When 80% of people in the U.S. suffer from a sore back at some point in their lives, it can be easy to dismiss that pain as just a minor nuisance. If you can still move around and it’s not that bad, it must not be serious, right? In some cases, aches and pains are the result of age or maybe a vigorous weekend of physical activity. In the case of compression fracture symptoms, though, they might start mild and get worse if left untreated. Here’s how to know the difference.

What is a compression fracture?

Our spinal column consists of 33 vertebrae in four sections:

1. Cervical spine (neck)
2. Thoracic spine (middle/upper back)
3. Lumbar spine (lower back)
4. Sacrum (base of the spine/tailbone)

The vertebrae in each of these sections are connected to the neighboring vertebra above and below, stabilized by connective tissue, and further supported by the muscles of the back. Movement is assisted by facet joints and eased by intervertebral discs.

This whole structure works beautifully—until it doesn’t. Vertebral compression fractures are small cracks or breaks in one or more vertebra. These fractures can occur anywhere along the spine but are most commonly found in the thoracic spine. This area of the spine includes the ribcage and is more rigid to protect sensitive vital organs. This same rigid protection means fractures are more likely.

Vertebral compression fracture causes

The bones of your spine are strong. The support systems within the spine that allow for both stability and movement contribute to that strength. But bones can weaken over time, especially when osteoporosis is present. Osteoporosis affects mostly women over the age of 55. Age thins and softens the bones. In severe osteoporosis, even a cough or sneeze can cause a vertebral compression fracture.

Vertebral compression fracture causes aren’t restricted to older adults, though. This type of injury can occur in full-contact sports, in car accidents, or with any other sudden trauma to an otherwise healthy back. And that can happen at any age and regardless of gender.

Another serious, but rare, cause of vertebral compression fracture is metastatic tumors. Cancer that spreads to the spine may cause breaks or cracks in the spine in patients under 55.

Types of compression fractures

There are three main types of compression fractures:

1. Wedge: This is the most common type of fracture. The front of the vertebra cracks, but the back remains intact. This forms a wedge shape that can lead to permanent spinal deformity (i.e. kyphosis). A wedge fracture is mechanically stable, and the spine is still able to function.
2. Crush: When the vertebrae crashes down evenly, this is referred to as a crush compression fracture. As with the wedge, a crush fracture can still function well, if painfully.
3. Burst: Of the three types of compression fractures, a burst is the most serious and unstable. The vertebra shatters and sends pieces of bone in all directions, even towards the spinal cord. This is considered an emergency situation that requires immediate medical attention.

It’s important to note that stable compression fractures may not cause additional damage. Unstable fractures require treatment to prevent more serious vertebral compression fracture symptoms from occurring.

What does a compression fracture feel like? 

Compression fractures range in effects from a minor to an excruciating pain.

Some people don’t have any vertebral compression fracture symptoms at all. They don’t even know they have one until another medical issue sends them to the doctor. For others, the pain is immediate and debilitating. Sharp, stabbing pain is characteristic of a vertebral compression fracture caused by sudden injury or trauma.

13 common vertebral compression fracture symptoms

As noted above, some people experience no vertebral compression fracture symptoms at all. This is most common when the fracture occurs in the early stages of osteoporosis.

Usually, pain will begin mildly after a minor event (e.g. lifting something heavy, bending and twisting at the same time, or jarring the spine). Symptoms from fractures due to osteoporosis may actually heal by themselves. Pain persists for about four to six weeks and can be managed with comfort measures.

Sometimes this pain becomes a dull ache right around the area of the fracture. Again, for many people, this pain will gradually subside over a period of weeks or months.

Others might find that their pain becomes chronic. This occurs for a couple reasons.

The injured person might have unconsciously changed how they walk or sit to relieve the pain in their back, or the healed bone may have changed the way it is sitting in the spine. Inactivity while the bone heals may also cause chronic pain as the body tightens up.

Regardless of the progression, here are 13 common vertebral compression fracture symptoms to look for. Note that not all who have vertebral compression fractures will experience the most severe symptoms, but it’s good to know what to look out for.

1. Sudden, sharp pain

A sudden sharp pain in the back is one of the first signs of a vertebral compression fracture. This may be a fleeting sensation after a jarring step. It might occur if you fall or sit down too suddenly. For some people, the pain is quick and brief. Others might experience a sharp pain that lingers.

2. Slight pain that gradually gets worse

Not all pain from compression fractures is sharp and sudden. Some people experience a mild onset that gradually worsens over time.

3. Pain that decreases when you lie down

Unlike sciatica (see below), you may experience pain relief when you lie down. This takes the pressure off the spine (and any compressed nerves).

4. Difficulty moving

A compromised spine may result in compromised movement. You may find yourself struggling to twist, bend, or stoop.

5. Pain in the back, arms, or legs

Some people report pain in the area of the fracture only. Others experience pain in the back, arms, or legs. Where pain is located depends on the fracture itself and other factors, including overall health or other underlying conditions.

6. Peripheral nerve pain

Peripheral nerve pain is pain that occurs in the extremities. People with diabetes are highly susceptible to peripheral nerve pain, but it can also occur in vertebral compression fractures.

7. Sciatica

Sciatica is the term for pain that occurs anywhere along the length of the sciatic nerve. If the vertebral compression fracture occurs in the lumbar spine, there is a possibility you will feel symptoms of sciatic pain. These include:

• Numbness in the legs and feet
• Buzzing or tingling sensation in the legs and feet (“pins and needles”)
• Burning or aching pain
• Pain that increases the longer you stay in one positions (sitting or standing)
• Tightness in the calf or hamstring
• Weakness in the legs

Sciatica is most commonly felt on one side of the body.

8. Spinal changes

In the later stages of thoracic compression fracture symptoms, you may notice changes to the spine. Instead of sloping slightly forward and up at the base of the neck, a thoracic compression fracture causes the spine to bulge outward. This may start as a mild bump and grow steadily worse without treatment.

9. Height loss

You may notice a loss of height over time, especially in the case of multiple fractures. Any one of the three types of vertebral compression fractures can cause a loss of height.

10. Tummy troubles

Another sign of multiple compression fractures is stomach issues. When your spine shortens, you may experience digestive issues such as constipation and low appetite.

11. Pain in the hips

Shortened spines bring the ribcage in close contact with the hips. If enough vertebrae are compromised, this might result in the ribcage actually touching the hip bones, rubbing and causing pain.

12. Difficulty breathing

Perhaps the most distressing of the vertebral compression fracture symptoms is also, thankfully, one of the least common. When multiple vertebrae are fractured, your lungs have less room for proper function. This may cause trouble breathing.

13. Loss of bowel or bladder control

This rare but serious compression fracture symptom requires immediate medical attention. Head straight to your nearest medical facility.

Are there compression fracture treatments that can help?

Compression fracture treatments for mild fractures are much different than treatments for compression fractures with the potential for serious damage.

The first and best treatment is prevention. Since many compression fractures can be traced to weak or thinned bones, preventing osteoporosis through diet and exercise is the best line of defense.

If you do experience minor pain associated with your compression fracture, non-steroidal anti-inflammatory drugs (NSAIDs) offer relief from pain and inflammation. A back brace can also help support your back as it heals.

With minor pain under control and a brace for support, physical therapy is your next option for compression fracture treatments. These strengthening exercises do not heal the fracture but provide support and strength to prevent further damage (and future fractures).

Some patients also find considerable relief using acupuncture for back pain. The treatment may be ancient, but modern support for it is growing.

If pain persists, or the threat of serious damage is possible, surgery may be an option. The two major types of vertebral compression fracture surgeries—vertebroplasty and kyphoplasty—are similar. Both surgeries increase the height between the collapsed vertebrae: vertebroplasty uses acrylic cement injected between the vertebrae; kyphoplasty uses a small balloon, inflated, to make space. Both of these procedures protect the structure of the spine while reducing back pain symptoms.

Another surgery, spinal disc decompression, may remove loose bone material or any disc material if the intervertebral disc has ruptured due to a fracture.

Except in emergency cases, surgery is generally only considered when other more conservative options have failed. Talk to your doctor about all of your options.

Get help 

Back pain might be common, but it doesn’t have to be chronic. If you are suffering from compression fracture symptoms, it’s time to find help.

The pain specialists at Arizona Pain are committed to helping you get your life back. We offer comprehensive, personalized treatment plans for compression fracture symptoms. Get in touch to schedule your first appointment today!

Weight loss and exercise are wonderful ways to prevent back pain, but did you also know that healthy movement could reduce existing back pain? It’s true. Researchers at Stanford University found that overweight people who increased the amount of time they spent moving by just 20 minutes daily reduced their risk of back pain by 32%. Weight loss has also been tied to a reduction in back pain. Shedding pounds through diet and exercise supports your back health in numerous ways. Here’s why, and later, how to lose weight in a healthy way.

1. Eating healthy, anti-inflammatory foods does a body good

Overweight people may eat diets full of fatty and sugary foods. These foods create inflammatory proteins that aggravate back pain. Conversely, eating powerful, healing foods such as cherries, salmon, and green tea fills your body with antioxidants that reduce inflammation and may reduce pain.

A study conducted at Michigan State University found that anthocyanins, the antioxidant that gives cherries their signature red color, may inhibit pain in essentially the same way as anti-inflammatory drugs. Other brightly colored fruits and vegetables contain similar natural compounds that fight pain. As a bonus, eating fruits and vegetables instead of processed, high-fat food can help people lose weight.

2. Exercised-induced weight loss builds muscle strength and reduces inflammation

Strengthening muscles in your abdomen and those surrounding your spine helps support your back and reduce pain. Without exercise, those same muscles weaken, leaving your spinal column to support the body’s weight alone. In overweight people, that task overwhelms the spine and often leads to back problems.

A study published in the American Journal of Epidemiology found that overweight and obese men who exercised for one hour each week reduced their risk of back pain by 20%. Researchers attributed the reduction to exercise’s work in reducing inflammation often found in overweight people.

3. Weight loss reduces the risk of conditions that may lead to back pain

Carrying excess weight and living a sedentary lifestyle have been linked to many health conditions, such as osteoarthritis and herniated discs, both of which can lead to back pain. Losing weight and exercising promotes a healthy skeleton and can reduce back pain.

5 ways to lose weight, in a healthy and not-starving kind of way 

Weight-loss efforts have the tendency to quickly morph from an initiative designed to help you feel better into one fueled by self-destructive behaviors like skipping meals and obsessively weighing yourself.

