Hallmark Card and Kay Jewelers commercials on TV are a reminder that Valentine's Day is quickly approaching.  It is so important to tell your loved ones how much you care about them, however, it is equally important to take care of yourself. 

I would like to remind everyone that this month has another important focus - February is American Heart Month.  Laser Spine Institute is known for relieving chronic back and neck pain.  But we're big fans of heart health too.

The American Heart Association has developed this simple, seven-step list to help you live a long, productive healthy life:

1.    Get active
2.    Eat better
3.    Control cholesterol
4.    Manage blood pressure
5.    Reduce blood sugar
6.    Lose weight
7.    Stop smoking

This is a great list to live by and I am making strides on many of these steps every day.  Show your family you love them this month not just for Valentine's Day but every day by taking care of yourself and staying heart-healthy.

As promised, below are additional tips to help you enjoy your holiday activities, while protecting your spine. The Center for Disease Control (CDC) also has excellent tips on general holiday safety, so I encourage you to visit their website. Happy Holidays!

Tip 3: Holiday Travel

Are you taking a long trip by car or plane? Consider a travel pillow to support your back or neck. An ice or heat pack can also be a helpful aid. When traveling with luggage, use suitcases with wheels to avoid the strain on muscles and joints from carrying on your shoulders.

Tip 4: Online Shopping

Many spend time at the computer shopping for holiday gifts online. To avoid lower back strain, sit back in a chair so your spine is fully supported. Thighs should be parallel with the floor with hips higher than your knees. The top of the monitor should be at eye level.

Q: I spend much of my time working at the computer and my neck has become stiff and what's worse - I feel a pinching sensation down my left arm. For six months, I have gone to a chiropractor. Can you help me understand where my pain is coming from and other options I might consider?

A: We often joke about our jobs or bosses being a "pain in the neck." But, some of our on-the-job habits can trigger the kind of neck pain that's no laughing matter. If you want to avoid developing neck problems, there are several things to keep in mind. Of course, if you are currently experiencing neck pain or stiffness, your doctor should rule out any serious medical causes.

Your physician should conduct a thorough clinical evaluation. Depending on your medical history, your doctor may order an MRI, which will reveal any anatomical abnormalities, such as nerve impingement or spinal stenosis.

The National Institute of Occupational Safety and Health (NIOSH) reports neck pain can develop for a number of reasons. For example, sitting at our desks, we put extra strain on the neck muscles when we:

• look down for extended periods without breaks
• cradle the phone between our neck and shoulder
• tense the muscles as we work

According to the American Association of Neurological Surgeons (AANS), there are two serious types of neck pain that require immediate medical attention. The first is dull pain in the neck that radiates down the shoulders and arms usually caused by a herniated disc in the neck pressing on the nerve root. The second sometimes isn't felt in the neck at all, that's because the pressure is on the spinal cord, causing imbalance or weakness in other parts of the body, such as the hands and arms.

While you can alleviate some of these problems through good posture and regular breaks, neck pain can also result from other factors including injury or underlying conditions. Consulting with your doctor as soon as possible is especially important if neck pain does any of the following:

• lasts for more than a week
• if it's accompanied by headache and fever
• if other symptoms are present such as numbness or tingling

It is important that the results of your treatment be directed to those levels causing your symptoms, not your MRI. Treatment can range from a conservative approach, i.e. medication, physical therapy and exercises, to spine surgery.


Dr. John Spallino is a Medical Information Specialist at LSI. In this capacity, he facilitates patient education by conducting nationwide informational seminars, in addition to interpreting and analyzing radiographic imaging. To learn more about Dr. Spallino, click here.

LSI's Ask the doctor column is also featured in our monthly newsletter, The Spinal Column. To subscribe, click here.

Earlier this month, I told you about LSI's commitment to educating the community and the various resources we provide. In that post, I wrote about our free interactive, educational seminars, where attendees learn about spine anatomy, available treatment options, and can meet with a board certified physician for an MRI or a CT scan review.

However, I also want to ensure that information is available at your fingertips, so beginning today, I will share answers to commonly asked questions and provide you with resources for accessing information about Laser Spine Institute, minimally invasive spine surgery, as well as general information about back pain.

Dr. Craig Burns, Medical Information Specialist, answers today's featured question, which came from one of our former patient's daughter and can also be found on our Facebook page. Feel free to submit your questions by commenting on this post.


Q: I'm a petite 54 year old woman and my mom has spinal stenosis. I had a full body MRI at 50, which showed mild osteoarthritis of the lumbar spine. I am very fit with a strong back and have no pain. Any advice as to what I can do now to avoid an outcome similar to my mother?

A: Genetics is a predictor of future potential medical issues. In addition to genetics, the daily wear and tear we place on our spines is also a very big contributor. As such, aging increases arthritis throughout our bodies and arthritic facet joints frequently cause spinal stenosis. Staying physically fit and maintaining an ideal body weight are good practices. If there is a small degree of spinal stenosis, the best exercise is swimming and a riding a recumbent bike. However, always remember to consult your physician before beginning an exercise regimen.

