Welcome to Advance Physical Therapy, Inc. Newsletter
It's hard to believe that it's already the end of April.  Just a few months ago, we were celebrating the beginning of the new year.  Now here we are almost 5 months into the "new" year and likely wondering where the time has gone.  Did I act on those new year resolutions to live healthier, have a more positive attitude and stress less?  Often times, these are difficult resolutions to fulfill because we are too busy trying to get through another day of work, school or events that require our undivided attention.  The good news is that it's never too late to be more PROACTIVE about our health and step forward to apply prevention strategies to avoid common injuries that inevitably can get the best of us.  Among the most common injuries that affect people's daily living, low back pain leads the pack.  Our March newsletter highlighted the fact that more than 80% of people experience some form of low back pain. That's a daunting statistic.  But small changes in our lives can make a huge impact on diminishing low back pain risks and keep us on the road to healthy living. 

The focus of this second installment of our low back pain series is a description of the signs and symptoms of the most common lumbar diagnoses.  In addition, you'll  learn how proper nutrition can speed the healing process from a low back injury.

To your health,

Advance Physical Therapy, Inc.


What is this Pain in my Back?

The evidence shows that degenerative changes in the spine can begin in the third decade of life.  By the time we are in our mid-30’s, many people will begin to feel the symptoms of degenerative disc disease.  The symptom may be as simple as having a gradual onset of morning stiffness in the low back.  At this point, the level of pain and disability is not severe enough to cause an interruption in the business of our daily hectic lives of working and raising a family.   As months ensue, the stiffness may take longer to go away in the morning, or stay a little stiff all day.  Then, you begin to feel an ache in your buttock during those long afternoon meetings.  Functionally, you may notice that your everyday movements, like picking up around the house, or bending over the sink in the morning is not as easy.  Even driving for awhile can make you shift around in the car seat and become uncomfortable.  By the time we see many patients in physical therapy, there is a new and unprecedented painful event, such as this one:  “Last Tuesday,  I was bending over to pick up the laundry basket, when I felt a sharp pain in my back and part of my buttock.  It was a little tender the rest of the day, but it wasn’t until I tried to get out of bed the next morning that I felt the most pain I’ve ever had. I couldn’t straighten up….After a couple of days, a very sharp pain was radiating down my leg.”  This sequence, from simple stiffness in the back to severe back buttock pain with radiation to the leg, is a sample history of someone in their 30’s, 40’s or 50’s who has degenerative disc disease that has progressed to a lumbar disc herniation with nerve root impingement, or sciatica.

During her classes, one of the world’s most renown educators for physical therapists, Shirley Sahrmann, Ph.D., DPT, says (with a chuckle) “If we’re lucky, we’ll all degenerate.”  It is, in other words, an expected and natural  part of aging.  If given a choice, we would prefer to do so slowly, rather than quickly (!)  Consider a typical story from a physical therapy patient with a back problem in their 60’s, 70’s or 80’s: “I have difficulty walking around the grocery store now.  I need to use a cart, even if I am not getting many items, because it helps me get my shopping done if I can lean forward…I used to be able to walk a mile a day, but now, I have to find a bench every 3 blocks, because my back aches and legs cramp and tire.  The only way to continue my walk is to sit and rest every 3 blocks.”  Older people who have particular problems with positions and activities that require the spine to remain straight, like walking or standing, most likely have spinal stenosis.  Besides an ache in the back, the nerves can become compressed by the severe loss of disc height and degenerative changes around the bony tunnel where the spinal cord and nerves travel within the spinal column, and cause the leg symptoms.

There are many more low back conditions that we treat at Advance Physical Therapy, Inc., but degenerative disc disease, disc herniation, sciatica and lumbar stenosis are the most common ones.  These conditions often co-exist.  When there is injury to lumbar discs and nerve roots, muscles often respond by spasming and cause the worst symptoms of an acute episode.

If you are interested in knowing what physical therapy can do to help you slow down the degenerate process, give us a call today!

Next month, we'll discuss effective treatment strategies for these and other low back conditions.

Nutrition that Increases Low Back Pain Recovery

Our bodies require the right nutrients for healing and restoration.  We are what we eat.  What we eat helps determine how much or little inflammation we produce that can ultimately affect how are tissues heal from injury.

Our bones provides the structural framework  for our muscles, tendons and ligaments to work.  Without the proper nutritional support, our bones can be susceptible to developing osteoporosis.  Osteoporosis, or thinning bones, is a serious condition that can result in tremendous pain with fractures.  Risk factors for osteoporosis include aging, being female, low body weight, low sex hormones such as during menopause, smoking, and some medications.  There are no symptoms of this bone disease until you fracture a bone. Prevention and treatment of osteoporosis include taking calcium, vitamin C & D, magnesium, zinc, copper and getting regular aerobic and resistance exercise.

Osteoarthritis (OA) also known as degenerative arthritis or degenerative joint disease or osteoarthrosis, is a group of mechanical abnormalities involving joint degradation, including articular cartilage and subchondral bone.  A variety of causes - hereditary, developmental, metabolic, and mechanical deficits - may initiate processes leading to loss of cartilage.  When bone surfaces become less well protected by cartilage, bone may be exposed and damaged.  As a result of decreased movement due to pain, regional muscles may weaken and ligaments may become more loose.  To minimize exposure to degenerative joint changes, some of the key nutritional support include maintaining an allergen free diet, avoiding alcohol, caffeine and high levels of dairy products, and including omega-3 Fatty Acids (cold water fish, flax seed, walnuts, soybeans), omega-6 Fatty Acids  (sunflower seeds, pumpkin seeds, safflower, sesame, corn), Vitamin C & E, glucosamine sulfate, calcium, and magnesium.

Nutritional support for strong muscles and tendons include magnesium (nuts, unmilled grains, dark-green leafy vegetables, legumes such as peas and bean), protein (beef, chicken), Vitamin C  to promote collagen healing and collagen strength, bioflavanoids (plant compounds, antioxidants which improves cardiovascular health, capillary strength and structure of connective tissues and the immune system), glucosamine sulfate to promote cartilage and bone health and repair and omega-3 fatty acids to promote to reduce systemic and joint inflammation.
Maintaining good nutritional support means taking in the "good stuff" but also avoiding the foods and external factors that may contribute to the inflammatory process.  These include minimizing the use of NSAIDS (non-steroidal anti-inflammatory agents) which decrease DNA synthesis (proliferative step in healing, inhibit proteoglygan synthesis and interfere with the metabolism of cartilage and bone, CORTICOSTEROIDS which decrease synthesis of collagen, proteoglycan, intestinal calcium absorption and may increase risks for osteoporosis and avascular necrosis, and STRESS which depletes intake of  magnesium, iron, selenium, zinc, phosphorus, and calcium that are vital to a healthy metabolism and provide significant stress protection.  Foods to avoid include red meat, shellfish and dairy products which may increase arachidonic acid and increase the inflammatory response; caffeine (coffee, tea, soda) which slows reaction time, decreases work productivity, depletes sodium, calcium, and magnesium in the body; alcohol which decreases magnesium; and gluten products (wheat, barley, rye, starch, grains).

If we can answer any questions or field any topics of interest regarding  physical therapy, health and wellness or about our programs, please contact us. We'd love to hear from you.
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2944 Broadway Street                         1208 E. Arques Avenue Suite #105
Redwood City, CA 94062                     Sunnyvale, CA 94085

(W) 650.261.0330                                 (W) 408.720.8225
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