During a time researchers and health care professionals are working collaboratively to re-evaluate the safety and efficacy of prescription drugs to address chronic pain, Gopal T. Raghunath, PT MS, DPT, CSCS, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C., says physical therapy offers a safer and more cost-efficient remedy for such conditions.
The topic is indeed appropriate as we dive into Pain Awareness Month, an annual effort by the American Chronic Pain Association (ACPA).
A staggering 25 million Americans suffer from chronic pain, according to the National Institutes of Health (NIH). A January 2015 report notes physical therapy as a suitable, non-pharmaceutical alternative for chronic pain management.
“Movement is in essence medicine for both the mind and body, and is indeed a healthier choice for those suffering from chronic pain,” said Dr. Raghunath.
The Centers for Disease Control & Prevention (CDC), in its newly released guidelines as of March, specifically highlights physical therapy as a safe and more effective treatment measure for chronic pain compared with opiates such as Vicodin and OxyContin. Additionally, the CDC reports that opioid use led to more than 28,000 deaths in 2014 alone.
Unlike acute pain, attributed to a specific ailment such as burn or fracture, and spanning from the time of injury to approximately 7 to 10 days, chronic pain is discomfort persisting for 3 months or more and carries an emotional component. The ACPA describes chronic pain as “pain that continues when it should not.”
“Individuals with chronic pain can begin to feel hopeless and, in turn, desperate for any solution, considering they have been suffering for a long period with minimal to no relief in symptoms,” said Dr. Raghunath. “Thus, it’s not surprising that prescription drugs including opiates may at first seem like a great option, though for many can be addicting. However, the side-effects can be harmful and, in turn, an unfavorable long-term solution.”
Through appropriate postural education, ergonomics, body awareness training, flexibility, strength and cardiovascular conditioning, physical therapists are licensed and trained specialists who evaluate, identify and assess the causes of chronic pain. Based on his/her physical findings, a physical therapist will customize a plan of care to address one’s condition, says Dr. Raghunath.
While conditions such as tendonitis, carpal tunnel syndrome and tennis elbow — known as repetitive strain injuries (RSIs) — are often linked to an occupation or some type of sports or recreational activity, Buffalo Grove physical therapist Gopal T. Raghunath, PT MS, DPT, CSCS, points out that the physical rigors of parenting can often lead to a similar level of pain and discomfort.
The continual lifting, carrying, reaching and twisting so common to parents of babies and toddlers, Dr. Raghunath says, make moms and dads susceptible to RSIs. As the name suggests, such injuries to the muscles, tendons and nerves are due to the repetitive use of specific regions of
the body to perform tasks, oftentimes in sustained awkward positions.
“Parents will hold, carry, rock and lift their babies dozens of times throughout the day, which after some time when performed for prolonged periods can take a toll on the body,” said Dr. Raghunath, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C. “This is the physical wear and tear of being a parent.”
Additionally, poor posture while performing these everyday parenting tasks can eventually compound the problem of RSIs.
“Performing these tasks with sub-optimal body mechanics places the body under unnecessary stress leading to pain, tenderness, tingling and
numbness, commonly observed in repetitive stress injuries,” Dr. Raghunath said.
Dr. Raghunath offers the following for maintaining good posture and avoiding repetitive stress injuries while parenting or babysitting, based on guidelines provided by the American Physical Therapy Association (APTA):
Lifting Baby from the Crib: When lifting your baby out of his/her crib, avoid reaching over guard railings and away from your body as this places undue loads to the spine. Instead, first bring the railings to its lowest setting, set your feet shoulder-width apart and bring your baby close to your body. Then, maintaining a slight arch in your back and bracing your spine tight, bend your knees and using power through your
legs, and slowly lift the baby.
Lifting Your Child from the Floor: Stand close to your child with back straight. Step forward with one foot and slowly lower yourself to one knee into a lunge position. Place both arms around your child holding him/her close to your body, and lift with your legs upon ascending up.
Repeat these steps when setting your child down to the floor.
Carrying Your Toddler: Avoid holding your child with one arm and/or balanced on your hip, as this can cause a muscle strain in the low back or sprain to the surrounding ligaments. Instead, hold him/her close to your chest with their legs wrapped around your waist, and balanced in the center of your body.
