise will become stronger.”

SOURCE: Journal of Strength and Conditioning Research, February 2009.

For some, chewing gum may be considered rude, impolite or just plain ‘uncool’. However, recent studies point that chewing gum actually helps strengthen facial muscles and also helps relieve stress to a great level.

“Often, our facial muscles are ignored when it comes to exercising. The only time they are put to use are when a person smiles and even that doesn’t last for too long. However, with chewing, it helps to target those muscles that have been inactive for quite some time and by chewing gum on a regular basis, it actually helps to tone and structure these muscles. The results may take some time to show up, but this is a proven method,” says Dr Niranjan Kumar, an orthodontist. This is also one of the reasons why sportspersons are often chewing gum on the field.

It is not just the facial muscles that get a great workout while chewing gum, the action also has other benefits. “The action of chewing helps increase saliva secretion and this has positive effects on the digestive process. Apart from that, chewing gum also helps control hunger pangs and is a favourite with weight watchers,” he adds.

Lower back pain is extremely common, it affects approximately 85% + of the population at some stage of their lives and is the largest musculoskeletal cause for sick leave and lost revenue. Many of those affected suffer chronic or recurrent episodes of back pain and this can understandably be very frustrating.

A large part of how we experience any pain and how we cope with it, is mental. There is of course the physical dysfunction or injury that is the basis for the pain starting but the mental aspect is extremely important and it is often overlooked. Commonly people who experience chronic back pain begin to feel down or even depressed and lack the confidence to partake in many activities, be it exercise, lifting or even normal daily activities like house chores or working. Does this sound like you? In many of these cases the lack of confidence and more importantly, the fear, associated with the pain is a large part of why the pain returns, doesn’t go away or is more extreme than the physical injury should produce. This is called ‘hypervigillance’ and there is a lot of research about it.

The reasons for the development of this are many and varied but the good news is, in most cases they can be dealt with effectively. Addressing your own beliefs, seeking treatment from a professional who can not only treat the physical side of things but educate you on your condition and give you guidelines that you can comfortably and confidently live through is vital and will provide you with a better overall prognosis. Breaking down the fear and understanding your pain is so important for you recovery and overall wellbeing.

Did you know that research has shown that if you have recovered from lower back pain in the past and then you get lower back pain again, you are actually more likely to cope well and recover again than not.

That is great news and it is important to keep in mind! Most people would assume that if they have back pain more than once, that they are getting worse and will go down hill further- well this does not have to be the case and you can take confidence in understanding that.

Getting to a health professional who can pinpoint your physical cause of pain and ease this as well as really taking the time to educate and help you understand what the pain is caused from and how/why it affects you is very important. It will give you confidence and allow you to take control and ownership over your symptoms so they don’t take over your life. We see many of these cases everyday and really enjoy explaining the problem and fixing it for you.

So next time you are feeling down about that sore, stiff, aching back don’t allow yourself to feel helpless and held back (pardon the pun), it is highly likely that there is a clear cause, it can be fixed and you will recover so you can enjoy the lifestyle that you want. If you want to feel better fast & have your pain explained to you, simply call the clinic, we’re here to help you.

Dr Ed Wittich

www.badbak.com