Should I get a cortisone injection?

When we have back pain, and we can often extend this to include shoulder pain and hip pain (because these are both heavily influenced by spinal alignment), it’s a common practice to want a quick fix like a cortisone injection or pain medicine. Sometimes we opt for a nerve block or surgery that we think will fix the problem... anything to deaden the sensation of pain.

What is my back pain telling me?

Back or joint pain is certainly no fun, but it gives us a lot of information, if we’ll listen to it. It tells us where we are out of balance. What muscles are too tight and which are too loose? Am I compressing the front, back or sides of my spine, and at which level? What’s over-efforting? What’s under-efforting? Are my legs and core helping me enough? (See my previous blog on appropriate core work for back pain.) Are my shoulders overworking because my core is underworking? How should I alter my approach to working out because of back pain?

Make sure you understand your imaging report.

I believe there are no shortcuts. We can enlist aid, but we have to take the long view of what’s creating the problem. We need to educate ourselves about our imaging report. Don't place your blind trust in a doctor to fix you. Master neutral spine and body positions. (In almost 100% of cases, stop doing cat/cow!) And do the appropriate physical work to resolve the misalignments, structural imbalances, and weaknesses that fail to support your joints. This is the only real way to take pressure off the nerve that is sending the pain signals. 

A quick fix is not a permanent solution.

A quick ‘fix’ will mask the underlying problem and allow the misalignments to continue so the pain will show up again...and probably worse. Take time. Gather information. Look at a dermatome map. That will tell you which nerve is compressed by the body part that is affected.

Correct your alignment for a real solution to back pain.
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Decompression (taking body weight and pressure off the nerve), postural correction, and targeted positional exercise to strengthen your weaknesses to be able to hold the corrected alignment, is the only solution. There are no shortcuts.

If you need help understanding your imaging report, or productive ways to exercise for your condition, I can help you!
www.MyBackandBodyClinic.com

The author, Jane DoCampo, M.A., E-RYT 500, C-IAYT, is a yoga therapist certified by the International Association of Yoga Therapists, and specializes in improving back pain, scoliosis, and postural problems. 

She works with students privately (in person or online), and in small groups teaching Backcare Essentials, Backcare Essentials and the Pelvic Floor, and Backcare Essentials and Scoliosis classes at her studio, My Back and Body Clinic, in Woodcliff Lake, NJ.

Best core exercises for back pain

We all hear that we should strengthen our core to improve back pain. The first image that probably comes to mind is old fashioned sit-ups, crunches, or pilates type leg lifts while directed to flatten the lumbar curve. In fact, when lying down to address core work, the number one question new students who come to me with back pain ask me is, “Should I flatten my lower back to the floor?” The answer is NO! NEVER!

What these exercises have in common is a shortening of the front body. Anyone who: sits, or walks in a slouched position; carries a baby with their hips swayed forward; spends a long time on a computer with their arms out in front of them; or who has text neck, is already too short in the front body and overly long in the back body (which includes a flattening in the lower back and back of neck). The above exercises would only increase that pattern.

More than that, if core strength is prescribed for lower back pain, and the pain is stemming from nerve pain, degenerative discs, herniated discs, stenosis, spondylolisthesis, or excessive lumbar lordosis, these exercises could be very dangerous, as lumbar flexion is contraindicated for all of these conditions.

For safety, keep your spine neutral

It is valuable to have MRI imaging to have an exact diagnosis, but, especially for the adult body, better safe than sorry. The safest core exercises are performed with a neutral spine, one that does not flex ‘flatten’ or extend ‘arch’ the lumbar spine.

Should I use a back brace?

Don’t rely on a back brace. It is the job of our core muscles, not a back brace, to keep the lumbar spine safe and stable. It is mandatory that we learn, and grow strong enough, to hold our vertebrae in centered joint positions with a small lumbar curve intact (not a large curve or a flattened one), to be free of back pain.  Exercises (with modifications for different ability levels) like leg lifts, planks, or triangle in yoga, challenge our core to hold the spine steady in varying positions. 

Think of this as a bracing activity of the core to not allow the spine to bend while challenging it with the weight of the legs in leg lifts, with the weight of the pelvis and head in plank, or with the weight of the torso and head in triangle.