Lugging Around that Infant Car Seat: Avoid carrying the infant car seat to one side of your body or around your forearm as you would a purse or handbag, as this places stress on the back, shoulder, and arm. Instead, carry the seat by the handle with both hands, elbows bent,
positioned in front of your body with its weight distributed evenly.
According to Dr. Raghunath, strong hip and lumbopelvic musculature can significantly reduce a parent or caretaker’s risk for developing RSIs.
The physical therapy at Buffalo Grove Physical Therapy & Sports Rehabilitation can provide customized core strengthening strategies, along
with assessing and treating your current musculoskeletal ailments.
It may seem like a simple matter of comfort, but approximately 80 percent of Americans engage in daily, long-duration use of laptop and desktop computers, primarily at work. Thus, workstation ergonomics is truly an issue of injury prevention, employee morale
and workplace productivity, says Buffalo Grove physical therapist Gopal T. Raghunath, PT MS, DPT, CSCS.
In fact, Occupational Safety and Health Administration (OSHA) statistics reveal that injuries resulting from workplace musculoskeletal disorders (WMSD) due to poor workspace ergonomics account for 34 percent of all lost workday injuries and illnesses.
Neck and low-back strains, carpal tunnel syndrome, and shoulder pain stemming from tendinitis and/or bursitis are becoming increasingly
prevalent in the workplace, despite being preventable, says Dr. Raghunath, owner/clinic director of Buffalo Grove Physical Therapy & Sports
“Sitting in fixed and constrained positions while typing or performing other clerical duties, and done repeatedly year after year, can take a toll on the body over time, leaving you more vulnerable to musculotendinous and nerve-related injuries, leading to missed workdays and lost
productivity,” Dr. Raghunath said.
OSHA estimates that implementation of proper workstation ergonomics can increase productivity by an average of 11 percent.
“Ultimately, a comfortable workspace that complements your body and ensures optimal postural health helps ensure high employee morale
and, in turn, maximizes workplace longevity and efficiency,” said Dr. Raghunath.
While both workers and workplaces come in varying shapes and sizes, below are some basic guidelines for creating a safe, comfortable and
healthy workstation, according to Dr. Raghunath:
- Adjust your desk, chair, keyboard and mouse to enable your forearms, wrists and hands to rest in a straight line, parallel to the floor. Use a supplementary wrist wrest for your keyboard and mouse, if needed.
- While sitting, allow your upper arms to rest normally on either side of your body, elbows bent 90 degrees.
- Keep your head level (or bent slightly forward) and in line with the rest of your body. The top of your computer monitor should sit slightly below eye level, with the screen about an arm’s length away.
- Ensure your chair provides appropriate lumbar support, allowing for a slight concave curve of the lower spine.
- Keep your knees at approximately the same (or slightly lower) height as your hips to ensure that your feet rest flat on the floor. If your feet still do not reach the floor, use a footrest as a bolster.
- Take frequent breaks throughout the day by standing up and stretching for a few minutes every half hour. Additionally, if possible take a
walk during break periods or during lunch.
- If stiffness, soreness, pain and/or numbness persist, it may be time to visit a physical therapist for a thorough assessment. However, before even reaching this point, the clinical team at Buffalo Grove Physical Therapy & Sports Rehabilitation can work with you to help prevent the onset of work-related musculoskeletal disorders (WMSD), in efforts to optimize workplace productivity and, ultimately, your bottom line.
Are you experiencing low back tightness or discomfort? Try going for a stroll, suggests Gopal T. Raghunath, PT MS, DPT, CSCS, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C.
According to Dr. Raghunath, studies show walking to be a safe and effective way to prevent, alleviate and treat low-back pain, a condition that according to the Centers for Disease Control & Prevention (CDC) affects 80 percent of U.S. citizens during their lifetime.
“The human body craves movement and exercise,” Dr. Raghunath said. “Walking provides a host of benefits for individuals who experience
chronic low-back pain and stiffness, ranging from weight reduction and increasing bone mineral density to helping to combat osteoporosis,
to improving cardiorespiratory fitness and reducing hypertension particularly for individuals struggling with diabetes or other metabolic
With increased daylight, and spring around the corner, organized events such as the annual “Take a Walk in the Park Day,” held each year on
March 30, are sure to help motivate people to hit the outdoors.
