Hey there, welcome to The Stay Healthy El Paso Podcast, I'm your host, Dr. David Middaugh, I'm a specialist physical therapist over at El Paso Manual Physical Therapy. And we're going to be answering the question today about how to choose the best pillow for a neck and shoulder pain problem.

We have so many clients here in the clinic that are wondering, they ask us all the time, what's the best pillow for me to have, should I get a polyester filled pillow, or feather pillow that I found this pillow online that cost $300 I found this other pillow at the store that cost 20 bucks. And we have all kinds of mixed answers and results.

The fact of the matter is, it's very confusing, there are so many options. And depending on what kind of neck and shoulder problem each individual has, you want to approach it differently. And it's more than just the pill of a pillow. It really is a tiny factor. But it is a factor and it can make a difference. So we want to talk about it in this podcast for you today.

Let’s break this down. The number one question you got to start with is what is your preferred sleeping position? Are you more of a side sleeper? Do you sleep on your back? Or do you tend to sleep on your stomach?

Now whenever I asked that question, the first answer I get is a little bit of everything. Sometimes I start on my side, and I end up on my back. I started on my stomach and then end up on my side. Or I started on my back and then end up on my stomach. We get all kinds of mixed things. And what I’ll go with is, where do you start usually? Where do you start to fall asleep? How do you get most comfortable? That is what I would look to optimize for.

So, if you’re a back sleeper, if you start sleeping on your back, then you have to consider whenever you lie on your back, how rounded is your back, how soft is your mattress, and how far up from the bed is your head. In other words, if your back is kind of flat, you have a flatter back and you lie down and your head’s kind of comfortable on the bed, then you might even be able to get away with no pillow or a thin pillow. You might not need the thickest pillow ever.

But if you have a rounded back because you’re naturally are kind of there. There are some people that are naturally there, and you’d like to sleep on your back then you’re going to need a thicker pillow, because what you’re looking to do is fill that space between your head and the bed whenever you lie down.

That’s the critical key component here, because what you need to do is rest your spine, rest your neck and upper back without letting your neck hang backwards, or putting excessive pressure through your spine, your upper back area. Whenever you lie back, you’re looking to fill that space between your head and the bed whenever you’re on your back.

It’s a similar concept for when you’re on your side. If you go lie down your side, now there’s a space between where your shoulder hits the bed and your head, there’s going to be that gap between either your head and the bed and it’s taken up by that space between your shoulder and your neck. So, you’re looking to get a pillow if you’re a side sleeper that fills that gap that tends to be a thicker pillow than if you’re a back sleeper.

You just have to consider the sizes of it and the thickness of the pillow and also how much it gives because some pillows are real thick, but you put your head on and then you sink down quite a bit so it ends up kind of being thin whenever you actually lie down on it. You have to just feel them whenever you go purchase a pillow and see what’s best for you.

If you’re a stomach sleeper, then it can get a little confusing because if you’re the type of stomach sleeper that you put your arm across your face and your heads turn to the side, then you probably don’t need the thickest pillow or maybe you want a pillow to hug, because some sleepers tend to not sleep completely flat, they’re kind of at an angle. So you need a pillow under your chest or shoulder and you’re going to be turned off to the side so you don’t need the thickest pillow for that situation.

Now some stomach sleepers are really more of a side sleeper but are towards their stomach. So that’s a situation where you might need an even thicker pillow. So you have to consider how far away your head is from the bed in this situation.

The next thing you want to consider is the filling of the pillow. You want to generally avoid the lumpy materials. The lumpy materials are going to be polyester and feathers or down is the other term that you’ll see on pillow labels. The reason for avoiding the lumpiness is because if you’re having a neck and shoulder problem, chances are you’re going to be tossing and turning at night, probably subconsciously. You’re not going to be even awake while you’re doing it.

And if you got this lumpy pillow that you’ve been able to manage whenever you’re not hurting because you can kind of just shove the pole together and get the all the polyester all the feathers together in one spot and put your head on there and you sleep through the night for the most part or if you wake up, you can do it again. But now you’ve got this neck and shoulder problem.

You want to get good quality rest so you want the entire pillow to be about the same cushion You want to avoid having those lumpy materials like down and polyester feathers, because when you roll around those lumps will be in position when you first start to go into sleep, but whenever you’re starting to wake up and move around because your neck and shoulders are hurting you, then you’re probably going to roll off those lumps and you’re not going to get the best quality sleep you want to make sure that the amount of cushion is evenly distributed, and not just a lump in one area where you started the night.

The third factor here is considered having multiple pillows for different sleeping positions, because you might start out on your back and you might need a thinner pillow in that instance, and mid in the middle of the night you might turn on your side and in now you need a thicker pillow because the gap between the bed in your head while you’re on your side from your shoulder is bigger than when you lie on your back.