Successful ways to lose weight — meaning a person drops pounds and keeps them off while staying healthy — have one thing in common: they’re undertaken as a lifestyle shift.

Losing weight requires thinking about food differently, fundamentally changing habits and behaviors to support a slimmer body. Restricting calorie intake until you lose five pounds and then returning to your typical eating methods doesn’t work.

But here are five weight-loss strategies that do.

1. Eat every meal

Skipping meals makes people hungry. And when extreme hunger strikes, it’s very difficult to make good eating choices. You may eat a half a bag of chips while waiting for your lunch to cook or scarf down a candy bar because your blood sugar has dropped and you need food now!

Instead of skipping meals, eat plenty of food, and eat often. While many people find three meals a day plenty, some research has shown that eating more frequent, smaller meals may be effective for supporting weight-loss efforts.

Research conducted at the University of Eastern Finland found that adolescents who ate five meals a day were less likely to be obese, regardless of their genetic propensity toward accumulating extra weight. Eating breakfast was a particularly important meal for keeping a trim waistline, researchers added.

In the Finland study, participants ate three meals and two snacks. Making sure to eat the right kinds of food is key to making any weight-loss strategy work, whether you eat three times a day or five.

Fill your plate with vegetables, lean protein, and whole grains that are as minimally processed as possible. Eat healthy, unprocessed snacks like celery and peanut butter, almonds and raisins, or a piece of fruit.

Food is fuel, and eating regular meals is particularly important for diabetics, who must maintain even levels of blood sugar. It’s also important for those who may be suffering from fatigue along with pain because eating every few hours helps keep energy levels high and give the body the nourishment it needs to heal itself.

2. Seek support

Some people can lose weight on their own. Others may find it helpful to embark on their journey with the support of a group, like Weight Watchers or Jenny Craig. These groups help people by giving food guidelines. They also provide accountability to those who need a little extra push to stay on track with eating goals.

If you’re not sure how to eat healthy, those groups are wonderful resources to learn how to choose food. Jenny Craig sells packaged food for you to eat while Weight Watchers guides people through a point system, where you can eat whatever you want as long as you stay within the required number of points.

These programs provide professional support as well as the opportunity to connect with others working to lose weight, but they can be costly. If you’d like to find encouragement without the high price tag, consider joining a weight loss support group like those on Meetup.com.

And if you need help learning how to eat healthy, consider ascribing to a diet style, like the Mediterranean diet, which emphasizes fruits, vegetables, and healthy fats like those in fish and nuts. Mediterranean diet cookbooks are readily available and a wonderful starting point for those embarking on a weight loss journey. Try The Mediterranean Diet for Beginners, which comes with 40 recipes and a weeklong diet plan to take the guesswork out of eating healthy.

3. Eat family meals

Busy schedules prevent many families from eating together, but research has found gathering around the dinner table may help you lose weight.

Research published in The Journal of Pediatrics found that family meals—even one or two each week—helped protect against rising levels of adolescent obesity. Researchers say:

“Coming together for meals may provide opportunities for emotional connections among family members, the food is more likely to be healthful, and adolescents may be exposed to parental modeling of healthful eating behaviors.”

4. Plan ahead to lose weight

Changing habits is never easy, but good planning helps create the inertia needed to shift diet choices.

Each week, perhaps on a Saturday or Sunday, plan ahead what you’ll eat for the following week. Find a few healthy recipes, whether on a food blog or from a cookbook, and buy all the necessary ingredients so you have them on hand.

Knowing what to eat takes the guesswork and thinking out of meal planning. The question of “What should I eat?” never seems to go away, partially because once it’s solved for one meal, it’s already time to figure out the next.

Most people have go-to meals, ones they make without even thinking. The idea is to create a new set of healthy, nutritious go-to meals through planning. Without planning ahead, lunchtime will come around, you’ll wonder what to eat, and end up eating an unhealthy go-to meal. Then you won’t meet your weight-loss goals, get mad at yourself, and develop the misconception that you’re not capable of losing weight.

It’s just not true! You can lose weight. It just requires good planning. Another part of planning ahead is deciding how you’ll handle those times you’re busy and don’t have time or the desire to cook.

Maybe you know you’ll be busy on Tuesday night, so on Monday, you make a big batch of soup, or pre-cut vegetables for a salad or quick stir-fry. Cooking in batches is a wonderful way to reduce the amount of time and energy spent cooking.

Many people with chronic pain might find it hard to chop vegetables or cook due to issues with joint pain or fatigue. In that case, you may plan ahead by buying pre-chopped vegetables. Or, ask a friend or family member to help you with cutting.

Achieve your desired weight loss by knowing what speed bumps you’ll face and plan ways to get around them. The obstacles will never go away, but you can develop ways to succeed despite them.

5. Indulge strategically

If you love chocolate, or cake, or ice cream, designate a cheat day where you can enjoy your favorites. You might also designate meals where you enjoy any fried or unhealthy food you want.

Losing weight is more about the choices you make over time, and not those made on any one given day. Taking the opportunity to enjoy delicious, but not-as-healthy foods makes eating healthy a true, sustainable lifestyle. It’s better to cheat once a week than to avoid cookies for months and binge by eating a whole box.

By looking to make lifestyle shifts, instead of depriving yourself on a restrictive diet, your plan to lose weight transforms from a torturous endeavor into a wonderful adventure. One characterized by learning about health and making choices every day to become a healthier, slimmer, more vibrant you.

What is your best tip to lose weight for reducing and preventing back pain? Ready to talk to a doctor about treating your back pain. Find one in your area here. 

A chiropractor’s signature technique of treating low back pain is spinal manipulation, with the stereotypical popping noise that’s actually the sound of a gas bubble releasing between joints. Did you know that there are multiple types of spinal manipulation? Some are completed by hand and others require the help of a small, specially designed instrument.

In addition to classic adjustment methods, chiropractors use other special therapies that are designed to reduce pain and improve the health of the spine and surrounding structures.

The specific method your chiropractor will use with you depends on your physical condition and the cause for your underlying back pain. And while chiropractors approach low back pain with a holistic approach, by addressing nutrition, stress, and exercise, spinal manipulation is an important tool for making sure the musculoskeletal system is in optimal alignment and reducing pain.

Here are the most common spinal manipulation and adjustment methods.

Toggle drop

This technique involves the use of a quick, precise thrust to a specific area of the spine to relieve back pain. When applying a toggle drop, the chiropractor crosses his or her hands and then presses firmly down, using the controlled motion to improve mobility in the vertebral joints.

Motion palpation

Rather than an adjustment, motion palpation is a diagnostic tool. It’s a way of observing the spine to identify any areas in the spinal column that are out of alignment or not moving freely.

The practice involves the chiropractor placing his or her hands at specific places along the spine and then guiding the patient through a series of movements. The chiropractor will feel the entire spinal column—from lumbar to thoracic—to identify any areas that feel out of alignment.

Lumbar roll

The lumbar roll is one of the more common chiropractic techniques, particularly for patients with low back pain.

For this technique, patients lie on their sides while the doctor stands on the front plane of the body. The chiropractor applies a rapid, precise thrust to the problematic area, returning the vertebrae to proper alignment.

Release work

Chiropractic release work involves gentle pressure placed along the spine to gently separate the vertebrae and encourage free flow of the spinal column while reducing pain.

Table adjustments

This type of spinal manipulation involves the use of a table that has a drop piece—a portion of the table literally drops below the rest. For this adjustment, the chiropractor examines the patient to ensure the body is in the proper positioning. The chiropractor applies a rapid thrust to the area out of alignment, and the table’s drop piece lowers down at the same time the thrust is applied.

The act of the table dropping down allows the force from the chiropractic adjustment to dissipate, making the adjustment more comfortable for both the patient and the doctor.

While many manual adjustments require the back to be twisted, table adjustments do not require this. This method is highly effective, but also very specialized, requiring both special equipment and skill. Table adjustments are wonderful for unlocking the spine and encouraging total mobility while reducing back pain.

Instrument adjustments

This is a gentle type of spinal manipulation that is not as hands-on as the previously described techniques. Chiropractors use a spring-loaded activator instrument to adjust the spine while the patient lies face down on the table.

The instrument provides a gentle method of freeing vertebrae, and it can also be used on the extremities to encourage optimal alignment.

Humans aren’t the only ones to benefit from instrument adjustments; animals can, too.

Manipulation with anesthesia

Some patients with lower back pain who don’t respond well to traditional spinal manipulations may undergo full anesthesia or twilight sedation before receiving an adjustment. This procedure takes place in an outpatient hospital setting so patients receive full oversight by qualified medical staff.

This type of therapy is typically reserved for those patients whose pain is extremely intense. It’s usually used on patients with chronic low back pain, as opposed to those experiencing pain from an acute cause like an injury or other trauma, according to research published in the journal Chiropractic and Manual Therapies.

Because this treatment is more invasive than other types of chiropractic adjustments, it’s typically not a first-line therapy, and used only when other treatments have failed.

In addition to these methods for adjusting the spine and encouraging proper alignment, chiropractors also use release techniques.

Flexion-distraction technique

People with low-back pain or leg pain resulting from disc injuries may benefit from this commonly used procedure.

To start, the patient lies on a specially designed table that stretches the spine. The chiropractor isolates the area with the affected discs, flexing the spine in a gentle pumping rhythm. Patients should feel no pain.

This procedure is believed to work by moving the disc away from the nerve, which reduces inflammation and pain.

The technique is typically performed over multiple sessions and often in conjunction with other therapies, such as physiotherapy. Patients are usually given exercises to do at home to alleviate the pain related to lower back disc injuries.

If, at the end of 12 sessions, patients have not improved, they’re usually referred for further imaging or a spinal specialist to investigate the problem.

A study published in the Journal of Alternative and Complementary Medicine compared patients with chronic low back pain who received flexion distraction to those who participated in an exercise program. Researchers followed the patients for one year after treatment, and found those who received flexion distraction reported less pain than those who participated in the exercise program.

Pelvic blocking

Another treatment used for patients with disc-related, low back pain is pelvic blocking. This procedure involves the use of cushioned wedges that are placed under each side of the pelvis. The chiropractor begins specific, gentle movements that allow gravity to encourage separation between the disc and the nerve, lessening pain.

This gentle, non-forceful method creates space for healing to happen. In those cases where patients do not demonstrate improvement, they are referred for spinal imaging or a specialist for further review.

Have you experienced any of these treatment methods for low back pain?