Relaxing and expanding the core is as important as training it to contract

We need to spend time relaxing the core and letting the muscles move through their full range of motion to be strong. As in, take off your spanx or stop slouching in front of the computer! Spend time lying on your side, or stretching out on your back with as little pillow as possible, (or better yet, hang from a pullup bar), and let the breathing muscles move your belly. If you watch a sleeping baby breathe, you will see a rise and fall in the belly. Muscles that are always held tense, tight, short, or overly long, are weaker muscles. If you watch an older person breathe who has lost the connection to their core muscles, even when they are sleeping, you may only see their chest move, rather than the belly.

Core muscles begin with your pelvic floor muscles

It also seems to be a little recognized fact that core muscles begin at the bottom of your pelvis in your pelvic floor. All the muscles in your pelvic bowl, in fact, not just your waistline muscles, need to support your spine. 

Pelvic muscles assist with lifting and bearing down core activities

Bracing is not the only job of the core. There is the responsibility while standing, bending, and picking up objects, to lift and hold some weight off the lumbar spine… to share the workload. 
Another lifting activity, is preventing the bladder contents from leaking until a bathroom is available.

Bearing down strength is also required. Think about childbirth, or going to the bathroom, where muscles are required to push out.

Pelvic floor dysfunction

Things that can cause the pelvic bowl muscles to underperform or become dysfunctional, are pelvic position, whether sitting or standing, and head/shoulder position. Stand up, sway your hips slightly forward toward your toes, and feel the pelvic bowl muscles turn off. Now draw your hips slightly back just above your ankles, and feel the subtle support from the pelvic bowl muscles. Similarly, notice the difference forward head and shoulder positions, versus upright posture, have on the pelvic bowl muscles.

Relaxation and expansion are also especially important for pelvic muscles as many people are chronically tense which is another aspect of pelvic floor dysfunction. Yoga positions that allow a relaxed expansion of the pelvis such as supta baddha konasana, side lying, or gentle inverted positions are exceeding useful for this purpose.

Please contact me if you need help with core strength for back pain, or pelvic floor dysfunction!
www.MyBackandBodyClinic.com

The author, Jane DoCampo, M.A., E-RYT 500, C-IAYT, is a yoga therapist certified by the International Association of Yoga Therapists, and specializes in improving back pain, scoliosis, and postural problems. 

She works with students privately (in person or online), and in small groups teaching Backcare Essentials, Backcare Essentials and the Pelvic Floor, and Backcare Essentials and Scoliosis classes at her studio, My Back and Body Clinic, in Woodcliff Lake, NJ.

Continuing from last time---
Who can benefit from our Scoliosis and ARPwave PRS program?
Some of our in-person and Skype clients include:

• A high school athlete with scoliosis who frequently injured himself due to the asymmetry in his body causing him to miss important games.
• A famous singer who had serious pain and disability because of her scoliosis and couldn't perform under pain medication.
• A teenager who despaired that her scoliosis was out of her control.
• A new mother in increased pain from the duties of mothering and not knowing how to help her scoliosis.

With this program, we can help you in-person or via Skype.
We will equip you with knowledge of your particular curve pattern, teach you curve specific movements that will counteract the progression of your scoliosis as well as develop full body strength which is essential to support your spine.
Also, you will be introduced to an ARPwave PRS that will keep you off pain medications, greatly accelerate your improvement, keep you neurologically in balance and even benefit you during sleep.
More on this next time....
Visit us at www.MyBackandBodyClinic.com

Daily Check List for a Better Life:
How I overcome Depression, Anxiety, Sadness, Frustration, Fear, Insecurity and a Bad Attitude.
Greetings! Life is hard-- really hard-- for everyone. And then every once in a while we get hit with something so bad we think we'll never survive it.
Probably my worst nightmare was a number of years ago when one of my sons was killed in a car crash. At one point I was so low that they put me on medication. That lasted one day. I got worse.
I learned that answers & solutions to life's big hits are not in a pill. Medication never gets to the source of the pain.
My solution has served me well for over 30 years now. It's based on my personal experience & has nothing to do with anyone's scientific studies or theories.
As I had to do, you must own your stuff. And conquer it yourself. I know it will work because if I can do it- so can you.
 
Daily Check List for a Better Life:
Make your bed-
Accomplish the 1st task of the day. If you can't get the little things right, you'll never get the big ones right. I got this from a US Navy SEALs Admiral.  
 
Read one chapter from the Book of Psalms Out Loud-
Please skip this one if you're not a believer. It not about religion, really. We all need to hear the Wisdom of the Ages. I can't tell you how mad at God I was after my son died.
 
