Smoking and Low Back Pain??

Does Smoking Cause Low Back Pain?
- Donald J. Frisco, MD

A new study strengthens the link between smoking and lower back pain, and also sheds light on the causes of degenerative lumbar spine problems.

The study on smoking and low back pain, which prospectively examined 1,337 physicians who graduated from Johns Hopkins University between 1948 and 1964, followed some participants for more than 50 years. Researchers discovered that smoking history, hypertension and coronary artery disease—all of which are risk factors for atherosclerosis, or occlusion of the arteries—were significantly associated with the development of low back pain.

These same risk factors, along with abnormally high blood cholesterol levels, were also significantly associated with the development of lumbar spondylosis. The findings provide support for the hypothesis that atherosclerosis causes lower back pain and degenerative disorders of the intervertebral discs.

Smoking and Low Back Pain Study Results:
The study results, which were reported at the 2001 annual meeting of the American Association of Orthopaedic Surgeons in San Fransisco, lend support to the theory that the mechanism of injury in low back pain is damage to the vascular structures of the discs and joints.

Numerous researchers have proposed a link between smoking and low back pain, but the exact nature of that link had remained largely untested in terms of long-term prospective studies. "Because we had the subjects' medical records and answers from self-reported questionnaires over such a long period of time, a 53-year period of time for the oldest patients, we were able to determine if the risk factors, such as smoking or high cholesterol, preceded the development of the disease years later," said Nicholas U. Ahn, Chief Resident in the Department of Orthopedic Surgery at the Johns Hopkins Hospital in Baltimore and co-author of the study.

"To prove a causative association from a long-term prospective study is very powerful because one can show that the cause occurred before the effect as opposed to the other way around," Dr. Ahn explained.

Conclusions from Smoking and Low Back Pain Study:
The study concluded that development of lower back pain was significantly associated with smoking history and hypertension, and the development of lumbar spondylosis was significantly associated with smoking history, and hypertension and high cholesterol. No significant association was reported betweekn diabetes and lower back pain or lumbar spondylosis.

At Rosa Chiropractic of Alexandria we use numerous modalities and techniques to help alleviate your back pain!

Ankle and Foot Pain from Summer's Flip Flops

Flip-Flop Flaws
According to a new study, the ubiquitous summer shoe may be bad for your ankles and feet.

Summer is when the rubber hits the road. We're talking about flip-flops, the ubiquitous sandals that consist of little more than a sole held onto the foot by a Y-shaped thong. Flip-flops used to be relegated to the beach or the locker room, but in the last few years they seem to have become the footwear of choice for a whole generation. Back in 2005 some members of the Northwestern University national champion women's lacrosse team drew flack for wearing flip-flops when they met with President Bush at the White House.

Questions of etiquette aside, flip-flops may not be the best choice for health reasons. In a study presented last week at the annual meeting of the American College of Sports Medicine, researchers at Auburn University found that flip-flops actually alter the way wearers walk. That change in gait can cause persistent foot and ankle pain—the kinds of problems usually associated with a fondness for Manolos and Jimmy Choos.

Justin Shroyer, a doctoral student in biomechanics at Auburn, and Dr. Wendi Weimar, the director of Auburn's biomechanics laboratory, were tossing around ideas for a research project when they hit upon a subject that seemed ripe for exploration. "We're biomechanists," explains Shroyer. "We can't go anywhere without analyzing the way someone walks." They noticed that when students came back from summer vacation they often complained of pain in their feet, ankles and lower legs. The same students were also likely to be flip-flop fans (as is Shroyer, as a matter of fact). Could there be a connection?

To find out, Shroyer solicited 39 college-age female and male volunteers. The participants wore thong-style, flat-soled flip-flops and then regular athletic shoes while walking on a platform that measured the force they exerted when their feet struck the ground. Shroyer also filmed them as they walked so he could study differences in the movements of their hips, legs, knees, ankles, feet and toes.

After digitizing all these images and analyzing the data, Shroyer came up with some disturbing conclusions for those of us who treasure the freedom of flip-flops. He found that flip-flop wearers take shorter steps. The result is more stress on the body because you have to move more to go the same distance as people wearing other kinds of shoes. That could mean a higher risk of muscle and joint pain in the legs.

