Disc Problem? This is the Information you need

 

Common Questions and Concerns regarding the

Treatment of Lumbar and Cervical Disc Problems

 

 

 

In order to provide you with the necessary information you need regarding the treatment from disc problems, we have created this handout to answer the most common questions.  Well-informed patients often have better outcomes.

 

   Table of Contents:                                                                                                      Page

 

1.     What is the nature of disc and spinal nerve problems?          1    

2.     Why me?                                         2

3.     What caused this problem?                              2

4.     Should I be alarmed?                                   2

5.     What can I expect?                                   3    

6.     If I have arm or leg numbness, tingling or weakness what does      3

      that mean?                     

7.     What are the effects of chiropractic manipulation?               4

8.     Should I be worried if my MRI or CT scan indicates          

       I have a relatively large herniation?                                                            4

9.     What would happen if I decided to have surgery instead

      of conservative non-operative care?                                                       4

10.  What must I do to help the process of healing?               5

11.  What specific exercises are safe and effective for my spine?          6

12.  Should I be taking drugs or nutritional supplements?          7

13.  In Closing                                        8

 

1.  What is the nature of disc and spinal nerve problems?

 

There are 26 spinal bones, known as vertebrae, each separated by cushions, known as discs.  The discs allow movement between the bones and create a separation between the bones (or vertebrae) so the nerves have a clear and spacious exit route between the vertebrae. The disc itself is made of cartilage, like the material that lines all of the joints.  The disc material can become irritated (inflamed), torn (herniated) or a piece of torn disc material can actually separate itself from the disc (sequestered).  The source of your pain can come from the irritated disc material itself, but commonly comes from indirect pressure on the nearby nerve, which is extremely sensitive.  A little pressure on the nerve will produce pain, while greater amounts of irritation can produce numbness, tingling and weakness.  It is the normal function of nerves to allow your muscles to properly contract, giving you a sense of strength, A further normal function of nerves to allow your skin to experience full sensation, which when decreased, results in numbness or tingling.

 

 

2. Why me?

 

Disc problems are fairly common.  The good news is they generally resolve with proper care and the passage of time.  They most commonly occur in 20 to 40 year olds and affect twice as many men as women.  Remember, however, these are just statistics and there are always exceptions.  We regularly see disc problems in patients that tend to sit for a living and / or who are otherwise sedentary, or who use their back more rigorously, particularly with bending, twisting and lifting while at work or play.  While genetic factors may play a role, we feel lifestyle plays a more important role. Just because your mom or dad had disc surgery, you shouldn’t expect to follow their path.

 

3. What caused this problem?

 

Only about one third of the patients complaining of symptoms related to irritated discs, report an acute onset attributable to a particular event, such as heavy lifting. Much more commonly a small movement, such as picking up a sock, can be the precipitating event.  More patients have a gradual onset of neck or low back pain, followed by arm or leg pain (sciatica).  These patients generally have experienced many episodes of similar pain within the previous 2 to 5 years. 

 

Specific stressors related to the onset of back pain related to an irritated disc include:

 

• Twisting and repetitive flexion
• Sedentary occupations or lifestyles
• Prolonged driving of motor vehicles
• Obesity
• Cigarette smoking
• Undue stress
• Overwork
• Lack of strength and flexibility

 

4. Should I be alarmed?

 

Generally speaking, disc problems, heal very well with conservative non- operative care, such as chiropractic treatment.  Studies show 98% of people recover without surgery. The worse case scenario for you with a disc problem (inflammation, herniation or sequestration) is that it would require surgery. In those rare cases where surgery is strongly indicated, the outcomes are generally very good, resulting in a pain free lifestyle.