Image by Steve Jurvetson via Flickr

Is it possible to develop chronic illness from doing…nothing? Turns out, “sitting diseases” and various health conditions are on the rise as we become more sedentary. Whether it’s an increase in the risk of diabetes, cancer, and heart disease or just increased pain from sitting at desk, here’s how to decrease your chances of chronic illness and to relieve pain.

Pain from sitting at desk is common

The statistics about sitting are grim:

• An estimated 36% of adults in the U.S. are completely sedentary in their free time
• Almost eight million people in the U.S. list their reason for disability as back pain
• Too much sitting increases your chance of premature death
• Sedentary lifestyles are more harmful than smoking

Even without discussing the monetary cost of too much seat time, pain from sitting at desk can make you very aware of the consequences. If you are managing multiple pain conditions, sitting can make each one of them more challenging and painful.

Keep reading for more on managing the different types of pain that come from sitting at desk.

How to deal with back pain from sitting at desk

Back pain from sitting at desk is the most common (and perhaps the most troubling) kind. It seems counterintuitive that simply being seated would cause so much pain, but here’s how it works.

Weight gain is the first thing you might notice as your lifestyle becomes more sedentary. When we exercise, our muscles release lipoprotein lipase, a molecule that helps process fats and sugars. Without movement, production of this molecule slows, and the pounds begin to add up. Carrying extra weight, especially in the belly, can add pressure to the lower back as that curve becomes more pronounced. This can lead to disc herniation and other serious injuries to the spine.

The strong muscles of the lower body—the glutes, the quadriceps, and the calves—also begin to atrophy without use. This weakness can cause us to rely on other parts of the body to hold us up, taxing muscles that are unused to this sort of task. Tight hamstrings also tug on the lower back and cause compression.

But there’s more. Sitting shortens the hip flexors on the front of the hips. This can be even more exaggerated if you hunch your shoulders over. Over time, this poor posture can lead to premature disc degeneration, with serious back pain from sitting at desk the consequence.

Maybe your job requires you to be seated for most of the day. So how do you deal with back pain from sitting at desk?

How to sit at your desk to avoid back pain

Start with the basics: good posture and ergonomics.

Ergonomics is the study of how people work. The focus is on the physical way we use our bodies in the course of our workday, with an eye to minimize the potential for injury due to over or improper use of our musculoskeletal system (bones and muscles).

Set yourself up for a pain-free workday by ergonomically modifying the way you sit at your desk. Sit as close to your desk as is comfortable to avoid the tendency to reach forward, placing an unnatural curve in your upper back. Keep your feet firmly on the floor, with knees directly above your ankles (use a small stool or cushion if your feet do not reach the floor completely).

Your upper arms should remain parallel to your spine, and your hands should form a 90-degree angle to the work surface. If you make these adjustments and realize that your chair or work surface is not conducive to proper posture, the following accessories can help.

The best accessories for reducing back pain at work

The best accessories for reducing back pain at work help to modify your work environment to suit you. Look for features in chairs and desks that adjust to you (instead of you adjusting to ill-fitting tools).

This includes desk chairs with:

• Adjustable seat and arm heights
• Adjustable lumbar support
• The correct seat depth to support proper posture all day

You can also consider sit-to-stand desks, treadmill desks, and stability balls that promote core engagement. Each type of desk has advantages in that they help you to maintain proper posture, encourage movement during the day, and adapt to meet your needs.

How to relieve and prevent back pain from sitting at desk

Even with proper posture and an ergonomically correct workspace, it’s crucial to bring some movement into your day every now and then. Set a timer for a stretch break every half hour and add a walk around the office on the hour.

If an important deadline keeps you at your desk, there are some chair yoga stretches that you can add instead of a walk. These poses can be completed at any fitness level; it’s amazing how much you can get your heart pumping doing a few deep breaths in chair-supported warrior pose!

Make sure to incorporate some full-body, stress-relieving exercise after work, too. A simple walk through the woods or a park after work can help promote good mental health and relieve and prevent back pain from sitting at desk.

How to deal with neck pain from sitting at desk

Neck pain from sitting at desk is an extension of the pain you feel from overall poor posture or ill-fitting office chairs and desks. We have become a society of “neck forward” people as we reach our heads forward and down to look at our smartphones and computer screens.

But consider this: for every inch your head sits forward of your shoulders, an additional ten pounds of pressure is placed on your spine. Now think about doing that for eight hours a day at work—that can be a real pain in the neck!

This head forward posture places excessive pressure on your shoulders and upper back, increasing your risk of disc herniation. It can also cause difficulty breathing and numbness in your hands and arms as the nerves to these areas are compressed.

How to sit at your desk to avoid neck pain

Start by ergonomically adjusting your workspace so that your eyes are level with the top of your computer screen. This keeps your gaze at the optimal level for comfort. Keep your mouse and other accessories within arm’s reach so there is no need to strain forward to use them.

The best way to avoid neck pain is to adjust your posture so that your head is over your shoulders (where it should be!). If you have spent years in a head-forward posture, this correction can take time and may feel uncomfortable at first. This is normal, as you are re-training your body.

Sit with feet flat on the ground, knees above the ankles. Imagine that you have a thread at the crown of your head, gently pulling your spine upwards. Keeping your chin parallel to floor, ease it back until your ears are directly above your shoulders (which are directly above your hips).

You may need to make this change gradually, but the more you notice and correct your posture, the less pain you will feel while sitting at your desk.

The best accessories for reducing neck pain at work

If your monitor is not at the proper level, look into adjustable monitor stands and desk mounts. These can be tailored to your desk even if it is a sit-stand model. You can also use a desktop document holder to make reading easier on your neck.

Finding yourself constantly reaching for something that is just a bit too far away? Consider organizing your desk so that everything is more conveniently within reach so as to minimize the strain of reaching forward.

How to relieve and prevent neck pain from sitting at desk

Since you are standing up once every 30 minutes to stretch to reduce back pain from sitting at desk, take some time to relieve neck pain while you’re at it.

As with back pain, yoga can help to relieve (and prevent) neck pain from sitting at desk. A few simple stretches to relax and release tension can be the difference between working comfortably and feeling terrible after a long day.

Add a little self-massage a few times a day for the added benefit of overall stress relief.

How to deal with shoulder pain from sitting at desk

Shoulder pain from sitting at desk is another consequence of poor posture and lack of movement during the day. A head forward posture rounds the upper back, placing strain on the tendons and muscles between the shoulder blades. The tips of the shoulders curve inward, overly stretching that connective tissue, too.

In addition to postural challenges, small repetitive motions can also cause injury over time, as can an improperly positioned armrest or desk height.

How to sit at your desk to avoid shoulder pain

The same rules for ergonomics and posture apply here, with one additional caveat: remove the armrests on your chair. In most cases, chair armrests hike the shoulders up.

This may feel comfortable at first, but it can lead to problems and shoulder pain in the future. If your desk, chair, and screen are at the proper height and your feet are solidly planted on the floor, you won’t even miss them.

The best accessories for reducing shoulder pain at work

The best accessories for reducing shoulder pain at work really depend on your job. Are you a customer service rep, on the phone all day? Invest in a headset to relieve not only shoulder pain but also pain in the neck.

Make sure that your upper arms are parallel to your spine, and your lower arms and wrists are in line with each other at a 90-degree angle from your body. This goes a long way to relieve not only shoulder pain but also neck pain (above) and wrist pain (see more below).

Finally, if you have shoulder pain due to injury, ask your doctor about a shoulder brace that can help you work more comfortably.

How to relieve and prevent shoulder pain from sitting at desk

Are you sensing a trend here? Standing up and simply moving your body twice an hour can go a long way to relieve and prevent shoulder pain from sitting at desk.

Dedicated yoga for shoulder pain can help when it hurts, but simply breaking up your day with a standing break, or adding variety to your tasks can go a long way towards preventing pain.

How to deal with wrist pain from sitting at desk

The repetitive nature of many sedentary desk-related tasks (e.g., typing and filing) can cause some serious wrist pain from sitting at desk. Coupled with poor ergonomics (more on that next), carpal tunnel syndrome (and overall wrist pain) is a serious condition that can become disabling.

When we use our wrists too much, without a break, or improperly, swelling in the wrist can place pressure on the median nerve as it passes through the carpal tunnel in the wrist. When this happens, pain, numbness, and tingling can be so bad as to immobilize your hands.

Simple overuse can also just cause fatigue and soreness in the wrists. Injury or pain in the neck and shoulders can also cause referred pain in the wrists.

How to sit at your desk to avoid wrist pain

Proper posture and ergonomics are key here. It’s crucial that your keyboard is at the proper height to allow your hands and wrists to be level with your forearms. Don’t lean the heel of your hands on your desk or laptop as you type, and keep your elbows close to the side of your body.

Avoid bending your wrists to the extreme in any direction. Yes, sometimes we need to move our hands in odd ways to get the job done but try to stay in the middle of your range of motion for most daily tasks.

And as always, sit properly to best support your whole body, all day long.

The best accessories for reducing wrist pain at work

If you have already been diagnosed with carpal tunnel system, most likely you have a brace and instructions to use it. Use it! This can go a long way to preventing further injury and helping your wrist heal.

Use padded wrist supports and keep your mouse at the same level as your keyboard for the most comfortable use. Talk to your doctor for additional support.

How to relieve and prevent wrist pain from sitting at desk

There is no need to stand to exercise your wrists, but they do need a little attention. Taking frequent breaks, every 15 minutes or so, to roll your wrists in circles in both directions or to flex and stretch your hands keeps the blood flowing and the muscles that support your wrists comfortable.

You can gently shake your hands to loosen and relax your wrists and arms to relieve and prevent wrist pain from sitting at desk. Or, try a few of the yoga poses for shoulder pain above to really get some relief.

Other forms of pain from sitting at desk

Believe it or not, simply sitting at your desk all day long can cause other types of pain you might not expect. Some people develop temporomandibular joint disorder (TMD or TMJ) due to tension in their neck and shoulders. A TMJ massage can help relieve this pain.

And we can all guess that sitting down for too long can be a real pain in the butt. As with the other conditions, moving your body is the quick and effective treatment. Simple stretches, regular breaks, and exercise outside of your workday can go a long way to counteract the effects from too much sitting.

Get help for chronic work pain

You’ve ergonomically modified your workspace, taken the breaks, and done the stretches, but you still have pain.