“Walking is perhaps the simplest, easiest, and most cost effective way to get fit and stay fit,” said Dr. Raghunath. “No expensive equipment or gym memberships required. Just appropriate attire, well-fitting shoes, and motivation to get moving.”
According to Dr. Raghunath, a regular walking regimen results in:
Increased Muscle Strength: Stronger feet, legs, hips, and core muscles lead to increased spinal stability and better balance.
Increased Bone Mineral Density: The weight-bearing effects of walking impart safe/sustained loads to the musculoskeletal system to help optimize bone density, in efforts fight osteoporosis and minimize falls and fractures.
Healthier Spine: Walking improves general circulation throughout the body to help nourish the spine’s soft tissues.
Improved Flexibility & Posture: In addition to regular stretching, walking facilitates improved range of motion representative of whole body movement patterns to help promote better functional mobility and prevent injuries.
According to a study published in The Spine Journal, walking stimulates the brain to release serotonin and endorphins, neurotransmitter
chemicals that boost your physical and mental well-being. With the “stop and smell the roses” effects provided by nature’s surroundings
during a walk in the park, the study discovered a 10 to 50 percent reduction in low-back pain after just a single walk.
“However, if your back pain is so severe, rendering you incapable of standing and walking for sustained periods, this could be a sign of injury,” said Dr. Raghunath. “Consulting a physical therapist for a thorough assessment to determine the source of your pain, and put you on a path toward healing, would be appropriate.”
Progressive therapeutic exercise plays a significant role in minimizing and/or preventing chronic low-back pain, and reinforces the healing power movement has on our everyday lives, says Gopal T. Raghunath, PT MS, DPT, CSCS, owner/clinic director of Buffalo Grove Physical Therapy & Sports Rehabilitation, P.C.
A study, published last month in JAMA (Journal of the American Medical Association), found that exercise reduced the risk of recurrent low-back pain by between 25 to 40 percent.
“For movement to be truly medicinal we must first move well and then move often,” said Dr. Raghunath. “This concept is illustrated every day in the clinic, and continually supported via countless research on back pain.”
Eighty percent of the U.S. population will experience an episode of low-back pain at some point in their lives, according to the National Institutes of Health, with 25 percent of the population having already suffered a bout of symptoms within the last three months. Low-back pain, accounts for 10 percent of primary care visits and $86 billion in annual health care expenditures.
A 2015 study published by BMC Health Services asserts that many of the costs associated with acute, non-specific back pain can be reduced by up to 60 percent when individuals seek early physical therapy intervention.
“Prescription medication and advanced imaging, such as MRI/CT scans, are indeed important and have its place and time to help control
symptoms and pinpoint etiology of the condition, respectively,” Dr. Raghunath said. “However, evidence suggests physical therapy as the
appropriate first step in treating low-back pain, which is also more cost effective.”
Studies have even demonstrated that physical therapy can help individuals either prolong or, in some instances, avoid surgery, depending on the nature and severity of the condition. For example:
Lumbar Stenosis: This is a narrowing of the spinal canal, causing irritation and/or compression of the nerve roots branching off of the spinal cord that innervate the back and lower legs, resulting in pain, tingling, numbness, weakness, and abnormal sensation/reflexes. A study published in the April 2015 edition of Annals of Internal Medicine states that Lumbar Stenosis can be treated just as successfully with physical therapy as with surgery, and with 15 percent fewer complications.
Degenerative Disc Disease (DDD): The thinning of the intervertebral discs, located between each of the spinal segments that act as shock absorbers, affecting 3 million people per year. A 2013 study conducted at Thomas Jefferson University Hospital found that patients who pursued surgical intervention to treat DDD did not experience greater relief in pain/disability, or improved health status, as compared with individuals who opted for physical therapy.
“A well-trained, licensed physical therapist can often effectively treat low-back pain conservatively via manual therapy, progressive functional mobility and/or stability training, cardiorespiratory conditioning, and education on appropriate activity level modification per a patient’s presenting symptoms.” said Dr. Raghunath. “If you or someone you know is experiencing acute or chronic low-back pain, a visit with an experienced physical therapist can lead to restored optimal spine function and get you back on the path to optimal health and happiness.”