![]() However, most patients do not need imaging at their first visit.Īfter the exam, we have a discussion: “This is what I think is happening with your spine, these are the treatments I would recommend, and this is how I think it will help you.” Since I’m part of a team, if I think a patient will get additional benefit or more benefit from seeing a physical therapist, physiatrist, spine surgeon, or other provider, I will also suggest that referral. If you haven’t had X-rays or other imaging and we need to order it, we can do that. ![]() For example, I’ll look at alignment, muscle tone, nerve function, how your body is moving, how well you can bend, turn, twist, and what kind of movements reproduce the symptoms you’re having. Then I’m going to perform an exam that assesses both the medical and mechanical aspects of your pain. This includes if you have images - MRIs, X-rays - or blood work. If your information is in Duke M圜hart, I’m going to read it beforehand. I first gather a lot of information about you by asking questions: how your pain began, what is the effect on your pain when you do this or that, what your level of pain is, and any other symptoms you may have. These bones are connected at the back with specialized joints. It won’t be a lot different from what you’re used to with other medical providers. Your lower back contains 5 vertebral bones stacked above each other with intervertebral discs in between. Our goals focus largely on returning people to the activities that are important in their lives, whether those are job-related, family or socially oriented, or recreational in nature. So, teaching patients how to think about pain is important. Pain scientists have found that anticipation of pain can lead to more episodes, more muscle spasms, more headaches, and so forth. Often, I’m trying to help patients by encouraging them: “Yes, you can do this,” or “When something like this happens, try to do this instead of that.” That way, they’re not anticipating pain and causing more pain and more muscle spasms. I look at your ergonomics: What do you do for work? How do you bend, turn, lift? Do you ride in a car all day? Do you sit in front of a computer? I try to understand what may be contributing to the pain or other symptoms you may be experiencing. We talk about flexibility we talk about strength-building we talk about balance. Research shows that there’s a correlation between pain and sleep, so it makes sense to incorporate simple changes in your sleep style that alleviate back pain - and less pain means better sleep.I spend about 20 to 25% of my time talking with and listening to my patients. “Sleeping on your stomach also forces you to turn your neck, which can cause neck and upper back pain.” “This position puts the most pressure on your spine’s muscles and joints because it flattens the natural curve of your spine,” he says. Hah, MD, a spine surgeon at Keck Medicine of USC and assistant professor of clinical orthopedic surgery at the Keck School of Medicine of USC. Sleeping on your stomach is the worst position for your spine, according to Raymond J. The worst sleep position: On your stomach If you’re pregnant, it’s a comfortable way to take the weight from your back. Try straightening your body into a relaxed position by untucking your chin and adjusting your knees. Known as the fetal position, it may be the most popular sleep style, but it promotes an uneven distribution of weight that can cause back pain and sore joints. If you can, stretch your legs out straight and tuck a pillow between your knees to keep your spine in a neutral alignment.Īnother type of side sleeping - with your legs bent upwards - is less ideal for your back. It’s also a good position for snorers or anyone with sleep apnea because it keeps your airways open. ![]() Side sleeping with your legs straight is the second-best position for avoiding back and neck pain. If you’re pregnant, however, you should avoid this position because it decreases blood circulation to the heart and baby. For optimal spine alignment, place one pillow underneath your head or neck and another underneath your knees. Even so, many people find it the hardest way to enjoy deep sleep. The best position to avoid back pain is lying flat on your back. So which sleep positions should you embrace and which should you avoid? Here’s a rundown, from best to worst. It also helps to sleep on a firm surface. The key is alignment: When you sleep with your spine in a neutral position, it reduces the strain on your back and neck. If you’ve ever woken up with a tingling arm or achy neck, you’ve experienced the negative effects of sleeping in the wrong position. Do you have neck or back pain? Your sleep style may be contributing.
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