Self-Care for Back Pain: Exercises to Help
the Healing Process
By Marc Heller, DC
When it comes to back pain, your first thoughts may be to take
over-the-counter pain medication and rest whenever possible. Two bad
options. First, medication is only going to temporarily relieve the pain, if
at all, and may be accompanied by various unpleasant side effects
attributable to drugs. Second, rest may actually hurt more than help. While
you're seeing your chiropractor, there are a few things you can do at home
to help the healing process. Believe it or not, it's based on the simple
principle of movement.
Whenever I see a patient with back pain, I always ask, "What do you do when
you are in pain? What exercises help your pain?" I am continually surprised
that very few patients know what self-care to do when they have an acute
episode of pain. That includes motivated patients and patients I have seen
before and carefully shown the right exercises. Maybe it is because when you
hurt, you stop thinking clearly; or maybe it is fear that the pain will get
worse. Both are valid excuses. Most of them just rest, ice the area, and use
non-steroidal anti-inflammatory drugs (without realizing that NSAIDs
actually block healing). Many of them say, "I hurt too much to exercise."
Why Movement Matters
The problem with this is that when you stop moving, when you are still,
everything tightens up, circulation slows down, and pain chemicals
accumulate in your muscles and joints. It's like waking up after sleeping in
a cold room on a lousy mattress with a draft. If you get moving, you'll
typically start to feel better.
So, here's the number-one rule to remember: Don't stop moving when you hurt.
I know, you are in pain and afraid to move, and sudden movements may cause
your back to "grab" or spasm. I am not telling you to ignore the pain. What
I am saying is that you need to find movements that will ease your pain. In
many cases, the most important thing to do when you hurt is to keep moving.
The body often tightens up and limits your motion. If you find a motion that
doesn't hurt you, it will probably help you. When you are hurting, you may
not be able to do your usual activities, but you must keep moving. Try
walking slowly, especially on flat and even ground. Try walking up a hill
(you can walk up a hill without walking down, on a treadmill). Try swimming
or simple motions in chest-deep water. Try basic pelvic tilts, staying
within a pain-free range.
Here are some basic principles. The movement should be pain free (or at
least cause minimal pain while being performed). When you have finished
doing the exercise, your pain should be somewhat diminished. You should feel
that you can move more freely. Your back should feel straighter and less
Backward bending is a great exercise when you're suffering from low back
pain. Start on the floor or other stable surface (top picture), then slowly
raise your upper body up while keeping your lower body stationary (bottom
picture). The final step involves extending your arms up (much like a
push-up). Basic Exercises for Low Back Pain
Here are two basic examples of self-care exercises that have stood the test
of time. Many of my patients have found variations on these and other types
of movements that act as "reset" buttons for their typical pain. You are the
one living in your body; you are the most likely one to know what is working
Lower back diagnosis is often very difficult and confusing. For the sake of
this article, let's divide low back pain exercises into two categories:
exercises that make your back feel better when you bend backward, and
exercises that make your back feel better when you bring your leg toward
Backward Bending (extension of the lumbar spine). An exercise called
the McKenzie extension is the first thing you should try if you have
sciatica (pain running down your leg). If these exercises work, your pain
will diminish and may centralize, which is a good thing. Centralize means
your pain goes less far down your leg, and you may feel it closer to the
spine. Bending backward may not feel good at first, but you should feel
better immediately afterward. If you feel worse afterward or the pain goes
farther down your leg, stop, as this is not the exercise for you.
How to Do It: Lie face-down on the floor, arms bent at your sides
(sort of like a starting push-up posture). Straighten your arms up slowly,
lifting your upper body off the floor as you do so.
Your legs and feet should stay on the ground. Hold for 3-5 seconds, then
slowly lower your upper body back down. Repeat 10 times, as often as once
If your pain or restriction is on one side, a variation on McKenzie
extension (lying on a raised surface with one leg on the floor, slightly
bent) may be more comfortable (keep the elevated leg straight).
Flexion Exercises (bringing the leg toward the chest). People with
lower back pain can also feel better with various types of leg flexion,
bringing the bent leg toward the chest, or doing contract-relax and then
bringing the bent leg toward the chest. These people usually have sacroiliac
joint problems. (The SI joints are located on either side of the spine in
the lower back.) These are also called Tigny exercises.
