Our bodies can act in funny ways. One minute you feel great, and the next moment you can have sharp lower back pain seemingly from no where or from a simple movement. Pain is felt in the brain in response to nervous system input. Once you reach the pain threshold you feel it. Before that point you might have felt no indication of a problem. Everyone is unique and different situations for the same person can provide a range of responses. There are many factors that influence pain and the threshold at which you feel it including: genetics, stress and coping mechanisms, gender, previous injuries, weight and psychological factors. Obviously there are some factors that we can and can not influence.
     Genetics, gender and many psychological factors are out of our control. People can have more pain receptors, or in the case of redheads, a mutation in the pain receptor gene. Women are more sensitive to pain but are equal in their ability to tolerate pain intensities, with the big exception of childbirth. People affected by depression and anxiety can be more sensitive to pain.
     There are aspects of pain that we have control over. The brain perceives pain based on input from the nervous system. We can't change the input from the nerves but we can change the perception. Reducing stress and using coping mechanisms such as breathing practices, biofeedback and relaxation. Meditation can also reduce the experience of pain. People who smoke, are sedentary and/or are over weight experience more pain. A plan to quit smoking, exercise and eat healthy can reduce pain significantly. Previous injuries can condition the brain to feel more pain especially when those injuries effect the nervous system directly or indirectly. Getting old injuries healthy and maintaining a proper exercise and stretching routine can go a long way to improving pain.

Dr. Nelson

     I often have people come to my office with lower back pain and say "I have Sciatica". It is true that Sciatica can cause lower back pain, but that is not the only symptom and Sciatica is not the only thing that can cause lower back pain.
     So what is Sciatica exactly? Sciatica is an irritation of the Sciatic nerve. The Sciatic nerve is comprised of the lower three nerve roots that come out of your lumbar spine L4, L5 and S1 as well as two sacral nerve roots S2 and S3. Irritation can happen as a spinal nerve exits the spinal canal, on the sciatic nerve itself or further down the line as the nerve splits and innervates muscles and skin. The Sciatic nerve sends signals to contract muscles and receives signals from nerves about touch, temperature and pain. The symptoms of Sciatica include: Lower back and/or leg pain, burning and/or electric like pain, weakness in muscles of the lower leg, loss of reflexes and numbness, tingling or pins and needles. The pain and numbness often happen in specific patterns associated with the nerve root that is involved, sometimes there are more than one levels effected. It can be subtle or completely disabling.
     There are actually several different causes of the irritation of the nerve giving different symptoms and prognosis. Herniated discs cause Sciatica when the disc puts pressure a nerve root. Facet syndrome is an irritation of the facet joints that can also affect the a nerve root and cause the symptoms of Sciatica. Piriformis syndrome is an entrapment of the Sciatic nerve from the piriformis muscle. Each of these causes are treated differently.
     The most important step is proper diagnosis, finding which area is irritating the nerve. Chiropractic care can help with Sciatic pain by reducing pressure on the nerve at any of these sites. If you suspect that you have Sciatica call your chiropractor today for a proper assessment.

Dr. Nelson

     There are different reasons for stretching: injury prevention, improved flexibility, and injury recovery. Each of these goals will have a different routine of timing, type and frequency. For all three, consistency is very important.
     Stretching to prevent injury works on two levels. The first is a warm type stretch which will increase circulation and bring blood to muscle you intend to use. The second is greater overall flexibility can reduce injury frequency. I will discuss this under the improved flexibility goal. A warm up stretch is of course best done before any vigorous exercise. The type of stretching is the key. Static stretching, eg the sit and hold a pose, is not the best choice before exercise. When your muscles are cold they have less flexibility and blood flow. You won't gain much in terms of flexibility stretching cold, and you won't get the blood flowing in a static posture. Dynamic stretching is best pre-exercise. Leg and arm swings anterior/posterior and lateral, shoulder shrugs, high knees and leg kicks are all good examples of dynamic stretches. Focus on the muscle groups you intend to use, start slow and build up intensity for 5 to 10 minutes. 