Arizona Pain can help if you’re in the Arizona area. We’ve developed a webinar series on how to manage multiple pain conditions at home. Take a look, then get in touch. We will work with you to develop a comprehensive pain management plan.

Lower back pain is a common complaint across the globe and it’s one of the leading causes of disability. What gets less attention but is arguably harder to treat than lower back pain is middle back pain. Middle back pain can be a complex condition, with many patients never finding out the root cause of it. The middle back is a complex part of the spine: its job protecting the vital organs is crucial, but it’s also susceptible to stubborn pain. If you suffer from middle back pain, here are some stretches and exercises that can help. As always, talk to your doctor to ensure these exercises will be helpful for your unique case.

What causes middle back pain?

Upper and middle back pain is not as common as lower back or neck pain, but it still accounts for a sizable amount of pain. The upper and middle part of the back are known as the thoracic back. This part of the back contains the T1 through T12 vertebrae, part of the rib cage, and various muscles and ligaments that hold your spine together.

While the lower back and neck are made to be more flexible, the upper and middle parts of the back, along with the rib cage, are built for support and to protect many of the vital organs of the human body. This rigid structure means that the middle and upper back are naturally less mobile. It also means that when something happens to this area of the spine—trauma or another condition—it can be more difficult to treat.

On the positive side, many common complaints in the lower back and the neck are rare in the middle back. Spinal stenosis, degenerative disc disease, or disc herniation are rarely reported as a cause of middle back pain.

The main causes of upper and middle back pain occur from overuse or an injury that usually develops from continuous strain or bad posture. Continual high stress can also cause muscle tension, which can eventually devolve into a vicious cycle of stressing over ever-increasing pain that even affects your sleep.

Conditions that put pressure on the spinal nerves can also cause upper and middle back pain, such as a fracture of a vertebrae, scoliosis, or osteoarthritis.

This is especially true for those who work at a computer every day or who work in highly repetitive and physically active industries (e.g., warehouse work and construction).

Middle back pain symptoms

Some common middle back pain symptoms include:

• Pain that is either localized or spread over a large area
• Discomfort with a slow onset that gradually increases in intensity
• Pain made worse by certain activities or positions
• Variable pain that can be dull, sharp, or burning

In some cases, upper and middle back pain can be a sign of much more severe issues such as a cancerous tumor and diseases that affect the heart, lungs, and kidneys. If you experience any of the following symptoms, make sure you consult a physician immediately:

• Numbness or weakness in your extremities, chest, or stomach
• Loss of bowel or bladder control
• Chest pain or pressure
• Nausea or vomiting
• Fever

Upper and middle back pain is also a common symptom of heart attack in women. If the onset of pain is sudden without any physical trauma, contact your doctor immediately.

How to stretch the middle back 

The one thing that most back pain has in common is that it can be relieved with simple stretches and exercises to build muscle strength and reduce tension. Mid-back stretches and middle back strengthening exercises can offer profound relief and healing for many chronic pain conditions.

But this area of the body can be difficult to stretch. The skeletal structure only allows movement so far in one direction; you cannot stretch bone. There is no need for huge, dramatic stretches, though. One way to think about it is to imagine the shoulder blades as flat plates that can be shifted around on the back. Connected to muscles and tendons, even starting with this simple visualization can be helpful.

Back stretches for middle back pain

There are many different ways to treat middle back pain. Options like ice therapy, over-the-counter medications, and massage only provide temporary symptom relief. Incorporating regular middle back strengthening exercises can go a long way towards a more permanent reduction of pain.

Middle back pain stretches should be incorporated gradually and with your doctor’s supervision. Remember when doing these stretches to pay attention to your breathing and to never hold your breath. Exhale while stretching the muscle and inhale when you start to relax it. Pay attention to how it feels when you move. If something feels “off” or causes sharp, stabbing pain, move carefully out of the stretch.

These eight middle back pain stretches are a great place to start. You can also find more in our yoga for middle back pain post.

1. Seated twist

A simple stretch you can do at the office or while sitting in front of the computer is a seated twist. Inhale deeply, then as you exhale, press your navel to your spine as you twist to the right. If your chair has armrests, place the right hand on the back of the right armrest and the left on the front. If not, place your right arm on the back of the chair and let your left arm come to the outside of your right thigh.

If it feels good for your neck, you can look gently over your right shoulder. Otherwise, just look forward or to the side. Hold for three to five full breaths, sitting tall on the inhale and pressing your navel to your spine on the exhale. Return to the center on an inhale, then twist to the other side.

2. Passive back bend

A passive back bend is an amazing stretch to do at the end of a long day and requires minimal effort. Start by rolling up a towel or use a pillow or yoga bolster. Lay it down horizontally so your shoulder blades can lay across it. Lie across the rolled-up item so your shoulder blades are supported.

Breathe deeply and relax into this stretch for at least five minutes. If you would like a deeper stretch, you can turn the pillow or towel so that it runs vertically up and down your spine, or you can add another pillow.

3. Supported hamstring stretch

Hamstrings stretches should be part of middle back strengthening exercises. Try a supported hamstring stretch. It’s easy on the back and only requires a chair.

Stand in front of a sturdy chair and place the heel of one foot up on the seat. Hinge at your hips to fold forward with your navel to your spine and a long, straight spine. If you feel any pain behind your knee, bend the knee. You want to feel this stretch in the belly of your hamstring.

Take three to five full, deep breaths, lengthening your spine on the inhale, and folding on the exhale. Switch sides. This is a good stretch to do periodically during the day.

4. Cat-cow pose

The cat-cow yoga pose can really help with back pain. Start on all fours with shoulders over wrists and hips over knees. Come into cow pose. Inhale, arch your lower back to let your belly reach towards the ground as you draw your shoulder blades onto your back. Let your heart shine through your upper arms and lift your gaze to the sky.

As you exhale, tuck your pelvis under and arch your back like a cat, letting the shoulder blades fall away from each other as you press your hands into the ground and drop your head.

Follow your breath for a series of five of these mid-back stretches.

5. Heart-melting pose

Heart-melting pose is also called “puppy pose” in yoga. Start on all fours with your hips directly above your knees. Keep your knees and hips in one straight line as you walk your hands forward to lower your forehead towards the ground.

If this pose feels too intense on your shoulders, keep your arms separated. You can also place a bolster or a couple of pillows underneath your chest (and a block underneath your forehead) if you cannot quite reach the ground.

Breathe here for at least ten breaths, then slowly walk your hands towards you to come out of the stretch.

6. Thread the needle

Start on all fours with your hips directly above your knees and your shoulders above your wrists. Inhale, then twist your torso to reach your right hand behind your left wrist, lower your body so that your shoulder and the right side of your face rests on the ground and the back of your right arm is on the ground stretching towards the left. You can keep your left hand where it is or stretch it forward. Take three to five breaths in this pose, then press into your left hand to unwind.

Repeat on the other side.

7. Shoulder flossing

Shoulder flossing moves the shoulder blades gently through their range of motion. It is the same shoulder action as cat and cow pose, only this time you keep your lower body still and engaged, with your navel pressing to your spine.

On all fours, inhale and press the floor away, feeling your shoulder blades slide away from each other. Exhale and drop your chest so that your shoulder blades come together on your back.

Repeat three or four times.

8. Half-dog at the wall

Half-dog at the wall is a great upper and mid-back stretch that also stretches tight hamstrings. Stand at the wall with your hands flat on the wall. Walk your feet back and begin to hinge at the hips, walking your hands down the wall to gradually form an “L” shape with your body.

Pull your navel to your spine and move your shoulder blades together and down your back as you reach the crown of your head towards the wall. This creates space between your shoulders and your ears. Let your chest relax towards the ground but keep your belly engaged.

If your hamstrings are tight, bend your knees slightly, but make sure that your hips and ankles are in one line. Take three to five breaths here, then slowly walk your hands up the wall as you walk your feet forward.

Middle back exercises to try

It’s important to support your middle back pain stretches with some whole-body exercise and targeted middle back strengthening exercises. Improving your overall level of fitness is a great way to address the mental health aspects of chronic pain as well. A stronger back is also less prone to further injury in the future.

For low-impact exercise, consider beginning a walking program or hopping in a pool three to five times a week. Both of these offer full-body exercise that works well if you are still in the acute stages of injury. Engaging in tai chi or yoga is another great meditative way to slowly increase your fitness level, in both body and mind!

Once you are feeling stronger and can add some cardio, the following are great options:

• Stair climbing
• Using a rowing machine
• Biking

As your fitness level increases, you can also start to add some specific strengthening exercises. Try these three middle back strengthening exercises to start.

1. Resistance band pulls

Stand with feet parallel and hip-distance apart. Holding a resistance band, lift your arms out in front of you at shoulder height. Keep your navel engaged and stand tall.

Inhale, and on an exhale pull hands away from each other. Squeeze your shoulder blades together as your hands separate, then slowly release back to center. Repeat three to five times for three sets, increasing either the number of repetitions or moving your hands closer together as you get stronger.

2. Dumbbell row

This can be completed on all fours or with the use of a bench or a chair.

On all fours, start with a dumbbell in each hand. Engage your navel to keep your lower back supported. Inhale, and on an exhale, slowly lift your elbow to bring the dumbbell in your right hand to your armpit. Keep your arm hugged close to your body.

If you are using a bench, your left knee and hand stays on the bench and your right leg stays on the ground as you row on the right side. Aim for five to seven rows, starting with one set and working up to three.

3. High plank dumbbell row

If you want to combine a core-strengthening exercise with a cardio workout and muscle strengthening all rolled into one low-impact exercise, this is the move for you.

Come into high plank with your hands wrapped around dumbbells instead of on the ground. Makes sure your shoulders and hips are in line. Press your navel towards the sky to keep your lower back safe.

Moving on either an inhale or an exhale (whichever feels most natural to you), shift your weight into your left hand as you bend your elbow and bring the right dumbbell to your armpit (as in the dumbbell row). Alternate sides, making sure to maintain proper plank form with the crown of your head reaching forward, and your heels reaching back.

Complete three to five on each side, rest, and try another set. Again, increase either the number of repetitions or the amount of weight, one at a time.

How to relieve middle back pain 

Middle back pain stretches and strengthening are a great way to work on healing middle back pain, but what if they don’t completely help with your pain? Sometimes you need more than one approach. Physical therapy, chiropractic care, acupuncture, and some types of injections are other treatment options to consider.

At Arizona Pain, we know that middle back pain can seem like an unsolvable riddle. With therapeutic options tailored to you, we can help you put the pieces together. Get in touch today.

