Chapter Two: Diagnosis of the Problem

Sometimes, with proper home care your symptoms will go away in a few days.  This does not mean that you are finished healing, or are well.  Many people often confuse the relief of their pain with being healed.  This is not necessarily true.  Resolution of symptoms, is not an indication of healing.

However, if you have had the same or similar problem before, you should not ignore it!  It won't just go away and will most likely occur more frequently depending on your age and what you ask your body to do.  Most of the time it is very easy for your chiropractor to correct your problem and can save you further pain and discomfort.  Right now you've probably said to yourself...

"Yeah, this thing has been bothering me off and on for the last several years ever since I..."

STOP ignoring your body.  It is trying to tell you something is wrong by sending you signals or symptoms!

Well, what is a symptom?

A symptom is your body's warning system that alerts you to a problem.  It is the fire alarm for a fire.

This may be:

•Pain

•Muscle Spasms

•Decreased Range of Motion (or inability to move as you did before)

•Inflammation

•Numbness and Tingling

•Burning

Remember, a symptom is just an indicator of a problem, it is not the problem itself.  So, to get rid of the symptom does not get rid of the problem.  Taking an aspirin to remove the pain does not alleviate the problem.  To say it another way, shutting off the fire alarm does not extinguish the fire.  So, one of the symptoms you are having is pain.

Pain is okay.  It is part of that alarm system letting you know that there is a problem.  But, do not ignore pain because you can further injure yourself.  If ignored long enough, it can lead to nerve damage, joint degeneration and possible organ problems.

Think of PAIN this way...

Prevent

Another

Injury

Now

Prevent Another Injury Now!

Your body wants you to know it is injured, to prevent any further damage to it.  That is one reason why excessive pain medication is not good.  It makes you believe you are healed when in fact you are not.  You then attempt to resume activities before your body is ready and you hurt yourself further.  The medication simply puts a mask on the problem.

Working through the pain is not good!

Most people have heard the saying, "No pain, no gain".  It may apply to weight lifting but it does not apply to an injury.  Do not be foolish, if you hurt, there is a problem.

Doc, I am not really sure how I hurt myself.

Sometimes, we just wake up with pain or move a certain way and feel pain.  Usually, however, an event has occurred maybe a day or two before that you don't even remember and now your back and neck are starting to hurt you.  Or perhaps, an old unresolved injury that was never cared for properly.  Most acute injuries occur in the low back from poor posture and lifting.  However, many injuries also occur to the neck and upper back through sports, home activities, or work conditions.

Let's talk about low back injuries first...

Most low back injuries occur from the combined movement of bending, lifting, and twisting.  This is when your back is the most susceptible to injury.  It can be easily hurt by something as simple as picking up a piece of paper from the floor or lifting an object improperly.  You can avoid injury by simply remembering to stay away from B.L.T.

B.L.T. is:

Bending

Lifting

Twisting

B.L.T. is not good for you!

There are proper ways to lift that will protect your back.  Remember these:

1. Always test the weight of the load.  If the object is awkward or too heavy--get some help--lift with someone else.
2. If you must lift, bend the knees, keep your back straight, keep the object you are lifting close in front of you and lift with your legs (the most powerful muscles in your body).
3. If it is a small object, place one hand on your knee or a stable surface, lean forward while extending the other leg behind you.

Now what about neck pain?

My problem is my neck, not my low back Doc!  What can I do?

Some people twist a certain way and hurt their neck or reach for an object and feel a sharp twinge of pain.  Others just wake up and complain that their neck is stiff and they can't move.  Sometimes the daily abuse of working at a desk or a computer finally takes its toll on the neck.  The same problems that effect the low back can affect the neck, such as:

• Strain/sprain
• Spasms
• Stress
• Joint problems
• Disc
• Pinched nerves

But neck difficulties can also cause:

• Headaches
• Visual disturbances
• Hearing disturbances
• Shoulder, arm and hand pain

Neck pain can be just as aggravating and painful as low back pain.  Whether the cause is an injury or a chronic or recurring problem, the muscles of the upper back and neck are placed under tremendous daily stresses.  You do not even realize the amount of times you move your neck and arms in daily activity.  Only when you injure yourself, then it becomes painfully clear.

Once you have hurt your neck you realize how important it is in your daily activities and no matter what you do it seems to touch every aspect of your life, from sleeping, to washing your hair, to driving your car and doing your job.  Whether you are a laborer or an office worker, your neck has to be in good condition or it will cause you relentless hours of misery.

Your neck consists of the same types of discs, joints, muscles and nerves as your low back.  The nerves of the neck form networks that travel to and interact with the nerves of the head, thorax, shoulder, arm and hand.  This area is generally the culprit in 85% of headaches that people suffer from.

