Sunday, December 31, 2006 

Lower back pain|Tensor fascia lata

Lower back pain is most commnely caused by L5 nerve root irritation and tensor fascia lata has very strong L5 nerve root representations in it.

 This muscle arises from the the pelvic bone in the region called the iliac crest.  It inserts into the iliotibial tract.  It is supplied by the superior gluteal nerve which carries predominantly L5 spinal nerve fibers (and also L4 nerve root fibers) into this muscle.  Its action is to bend the thigh upwards (hip flexion), roll the thigh inward (internal rotation) and to spread the thigh away from the midline (abduction).  It also assists in straightening the knee. 

This muscle becomes very prone to injury since it is chronically stretched while we are sitting since both the hip and knees are bent.  Since the L5 nerve root is very easily injured or irritated from presence of degenerative arthritis of the spine, slipped disc, bulging disc, the tensor fascia lata often has underlying neurogenic weakness. 

When the patient complains of pain and spasm in the lateral aspect of the thigh, often the diagnosis entertained is that of irritation of the lateral femoral cutaneous nerve of the thigh known as meralgia paresthetica.  More important is to consider is the common situation of L5 nerve root irritation with pain and spasm in the tensor fascia lata muscle.

Tensor fascia lata has similar functions to that of the rectus femoris which is part of the quadriceps muscle.  Pain and spasm with weakness of these two muscles will lead to overaction of the hamstrings at the knee.  This is the chief cause of inability to straighten the knee while performing the straight leg raising testing.

In treating lower back pain, in addition to treating the entire spine muscles, treatments must always include the gluteus maximus, adductor magnus, tensor fascia lata and rectus femoris muscles due to their prime role in being subjected to injurious lengthening contractions on a daily basis.

© 2007 copyright www.stopmusclepain.com lower back pain

Tags: lower body topics
Categories: Lower Body Topics
No Comments »

Saturday, December 30, 2006 

Lower back|hip|and groin pain: The role of adductor magnus

In treating lower back pain, hip pain and groin pain, all muscles that cross the hip and groin region have to be considered.  The muscles that are most responsible for the hip pain and groin pain are the large muscles that are subjected to lengthening contractions and those which cross multiple joints.  Adductor magnus muscle is a large muscle subjected to constant lengthening contractions and although it does not cross multiple joints, it helps the function of the gluteus maximus and tensor fascia lata and thus comes one of the most important muscles to be treated for hip pain and groin pain.

The name "magnus" in adductor magnus signifies that this a large muscle like the gluteus maximus.  This is thus the other huge muscle supplied by the spinal nerve roots from the lower back.  The adductor magnus has nerve root fibers from L2 to S3 nerve roots. It is supplied by two peripheral nerves, the obturator nerve and the sciatic nerve.  The obturator portion supplies the L2-L4 nerve roots and the sciatic portion supplies the L4-S3 nerve roots to the muscle. 

Adductor magnus muscle arises from the ischial tuberosity and the adjacent parts of the ischial and pubic bones.   The ischial tuberosity bone is underneath the gluteus maximus and is the bone of the pelvis upon which you sit. The muscle inserts into the inner aspect of the thigh bone stretching from the hip to just above the knee. 

There are 2 parts to this muscle.  The upper part’s function is to bring the thigh toward the midline (adduction).  It also assist in bending the hip up (flexion) and to roll the thigh inward (internal rotation) and thus helps the tensor fascia lata in its capacity to perform hip flexion and internal rotation. The lower part together with the gluteus maximus brings the thigh backward (extension) and rolls it outward (external rotation). 

Since the lower spinal nerve roots, especially the L5 and S1 roots are commonly injured or irritated from presence of degenerative arthritis of the spine, slipped disc, bulging disc etc., the lower part of adductor magnus is commonly weaker than the upper part. Those of us who have sedentary life-styles sitting and working all day long, creates a condition for shortening and tightening of the upper fibers of the adductor magnus which assist in flexion and adduction.  Simultaneously, the sitting position causes a lengthening contraction of the lower part of this muscle causing overstretching and weakening these fibers. 