A thicker pillow that sustains its thickness is the best thing at that point. The general idea is you want your spine to be straight. So if you lie on your side, you don’t want your head hanging down towards the bed and your neck bending sideways. That’s not going to be very good on your neck, especially if it’s irritated in the shoulder as well. It’s going to put more pressure on the shoulder and it’s going to stretch out the tissues on the opposite shoulder that’s up from the bed.

It’s just not a good situation to have your head hanging downwards. So get a thicker pillow and a thinner pillow. Now we here at the clinic have custom pillows, we have a special pillow called pillow wise. And they come in six different sizes, they have different colored trim on them to indicate the sizes and they’re shaped differently on each end. On one end, they’re thinner, and on the other end, they’re thicker. And they are made out of memory foam so that they can evenly distribute the weight of your head or your soldiers, whatever you’re resting on here.

They’re designed so that when you lie on your back, you can lie down on the thinner end and it’s not pushing your head up so much and pushing your neck out of alignment. Or if you lie on your side, you can flip the pillow around and lie on the thicker end, so that it fills that gap between your shoulder and your, between the bed and your head where your shoulders pushing your head away from the bed more.

And depending on how broad your shoulders are, depending on your genetics, your exact sleeping position, because if you’re not directly on your side, then you’re kind of more leaning towards your back or leaning towards the front than you you’re going to want a thinner pillow because your head’s going to be closer to the bed.

Here in the clinic, these pillows that we have, there are six sizes, and we custom fit each patient to them, each patient that needs to get a pillow. Based on measurements, we actually measure their neck circumference we measure the distance from their head to their shoulder. And then we take other factors into consideration as far as how they sleep. We ask them a lot of these questions that I’m talking through with you right now so that we can best fit them to the pillow, and we found amazing results.

And I just want to give you the caveats here. The results are great and that the patients are getting better quality sleep. But we’re not solving a neck and shoulder problem. Pillows don’t solve neck and shoulder problems, they merely allow you to get better sleep, which is critical if you’re dealing with a neck and shoulder problem. Because the more you sleep, the better you can heal. And of course, the less grumpy you are and the overall healthier. You’ll be on other ends of your health, not just your neck and shoulder problem your immune systems I’m getting at.

If you get good quality sleep, you’re putting yourself in a better position overall to fix the neck and shoulder problem. But if you’ve got a rotator cuff tear and arthritis problem, a pinched nerve, or other issues that can affect the neck and shoulder, then this pillow type that we offer here, the pillows that I’m describing that you might go find at the store are not going to solve it. There’s usually some underlying root cause problem of muscle imbalance, some joints that are stuck, some other issues that need to be addressed so that your sleep can get better at night.

Think of it this way, if you fell, and hopefully this doesn’t ever happen to you. But if you fell really bad and skinned your knee on concrete or road or something like that, and you just had this massive road rash, let’s say you have like a six inch circle of road rash on your knee. It would hurt tremendously. Obviously, it would hurt even if you stayed still, if you were just lying down in bed at night, and you just had Road Rash earlier that day. Your knee would probably throb and hurt. And that’s just how it’s going to happen.

That doesn’t mean that you need a special pillow for it necessarily. It’s healing right now. So you just need to give it time and it will heal as it scabs over, as it goes through the healing process and eventually develop a scar and your skin is fine and your knees fine. Then it’s not going to bother you anymore. You don’t have to worry about it. But while it’s healing, it’s going to kind of bother you.

People that have rotator cuff tears, or arthritis problems in their neck or pinched nerves, it’s kind of like they have a fresh injury like that Road Rash example that I’m telling you about. And it’s just going to hurt and throb no matter what at night. So what you’re looking for is getting in the most comfortable position possible so that you can get sleep. But what you have to be doing simultaneously is figuring out how to solve that pinched nerve, arthritis, rotator cuff tear or other neck and shoulder problem during the day so that it’s not getting so irritated during the day so that at night, you’re able to rest better.

It matters more what you do during the day to solve your neck and shoulder problems so that your sleeping can become better and better over time. I just want to make sure that you’re approaching this correctly, because we get patients in here all the time that swear, they need a better pillow or even a mattress and they even go spend quite a bit of money on it. Which is fine if you needed a mattress or pillow.

Anyway, I’m not stopping you from doing it. I just want you to do it for the right reason, make sure that you’re looking to get it fixed. I want you to be in a situation where you don’t have to have surgery and having to rely on medications to go to sleep at night, or pain medications to get through the night. It’s not a healthy thing for you to be doing. You need to solve that that problem, the root of the problem, and it’s usually done while you’re awake.

So that being said, choose your pills wisely. Make sure that you understand that you’re just looking at getting that extra hour or two of quality sleep. You’re not looking to solve the whole neck problem or the whole shoulder problem.

