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Chronic Back Pain

My Healthy Journey: Chronic Back Pain

The Opioid Epidemic and Chronic Back Pain

Over the last year, the leading news story in health care has been the opioid epidemic. And chronic pain, particularly chronic back pain, has been at the top of the list of reasons why people use opioids long term. 

Chronic pain is pain that lasts longer than 12 weeks, and for many, it’s pain that can last the rest of their lives. Chronic pain can happen because of a genetic problem or disorder or an injury or accident. Many people who survive serious car accidents or workplace accidents deal with chronic pain for the rest of their lives. 

And back injuries are a leading cause of chronic pain. Business Insider took a look at a study that dug into the relationship between chronic back pain and opioid use disorder:

Amino - Chronic Back Pain and Opioid Use Disorder

Having back surgery increases your chances of relying on opioids to manage pain by over 7 times! Other back problems raise your chances by over 2 times. 

Obviously, these are also people who are likely to get long-term opioid prescriptions from their doctors.

How Doctors Treat Chronic Pain

For decades, the standard for doctors has been to treat this kind of ongoing pain with opioids. Now, with opioid drug overdoses skyrocketing, doctors are making changes.

Early estimates show that opioids took 53,000 American lives in 2016, more than those killed in car accidents.

Opioids don’t just turn off your pain receptors. They also let your brain release more dopamine, which can help relieve stress and anxiety and make you happier.

But when you take an opioid permanently, you can build a tolerance to it, which means you need more and more to manage your pain and to feel good. Both the pain relief for chronic sufferers and the way it makes you feel can become addictive.

Not to mention, opioids can change how often certain neurons in your brain fire, which means that when you’re not on opioids, you actually get more anxious and unhappy until you take more, causing serious withdrawals. 

The Centers for Disease Control and Prevention (CDC) has revised their guidelines to help doctors try other treatments first, and doctors are hard at work to find new ways to treat pain.

Waiting for Chronic Back Pain

So why is this part of my healthy journey? I have my own chronic back pain.

I’m lucky. I’ve never taken opioids for my back pain, so I’ve avoided those issues, but I do understand what it’s like to live with pain as a part of your daily life and why people would be willing to take opioids to stop it.

My father has had a slipped disc in his back my entire life. I’ve always known what back pain looks like. I also always thought it might happen to me. Not only can these issues be hereditary, but I also take after my father physically.

Combine that with the slouch of someone who hated always being the tallest in her class as a child and now sits in front of a computer all day, and I always suspected that back problems were coming for me.

My Chronic Back Pain

The pain started for me in college, when I was no longer playing sports or working out in P.E. every day. One year, I chose to live in the loop in Chicago instead of by my campus, so as part of my daily commute, I walked about an hour and a half. That was when I really started to throw out my back once in a while.

But it wasn’t until I worked at Starbucks after college that I really started to have serious problems regularly. Being on my feet all day and bending up and down with milk jugs all the time really started to take a toll on my back.

I’ll get building back pain on one side of my lower back. It can switch sides, and one side is usually worse than the other. And when it fully goes out, my knee on that side can sometimes buckle, which if I’m not ready for it, can actually knock me down. And sometimes it’s so bad that getting out of bed, getting up and down, or just falling asleep, is a challenge. 

Getting Help

I’ve always known this pain might hit me one day, and when it started, I talked to my dad a lot about what was going on. My symptoms match his exactly.

Since I knew what the issue was from my father’s medical history, I wasn’t really worried about getting an official diagnosis.

I also already knew that I didn’t want to take opioids or painkillers long term. I’m one of those people who rarely takes even Tylenol. And when I had serious opioids after I had my wisdom teeth removed, they made me feel disoriented and nauseous.

My older brother had a serious workplace injury when I was in high school. He broke his pelvis and some of his spine. He’d seen a chiropractor, among many other specialists, when he was recovering, and he still sees one sometimes to cope with his own chronic pain.

I decided to explore that as a treatment option instead. My new chiropractor ran some X-rays and told me that my pelvis is tilted, which lets my disc slip back and forth instead of holding it in place. 

Through a series of adjustments, he worked to bring my pelvis back in line, and brought me some real relief. 