Due to the tight and shortened muscles that bend the thigh upward (hip flexors) from habitual sitting, all the muscles that bring the thigh backward (hip extensors) such as gluteus maximus, adductor magnus and hamstring muscles become prone to injury.  Any motion that involves a sudden forceful contraction of these muscles, such as in a fall or a car accident will cause significant injury since these muscles as well as the nerve roots supplying these muscles are vulnerable to trauma. 

In all cases of nerve related muscular groin pain, there is excessive contraction of the hip flexor muscles in the presence of weakness of the hip extensor muscles.  Treatment of groin pain must first start with relaxing the spasm within the spine extensors and hip extensors by using massage or electrical stimulation.  The treatment of choice is motor point stimulation using eToims Twitch Relief Method. 

Reduction of spasm within the spine and hip extensor muscles will allow return of effective length for these muscles to contract efficiently.   As the spine and hip extensor muscles become stronger, the hip flexor muscles are no longer contracting unopposed and the hip pain and groin pain treatment can then be directed to the hip flexor muscles such as tensor fascia lata, rectus femoris, and the upper part of the adductor magnus muscles.   

Please also refer to the blog posted on 12/13/06 concerning the see-saw principle of muscle action.

© 2007 copyright www.stopmusclepain.com Lower back pain|hip pain|groin pain

Tags: lower body topics
Categories: Lower Body Topics
No Comments »

Friday, December 29, 2006 

In treating lower back pain, mid back and neck pain, the gluteus maximus muscle must be routinely included.  

Anantomy: This muscle arises from the iliac bone, sacrum and tailbone (coccyx). It also has attachments to the thoracolumbar fascia into which the latissimus dorsi and trapezius muscles are also attached. Gluteus maximus inserts into the thigh bone and the thick fascia at the side of the thigh known as the iliotibial tract. 

On its contraction, the thigh moves backward (extension).  It is also used for bringing the thighs together (adduction) and in rolling the thigh outward (external rotation).  It is responsible for keeping the spine erect.  Its contraction is necessary to return to the erect position from a crouched or squat position. 

Gluteus maximus is used (actually over used) daily in stabilizing or lengthening contractions.  During ambulation, as the heel strikes the ground, this muscle must undergo a lengthening contraction to stabilize the hip.  Weakness in this muscle causes the hip to collapse making the person fall forward.  Therefore, patients who have severe weakness of this muscle tend to keep the head and spine backward so that the weight line can fall behind the hip as they walk.  This characteristic gait is called the lordotic gait. 

When a person is sitting, this muscle is stretched due to having to contract in a lengthening contraction.  Since lengthening contractions are injurious to the muscle, gluteus maximus is usually weak in most people. 

Nerve related weakness in this muscle occurs easily since this muscle is supplied by the S1 nerve root which is commonly injured or irritated from presence of degenerative arthritis of the spine, slipped disc, bulging disc etc. S1 nerve root irritation compounded by spasm leading to tightening and shortening of the gluteus maximus can give rise to symptoms of pain, tingling and numbness from compressing the sciatic nerve (sciatica). 

Sciatic nerve irritation from pyriformis syndrome is very rare.  Usually, the sciatica symptoms are due to tightening and shortening of the gluteus maximus which pushes on the if pyriformis muscle to press on the sciatic nerve. 

Pain and weakness in the gluteus maximus will aggravate low back pain.  Symptoms of pain in the sacroiliac joint region is primarily due to S1 nerve root irritation causing pain and spasm in the gluteus maximus muscle. 

Treatment of neck, mid back pain and pain in the upper and lower limbs is never complete without treating the gluteus maximus due to the connections through the thoracolumbar fascia. 

To relax the gluteus maximus, massage regularly by pounding this muscle or using an electric massager. 

To strengthen the gluteus maximus muscle for patients with chronic pain, the exercises include pelvic tilt and bridging exercises.  Patients can also perform pelvic tilt exercises while walking, sitting or standing.  Partial squats by bending the knees for about 30° and returning to the erect position while keeping the spine straight and supported against a wall can be performed. 

