Lower Back Do’s and Dont’s

Several times every day people ask, what position should I be sleeping in, how should my chair be set, how should I lift, how should I bend?  Below are the answers to the most common questions back pain sufferers ask. 

Please do not substitute this information for medical advice, seek specific answers from your doctor or when you’re in
Beverly Hills, stop by the Beverly Hills Comprehensive Medical Group and talk to Dr. Daniel Jacobsen. 

Bending: Avoid prolonged bending from the waist, especially with your knees straight.  Avoid 15-45° bending with your knees straight, such as when brushing your teeth, shaving or washing the dishes.

Sitting: Avoid prolonged sitting. If you must sit, get up and move around every twenty minutes. Sit with your knees at hip level or slightly higher than your hips. Use a small towel rolled behind your back to add support in the lumbar (waist) area.  Don’t slouch. 

Standing: Avoid prolonged standing without moving.  Stand with one foot in front of the other with knees slightly bent.  Or try placing one foot on a stool; this position will reduce the pressure on your lower back. 

Sleeping: Sleep on a firm mattress. The floor is too firm. If sleeping on your back, place pillows under your knees.  If sleeping on your side, keep your knees bent and place a pillow between them.  When rising from a lying position, use your arms for support; roll first to your side, and then push yourself up with your arms. 

Driving: Bring your seat forward to a position where your knees are slightly higher than your hips.  Keep the seat back in an upright position and avoid slouching.  Use a towel roll or backrest for support for your lower back.   

Lifting: Avoid lifting. If you must lift, squat down to the floor and keep the object as close to you as possible. Use the strength in your legs instead of your back.   

Activity: Stay as active as possible without pain.  Muscles tighten up and stay in spasm if they are not allowed to stretch.  Movement stretches them, keeps them warmed up.  Walking on level ground is a great exercise for lower back pain. 

Osteoarthritis Treatment Options

Osteoarthritis (aka OA, DJD or in degenerative joint disease) is a very common problem that I (Daniel Jacobsen, DC) treat in my office in
Beverly Hills California.  The most common symptoms are restricted motion or movement, joint pain and sometimes swelling. It seems that most of the public and a lot of physicians believe that it is from normal wear and tear of joints.  And most/all people over the age of 65 either have or will get osteoarthritis.  The typical medical treatment for OA/DJ D. is NSAIDS (Advil, ibuprofen, Motrin, Aleve) or prescription medication like Celebrex (remember Vioxx).  Recent studies seem to contradict the normal wear and tear opinion that most people have.  A recent study showed older (65 plus years) joggers had less degeneration in their knees then their sedentary counterparts.    According to Joseph A. Buckwalter, MD, is professor and chair of the department of orthopedic surgery at the University of Iowa Hospitals and Clinics in
Iowa City.  longitudinal studies of patients with hip and knee OA show that over a decade or more, the radiographic signs of joint degeneration do not progress in one- to two-thirds of patients, and a longitudinal study of 63 patients showed that over 11 years, 10% of patients demonstrated improvement in the radiographic signs of joint degeneration. Therefore, it appears that OA is not the inevitable result of normal wear and tear based on the evidence. Double-blind clinical evaluation of the relative efficacy of ibuprofen and Glucosamine sulphate in the management of osteoarthritis of the knee in out-patients.
A double-blind trial was carried out in 40 out-patients with unilateral osteoarthritis of the knee to compare the efficacy and tolerance of oral treatment with 1.5 g Glucosamine sulphate or 1.2 g ibuprofen daily over a period of 8 weeks. Pain scores decreased faster during the first 2 weeks in the ibuprofen than in the Glucosamine treatment group. Although the rate of decrease was slower, the reduction in pain scores was continued throughout the trial period in patients taking Glucosamine and the difference between the two groups turned significantly in favor of Glucosamine at Week 8. No significant differences were observed in swelling or any of the other parameters monitored. Tolerance was satisfactory with both treatments, with only minor complaints being reported by 2 patients on Glucosamine compared with 5 patients on ibuprofen.Author: Lopes-Vaz-A
Curr-Med-Res-Opin. 1982; 8(3): 145-9I recommend to my patients a combination of Glucosamine sulphate, MSM and omega-3 softgel caps (natural Cox-2 inhibitor) I recommend that they do range of motion exercises, stretching and physical therapy modalities to reduce pain, swelling and inflammation.  As they progress we begin to increase to resistance bands or weights.  Most patients see significant improvement with exercise. 