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Watch Your Step: Footwear and Lower Back Pain

Certain types of footwear have the potential to cause discomfort or intensify existing back pain. Therefore, you should be extremely careful when making shoe selections and ensure that your choices are conducive to a healthy spine.  Below, you will find an outline of important features of back-friendly footwear, including sole, support, and heel height, as well as situational factors, such as occasion and  specific activities.



Sole
Your shoes should provide - support, shock absorbency and durability. The discs in your spine allow for movement and provide a cushion to the spinal joints. Therefore, a good sole to your shoes preserve and compliment this cushion. This prevents strain and pain to your spinal ligaments and provides improved stamina and energy in your daily activities.

Support
Properly fitting shoes with arch supports help to evenly distribute your weight over the entire foot and prevents overuse one side of your body. In addition, 25% of the bones in the body are located in the foot and if they are not well supported, you accommodate these strains in the back and limbs, in order to continue moving. The correctly fitting shoe can immediately redirect your posture and gait into normal healthy patterns.

Style
High heels and uncomfortable shoes result in poor posture and altered gait patterns to accommodate the change in your center of gravity, which places abnormal stresses and strains on your spine. Choose shoes with anatomically correct, removable foot beds that offer good support, shock-absorbing heels, rubber compound shoes and roomy toe boxes. Remember, painful, cramped feet are reflected in your body posture and movement.

Occasion
Shoes should be chosen based upon specific activities. Certain types of shoes are more suitable for casual walking, running, hiking, etc. Therefore, you should select shoes that are designed for specific activities. Finally, change your shoes frequently to avoid loading your spine and joints in the same patterns.

Exercise and professions, such as chefs, nurses, teachers, doctors, require standing or walking for extending periods of time. In fact, the average person takes 5,000 to 8,000 steps daily, which adds up to about 100,000.00 miles over a lifetime.  Spending long periods of time standing adds stress on your feet, ankles, knees, hips and back. Since these activities are a part of daily living, it is necessary to take proper steps to mitigate damaging effects.

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In August's issue of our newsletter, The Spinal Column, LSI's Director of Functional Rehabilitation and Physical Therapy, Irene Rademeyer discusses the impact of sporting activities on the spine and provides helpful injury prevention tips. As a former athlete, I know the toll that sporting activities take on one's spine all too well, but I also know that with adequate care, one can participate in their favorite sport while maintaining a healthy spine. So, whether you tackle, swing, hit, dribble, or pitch, it is imperative that you practice, prevent and protect!

Be a Good Sport - Tips for Protecting your Spine

Professional athletes are known to have rigorous routines before and after competition, in order to prevent injuries and stay ahead of the competition. If you live an active lifestyle, it is important for you to follow this practice.

Here are some simple tips provided by the Laser Spine Institute's Functional Rehabilitation Department:

1. Complete a stretching and warm-up routine before playing. It is a good idea to do spinal stretches lying down. For example, perform flexion, rotation and extension stretches. We can achieve better muscle and ligament stretching of the spinal joints if we do them in this unloaded position. Include the specific body stretches and warm -ups recommended for your specific sport.

2. Following a sports activity, it is good to ice your spine to reduce any inflammation or swelling and prevent muscle spasm and nerve irritation. All sports place some strain on our spine and icing is good aftercare. Cycling keeps the spine in a prolonged flexion posture, running results in spinal joint pounding, tennis creates joint compression etc.

3. Professional athletes usually leave the competition if they have an injury. It is highly recommended not to play through pain or spasm. Recognize that painful symptoms typically indicate a more serious injury. Continuing to play may result in permanent or more serious injury to the spine.

4. Avoid over-playing, such as several days in a row, because spinal muscles and joints need a recovery period after strenuous exercise. If you continue to play with fatigued muscles, there is a much greater likelihood of sustaining joint and nerve injury.

5. Build some rest days into your training and sports activities to allow your body to heal and muscles to repair.

6. Consider cross-training to stay balanced and healthy. Keeping muscles conditioned will provide extra support to the spine.

7. Swimming and pool exercises provide excellent aerobics and overall muscle strengthening having support of the water allows less strain on the body. Remember with all our training programs - our muscles are often stronger and capable of heavier exercise than our joints. If your spine is stiff and uncomfortable 24 hours after your training or sports activity, that is often a sign of swelling and inflammation in the spinal joints or nerve tissue. Decrease the intensity of your training, give yourself more rest days and restructure your sport, so that this does not persist.

Your goal is to play your sport well and successfully, but avoid permanent spinal injury that can affect the rest of your life.

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Q:  Does a family history of osteoporosis increase my chances of developing spinal complications?

A: It may. Let's start off by defining the term "osteoporosis". "Osteoporosis" literally means "porous bones." This condition occurs when bones begin to lose some of their essential elements, the most important of which is calcium. Over time, bone mass decreases. As a result, bones lose their strength, become fragile, and break easily. In extreme cases, even a sneeze or a sudden movement may be enough to break a bone.