Since the gluteus maximus is rarely used in shortening contractions, the principle is to help this muscle contract actively.  Training to walk backwards while holding onto a railing or a wall is also necessary for getting this muscle to actively contract.  The most efficient way to selectively activate this muscle is to perform motor point stimulation choosing eToims Twitch Relief Method.    

© 2007 copyright www.stopmusclepain.com Neck pain|lower back pain  

Tags: lower body topics
Categories: Lower Body Topics
No Comments »

Thursday, December 28, 2006

Aerobic exercise|chronic pain

Aerobic exercise is commonly performed through pain since commonly people subscribe to the notion that "no pain is no gain. 

In nerve related muscle pain, however, the major component of pain is secondary to lack of blood supply to the muscles and nerves.  This arises because the muscles have become very tight and shortened secondary to spinal nerve root irritation from sudden onset or slow insidious trauma.  The tight muscles press upon the intramuscular nerves and blood vessels. These tissues are very pain sensitive and in the presence of poor blood supply to these tissues as well as muscle, pain results.  Additionally, the tight and shortened muscles can have a traction effect on the bones and joints creating more pain. 

When one performs aerobic exercises in the presence of chronic pain due to tight muscles, the muscles shorten even more causing further compression on the intramuscular nerves and blood vessels.  This leads to more pain since the contraction of muscle utilizes energy which in normal situations is supported by an increase in blood flow to the muscle but this mechanism is unsupported in patients with chronic pain.  The supply of blood continues to be poor while the demand for more blood is increased.  The exercise also produces pain provoking waste products that need to be washed out but their stagnation causes congestion leading to more pain.   Additionally, the increase in tightness of the muscles will have a further traction effect on the pain sensitive bones and joints and the pain becomes magnified. Further nerve damage will also add on to the pain.

Many patients state feeling better during the aerobic exercise or stretch exercise. This may be due to the release of morphine like neurochemicals called endorphins from the brain and spinal cord which have pain relieving effects.  However, the pain increases over the next day or two. Although they feel worse after the exercise, patients feel compelled to continue with daily exercise even though they have more pain.  They do not see the direct connection between exercise and the increase in pain since during exercise they may feel better.   

Often, chronic pain patients also perform aerobic exercise in pain believing the "no pain no gain" model.  This is an inappropriate model for patients to follow.  Patients who have pain must stop immediately when they feel their muscles tighten, allowing the muscles to rest.  

Patients should exercise and rest for an equal amount of time that they exercised, for example, if they exercised for five minutes, they must rest for five minutes.  They can do this type of of exercise multiple times during the day rather than one long period of exercise for 30 minutes.  The duration of exercise is best determined by the time of onset of the exercise to onset of discomfort rather than to increase in pain.  The duration of rest is determined by the time taken for the pain to dissipate.  This pattern of exercise will help prevent the underlying pain from getting worse.

© 2007 copyright www.stopmusclepain.com Aerobic exercise|chronic pain

Tags: pain
Categories: Pain
No Comments »

Wednesday, December 27, 2006 

Rear-ended car accidents are common and the incidence of whiplash injuries is in the range of one million annually in the United States¹.  Due to the backward movement of the head upon the neck followed by a forward movement of the head, a whiplash injury often results in nerve related myofascial pain.

Patients may suffer from neck, mid-back, and lower back pain and pain down the upper and lower limbs in various combinations.  Often, these patients with whiplash injuries sure to car accidents and other trauma also suffer from muscle contraction headaches, temporomandibular joint pain and a clicking noise in the jaw joint with jaw movements, dizziness, unsteadiness, tingling and numbness and coldness in the fingers.  Patients can also suffer from post-traumatic fibromyalgia resulting in total body pain. Soft tissue trauma to the neck can result in an increased incidence of fibromyalgia compared with other injuries. There may also be a post-concussion syndrome leading to memory deficits and concentration problems.

Although symptoms may dissipate within three months of the car accident, 30% of the patients may continue with chronic neck symptoms and 10% of the patients may have chronic headaches.  6% of the patients may not be able to return to work even after one year post car accident.   