 

Rarely, (less than 1/10th of one percent), the spinal cord can be jeopardized or pressurized by a large centrally extruded herniated disc. An extruded disc is torn to the degree that a large part is now outside of the confines of the normal disc size.  This condition is knows as cauda equina.  If you experience loss of bowel, bladder control, or sexual function, along with pain and numbness and severe weakness in both legs, you need to consult with us immediately as this condition commonly requires surgery. We will need to evaluate you and ensure you receive the proper referral to another specialist. We have very good relationships with the orthopedic, neurosurgical, and neurology community and we will make sure you get the best proper care in the case of an emergency.

 

 

5. What can I expect?

 

The good news is less than 2% of people with disc problems causing nerve irritation and leg pain require surgery to fix their problem.  Even if you are experiencing nerve irritation (numbness, tingling, sharp or burning pain in the legs and/or a sense of weakness) you can have a very favorable outcome in 4 to 6 weeks with conservative therapy, such as chiropractic care and physical therapy.

 

You can expect resolution within 4 weeks for a simple problem, whereas a very severe problem may require therapy for several months, even extending 6 to 12 months depending upon the severity.  Care is more frequent during the first few weeks and then becomes much less frequent in the following few months.  Once symptoms have resolved and you are able to do more of your normal activities without pain flaring up, your care is considered complete.  After that point, simple daily exercises are critical to decrease the chance of the problem recurring. We will do our very best to make sure you understand the importance and proper technique for particular exercises.

 

 

6. If I have arm or leg numbness, tingling, skin sensitivity, pain or weakness due to nerve pressure, what does this mean?

 

During the early and painful stages of disc irritation, the nerves become super-sensitized.  This may mean that your skin becomes very sensitive, or you might feel sharp or burning pain in the buttock, groin or leg area, leaving you with a preference not to have any pressure on the area.  The muscles may have more of a tendency to cramp or spasm.  These are normal consequences of nerve irritation.  Successful treatment will reduce these problems completely.

 

If you have neurological challenges  (i.e. numbness, tingling, pain or weakness in your arms or legs), this suggests your case may be more complicated and may require additional care.  Following are suggested time lines for full recovery for particular conditions.  The most important thing to realize, however, is that ongoing care only occurs if you show measurable improvement both in how you feel and how your body functions.

 

• 6 to 12 weeks – for mild sensory loss with or without mild muscle weakness.
• 3 to 6 months – for moderate muscle weakness and loss of reflex.
• Up to 12 months – for severe motor loss (i.e. leg or arm weakness).

 

 

 

 

7. What are the effects of chiropractic treatment?

 

There are more studies positively supporting the effective management and relief of back pain through manipulation (the primary tool used by chiropractors) as compared to any other approaches, including surgery, physical therapy, and medication.

 

Some patients may feel nervous about their initial treatment with a chiropractic physician, particularly if they are not familiar with what happens during a session in a chiropractic office.  We will explain our procedures and provide care that is comfortable and effective. The majority of our patient's feel very comfortable with and enjoy their treatment, and have excellent outcomes. 

 

Despite our success, all therapies or medical procedures produce some mild and temporary side effects.  Following is a list of these side effects or types of temporary discomfort that may occur after manipulation:

 

• Local discomfort at the site of treatment            53%
• Fatigue                                                             11%
• Radiating discomfort into the leg or arm            10% 

 

8. Should I be worried if my MRI or CT scan indicates I have a relatively large herniation?

 

While this may not make sense at first glance, a patient with a larger disc herniation does not necessarily have a worse prognosis than a patient with a small herniation. Studies with people, who have shown large sized herniations on their MRI, show better cure rates.  The point we want to make here is we cannot assume just because a disc herniation is large, that the person will have a better or worse prognosis that a patient with a smaller herniation. 

 

 

9. What would happen if I decided to have surgery instead of conservative non-operative care?

 

Studies show there is no difference between the outcomes of patients who either had surgery or tried non-surgical treatment (chiropractic care) at 4 and 10 years following the time of the surgery or treatment.  This suggests patients will often feel the same after 4 or 10 years regardless if they had surgery or not.

