Is How You Sleep Causing Your Back or Neck Pain?

 I get asked this question quite often from my patients with back or neck pain, so I thought I would address it to the masses.  It seems most people sleep on one side or the other, followed by a smaller group who sleep on their back, then by the smallest group who tend to sleep on their stomach.  At least, that’s what I have experienced with my group of patients.    So which sleeping position is correct?  Well I think that all depends on each individual person and his/her needs.  

The best overall sleeping position is sleeping on the back.  It helps prevent neck and back pain because the head is in a neutral position.  Now this could be dependent on the type and size of pillow you choose.  A pillow that is too thick may cause excessive neck flexion (forward bending) which may be uncomfortable.  The same idea goes for a pillow that is too thin.  It can cause excessive neck extension (backward bending).  Sleeping on your back with a good, neutral pillow can help reduce acid reflux symptoms by keeping the head elevated above the level of the stomach so stomach acid cannot go back up the esophagus.  The only drawback to sleeping on your back is if you snore!  When lying in your back, your tongue and soft palate relax and fall to the back of your throat creating a vibrating sound…SNORING!  

Sleeping on your side is considered an acceptable sleeping position…if done correctly!  It can help reduce snoring by keeping the tongue and soft palate engaged which keeps it from falling to the back of your throat creating the vibration.  This position can also help reduce acid reflux if your pillow is thick enough to keep your head above the level of your stomach.  A lot of pregnant women find this position the most comfortable as it absorbs a lot of the weight of the growing belly.  If you are pregnant and sleeping on your side, be sure to do so on your left side to avoid constricting blood flow in the abdomen.  I highly recommend putting a pillow between your knees when sleeping in this position in order to keep the pelvis as neutral as possible.  Without a pillow between the knees, the top leg tends to drop to the bed creating a stretching of the low back and pelvis which can aggravate the low back.

While sleeping on the side can be good, sleeping in the fetal position is not good.  The fetal position causes over-arching of the spine which can restrict movement of the diaphragm and reduce breathing quality.  Fetal position can also increase arthritis pain because the knees are bent for long periods of time causing stiffness and decreased mobility.  A good way to combat negative effects of the fetal position is to tuck a pillow between your knees and wrap your arms around it thus causing your spine to flatten out. 

The one sleeping position to AVOID at all costs is sleeping on your stomach!  This posture causes hyperextension of the spine, especially in the low back.  Many people with back pain have an increased curvature in the lumbar spine (low back) which puts added pressure on the joints and discs, therefore sleeping in this exaggerated position for several hours a night will only make that pain worse.  Also, when you sleep on your stomach, you must turn your head one way or the other which creates pressure and irritation on the joints in the neck, not to mention the muscles.  The prolonged rotation of the head while sleeping in this position can aggravate and already existing neck problem or create a new one.  

Finding a comfortable position to sleep in can be a difficult thing for a lot of people; especially if you are already in pain.  So if the position that works for you isn’t the best position listed here, that’s okay.  Just understand that you are subjecting yourself to the risk of increased pain and dysfunction later.  Seeing a chiropractor for consistent adjustments can help relieve the pain and pressure on the spine in the long term.  Don’t hesitate to call for an appointment today.  

 

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

Magnesium Deficiency

Until recently, I have not really given much thought to magnesium and what it does throughout our bodies.  On a molecular level, I have known for quite some time that it is involved in numerous chemical reactions in the body, but it never really clicked to me how very important it is.  That all changed when I started having heart palpitations a few weeks ago.  I have never had any heart problems in the past.  I have never had a murmur or arrhythmias (irregular heartbeats) and all EKGs were “disgustingly normal” (as a doctor once told me).  So, naturally, I was very worried when, out of the blue, I started feeling a pressure in my chest, fluttering of my heart and was experiencing a drop in blood pressure, increase in resting heart rate and occasionally irregular heartbeats.  After weeks of testing, all anyone could tell me was that MAYBE I was deficient in magnesium.  So that made me want to find out more...

 

Believe it or not, testing for magnesium levels in the blood is extremely inaccurate.  Serum magnesium (magnesium in the blood) accounts for about 1% of magnesium in the body’s tissues.  1%!!!  So when having your blood tested, take that result with a grain of salt because it may or may not be telling you the entire story.  Magnesium deficiency manifests in many different ways and can mimic so many other disorders that it is extremely difficult to correctly diagnose.  Here are some symptoms associated with low magnesium:

Muscular:
Weakness
Muscle spasms
Tics
Muscle cramps
Hyperactive reflexes
Loss of muscle coordination
Tremors
Involuntary eye movement or vertigo
Difficulty swallowing

Neurological:
Behavioral disturbances               
Irritability and anxiety
Lethargy
Loss of memory and cognitive function
Loss of appetite                               
Nausea and vomiting
Seizures

Cardiovascular:
Irregular or rapid heartbeat
Coronary spasms

Metabolic:
Increased intracellular calcium
Hyperglycemia
Calcium deficiency
Potassium deficiency

Also, be on the lookout for issues bone issues.  When your body is in a state of “functioning” low magnesium, the body will strip magnesium from bone to utilize it in other biochemical reactions which can cause damage to the bones.  If this is occurring, testing for magnesium levels will likely return normal, which can lead to a missed diagnosis.