Toes are another problem area. "When you wear flip-flops, you kind of scrunch your toes to keep the flip-flop on your foot," Shroyer says. That constant pressure often adds up to throbbing and tenderness in the toes. "The body is an amazing machine," Shroyer explains. "When you do one thing, other things turn off and on. By engaging the muscles that scrunch your toes, you are turning off the muscles that would bring your toes up." That also means that you can't lift your foot up as much when you walk—hence the characteristic flip-flop shuffle.

Shroyer's analysis of the mechanics of flip-flop wearing isn't the first warning about their dangers. The American College of Foot and Ankle Surgeons has reported an increase in heel pain among flip-flop wearers, especially in the spring, when they make the switch from sturdier winter shoes. The problem is exacerbated when people who are overweight or sedentary wear flip-flops. One of the most common sources of heel pain is plantar fasciitis, an inflammation of the connective tissue that links the toes to the heel bone. Being overweight and wearing ill-fitting shoes make it much more likely that you will suffer from plantar fasciitis. Thin-soled flip-flops without arch support aggravate the effects of any existing sources of strain on the legs and feet (such as too much weight or weak muscle tone).

Does this mean that you should throw out your beloved flip-flops or walk barefoot? Not necessarily. Like all good things, flip-flops are probably fine in moderation. Wear them at the beach or even for short jaunts to the mall. But don't make them your everyday footwear. You can get much the same look from sandals that have a little more arch support or another strap that keeps them on (and gives your scrunched up toes a rest). Shroyer also suggests replacing flip-flops more often. "Usually people break their shoes in so they become more comfortable," he says. With flip-flops, he says, "that is probably the point where you need to get rid of them."

If you're already experiencing pain, kick those flip-flops to the back of your closet and slip on footwear with more support until you feel better. If you have flat fleet, arch supports may help; you can find relatively inexpensive ones at the drugstore. If the pain doesn't go away, see your doctor. In a few cases foot and heel pain could signal more serious medical conditions like arthritis or even a stress fracture.

May is Posture Month

Stand taller for posture month

May is National Correct Posture Month, and it seems mom was even right about standing up straight. Improving your posture is not just about looking good. Studies show people with better posture really are healthier and actually live longer.

From kids with backpacks or cane-carrying seniors — studies show poor posture is a major cause of back and neck pain for all ages, and over time often contributes to digestive and cardio-pulmonary problems.

Here's three things to help keep you standing tall:

1. Take an annual posture picture to set the benchmark for your body. Ask a friend to take your picture from the front, back and side. Print them out, one to a sheet, and look at your body symmetry.

Just comparing posture pictures from year to year can be eye-opening. You can assess your alignment by putting a dot between your feet on the front and back view, and at your ankle on the side view. Then, fold each paper in half neatly at the dot.

Front and back view: The two halves of your body should be the same. If your head and/or torso is off to one side, or your arms are hanging differently, your posture is not symmetrical.

Side view: The line from your ankle should pass thru your shoulder and ear. If your head is way forward of that line, you may have a posture distortion called forward head posture (FHP).

File your posture picture and compare it to a new one next year.

2. Do posture strengthening exercises to maximize the benefit of any workout, or as a beginning exercise to get in shape. Yoga, Tai-Chi, and Pilates are all great for building body awareness and control.

Best posture stork: Train yourself to Vertical wall stand: Back up to a wall so your heels, buttocks, shoulders, and head all lightly touch the wall while you keep everything level, relaxed and aligned — and take three slow breaths, feeling your body’s best posture. Note: If you feel any areas of stress, get your posture checked by a professional.stand tall while building good posture by balancing on one foot. First, stand tall with your best posture and then focus on staying tall and straight as you lift your thigh so your knee is at hip height. Keep standing tall for 30 seconds on each side, focusing on keeping your body well aligned.

3. Choose smart posture habits, Get a good chair, and change it's position during the day. If you're going to play videogames, exercise more than your thumbs with games with one that makes you move such as the motion sensing videogame consoles.

Invest in quality shoes, and consider using a shoe insert or orthotic, especially if you've had foot problems.

If you have back pain, neck soreness, or other posture problem — or want to find out how strengthening your posture can improve sports performance (ie golf, tennis, baseball) and wellness — help is available. Consult a certified posture exercise professional or other chiropractor, PT, or massage therapists trained to analyze posture pictures and teach individualized posture exercise routines for pain management and wellness.

Your posture is how the world sees you, and a bit of effort at strengthening your posture is an anti-aging habit to make you look and feel better, avoid injury and exercise effectively to stay active and age well.