Archive for August, 2011

Back Pain & Sex: Safest Positions and Recommendations

Tuesday, August 30th, 2011 at 3:40 PM

Back Pain and Sex

Back pain and sex don’t go together very well and if you or your partner are among the 35 million people who have back pain, you know that back pain can disrupt your relationship. Sex is an important part of the intimacy between couples, and attitudes about sex, about rejection and about our self-image when we don’t feel up to a sexual encounter can haunt a couple for a long time.

Sex should be pleasurable

Sex is supposed to be pleasurable for both of you and the fear of hurting yourself or your partner inhibits the spontaneous joy that you probably felt before your back pain developed. But what can you do about it? Most couples in which one or the other is restricted by back pain will eventually get around to realizing that back pain does not automatically mean no more sex. What it does mean is that you will need to make some accommodations to the pain and or the fear of it. It also means you will need to talk about sex in a slightly different way than you are used to.

Let’s back up for a second and begin with a very strong suggestion. Because pain has both a psychological component and a physical component, getting a sound diagnosis is critical to putting your mind at rest about what is wrong and secondly having a sound diagnosis will also give you guidelines for your physical limitations.

Secondly, after you have the diagnosis, involve the doctor or physical therapist in a frank discussion about dos and don’ts. Maybe that’s an uncomfortable subject for you, but these days we are talking more openly about sex and you should tap into the doctor’s experience here. In a perfect world the doctor would open the discussion for you, but if they don’t you may have to initiate it. Ideally your partner should be present because he or she will have his or her own questions and concerns.

Starting off right

To start sex off right, start off with a massage, or ice down the painful area. A warm shower together might help too. That way the muscles are relaxed.

Positions

Here are some of the safest sex positions that can help you enjoy a pain-free experience.

For males:

Lay on a firm surface and use pillows to support your knees and head. You might like to try placing a small rolled towel under your lower back.
Try a side-by-side position.
Place a pillow under your lower back while your partner straddles you on top. You can also sit in a sturdy chair instead of lying down

For females:

Try missionary position with the legs bent toward the chest.
Sit on the edge of a chair and have your kneel between your legs for entry.
Rear entry may also be more comfortable for women with back pain.
Try it kneeling on the bed or lying on your belly with a pillow under her chest.
Sit on your partner’s lap as he sits in a chair.

Remember, the health of your back is dependent on many dynamic factors. Your symptoms may change over time so you may need to work with your health care provider from time to time as you go through the many stages of recovery. A word of caution is in order at this point. It is pretty common to begin feeling better and then overdo it and have your back pain symptoms flair up. We call this, the whoopee effect and it can happen to anyone. Just remember that as you improve gradually, so should your activity level also increase gradually.

As I mentioned earlier pain has two parts. There is the physical part. This is the actual stimulation of the nerve, like a painful tooth or a herniated disc pressing on the nerve. And then there is the subjective or the psychological part. This is how it feels to you and includes, among other things, such attitudes as fear that it will get worse or last forever, what will it means to be chronically disabled, and what you believe your partner thinks about it as well as how you are coping with your condition.

So, at the top of your agenda there needs to be a frank discussion of your pain limitations and expectations about sex. It is a mistake to believe that your partner understands what it feels like. It is your responsibility to communicate those limitations as clearly as possible; it is their responsibility to listen and try to understand. Pain, after all, is invisible and subjective. That means your pain is unique to you.

We have heard people liken back pain to everything from a hot poker going down one or both legs to a chronic aching sensation localized to the lumbar area. It doesn’t matter what words you use, just try to explain the pain, what causes it (position, certain movements, or whatever), and what feels good or is what is comfortable for you.

Is it obvious that if it hurts, don’t do it is generally good advice but some positions and techniques hurt more than others? It may require some gentle experimentation to find out what works but as in most sex advice, “gentle” is the best place to start.

In terms of maximizing yours and your partner’s sexual pleasure, it is very important to stress that all you really need is your imagination and the willingness to experiment to open up new areas of intimacy. But it all begins with willingness to try. And given that, you just may find that the lemon of back pain can be turned into the lemonade of new sources of mutual pleasure.