 

Other studies show if you can handle the discomfort for 30 days, it is far more beneficial to try and complete the suggested trial of conservative chiropractic care because of the chance of resolution of the problem. We realize there are a small percentage of patients that will absolutely require surgery.   We have very good working relationships with both the orthopedic and neuro surgical community and will make every effort to ensure you get the best care.

 

 

 

10. What must I do to help the process of healing?

The following are excellent suggestions to help you recover:

 

• First of all, trust your body’s ability to heal.

 

• Be as active as you possibly can, letting pain be your guide.  Movement is your friend.

 

• Bed rest is only necessary if it is the only place you can get any relief.  Even with this situation, you will need to try to get up and do your exercises regularly, despite discomfort. 

 

• For low back problems, sleeping on your back with a pillow under your knees or on your side with a pillow between your knees generally result in the least discomfort.

 

• For neck problems, a pillow under your neck that allows it to extend backwards is much better than a pillow that props up your head in bed.

 

• In the vast majority of situations, increased pain does not necessarily mean more injury.

 

• Drink plenty of water and get reasonable rest, including adequate sleep.

 

• Eat enough fiber (fruits and vegetables) to reduce constipation, which can increase back pain. If this continues to be problem, consult your physician for further suggestions.

 

• Pay close attention keeping your pelvis in a neutral and safe position.  When seated, be sure to sit way back in your chair, while supporting your back by the seat back.  A small pillow between your low back and chair can minimize disc swelling.  You may benefit from a half roll placed behind your back while sitting. 

 

• Do the exercises prescribed to increase the strength of the core pelvic muscles or the front of your neck, depending on whether you are having back or neck problems. You are the only one in control of this very important component of your healing. We will provide you handouts so you will not forget the key aspects of any of the exercises and gladly review them as needed.

 

• Avoid heavy lifting for a few weeks and  learn to ask for help.  Give your spine 4 to 6 weeks to recover before you begin heavy lifting.

 

• Feel free to discuss your life stressors (at home and work) with us, so those issues can be effectively addressed. Reducing stress will allow you to heal more effectively.

 

 

·      Research shows poor sleep, poor attitude toward recovery, lack of proper nutrition, unmanaged stress, worry and fear all contribute to increased levels of pain.  Our job is to encourage you to take the proper steps in those areas to ensure efficient and effective recovery.

 

 

11. What specific exercises are safe and effective for my back or neck?

 

·      Focus on letting the disc heal by doing the specific exercises provided which focus on decreasing the swelling and pressure on the disc.  

 

·      Following are three specific actions of you are having back pain. These should be done on a regular basis during the early phase of your treatment.

 

·      While lying on your back, put your legs up on a chair or couch so your back and thighs are at 90 degrees. Simply relax, breathe and hold this posture for 5 to 10 minutes, once in the morning and then at the end of your day.  This helps stretch the connective tissue of the back and neutralize the pressure on the disc.

 

·      If you have a relatively strong upper body, stand in between two stable chairs (placed apart about the width of your body) placed back to back to each other.  Place your hands on the top of the back rest.  With arms kept straight, slowly bend your knees and let the weight of your legs and low back “sag” down as you feel a sense of traction on your low back. Hold this for 5 seconds and repeat several times, perhaps 3 to 4 times each day.  

 

·      Lastly, lie head down for a minute or two on an incline board that has the top of the board securely elevated 2 feet off the floor.  Putting your arms over your head can increase the traction.

 

·      Following are two specific actions of you are having neck pain. These should be done on a regular basis during the early phase of your treatment.

 

·      While lying on your back without a pillow, gently direct your visual gaze downwards towards your navel. Be careful not to lift your head off the table or bed.  Hold for one second then relax your gaze. Repeat 10 times slowly.

 

·      When the first exercise is well tolerated, add the following motion. After fully completing the gaze towards your belly button, while making sure your chin stays tucked towards the table or bed, slightly lift the forehead towards the ceiling, making sure to lift only 2 to 3 inches.  Hold this posture for 1 to 2 seconds only.  Drop the head making sure the chin is held is a tucked posture the entire time.  Repeat this 3 to 10 times depending on how well you can do this exercise. This should be done 2 to 4 times a day.

