JohnstonPT: Is it Back Pain Or Sciatica?

Health & Fitness Newsletter by Johnston & Elevate Physical Therapy & Sports Medicine

NEWSLETTER THE HEALTH & FITNESS

2020 put more force through our joints. But, force through our joints is agoodandperfectly normal thing! Forces that our body are ready to handle cause positive changes for us and that includes increasing resilience of our joints. Stop me if you have heard this before-- a Physical Therapist advocating for more exercise! However, I’m backed with science and progressive overload is our best pathway forward in MOST cases. So, if I eat reasonably well, walk daily, and participate in strength training several times per week, why domy pain andmobility limitations persist?Well, that’s where we as Physical Therapists would start to consider the intensity of your exercise, making sure we are progressively overloading appropriately. We also need to consider the emotional/psychological components of pain and how our expectations can directly influence our function. Predictors of pain with OA can even be broad in scope such as the presence of positive social support, genetic factors, or type of occupation. A predictor of pain can also be simply the belief that OA is degenerative, never improving, always painful, and will always limit mobility, function, or both. A common patient comment we hear is “According to this X-Ray/MRI my (back, knee, hip) looks like that of a 100 year old due to somuch arthritis.” I hope reading this can help with the realization that this diagnosis/radiographic finding is entirely normal (especially as we gain more experience in life) and will rarely be the source of our limitation. Let’s look at our physical activity, nutrition, stress levels, and our own beliefs about our future before we definitively conclude thatwewill forever beailedbyadiagnosisof osteoarthritis. We each have a huge influence in howwe feel and what we can accomplish everyday. Want Proof? Look up the names Nathalie Lambert and Kristie Armstrong. These Olympic medalists both won their hardware after they were given a diagnosis of osteoarthritis in their 20s. If you are struggling with pain or limited from doing what you want- please reach out. That’s what we are here for. Let us know if there is any way we can help you get back on the path to your best. Give us a call or send us an email andwe can seewhat would be your next best step.

NOTES FROM DAVE Arthritis is one of the most commonly diagnosed conditions in adults in the United States. According to the CDC, nearly 55 million adults had doctor-

diagnosedarthritis in2017. Subsequently, 24millionadults have reportedactivity limitationsdirectly resulting fromtheir arthritis. Of the many varying types of arthritis, the most commonly diagnosed is osteoarthritis (abbreviated OA). The large difference between the amount of diagnosed cases and the number of individuals who present with pain/decreased function is the basis for this article. Why doesosteoarthritis causepainsometimes- but not always? Are there better predictors for pain than only a diagnosis of osteoarthritis? If arthritis is the cause of my pain, what can I do to improve my day-to-day function? Let’s startwitha simplequestion that Imay have answered for us already. Does osteoarthritis always cause pain?The science tells uswe can definitively say- NO. Many sources, including the CDC/institutes of arthritis, will tell us there is a greater incidence of arthritis than there are symptomatic cases. Perfect! But, if I google osteoarthritis, we are met with a daunting medical explanation that includes loss of cartilage, decreased joint line spacing, compromised sub- chondral bone, and formation of cysts/osteophytes (bone spurs)! AH- sounds scary! But, if we dig a little deeper, we begin to understand that there is more to our pain than this medical explanation. I’m going to use the broad term of ‘resilience’ to help describe why we have pain sometimes, but not always. Resilience can include physical, emotional, and mental components that we find to be better predictors of pain than simply a diagnosis of OA. In physical components, we have predictors such as exercise intensity/frequency, type of exercise, andbody composition.Whenwe have our nutrition andworkout routine inorder, we have significantly less discomfort in the presence of OA. Many times we hear our clients avoid strengthening exercises due to the (perfectly reasonable) thought that squatting and lunging

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• Physical Therapy • Work Injury Rehab • Sports Injury Rehab

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NEWSLETTER THE HEALTH & FITNESS

2020

DON’T LET BACK PAIN OR SCIATICA SLOWDOWN YOUR PROGRESS INSIDE: • Understanding Back Pain • Relieve Back Pain In Minutes • Patient Success Spotlight • Staff Updates

Whether you have pain or have been suffering for a long time, seeing a physical therapist at one of our clinics can help you return to a more active and pain-free life. Give us a call today! Working with a physical therapist is, hands down, the best thing that you can do when you are looking to overcome back pain. A physical therapist can identify the cause of the back pain and present you with helpful strategies that can strengthen your back and reduce the severity of your pain. Physical therapy for back pain often includes a combination of targeted massage, flexibility and range of motion training, muscle building, and targeted stretching techniques. Using these strategies in combination with anti-inflammatory medication, as recommended by your physician, is often considered the most-efficient approach to handling back pain and is recommended by the American Academy of Orthopedic Surgeons.

Does life ever feel like one large pain in the back? Back pain is difficult to deal with on a daily basis, yet for so many people, this is a total reality. By certain estimates, as many as 85 percent of adults in the United States struggle with back pain at some point in their lives. The most common type of back pain experienced is in the lower back, and it can happen for any variety of reasons. Being in a car accident can cause you to experience lingering back pain for years after the accident. Accidents at work can lead to similar consequences. But sometimes the cause of your back pain isn’t as straightforward. Back pain can also develop for any number of common reasons — things that you do every day without thinking twice. An old desk chair that doesn’t provide much lumbar support can take its toll over time, as can wearing shoes that don’t have much support, or even gaining weight, particularly around the stomach area. Too many people consider back pain a normal experience of their lives and don’t immediately seek support that could make the pain an issue of the past.

