Flexibility is overlooked in preventing Back and Joint Pain and Stiffness

Singapore Spine

"Keep yourself flexible as part of a regular exercise regime" states Dr Prem Pillay from the Neuro Spine and Pain Center Singapore.
Effective fitness programs should include cardiovascular training, strength building and flexibility exercises, but the flexibility component is often overlooked, according to the American Academy of Orthopaedic Surgeons.
"Increasing your flexibility improves your ability to move easily," orthopedic surgeon Dr. Raymond Rocco Monto, of Nantucket, Mass., said in an academy news release. Dr Prem Pillay agrees and says "Don`t focus on strength and cardiovascular excercises only"
"Some joints lose up to 50 percent of motion as we age. There are many ways to improve your joint flexibility, including controlled stretches held for 10-30 seconds, stretches that rely on reflexes to produce deeper flexibility, as well as yoga and pilates," explained Monto.
Including flexibility exercises in your workouts helps reduce back and joint pain, increases circulation, improves joint motion, boosts athletic performance and improves muscle health.
To get the most out of flexibility training, always warm up before you stretch, Monto said. Stretching cold muscles can lead to injuries.
He advises stretching slowly and gently, and breathing into your stretch to avoid muscle tension. Relax and hold each stretch for 10 to 30 seconds.
Don't bounce while stretching because doing so can cause injuries. Also, stretching should not hurt, Monto said. If you feel pain, go easier on the stretch, breathe deeply and relax into it.
"Certain sports such as Table Tennis and Badminton incorporate flexiblity as a part of the sport movement and this is useful to those who practise it" says Dr Prem Pillay. Akido,"Wu Shu and other martial arts also have a good flexibility component that is useful"states Dr Prem. However Back pain that persists despite the correct exercise regime should be check out by a Spine Specialist as it may be linked to Spine nerve irritation and not a simple muscle strain.

SOURCE: American Academy of Orthopaedic Surgeons, news release, Nov. 4, 2015
Neuro Spine and Pain Center Singapore (http://www.singaporespine.org)
Medline Plus,USA

Wireless Pain Relief is Coming. Singapore Spine : Advanced Treatments for Back Pain 

A new generation of wireless pain relieving devices can be implanted or injected to sites in the body to relieve pain.

Building on wireless technology that has the potential to interfere with pain, scientists have developed flexible, implantable devices that can activate -- and, in theory, block -- pain signals in the body and spinal cord before those signals reach the brain.

The researchers, at Washington University School of Medicine in St. Louis and the University of Illinois at Urbana-Champaign, said the implants one day may be used in different parts of the body to fight pain that doesn't respond to other therapies.
"Our eventual goal is to use this technology to treat pain in very specific locations by providing a kind of 'switch' to turn off the pain signals long before they reach the brain," said co-senior investigator Robert W. Gereau IV, PhD, the Dr. Seymour and Rose T. Brown Professor of Anesthesiology and director of the Washington University Pain Center.
The study is published online Nov. 9 in the journal Nature Biotechnology.
Because the devices are soft and stretchable, they can be implanted into parts of the body that move, Gereau explained. The devices previously developed by the scientists had to be anchored to bone.
"But when we're studying neurons in the spinal cord or in other areas outside of the central nervous system, we need stretchable implants that don't require anchoring," he said.
The new devices are held in place with sutures. Like the previous models, they contain microLED lights that can activate specific nerve cells. Gereau said he hopes to use the implants to blunt pain signals in patients who have pain that cannot be managed with standard therapies.
The researchers experimented with mice that were genetically engineered to have light-sensitive proteins on some of their nerve cells. To demonstrate that the implants could influence the pain pathway in nerve cells, the researchers activated a pain response with light. When the mice walked through a specific area in a maze, the implanted devices lit up and caused the mice to feel discomfort. Upon leaving that part of the maze, the devices turned off, and the discomfort dissipated. As a result, the animals quickly learned to avoid that part of the maze.
The experiment would have been very difficult with older optogenetic devices, which are tethered to a power source and can inhibit the movement of the mice.
Because the new, smaller, devices are flexible and can be held in place with sutures, they also may have potential uses in or around the bladder, stomach, intestines, heart or other organs, according to co-principal investigator John A. Rogers, PhD, professor of materials science and engineering at the University of Illinois.
"They provide unique, biocompatible platforms for wireless delivery of light to virtually any targeted organ in the body," he said.
Rogers and Gereau designed the implants with an eye toward manufacturing processes that would allow for mass production so the devices could be available to other researchers. Gereau, Rogers and Michael R. Bruchas, PhD, associate professor of anesthesiology at Washington University, have launched a company called NeuroLux to aid in that goal.

