Dr. Kofman's Health News, Notes and Quotes

When it comes to back pain, your first thoughts may be to take over-the-counter pain medication and rest whenever possible. Two bad options. First, medication is only going to temporarily relieve the pain, if at all, and may be accompanied by various unpleasant side effects attributable to drugs. Second, rest may actually hurt more than help. While you're seeing your chiropractor, there are a few things you can do at home to help the healing process. Believe it or not, it's based on the simple principle of movement.

When you stop moving, everything tightens up, circulation slows down, and pain chemicals accumulate in your muscles and joints. It's like waking up after sleeping in a cold room on a lousy mattress with a draft. You need to move. Here are two simple exercises to get you started (discuss these with your doctor first):

Exercise #1: Backward Bending (extension of the lumbar spine). An exercise called the McKenzie extension is the first thing you should try if you have sciatica (pain running down your leg). If these exercises work, your pain will diminish and may centralize, which is a good thing. Centralize means your pain goes less far down your leg, and you may feel it closer to the spine. Bending backward may not feel good at first, but you should feel better immediately afterward. If you feel worse afterward or the pain goes farther down your leg, stop, as this is not the exercise for you.

How to Do It: Lie face-down on the floor, arms bent at your sides (sort of like a starting push-up posture). Straighten your arms up slowly, lifting your upper body off the floor as you do so. Your legs and feet should stay on the ground. Hold for 3-5 seconds, then slowly lower your upper body back down. Repeat 10 times, as often as once per hour

Exercise #2: Flexion Exercises (bringing the leg toward the chest). People with lower back pain can also feel better with various types of leg flexion, bringing the bent leg toward the chest, or doing contract-relax and then bringing the bent leg toward the chest. These people usually have sacroiliac joint problems. (The SI joints are located on either side of the spine in the lower back.)

How to Do It: Lie on your back with one leg bent and then other flat on the floor. Bring the bent leg up toward the chest. Wrap your arms around the leg and then try to lower it toward the floor for 3-5 seconds, resisting with your arms. Relax, and then pull the bent leg up farther toward the chest. Repeat the entire process three times.

To reduce your risk of injury, consult with your doctor before doing these exercises for the first time, particularly if your pain is new and/or you would like further explanation of how to perform the exercises correctly.

Talk to your doctor about the importance of balance and proper posture, and how the two of you can work together to help maintain both for a lifetime.

It's common knowledge that regular exercise is all the more important during pregnancy. Why? Well, for one thing, because the combination of developing child, hormonal fluctuations, and other factors means you will likely gain a moderate amount of weight as part of the natural process.

Moreover, as any mother will tell you, delivering a baby can be a physically traumatic - albeit joyous - experience; exercise in the months leading up to that day helps strengthen your muscles and heart, which can be placed under severe stress during delivery.

Less well-known is that exercising during pregnancy may make for a healthier child. Consider a recent study involving pregnant women (ages 30-35) who were divided into two groups - one group that performed moderate-intensity aerobic exercise for 30 minutes per day at least three times per week, and a second group that did not perform regular exercise over the same time period. The study revealed the following:

• Fetal heart rate was significantly lower (a good thing, within reason) in the exercise group during fetal breathing and non-breathing movement periods.
  
• Fetal short-term and overall heart rate variability (indicative of a mature neurologic system) were higher in the exercise group during breathing movements.
  
• The exercise-exposed fetuses had higher measures of vagal (cardiovascular) control during breathing movements.
  

The most important goal when undertaking any exercise program is not to build muscle, burn fat, increase cardiovascular capacity, or anything else. Those are important, but the number-one priority is to keep from being injured. That's the only way you'll have a real chance of reaching your fitness goals. Here are four movements to avoid when exercising, along with a few exercises that are often performed incorrectly:

1. Don't use jerking motions, especially when lifting. Speed is fine when done appropriately, but you should always have fluid motion and proper form when performing any and all exercises; otherwise you could strain or even tear something.
   
2. Don't use body parts not required for the exercise. Have you ever seen people doing biceps curls and rounding their shoulders or arching their backs? Those are just two of the big no-no's that can lead to injury.
   
