Millions of people suffer from back pain. Most of those people think there is little one can do about back pain other than ice it, take some muscle relaxers and maybe pop ibuprofen by the thousands. A significant number of them would probably be surprised to find out that their feet might be causing all the problems!

A short history of Podiatry.

A podiatrist must be licensed in the United States. And the license comes from the state in which they want to practice. This follows an education of about eight years. Four years of pre-medicine followed by a doctoral degree which is another four years. It’s a very difficult curriculum and it’s not uncommon for students to drop out throughout the four years. The 7 - 8 years must then be followed by 2 - 3 years of residency.

The Foot.

The foot is surprisingly delicate considering that some experts estimate that we walk the circumference of the earth throughout our life. That is a lot of steps and just 26 bones and 33 joints to take that repeated stress over your lifetime. For some people this turns out fine but for quite a few an injury of some sort causes a slight shift in the balance and gait of their walk. This tiny change in balance often throws the entire body out of balance.

That’s when we become susceptible to back strains. Our feet are shock absorbers and when they are not stepping correctly they lose their ability to distribute the shock our bodies produce with each step. Instead our weight becomes focused on one area of the foot and an imbalance happens. Any small change can trigger this. If a person develops a corn that becomes painful they will very often develop a change in their walk so there is less pain. This same change that lessens the pain now will often be the culprit in severe knee or back pain a few years later.

Podiatry has developed a way to discover these flaws in our step. They use a computer program that is hooked into a “board” that a patient walks across. Their weight is registered to an exact degree per square inch and then the program calculates what they need to do to correct it. The program will then design something that’s inserted into the shoe called an “orthotic” which is created precisely to counter all the ill effects your feet have suffered over the years. They put your feet back into balance.

An orthotic is surprisingly cheap and for some people it is simply a miracle. But since almost everybody that walks over a mile a day probably has some problems with the balance in their feet orthotics is a good idea for everyone. They decrease that worn feeling a person feels after walking all day and coupled with a great walkinp>Millions of people suffer from back pain. Most of those people think there is little one can do about back pain other than ice it, take some muscle relaxers and maybe pop ibuprofen by the thousands. A significant number of them would probably be surprised to find out that their feet might be causing all the problems!

A short history of Podiatry.

A podiatrist must be licensed in the United States. And the license comes from the state in which they want to practice. This follows an education of about eight years. Four years of pre-medicine followed by a doctoral degree which is another four years. It’s a very difficult curriculum and it’s not uncommon for students to drop out throughout the four years. The 7 - 8 years must then be followed by 2 - 3 years of residency.

The Foot.

The foot is surprisingly delicate considering that some experts estimate that we walk the circumference of the earth throughout our life. That is a lot of steps and just 26 bones and 33 joints to take that repeated stress over your lifetime. For some people this turns out fine but for quite a few an injury of some sort causes a slight shift in the balance and gait of their walk. This tiny change in balance often throws the entire body out of balance.

That’s when we become susceptible to back strains. Our feet are shock absorbers and when they are not stepping correctly they lose their ability to distribute the shock our bodies produce with each step. Instead our weight becomes focused on one area of the foot and an imbalance happens. Any small change can trigger this. If a person develops a corn that becomes painful they will very often develop a change in their walk so there is less pain. This same change that lessens the pain now will often be the culprit in severe knee or back pain a few years later.

Podiatry has developed a way to discover these flaws in our step. They use a computer program that is hooked into a “board” that a patient walks across. Their weight is registered to an exact degree per square inch and then the program calculates what they need to do to correct it. The program will then design something that’s inserted into the shoe called an “orthotic” which is created precisely to counter all the ill effects your feet have suffered over the years. They put your feet back into balance.

An orthotic is surprisingly cheap and for some people it is simply a miracle. But since almost everybody that walks over a mile a day probably has some problems with the balance in their feet orthotics is a good idea for everyone. They decrease that worn feeling a person feels after walking all day and coupled with a great walking shoe that absorbs the body’s weight anyone can experience significant gains in the control of foot pain. Many times this results in the elimination of foot pain or a drastic reduction.

Podiatry often recommends orthotics as a matter of course because the benefits always outweigh the very low cost of creating this insole knee and back savior.

What Causes Back Problems & How to Get Relief From Them?

Understanding the causes of back problems & the associated pain is the key to applying the correct treatment to get relief from it. This is because back pain is often difficult to treat effectively, so a better understanding of the causes of the pain will assist sufferers to get relief from it.

The following are the 5 Common Causes of Back Pain

1. Posture -
   A bad posture can increase stress to the muscles, nerves, or ligaments in the lower back.
   For example sitting in front of your computer all day in a chair that is not ergonomically suited for your back will almost certainly result in poor posture & therefore increase stress on the spine and cause lower back problems.
2. Weak Abdominal Muscles -
   Having weak abs places more stress on the spinal column during certain movements thereby causing pain.
3. Lumbar Muscle Strain -
   Lumbar muscle strains are the most common cause of low back pain & most cases of back discomfort from muscle strains are resolved completely within a few weeks.
4. Being Overweight -
   Being overweight and not getting enough physical activity will usually stress the spine causing pain.
5. Slipped Discs & Other Spinal Conditions -
   Slipped discs, pinched nerves, sciatica, aging, degenerative discs, compression fractures, spinal tumors and infections are other common causes of lower back pain.
   If you have any of these symptoms you should seek out professional diagnosis before embarking on any exercise regime.