You might consider chiropractic care as something that only “fixes” the spine, but it’s so much more than that. A misaligned spine can contribute to serious conditions, some of which can lead to sciatic pain. Fortunately, seeing a chiropractor for sciatica can help not only relieve sciatic pain but also treat the underlying condition that caused it. Here’s how.

How does chiropractic care for sciatica work?

Visiting a chiropractor for sciatica can help relieve pain that occurs as a result of pressure on your sciatic nerve. The focus of your visit will depend on your underlying condition, but in general, chiropractors aim to bring your spine into healthy alignment.

Not only does healthy spinal alignment support overall wellness, but it also allows the body to function more efficiently. If one part of the body is compensating for spinal misalignment, this can begin to have a ripple effect. Pain may begin to appear in other areas of the body due to the stress of imbalance. Sciatica chiropractic care seeks to bring the whole body back to proper alignment and balance.

Why is sciatica so hard to treat?

Sciatica is the name for a particular type of pain that originates in the sciatic nerve.

Your sciatic nerve is the longest (and widest) nerve in the body, running from the lower back, across the glutes, and down the side of the hip to the lower leg and foot. Any injury, damage, or pressure along this nerve can cause pain that makes daily life challenging.

Sciatica is hard to treat because the underlying conditions that are leading to damage must be diagnosed and addressed. Diagnosing those underlying conditions can take time. Unfortunately, until that is complete, sciatica symptoms can only be temporarily relieved.

In general, sciatica does not go away on its own and will likely get worse over time if left untreated.

Do I have sciatica?

Sciatic pain is unmistakable and can be very intense. Some people experience a sudden onset of pain, while others notice a gradual worsening of symptoms.

The most common symptoms of sciatica include the following:

• Lower back pain
• Pain that radiates down the legs
• Increased pain with long periods of sitting or standing
• Pain when going from sitting to standing (or vice versa)
• Pain in the hip
• Burning pain
• Weakness and pain in the legs
• Feeling of “pins and needles” along the leg and in the toes
• Numbness
• Tight calves

These symptoms are most often experienced on one side of the body only. If you experience loss of bowel or bladder control or extreme weakness in the lower limbs, this is considered a medical emergency. Get treatment immediately.

There are a number of risk factors for sciatic pain. One of the most common is also the only underlying condition that usually resolves itself (and the pain): pregnancy.

Other risk factors include:

• A sedentary lifestyle: Sitting too much increases your chances of nerve pain
• Age: Older people are more at risk for underlying conditions that cause sciatica
• Obesity: Obesity is comorbid for a variety of sciatica-related conditions
• Occupation: Heavy lifting or repetitive motion activities can place you at higher risk

What does a chiropractor for sciatica do?

Seeing a chiropractor for sciatica connects you with a healthcare provider that takes your full wellness into consideration.

You’ll likely undergo a series of spinal manipulations and adjustments. Some of these are manual adjustments, and others of these involve specialized equipment (e.g., handheld tools or a chiropractic table). They may also recommend other therapies, such as at-home stretches or nutritional changes.

Chiropractic techniques for sciatica

Chiropractic techniques for sciatica focus on aligning your spine and bringing strength and stability to the whole spinal structure. To do this, your chiropractor may utilize the following techniques.

Note that there are over 200 different types of chiropractic adjustments. Your doctor will work with you to determine which will be most effective for your underlying condition.

Diversified technique

This high-velocity, low-amplitude technique moves misaligned vertebra back into place. The characteristic “cracking” sound is actually the sound of small gas bubbles in the joint being released. This is a harmless, painless side effect of treatment.

Spinal mobilization

The goal of this chiropractic technique for sciatica is similar to the diversified technique but gentler. Instead of a high velocity thrust, spinal mobilization uses steady, firm pressure to the spine to guide it into alignment.

Myofascial release

When tight fascia is contributing to sciatica, myofascial release can help. Once your chiropractor identifies the area of tightness, they’ll apply steady pressure until the fascia begins to release. This also increases blood flow to the area and can promote healing.

Palmer upper cervical adjustment

While sciatic pain originates in the lower back, there are conditions in the cervical spine that can travel down to the lower spine. If this is the case, an upper cervical adjustment may be a good tool.

Chiropractic exercises for sciatica

When you feel the pain of sciatica creeping up but can’t schedule a chiropractic appointment right away, there are chiropractic exercises for sciatica that can mimic the effects of in-office chiropractic care. Only do these once approved to do so by your doctor.

• Cobra pose: This pose compresses the lower vertebrae and then provides release
• Child’s pose: Offers a long, lengthening stretch along the whole spine
• Knees to chest: Rocking on your back with your knees to your chest gives a gentle opening and massage to the back muscles at the same time

At-home stretches will not replace seeing a chiropractor for sciatica, but it can be a stopgap measure until your next appointment. Ask your chiropractor for suggestions on the most helpful pain-relieving stretches for sciatica for you.

Beyond chiropractic

Many chiropractors don’t just offer manipulations and adjustments. Doctors of chiropractic have extensive, general medical training and may also specialize in complementary treatments. This can include things like:

• Recommendations for lifestyle changes (including ergonomic recommendations)
• Exercise and nutritional counseling
• Information on supplements
• Complementary treatments (e.g., meditative exercise, acupuncture, and biofeedback)

Because they are focused on holistic treatment options, chiropractors may recommend concurrent treatment options to address your overall wellness, not just your sciatic pain.

What can I expect during my chiropractor appointment?

At your first chiropractic appointment, expect to spend a good amount of time discussing your medical history. Your chiropractor will want to know:

• What symptoms you are currently experiencing
• How long you have had those symptoms
• Pain level on a daily basis and what makes it worse or better
• Diagnosis (if any) from other doctors
• Family history
• General lifestyle information (e.g., diet and activity levels)
• Current medications or treatments
• Any other health concerns you have

If you have a diagnosis from your doctor, your chiropractor will want to see that, as well as any tests or X-rays you have to support the diagnosis.

After they gather all of this information, your chiropractor will conduct a physical exam. This is usually conducted while you are fully clothed. It usually consists of range of motion exercises and palpation of the painful area.

If you do not have a formal diagnosis, your chiropractor may order imaging studies (e.g., X-rays or CT scans) to see if there is any visible injury or spinal misalignment.

From all of this information, your chiropractor will then affirm your doctor’s diagnosis and develop a treatment plan, or they will have more information to make a diagnosis of their own.

Once a diagnosis is confirmed, they’ll start care depending on the best approach for your condition.

Will chiropractic care for sciatica hurt?

This is one of the most frequently asked questions that is completely understandable. After all, you are already in pain. Why would you want to receive treatment that hurts?

The good news is that most patients find chiropractic care for sciatica to be pain-free. In fact, most people experience immediate pain relief after treatment. Sometimes the adjustment may cause brief discomfort, but that should pass quickly.

If you do experience increased pain during treatment, tell your doctor immediately. Their goal is to provide comfort and healing, not a worsening of symptoms.

What will recovery be like?

Recovery from chiropractic care is usually easy and uneventful. In most cases, you can receive treatment and go on about your daily life as usual. You may feel lingering muscle soreness, but that should ease quickly.

There are a few people for whom chiropractic care is not recommended. If you have severe osteoporosis or cancer of the spine, chiropractic care is not a good choice.

In some cases, herniated or bulging discs may be made worse by chiropractic care. If you experience tingling in the legs, loss of bowel or bladder control, or weakness in the lower extremities, head to your nearest emergency room for treatment. For people at risk of stroke, cervical (neck) adjustments are not recommended. These can increase the risk of stroke.

Overall, chiropractic care is generally recognized safe, with few side effects.

How many visits will I have to a chiropractor for sciatica?

In general, most patients find relief from symptoms within six to ten visits to the chiropractor. This is a generalization, though. You might find you need many more or far fewer. Your chiropractor can tell you what to expect at your first visit, including how many visits you might need and how often. They’ll also discuss the treatment plan during the acute phase of treatment and potential options as you move into maintenance, or ongoing, care.

Other sciatica treatments

Sciatica is a complicated condition that responds best to variety of treatments. In addition to using chiropractic exercises for sciatica, other sciatica treatments than can help include:

1. Physical therapy: Targeted exercise that builds muscular support for the spine
2. Deep tissue massage: Deep tissue massage can release muscle tension that causes pressure on the sciatic nerve
3. Acupuncture: This complementary treatment triggers endorphin production and can ease pain
4. Medications: Over-the-counter and prescription medication helps to ease inflammation and pain
5. Transcutaneous electrical stimulation (TENs): TENS machines replace painful nerve signals with a mild electrical buzz
6. Epidural steroid injections (ESI): Medications for pain and inflammation are injected directly to the affected nerves
7. Lysis of adhesions: Lysis of adhesions breaks up the scar tissue that is causing pressure and pain
8. Disc decompression: For opening up the intervertebral space and relieving pressure
9. Spinal cord stimulation (SCS): An implanted device that “mutes” pain signals
10. Intrathecal pump implants: These implants deliver regular, powerful pain relief
11. Percutaneous discectomy: Damaged disc material is removed to create space between the vertebrae

Sciatica can be challenging to treat, but you do have options.

If you’re in Arizona and are considering seeing a chiropractor for sciatica, Arizona Pain can help. We believe in creating comprehensive treatment plans tailored to each person in pain. Get in touch to schedule your appointment today!

Back pain affects approximately 80% of people at some point in their lives, with lower back pain being the most common complaint. Although minor aches and pain or an acute injury may disappear on their own with rest and gentle stretching, some conditions require more attention and time, especially if the pain becomes chronic. One of these conditions is herniated disc. Knowing what to do for herniated disc often depends on when you begin your treatment. Here are 14 approaches that may help you.

What is a herniated disc?

A herniated disc occurs due to the spinal column’s unique combination of strength and weakness. The spine is made up of 33 vertebrae in five different sections:

1. Cervical (neck)
2. Thoracic (upper back)
3. Lumbar (lower back)
4. Sacrum (bottom of the spine)
5. Coccyx (largely immobile bottom tip of the spine)

These vertebrae are held in place with connective tissue and ligaments to protect the spinal cord and nerves that emerge from the spinal column. Facet joints help further stabilize this structure.

Between each vertebra is an intervertebral disc. These discs are small sacs of jelly-like fluid called nucleus pulposus. Intervertebral discs provide a cushion between vertebrae, a sort of shock absorber in the spine that allows for smooth, comfortable movement along the spine.