How to Do It: Lie on your back with one leg bent and then other flat
on the floor. Bring the bent leg up toward the chest. Wrap your arms around
the leg and then try to lower it toward the floor for 3-5 seconds, resisting
with your arms. Relax, and then pull the bent leg up farther toward the
chest. Repeat the entire process three times.
Ginger Root for
by Michael Greger M.D.
Many successful herbal
treatments start like this: Some doctor learns that
some plant has been used in some ancient medical
tradition, like ginger for headaches. Well, the
physician has patients with headaches and so tries
advising one with migraines to give it a try since
it’s just some safe, common spice. At the first sign
of a migraine coming on, the patient mixed a quarter
teaspoon of powdered ginger in some water, drank it
down, and poof! Within a half-hour, the migraine
went away. It worked every time for them with no
side effects. That’s what’s called a case report.
Case reports have
played an important role in the history of medicine,
though. AIDS was first discovered as a series of
case reports. Some young guy walks into a clinic in
Los Angeles with a bad case of thrush, and the rest
is history. Reports of an unusual side effect of a
failed chest pain drug led to the billion-dollar
blockbuster, Viagra. Case reports may represent the
weakest level of evidence, but they are often the
first line of evidence, where everything starts. The
ginger and migraine report isn’t helpful in itself,
but it can inspire researchers to put the treatment
to the test.
The problem is, who’s
going to fund it? The market for migraine drugs is
worth billions of dollars. A quarter teaspoon of
powdered ginger costs about a penny. Who would fund
a study pitting ginger versus the leading migraine
No one… that is, until
now. A double-blinded, randomized, controlled,
clinical trial compared the efficacy of ginger to
sumatriptan, also known as Imitrex, one of the
top-selling billion-dollar drugs in the world in the
treatment of migraine headaches. Researchers tried
using only one-eighth of a teaspoon of powdered
ginger versus a good dose of the drug.
They both worked just
as well and just as fast.
Most patients started out in moderate or severe pain
but, after taking the ginger or the drug, ended up
in mild pain or completely pain-free. The same
proportion of migraine sufferers reported
satisfaction with the results either way. As far as
I’m concerned, ginger won—not only because it’s a
few billion dollars cheaper than the drug, but
because there were significantly fewer side effects
in the ginger group. People taking sumatriptan
reported dizziness, a sedative effect, vertigo, and
heartburn. The only thing reported for ginger was an
upset tummy in about 1 out of 25 people. (As a note
of caution, taking a whole tablespoon of ginger
powder at one time on an empty stomach could
irritate anyone’s stomach.)
An eighth of a
teaspoon of ginger is not only up to 3000-times
cheaper than the drug, but you’re also less likely
to end up as a case report yourself of someone who
had a heart attack or died after taking the
drug—tragedies that have occurred due to sumatriptan.
The Cost of Medical Research; It’s Not What
by Dr. James Bogash
The drug companies use the cost of drug development as a rationale for
charging massive amounts for new drugs when they get brought to market under
The reality is that many of these drugs are priced far above what it cost to
bring it to market and definitely beyond what it costs to produce. In other
words, it has nothing to do with what the drug company’s costs were or are;
it instead has to do with how much the market will bear the costs. This
leads to massive profits.
But this is NOT where the true cost of these drugs lie for society.
The true cost lies with the fact that many of these drugs are a complete
waste of money. (This of course does not begin to account for the damage
done from drugs that are later taken off the market or given black box
warnings for safety reasons discovered after the drug was launched)
Sound a little extremist?
Before you judge me, you need to understand the concept of SURROGATE END
MARKERS, which I have discussed many times before. A surrogate end marker
is used in drug research studies to basically save money and time.
The ultimate classic example is cholesterol lowering drugs. Lipotor was
initially approved and based on its ability to lower cholesterol levels.
What I usually point out is that no one really gives a hoot about his or her
cholesterol levels, it’s just that no one wants to have a heart attack or
stroke. Using cholesterol as the surrogate end marker for heart attacks,
the Pfizer did not need to run years-longer, more expensive studies to see
if Lipitor actually lowered rates of heart attacks.
And that’s what happened. It took YEARS before the studies on statins were
done and published to see if cholesterol lowering drugs actually lowered
rates of heart attacks. When the dust finally settled on the topic, the
results were less-than-stunning. About a 1% absolute reduction in the rates
of heart attacks.
The amount of money wasted (and continuing to be wasted) on this class of
drugs is beyond most of our comprehension.
If this was an isolated example everything would be maybe OK, but it’s not.