Although patients may complain of pain predominantly on one side, careful neuromusculoskeletal examination will reveal tenderness in many muscles on both sides of the spine, and in both upper and lower limbs with accompanied restriction in range of motion in many joints.  Sluggish tendon reflexes may be present. 

The most motion in a whiplash injury from a car accident occurs at the C5-C6 vertebra level following 5g acceleration but force is also distributed to the C4-C5 to C7-T1 levels depending on the intensity of acceleration².  Cervical spine x-rays may show straightening of the cervical spine due to paraspinal spasm.  CAT scan and MRI scan are often performed to rule out presence of herniated cervical disk and nerve root impingement.  Commonly the facet joints are involved.  These tests may be normal since in a whiplash, the injury is to multiple level bilateral spinal nerve roots. 

The nerve roots in trauma induced whiplash injuries become irritated from being stretched, distorted, kinked or transiently compressed against bone either at the level of the disc or more outward away from the center of the spinal canal in the region of the foramen through where the nerve roots exit.  Whiplash type injuries of the nerve roots can occur also with falls, sudden recoil type movements from lifting injuries or with any sudden jerky and forceful movements to the head, neck and lower back.

Quantitative electrodiagnostic studies which reveal the extent of the nerve damage is most useful for determining the outcome for recovery. The prognosis for recovery is dependent on the number and extent of nerve roots involved, presence of nerve root impingement, age of the patient, associated degree of underlying degenerative spine disease, multiplicity and diffuseness of symptoms and the initial high pain levels on presentation, etc. These nerve related factors are more important than the speed or severity of collision or the extent of damage to the vehicle but these factors do contribute to the amount of nerve damage induced. 

Routine treatments include physical therapy with use of cold modalities in the acute condition and heat modalities such as hot packs after the first 24-48 hours.  Medications will include anti-inflammatory medications, pain pills and muscle relaxants.  Mobilization of the tissues using massage, TENS unit and gentle active range of motion can be useful.  If cervical collars are used, the narrow portion of the collar must be kept in the front.  As a general principle, the use of the cervical collar should be limited to two hours on and two hours off.  A good cervical pillow that supports the neck well during sleep is essential.  Patients must lie on their back to sleep.  They must not sleep on their sides or on the abdomen. They must not place pressure on their arms and must avoid sleeping with their arms under the pillow or head.

Acute nerve related muscle pain is most responsive to eToims Twitch Relief Method with treatment directed towards muscles supplied C2 through C8 nerve roots with emphasis on muscles supplied by the C6 and C7 nerve roots and the trapezius muscles supplied by the C4 nerve root.  The entire spine from neck to the lower back needs to be treated.  After controlling the neck pain, treatments also have to be directed to the muscles supplied by the lumbosacral nerve roots.    

1. Evans RW. Some observations on whiplash injuries. Neurologic Clinics.        10(4):975-97, 1992 Nov.

2. Ito S. Ivancic PC. Panjabi MM. Cunningham BW. Soft tissue injury threshold during simulated whiplash: a biomechanical investigation. Spine. 29(9):979-87, 2004

© 2007 copyright www.stopmusclepain.com car accidents

Tags: upper body topics
Categories: Upper Body Topics
No Comments »

Tuesday, December 26, 2006 

Neck pain may not be the obvious complants but you will often many people you know, including strangers, stretching their neck from side to side to relieve tightness in the neck and to ease neck muscle tension. 

In fact, you may already be one of those people doing the neck stretches since a lot of people feel some neck tightness and stiffness.  You may be doing it frequently and you may have noticed some feeling of relief when you hear a popping noise or click in the neck.  This noise may come from a displaced tendon or a myofascial band or ligament that moved back in place abruptly when the joint is stretched.  As the neck is stretched, the joint capsules may also be stretched making more room for displacement and escape of gases in the joint fluid known as synovial fluid.  This fluid is a joint lubricant and has nutrients and dissolved gases such as oxygen, carbon dioxide and nitrogen.  When the gases escape from the fluid, a popping noise may result.