Thanks for listening to our podcast, guys. If you're interested in what our pillows are like, they're not on our website, we don't sell them online. And we can't really, the maker doesn't even sell them online to the public. They have to be purchased through a medical office like a physical therapist’s office like ours. So, if you're looking up our pillows, they're called pillowise. So you can just go to pillowise.com or Google pillowise and you'll find our pillows and kind of how they work and they're pretty nice, they're there.

They're pretty high-end phenomenal pillows, we love them all our patients that have bought them love them. When patients buy multiples, often just because they want to you know want in their RV, when they're at their home, when at their guests room for their spouse. Oftentimes spouses come in and buy one because they get to try it out as well. And they really like it and they want their size pillow because they're all custom fitted for each individual's sleeping preferences in size their neck and shoulder size.

So anyways, you can call our office at 915-503-1314 to set up a time to come in and get fitted for a pillow if you if you wanted to do that. Our staff has special training on how to fit you for the pillow. And then also what I recommend is getting a discovery visit during which physical therapists can check your neck and shoulder problem out to make sure that you have all the information necessary to properly address your neck and shoulder problem.

We're not talking about certain treatment at this point, just knowing what's going on with your shoulder and neck problems so that you can have a better expectation of how this pillow can help you out and how to properly use the pillow what to expect with the pillow regarding your neck and shoulder problem.

Anyways, if you found this podcast was helpful for you, please give us five stars on whatever platform you're listening to this on. That helps us get this podcast out to people that potentially need our help people that want to get better in their health and just are trying to figure this out and learn how. So you'd be helping them out. I could care less about it for my ego for my sake. I want the people to get the help they need so please give us five-star reviews so that they can get help. We'll talk soon again. Have a great day.

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Hey there, welcome to the Stay Healthy El Paso Podcast. I'm your host, Dr. David Middaugh, physical therapist over at El Paso Manual Physical Therapy. And I'm going to cover with you today how to get rid of lower back pain. Now this is a simple explanation from the perspective of a specialist physical therapist. I'm going to get into the nitty gritty details about how back pain develops, how the medical field at large looks at it, and then a proper level headed way to move into fixing it for the long term.

I split this up into seven pieces. So I’m going to cover each one by one.

Number one, understand that it’s a process and not a procedure to fix a lower back pain problem.

What I mean by that, just to unpack it a bit more, is many people even in the medical field believe that fixing a lower back pain problem is just a matter of having a procedure done or a technique or a medication. In other words, they have this belief that you do this one thing, and when you’re done with that one thing, then you come out with the back pain gone or resolved. And it’s just not the case.

The fact of the matter is, it is a process to properly fix a lower back pain problem for the long term. Now it can be a procedure or a technique or surgery or something like that, to get short term relief of back pain, it is possible to get pain gone today or maybe even for a few days or maybe even for a few weeks or months. But to properly fix it for the long term where you feel like you have control over the back problem, and you know what to do to make it stay healthy and not allow that problem to come back and turn into a worst problem as time goes on. That is a process.

I see it so many times where a patient comes in for their first appointment with us here in the clinic. And they’ve got a back problem. And they said, I’ve tried this, I’ve tried that, I’ve tried seeing this person and that person, this medical expert, and this medication and this exercise and this and this and that. And many times, I’m listening to them thinking, well, you’ve tried many aspects of the process, but haven’t really been guided on how to walk through all of those pieces in a structured strategic manner to fix the back pain problem.

And that’s part of the issue, it’s just not organized, and it’s not done well. And there’s a false expectation that this one thing that you do that one medication you take, or that injection, or that one visit to the doctor is going to fix it for good. But it’s just not the case. It is a process over time, and learning has to occur.

I’ve got small children now that are learning how to read. And it’s not just one class are learning the alphabet that gets kids to read, it’s practice and replicate and development. Once they learn how to read a three-letter word, and they’ve got to expand to a five-letter word, and then you have more complications to reading like plurals and conjunctions and irregular plurals. There are all kinds of different aspects to learning how to read. And it’s a process.

It’s a process that happens over time. But in one day, you might learn one aspect of it and then the next day, you want another aspect of it and as you keep building on that over time, then you develop a process that helps you meet the outcome, which for somebody with lower back pain, they want it gone forever and not ever have to step into a surgeon’s office to get something handle there, or to get injections or medications for the long term.

Number two, don’t be afraid of big words for medical people.

The same thing when we get patients in for their first visit for a back pain problem, oftentimes, they hear stuff like degeneration, osteoarthritis, osteopenia, facet arthroscopy, they throw all these big terms out there. And it’s quite scary for patients, especially if they’re not in the medical field or don’t have an understanding. It’s quite scary for patients to hear that.