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This article has been a guest post by Dr.Jerry Corners, MD

Herniated Disc Treatment: What Types Of Things Work Well

Friday, August 26th, 2011 at 3:41 PM

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Herniated Disc Treatment

You’ve probably heard people say they have a “slipped” or “ruptured” disc in the back. Sometimes they complain that their back “went out”. What they’re most likely describing is a herniated disc. This condition is a common source of back and leg pain. At the bottom of this article I explain the best herniated disc treatment, but first I want to do some explaining.

Discs are soft cushions found between the vertebrae that make up the spinal column (your backbone). In the middle of the spinal column is the spinal canal, a hollow space that contains the spinal cord. The nerves that supply the arms, leg, and torso come from the spinal cord. The nerves from the neck supply the arms and hands, and the nerves from the low back supply the butt and legs. The discs between the vertebrae allow the back to move freely and act like shock absorbers.

The disc is made up of two main sections. The outer part (the annulus) is made up of tough cartilage that is comprised of series of rings. The center of the disc is a jelly-like substance called the nucleus pulposus. A disc herniates or ruptures when part of the jelly center pushes through the outer wall of the disc into the spinal canal, and puts pressure on the nerves. A disc bulge is when the jelly substance pushes the outer wall but doesn’t completely go through the wall.

What do you feel?

Lower back pain will affect four out of five people during their lifetime. The most common symptom of a herniated disc is “sciatica”. Sciatica leg pain is best described as a sharp, often shooting pain that begins in the buttocks and goes down the back of one leg. This is most often caused by pressure on the sciatic nerve that exits the spinal cord. Other symptoms include:

Weakness in one leg or both legs
Numbness and tingling in one leg (pins & needles)
A burning pain centered in the low back
Loss of bladder or bowel control (seek medical attention
immediately)
Back pain with gradually increasing leg pain. (If you have
weakness in both legs. Seek immediate attention.)

How do you know you have a herniated disc?

Your medical history is key to a proper diagnosis. A physical examination can usually determine which nerve roots are affected (and how seriously). A simple x-ray may show evidence of disc or degenerative spine changes. An MRI (magnetic resonance imaging) is usually the best option (most expensive) to determine which disc has herniated.

Why do discs herniate?

Discs are primarily composed of water. As we become older (after the age of 30), the water content decreases, so the discs begin to shrink and lose their shape. When the disc becomes smaller the space between the vertebrae decreases and become narrower. Also, as the disc loses water content the disc itself becomes less flexible.

While aging, excess weight, improper lifting and the decrease in water in the discs all contribute to the breaking down of discs, the primary cause of a herniation or bluge is uneven compression and torsion that’s placed on the discs.

This uneven pressure is caused by imbalances in muscles that pull the spine out of its normal position and then your body is forced to function in what I call a physical dysfunction. Every human being develops these dysfunctions over time and eventually they cause enough damage to create pain.

The best herniated disc treatment

When it comes to herniated disc treatment, there are traditional treatments such as ice/heat, ultrasound, electrical stimulation, cortisone injections, anti-inflammatory medications and even surgery. While these may deliver some relief, it will usually be temporary if at all.

But the major problem with these traditional treatments is that they can’t fix or heal a herniated disc as they do not address the actual cause of the problem. For example, even if you were to have a surgery and get some pain relief, the fact is the dysfunctions that caused the disc to herniated in the first place are still there and if not addressed, they will continue to place uneven pressure and strain on the discs and sooner or later you will likely have another problem
with that disc, or others.

Without identifying and addressing the underlying cause of the problem, which is the physical dysfunctions caused by imbalances in muscles, you will likely continue to suffer with this condition and the continuous flare ups for years. Unfortunately, most doctors, chiropractors and physical therapists don’t spend time or focus on identifying the physical dysfunctions that are responsible for the condition so most people end up jumping from one useless traditional treatment to the next and suffer for months or years unnecessarily.

If you have been diagnosed with a herniated disc, or are wondering if your back pain may be caused by a herniated disc, either way you must identify and address the physical dysfunctions that are causing your pain as part of your recovery.

