Is Sitting the New Smoking?

As chiropractors in the Downtown/Financial District of San Francisco, we see the effects of sitting every day. Conditions include chronic headaches, low back pain, muscle spasms, stiff neck, hip pain, knee pain, degenerative disc disease in people as early as their 20's among other things. Many patients ask us why they have these pains and degenerative changes, since they are so young and otherwise healthy. Although they may not have the symptoms, most have on thing in common: 90% are sitting 6-12 hours a day.

Recently, Anup Kanodia, a physician and researcher at Ohio State University, Wexner Medical Center said, "Sitting is the new smoking".  According to an Australian study published in October 2012 in the British Journal of Sports Medicine, every hour of sitting, cuts about 22 minutes of the person's life, while it is estimated that smokers shorten their lives by about 11 minutes per cigarette.

No one wants to grow old with low back pain.  As chiropractors our goal is help you get out of pain, but more importantly to stay without pain, with better function, so that you can age as healthy as you possibly can be.  I have a 32 year old patient, who I love quoting: " I am here because I want to be the healthiest senior citizen I can possibly be."

Here is a look at how sitting affects us, as we sit for extended periods of time the posterior muscles in the low back, middle back, neck and pelvis become elongated, weak, inhibited, and underused. The hip and neck flexors on the other hand become short and taut. We mostly feel the muscle's response to sitting in the form of muscle spasms or tension, but the problem is far beyond the muscle. Prolonged slumped postures cause micro sprains and strains to the joints of the back and neck over prolonged periods of time. This leads to lose of neutral curvatures in the lumbar spine and the cervical spine, deformation of  ligaments that are elongated in the back and shortened in the front, disc compression, disc thinning, disc bulges, pain radiating to the arms or legs, or disc tears. The body overreacts to this damage and starts producing increased muscle tone, which feels like spasm, tension, knots in the muscles.  Naturally because it feels like spasm we start stretching the muscles instead of what we need to do, strengthen them.

So next time, you experience a spasm in the lower back, stiffness in the neck, sensitivity to certain movements or unexpected movements especially in the morning,  pain after sitting and standing,  or pain from sitting, standing, lifting or carrying, take into consideration that it may not just be a muscle spasm, and most likely a weakened disc that is likely to suffer further if not treated as such.  

Our chiropractors specialize in posture evaluation, muscle testing to identify front to back and left to right muscle imbalances.We are experts in differential diagnosis meaning we do all the orthopedic tests to help us differentiate a simple muscle spasm from, joint sprain/ strain and dysfunction , from disc protrusion or bulge.  We combine chiropractic, massage, physical therapy on the same visit to address all the structures involved: muscles, joints, nerves and discs.  For more information about this article and to contact Dr. Mazgaloff go to www.chirohealthsf.com.

Easy and Practical Ways to Improve Your Posture

Correct posture is a simple but very important way to keep the many intricate structures in the back and spine healthy. It is much more than cosmetic-good posture and back support are critical to reducing the incidence and levels of back pain and neck pain. Back support is especially important for patients who spend many hours sitting in an office chair or standing throughout the day. 

Not maintaining good posture and adequate back support can add strain to muscles and put stress on the spine. Over time, the stress of poor posture can change the anatomical characteristics of the spine, leading to the possibility of constricted blood vessels and nerves, as well as problems with muscles, discs and joints. All of these can be major contributors to back and neck pain, as well as headaches, fatigue, and possibly even concerns with major organs and breathing.

As a gift this month we are offering free postural evaluations to friends, family and co-workers of our patients. So if you know of anyone that could benefit from our care, have them call us and set an appointment. Below are also simple ways for you to work on your posture and work and at home. 

All you need are two tennis balls. Whether you are at work or your home computer try this easy trick. The idea is to sit up straight and keep the tennis balls pinned against the chair with your shoulder blades.If the balls start to slide down then you know that your posture is incorrect. 

  For this next tip all you need some type of tape that will stay on your skin. This could be special kinesio-tape or first aid tape. Start by retracting you shoulder blades then tape from the middle of one shoulder blade to the other. If you let your shoulders roll forward or begin to slouch you will feel the tape tighten up and pull on you. 