Conditions commonly associated with magnesium deficiency include depression, chronic fatigue syndrome, ADHD, epilepsy, Parkinson’s disease, sleep problems, migraine headaches, cluster headaches, osteoporosis, premenstrual syndrome (PMS), chest pain (angina), cardiac arrhythmias (irregular heartbeat), coronary artery disease or atherosclerosis, hypertension, type II diabetes, and asthma.  The presence of any of these conditions could point to chronic hypomagnesemia (low magnesium).   

Treatment for magnesium deficiency can be as simple as taking a magnesium supplement or increasing the natural intake of magnesium through dietary changes.  More severe cases may require the intake of magnesium through an IV.  Simple magnesium supplements can be purchased at any grocery store or multi-purpose retailer for relatively cheap and it is usually recommended to begin supplementation with 250mg doses.  Foods such as rice, spinach, watermelon, pumpkin seeds, oatmeal and avocado are rich in magnesium and can help boost levels naturally. 

So…after about a week of taking magnesium supplements, my original symptoms of heart palpitations, decreased blood pressure and increased heart rate have all practically disappeared.  I guess the doctors got it right.  I will continue to supplement magnesium in order to keep my body running as efficiently as possible.  If you think that you may have magnesium deficiency, talk to your doctor before you start taking supplements to confirm that is the problem.  I wouldn’t want any of you taking supplements unnecessarily. 

 

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

Sacroiliac Joint Dysfunction

When you think about low back pain, your mind tends to go to disc herniation or muscle strain.  Very rarely does it go to sacroiliac (SI) joint dysfunction.  But recent studies show that up to 30% of low back pain is caused by an issue in the sacroiliac joint.  

What is the sacroiliac joint exactly?

The sacroiliac joint joins the sacrum (triangular shaped tail bone) to the ilia (“hip bones”)…hence sacro-iliac.  These joints play a large role in the ability to walk and move the torso; therefore they are used a lot…and quite often overused.  Many muscles and ligaments surround and attach to the SI joint and can contribute to pain and inflammation if the joint is dysfunctional.  The joint relies highly on the strength of these ligaments for support and structure. 

How can the SI joint become dysfunctional?

There are many causes of SI joint dysfunction, but the most common mechanism of injury is due to a combination of vertical compression and rapid rotation (lifting a heavy object and twisting).  These motions create both a load and a shearing of the joint which is the action the ligaments are meant to resist, however, when done repeatedly, the ligaments weaken and become less effective.  Falling on the buttocks can also create the load and shearing of the joint causing a similar dysfunction.  Anatomical alterations such as leg length differences, gait abnormalities, scoliosis, and even pregnancy can lead to a predisposition for dysfunction.

What are common symptoms of SI joint dysfunction?

Common symptoms include pain in the low back, buttocks, leg, groin and/or hip, urinary frequency, and intermittent numbness or tingling.  The pain can range from sharp and stabbing to dull and aching and tends to increase with physical activity.  The pain can also increase with sustained positions such as prolonged sitting or standing in one place for a long time.  Actions such as bending forward, climbing stairs or hills and standing from a seated position can also provoke the pain.  The symptoms vary so drastically from one patient to another because there are several muscles and nerve roots involved which causes the pain to manifest differently in each case.  The muscles that can affect the sacroiliac joint include the piriformis, rectus femoris, gluteus maximus and minimus, erector spinae, latissimus dorsi and iliacus.  These muscles can be found in the buttocks, thigh, mid back and low back, thus causing pain in any of these areas.  The nerve supply to the SI joint ranges from the upper portion of the lumbar spine (low back) all the way down through the sacrum (tail bone region) which creates a unique pain referral pattern for each person depending on which nerve roots are affected.

How can SI joint dysfunction be diagnosed? 

Imaging studies such as x-ray, CT scan, and MRI do not usually show abnormalities and therefore are not reliable for diagnosis.  However, a clinician…like a CHIROPRACTOR J, are highly trained in diagnosis of musculoskeletal problems and can reach a probable diagnosis of SI joint dysfunction using a hands on approach through palpation and orthopedic tests which provoke the pain thus giving a positive result.  There are many of these tests designed to indicate SI joint problems, but testing positive three particular tests is both sensitive and specific to a correct diagnosis.  Those tests are called Patrick’s Test (or FABERE’s), Gaenslen’s Test and Yeoman’s Test and are demonstrated in the picture below.

How is SI joint dysfunction treated?

Treatment is usually dependent on duration and severity of the pain and dysfunction.  New injuries and even recurrent flare ups or exacerbations benefit greatly from chiropractic manipulation because we are able to realign the pelvis to its proper orientation and perform any soft tissue treatments necessary to relax the muscles and ligaments that may be contributing to the dysfunction.  Chiropractors can also help stabilize the SI joint using a multitude of different taping techniques as well.  If the dysfunction is severe enough, combining physical therapy with chiropractic care is indicated.  In worst case scenarios, steroid injections and even surgery may be necessary to completely relieve the pain. 

As a chiropractic physician, it is always my goal to treat any musculoskeletal issue conservatively first before resulting to invasive treatments like injections and surgery because there are always adverse effects to those treatments such as immobilization and chronic pain. 

So if you are experiencing low back pain that does not seem to be going away, come in and see me!

 

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade, Manhattan, or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.