A herniated disc occurs when pressure or force exerted on the spine causes the intervertebral disc to push between the vertebrae and rupture, releasing some or all of the nucleus pulposus.

Herniated disc vs. bulging disc

Herniated disc differs from a bulging disc in that a bulging disc is still intact, just protruding from between the vertebrae.

A herniated disc has actually burst and no longer provides any cushion or shock absorption. Bone begins to rub painfully on bone, leading to symptoms that may be unrelieved by most comfort measures.

What causes a herniated disc?

Common herniated disc causes include:

• Disc degeneration: The natural process of aging causes wear on a disc, making it susceptible to herniation
• Spinal stenosis: This narrowing of the spinal cord is also most often seen in older people
• Injury: Trauma to the spine can cause disc herniation
• Repetitive motion: People who work jobs with repetitive motion and heavy lifting are more likely to suffer back problems (including herniated discs)

Genetics also play a part in the development of herniated discs, as does a person’s weight and occupation. More weight on the body tends to mean less activity and more stress on all of the body’s structures. Physically demanding occupations or those with repetitive motions also put workers at increased risk of a herniated disc.

Do I have a herniated disc?

Herniated disc symptoms are difficult to ignore. In addition to pain that can be regular or intermittent, other herniated disc symptoms can include:

• Leg pain: Herniated discs can lead to sciatic pain, a pain that radiates from the lower back, across the buttocks, and down the side of your hip and leg. This pain may be shooting with sudden movement (i.e., when you sneeze) or it may be a dull, constant ache that worsens with too much standing or sitting.
• Numbness and tingling: These symptoms are a sign that nerves are being impinged or compressed by the vertebrae.
• Weakness: Weakness develops as nerve involvement continues.

If the herniated disc is in your neck, you may experience pain across the shoulders and upper back. This may worsen as the nerves continue to compress.

In some instances, people with herniated discs have no symptoms. The only way to confirm a diagnosis is to visit your doctor. They will conduct a thorough physical exam that might include a CT scan, MRI, or X-ray (to rule out other conditions). Your doctor will also test your strength and reflexes, but imaging is the best way to get an accurate diagnosis.

It is important to get a proper diagnosis not only for the herniated disc but also the underlying cause. Your treatment approach may vary depending on what caused the disc to herniate. If the disc is herniated and treated but the underlying cause remains, re-herniation is possible.

What to do for herniated disc: 14 approaches

For some people, a herniated disc resolves itself without any intervention whatsoever. The symptoms may be minimal and simply disappear on their own.

For others, there are a variety of herniated disc approaches to ease symptoms and prevent further injury. Here are 14 approaches to treating herniated discs, from steps to take when you first notice pain to more interventional treatment options.

Note though that of the most serious herniated disc symptoms is a sudden loss of bowel or bladder control. This may be accompanied by suddenly worsening symptoms or something called saddle anesthesia (numbness in the areas that would touch a saddle – back of the legs and inner thighs). If this occurs, treat it as an emergency situation and head to the ER immediately.

First steps

When you first notice herniated disc pain, there are steps you can take to ease symptoms, even before a diagnosis.

1. Brief rest

Although rest is not indicated as a long-term strategy for the treatment of herniated disc, in the acute phase it can be necessary.

Most pain physicians do not recommend rest for longer than three days, but it can be very healing and helpful when the pain is at its peak.

2. Hot and cold therapy

Treating back pain with hot and cold therapy can work well when combined with rest.

Hot therapy (i.e., with a heating pad) can relax and loosen muscle spasms, while cold therapy (ice packs and frozen peas, most often) reduce inflammation and can ease pain.

3. Over-the-counter medications

Some pain and inflammation can be easily managed with over-the-counter pain medications like ibuprofen and naproxen sodium.

These should only be taken as directed by your doctor, as they can come with a host of gastrointestinal side effects when taken in large quantities over a long period of time.

4. Exercise

Disc degeneration may be a natural occurrence as we age, but you can support a strong, healthy back with regular exercise. In addition to whole-body exercise like walking, running, swimming, and biking, targeted exercises for a strong core and back help support the structures of the spine and reduce the chances of injury and pain as you age.

These approaches work best for mild pain in the beginning stages of disc herniation. It may be possible to slow, halt, or reverse the progression without further treatment, as discussed below.

Advanced care

If you find that your pain persists after non-interventional approaches, it’s time to talk to your doctor and explore other options.

1. Physical therapy

Physical therapists work with your pain specialist to design an exercise program for your herniated disc.

They will work with you on the proper form and technique to maximize your workout for best results. Most programs combine stretching routines with targeted strengthening exercises.

2. TENS unit therapy

Transcutaneous electrical nerve stimulation (TENS) replaces pain signals with a mild buzzing sensation.

A mild electrical pulse is delivered through the skin to the nerves as close to the area of pain as possible. The patient controls the signal with a small, cellphone-sized power pack. The electrical signal disrupts pain signals and can offer significant pain relief. Many patients find that a TENS unit relieves pain when other options do not.

3. Radiofrequency ablation

Radiofrequency ablation uses heat to destroy pain-sensing nerves and disrupt the pain signal caused by a herniated disc.

This procedure may offer long-lasting pain relief, but some patients may need more than one treatment.

4. Steroid injections

Steroid injections can help with herniated discs in both the lumbar and cervical spine.

Some patients find that the risks of these injections are worth the opportunity to avoid more invasive surgeries for their herniated disc.

5. Percutaneous discectomy

Herniated disc surgery is a treatment of last resort after other conservative approaches have failed.

A percutaneous discectomy removes the disc material to relieve pressure on the nerves. This procedure is considered less invasive than other types of surgery, some of which may fuse vertebrae together for support or insert pins to maintain space between the vertebrae.

How to heal a herniated disc naturally

As stated above, many people with herniated discs do not require any medical intervention beyond their diagnosis. There are steps you can take at home to start on the path towards herniated disc recovery.

1. At-home care

At-home care for herniated disc means using your body mindfully as you go about your daily tasks. Pay attention to the ways you reach for things on shelves or how you bend over to tie your shoes. Are you engaging your core as you move? Are you picking up objects the correct way? This can help support your healing back.

Likewise, at-home care means taking care of yourself with a proper diet. Look for anti-inflammatory foods that include plenty of fresh vegetables and fruit, lean proteins, and whole grains. Not only will this give your body the fuel it needs for healing, but it might also help you gain (or maintain) a healthy BMI.

2. Massage

Massage can help soothe tight muscles and areas around the herniated disc but don’t use it for the area of the disc itself, especially in the acute phases.

After the acute phase passes, massage can help you reduce stress and tension in the back. Work with a therapist who has extensive experience with sports massages or care for those with back conditions.

3. Herniated disc exercises (plus herniated disc exercises to avoid)

The best herniated disc exercises are those that help you stabilize your core, bringing length to your spine, and building muscles on the lower back, belly, and sides of the abdomen. Think side planks, bridge poses, and partial crunches.

Additionally, tight hamstrings can make your herniated disc pain worse. A simple L-shaped fold at the wall and hamstring stretches on the floor (use a belt or a scarf for support, see below) can help loosen tight hamstrings and give you more freedom in your spine.

There are also exercises to avoid when it comes to herniated discs. Although stretching out your lower back in a deep forward bend may feel good (and seem like it’s helping stretch your hamstrings), you may reach a point where the stretch gets painful. Too much stretch in that area, or too deeply stretching when your body isn’t ready, can make the pain worse.

4. Yoga for herniated discs

Yoga for herniated discs is one of the best things you can do for your body and mind. Find a therapeutic yoga class near you, and get there early to talk to the teacher so they know you are working with a healing back.

Focusing not only on a sequence of breath-supported, low-impact exercise but also on training your mind to remain in the moment without judgement can help you manage your pain as your back heals.

5. Back brace for herniated disc

One of the best treatments for lower back pain, including pain from a herniated disc, is to get a little support.

Back braces can help you go about your daily life with less pain, especially as you work with your doctor to coordinate other treatments. You can also use them while engaging in low-impact cardio or other exercises.

At Arizona Pain, we know what to do for herniated disc, and it starts with a proper diagnosis and a comprehensive treatment plan to help you get your life back. Get in touch today.

If you suffer from back pain, you already know what a negative impact it can have on your life. Activities you once enjoyed and performed with ease suddenly become difficult, and even just trying to sit and relax can be painful. One of the culprits behind many people’s back pain is a herniated disc. Read on to learn more about the common signs, symptoms, and treatments of a herniated disc.

What is a herniated disc?

People sometimes refer to herniated discs as ruptured discs, slipped discs, or disc prolapses. All of these names imply that something has gone wrong with part of your body. But what exactly is a disc, and what happens to it when it herniates?

The bones that make up your spine are called vertebrae. They are separated from one another by thin layers, or discs, filled with a jelly-like substance called the nucleus pulposus. In a healthy spine, these discs prevent your vertebrae from grinding against each other, allowing you to move about pain-free.

But, as with all other body parts, these discs can become damaged or broken over time. Sometimes, the outer layer of the disc (called the annulus fibrosus) breaks. This causes the jelly to spill out and forces the vertebrae into direct contact with each other. The jelly may also come into contact with one of the many nerves running up and down the spine.

This can lead to back pain and other uncomfortable, even debilitating symptoms.

Herniated disc vs. bulging disc

Herniation is not the only condition that can affect your spinal discs. A bulging disc occurs when the disc slips from its proper place between the vertebrae. This condition may be completely asymptomatic, or it may cause many of the same problems as a herniated disc, including pain, tingling, and numbness.

The critical difference is that, in cases of a bulging disc, the disc remains intact even as it moves where it isn’t supposed to be. A herniated disc has been damaged in such a way that it is no longer in one whole, undamaged piece. If a bulging disc is left untreated for too long, it may become herniated.

Types of herniated discs

The type of herniated disc you have depends on where it is located. Your back consists of four to five regions, depending on how you divide up the spine.

• Cervical: This refers to the vertebrae in your neck.
• Thoracic: This region covers your upper and middle back, from the base of your neck to approximately just below the ribcage.
• Lumbar: The lumbar region is more commonly referred to as your lower back.
• Sacral: The sacrum is at the base of your spine and consists of several fused vertebrae within your pelvic cavity.
• Coccygeal: Also called the tailbone, the coccygeal region is the very end of your spine. It is sometimes combined with the sacral region rather than split into its own distinct region.

Lumbar disc herniation is the most common type of disc herniation. However, it is possible to suffer disc herniation in the cervical and thoracic regions as well.