 

 

 

12. Should I be take drugs or nutritional supplements?

 

Below are medications commonly prescribed for back pain. If you are not sleeping or your pain is worsening, a short course of medication may help you over the “hump” so you can heal. They are not a long- term solution. We can refer you to the appropriate M.D. who will discuss the risks/benefits of these medications.

 

Corticosteroids

If you have severe leg pain, your medical doctor may consider a short course of corticosteroids.  This is a very powerful anti-inflammatory and can reduce the swelling of the disc so you can begin to do your exercises more effectively. The latest research shows that steroid injections (ESI’s) do not have any long-term benefit for low back pain.

 

NSAIDS (non steroidal anti inflammatories) along with analgesics (pain killers)

These may be recommended by your medical doctor to help in the initial phases to reduce the pain and swelling. The makers of Advil (ibuprofen) recommend that you do not take these more than seven days in a row.

 

Muscle relaxant

This use is considered somewhat controversial because over time, they become ineffective.

However, they have proven to be useful if your pain is severe enough to prevent you from standing straight.  Note: Muscle relaxants don’t really relax the muscles (if they did our heart and diaphragm would stop working) They work by altering your brain’s perception of pain.

 

Narcotics

These prescription drugs may be reserved for patients with severe pain and great care is taken to reduce the chance of addiction, constipation and sedation – all which are common side effects.

 

 

 

 

 

Proteolytic Enzymes

During the acute phase of pain, (generally the first week or two) proteolytic enzymes may be helpful in reducing inflammation of the disc tissue, and subsequently reducing the nerve pain.  Unlike the medications described above, you can purchase these enzymes in health food stores easily without a prescription.  Studies on proteolytic enzymes show them to reduce the healing time for disc herniations and show no reported secondary side effects.  These enzymes improve local circulation and reduce edema (swelling).  Following are the suggested types of enzymes and dosages:

 

Sleep Aids

If your sleep is disrupted, consider sleep aids such as valerian root (300 to 500 milligrams of valerian 1 hour before bed).

 

Glucosamine Sulphate/ MSM

One of the best-researched supplements is a glucosamine sulphate supplement.  This product contains the constituent for the material that makes up the disc material. It is best to combine glucosamine with another supplement known as MSM.  Typically distributors will combine these two supplements.  Many of these supplements will also include chondroitin sulphate. Literature suggests that chondroitin sulphate is not as critical an element for disc improvement or pain relief.

 

However, if you are a diabetic or allergic to shellfish, chondroitin sulphate is safe for you to take. Some studies have shown the glucosamine   to minimally raise glucose blood levels and because it is commonly derived from shells, those patients allergic to shellfish may choose to do a trial of chondroitin sulphate alone.

 

The therapeutic dose of glucosamine is 1500 milligrams per day and should be continued for 3 months. At the end of three months, when your condition stabilizes and your pain is well under control, you can reduce the dosage to 1000 milligrams per day.  While some say you should take 500 milligrams, 3 separate times per day, if you find it difficult to remember to take the supplements 3 times a day, it is better to take the entire dose in the morning. 

 

13.  In Closing:

 

If you have a particular question that is not answered in this handout, please be sure to ask your chiropractor.  Knowledge is power and assists in the healing process.

 

Thank you for taking the time to read this information and allowing us to help you recover from this challenging condition.  We have great confidence we can provide you with care that will allow you an excellent chance of recovery.

This information was kindly supplied by Dr. Kelli Pearson, D.C. of Spokane, WA

 

.        Dana Weary, DC DABCO                        Susan Barrett, DC

 

Where Did My Back Go?