Whilst it’s interesting to note that suffering from a back problem is a common condition that affects up to 90% of Americans at some point in their lives, this condition can be treated quite effectively with the right exercises to improve posture and core strength.

However, whilst most episodes of back pain only last a few days and have completely resolved within a few weeks, you should get medical advice or go to your doctor if you have a new back problem for further evaluation.o improve

Low back pain is one of the most common reasons for consulting a physician. Despite little supporting scientific evidence, bed rest was considered the primary treatment from the late 19th century. What has changed now is how back pain is understood and managed.

History of Back Pain and Rest

Rest was first proposed as a treatment by John Hunter (1728-1793), a Scottish surgeon, in his study on wounds and inflammation. He believed that the first and most important requisite for restoration of inflamed, injured parts is rest, as rest is necessary for repairing injured parts. This proposed idea of rest as a treatment was further amplified by John Hilton (1804-1878), a British surgeon, in his 1862 series of lectures on “Rest and Pain” to the Royal College of Surgeons. He claimed that it is the natural treatment for the inflammation of injury and wounds.

Their theory of injury leading to an inflammatory response that requires rest to heal the body had a huge influence throughout the field of medicine even though their works revolves around only on inflammation and wounds. Physicians all over the world started to use rest as a treatment for a wide range of conditions, from myocardial infarction to normal childbirth.

Throughout the 19th century, the orthopedic principle of rest became dominant. The rationale of rest for back pain started from the idea that pain was due to injury. With injury, inflammation occurs and thus rest was essential for healing. If the primary injury was not properly treated with rest, chronic pain would develop. It was believed that movements, physical activities and repeated back injuries during the inflammatory phase may increase pain and so must be harmful, and thus should be avoided.

This thinking was later applied in the treatment of a ruptured disc, where the disc “comes out”. The idea was that with bed rest, i.e. lying down, disc pressure is the lowest and the disc will somehow “go back”. Unfortunately, there was no scientific evidence back then to support bed rest as treatment. Orthopaedic doctors just followed with what was taught to them, i.e. bed rest. By 1900, a standard orthopaedic text was published and recommended two to six weeks of bed rest for acute back pain.

Doubts Form in Approach

Although some doctors during the 19th century did question the use of bed rest, it was not until the 1980s that its efficacy as a treatment for back pain began to be seriously questioned. However, many then still felt that some rest was necessary, and initial studies only questioned the amount of rest that was needed rather than whether it was needed at all.

In 1986, Deyo et al were the first few to investigate the use of bed rest in low back pain. The study compared the functional status and symptoms of a group that received 7 days of bed rest with a second group that received 2 days of bed rest. No difference was found between the two groups in terms of the functional status and symptoms. This later formed the basis for several guidelines that advise no more than 2 days of rest for patients with acute low back pain.

Over the years, studies have emerged showing that bed rest of any duration is not effective for low back pain and that it often delays recovery. In fact, other than delayed recovery, prolonged bed rest can also have detrimental effects on the body. Patients with prolonged bed rest may end up with osteoporosis (bone calcium loss), muscle wasting due to muscle protein loss, deep vein thrombosis and undesirable psychological effects.

Current Approach

So the question now is, if bed rest has been shown to be detrimental and ineffective as treatment, would early activity be better?

Several studies have looked at the effects of advice to stay active in the treatment of acute low back pain and found that advice to stay active was better or similar to advice to rest in bed. In an update of a 2004 Cochrane Review of trials on bed rest for acute low back pain and sciatica, it was found that for patients with acute pain, advice to rest in bed was less effective in reducing pain and improving an individual’s ability to perform every day activities than advice to stay active. For patients with sciatica, there was little or no difference between advice to rest in bed and advice to stay active.

For chronic back pain sufferers, exercise therapy has been supported by good evidence to reducing time taken to return to work and improving functional status. Patients prescribed with graded exercises have been shown to return to work sooner, have less disability, and have fewer pain complaints than patients treated with medications and bed rest.

Conclusion

Given the extensive research done in recent years, there is rising evidence to point towards avoidance of bed rest for the management of back pain. Advice on early, progressive activity, with no more than 2 days of bed rest, will serve as the preferred current approach.

References

1. Allan, David B. and Waddell, Gordon(1989). A historical perspective on low back pain and disability’,Acta Orthopaedica,60:3,1-23.
2. Deyo RA, Diehl AK, Rosenthal M. How many days of bed rest for acute low back pain? The New England Journal of Medicine 1986; 315:1064-1070.
3. Gorden Waddell. The Back Pain Revolution. Churchill Livingstone, New York. 1999.
4. Hagen KB, Hilde G, Jamtvedt G, Winnem M. Bed rest for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD001254. DOI: 10.1002/14651858.CD001254.pub2.
5. Lindstrom I, Ohlund C, Eek C, et al. Mobility, strength, and fitness after a graded activity program for patients with subacute low back pain: a randomized prospective clinical study with a behavioral therapy approach. Spine 1992; 17:641-652.
6. Lindstrom I, Ohlund C, Eek C, et al. The effect of graded activity on patients with subacute low back pain: a randomized prospective clinical study with an operant-conditioning behavorial approach. Physical Therapy 1992; 72:279-293.