Friday 20 March 2020

Why my UPPER BACK hurts whole day?

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"Whenever I look at my phone, read books, work in kitchen or on my laptop the neck feels stiff and upper back hurts. Any stress be it a mental or a physical one causes flare up in my pain. I can't keep having medicines everyday. I just don't wake up good, it hurts. I feel its endless and pain has become a part of my life."



Do you also feel the same when your upper back hurts? That constant pain almost convinces you to live with it and suffering becomes part of your everyday life. Even when you try managing your pain you end up in frustration because either the pain doesn't change or the relief is very temporary.



Everyone is so keen on diagnosing the problem through investigations such as X-RAYs or MRI Scans showing the blind belief on something so incomplete. Most of the problems depicted by these tests are normal after a certain age and on the other side the results can be totally negative inspite of a bad pain you are complaining off.



Do we really know what is going wrong with the body?



Are we catering to the problem in the best way possible?



Do you really think the solution to the problem does not exist?




Wait!!! This blog may have answer to your problem. Well, we have to break down the problem by looking into the root cause of upper back and neck pain.



What ! what did I just say? ROOT CAUSE...



"Neck and head sits on rest of the spine"


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The upper back behaves like a root of the tree for your neck. A healthy strong root is necessary for the tree to survive better. Also mechanically the 7 bones of the neck (Vertebraes C1-C7) moves along with upto 4 bones of your upper back (T1-T4). And they  further get support from rest of the spine.



Consider spine like a group of blocks piled up on top of each other and any misbehaviour by one block can affect the other at a different location. A physiotherapist trained in manual therapy can assess and treat such problems by techniques using hands or mobility drills and exercises or a combination of all.



Scary bones can't move alone

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Bones never move on their own, they need muscles to move your scary skeleton. Muscles can get tight in response to pain or your inactive lifestyle which may limit the movement and can get weak leading to poor concious control in the spine. Bad movement around spine surely creates trouble because nerves originate from spine which carry sensation of pain.




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Manipulating your tight  muscles to loosen up their grip on stiff spine or self myofascial releases  done at home or exercises specific to the problem or a combination of all can be really helpful in managing pain and restoring spine health.



Deep is the real sleep

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Sleep like a child. Sleeping enough is almost like system reset for the brain and the body as it consumes one third of your life duration. When people do not sleep enough, the body cannot recover from the stress given on the previous day. Moreover, sleeping in wrong posture doesn't allow muscles to rest enough and you may get pain as soon as you wakeup. Some of you might have experienced early morning flare ups in upper back and neck pain.



Pillows are nice sleeping fellows


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A good pillow support is necessary to make the muscles and joints well supported. Pillow must provide support under the neck more than your head. Pillows are always about hit and trial, so how high or low the pillow should be, is a matter of personal choice.



"Block in mind is a block in the body"

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Stress affects far more strongly when you do not realize it is a problem in the first place. When the mind gets blocked with disturbing thoughts consciously or subconsciously, it affects your physical health and also how you perceive pain. 



A friend in need is a friend in deed. Truly said, sometimes you need to open up about your problems rather facing alone. You need someone who won't judge any wrong doing against you, by you or around you. This confidence in someone melts you down, you share and take a step towards solution. Trust me at times this is it, your pain dissolves mentally and physically both.



This is just one example of many sufferings the body goes through due to our changing lifestyle, reduced physical activities and gadgets. I think pain is far different from how it is being approached based only on investigations. A lot more things can be picked up and treated using good clinical skills.



This is not a medical advice but generic suggestion on how you can self educate to bring some change in your daily suffering. Kindly feel free to comment here or contact on the details below in case of any doubt or help required.




Dr. Kunal Vashist, PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

Movement Specialist (USA)

Email: kvashist.physio@gmail.com

Contact No. 9968302757




Friday 10 January 2020

Doctors are MIS-Treating the BACK PAIN....

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YES !!! YOU READ IT CORRECTLY.