What are herniated disc causes and risk factors?

Pretty much anyone can herniate a disc if they are unlucky enough. However, there are certain factors that increase your chances of developing this condition.

Here are some of the most common herniated disc causes and risk factors.

Injury

Herniated disc causes often involve some sort of trauma to your back. This can be something as serious as a fall or sports-related injury, or something as simple as changing positions too abruptly.

The more you put strain on your back, the more likely you are to suffer a herniated disc. This means that athletes and people with physically strenuous occupations are at greater risk than others.

Gender

While herniation can affect people of all genders, males are generally more susceptible to it than females.

Age

As you get older, your bones become more susceptible to injury. This is in addition to the wear and tear that accumulates naturally over a lifetime.

So, while herniated discs can affect people of all ages, they are more likely to occur in people with older, typically more damaged spines.

Lifestyle

Regular exercise is an important part of living a long, healthy life. Without it, your body becomes weaker, making it more likely for something to go wrong.

Being overweight is another risk factor for disc herniation. Extra weight causes the spine to work harder to move your body, and that strain can leave you susceptible to a herniated disc.

What are common herniated disc symptoms?

Herniated disc symptoms may vary depending on the individual and where the herniation occurs. Symptoms often come not from the herniated disc itself, but from its contact with your nerves in the spine.

For many people, this means that there are few, if any, early warning signs or symptoms. If your herniated disc has not come into contact with a nerve, then you may not have symptoms at all. In this case, you probably won’t know you have a herniated disc until symptoms manifest, or until a doctor runs tests for another reason and discovers the herniated disc accidentally.

Pain

Once the herniated disc does touch a nerve, you will begin to experience symptoms, including back pain. But pain is not the only symptom associated with disc herniation. You may also experience the following symptoms.

Tingling

Where you feel tingling will depend on where your disc herniation is.

If it’s in your lower back, as is most usual, then you may experience tingling in your leg and foot. If the herniated disc is in your neck, you may feel tingling in your arm and hand instead.

Weakness

With your spine not functioning the way it’s supposed to, you may notice you have more trouble with certain activities, such as walking or bending, than you did before.

Numbness

Some people with a herniated disc lose feeling in certain body parts.

If you have a herniated lumbar disc, then your leg and foot could be affected. If it is a herniated cervical disc, the numbness may affect your arm and hand. A herniated thoracic disc can affect either your upper or lower extremities.

Do I have a herniated disc?

Back pain, especially lower back pain, is incredibly common. Over 80% of adults will experience back pain at some point in their lives, thanks to a wide range of primary conditions. So how can you tell if a herniated disc causes your back pain, or if it’s something else?

By yourself, you can’t, at least not for certain. Only a doctor can make a formal diagnosis, through the use of one or more diagnostic tests.

At your appointment, your doctor will likely perform some basic tests, such as those measuring muscle strength and reflexes. In some cases, your doctor may also take an image of your spine with an X-ray or an MRI. With these images, they can have a direct look at the herniated disc or other problems causing your back pain.

Is a herniated disc serious?

If you have a herniated disc, the prognosis is generally quite good. Symptoms often become less acute over time. In some cases, symptoms go away entirely without treatment. For the majority of patients, herniated disc recovery time is generally a few weeks to a few months.

Knowing this doesn’t make it easier to deal with the pain and other symptoms you have right now, but know that your current situation is generally not permanent and will likely clear up without drastic medical intervention.

Very rarely, a herniated disc becomes serious enough to warrant immediate medical attention. If your symptoms are so severe that you can’t perform basic tasks, go to a doctor or emergency room right away.

Especially serious herniated disc cases may lead to cauda equina syndrome. This rare condition is characterized by extreme lower back pain, weakness and/or numbness in the groin and lower extremities, and loss of bowel and/or bladder control.

If you’re experiencing these symptoms, it requires an emergency trip to the doctor and, in most cases, emergency surgery. Allowing your case to go untreated may result in permanent damage, including incontinence and paralysis.

What are herniated disc treatments?

If your back pain has bothered you for a while, you have probably already sought out ways to treat it on your own. The best way to approach this condition, though, is under your doctor’s care.

Once you receive an official diagnosis, talk with your doctor before starting any new treatments. They’ll discuss treatments that could work best for your exact condition and symptoms, as well as complementary therapies to help with your symptoms.

Rest

Rest is important when you have suffered an injury. But even with this most basic of pain remedies, there is a helpful way and a harmful way to go about doing it.

Long periods of bed rest, for example, can further weaken your back, which will make it even more difficult to recover. Try interspersing periods of rest with periods of gentle exercise, if okayed by your doctor.

Exercise

Some exercises can help you feel better, while others can actually make a herniated disc worse. Walking, for example, is a cheap form of exercise that can often reduce your lower back pain.

Again, talk with your doctor to get an idea of which exercises are best for you. Basically, if an exercise – or any type of movement – aggravates your symptoms, stop. If possible, don’t perform that activity again until your back has healed more.

Lifestyle changes

Losing weight may also relieve herniated disc symptoms and protect your back from similar injuries in the future.

With the guidance and approval of your doctor, you can reach a healthier weight with a low-impact exercise regimen and regular, nutritious meals.

Medications

Many people use medicine to relieve pain. You may already be taking over-the-counter medicines like ibuprofen.

If you are still experiencing significant pain even while taking these medications, talk to your doctor about what could help during acute pain flare-ups.

Physical therapy

Physical therapy is another common herniated disc treatment. A physical therapist is a professional who specializes in helping people regain their previous range of motion as much as possible, while also strengthening the muscles around the injured area.

To do this, they will take stock of your condition and develop a treatment plan specifically for you. This plan will likely include multiple treatment approaches, including exercises, stretches, heat/cold therapy, and more.

Interventional treatments

In some cases, the treatments outlined above will not be enough to manage your pain. If that is true for you, your doctor may suggest a more interventional form of treatment, such as injections or surgery.

Injections, including cortisone injections, can help when your chronic pain becomes too severe to be managed by more conservative treatments. These injections have the potential to offer effective, long-term pain relief, but they can also cause serious side effects if used too frequently. Your doctor will help you decide if the risks are worth the benefits in your case.

There are also multiple kinds of herniated disc surgery, including partial or total removal of the affected disc or the insertion of an artificial disc to replace the damaged one.

Find help for your pain

Only 10% of herniated lumbar discs require surgery. The majority of patients will heal with more conservative treatment approaches and time.

If you live in Arizona and need help with your herniated disc pain, click below to connect with one of the pain specialists at Arizona Pain. Our team can guide you through the treatment process and help select the approach that’s best for you. Together, you’ll develop a treatment plan that combines complementary, non-invasive treatments for longer-term relief, along with interventional approaches if you’re suffering from severe pain.

Back pain is the second leading cause for visits to the doctor and the most common reason for missed work. Economically, low back pain alone costs the U.S. $100-$200 billion annually. On a personal level, back pain impacts a person’s ability to function in life every day, from small things like cooking dinner to picking up a child. Cost of treatment should not be a deciding factor on whether or not a back pain sufferer finds relief. What if the key to curing your low back pain was as easy as slipping on some shoes? And what if that same cure was free? What about walking? Is walking good for lower back pain? Walking may not cure the most severe forms of chronic back pain, but in many cases, walking is the cheapest, easiest, and most effective way to help heal and prevent back pain.

Is walking good for lower back pain?

Dr. Michal Katz-Leurer from Tel Aviv University’s Stanley Steyer School of Health Professions at the Sackler faculty of medicine and colleague Ilana Shnayderman, a graduate student at the department of physical therapy and a practicing physiotherapist at Maccabi Health Care, found in a recent small-scale study that a program of daily 20-minute aerobic walking that gradually increased to 40 minutes as endurance built was just as effective for low back pain as a twice-weekly muscle-strengthening program typical of physical therapy clinics for back pain.

The walking in the above trial was “aerobic,” meaning that participants were not just strolling along. A slow walk, while not as damaging as high-impact activities such as running, compresses the low back at a steady, constant rate and does not flex the spine.

Faster walking allows more movement and motion in the spine, especially when swinging arms are added. This ups the aerobic ante, too, allowing not only for therapeutic relief of back pain but also cardiovascular benefits.

Why is walking good for lower back pain?

Movement in the back and spine seems to be one of the keys to treatment, and another beneficial type of walking is that of hiking with a loaded backpack over varied terrain. Adding 20 to 25 pounds of weight in a backpack forces the body to remain upright to balance the weight. The uneven terrain helps promote increased movement in the lower body, moving the spine and its attendant muscles.

In addition to promoting movement, which increases blood flow to muscles, and spinal flexibility, walking promotes an overall feeling of well-being.

Aerobic walking releases serotonin and releases endorphins, both “feel-good” chemicals in the brain. Combining this feel-good release of chemicals with work in the large muscles of the torso and legs actually distracts the brain with overwhelming signals. This may result in a decrease in the sensation of pain. This is simply because your brain is too busy processing your large-muscle movement and the surge of serotonin. This is the gate-theory of pain control. Large signals get more attention than small signals, and muscle movement is a larger signal than pain.

How to get started with walking for lower back pain

Talk to your doctor before starting a new exercise program, then lace up your shoes. Here are a few starting guidelines.

Start slowly, then work up

Especially if you have not exercised in a while, it is important to begin slowly. You needn’t plan on hours-long walks. You may start with just ten minutes of walking around the block or on the treadmill. As you gain strength and endurance, add time or intensity, one at a time (not concurrently). So go for longer walks at the same rate or walks of the same distance at a faster pace.

If you can sing when you walk, speed up

The rule of thumb for aerobic walking is if you can sing, you are not going fast enough to realize the most benefit. A good aerobic pace is when you can hold a conversation but not belt out a Broadway tune.

Use good form

Many people with low back pain suffer from lordosis, an overarching of the lumbar curve. This compresses the lumbar vertebrae and causes pain and can eventually cause serious damage. Before you start, take some time to check your posture. Raise your arms above your head (or high as you can if you have shoulder pain) and see what the rest of your body does. If your ribs stick out or your back arch increases, this is good information.

To begin to correct lordosis, lengthen your tailbone down without hunching forward. Lift up tall through the crown of your head. To place your shoulders where they belong, roll them forward, up, then back. Your shoulder blades should be on your back, tailbone should stretching down without tucking the pelvis, ribs should not be splaying forward, and crown of the head should be lengthening up.