 

When your back goes out…

When most people say "my back went out the other day", they mean they had a sudden onset of lower back pain usually while doing something easy like picking up the newspaper. Standing up straight is impossible, practically every movement hurts and your only choice is to get off your feet or grin and bear it while walking crooked. Some describe this as a "slipped disc". After a few days, the pain subsides, you can stand up straighter and certain motions hurt less. After two or three weeks, you have forgotten all about it.

What does it mean when your "back goes out"? Where does it go?


Here's the truth: discs cannot slip. The disc (intervertebral disc) resides between each of the bones in your lower back. A paradox in construction, it is tough yet gooey, stiff yet flexible and firm yet soft. The yin and yang of the spine, the disc has two main parts: the inner core known as the nucleus and the outer strapping known as the annulus. The disc is not a slippery material and cannot pop out of your spine like a cork out of a champagne bottle (when you herniate a disc, the nucleus has broken through the annular wall). When your "back goes out", you most likely have torn or sprained some of the outer strapping (annulus) of your disc.

The outer annulus has a blood supply (unlike the gooey core). And wherever you find blood you will find nerve. When the annulus tears, the nerve fiber becomes sensitized to tension and pressure from the chemical inflammatory process. Movement hurts. Sitting hurts. Everything hurts. This is very similar to an ankle sprain and, in fact, the annulus is a ligament both in structure and function. When your back goes out, you have sprained the annulus. The only question is how badly.

Generally, the first few episodes of "throwing your back out" are several months or years apart. Then, the frequency increases. Soon, your back is going out almost as frequently as you take out the trash. If you are not careful, these episodes will lead you to the surgeon's operating room.

One reason the episodes increase in frequency is that the tear has not healed enough before you return to your routine activities. For most people in the US this is sitting. Sitting is the enemy of back pain. The pressure in your disc while sitting is almost as high as bending over. It is this pressure that causes the problems. Imagine walking out to your car one morning and noticing that the right back tire has a small bulge in it. The tire looks a little flat too. Would you add air to the tire? Would you pump more air into an already compromised tire? If you do, the tire may blow. This is what sitting does to your injured disc. The increased pressure pushes the fibers apart, reduces badly needed nutrient flow and lowers the pH level making it more acidic (and as a general rule, acid is not well liked by your body except of course in your stomach).

The first episode is the one to really pay attention to if you would like to stay off the operating table. When you reach just the wrong way, pick up the newspaper or brush your teeth and cannot stand up straight, it is time to get some help. Think about it. How sturdy is your spine if brushing your teeth "throws your back out"?

The outer rim of the annulus, where the first tears occur, can heal but it needs some help. A poor blood supply coupled with a low rate of energy use makes healing difficult. Two things that help your annulus heal is the rate of blood flow in the spine called the perfusion rate and maintaining adequate disc height . Walking is a great start but more importantly, limit your sitting time. And if you must sit, invest in a chair that allows you to tilt backward. This will lower the disc pressure. Remember, too much pressure is not healthy for your injured spine,

So, I think we can safely conclude your back goes nowhere but downhill when you sprain your annulus and fail to heed the warning signs. So the next time your back “goes out” or you “slip a disc”, it’s time to do something about it.

This article (mostly) was from a PT named Doug Kelsey who did a great job with making  back anatomy interesting.

Blood Pressure changes and chiropractic

This study was released about a year ago and has been generating interest ever since.  It was mentioned recently on "Good Morning America".  This review was from webMD.

Chiropractic Cuts Blood Pressure

Study Finds Special 'Atlas Adjustment' Lowers Blood Pressure

By Daniel J. DeNoon

WebMD Medical News

Reviewed by Louise Chang, MD

 

 

March 16, 2007 -- A special chiropractic adjustment can significantly lower high blood pressure, a placebo-controlled study suggests.

"This procedure has the effect of not one, but two blood-pressure medications given in combination," study leader George Bakris, MD, tells WebMD. "And it seems to be adverse-event free. We saw no side effects and no problems," adds Bakris, director of the University of Chicago hypertension center.