      Stretching to improve flexibility comes in different forms. Many people think of yoga or ballet and the extremes of flexibility. Increasing your flexibility can reduce injuries, up until a point. There is a trade off of strength for flexibility. Think of it as a bell curve, or inverted U curve. Inflexible people are prone to injury because their limit of flexibility is low and they push their boundaries easily. Extremely flexible people can give up strength for more range at their end limits which can lead to injury as the muscles become a larger portion of stability than the joint capsules and ligaments. More is not always better. That said, extreme flexibility is far less of an issue than limited flexibility. The best time to increase flexibility is when muscles and ligaments are already warm. Traditional static stretching will receive the most benefit following exercise. Balance is key, if you stretch your hamstrings, stretch your quads as well. Also, do not stretch into pain. Dynamic stretching such as during a yoga class is a great way to increase flexibility. If you have attended a class before you may have noticed that they generally start out light and build in intensity. The most vigorous stretching is near the end where you will get the most benefit. Yoga also incorporates balance work, which I personal feel is a great attribute to improve. Consistency is important which ever method you choose. If you stretch once a week then you may see benefits a year later. If you stretch 3 times a week or do a 40 day yoga challenge you may see benefits much more quickly. Everyone's body composition is unique and will progress and different speeds.

     Stretching is a vital component of recovering from injury. After an injury your body lays down scar tissue to hold together the damaged tissue. Initially scar tissue is disorganized and has a random arrangement. Movement breaks through that randomness and helps your body remodel the scar tissue to have a similar function to the tissue it is replacing. It is best to stretch without pain and at a mild or moderate level. The key for injury recovery is consistency. Stretching 3 or 4 times a day will help the tissues regain their former flexibility. It is an organic process that can take up to a year or more depending on the age and severity of the injury. Chiropractic care can facilitate this process by breaking scar tissue in difficult to stretch areas.

Dr. Nelson

     Maintaining a health weight is important for many aspects of health. There are main differing points of view on the definition of a healthy weight. One reason is that there are many ways to measure a healthy body weight. BMI is a simple measure of height vs. weight but isn't particularly valid for muscular people. Body composition is a better measure but skin fold testing is rarely done outside of personal training. Body composition can be measured by electrical current and is included in some scales, however hydration levels can create inconsistency. And some people just have a gut feeling that they are in at unhealthy weight. But that's all for another time, including the reasons for maintaining that healthy weight.

      This post is about losing weight. It doesn't matter if your goals are motivated by health or vanity. You have decided to lose some amount of weight. I have a bachelor degree in kinesiology and plenty of personal experience in many types of exercise so of course I get questions about exercise and weight loss. There are many great benefits of exercise and weight loss is one of them, but, and this is a big but, it doesn't guarantee success. Many people who exercise end up eating more. Depending on your cravings, will power and an underestimation of the actual calories burned during your workout, you may actually wipe out all of the weight loss benefits of exercise. Running 1 mile will, roughly speaking, burns between 100-150 calories depending on your speed, weight and efficiency. A little more for men, a little less for women. How many calories were in that can of coke or beer you had after your workout, or even with lunch or dinner? 150-200? In my opinion it is much easier to eliminate excess empty calories than to tack on an extra mile in a workout. 

     Alcohol is particularly troubling because of it's effect on metabolism. Your body can burn alcohol for 7 calories per gram. More than sugar and protein at 4 calories per gram and less than fat at 9 calories per gram. Alcohol is not useful for anything other than those calories and the byproducts of metabolism cause a hangover. Your liver has to process alcohol, but your liver also works on many other metabolic pathways. Your liver is critical in many forms of sugar metabolism: fructose processing (a form of sugar naturally in fruit among other things), storage of glucose as glycogen and maintenance of blood glucose levels. Nonessential amino acids are synthesized in the liver and ammonia, a toxic byproduct of protein metabolism, is converted to urea.  The liver is responsible for a large amount of fatty acid metabolism as well. Your liver has all the protein machinery present to convert alcohol into fatty acids, which then go into your blood stream and to surrounding muscle and fat cells. So not only are you taxing your liver with extra work, which may slow down the good metabolic processes, you are also giving it a lot of energy to create the fat you are trying so hard to lose.

     In the ideal world you can employ all 3 strategies: Exercise, eat well and save alcohol only for special occasions. But if you can't do all 3 at once start with nutrition and reducing alcohol consumption.

