healthy person woman sport

Manage Back Pain in Four Easy Steps

This article was originally published on March 4, 2013. In an effort to provide the best possible information to our patients and web visitors, we’ve spruced up the article with a few updates regarding how to manage back pain. This article was updated on January 17, 2016.

We know that experiencing chronic back pain can be the worst thing imaginable. However, here are a few simple steps you can take to help manage back pain, whether you’re experiencing a flare-up or your typical daily pain.

  1. Control inflammation:  Avoid heat if you’re flared-up.  You can apply an ice pack over a painful area for 20 minutes, several times/day. For a homemade solution, you can make an ice pack with 5 parts water to 1 part rubbing alcohol in a zip lock bag, then place it in your freezer. For daily pain, moist heat can be helpful with relaxing tight muscles.  A hot water bottle or towel soaked in hot water are preferred over heating pads to minimize the risk of skin burns.
  2. Keep moving!  In general, bed rest should be avoided in order to maximize blood flow and maintain your mobility.  Try to perform your normal daily activities if you can.
  3. Stretch the affected muscles gently (without increasing pain) 2 – 3x/day, followed by icing the aching muscles. Just like doing your daily activities, stretching will help you maintain mobility.
  4. Breath!  Both an effective relaxation and pain management technique, therapeutic breathing helps to relax tight muscles and reduce stress, and as a result, decrease pain.

Manage back pain with a deep breathing technique

Step 1:  Lie down or relax in a chair.  Place one hand over your belly, which you should feel rise and fall during each breath (avoid breathing with your chest).  Breathe in 4 seconds through your nose, and out 4 seconds through pursed lips.

Step 2:  Practice this technique when stretching to make them more effective by helping to relax tight muscles.

Step 3:  Use this technique when experiencing increased pain for better pain management.


Did these tips help? Do you have anything to add? If so, send us a tweet at @PDRClinics. We’d love to hear from you!

Book Focus Text Dictionary

Focus on Function: Our Treatment Philosophy

This article is a revised version of a post published on January 07, 2013. We have updated the article so that it is easier to read for most web visitors. This article was updated on January 16, 2017.

We believe that if we focus on pain and structure alone, patients suffering from chronic back pain are led down the wrong road, often leading to unnecessary treatment with little improvement in outcomes.  Reducing the surgical incidence of low back pain, and being the leader in non-surgical treatment of low back pain is PDR Clinics’ vision. The primary goal of our treatment approach is to restore a patient’s function so that they may avoid costly surgical interventions, ongoing use of medications, and continued use of medical services. To do this, our focus is on functional restoration both of the spine and of the whole body.

Our Focus on the Pain Cycle

When a person experiences low back or neck pain, the natural response is muscle guarding and compensation.  An initial “disc injury or back strain” becomes a widespread neuromuscular problem. This leads to more problems and more pain. Altered muscle activity leads to systemic and predictable patterns of muscle and postural imbalance. Persistent imbalance to the motor system creates tissue changes, particularly inhibition and atrophy of the supporting multifidus and transverse abdominus musculature, and chronic spasm and tightness of other muscle groups such as the psoas or piriformis. Connective tissue fibrosis also results from abnormal movement, leading to more pain and dysfunction. Weakness and decreased range of motion change joint mechanics and place abnormal stress to the spinal segments.  As a result, more pain and inflammation ensue. [i][ii][iii][iv][v]

Our Focus on the Recycle Cycle

For recovery to occur, the treatment must focus on both spinal function and whole body function. In the recovery or treatment cycle, we introduce isolated MedX exercise to focus on improving the mobility (range of motion), stability, and strength of the spine (spinal function). The MedX exercise literature demonstrates superior isolation in strengthening the supporting spinal muscles and discourages the typical compensatory movement patterns. [vi][vii][viii] Research has clearly demonstrated patients with low back pain develop wasting of the multifudus muscles of the spine which correlates with onset of low back pain. [ix] Furthermore, the muscle wasting occurs early and does not reverse automatically, even when symptoms resolve. [x] Isolation and strengthening of the multifidus and related spinal muscles with MedX equipment results in improved spinal function and a reduction in pain and future episodes of low back pain. Concurrently, we begin to progress around the treatment cycle with home based activities and patient education. Mobility, stability, and strength activities are introduced along a progression, based upon concepts of lumbar stabilization. [xi][xii][xiii] Training the patient in stretching, core initiation and progression into trunk stabilization and strength is a key to regaining normalized motor patterns. PDR’s training and education in protective and proper body mechanics with movement helps restore whole body function.