Dr Prem Pillay,  Medical Director of the Neuro Spine and Pain Center Singapore calls this advance , an important breakthrough in pain treatment particularly for pain patients who have intractable pain that cannot be relived with the usual treatments of pain meds, physiotherapy, pain injections and spinal surgery. He states that the current devices include Spinal Cord Stimulators that may need more invasive surgery to implant, are more bulky and require battery sources  that need to be replaced.

References:

Science Daily : Nov 2015

Sung Il Park, Daniel S Brenner, Gunchul Shin, Clinton D Morgan, Bryan A Copits, Ha Uk Chung, Melanie Y Pullen, Kyung Nim Noh, Steve Davidson, Soong Ju Oh, Jangyeol Yoon, Kyung-In Jang, Vijay K Samineni, Megan Norman, Jose G Grajales-Reyes, Sherri K Vogt, Saranya S Sundaram, Kellie M Wilson, Jeong Sook Ha, Renxiao Xu, Taisong Pan, Tae-il Kim, Yonggang Huang, Michael C Montana, Judith P Golden, Michael R Bruchas, Robert W Gereau, John A Rogers. Soft, stretchable, fully implantable miniaturized optoelectronic systems for wireless optogenetics. Nature Biotechnology, 2015; DOI: 10.1038/nbt.3415

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Back Pain in Tennis Players : Who gets it and How do you treat it.

Back Pain in Tennis Players : Even the Great ones get it. How do you avoid it and treat it?

Samantha Newgy
World Medical News 










          

Roger Federer suffers from it and so does Andy Murray. Federer has sufferred back pain and back spasms several time in his career but this season appears to be the worst for him so far. He has been defeated by a far weaker player and has had to exit the Swiss Open this year because of severe back pain.

We interviewed Dr Prem Pillay, a Neurosurgeon and Spine Specialist, on his views and advice. He has noticed that both professional and amatuer tennis players can suffer from back pain. There are several reasons. In amateur players a frequent reason is lack of a proper warm up prior to actual playing. The back muscles should be properly stretched and warmed up states Dr Prem for about 5-15 mintues as part of a general warm up prior to play. The most important stroke in Tennis is the service action. This puts significant stress on the Back as it is a quick and forceful action requiring back and neck extension followed by back flexion explains Dr Prem .   Back muscle strain can occur without a proper warm up. In some cases actual small tears can occur in the large muscle groups called the Para-Spinal muscles in the mid to low back. In professionals, the reasons can be different. They have to train hard and play in numerous tournaments. This exposes them to a higher chance of a back injury from the sheer hours of playing they subject themselves to per week and per season. Some players with a weak spine are often weeded out early in their careers states Dr Prem Pillay. However even experienced players with perfect strokes and services can suffer a back injury. Over time some players can develop weakness in the Spine Discs in the back. A Spine Disc injury can develop either suddenly or more usually over time. The accumulative effect of physical stress on the spine from  high level play can casue spine disc protrusions which can be associated with back pain and back spasms. Some players even have arm pain or leg pain from the spine disc protrusions pinching nerve in the neck and low back respective states Dr Prem , the Spine Specialist. He recommends that those that suffer back pain from tennis put effort into a back strengthening program after a careful evaluation by a Spine specialist.Dr Prem Pillay's advice for Roger Federer is to get a proper spine evaluation done and a high quality MRI of the whole spine. A spine rehab program that incooperates an aquatic physio component would be helpful. A slipped disc or Disc protrusion that is significant on MRI could be treated by an advanced spine injection method called Discoplasty using either a laser or a superior to laser technology as a one hour day treatment without surgery, Most athletes including tennis players and others can return to sports activies by the next day. Furthur information is available at www.singaporespine.org or by contacting Dr Prem Pillay at clinicsg@yahoo.com.