Blood pressure medications for stage 1 hypertension (systolic <160 or
diastolic <100) do not lower the risk of heart attack, stroke or death.
What the heck are we wasted BILLIONS of dollars on them then??? (I’d love
an answer, but I fear the question is largely rhetorical)
Fancy new cancer drugs that improve “disease free survival” do not actually
help cancer patients live longer but cost tens of thousands of dollars more
But we can’t leave diabetes medications out of the mix. About a decade ago,
there began a massive shift in research dollars towards a gut hormone called
GLP-1 that happened after researchers found that a compound in Gila monster
spit could act the same in our bodies.
Since that time, published research on this hormone and the class of drugs
that could slow down our body’s own breakdown of GLP-1 (normally only last
about 1-2 minutes in our own body) has dominated the diabetes medical
journal landscape. These two types of drugs (GLP-1 like drugs and drugs
that slow down our body’s breakdown of this same hormone) hit the diabetes
drug market at a full-on sprint with names like Byetta, Vicotoza, Januvia
And they weren’t cheap (lots of variables, but on average $300+ / month)
But no one could argue that they did a better job of control blood sugar (if
you can ignore those pesky side effects like acute pancreatitis and
pancreatic cancer). But one COULD argue that the lesson from the past about
using surrogate end markers almost always ends up to be a bad plan.
You see, most diabetics die of heart-related complications. This means that
any drug used to treat diabetes really has to have an impact on heart
disease if it’s going to be worth squat.
I’m betting you can see where I’m going with this….
particular study researchers evaluated any published studies
done on the benefit of DPP-4 inhibitors (the drugs that block the enzyme
that breaks down GLP-2 so quickly) and major adverse cardiovascular events
(MACE). Here’s what they found when they looked over 69 different trials
with almost 68,000 patients:
Luckily, when compared to another class of diabetes drugs called
sulfonylureas, DPP-4 inhibitors were associated with a 42% lower risk of
But when the DPP-4 inhibitors were compared to the newest class of drug for
diabetes (SGLT2 inhibitors, which allow sugar to be lost through the
kidneys) they were linked to a 89% higher risk of MACE.
When compared to placebo the expensive, heavily used, new class of drugs
that mess with the GLP-1 pathway, there was no benefit on major
To sum this up, an entire new class of drugs designed to help diabetics
manage blood sugar are pretty much worthless at preventing the major
complication in diabetics.
With this in mind, it doesn’t matter squat what it cost to develop or what
it costs to manufacture because the drug doesn’t really help diabetics in
the long run. This means that cost to society is equal to pretty much every
dime spent by the healthcare system on this class of drugs PLUS the medical
costs associated with the sometimes dangerous and fatal side effects from
Good thing more people have access to drugs through the Affordable Care Act.
A War You Can Win: 9 Ways to Make Better
By David Seaman, DC, MS, DABCN
The average American consumes approximately 60 percent of calories from
sugar, flour and refined oils.1 A donut is a good example of a so-called
"food" that represents these calorie sources.
We also consume a considerable number of calories from French fries and
ketchup, each of which began as vegetation, but after refinement represents
more sugar, flour and refined oil calories. Generally, Americans consume
very little in the way of vegetables and fruit. The result is big business
for the refined-food manufacturers and ultimately, Big Pharma. But what
about us? Here's how you can fight back.
Unhealthy Food Is Big Business
The cost of producing foods made with sugar, flour and refined oil is modest
when it comes to the price of these commodities. In other words, there is
still an acceptable profit margin for "foods" made with these calorie
sources. And companies that use these calorie sources are still doing very
well financially. To confirm this, all one needs to do is look at the stock
prices of companies that use huge amounts of these calories sources. For
example, the stock price for Coca-Cola was $11 in 1995, $21 in 2009 and $39
in June 2015. For McDonald's, the stock price during those years were $15,
$55 and $95.
Clearly, if one is involved in the selling of refined calories, there is a
financial benefit. Refined calories are a good business. If you would have
put all your money in Coca-Cola or McDonald's in 2009, you might be able to
retire right now because you would have doubled your money. Imagine that –
your retirement would be based on sugar, flour and refined oil.
What about the people who eat calories from sugar, flour and refined oils?
I've labeled these folks "dietary crackheads" because these calories are
addictive.2 To be fair, even if you eat few calories from dietary crack, you
can still be a dietary crackhead. This is because almost everyone loves the
taste of dietary crack, and most of us would like to eat a lot of it, which
means we are either practicing or non-practicing dietary crackheads. (I have
been mostly a non-practicing dietary crackhead for many years.)
