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frequently asked question
1) Do I use ice on my injury? Do I use heat on my injury?

Ans: The general rule of thumb is to use ice in the acute stage of an injury (within the first 24-48 hours) or whenever swelling is showing. Ice helps to reduce inflammation and swelling by decreasing blood flow to the area that is injured. The general guideline is to apply ice indirectly (not directly on the skin) for 20 minutes, remove the ice for at least 20 minutes, and repeat as necessary.

Heat is used to increase blood flow, which helps promote pain relief after inflammation and swelling subside. Heat is also used to assist in warming muscles up prior to exercise, any physical activity, or physical therapy.

2) What is a muscle strain?

Ans: Unlike a sprain, which is the stretching or tearing of a ligament, usually in the ankle, a strain in the stretching of a muscle or tendon. Most strains happen in the lower back and hamstring muscles in the back of the thigh.


3) Can I take medicine to heal a muscle injury?

Ans: Non-prescription pain medicines, such as ibuprophen (NSAIDs) and acetominophen can reduce pain and swelling. Take these medicines according to package instructions. You can also relieve pain with ice packs. You can buy compression bandages at the pharmacy.


4) How can I treat a muscle sprain or strain?
Ans: The first sign of an injury is usually pain and swelling to the injured area. For the first few days, use RICE therapy—Rest, Ice packs, Compression and Elevation.


5) How can I keep from having problems with my spine after spine surgery?

Ans: After spine surgery, it is possible that you may develop back discomfort in the future. To take care of your spine if soreness or other symptoms return, your physical therapist will give you a thorough home program when you complete your therapy treatments. Continuing with your home program is a way to keep your spine healthy over time. He or she may also show you how to control pain or other symptoms if they do not completely go away, or if they return in the future. These may include the use of ice, heat, positioning, or rest.


6) What exercises should I continue doing to keep my low back toned and healthy?

Ans: Common factors in chronic and recurring back pain include weak abdominal and trunk muscles, unhealthy posture, and overall deconditioning due to lack of exercise. Exercises should be chosen to offset each of the problem areas that contribute to back pain. Lumbar and abdominal stabilization: Studies show that exercise training for the abdominal and low-back muscles can improve back stability, reduce pain, and make it easier to do activities of daily living.
Postural exercises: Putting safe posture in action is important to protect your back from small injuries that add up when the spine is strained in awkward or stationary postures.

Aerobic conditioning: A well-rounded program for maintaining a healthy spine should include some form of aerobic exercises. Examples may include walking, cross-country skiing, or swimming. It is important that you choose an aerobic activity you enjoy, so you'll stick with it. Remember to always check with your doctor or physical therapist before beginning an exercise program.


7) I get a lot of back pain when I sit at my computer. Do I need a new chair?

Ans: Poor sitting posture can cause back pain. Be sure to sit with your spine in good upright alignment. Improve your sitting posture by using a comfortable chair designed to support optimal posture. Avoid slouching by keeping your low back firmly against the back of the chair. Slouching your spine can strain your neck forward, putting extra pressure on the nerves and arteries leading to your arms. Your shoulders should be relaxed, and your elbows, hips, and knees should be bent at right angles (90 degrees). Avoid putting pressure on the back of your knees. Your feet should be kept flat on the floor or supported by a footrest. If your chair does not give you the support you need to keep in good body alignment, you may need a new chair. Otherwise, try placing a rolled towel or pillow against the small of your back, or consider purchasing one of the many commercial lumbar cushions that are available to help improve your sitting posture.


8) If I have pain above or behind my knee, is it still considered knee pain?

Ans: Yes, pain around or behind the knee joint may still be considered knee pain. Pain that originates in the joint itself often radiates to muscles around the injured area. Knee pain is typically divided into three categories. Acute injury describes the trauma from an accident such as a dislocated knee or torn ligament. Medical conditions which may be ongoing are a second category—arthritis is a common example of a medical condition which can cause knee pain. Chronic or overuse conditions are the third category. Chronic pain describes pain that continues for six months or more. Bursitis, tendonitis or patellar syndromes are examples of chronic pain. All three types of knee pain can cause discomfort behind, below or above the joint itself.


9) When is surgery necessary for patients with spine problems?

An : Most back problems respond to conservative treatments, including anti-inflammatory medication, hot or cold therapy, gentle massage and physical therapy. When conservative treatments don’t alleviate the pain, other therapies may be used, including: epidural steroids, injections, joint and nerve blocks, and medications. If interventional therapy does not help, back surgery may be considered as a last resort.

Surgery may be appropriate for patients experiencing severe pain or when there is a significant neurological impairment, such as muscle weakness, a change in gait, or bowel and urinary dysfunction.