It is however important that the click or popping noise in the neck, should result easily from a slow smooth stretch.  Do not perform rapid stretches or forceful stretches or maniplulate yourself just to hear that click or pop since you can get injured. 

When you are performing passive self-stretching exercises or when someone else is helping you to perform a stretch, there is more force transmitted to the muscle.  There is the chance that you can over-stretch the soft tissues that are stretchable and still not have enough stretch force penetration to relax tight areas which may be deep inside the muscle.

The muscles that are most responsible for neck tightness are the trapezius, splenius capitis and cervicis, sternocleidomastoid and levator scapulae muscles.

Trapezius, splenius capitis and cervicis: When these muscles are tight without pain, the person will have difficulty with neck bending and looking down since these muscles are involuntarily stretched.  When these muscles are in pain, the person will have difficulty looking up since these muscles have to actively contract.  Therefore to stretch these muscles, the person should bend the neck and chin down.  To actively contract these muscles, the person should bend the neck backward and point the chin up.

Sternocleidomastoid: This muscle is responsible for head and face rotation to the opposite side.  Therefore, if the left sternocleidomastoid muscle is in pain, the person will have difficulty looking to the right since its contraction brings on pain. If the left sternocleidomastoid muscle is chronically tight and shortened, the head will be tilted to the left with the chin pointing to the right.  You will be able to see the taut, cord-like sternocleidomastoid muscle at the outer part of the front of the neck. The splenius cervicis and capitis muscles also have weak capacity to rotate the head to the same side.

The sternocleidomastoid muscle is also responsible for bending the head and neck down.  Therefore when this muscle is in pain, the person will have difficulty looking down due to active contraction of the muscle.  If the muscle is tight, the person will have difficulty looking up due to involuntary stretching of the muscle. 

Splenius cervicis and capitis and the levator scapulae muscles: Inclining the head to one side is performed by these muscles.  If these muscles on the left side are tight, they will have difficulty with inclining the head to the left and the person will usually incline the head to the right to stretch these muscles.  Difficulty inclining the head to the left can also be related to pain in the right trapezius, right sternocleidomastoid and right levator scapulae muscles. 

Since the trapezius, splenius capitis and cervicis are the muscles commonly injured due to the constant lengthening contraction imposed on them daily, head movements are mainly controlled by pain or tightness in these muscles.To relieve the pain or tightness in the neck muscles, the treatment should be directed toward the trapezius first since this is the largest muscle and spreads over multiple joints. 

The trapezius muscle is usually very tight and to get this muscle to relax, the treatments must include selective activation of individual muscles.  In treatments using eToims Twitch Relief Method, selective activation would be directed to the entire paraspinal muscles, latissimus dorsi and the gluteus maximus muscles.  Neck tightness usually will not get significantly better unless the mid back and the lower back muscles including the lower limb muscles are released of the tightness and spasm within these muscles.

© 2007 copyright www.stopmusclepain.com neck pain|tight muscles

Tags: upper body topics
Categories: Upper Body Topics
No Comments »

Monday, December 25, 2006 

Itching is an unpleasant sensation in the skin leading to the desire to scratch.  When localized, it creates a situation in which the person is always aware of an abnormal, predominantly irritating, itch sensation or discomfort in a particular area.  

 It is quite common for an animal with a sore to constantly lick the area of the sore to ease the discomfort.  Similarly the patient with a chronic localized itch is motivated to frequently or constantly scratch, touch, press, rub, or dig fingernails into that area to feel some relief.   

In a not uncommon condition known as Notalgia paresthetica, the itch is localized to the mid back at about the lower angle of the shoulder blade in the region between T2 to T6 dermatomes.  The characteristic symptom is itch on the back, occasionally accompanied by pain, tingling, and/or super-sensitivity, which results in a well-circumscribed darkened patch in the itch area.

Entrapment of the spinal sensory nerve roots due to degenerative spine conditions have been considered as the cause of the chronic itch¹. Skin biopsies had shown postinflammatory hyperpigmentation without amyloid deposits. Friction amyloidosis can arise with irritation from scratching. Some hereditary cases have been noted mainly in young patients, associated with multiple endocrine malignancy type 2A². The itch may be caused by activity in very small slowly conducting C nerve fibers. 