Dr. Nelson

     Stress is rampant in our busy lives. Unsurprisingly it is related to back pain in more ways than one.
Physiologically our bodies respond to the perception of many forms of stress the same way we would respond to danger. Our sympathetic nervous system kicks in the 'fight or flight' response through hormones that elevate heart rate, cause shortness of breath, increase sweating and tighten muscles. Our bodies put short term survival above long term health. Respectively, when we are relaxed, the parasympathetic nervous system kicks in the 'rest and digest' response which promotes blood flow to the gut, decreases heart rate and lets our bodies heal.    
     Unfortunately our body doesn't distinguish between stress at work or at home from physical threats. Physical, mental and chemical stress all influence our levels of back pain. Cortisol is released with stress, increasing inflammation and all the associated negative effects. Tension in muscles hold on to poor postures which can even influence our emotions. Stress can drive us to eat unhealthy foods which add further chemical stress to the equation. Stress can also cause a normally careful person to be reckless in many ways as we think less and react more.
     There are many ways to reduce stress that can also help with back pain: Laughter is the best medicine, especially for stress. Your social network can help you ease tension, relax and even vent. Meditate, breath deeply or practice mindfulness to bring an inner calm. Focus on the little things like your breathe, the small details of the world or even your own emotions and thoughts. Be grateful, focus on things that you have and love, not problems in the future or things you want. Exercise is a great way to burn off frustration and get your blood flowing, there are many other benefits at any intensity. If you notice you are stressed try these methods out, you might find some more effective than others. Remember which ones are the best for your body and make a habit of looking for and diffusing your stress

Dr. Nelson

Vitamin D is important for good overall health including healthy muscles, heart, lungs, brain and bones. Winter typically brings less sunshine and we also cover our skin to stay warm.  Your body makes its own Vitamin D from exposure to sunlight and it is supplemented in our diet. I became interested about the role of Vitamin D after I heard that most of the 2009/10 Stanley Cup Champion Chicago Blackhawks prescribed 5000IU daily by their team Doctor.

Vitamin D is an oil soluble vitamin that is created when your skin is exposed to ultraviolet light but can also be ingested in a small number of foods or as a supplement. UVB is the specific wave length that stimulates the production. UVB is partially absorbed by cloud cover, pollution and sunscreen and it is completely blocked by glass and most thick winter clothing. This reaction can create a lot of vitamin D for your body; 15 minutes full body exposure (without sunscreen) can create 25,000IU during peak sun hours. There are different forms of vitamin D that are present in your body that become active when processed by your liver and kidneys.

Vitamin D is actually a hormone and is important in many bodily functions. It is well known for increases calcium absorption in the gut and it also helps your bones utilizes the calcium. Vitamin D is linked to reduced rates of colorectal, prostate, breast and pancreatic cancer, but it is not a clear relationship. Lesser know functions of Vitamin D are that it modulates cell growth, neuromuscular function, enhances the immune system and reduces inflammation. These are the reasons that the Blackhawks are taking Vitamin D: decreased healing times, increased athletic performance and a boosted immune system.

The most studied function is that of bone health. It is well understood and documented that decreased levels of vitamin D cause Rickets in children and osteomalacia (soft bones) in adults. The levels of serum 25(OH)D, a form of Vitamin D in your blood that has the longest half life(15 days), can predict these conditions quite accurately. When looking at cell growth (healing), neuromuscular function (physical performance), immune function and reduced inflammation, the minimal serum levels of 25(OH)D are more vague and less understood. Compounding this problem is the fact that vitamin D is oil soluble and there are consequences of ingesting too much, such as soft tissue calcification, heart arrhythmia and kidney stones. These are typically reported in cases where people take a supplement of 10,000+ IU daily. Extended exposure to the sun does not cause vitamin D toxicity because heat from the sun increases the breakdown rate of the Vitamin D created in the skin.

Recently the recommended daily intake was increased from 400IU to 1000IU, which is a step in the right direction but with the northern climate it may be not enough, specifically in winter.

Vitamin D3 can be found in most fish and fish oils, especially deep-water fish, and in liver, beef and egg yolks. Many dairy products and orange juices are fortified with vitamin D2. However, the liquid form of Vitamin D3 is the most bio-available supplement.

In summary Vitamin D is an important aspect of maintaining health. In our climate it is readily available in the summer but should be supplemented in the darker winter months. Supplementation for adults between 1000-4000IU per day with D3 in liquid form is optimal depending on lifestyle, activity level and sun exposure.


Dr. Nelson