Read one section of the New Testament Out Loud-
Please skip this one if you're not a believer. Getting insight into what Jesus was all about will at least help you understand your crazed Christian friends. And he was called the Prince of Peace & Peace is something we all need.
 
Breathe-
Deep, intentional, focused breathing rejuvenates every cell in your being. I like Wim Hof's method. It's quick & effective. 30 quick deep breaths without a full exhale. Empty yourself of air & stay empty as long as you can. Inhale one big breath & hold as long as you can. Repeat the entire cycle 2 more times.
 
Cold water rinse off-
This is my wimpy version of all the ice bath & cryogenics that is popular. At the end of a nice hot shower, turn the pressure down low and turn the temp down to cold. Let the water run over you (I have it aimed at my chest) for 15 seconds, build up to 1 minute. You will have an awesome glow for at least an hour afterward. I hate being cold. The effects of this are just the opposite. The process is counter-intuitive but very effective.
 
Read one chapter of a real book-
Get something that will Inspire or Motivate or Instruct you. Hold it in your hands. Don't rush through it. Pause and think about things. Underline what jumps out at you. Even if you only read 1 sentence that is profound, it can brighten your entire day.
 
Affirm positive things-
On a small piece of paper write down your goals. Also, write down the answer to the question 'Who are you?' Carry that piece of paper with you- everywhere. Whenever your thinking gets dark or you feel defeated, read what is on the paper. Use it as often as needed. Don't leave home without it.
 
Love on people instead of judging them-
This might the hardest thing on the list. Fight to get it right as often as you can.
 
Get the blood pumping at least 3 times a day-
Use a SandDune Stepper for 5-7 minutes 3 times a day. Not only does it get your blood pumping to all your joints & work against the negative effects of sitting for long periods, it lifts your mood. As an alternative there are other movements one can do without a Dune such as our Spinal Hygiene series or upper and lower body neurologic In-Balance protocols.
 
Eat smart-
Don't be a victim of processed foods or familial eating habits. The foods you eat can either add to your health & sense of well being or take away from it. A body that has to work overtime to digest is a stressed out body. Eat to nourish, repair and energize. Don't let old habits ruin your health and add to life's regular problems. If you think you know how to eat but are in terrible shape or have to be on medications then 'you really don't have a clue'.
Humble yourself. It's okay to need help. Seek out someone who exudes health & wellness not some 'expert' who does not look like they are taking their own advice. An older person would be a better choice here since the cumulative effect of what they believe will be visible. Be open to wisdom in this area.  
 
Drink smarter-
Keep it pure. No sugar, no artificial sweeteners or flavorings or colorings. Be aware of how one becomes dehydrated. Dehydration makes the body feel stiff, de-energized and sluggish.
It's easy to stay hydrated.
My personal pet peeve- folks who walk around with a huge jug of water. Drink when you are thirsty. Too much water flushes out valuable minerals.
We all know the saying 'an apple a day keeps the doctor away'. Actually an apple a day (or 2 of if you drink dehydrating beverages) is a much more efficient and healthful way to stay hydrated.
 
Put something positive in your head just before you shut the light out at night-
This is critical since your subconscious mind never sleeps. It keeps working. Giving it something positive & uplifting to work on through the night will yield a higher quality sleep.
Maybe it's that book you are reading or a quote from a favorite author or a prayer or a poem.
Try it out. Watch a scary movie followed by the day's news and go to sleep one night then see how you feel in the morning. The next night try my suggestion.
Don't leave this off your checklist.
 
Please note that this is a serious list. I am not trivializing serious mental conditions. It has been my experience that in all medical matters a holistic approach always yields better results.
 
Everything in the human body is connected. Unless it is blunt force trauma, I have found that where you feel hurt is not the origin or source of your pain.
 
Following this Daily Check List will help you to better 'own your health'. You will be empowered, strengthened and girded up. You will not get sick as often and if you do get sick or injured, you will recover faster.
 
Once you have taken command of yourself then you can enjoy true happiness. For to have true happiness we must be strong enough to reach beyond ourselves. It's been posted on each refrigerator I've had for the last 35 years- The Secret of Happiness? Find a Hurt & Heal It.
 
Get outside yourself and really live.
 
As my old friend David DeNotaris always says- Make It a Great Day!....