But what about those who consume 60 percent of their calories from dietary
crack? What happens to them over time? The answer is obvious: most gain
weight and eventually develop the metabolic syndrome. Unfortunately, 34
percent of individuals 20 years and older in America have the metabolic
syndrome.3 Clearly, the consumers of dietary crack do not benefit unless
they simultaneously own stock in companies that distribute "dietary crack."
The metabolic syndrome is an interesting condition because it is a
pro-inflammatory metabolic state that can last for many years before an
overt disease develops, which then requires a specific drug or surgical
intervention. Here is example of conditions that develop after the metabolic
syndrome state is achieved by eating dietary crack: acne, type 2 diabetes,
cancer, cardiovascular disease, stroke, hypertension, polycystic ovarian
syndrome, non-alcoholic fatty liver disease, gallstones, sleep apnea,
myopia, male vertex balding, depression, low testosterone, and erectile
Practically speaking, someone might take acne medication for several years
before graduating to metformin for elevated blood glucose and a statin for
elevated cholesterol. Eventually, by the time a man is 50 years of age, he
may be taking medications for glucose, cholesterol, hypertension, depression
and erectile dysfunction. And during this time, he has continued to eat 60
percent of his calories from dietary crack.
How does this man benefit beyond the temporary pleasure he gets from the
taste of dietary crack? Clearly, there is no benefit for him – just
suffering. And the suffering can continue if he develops vascular disease or
cancer that requires surgical intervention.
Big Pharma Continues to Reap the Financial Rewards
In addition to the manufacturers of dietary crack, the pharmaceutical
companies and the hospital system are also beneficiaries. While many drug
companies had their peak stock price during the tech bubble days (2000),
they are certainly not suffering. Their stock prices have a similar upward
pattern as the refined food-producing companies. When you get a chance,
check out the stock price patterns for Merck, Pfizer and AstraZeneca. Like
the refined-calorie producers, drugs companies would have been a good
investment over the past several decades.
How to Make Better Food Choices
Refined foods and drugs continue to be growing industries. They obviously
have a good business model. Interestingly, people like to blame refined-food
companies and drug companies for our bad health. In my opinion, this is
completely incorrect and reflects a state of ignorance. If I eat dietary
crack and take medications as a result, it is my fault. No one is forcing me
to eat their refined calories or take their drugs and support industries
that subsequently benefit. This is a voluntary choice made by the majority
of Americans. Simply put, we need to make better choices.
The challenge, of course, is to avoid refined calories on a long-term basis.
This can be complicated for many people, even if you're wellness-inclined.
So, here is a list of things you can do:
Cultivate a proper eating mindset – this involves finding a reason to truly
"care" about avoiding disease-promoting refined foods.
Understand that almost everyone will always like the taste of dietary crack.
Do not feel guilty about wanting it or occasionally partaking. Just don't
overdo it on a chronic basis.
Eat more vegetables during meals to create the sensation of fullness. In
general, the feeling of gut fullness must be respected in spite of what
food-eating thoughts one might have.
Keep dietary crack out of the house so there is no temptation at home.
Drink more water.
Build up to exercising at an aggressive-enough level that appetite
Get adequate sleep, as less than six hours per night on a chronic basis can
promote weight gain by various metabolic mechanisms.
Fight stress with exercise, not by eating excess / unhealthy food.
Mentally accept that steps #1-8 represent a process to utilize throughout
Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the
Western diet: health implications for the 21st century. Am J Clin Nutr,
Seaman DR. "Dietary 'Crackheads' and the Never-Ending Battle Against the
Bulging Waistline." Dynamic Chiropractic, April 1, 2013.
Seaman DR, Palombo AD. An overview of the identification and management of
the metabolic syndrome in chiropractic practice. J Chiropr Med,
Seaman DR. Body mass index and musculoskeletal pain: is there a connection?
Chiropractic Man Ther, 2013;21:15.
Wang C, Jackson G, Jones TH, et al. Low testosterone associated with obesity
and the metabolic syndrome contributes to sexual dysfunction and
cardiovascular disease risk in men with type 2 diabetes. Diabetes Care,
David Seaman, MS, DC, DACBN, is the author of Clinical Nutrition for
Pain, Inflammation and Tissue Healing. He has a master's degree in nutrition
from the University of Bridgeport, Conn., and lectures on nutrition for
Anabolic Labs (www.anaboliclabs.com).