Eight weeks after undergoing the procedure, 25 patients with early-stage high blood pressure had significantly lower blood pressure than 25 similar patients who underwent a sham chiropractic adjustment. Because patients can't feel the technique, they were unable to tell which group they were in.

X-rays showed that the procedure realigned the Atlas vertebra -- the doughnut-like bone at the very top of the spine -- with the spine in the treated patients, but not in the sham-treated patients.

Compared to the sham-treated patients, those who got the real procedure saw an average 14 mm Hg greater drop in systolic blood pressure (the top number in a blood pressure count), and an average 8 mm Hg greater drop in diastolic blood pressure (the bottom blood pressure number).

None of the patients took blood pressure medicine during the eight-week study.

"When the statistician brought me the data, I actually didn't believe it. It was way too good to be true," Bakris says. "The statistician said, 'I don't even believe it.' But we checked for everything, and there it was."

Bakris and colleagues report their findings in the advance online issue of the Journal of Human Hypertension.

Atlas Adjustment and Hypertension

The procedure calls for adjustment of the C-1 vertebra. It's called the Atlas vertebra because it holds up the head, just as the titan Atlas holds up the world in Greek mythology.

Marshall Dickholtz Sr., DC, of the Chiropractic Health Center, in Chicago, is the 84-year-old chiropractor who performed all the procedures in the study. He calls the Atlas vertebra "the fuse box to the body."

"At the base of the brain are two centers that control all the muscles of the body. If you pinch the base of the brain -- if the Atlas gets locked in a position as little as a half a millimeter out of line -- it doesn't cause any pain but it upsets these centers," Dickholtz tells WebMD.

The subtle adjustment is practiced by the very small subgroup of chiropractors certified in National Upper Cervical Chiropractic (NUCCA) techniques. The procedure employs precise measurements to determine a patient's Atlas vertebra alignment. If realignment is deemed necessary, the chiropractor uses his or her hands to gently manipulate the vertebra.

"We are not doctors. We are spinal engineers," Dickholtz says. "We use mathematics, geometry, and physics to learn how to slide everything back into place." Atlas Adjustment and Hypertension continued...

What does this have to do with high blood pressure ?

Bakris notes that some researchers have suggested that injury to the Atlas vertebra can affect blood flow in the arteries at the base of the skull. Dickholtz thinks the misaligned Atlas triggers release of signals that make the arteries contract. Whether the procedure actually fixes such injuries is unknown, Bakris says.

Bakris began the study after a fellow doctor told him that something strange was happening in his family practice. The doctor had been sending some of his patients to a chiropractor. Some of these patients had high blood pressure.

Yet after seeing the chiropractor, the patients' blood pressure had normalized -- and a few of them were able to stop taking their blood pressure medications.

So Bakris, then at Rush University, designed the pilot study with 50 patients. He's now organizing a much bigger clinical trial.

"Is it going to be for everybody with high blood pressure? No," Bakris says. "We clearly need to identify those who can benefit. It is pretty clear that some kind of head or neck trauma early in life is related to this. This is really a work in progress. It is certainly in the early stages of research."

Dickholtz has been teaching, practicing, and studying the NUCCA technique for 50 years. He says high blood pressure is far from the only thing an Atlas misalignment causes.

"On the other hand, if people have high blood pressure, there is a tremendous possibility they need an Atlas adjustment

A warm and fuzzy moment

The Cracked Pot

A water bearer in India had two large pots, each hung on each end of a pole which he carried across his neck. One of the pots had a crack in it, and while the other pot was perfect and always delivered a full portion of water at the end of the long walk from the stream to the master’s house, the cracked pot arrived only half full.

For a full two years this went on daily, with the bearer delivering only one and a half pots full of water to his master’s house. Of course, the perfect pot was proud of its accomplishments, perfect to the end for which it was made. But the poor cracked pot was ashamed of its own imperfection, and miserable that is was able to accomplish only half of what it had been made to do.