Treatments directed to benign chronic itch have consisted of physical therapy with ultrasound to the area involved, local application of capsaicin (a compound made from chili pepper), oral medications used in the control of seizures, low-frequency electrical stimulation, TENS (Transcutaneous Electrical Nerve Stimulation), acupuncture and dry muscle-needling methods.

Massage to the area of the itch and other related muscles along the spine and upper and lower limbs can help in relieving the itch.  

Massage to the area of the itch and other related muscles along the spine and upper and lower limbs can help in relieving the itch.  

The more powerful and effective way is to relax the muscle in the itch area through motor point (nerve-muscle meeting point) stimulation.  The goal of motor point stimulation with eToims (Electrical Twitch-Obtaining Intramuscular Stimulation) in the treatment of localized itching is to get the muscle to actively contract through stimulation of its nerve.  This contraction releases the local muscle spasms in the area of the itch.  The eToims treatment  must also locate and release muscle spasms in the entire spine from the neck to the base of the spine including the upper and lower limb power muscles. 

Many of these patients with chronic benign itch have associated cervical, thoracic and lumbosacral nerve root irritation related to aging.  As a result, they have tight and shortened muscles not only in the region of the itch but have restriction of range of motion of the neck, entire spine, upper and lower limb joints.  

The muscles which must be included in the eToims treatment are the (1) huge muscles, (2) muscles involved in lengthening or stabilizing contractions, and (3) muscles that cross two or more joints.  It is essential to include the prime mover muscles supplied by the neck, midback and lower back nerves even when the itch is local since the muscles are connected to each other through the myofascial tissue that covers them.  The muscles in the area of the itch which are usually secondary muscles in lifting activities will not get a chance to heal as long as they remain ischemic from being continued to be used as substitutes for the tight and shortened powerful prime mover muscles used in lifting.      

If the condition is long-standing, the itch cannot be cured since it is a nerve related situation.  Ongoing nerve degeneration is maintained and nerve regeneration is prevented by a self-perpetuating cycle of muscle spasms that continue to act as a vice to the intramuscular nerves and blood vessels. 

However when eToims treatments are maintained regularly, new nerve injury initiated by new muscle spasms even from activities of daily living can be immediately relaxed.  The twitch associated active exercise plus the internal stretch effect immediately releases the newly injured nerves.  Twitch Relief Method can thus achieve a cure at sites of new nerve injury and the associated increased blood flow can aid in the regeneration of chronic nerve injury.

1.       Savk O. Savk E. Investigation of spinal pathology in notalgia paresthetica. Journal of the American Academy of Dermatology. 52(6):1085-7, 2005 Jun.

2.       Rivollier C. Emy P. Armingaud P. Buzacoux J. Chadenas D. Legoux A. Esteve E. [Paresthetic notalgia and multiple endocrine neoplasia type 2a (Sipple's syndrome): 3 cases]. Annales de Dermatologie et de Venereologie. 126(6-7):522-4, 1999 Jun-Jul.

© 2007 copyright www.stopmusclepain.com twitch|itch

Tags: lower body topics, pain, upper body topics
Categories: Upper Body Topics, Lower Body Topics, Pain
No Comments »

Sunday, December 24, 2006 

Massage|stomach discomfort 

Tags: pain
Categories: Pain
No Comments »

Saturday, December 23, 2006  

As the weather gets cold and damp, many patients start complaining of more stiffness and tightness of the muscles.  They also state having more symptoms with increase in humidity. 

Commonly ice is used immediately and within 24 hours of an injury to prevent or reduce pain, inflammation and resultant swelling of soft tissues.  However, in patients with chronic nerve related muscle pain, the pain and swelling in the soft tissues is not related to inflammatory causes.  Therefore many patients with chronic pain will find that their muscle pain becomes worse on using ice. 

The swelling of the muscles in nerve related muscle pain is due to muscle shortening and tightness.  This muscle shortening acts as a vice-like effect to the intramuscular nerves and blood vessels and pain also arises from the traction effect of the shortened muscles on bones and joints.  Since these structures are very pain sensitive, suffering results. 