Unfortunately, I’ve done some state-hopping since then, and while I’m still in better shape than I used to be, I haven’t had time to find a new chiropractor yet. 

Starting to Deal with Your Pain

So what can you do to tackle your chronic pain? 

  1. First and foremost, go see your doctor, especially if you’ve been injured or don’t have a family history of back issues. You might need surgery or other serious help.

  2. Consider your treatment options. Surgery can be an option for many chronic back problems, but it has costs. It’s expensive and can cause its own set of pain problems. Opioids are highly addictive. Talk to your doctor about other options, like chiropractic treatment or acupuncture.

  3. Talk to your insurance company. Insurance companies want to stop the opioid epidemic too, and more plans are covering alternative therapies like chiropractic visits than ever before.

  4. Talk to your employer. If you have insurance through your employer, talk to them about making sure other therapies are covered on your group plan.

  5. Work with your care team on a treatment plan to cope with and manage your pain.

Learning to Manage Pain

So how do I manage my chronic back pain without drugs?

  • Set expectations. Knowing I would probably grow up to develop chronic back pain means I’ve always been ready for it. Accepting that pain will be a part of my life helps me feel in control.

  • Find a treatment that helps. For me, this has been regular chiropractic adjustments that help relieve tension and keep my disc in place. 

  • Get massages. I get the occasional massage to help relieve tension in the muscles in my back too. Many people with back pain get regular massages and swear by them.

  • Exercise and eat right. Even just a few extra pounds can put enormous stress on your spine if you already have back problems. And exercise can strengthen the muscles in your back. Focus on low-impact activities and strengthen your core if you’re already in pain.

    And choose your cardio wisely. Running outdoors or on inclines can be really hard on your back and pelvis. Try running on a treadmill, walking, or biking instead.

  • Try yoga, pilates, or tai chi. Yes, these are technically forms of exercise, but they’re more than that too. A new study found that yoga can actually help relieve back pain itself, but recommends gentle poses. And the routine they used is free online. I find it highly relaxing and a nice way to stretch and wind down, and you can do it as often as you want.

  • Get plenty of sleep. You’d be surprised how sleep affects other parts of your life. When I’m sleep deprived, my back is much more likely to go out. And since I struggle to sleep once my back’s out, it makes for a long sleepless week in that situation.

  • Try little treatments and tricks. I ice my back and use heating pads. I also take over-the-counter pain meds before bed if my back feels like it will go out during the night. If my back’s already out, lying on the floor (if I have someone handy to help me get up later) can help. Putting a pillow between my knees can also help while I’m trying to fall asleep.

  • Meditate. Meditation can help you clear your mind and refocus, and mindfulness can be surprisingly helpful in overcoming pain. There are easy apps you can try to get started too.

  • Talk to someone or journal. Chronic pain can be emotional. You hurt. You can’t escape it, and it can feel hopeless. Talk to a close loved one, journal about what’s happening, or visit a therapist. It can help you blow off steam, lighten your mental load, feel heard, and document your pain’s progression.

  • Practice self-care. Stress and tension can tighten up everything in your back. Find ways to reduce and fight stress in your life. And find little pleasures that you can focus on each day, like your favorite coffee, trading back rubs with your significant other, or cuddling your pet.

Most importantly, get help when you need it. Never let your pain push you so far that you can’t handle it or you fall into depression. Talk to your doctor to keep your mind and body healthy, even in the face of chronic pain.

Reaching New Heights through Change

Long View: One Small Change for Better Health

Some friends and I made a New Year’s resolution to climb a mountain in Colorado and circled a date in July on the calendar. To prepare, one friend decided to change one thing – just one.

As a hospital nurse practitioner, she decided to take only the stairs throughout the day. She climbed to the 5th floor for daily rounds, down to her office, back up to the 3rd floor for clinics. You get the idea. When July rolled around, her legs were toned and her lungs were strengthened to the point that she climbed that mountain and lived to tell about it. One simple change was all it took – pretty impressive.

Many people set ambitious nutrition and fitness goals for the New Year. If you’re anything like me, those ambitious goals are scrapped by Super Bowl Sunday. What if we all committed to making just one change for the coming year? What if we circled a date on the calendar (January 2 doesn’t count) and stuck to it? Would the cumulative effect make us healthier?