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UNDERSTANDING BACK PAIN 7 4 6 2 8

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Being educated about your back pain can help you make the right choices to overcome it as quickly as possible. One of the biggest problems with back pain is that it often lingers. This leads many people to deal with back pain for years on end without seemingly any end in sight. While there is back pain that develops as a result of strain or sprain, there is also something called low back degenerative disc disease, which happens when the discs in your spine start to break down. This frequently develops as a result of repetitive back injury and can also develop as a result of age. With degenerative disc disease, the space between the discs begins to collapse and become unstable, and can cause back pain to develop. When you work with a physical therapist to overcome back pain as a result of degenerative disc disease, your physical therapist will begin by strengthening core muscle groups, which includes the abdominal wall, and will provide you with education and targeted stretching techniques to alleviate pain. While some back pain is easy to identify as pain, such as is the case with degenerative disc disease, there are other situations in which the pain may be a bit more complicated to understand. One of the most common back issues experienced is sciatica pain. The cause of this sort of pain is often more difficult to identify — especially by those who aren’t familiar with the problem. How can you tell the difference between back pain and sciatica pain? The answer is that sciatica pain is characterized by the following factors: • Typically pain is only present in one side of the buttocks or leg • The pain becomes worse when you are sitting • The leg pain develops more as a burning, tingling or searing sensation, and not as a plain ache • There is a sharp pain that occurs at times, making it sometimes difficult to stand or walk 1 3 5 2 5 9 9 6 4 8 4 1 6 2 3 7 8 6 5 4 1 2 8 8 4 3 4 9 1 http://1sudoku.com n° 35089 - Level Hard

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• The pain is radiating, shooting down the leg and sometimes even into the feet and toes Sciatica pain develops in the nerves that connect the lower back to the legs, and so while the pain itself is generated from the back, a lot of time, the experience of the pain is more largely associated with the upper legs. What’s more, sciatica pain doesn’t always develop like pain in the traditional sense. Sciatica pain instead causes a buildup of tingling, numbness and weakness in the lower back and upper legs, and the pain isn’t consistent either. The sensation will typically run through the leg in waves, causing discomfort at seemingly unpredictable times. If you are experiencing back pain and you haven’t talked to a medical professional about the concern, then now is the time to take action. Working with a physical therapist can cut your time struggling with back pain literally in half. For more information about overcoming back pain, contact us. 3 7 9 2 1 n° 37953 - Level Hard http://1sudoku.com 5 9 7 6 3 9 5 1 8

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Source: https://www.spine-health.com/conditions/sciatica/what-you-need-know-about-sciatica

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I hope this newsletter finds you all doing well and I hope you enjoyed “Notes fromDave” on osteoarthritis. During these challenging times with the COVID-19 pandemic we’ve had a very busy staff. Even when we couldn’t see people in clinic, I couldn’t be more proud of how they have maximized their time. We are all continuing our education to serve you as best possible! There has been a record level of continuing education performed by our physical therapists over the course of the past five months. We’ve been fortunate to be able to host a number of different courses for local and regional physical therapists and can’t wait to use the new skills we have each learned to help optimize the outcomes of our clients. To highlight just a few: Grant Jacobson at Elevate has completed a number of Therapeutic Neuroscience courses on-line and has hosted two advanced courses at our Johnston clinic. As pictured last month, Amy, Tamie and Ben each completed level II functional dry needling coursework as we hosted this advanced class. Bryan Sumner, Andrew and a number of therapists from around Iowa completed a spinal manipulation course where we again hosted a weekend intensive class. We’ve all taken advantage of on-line learning opportunities and continue to advance our tool bag of therapeutic interventions to be the best possible therapists we can be. As we continue to dive into the science behind the art of physical therapy, we will be better equipped to help our clients achieve their goals in the safest and fastest way possible. Stay well! 6 1 3 2 1 5 8 4 4 3 2 5 2 6 2 9 http://1sudoku.com n° 318674 - Level Hard

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www.johnstonpt.com Play on your mobile these puzzles and find their solutions by flashing the codes below : n° 35089 n° 37953 n° 327735 n° 319375

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Patient Success Spotlight

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Johnston Clinic

“Professional and fully explained everything!” “Dave worked with me to regain strength and flexibility following surgery. He was professional and fully explained everything we were doing and why. If his employer would allow, I would hire him as a personal trainer at the gym.” - K.G.

INSTRUCTIONS:

1. Open your smart phone to the camera app 2. Center the QR code above in the frame (this will take you directly to our Google Review page) 3. Tell us how we’ve done! Elevate Clinic

Relieve Back Pain In Minutes Try this movement if you are experiencing back pain.

SCIATICA NERVE GLIDE SEATED Sit slouched with hands behind your back. Straighten one leg and simultaneously sit up tall (Like your foot is kicking your head upwards). Bend your leg back to the original position while simultaneously slouching again. Repeat 5 times.

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If this exercise does not provide you relief/help, please consider an evaluation to see if we can identify the source of your pain and provide a plan to get you back to normal.

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