After two years of what it perceived to be a bitter failure, it spoke to the water bearer one day by the stream.

“I am ashamed of myself, and I want to apologize to you.”

“Why?” asked the bearer. “What are you ashamed of?”

“I have been able, for these past two years, to deliver only half my load because this crack in my side causes water to leak out all the way back to your master’s house. Because of my flaws, you have to do all of this work, and you don’t get full value from your efforts,” the pot said.

The water bearer felt sorry for the old cracked pot, and in his compassion he said,

“As we return to the master’s house, I want you to notice the beautiful flowers along the path.”

Indeed, as they went up the hill, the old cracked pot took notice of the sun warming the beautiful wild flowers on the side of the path, and this cheered it some. But at the end of the trail, it still felt bad because it had leaked out half its load, and so again it apologized to the bearer for its failure.

The bearer said to the pot, “Did you notice that there were flowers only on your side of the path, but not on the other pot’s side? That’s because I have always known about your flaw, and I took advantage of it. I planted flower seeds on your side of the path, and every day while we walk back from the stream, you’ve watered them.

For two years I have been able to pick these beautiful flowers to decorate my master’s table. Without you being just the way you are, he would not have this beauty to grace his house.”

Moral: Each of us has our own unique flaws. We’re all “cracked pots”, but it is the cracks and flaws we each have that make our lives together so very interesting and rewarding.

Better than Prozac!

Exercise as an antidote

to depression and anxiety

is not a new concept.

In the 18^th century Scotland, doctors in mental hospitals prescribed heavy farm chores as “the best medicine” for their patients and documented marked improvements in mood behavior. Now scientists are studying the link between exercise and mood changes at close range and coming up with some fascinating results.

One expert in the field says, “Exercise is clearly associated with mental health benefits.” And moderate exercisers show lowered blood-pressure levels and resultant positive mood. The key is moderate exercise, performed a minimum of 30 minutes, three or four times a week. Brisk walking, swimming, lifting weights, and bicycling – all achieve good results.

People, who exercise regularly, even at something as simple as walking or bicycling, are more flexible. They experience less stress on the muscles and joints when they do bend down the wrong way. Conditioned muscles recover faster too. It’s the couch potato who hauls himself erect one Saturday afternoon to rake the leaves or shovel snow who has trouble.

By using simple relaxation techniques, exercising and making changes in our lifestyles, we can manage stress and take control of your lives. Once you have become aware of stress, it’s time to relax. There are many techniques for relaxing (and no one better than the other), but the most basic is deep breathing. One of the body’s automatic reactions to stress is rapid, shallow breathing. Breathing slowly and deeply is one of the ways you can “turn off” your stress reaction and “turn on” your relaxation response.

Muscle and joint aches and pains are a common complaint for many of us, living as we do in a sedentary, high-stress society. The cliché warning us to “use it or lose it” isn’t far off the mark. If you think some our aches and pains are just another consequence of aging, you’re wrong – more often, it’s a result of inactivity and weaker muscles.

Doctors now say that walking is one of the best exercises. It helps the total circulation of blood throughout the body, and thus has a direct effect on your overall feeling of health. Researchers agree that exercise helps to ease anxiety and lift spirits.

A good way to live your day-Thanks to Doug Kelsey PT for the article

The Wisdom of Pope John XXIII: One Day at a Time

I stumbled upon "The daily decalogue of Pope John XXIII" today while doing some research and after I read it, thought you might like to read it too. One of the things I like about it is the focus on just one day. When you think about trying to change something about yourself and making that change stick forever, it can be overwhelming. Read through the list and if something resonates with you, choose to act on it for just one day and notice what happens.

1) Only for today, I will seek to live the livelong day positively without wishing to solve the problems of my life all at once.

2) Only for today, I will take the greatest care of my appearance: I will dress modestly; I will not raise my voice; I will be courteous in my behaviour; I will not criticize anyone; I will not claim to improve or to discipline anyone except myself.