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This has been a guest post by Dr. Robert Duvall, DPT, ATC, MGFI

Dr. Robert Duvall is a Doctor of Physical Therapy and Certified Athletic Trainer. He has helped Thousands of people identify and cure their back pain by educating them with articles such as the one above…

To read more articles by Dr. Duvall you can visit the Articles Section at the Healthy Back Institute.

Myofascial Pain Syndrome

Tuesday, August 23rd, 2011 at 3:40 PM

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Muscle knots… Who would have thought they could be such a pain in the ass.. and back.. and hip.. and neck.. and leg? - Yikes!

Myofascial Pain Syndrome (muscle knots, muscle pain) is often misdiagnosed as a more serious back problem – misalignment of the hips, a herniated or bulging disc, or sciatica, just to name a few. Luckily, most cases of chronic back pain are not nearly as serious as they seem (or feel). More often than not the pain is actually being caused by ‘trigger points’, also known as muscle knots.

If you’re new to trigger points (TrPs) then you’re probably thinking something like ‘No way! My pain is real, horrible, crippling back pain and my doctor said I have a herniated L5 lumbar disc that’s putting pressure on my sciatic nerve and that is what’s causing it. My pain is definitely NOT caused by a simple muscle knot! My pain is MUCH more serious!’ But before you move on to the next article looking for help with low back pain, neck pain, or sciatica, please give this article some attention.

I’ve been suffering from bad back pain, sciatic pain, and pain that feels like it’s just under my butt cheek, across my lower back, and into my hip, sometimes radiating down my right leg. This has been going on for a long time, several years, and the pain can be extreme sometimes. I’ve been ‘diagnosed’ with having a right side high hip with a backwards tilt on the right side as well, so it’s easy to believe that my twisted hips are causing uneven pressure on the lower discs in my back, also putting pressure on my sciatic nerve.

At first it seems completely logical why I’d have such terrible, nagging back pain, but luckily I am now convinced that most of my pain is actually being caused by something much, much simpler… And easier to treat! Myofascial pain is looking more and more like the culprit behind my persistent back pain.

After a few trigger point therapy sessions and a lot of studying myofascial pain, I am fairly certain that the majority of my pain is actually being caused by nasty trigger points. My pain level seems to be going down after each trigger point therapy session. That’s right, simple muscle knots can cause an incredible amount of pain! Who woulda thunk it?!

Trigger points often mimick more serious injuries and can lead even the best physical therapists and chiropractors to give an incorrect diagnoses. The patient usually accepts the incorrect diagnoses because things like herniated discs, pinched nerves, and improper alignment sound like they would hurt, while muscle knots don’t sound all that painful. Usually trigger points go untended and they are actually the true cause of most chronic back pain.

I’m not saying that herniated discs, sciatica, and improper alignment are nonexistent, they certainly are real and they happen more often than they should, but often if the injury doesn’t seem to heal after a few weeks it’s because of trigger points, not an injury that won’t heal. Our bodies are designed to heal from injury, and pain is supposed to alert us to something that’s not quite right with our bodies. Unfortunately, muscle knots can hurt an awful lot, and they mimick the effects of other back injuries… Leading the patient and doctor to both believe the pain is coming from something other than muscles.

Luckily, once a person becomes aware of trigger points and how to treat them their pain often becomes much more bearable or even nonexistent. After a few weeks of trigger point work much of the pain can be completely eliminated. Some people even get instant relief after only one or two sessions! And the best part about finding out about trigger points is finding out that they are easy to treat, even on your own at home.

There is one absolutely fantastic tutorial about trigger points and back pain and it’s available at SaveYourself.ca. It’s an ebook, so you can only read it on the website, you don’t actually get a physical copy of the book, but I highly recommend it if you’re interested in learning about trigger points and how to treat them. Paul’s writing style in the tutorial makes it an easy and even entertaining read and it’s the best resource I’ve ever found for trigger points and myofascial pain syndrome information and self-treatments. There is also a really good book called the Trigger Point Therapy Workbook. You can find out more about that book in the back pain books portion of this website.

More trigger point info coming soon!

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