Vitamins

This week at the office a patient who was pregnant asked me if she needed to take prenatal vitamins.  My immediate response was yes.  I asked her about her diet, how many fruits was she eating a day, how many vegetables was she eating a day, how much protein which she getting, was she able to eat dairy (milk, cheese) and was she eating as much as she was before she was pregnant.  She told me that she was not eating as many vegetables as she was before she was pregnant because of the smell.  Her first trimester she had trouble eating at all (she was at in her second trimester).  I asked her what her obstetrician and recommended and she replied he gave me a prescription for prenatal vitamins but never asked about my diet or eating habits.  His nurse/assistant asked if I was taking my vitamins on follow-up visits and I said no, but it was never discussed again.I referred her to a web site for the American Pregnancy Association, below is their opinion.  “A balanced diet is the best way to receive nutrients, but vitamin supplements can also be beneficial. Pregnant women should only take vitamin supplements on a health care provider’s recommendation. Supplements do not replace a healthy diet but rather ensure that a woman is receiving enough daily nutrients. Vitamin supplements work best when taken as part of a healthy diet and not as a substitute for a healthy diet” Professionally I believe that everyone, pregnant women, non-pregnant women, men and children should be taking a vitamin supplement.  My wife, my children and I all take vitamins if not daily at least 4-5 days per week. According to the American Medical Association (June 19, 2002) 

“Vitamins for Chronic Disease Prevention in Adults Clinical Applications

Robert H. Fletcher, MD,MSc; Kathleen M. Fairfield, MD,DrPH JAMA. 2002;287:3127-3129. Vitamin deficiency syndromes such as scurvy and beriberi are uncommon in Western societies. However, suboptimal intake of some vitamins, above levels causing classic vitamin deficiency, is a risk factor for chronic diseases and common in the general population, especially the elderly. Suboptimal folic acid levels, along with suboptimal levels of vitamins B₆ and B₁₂, are a risk factor for cardiovascular disease, neural tube defects, and colon and breast cancer; low levels of vitamin D contribute to osteopenia and fractures; and low levels of the antioxidant vitamins (vitamins A, E, and C) may increase risk for several chronic diseases. Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements”

 I recommend to all my patients, friends and family that they take my Wellness Pack. I worked with a Ph.D., a medical doctor, a nutritional consultant and a vitamin manufacturer to put together the best product with the highest quality the ingredients I could find and priced at very reasonable.  It took six months of formulation and reformulation to get the product I wanted and this is the third generation of the product, as more information became available to formulation changed. You can buy the Wellness Pack online or if you’re in Beverly Hills, come by the office.

The Leading Causes of Death In Men and Women

The top 10 causes of death in men

heart disease

cancer

accidents

stroke

chronic obstructive pulmonary disease

diabetes

pneumonia and influenza

suicide

kidney disease

liver disease

The top 8 leading causes of death in women

heart disease

cancer

stroke

chronic obstructive pulmonary disease

Alzheimer’s

diabetes

accidents

pneumonia and influenza

What would be the effect of a healthy diet, regular exercise, vitamin supplementation and a positive mental attitude on these diseases?

Eating Fish While Pregnant

Last week I was contacted by two Beverly Hills obstetricians. They wanted to sell/give my fish oil supplements to their patients.  There has been a huge demand in pregnant women for fish oil supplements.  Recently there have been two publish studies on fish consumption and pregnancy.  The first study was from Denmark and related premature birth to low fish consumption.  The premature birth rate is 7.9% in non fish eaters and 1.9% in women who ate 2 servings per week.

The second study published last Friday in the British Medical Journal  (The Lancet) tracted the eating habits of over 11,000 pregnant women and the IQ’s of their children.

The children of low or non fish eaters were 48% more likely to have lower verbal IQ scores than the the children of the regular fish eaters. The fish eater children also did better in fine motor, communication, speech and social skills.

My omega-3 concentrate softgel capsules are pharmaceutical grade and free from toxins. The are available from my website or my office. click the links.

Yours in Health,

Dr Dan

Fish Oil (omega-3 concentrate) Facts

There is an old Italian Saying:“Sono divencete veccio, Troppo presto, ma Furbo troppo tardi”

It means” I got old too soon and smart too late”  There is so much research and evidence on the benefits of omega-3 concentrate that it is my professional opinion that everyone should be taking this supplement on a daily basis. 

• The benefits of fish oil to the human body have been very well-established in research and multiple health studies.
• EPA and DHA are essential fatty acids which means the human body cannot synthesize them so we must get an even from either food sources or nutritional supplementation.
• Fish oil is the best source of two long-chain essential fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)–the omega-3 fats
• The human body benefits may include heart health, brain function and inhibition of abnormal cell growth.
• Pure fish oil concentrate is probably a better source than the fish is made from because it is purified of toxins (mercury and pesticides).
• Most Americans (civilized Western diet) do not take in enough EPA and DHA in their diet to maintain optimum health.

• Vegetarian sources (flaxseed oil, walnuts, and almonds) of omega-3 do not provide EPA and DHA.  They provide alpha-linolenic acid which the body must convert to EPA and DHA

If I’d known I was gonna live this long. I’d have taken better care of myself. -Eubie Blake At Age 100 

We sell a pharmaceutical grade omega-3 concentrate softgel (easy to swallow) on our web site and at the Beverly Hills office.  Each tablet is 1000 mg concentrated and purified fish oil.