Standing Workstations

We've all heard it before: Sitting for long periods is bad for you! Of course, most of us have jobs that require sitting at a desk for 8-9 hours every day. Sitting can cause increased pressure on lumbar inter-vertebral discs, low back sprains and strains, forward head posture, headaches and upper back pain. In an effort to decrease employee injuries and increase comfort, many modern offices are offering a new alternative: Standing Workstations.

A standing workstation is essentially a desk raised to a height at which the user can stand comfortably. This allows you to move more freely than sitting in a chair, which decreases the strain on your lower back. Because you are moving more, you also have more blood flow to your spinal muscles. This keeps the muscles functioning at a higher level and helps them to protect the spine from minor injuries. People who are standing generally have better posture than those who are seated, which also helps to decrease the strain on the neck and upper back.

Standing can have its own drawbacks, however. Many people who stand for hours at a time report hip pain, knee pain, foot pain and lower back pain as common. This is because of the pressure of the weight of your body on your pelvis and legs. Some of this strain can be alleviated by standing on a padded surface.

Perhaps the best solution is the convertible work station. These are a relatively new option that allow the employee to easily transition their desk from a seated to standing height, and back again. Many of my patients who have convertible work stations say they like to mix it up: start the day standing and then sit after lunch, or make Monday a standing day and Tuesday a sitting day, etc. The convertible option allows the desk user to make the desk really work for them. While it is still important to have an ergonomics evaluation of the convertible workstations, we feel they are a great long-term solution to the problem of spinal stress in the workplace.

Case of the week - Sacroiliac Tension

Patient: 30 year old female office worker complains of right sacroiliac pain of several years duration. Pain has increased recently with increased time spent sitting at work and increased stress level. Pain is worst in the morning, feeling as though pressure needs to be released. Patient has tried massage and exercise, but the pressure remains. These treatments helped alleviate pain, but did not affect the “pressure”.

Examination: Significant bilateral sacroiliac joint dysfunction and lumbar joint dysfunction at L4 and L5 levels. Fortin Finger Sign. Tight and tender muscles in the right piriformis, right lumbar paraspinal muscles. Tight and tender right upper thoracic spine with right rib joint dysfunction. Range of motion, muscle testing and nerve testing were within normal.

Discussion: This patient displayed a classic finding in sacroiliac joint cases: the Fortin Finger Sign. Elegant in its simplicity, the Fortin Finger Sign indicates that the patient points directly to the sacroiliac joint when describing their pain. This sign is highly specific for the diagnosis of a sacroiliac joint problem. Lest you think Fortin to be moronic, it is actually very common for a patient to complain of pain in one location, while the source of that pain is located elsewhere. In this case, the patient’s pain and feeling of pressure were due to a chronic joint dysfunction of the sacroiliac joints. This dysfunction was so longstanding, it began to affect other areas of the spine, including the lumbar and thoracic spines. The patient’s long hours using a mouse at a computer were contributory to the thoracic pain.

Outcome: The patient underwent a series of treatments involving adjusting of the sacroiliac joints, the lumbar spine and the thoracic spine and ribs. Treatment also involved significant ergonomic corrections to the patient’s workstation and included postural re-training exercises to help the patient maintain the effects of her care.

Exercise: Knees to Chest – A great way to reduce tension on your sacroiliac joint is to stretch it in a flexed position. To achieve this, lay on your back on a comfortable surface. Slowly bring both knees to your chest and hug them with your arms. Take a deep breath, and, as you exhale, sue your arms to pull your knees closer to your chest. Repeat until you feel a stretch in your low back, just above your buttocks. Hold the stretch for 10 seconds, and then release very slowly, returning your legs to the ground. Do this once in the morning and once at night to help maintain your sacroiliac joint flexibility.

Remember never to engage in an exercise without first consulting your chiropractic physician to see if it is safe for you and your unique conditions.

Suggestion: Ergonomic Support – For all the hours we spend seated, we need to make sure our spines are supported. Evaluate your chair to make sure it allows your spine to be supported, with a lumbar curve and arm rests at the proper height. Ask your chiropractor to help you fix your chair for your specific needs, and watch your productivity soar!

Remember never to engage in an exercise without first consulting your chiropractic physician to see if it is safe for you and your unique conditions.