Do you suffer from lower back, hip or leg pain? If so, are you dealing with it as effectively as possible? Whether this type of pain is your present or future problem, you may want to better understand what you are dealing with and what you might do about it.
This pearl is the first in a three-part series for dealing with the kind of pain that most dentists and their staff are plagued with; it also applies to everybody with body pain. Part-1 will deal with lower back, hip and leg pain and spinal stenosis, a problem for too many workers. Pearl-2 will deal with upper body, shoulder and neck pain, another type of suffered by dental staff and clerical workers. Part-3 will deal with TMJ pain, suffered by many.
Disclaimer
The opinions stated here are based on over 50 years of personal research and what has and has not worked for my clients, my acquaintances and me. This is an offering to get you thinking outside of the “pill box” and possibly resolve the root of your pain instead of only covering it up with medications—medications are helpful, but they are not the only path you could take to resolve your pains. There are no guarantees that any of this will work for you and some may have adverse affects, like all medications, which tells you what NOT to do, but it’s worth a try if what you are now doing isn’t helping you.
See the attached PDF for devices that can be used to help reduce your lower body pain. There are also many other products/services available on line that you can use.
Statistics
More than 70% of US dentists suffer from chronic lower back hip and leg pain. Many also suffer from spinal stenosis, but to a lesser percentage of their population. Eighty percent of the entire US population and 40% of clerical workers suffer from occasional back pain, with 5% suffering from chronic lower back pain. Eleven percent of the US population under 50 years and 20% over 50 years suffer from spinal stenosis. Thirty-nine percent of the US population suffers from lower limb pain. Forty-three percent of the US population is obese and suffer mild to severe lower back pain. Thus, lower back, hip and lower limb pain has become an epidemic in the US, especially among dentists, clerical workers and obese people.
There is Hope
I have been dealing with lower back, hip and leg pain (caused by: gymnastic injuries, bad habits, etc.) for over half a century and I have developed painful lumbar stenosis over the last decade. I also have occasional upper back, shoulder pain and neck. Being a doctor of bioengineering and a strong director, I seek out the cause of my maladies and try to resolve them—that’s my thing and I am usually successful. Much of what I have discovered over the past six decades comes from my own research and experimentation plus the knowledge and experiences of others. But let’s face it, you couldn’t care less about any of this if you are in pain. What you do care about is what causes your pain and what you can do to relieve it. If you are in pain, you may be aware of what is presented here—but it is the purpose of this pearl to give you more tools to be able to deal with your pain. There is a great deal in this 3-part pearl series about avoiding/releaving body pain—some or all of it may apply to you and/or those you love.
Causes of Lower Back Pain
► Unhealthy sitting or standing positions while working (twisted and/or bent over, slouching, etc.)
► Sitting or standing in the same position for hours
► Driving in a laid back or forward body position
► Sitting with bulky things (wallets, cell phones, etc.) in your back pockets
► Slouching when standing, sitting or walking instead of keeping your spine straight
► Walking/jogging/running with your hands in your pockets or while holding weights, which is contrary to natural walking with your unburdened arms swinging freely at your sides, which keeps your spine healthy.
► Spinal injuries, torn ligaments, weakened muscles, old age, etc.
► Spinal (usually lumbar) stenosis
► "Pelvic tilting" when one hip is higher or lower than the other
► "Pelvic twisting" when your hips are rotated out of a healthy position
► Obesity, which causes spinal compression and mild to severe hip and spinal pain
► Tight belt, pants or underwear, which causes leg innervation problems, numbness and pain in your legs
► Trigger points that cause lower back, hip and leg pain.
After observing thousands of dentists and their clinical and clerical assistants for over 50 years it is obvious that many they don’t sit/stand properly when treating patients, which causes their upper and lower back pain. Clinically, it is best to sit/stand behind the patient or as much in front of the patient as possible to avoid twisting your pelvis. It is also important to keep your back straight and keep the shoulders pushed back to take the pressure off of your lower back (a posture corrector helps with this). Try to avoid leaning to one side to avoid tilting your pelvis, making one leg shorter/longer than the other. Dentists/assistants who work on the right side of the patient in the chair tend to tilt their pelvis down on the left side and twist it clockwise from left to right. This causes lower back pain; and if you also have lumbar stenosis the pain it's unbearable—many people don’t even know that they have spinal stenosis until they have a spinal MRI. This pelvic tilting/twisting can also be a result of sleeping on only one side for many years.
