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Take Control of Your Flare-Ups: Part One

This article is part of a two-part series. You are currently reading part one. When you’re done, check out Take Control of Your Flare-Ups: Part Two. It’s just a click away!

There are two main objectives when treating a back or neck pain flare-up:

  • Control Inflammation
  • Maintain ROM (range of motion)

Inflammation comes out of the bloodstream or from damaged tissue. It is the body’s universal response to injury.  If you cut, bruise, burn, sprain or strain yourself the blood vessel pores will dilate and allow fluid to spill out around the injured area. The inflammatory response must be controlled after a back or neck strain. Ice packs control inflammation by constricting blood vessel pores. Heat increases inflammation by dilating blood vessel pores. DO NOT apply hot packs or electric heating pads to a flared up area.  Ice packs should be applied to the injured area for 15 – 20 minutes 4-5 times per day.  Be sure that two of those times are morning and evening (before bedtime).  Leave at least 40 minutes between ice pack treatments. Do not stay in bed if you can tolerate the upright position. Anti-inflammatory medicine can be helpful if allowed by your doctor.

During your recovery period it is important to maintain your ROM. Gentle stretching exercises 2-3 times per day are recommended. You might not be able to stretch as far as you could prior to your flare-up so modify your stretches so that you do not increase your pain level. If you are unable to stretch without increasing pain do the following each time you apply an ice pack:

  • For LOW BACK PAIN –  do 5 repetitions of the pelvic tilt.  Hold for 1-2 seconds.  Make the tilt small enough that it does not increase pain.
  • For NECK PAIN – do 5 slow repetitions of cervical rotation while lying down.  Avoid pain at end range.

Add in your stretch routine and cardio exercise as tolerated.  Postpone your strengthening until the flare-up is resolved.  You might have to decrease repetitions and/or weight when strengthening is resumed.  A flare-up should be under control within three days. You may not be back to 100% but you should start to feel better.  If this is not the case you should consult your rehab therapist or your doctor.

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Eat Well, Hurt Less: Chronic Inflammation

Chronic inflammation is at the root of many health problems, including chronic pain. Eating certain foods can actually promote more inflammation and directly affect your stress and healing within your body. This can ultimately cause more pain, overeating, redness and swelling. However, good food choices can be a helpful way to decrease inflammation.

Below are some considerations for using food to your benefit in decreasing inflammation and supporting your immune system:

Limit flour and sugar

This type of food causes a sudden rise in blood sugar which increases insulin. When insulin is high you increase the pro- inflammatory cells and your immune system fatigues. Sometimes labels are confusing, so watch for these hidden sugars in your foods.

List of words meaning “added sugar: brown sugar,corn syrup, corn sweetener, raw sugar, dextrose, fructose, fruit juice concentrate, syrup, honey, invert sugar, maltose, maltodextrin, malt syrup, molasses, sucrose, sugar, white grape juice, lactose, high fructose corn syrup

Consider allergies or other sensitivities

Foods that you are allergic or sensitive to cause higher insulin levels which increases the stress hormone. Your body holds onto the fat and does not allow it to break down. Food allergies also cause the release of histamine, causing the redness and swelling associated with inflammation.

Additives in foods that may cause allergic reactions or other problems include: artificial coloring, Yellow 5, aspartame, MSG (monosodium glutamate), sulfites, casein, sodium bisulfite, aspartame (NutraSweet).

Avoid the intake of trans-fats

Eating foods with trans-fats does not allow the anti-inflammatory action in our cells to take place.

  • Try to avoid refined trans-fat, omega-6 oil in cooking and use more olive oil.  These oils are predominant in processed foods made from grains (crackers, cereals, etc) and include: soy, corn, peanut, sunflower, cottonseed
  • Minimize intake of red meats that promote inflammation including beef, pork and lamb
  • Eliminate processed and refined foods as much as possible

Eat more foods that decrease inflammation and support your immune system

There are plenty of foods may help with anti-inflammation. When looking at foods, keep the following in mind:

  • Eat a well balanced variety of wholesome foods
  • Eat only unsaturated fats
  • Eat good sources of omega-3 fatty acids daily: wild Alaskan salmon, canned sardines, mussels, striped sea bass, oysters, herring, black cod, Rainbow trout, albacore tuna, soy bean oil, canola oil, flax seeds, walnuts, grass-fed/free range meats
  • Eat whole grains.  The first ingredient on the list must say whole grain for it to be a good source
  • Eat lean protein: beans, chicken, turkey, wild game (bison, elk, etc.), fish
  • Eat plenty of fruits and vegetables