3) Only for today, I will be happy in the certainty that I was created to be happy, not only in the other world but also in this one.

4) Only for today, I will adapt to circumstances, without requiring all circumstances to be adapted to my own wishes.

5) Only for today, I will devote 10 minutes of my time to some good reading, remembering that just as food is necessary to the life of the body, so good reading is necessary to the life of the soul.

6) Only for today, I will do one good deed and not tell anyone about it.

7) Only for today, I will do at least one thing I do not like doing; and if my feelings are hurt, I will make sure that no one notices.

8) Only for today, I will make a plan for myself: I may not follow it to the letter, but I will make it. And I will be on guard against two evils: hastiness and indecision.

9) Only for today, I will firmly believe, despite appearances, that the good Providence of God cares for me as no one else who exists in this world.

10) Only for today, I will have no fears. In particular, I will not be afraid to enjoy what is beautiful and to believe in goodness. Indeed, for 12 hours I can certainly do what might cause me consternation were I to believe I had to do it all my life.

It may not be authored by George Carlin, but it's still good

George Carlin's New Rules for 2007

 

New Rule: Stop giving me that pop-up ad for classmates.com! There's a reason you don't talk to people for 25 years. Because you don't particularly like them! Besides, I already know what the captain of the football team is doing these days--mowing my lawn.

 

New Rule: Don't eat anything that's served to you out a window unless you're a seagull. People are acting all shocked that a human finger was found in a bowl of Wendy's chili. Hey, it cost less than a dollar. What did you expect it to contain? Trout?

 

New Rule: If you need to shave and you still collect baseball cards, you're a dope. If you're a kid, the cards are keepsakes of your idols. If you're a grown man, they're pictures of men.

 

New Rule: Ladies, leave your eyebrows alone. Here's how much men care about your eyebrows: do you have two of them? Okay, we're done.

 

New Rule: There's no such thing as flavored water. There's a whole aisle of this crap at the supermarket, water, but without that watery taste. Sorry, but flavored water is called a soft drink. You want flavored water? Pour some scotch over ice and let it melt. That's your flavored water.

 

New Rule: Stop screwing with old people. Target is introducing a redesigned pill bottle that's square, with a bigger label. And the top is now the bottom. And by the time grandpa figures out how to open it, his ass will be in the morgue. Congratulations, Target, you just solved the Social Security crisis.

 

New Rule: I'm not the cashier! By the time I look up from sliding my card, entering my PIN number, pressing "Enter," verifying the amount, deciding, no, I don't want cash back, and pressing "Enter" again, the kid who is supposed to be ringing me up is standing there eating my Almond Joy.

 

New Rule: Just because your tattoo has Chinese characters in it doesn't make you spiritual. It's right above the crack of your ass. And it translates to "beef with broccoli." The last time you did anything spiritual, you were praying to God you weren't pregnant. You're not spiritual. You're just high.

 

New Rule: Competitive eating isn't a sport. It's one of the seven deadly sins. ESPN recently televised the U.S. Open of Competitive Eating, because watching those athletes at the poker table was just too damned exciting. What's next, competitive farting? Oh wait! They're already doing that. It's called "The Howard Stern Show."

 

New Rule: I don't need a bigger mega M&Ms. If I'm extra hungry for M&Ms, I'll go nuts and eat two.

 

New Rule: If you're going to insist on making movies based on crappy, old television shows, then you have to give everyone in the Cineplex a remote so we can see what's playing on the other screens. Let's remember the reason something was a television show in the first place is that the idea wasn't good enough to be a movie.

 

New Rule: No more gift registries. You know, it used to be just for weddings. Now it's for babies and new homes and graduations from rehab. Picking out the stuff you want and having other people buy it for you isn't gift giving, it's the white people version of looting.

 

New Rule: When I ask how old your toddler is, I don't need to know in months. "27 Months." "He's two," will do just fine. He's not a cheese. And I didn't really care in the first place.

 

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