Personally, after 40 years of sleeping on my left side (due to a blocked left sinus) I tilted my pelvis down on the left side and twisted it clockwise (similar to dentist/staff, golfers, tennis, etc., tilting/twisting), causing lower back pain for decades and exacerbating my recently developed spinal stenosis. To deal with this I had my nephew, a state of the art chiropractor, reviewed my MRI and examined me. He adjusted my pelvic tilting/twisting, but it came back quickly. We eventually decided to use “wedges” (see attached PDF) and found the ideal wedge positions for me—we attached the wedges to a board to keep them in place. I then laid with my hips on that “Wedge-Board" for 20 minutes a day for 30 days and corrected the severe pelvic tilting/twisting. Even though I corrected that tilting/twisting, it keeps coming back so I do weekly maintenance by laying on my Wedge-Board for about 5-10 minutes. Today (two years later), I wouldn’t have been able bend over or possibly even walk without excruciating pain if I hadn’t corrected the pelvic tilting/twisting—the fact is, I don’t have much lumbar/stenosis pain now; and when I do I resolve it.
A note! If your pain is on your right side your pelvic tilting is probably down on the left and pelvic twisting is from left to right. If your pain is on your left side your pelvic tilting is probably down on the right and pelvic twisting is from right to left.
Bottom line: if you have pelvic tilting/twisting you need to resolve it or else learn to live with your ongoing pain.
Possible Ways to Avoid Your Lower Back, Hip & Lower Body Pain:
Please note: some of these remedies provide temporary relief in minutes (Voltaren, Trigger Point Massage, stretching exercises, etc.) and some provide long-term relief, but take days for your entire body to adjust (Habits Correction, Posture Correction, Wedge-Board, related exercises, etc.).
► Avoid putting anything in your back pockets (no wallets, cell phones, etc.); they will tilt/twist your pelvis when you sit for long periods of time.
► Avoid hunching over; sit as upright as possible with your shoulders back—use a “Posture Corrector" if needed (see attached PDF). Wearing it for 4-5 hrs/day can help with the pain, since there are many body adjustments going on and it takes a few days to work. The main purpose of the posture corrector is to reduce upper back, shoulder and neck pain, but being upright also takes the pressure of your lower back.
► When driving, sit up straight: the back of the seat and you should be mostly straight up (don’t hunch forward or lay backward)—this will take the pressure off of your lower back and reduce that "getting out of the car pain".
► When walking, keep your shoulders back, head up and looking mostly ahead and walking with your arms naturally swinging at your side. Don’t shuffle, walk naturally from heal to toe (i.e., there should be no "slapping sound" or "shuffling sound" of your shoes). Walk at a natural pace to keep you upright—this will also help you get over a fear of falling. If using a walker, consider it a safety divice and not a means of support—again, walk heal to toe with your shoulders back and head looking forward.
► Avoid sleeping on just one side, switch throughout the night if possible. But, if you notice that sleeping on one side causes lower back pain the next day, try to avoid sleeping on that side for a while to see if it helps.
► Avoid watching TV/phone or reading in one position for more than an hour—get up and move around. One of the big disadvantages of using a TV remote is that you don’t have to get up during the commercials; you can just switch channels or fast-forward a recorded show for hours on end. This equally applies to cell phone usage.
Three Important Stretching Exercises to do Upon Awakening Daily to Lessen your Daily Pain:
I do these stretching exercises (which takes 1 to 2 minutes) every morning when I get up. Doing this, my lower back, hip, leg pain and spinal stenosis pain is almost nonexistent, except when I sit in one place for hours and need to resolve the pain it causes.
1) Stretch your groin adductor muscles that painfully pull on your pelvis (and also cause knee pain). Stand next to your bed in your bare feet and do a “side split” with your feet facing forward and with your hands on the bed (for vertical support) at a comfortable width apart. Take at least six deep breaths and with each deep breath slide your feet a little wider, getting closer to the floor and stretching your adductor muscles more with each breath—you should feel less lumbar and knee pain when done.
2) If you tend to trip over your toes when walking it is probably due to tight calf muscles tilting your toes down—this also occurs when using a walker; making you rely on it for balance instead of for safety. Even if that is not a problem, stiff calf muscles pull on your pelvis causing pain. To resolve this you need to stretch your calf muscles. While standing next to your bed and with your hands on the bed for vertical support, a straight body and your feet flat on the floor behind you; take six deep breaths and with each breath bend your elbows and thus your straight body further down—make sure that your heels stay on the floor. You should feel more strain on your calf muscles with each breath. You should also feel less lumbar pain when done.