MIS treating the back pain here means using M- Medicines, I- Injections and S- Surgeries. Studies have shown that back pain is an outcome of poor physical activities, mental stress and sleep disorders. None of it needs medicine if the pain is not acute. Moreover in chronic stage injections and surgeries have almost failed to show promising results so far. 



Why medicine and surgery doesn't help in long term back pain? The answer lies in what causes a long term back pain or chronic back pain.


From last one Decade I have been raising my voice against managing LOW BACK PAIN through surgeries and injections. No! This doesn't mean they are not required but definitely not at a scale at which surgeons and hospitals are performing it. 



Yes surgeons do not immediately operate on every patient who complains back pain. But what you want them to do when every time you enter their office saying no relief and high suffering. Most people who undergo operations for back pain have not done enough but only tried  medication with no exercises or lifestyle change before opting for their surgeon's advice.


"BACKPAIN SURGERY IS NOT A SOLUTION BUT AN OPTION"



Long term back pains are non-specific (80%) in nature which means the pain is caused by tight muscles, stiff joints, lack of physical activities, Stressed life or Sleep difficulties. Some backpains are specific meaning they have a disease involved like Disc bulge, sciatica, spondylosis and spondylo-listhesis etc. There is a very thin line between non-specific and specific back pain because above 40 years of age it is very common to find damage in spine structures even if someone's back is pain free. In fact studies have shown, after 40 years of age chances of having one or more disc bulges increase with every decade of life with or without a back pain.



So for now it is sure that even if your investigations reveal a structural damage to your spine, your suffering may not be caused by it. A thorough clinical checkup designed to investigate your source of pain is necessary to confirm your diagnosis. Also your check up must involve your muscle flexibility testing, spine and peripheral mobility assement, strength and functional testing. A careful history taking to understand your basic life issues related to mental health, sleep troubles and much more is also needed. This definitely needs excellent clinical skills by your doctor rather than a hybrid XRAY / MRI Machine.



Backpains are funny as they scare the hell out of you giving you worse nightmares but still the reason can be very simple when checked thoroughly. Most back pains doesn't respond well or benefits temporarily with medication. The limited use of medication is only to control some inflammation and give you a good start in your recovery process.



The real nature of our spine is to be strong and functional at the same time. Pain restricts our movements and makes the unused muscles weak. Well this can be other way round also. Reduced physical activities and long hours of sitting (leisure or work related) can make spine weak and stiff resulting in pain.



A proper diagnosis not just based on investigation is required to select which patient needs injection or surgery. In my opinion all patients except emergency situations should work hard on regaining the spine mobility and strength. Rehabilitation or physiotherapy should focus on getting their functional recovery and putting them back to physical activites which they like. 



Reaching out to a physiotherapist can help as they can do a damage assesment as well as bio-mechanical assessment of your whole body including spine. At times we have issues in spine superimposed with stiffness and weakness around it. Physiotherapist will help you in pain education, exercises and way to increase physical activities which is backed by scientific evidence in today's world in dealing even with complex spine disorders.



What your spine doesn't like:



  • Prolonged sitting hours
  • Prolonged standing hours
  • Less physical activities
  • Lack of hydration
  • Stiffness and poor mobility
  • Wrong sitting or standing habits
  • Stress in life
  • Lack of sleep




What your spine likes:



  • Active movements throughout the day
  • Good range of motion
  • Less physical and mental stress
  • Goodnight sleep
  • Strong and flexible muscles 
  • Cardiovascular health to provide enough oxygen and blood flow


"In BACK PAIN - Our spine is more robust than our mind" - KUNAL VASHIST



In case of any further questions, Feel free to ask for any furhter information but do not use the blog as a medical reference. Your treating doctor knows the best about you compared to a write up which doesnt even know you.


Dr. Kunal Vashist, PT

MPT (Ortho), Manual Therapy

Dry Needling Practitioner

Movement Specialist (usa)

Contact Details:
998302757
kvashist.physio@gmail.com