The muscle pain also arises from poor local blood flow to those areas where the muscle spasm is intense. The efficient way to increase blood flow to the painful areas related to muscle spasm is to move the muscles passively through massage, or actively through selective muscle contraction with eToims Twitch Relief Method.  These muscle movements produce an internal stretch of the muscles and encourage local blood flow.  The increase in blood flow brings warmth to the areas in spasm additionally helping the muscles to relax. 

Patients with chronic nerve related muscle pain will thus find it more useful to use heat rather than ice for pain relief.  Moist heat is preferable to better induce muscle relaxation.  Hot soaks, warm baths, warm whirlpools, warm showers are all useful.  While receiving moist heat, patients will also find it useful to massage the muscles since massage is more effective while the muscles are warm. 

Tags: pain
Categories: Pain
No Comments »

Friday, December 22, 2006 

Blues traveler|nerve muscle pain

Traveler blues can occur because traveling is indeed stressful due to performing unusual and excessive activities.  There is much lifting involved, sitting for long hours and active movements associated with performing leisure and recreational activities packed into a short vacation period.  You may be able to cut down on injuries with the helpful tips listed below to avoid the blues in the traveler.  These tips are useful for everybody, especially those who already have nerve related muscle pain.

1.  Luggage:

• Pack light.  Rather than bringing down steps a heavy suitcase, bring the clothes downstairs and pack downstairs. 
• Make sure that you alone can lift your luggage in preparation for the fact that there may be no one around to help you lift.
• Use both arms for lifting.
• Avoid putting anything slung across your shoulders for prolonged periods. 
• Carry bags close to your chest with elbows at the side of your trunk.
• Avoid overhead lifting.
• Do not plan to store your luggage in the overhead luggage storage area.  Injuries will occur from lifting and retrieving luggage stored in the overhead compartment.
• Check your luggage rather than planning to take luggage onto the plane.
• If planning to take luggage onto the airplane, the luggage should be able to fit under the seat.
• Change sides frequently on pulling luggage on wheels since it places a torque onto your spine.  This will prevent an uneven pull only on one side tiring the muscles only on that side making the muscles vulnerable to injury.
• It is better to push your luggage rather than pull it behind you.

1. Sitting

• Place an inflatable collar around your neck soon as you sit down.  You may fall asleep suddenly so it is best to prepare to have the neck supported.
• Avoid putting pressure on your elbows to prevent injury to the ulnar nerves.  Do not sit with the point of your elbows resting on the armrest for longer than 5-10 minutes at a stretch.  It is better to place the forearm on the armrest.  However, the best position is to have your hands on your lap.
• Do not cross your ankles or knees while sitting in order to avoid putting pressure on the peroneal nerve at the front of the ankle.  Instead perform ankle circles frequently for blood circulation.
• Avoid wearing knee-high hoses or tight socks.  This will prevent foot and ankle edema especially on long trips.
• Read with the book propped up on the tray table to avoid having to hold the book in your hands and tiring the muscles unnecessarily.
• Frequently lift your buttocks off the seat to prevent prolonged pressure on the sciatic nerves.
• Get up and walk frequently.
• Perform pelvic tilt exercises while sitting, standing or walking.
• Place a golf ball or even a small face-cream jar behind your back and lean into it to get a stretch massage effect.  Massage various places along the entire spine especially between the shoulder blades.

1. Sleeping

• Avoid sleeping using the hand to support your head with the elbow propped on the armrest. The last two digits of the hand will become numb from putting on pressure to the ulnar nerve at the elbow.  The hand can become weak with tingling in the first three digits from putting pressure on the median nerve at the wrist.
• Always have the chair reclined.
• Keep your feet elevated.  If there is no footrest place your feet on the luggage underneath the front seat.

  Medications:

Chronic pain patients have found it useful to take pain medications pre-emptively upon boarding the flight.

© 2007 copyright www.stopmusclepain.com blues traveler

Tags: pain
Categories: Pain
No Comments »