Osteoporosis is a serious health problem, affecting approximately 28 million people in the United States and is responsible for about 1.5 million fractures (broken bones) each year. The most common locations where breaks occur are the hip, spine, and wrist. Hip and spine injuries are the most serious, often requiring hospitalization and major surgery. They may also lead to other serious consequences, including permanent disability and death.

Contributing Factors

While a decrease in bone mass is a normal part of aging, there are certain factors that increase a person's risk for osteoporosis. These factors include:

• Gender- Women are more likely to have osteoporosis than men. Women commonly lose 30 to 50% of their bone mass over their lifetimes, while men lose about 20 to 35%.

• Race- Caucasian and Asian women are at somewhat higher risk for osteoporosis than are African American and Hispanic women.

• Body structure- Individuals with smaller, thinner bones are at higher risk for osteoporosis.

• Early menopause- Women who experience menopause earlier start losing bone mass earlier.

•  Lifestyle- Alcohol consumption and tobacco use are thought to increase risk for osteoporosis. Lack of exercise may have the same effect.

• Diet- Two important nutrients needed for bone formation are protein and calcium. A diet low in either of these nutrients may lead to osteoporosis.

Complications

In addition to fracture of vertebrae in the spine, spinal stenosis may also result from osteoporosis. Spinal stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and nerves. This is usually due to the natural process of spinal degeneration that occurs with aging. However, it can also be caused by spinal disc herniation, osteoporosis or a tumor. Spinal stenosis can affect either the cervical or lumbar vertebrae.

One can observe that osteoporosis and spinal stenosis can go hand to hand. Therefore, treatment should be directed at both conditions. At LSI, while we do not treat osteoporosis, endoscopic spine surgery is an excellent option for treating spinal stenosis.

Goals and Methods of Treatment for Osteoporosis

Since there is currently no cure for osteoporosis, the best recommendation is prevention. In the event that the condition is present, treatment should be pursued. Available treatment options for osteoporosis include:

• Drug therapy - several medications are approved by the U.S. Food and Drug Administration (FDA) for the prevention and treatment of osteoporosis.

• Surgery - In the event that pain is not relieved through medical management, surgery may be performed. This type of surgery is called percutaneous vertebroplasty and involves injecting bone cement (polymethylmethacrylate or PMMA) into the body of the fractured vertebrae.

The main goals of treatment are to slow the progression of the disease, minimize the risks of complications that may cause pain or reduction in function, maximize mobility and reduce the risk of falls and fractures. If these goals are achieved, osteoporosis patients are able to enjoy a relatively active lifestyle.

Dr. John Spallino is a Medical Information Specialist at LSI. In this capacity, he facilitates patient education by conducting nationwide informational seminars, in addition to interpreting and analyzing radiographic imaging. To learn more about Dr. Spallino, click here.

LSI's Ask the doctor column is also featured in our monthly newsletter, The Spinal Column. To subscribe, click here.

In recognition of Administrative Professionals Day, LSI Director of Physical Therapy, Irene Rademeyer PT.OCS., provided some helpful tips for keeping your spine in line while you are hard at work in your office. At LSI, we provided beach balls for members of staff.  These balls are economical and are useful for lumbar support. You should try them!

Common Mistakes
•    Sitting at a desk longer than 30 minutes without moving
•    Poor sitting and working postures
•    Incorrect ergonomics for the computer, desk and the person working there
•    Sustaining the same position constantly while working
•    Using medication for relief of back and neck pain while at work

Easy Solutions
•    Alternate sitting at a desk to working at a standing station and taking frequent walks
•    Improve work posture by using a partially inflated beach ball (5 - 10%), behind back and a
     mobile footrest under feet
•    Correct the ergonomics of a workstation and have the computer at eye level with the chair
     at the appropriate level for the person's height
•    Do chair exercises, such as neck and shoulder exercises, pelvic rocking, abdominal
     bracing and spinal lengthening
•    "Listen to your body" by moving before developing muscle tension and joint stiffness

I hope you found these tips useful and I would be interested to hear about your spine protection practices! Remember, the small steps that you take today may amount to great leaps on your path to a healthy spine. To read Irene's article in its entirety, click here.

The spine provides stability, enables mobility, and protects the spinal cord, major organs and nerves. Therefore, it is extremely important to prevent injury to this vital and complex structure. While there are some conditions that emerge due to natural wear and tear as we age, our daily activities also have the potential to inhibit the proper function of the spine, often resulting in severe pain.  For that reason, we should take all possible and necessary steps to protect our spine by ensuring that our daily habits are conducive to spinal health. 

In the March issue of our monthly newsletter, The Spinal Column, our Director of Physical Therapy, Irene Rademeyer, provided some useful prevention tips. These include: - proper posture, adequate back support, and stretching.  Many of us pay little attention to our habits and this article will help to raise your awareness and keep your spine in line!  To read Irene's article or to subscribe to The Spinal Column, please click here.