Irritation or pressure on the nerves that extend from the neck can also be the cause of your shoulder, arm or hand pain.  Not only can it cause pain, but also numbness and tingling in those areas.  Thus, many times what is thought to be carpal tunnel syndrome of the wrist can actually be a cervical (neck) problem and can be eliminated.

Let's talk about warning signals...

• Numbness or tingling
• Loss of strength in hands or arms
• Loss of coordination in hands or arms
• Burning or radiating pain (pain that travels to another area)
• Dizziness, nausea, fainting
• Any visual or hearing disturbances

Doc, I need relief now!

Okay, here's what to do.

Use these procedures for neck or back pain

• Before you do anything, apply T.L.C.
• Next, to ice or not to ice, that is the question...or, should I use heat?  ICE should be used within the first 48 hours of injury--no heat!

When in doubt--ICE!!!

Remember this system...R.I.C.E.

Rest...rest the injured body part.

Ice...apply ice packs to the injured area (20 minutes on and 40 minutes off).  Ice pack should be soft and conform to the injured area.

Compress...apply pressure to the iced area.  Even after ice is removed, keep an elastic wrap on the area to keep the pressure on.

Elevate...raise the affected area if possible.  If you use this system chances are very good you will have saved yourself from additional pain and injury as well as speed up your recovery.

But why can't I use heat, it feels sooo good!

When you are first injured, damage has been created deep in the tissue.  This means torn fibers, cellular waste, and inflammation.

Inflammation=S.H.A.R.P.

Inflammation is the body's answer to containing and protecting the injured area--but it does produce pain--remember PAIN? (Preven-Another-Injury-Now)

Swelling

Heat

And

Redness

Pain

Now, do you really want to add heat to that?  ...NO!  Heat will increase inflammation.  So you will increase SHARP.  Heat feels god to tired and fatigued muscles, but it is no good yet.

So the answer is ICE because it...

• Reduces the inflammation
• Increase circulation
• Flushes waste material
• Slows down the nerves firing pain information to the brain

What about medication, Doc?

For this you need to speak to your family physician.  Remember that all medication, even over the counter medication, can have side effects such as irritation, drowsiness, or ulcers and eventually kidney or liver damage.  So let's try to get you through this without medication.

Did you know that one acetaminophen (the active ingredient in Tylenol) every four days increases the risk of kidney disease 2.4 times?

Did you know that one ibuprofen (the active ingredient in Motrin and Advil) every four days increases the risk of kidney disease 8.8 times?

Let's talk about alternatives to medication...

Natural remedies can be very good alternatives to medication.  Certain herbs, vitamins and minerals can provide pain relief, decrease inflammation, and aid in sleep.  Here are some basic common herbal remedies which have been proven helpful to many people:

Glucosamine Sulfate helps to rebuild damaged cartilage by stimulation and regulating connective tissue sythesis.

Kava Kava & Valerian Root two excellent herbs that are natural sedatives and aid in sleeping.

Bromelain & Quercetin have been shown to reduce inflammation.

Butchers Broom, Horse Chestnut, Citrus Bioflavonoids, and Vitamin C have been shown to support healthy collagen synthesis and aid in wound repair.

Capsaicin decreases pain.

Clove serves as an anesthetic and provides pain relief.

White Willow natural counterpart to aspirin.

Please check with your local doctor of chiropractic.  They have studied nutrition and many have advanced degrees in Nutritional Science.  Also, your local health food store will have additional information, suggestions, and cautions.  Always check for indications and contraindications of usage.  Be aware of any possible side effects or interactions with herbs and medications.  You can also research the effects of herbs at your local library or on the internet.

Let's talk about rest...

Resting in bed can be good, but not for prolonged periods.  The body heals during periods of rest, but extended bed rest weakens the joints and muscles of your spine.

When you do rest, sleep on your back with one pillow under your nedk and a pillow under your knees.  This will help support the curve of the neck, flatten your pelvis, and relieve the pressure on your low back.  Sleeping on your side is not as good but is acceptable, if you place a pillow between your knees so that your legs remain slightly flexed and parallel.  This will keep you from twisting your pelvis and torquing your spine.

DO NOT SLEEP ON YOUR STOMACH!  This position puts stress on your nedfk and spine and is not good for you.

Avoid sitting for long periods of time (including in the car) especially if you have a low back problem.  There is more pressure on your spine while sitting than in any other position.

When you do sit, rest your feet on a low stool or book, anything to keep pressure off your back.

When you are up and walking, wear comfortable, low heeled shoes that give adequate support.