[i] Langeven H, Sherman K.  Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms.  Medical Hypotheses 2007: 68: 74-80.
[ii] Kader DF, Wardlaw D, Smith FW.  Correlation between the MRI changes in the lumbar multifidus muscles and leg pain.  Clinical Radiology 2000: 55: 145-149.
[iii] Danneels, L, Vanderstraeten G, Cambier D.  CT imaging of trunk muscles in chronic low back pain patients and healthy control subjects.  Eur Spine J 2000: 9: 266-272.
[iv] Kjaer, P, Bendix T, Sorensen J, et al.  Are MRI-defined fat infiltrations in the multifidus muscles associated with low back pain?  2007.
[v] Flicker,et. al. Lumbar muscle usage in chronic low back pain.  Magnetic resonance image evaluation. Spine. 1993 Apr;18(5):582-6.
[vi] Graves J, Webb D, Pollock M, et al.  Pelvic stabilization during resistance training:  Its effect on the development of lumbar extension strength.  Arch Phys Med Rehabilitation 1994: 75: 210-215.
[vii] Carpenter D, Graves J, Pollack M, et al.  Effect of 12 and 20 weeks of resistance training on lumbar extension torque production.  Physical Therapy 1991: 71: 580-587.
[viii] Russel G, Highland T, Dreisinger T, Vie L.  Changes in isometric strength and range of motion of the isolated lumbar spine following eight weeks of clinical rehabilitation.  Presented at the North American Spine Society Annual Meeting,Monterey,CA, 1990.
[ix] Kamas et. Al.  CT measurement of trunk muscle area in patients with chronic LBP. Diag Interv Radiol. 2007 Sep;13(3):144-8.
[x] Hides, J. , Richardson, C, Jull G.  Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain.  Spine 1996: 21: 2763-2769.
[xi] Richardson C, Hides J, Hodges P.  2004.  Therapeutic Exercise for Lumbopelvic Stabilization:  A Motor Approach for the Treatment and Prevention of Low Back Pain.  Elsevier Science Health Science
[xii] O’Sullivan et al. 1997. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine 22:2559-2976
[xiii] Risch et al. 1993. Lumbar strengthening in chronic low back pain patients. Physiologic and psychologic benefits. Spine 18:232-238

Christmas Holiday Cookies Gingerbread

Managing Stress This Holiday Season

With the holiday season fast approaching, you need to learn how to positively deal with your holiday stress. Why? Keep reading to learn more.

The nervous system’s response to stress is commonly called the “fight or flight” response. This response is a heightened activation of the sympathetic nervous system (SNS) which is responsible for getting the body ready for survival. When stressed, our heart rate and blood pressure rises, our pupils enlarge, and our muscles tense.

When the body relaxes, the heart rate and blood pressure reduces, muscles unwind, and our breath deepens. In a state of relaxation, our nerves quiet, more oxygen is exchanged in the body, and the sensation of pain is reduced.

Prolonged physical and mental stress can contribute to headaches, nausea, fatigue, nervousness, indecision, and poor job performance. Emotional stress can contribute to increased muscle contraction, leading to weakness and fatigue. Under intense stress, muscles may become tight, inelastic and prone to injury and pain.

Stress management becomes a very important piece to daily life and pain management.  Here are some tips to help manage your holiday stress:

Stress Management Tips:

  • Identify and acknowledge the factors that may be causing stress in your life.
  • Prioritize your activities and commitments.
  • Set attainable goals.
  • Schedule time for yourself and enjoy a relaxing activity.
  • Maintain good nutrition. Avoid high levels of caffeine and sugars.
  • Use relaxation techniques to reduce the negative effects of stress and allow recuperation.
  • Use the three natural tranquilizers– music, laughter, and exercise. Research has shown that people who exercise regularly are more emotionally stable, less tense, and more creative.
  • Practice deep breathing using your diaphragm (belly) versus using your chest to breathe. Combine deep belly breathing while you exercise and stretch a few times a day.

With all this said, PDR Clinics wishes you and your family a happy holidays! We look forward to serving you and your family during another exciting holiday season.