3) Bend over to open up your spine. Bend over with your knees bent and the tips of your fingers touching the floor. Take six slow deep breaths and as you exhale straighten your legs a little. Do this until your legs are straight or you can't straighten them any more—if you get a “pop” in your spine while doing this your pain will be much relieved. Note: wearing a “Posture Corrector” for 3-5 hrs/day for a few days will allow you to bend over much further; it also reduces the "straightening up" pain.
When RETIRING for the day, you might correct Pelvic Tilting/twisting:
You might also be able to resolve moderate pelvic “tilting/twisting” without a chiropractor or wedge-board. Before going to bed, without socks, sit on the floor with your entire upper and lower back flat up against a wall and your legs stretched out in front of you. Next, notice whether your ankle bones are in line—if not in line, the leg whose ankle bone is closest to your body will be your short leg—it is, probably was and probably will be your short leg for the rest of your life. Now that you know which leg is your short leg, you can probably correct it as you rest. Lay flat on your front on your bed with your legs straight and slightly apart. If your left leg is shorter place the wrist/palm of your left hand just below your left hip bone on the bed, pushing it up. If your right leg seems shorter place the wrist/palm of your right hand below your right hip bone on the bed, pushing it up. Lie in this position for at least 60 minutes—actually, it works better if you just fall asleep because you will naturally change positions later on. The pain from the pelvic tilting should eventually subside—if not repeat the exercise the next evening or when that pain returns—if none of this works and your legs are an inch or more apart you need a chiropractic visit.
Other Helpful things for Temporary relieve your lower back, hip and lower body pain:
► Rub Voltaren ointment into the painful area for temporary localized relief.
► Lie with your painful hip area on a 4” by 6” by ½” thick ceramic magnet (north side towards body) for about 5 to 10 minutes for localized relief (see attached PDF).
► Gently use a “Massage Gun” (see attached PDF) on a low setting on the entire area surrounding the pain for at least 2 minutes for relief when nothing else works; a microwave heating pad also helps.
► Get a deep tissue full body massage at least once a year.
► Learn about and use “Trigger Point Therapy”, it is very helpful (see attached PDF)
► Do daily lower back exercises to keep your lower back and leg mussels supple and not pulling on your joints (see attached PDF).
► Get serious? Find a “state-of-the-art” chiropractor and get evaluated immediately or as needed, hopefully with a spinal MRI—the initial evaluation and correction is most important. If you have a tilted/twisted pelvis design a “Wedge-Board” and use it as needed.
► For spine and joint pain, try “Guided Lumbar Epidural Corticosteroid” injections (steroid injections) to provide pain relief within 24-48 hours—unfortunately, it doesn’t last very long. Radio Frequency Ablation (RFA) takes the same amount of time to work but last for months if done properly. RFA also treats larger areas of the body than standard Corticosteroid injections. If either method provides long-lasting results for you—great! But if not, it is better to avoid or correct the problem then it is to try and mask it with temporary drug therapy or nerve damage.
► If you are obese, lose the excess weight. If your lower spine is compressed due to obesity or bad habits, stretch it. Lie on a high bed or table with the edge of the bed/table resting comfortably on your upper lumbar area and your legs dangling. Gravity will pull on your legs and stretch your lower back, opening up your spine and relieving the spinal compression after about 2 to 5 minutes—this may not work for everybody, but it is worth a try and it feels good when done. It also helps if you can hang relaxed (not tensed) from a high bar (with legs dangling) for a few minutes.
► If you have leg pain, tingling, numbness or dysfunction it can be caused by tightness around your waist. Belts, pants or tight elastic underwear can press on your "belt" area and cut off blood and innervation to your lower body, causing leg pain, tingling, numbness or dysfunction. This problem is exacerbated if you have a protrusive stomach or excessive waist body fat. To help resolve this, loosen your belt (or wear suspenders) and/or wear “comfort-waist” pants that expand. It also helps to cut your underwear elastic half way down (on front, back and sides) to relieve that kind of pressure on your lumbar area. Also, if you get leg cramps it can be caused by a calcium plus vitamin-D deficiency.
► If you have gout pain in your feet or big toe, smash the trigger points in your shin muscles to relieve that pain. You might also find help with gout pain by clicking on this link.
I hope that this pearl can help you with your lower back, hip and lower body pain; something that sometimes seems impossible to resolve—but it can be resolved or at least reduced. Try as many therapies as possible until you find what works for you after a few days. The next pearl in this series will deal with upper back, shoulder and neck pain.