Foods that will help with the release of serotonin, a hormone that helps regulate and control activity of cells and organs: whole grains (brown rice, oatmeal, buckwheat, wild rice, whole grain breads and pastas), nuts (almonds, walnuts, pecans, pistachios, cashews, peanuts, peanut butter), high tryptophan protein (turkey, milk, cheese, cottage cheese, eggs), beans and legumes (soybeans, black beans, pinto beans, lima beans, lentils), seeds (pumpkin, sunflower, sesame, flax seeds), root vegetables (carrots, beets, potatoes, sweet potatoes, onions, turnips, squash), green, yellow, red and leafy vegetables and garlic.

Watch for foods with a high glycemic index

The glycemic index (GI) is a way to rank carbohydrate rich foods according to the blood glucose response following their intake. This reflects the rate of digestion and absorption. Foods with a higher GI will cause a rapid short-lived rise in blood glucose.

Examples of foods with their GI:

High: white bread, bagels, crackers, rice cakes, donuts, cookies, bacon, sausage, microwave popcorn

Moderate: sucrose, soft drinks, oats, tropical fruits (bananas and mangoes)

Low: fructose, milk, yogurt, lentils, pasta, cold climate fruits (apples and oranges)

Drink plenty of water

The Food and Nutrition Board recommends 2.7 liters (91 ounces) of water each day for women and 3.7 liters for men.  About 80% of this intake is from fluid and 20% from food.

Monitor your salt intake

The DASH (Dietary Approaches to Stop Hypertension) eating plan bases its diet on 2,400 milligrams of sodium per day and suggests further lowering salt intake to 1,500 milligrams per day (2,400 mg of sodium equals 6 gm or 1 teaspoon of table salt).

For lower sodium options: buy fresh, frozen, or canned with no-salt-added vegetables; choose low or reduced-sodium, or no-salt-added versions of foods and condiments when available; limit cured foods (such as bacon and ham), foods packed in brine (such as pickles, pickled vegetables, olives) and condiments (such as MSG, mustard, horseradish, ketchup and barbecue sauce); use spices instead of salt (herbs, spices, lemon, lime, vinegar or salt-free seasoning blends).

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What is Delayed Onset Muscle Soreness (DOMS)

Delayed Onset Muscle Soreness (DOMS) is a normal reaction to exercise or physical activity in which muscle soreness develops within 12- 48 hours after a strenuous activity.  The soreness is believed to be a result of microscopic tears in the muscle fibers, and associated swelling response.  This response is a part of the adaptation process, which allows the muscle to have more stamina and strength as it re-builds from the exercise load placed upon it.

It is important to realize that DOMS soreness does not mean that there is a muscle injury!  DOMS typically disappears within 48-72 hours, and is much less intense the more frequent the exercise routine is performed.

Some helpful advice

DOMS symptoms have been shown to be less intense in some individuals that follow this advice:

Warm Up – Start with a few stretches targeting the area of the body you will be working.  For example: Playing Tennis? Stretch legs, back and arms, Going Biking? Stretch legs and lower back.  Also do some “dynamic stretches” which mimic the movements you’re about to do.  For example: Going Jogging? Start by walking briskly for a few minutes.  Going Golfing? Start by holding a light hand weight and rotating your upper body from side to side.

Cool Down – Slow down the activity you are doing for the last few minutes before you just stop.  Don’t just sit or lie down, but continue to move by walking around a little, get a drink.  Don’t forget to stretch!  Stretching will help loosen up the muscles you just worked out, and help you get ready for your next workout.

Ice – Exercising naturally causes an inflammation response.  Ice will decrease the temperature in the area, and help decrease the inflammation.  Icing 10-20 minutes is plenty, and it can be done as needed throughout the day.

Massage – If you have the time and money, booking a massage will help the aching muscles.  A massage therapist can help work the toxins out of the sore muscles, and help them to relax.  Don’t have the time or money for a professional massage, try rubbing the area yourself.

Don’t Stop Moving – If the pain isn’t too bad do some light exercise, you can work the same muscles just use lighter weights, less reps, or less intensity.  Sitting or lying down for too long will just cause the sore muscles to stiffen up even more.