Some small changes you could make to your eating and fitness habits:

  • Start by switching out your afternoon vending machine snack with a piece of fruit and some nuts one day a week.
  • Is lunch a fast food adventure? Switch those large fries with a small order of fries, and get water instead of soda. Better yet, trade your fast food meal with a lunch you packed yourself once a week.
  • Walking more is one thing we all can add to our daily lives, and it can be easier than you think. Try taking one full lap around your local big-box store before you start shopping. Chances are you’ll add an extra quarter of a mile to your daily mileage.
  • Tai Chi is a wonderful exercise to add. Chris Cady-Jones coordinates Tai Chi for Balance in our Omaha market. She says, “Tai Chi is a low impact exercise gaining popularity due to its positive effects on social and mental well-being, improved balance, and physical functioning. It also reduces your risk for falls.”

We won’t all climb a real mountain in 2016. But by making just one small change in our everyday lives, we might climb our own personal mountain toward a healthier and more active New Year.

Lora Felger is a community and broker liaison at Health Alliance. She is the mother of two terrific boys, a world traveler, and a major Iowa State Cyclones fan.

Don't Fall with Tai Chi

Your Ultimate Guide to Fall Prevention

Each year as the weather turns icy, we return to one major health topic for older adults, avoiding a fall. How big is the risk actually, though?

Truth in Numbers

No matter how healthy you are, falling is a real risk. About 1 out of 3 adults age 65 or older falls each year, but less than half of those talk to their doctors about it.

Sure, you might think, but everyone falls once in a while, right? Kids fall all the time! But your mom falling could be a lot more serious than your toddler. Falls are the leading cause of fatal and nonfatal injuries in older adults.

In 2013, 2.5 million people were treated for nonfatal falls, and 734,000 of those had to be hospitalized. And in 2012, the medical costs from falls reached $30 billion.

They cause the most broken bones, traumatic brain injuries, and over 95% of hip fractures in older adults. And women are twice as likely as men to break a bone.

What Causes A Fall

Icy and slippery weather is of course a big reason that falls happen, but winter isn’t the only time to protect yourself and your loved ones.

Seeing is an essential part of most of our days, but as you age and your vision gets worse, it can increase your risk of falling. If you can’t see the danger, it’s harder to avoid it.

Some medications, both prescription and over-the-counter can cause side effects, like dizziness and drowsiness, that can make it more likely you’ll take a tumble.

Dangers in your homes, like tripping hazards, stairs, and slippery bathtubs, are a huge risk.

And many people who fall once are afraid of falling again and what could happen if they do. This leads them to limit their activities, lowering their mobility and fitness, which can actually increase their chances of falling and of getting hurt.

A recent study also found that many people’s falls are because of an infection, which can cause low blood pressure, which can make you feel dizzy or lightheaded. This can both lead to your fall, or make you confused about what happened afterwards.

Year-Round Protection

There are ways to help stop falls before they happen:

Get your eyes checked each year, and always keep your glasses prescription as up to date as possible.

Ask your doctor to review all your meds, and see if there are other options for any drugs that might be increasing your risk of falling.

Fall-proof your home. Adding grab bars in the bathroom and railings to stairs and even improving the lighting in your home can make a huge difference.

Get enough calcium and Vitamin D from foods like dairy, soy milk, orange juice, and salmon, or take a regular supplement.

Get tested for osteoporosis.

Remove clutter. A messy house can actually increase your chance of falling at home. Learn more.

Get active! There are great options and resources for getting healthy at any age.

  • Tai Chi is especially helpful for improving your balance and leg strength. Use this Tai Chi Fall Prevention Toolkit to get started now.
  • Try walking outside with friends or family.
  • Weight bearing exercises can lower your chance of hip fractures.
  • Water aerobics is a great way to move without stressing your joints.
  • Moving to the beat and changing to a rhythm are shown to reduce falls. Get dancing at your local senior center’s events, take lessons, or just let loose at home.
  • We want to help, too. Our Medicare members have perks to help you get fit at a gym of your choice.  Our members also get discounts at certain fitness locations.

All statistics are from the Centers for Disease Control and Prevention (CDC).