10) What should I do when my back hurts?

Ans: Avoid activities that could aggravate your back further. While your inclination may be to take to your bed, however, the latest research indicates that continuing to be active can enhance recovery from back pain. Bed rest and inactivity for more than one or two days may actually be harmful, because you lose strength, flexibility and endurance.

• Maintain physical activity, but be careful to avoid any movements which produce aggravated pain in the back.
• Take over-the-counter pain anti-inflammatory medication.
• Apply ice on the back for 15 to 20 minutes at a time, three to five times a day, to reduce swelling, inflammation and soreness.
• Pursue low-impact exercise like walking or water aerobics.
• When sleeping, find a comfortable position (perhaps on your side, with a pillow between the knees) and try to maintain it.


11) Why do joints make popping and cracking noises?

Ans: Joints can make different noises--some are serious and some are not.
Some people learn how to "pop their knuckles." By pushing or pulling a joint in a certain way an air bubble can suddenly appear in the joint with a "pop." Once the bubble is there the joint cannot be popped again until the air has been reabsorbed.


Some joints crack as the ligaments and tendons that pass over them slide past bumps on the bones. Individuals who "crack their neck" make noise in this way.
Other joints lock up intermittently--often with a loud pop--because something gets caught in between the joint surfaces. A torn cartilage in the knee or a loose piece of bone or cartilage in the joint can do this. Once a joint is stuck in this way, it may need to be wiggled around to unlock it. This may also cause a pop.

Finally joints that are arthritic may crack and grind. These noises usually occur each time the joint is moved. This noise is due to the roughness of the joint surface due to loss of the smooth cartilage.


12) How can I manage arthritis pain?

Ans: Both medical treatment and self-management strategies are very important. The Arthritis Self-Management Program and the Chronic Disease Self-Management Program. These programs help people learn the techniques needed to manage their arthritis on a day to day basis and gain the confidence to carry it out.

Physical activity can also help reduce pain. Programs like Arthritis Foundation Exercise Program and Enhance Fitness can help can help you safely increase yours physical activity.


13) What should I do if I have pain when I exercise?

Ans: It’s normal for people with arthritis to experience some soreness or aching in joints and surrounding muscles during and after exercise. This is especially true in the first 4 to 6 weeks of starting an exercise program. However, most people with arthritis find if they stick with exercise they will have significant long-term pain relief.


• Modify your exercise program by reducing the frequency (days per week) or duration (amount of time each session) until pain improves.
• Change the type of exercise to reduce impact on the joints – for example switch from walking to water aerobics.
• Do proper warm-up and cool-down before and after exercise.
• Exercise at a comfortable pace – you should be able to carry on a conversation while exercising.
• Make sure you have good fitting, comfortable shoes.

• Pain is sharp, stabbing, and constant.
• Pain that causes you to limp.
• Pain that lasts more than 2 hours after exercise or gets worse at night.
• Pain is not relieved by rest, medication, or hot/cold packs.
• Large increases in swelling or your joints feel “hot” or are red.


14) How does body weight influence arthritis?

Ans: Weight control is essential; research suggests that maintaining a healthy weight reduces the risk of developing osteoarthritis and may decrease disease progression. A loss of just 11 pounds can decrease the occurrence (incidence) of new knee osteoarthritis, and losing just 5% of body weight (12 pounds in a 250 pound person) can reduce pain and disability. Calculate your Body Mass Index (BMI). Read more about healthy weight.


15) What injuries cause shoulder pain and tightness?

Ans: Shoulder pain and tightness can be caused by repetitive motion injuries, sudden injuries, strains and sprains, instability, dislocations, frozen shoulder and pinched nerves. These injuries can limit your range of motion and cause weakness and stiffness in the shoulder and arm. If you suspect you have a shoulder injury, you should call our chiropractor and request and initial appointment and evaluation.


16) How long with it take before I experience relief from the tightness in my muscles and shoulders and inflammation and swelling?

Ans: There are several factors that impact an individual’s healing time and pain relief, tightness and swelling, including the severity of the injury, length of time you have had the injury and any underlying health conditions. In general, new injuries in individuals that have very few underlying health injuries heal faster than individuals with chronic injuries in their shoulders and underlying health conditions.
Most people feel better after several sessions with our chiropractor and are able to reduce the number of pain pills they take each day. However, our chiropractor will be able to give you a time-frame for your treatment after your initial evaluation and the first few sessions.


17) I have a shoulder injury. I’ve had months of physical therapy, shoulder exercises, and acupuncture but I still have shoulder pain. I am considering shoulder surgery. What makes your treatment different? How long does it take?