Recognize there may be soreness, but don’t ignore pain

You may be sore after your first session. You are exercising muscles and flexing vertebrae that may be stiff from overuse. And, you are likely waking up areas in your body that have had a long slumber, so some soreness is normal and to be expected. Pain, however, is another story. Sharp, stabbing pain, or pain that radiates is a warning sign to back off. Do not ignore your body’s signals, but don’t be scared off by the soreness that comes after a good workout.

Recruit support

Sticking with exercise, especially when it might cause some soreness initially, can be difficult. Make your walks a time to catch up with your kids or visit with friends. Scheduling your walks as social time instead of just a work out can help you get into a routine and stick with it.

While a program of regular exercise can be difficult to get started (and stick with!), it is important to understand that you are not alone in trying to improve your health – literally. More evidence is growing that regular walking groups are good for not only your body but also your mind. Creating a walking group is a great way to improve your health while building supportive, positive relationships in your community.

Start a walking group

The idea of gathering in a group to exercise is not new, but recent research has shown that people who joined walking groups experienced lower blood pressure, resting heart rate, and total cholesterol. Additionally, they had a lower body mass index, a good indicator of physical fitness, and were more likely to stick with regular exercise than those who walked alone.

Researchers from the University of East Anglia used data gathered from over 1,800 study participants in 14 countries. These walkers spent a total of 74,000 hours walking in groups. They included people with health conditions such as Parkinson’s disease, fibromyalgia, obesity, diabetes, and heart disease.

Study leader Sarah Hanson of UEA’s Norwich Medical School pointed out that it isn’t just the activity that makes a walking group such a powerful tool for good health, saying:

“People who walk in groups also tend to have a more positive attitude toward physical activity, a shared experience of wellness, and say they feel less lonely and isolated. Taking regular walks can also be a catalyst for adopting other healthy behaviours. The research evidence suggests people enjoy attending walking groups and appear less likely to drop out than many other forms of activity.”

Get outdoors

The social benefits of walks appear to be amplified when they are taken out in nature instead of in a gym or at a track, even helping to ameliorate depression and stress.

Researchers at the University of Michigan found that outdoor group walking significantly boosted mood and improved walkers’ sense of well-being. Senior author Sara Warber, M.D., associate professor of family medicine at the U-M Medical School and member of the Institute for Healthcare Policy and Innovation, studied nearly 2,000 people participating in walks through the Walking for Health program in England. This program organizes over 70,000 walkers into 3,000 walks annually.

Warber pointed out the high return on investment when joining a walking group, specifically one that meets outdoors, saying:

“Walking is an inexpensive, low risk and accessible form of exercise and it turns out that combined with nature and group settings, it may be a very powerful, under-utilized stress buster. Our findings suggest that something as simple as joining an outdoor walking group may not only improve someone’s daily positive emotions but may also contribute a non-pharmacological approach to serious conditions like depression.”

Celebrate success

Whether it is months in existence, miles walked, or some other goal reached, take some time to celebrate. And, after several walks, take some time to figure out what is working and what needs work in your walking program.

What other tips do you have for getting started with a walking program for lower back pain?

Chronic pain and mood disorders can often go hand-in-hand. In fact, as many as 50% of people with chronic pain also have depression. It seems that one particular pair of conditions – depression and back pain – may be particularly widespread. Considering how often chronic pain and mood disorders can co-occur, this isn’t very surprising. After all, back pain is one of the most commonly-reported pain conditions, and depression is one of the most common mood disorders.

How many people are affected by depression and back pain? 

Both depression and back pain afflict a large number of people. Over 26 million people in the United States suffer from back pain, making it the leading cause of disability among people in the U.S. under the age of 45. People who have low back pain are commonly in poorer physical and mental health than people without low back pain.

Around 20.9 million people in the United States suffer from some sort of mood disorder. Out of these people, a whopping 14.8 million have depression. Depression can (and often does) co-occur with other mood disorders, as well as with illnesses, pain, and medical conditions.

Why do they occur together? 

Back pain and depression often co-occur, largely because it’s possible for each condition to cause (or worsen) the other.

Dealing with chronic back pain can cause a lot of stress. Back pain can even affect a person’s ability to work, interfere with relationships, and chip away at self-esteem. Sleep can be disrupted by back pain, and the ensuing fatigue can further decrease quality of life.

Back pain can also make physical activity difficult or unappealing. Even if, in the long run, physical activity might help with back pain, it can initially be hard to get started or cause some aches and pains. Lessened physical fitness can further reduce self-esteem and interfere with relationships.

Aside from the effects of back pain, the pain itself can increase the risk of depression. It’s easy to focus on pain, which can magnify its effects. The higher the perception of pain is, the more likely it is to cause depression. Once depression has set in, it can cause emotional interpretations of pain, which lead to increased perception of pain. In other words, pain worsens depression, and depression worsens pain, which further worsens pain. As is obvious, the cycle can go around and around, worsening steadily over time if there is no intervention.

Just as back pain can lead to depression, depression can lead to back pain. Sleep disturbance, social withdrawal, difficulty at work, lowered self-esteem, and withdrawal from activities can all occur with depression. Additionally, many people experience physical symptoms, like pain, as a result of depression. Indeed, for some people, physical pain may be the primary symptom of their depression.

Medication use

Also, some overuse or abuse of some medications can lead to depression. Opioids, for instance, are a pain medication, but they carry a high risk of abuse, addiction, and depression. Unfortunately, when depression is causing or contributing to back pain, treating the back pain is unlikely to work unless paired with treatment for depression.

This can lead to feelings of hopelessness about ineffective treatment, which can further exacerbate depression and the risk for overuse of pain medications.

Recent research 

Recent research suggests there may be deeper reasons for the common co-occurrence of back pain and depression.

A study carried out by researchers at UC Irvine and UCLA examined the brains of rodents with chronic pain. They found that chronic pain can cause brain inflammation. This pain-derived brain inflammation causes faster growth and activation of a type of immune cell, called microglia. Microglia cells trigger chemical signals that restrict dopamine release. Dopamine aids in controlling the reward and pleasure centers of the brain, but it’s also involved in pain responses. As noted on Scientific American’s blog, it’s also involved in depressive behavior:

“[D]opamine could also be important in major depressive disorder. People with depression often exhibit reduced motivation, anhedonia (a decrease in pleasure from usually enjoyed things), sometimes motor decreases as well. All of these are linked with dopamine.”

Opioid pain medications also work by triggering the release of dopamine. However, the pain-derived brain inflammation and its resultant increased microglia cells mean that opioids can fail to trigger a dopamine response. This explains why opioids are often ineffective in treating chronic pain. If further research can continue to explain the mechanisms behind the relationship between chronic pain and depression, a targeted, more effective therapy can be developed.

Researchers are also considering the possibility of genetics playing a role. Data concerning over 2,000 twins was analyzed to look for genetic factors relating to both back pain and depression. Interestingly, the group with the strongest association between back pain and depression was the non-identical twin group. When identical pairs of twins were considered, the association disappeared.

Treating depression and back pain

Just as the development of back pain and depression can go hand-in-hand, treatment for these conditions can work together, too.

Treating a person’s pain while ignoring his or her depression can prove ineffective, and treating his or her depression while ignoring his or her pain can be ineffective, too. However, just because treating one or the other may not solve both issues completely doesn’t mean it can’t help, as explained at Everyday Health:

“What’s interesting about back pain and depression is that they seem to be so closely tied that getting depression relief may actually lead to back pain relief… On the flip side of the coin, getting back pain relief can also help the depression improve.”

Therefore, treating one or the other is much better than treating neither.

The best case scenario, though, is undergoing treatment for both back pain and depression. The first step in getting treatment is discussing all issues, physical, mental, and emotional, with a primary care physician. From there, the physician should be able to suggest specialists and coordinate treatment for both conditions.

But, one of the first steps to treating it is actually knowing if you have depression to begin with. Here’s how to diagnose this condition.

How to diagnose depression

You find yourself snapping at your kids. Maybe your temper flares more often in traffic. You don’t seem to have as much patience as you normally do, or small things get under your skin more than they used to. On top of that, your back has started hurting right around your shoulders, so much so that it can be hard to fall asleep at night. The signs of depression don’t always show up on a billboard; you may be suffering from depression and not realize it. One in four people suffer from some form of mental illness in their lives, but we still have a hard time bringing this “hidden illness” into light. Here are a few ways to do that.

What to watch for 

Depression can manifest itself in sometimes hidden ways. The most common signs of depression are:

• Changes in appetite
• Changes in sleep habits
• Low energy or fatigue
• Withdrawal or social isolation
• Feelings of worthlessness

Some people may experience these common signs in uncommon ways, such as:

• Increase in anger or irritability: You may be short-tempered or quick to anger or snappish
• More mood swings: You may find yourself going from one extreme to another in a flash
• Anxiety in social situations: You may experience anxiety in situations where you previously felt none
• Physical pain not related to injury: Pain in the hips, lower back, and shoulders indicate chronic clenching or stress

Some of these may be triggered by traumatic events. Some may be as a result of treatment for another condition. Regardless, it is important to talk to your doctor if these symptoms persist. Consider this first meeting a fact-finding session more than a diagnosis, and go in with an open mind (and heart).

Talk about it

If you have suffered from periods of depression or anxiety, it can be helpful to others going through a similar experience to know they are not alone. Depression can be socially isolating. The depressed person often feels alone and may question if anyone cares about them. Remind them that they are loved, you get it, and you are here for them. Often a person suffering from depression is plagued with the idea that they are their illness.

National Institue of Mental Health director Thomas Insel believes we should discuss mental illness in the same way we discuss things like cardiovascular disease, noting:

“We need to talk about mental disorders the way we talk about other medical disorders. We generally don’t let having a medical illness define a person’s identity, yet we are very cautious about revealing mental illness because it will somehow define a person’s competence or even suggest dangerousness.”

Don’t ignore it

Ninety percent of people who commit suicide suffer from mental illness, often undiagnosed. If you or someone you love is showing signs of depression that are persistent and lasting longer than two months, it is important to not ignore it.

There are ways to ease into conversations about sadness and depression, but sometimes we feel awkward and uneasy, especially when the depression may be related to grief or a traumatic event. When someone has died, we may hesitate to bring up that person for fear of “triggering” depression, but chances are good that talking about it may be just the thing that encourages someone to seek help.

Depression and back pain are a complicated and often related set of conditions. If you suffer from these conditions, head to the comments to share how you’ve dealt with them in your own life.