3. Don't lock out your knees or elbows. Never lock your joints when working out; keep them slightly bent so the weight will not be transferred to the joints.
   
4. Don't arch your back. Picture someone on the barbell bench press, lifting a weight that is actually too heavy for them. Chances are that eventually, they will start arching their back. Sooner than later, that back is going to give out and they won't be able to exercise for days, weeks or even longer.
   

Rheumatoid arthritis (RA) is a chronic condition that causes joint pain and loss of mobility. Approximately 3 percent of the population is affected, with women outnumbering men by approximately three to one. Several important clinical trials suggest supplementing with antioxidant vitamins and minerals, specifically vitamin E, vitamin C and selenium, can help manage RA.

Vitamin E: One study tested vitamin E supplementation against the anti-inflammatory drug diclofenac sodium in hospitalized RA patients. Patients were administered 400 mg of natural vitamin E, three times daily, or the standard anti-inflammatory dosage of diclofenac sodium. After three weeks of treatment, both groups showed the same significant degree of improvement with respect to joint stiffness, improved grip strength, and pain reduction.

Vitamin C: Animal studies suggest that vitamin C reduces inflammation and swelling, and contributes to greater pain tolerance in animals with arthritis. These findings are encouraging for RA patients, particularly if continuing research proves that this benefit applies to humans as well.

Selenium: Patients with rheumatoid arthritis have been shown to have lower blood levels of selenium. In an important 1997 study, patients given 200 micrograms of selenium daily for three months reported fewer tender and swollen joints, and less morning stiffness. They also required lower doses of anti-inflammatory medication than patients in the control group (who weren't taking daily selenium).

As you can see, several important clinical trials suggest supplementing with antioxidant vitamins and minerals, specifically vitamin E, vitamin C and selenium, can help manage RA. In many cases, the need for anti-inflammatory drugs (which are commonly prescribed to arthritis patients) can be significantly reduced and sometimes eliminated when antioxidant supplementation is co-administered. This is important because long-term use of anti-inflammatory drugs is associated with many adverse and life-threatening side effects. As such, any safe and effective treatment that reduces the need to take these medications is worth considering. If you have RA or know someone who does, talk to your doctor about the benefit of nutritional supplementation to help manage your/their condition.

These days, people are constantly "connected" to their hand-held devices, whether it is their cellular phones, portable video games like Nintendo DS, e-readers such as Amazon Kindle, or they are just using apps on an iPhone. A Kaiser Family Foundation survey found that young people 8-18 years old spend in excess of seven-and-a-half hours a day using some form of mobile media. As a result, this younger demographic will surely be developing a condition known as forward head posture (FHP).

As technology advances in the market of hand-held mobile devices, it's important to understand that where the head goes, the body will follow. If you have forward head posture, then you will have rolled shoulders. With rolled shoulders, a concave chest can follow, and often a pelvic tuck, all of which can contribute to progressive pain and dysfunction over time.

Because the demographic of people ages 13-27 is one of the largest groups of texters, we can expect to see a large increase of medical and chiropractic conditions within the next decade. The amount of time spent in a forward head tilt while texting or gaming, surfing or browsing the Web has increased as hand-held mobile devices such as cell phones, video games, and MP3 players have become smaller, mobile and essentially a direct extension of the person.

Look around you and you will see people with FHP using hand-held mobile device at tables in restaurants, at red lights in their cars, walking through the mall, in line at the grocery store, and even sitting in doctors' reception areas. We are a society that is "connected," now more than ever before, and we are suffering the health consequences.

Of course, forward head posture is not a new condition. Chiropractors have been treating and educating patients on the dangers of FHP for years, and the health conditions that FHP or anterior head carriage contribute to are well-researched and documented.

With all this said, it's important to understand the negative effects of a repetitive stress syndrome and appreciate how many hours you are using your hand-held mobile devices and how many hours your children are using these devices. Talk to your doctor about forward head posture, the dangers of text messaging and other behaviors that put your body in stressful positions, and how you can avoid the pain before it starts.