Ans: Physical therapy exercises the soft tissue around the joint. However, in many shoulder cases there is a shoulder impingement on the joint much like a rubber band that has been wrapped too tight. You can exercise the shoulder. You can put on heat and/or ice. You can take pain killers to cover the pain. You can massage the shoulder and it might feel good for a little bit. You can even do acupuncture. However, unless the impingement is removed, the joint can never move properly and you will still have shoulder pain symptoms. This tissue does not get moved doing traditional rehab that physical therapy performs.


18) What are osteoporosis risk factors that cannot be changed?

Gender - Women are at higher risk for osteoporosis than men. They have smaller bones and lose bone more rapidly than men do because of hormone      changes that occur after menopause. Therefore, if you are a woman, you are at higher risk for osteoporosis.
Age - Because bones become thinner with age, the older you are, the greater your risk of osteoporosis.
Ethnicity - Caucasian and Asian women are at the highest risk for osteoporosis. This is mainly due to differences in bone mass and density compared with     other ethnic groups. African-American and Hispanic women are also at risk, but less so.
Family History- Osteoporosis tends to run in families. If a family member has osteoporosis or breaks a bone, there is a greater chance that you will too.
History of Previous Fracture. People who have had a fracture after the age of 50 are at high risk of having another.


19) Why are women at greater risk for osteoporosis than men?

Ans : Women have smaller bones, and they lose bone more rapidly than men because of hormone changes that occur after menopause. Therefore, women are at higher risk for osteoporosis.


20) Can I still enjoy sports with osteoporosis?

Ans: Avoid sports and activities that are high-impact and/or twist your spine or bend forward from the waist, such as conventional sit-ups, toe touches, or swinging a golf club. Look for ways to modify sports and leisure activities that you enjoy to protect your bones, or cultivate new forms of physical activity that put less stress on your skeleton.


21) What can increase the risk of a bone fracture?

Ans: The more likely you are to fall, the higher your risk for a fracture. And more severe falls increase your risk for fractures.
Factors that increase your risk of falling and of fracturing a bone include

• decreased muscle strength

• poor balance

• impaired eyesight

• impaired mental abilities

• certain medications, such as tranquilizers and muscle relaxants

• hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks.


22) I have no family history of osteoporosis. I eat a healthy diet and exercise. How did I get osteoporosis?

Ans: In addition to your family history, there are many factors that can increase your likelihood of developing osteoporosis. That’s why estimates suggest that about one in two women and up to one in four men will break a bone in their lifetime due to osteoporosis. You are at increased risk of developing osteoporosis if you are a postmenopausal woman with a small and thin build. As you age, your risk of osteoporosis and broken bones increases. Also, certain medical conditions or taking certain medicines may increase your chance of developing osteoporosis. To learn more about these medical conditions and medications.


23) Is the stiffness and pain in my legs and back due to my osteoporosis?

Ans: Stiffness and pain in the legs or knees are most commonly associated with osteoarthritis and are rarely caused by osteoporosis. Back pain, however, may be due to osteoporosis or other conditions such as osteoarthritis or degenerative disc disease. It is possible to have osteoporosis and osteoarthritis as well as other conditions at the same time.


Osteoporosis is called a “silent disease” because there are generally no symptoms or pain until you break a bone. For the pain you are having, we encourage you to speak with your doctor or other healthcare provider to determine the cause and to help you find relief from your pain.
When a person with osteoporosis in the spine has back pain, this may be caused by a broken bone in the spine. When you have osteoporosis and are having back pain, you should see a healthcare provider to find out if you have broken a bone in the spine. A lateral x-ray of the spine or a vertebral fracture assessment (VFA) can be used to look for broken bones in the spine.

For people with osteoporosis in the spine, it is important to protect the spine from broken bones by moving properly during exercise and daily activities. For example, do not bend over from the waist and avoid twisting motions of the trunk. Also, don’t carry packages that are too heavy or reach for objects on a high shelf.


24) Does vein disease affect women and men equally?

Ans: More than half of all women will develop varicose vein disease over the course of their lifetime. However, 40 to 45 percent of all men will develop vein disease as well. The unique hormonal conditions that women face, such as pregnancy and menopause, often cause their veins to become worse. This is likely why more women than men seek treatment for their condition.


25) What are some of the common activities or sports that can impact the hips?

Ans: Recently, more and more athletes are being diagnosed with labral tears or impingement of the hip. This is especially common in athletes who perform repeated hip flexion such as runners, hockey players, soccer players, martial arts competitors, wrestlers, skiers and football players.

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