And then inevitably, what patients will do is they may get an MRI report or, or some documentation from the doctor’s office where they just remember the word and they write it down, or they start googling it, and they find all kinds of terrible things that happen in extreme cases of those conditions that are described in those big words.

But the reality is that in nine out of ten back pain cases, where a doctor or a physician or some medical expert might tell you have facet arthropathy, or degenerative disc disease or so they throw out some of those big terms, and nine out of ten of those cases, they’re fixable. Without surgery, medications and injections, and they do stay better for the long term.

It’s really the minority of people that need to have some sort of procedure done or something invasive. Or where they have to face that they’re going to have some discomfort, or some level of their condition lasts for the rest of their lifetime. But that’s really just a small percentage of cases.

Number three, wait as long as you possibly can before getting an MRI.

There are other imaging procedures that are done x- rays, CT scans, and those are a little lower level than an MRI. And what you have to understand about getting an MRI is that it’s, it’s pretty detailed, but there’s also a high risk for what we call false positives. Meaning they found something that’s on the MRI, but if we were to open up the body and look inside, it’s not really there. It’s just the way the MRI image was produced. It looks like there’s something there that isn’t, so that’s a false positive.

The reason a MRI report might say, you have arthritis at this level. And in reality, you don’t, it was just a distorted image on the MRI. So if you go get an MRI, what it does is it opens you up to potentially having conversations with the doctor about getting procedures done in parts of the lower back, that may not even need anything done.

The reality of this, and we have it proven in research is, that it’s rarely the case that where there’s a problem on an MRI, that’s the source of pain. They’ve done research studies where they have found that they’ll do MRIs on everybody, on a bunch of people that have back pain and they’ll do MRIs on people that have no back pain. And they’ll find that across the board, whether they have back pain or not, there’s positive findings are they find stuff that’s wrong with their MRIs in their low backs.

Doctors can’t really categorize who has pain or who doesn’t, if they’re just purely looking at MRIs because somebody that has no back pain could have arthritis in their MRI or some disc problem on their MRI, but they’re okay, they don’t have any problems in real life and they’re able to do everything that they want to do.

So this is good news because it is possible for you to go get MRI if you’ve already had an MRI, have some positive findings on there have some disk issues some arthritis problem, but then it resolves, it gets better. But if you had an MRI after the fact it might still be there on the MRI because you’ve converted into one of those people that no longer has back pain but has a positive finding on an MRI.

Your best bet is to pursue natural treatments, pursue noninvasive treatments so that you can avoid having the MRI and then having to end up, because doctors are recommending you to go into some sort of invasive treatment or some medicinal treatment that has some side effects potentially for you.

Number four, exercise is king.

When it comes to lower back pain across the board, if you look at all the medical literature, all the scientific research studies, some form of exercise tends to produce positive results in people that have lower back pain.

Now that’s a big huge generalization. And the fact is we get patients to come into the clinic all the time that say, they’re listing out all the things, they try to try this, I’ve tried that. Some of those are, I’ve tried crunches, and I’ve tried squats. and I’ve tried this exercise I found on YouTube and this other one that was recommended to me for my friend, and my family member who resolved their back pain, but it didn’t work for me.

The fact of the matter with exercises, finding the right ones for your specific back problem is what needs to be done. There’s likely some muscle that needs to be strengthened, or some exercises you need to start out with, and then over time work into harder exercises, because it’s a process it’s not a procedure. In order to fully resolve a back problem and keep it gone for good.

And number five, if exercise is king, then habits are queen.

What I mean by that is, what you tend to do in the body position and the way that you move when you’re doing those things. If you have a desk job and you tend to sit for longer periods of time, or if you love watching shows on TV, then you probably also sit for long periods of time. Now where you sit, the way your chair is set up, the support on the chair, if you drive a lot, the car seat that you’re in its support as well, might affect the position of your back. And it could affect the health of your back.

The habits that you’re in, greatly affect your back problem. It’s also the movement, how you move through life, the way that you walk, the way that you get up. your exercise routine that you keep or don’t keep, the habits that you do are a big deal.

Here in the clinic, when we see patients with back pain, we’re often asking them about their daily routine about their lifestyle, so that we can get the information we need to better guide them on how to modify those things, the way they sit the way they move their exercise routine so that they can build good habits or tweak their mediocre habits so that they become good habits so that it benefits your back problem.

Number six, there will be ups and downs in getting your back pain problem taken care of.

Just understand that. And I tell this to patients all the time, whenever they start out here in the clinic, that you’re probably going to get better right away, you’re going to start feeling better here within the next couple of weeks, and then expect a flare up. Because inevitably, as people feel better, they get a little more confident they start wanting to do the things that they love to do before they had back pain. And they’re not quite ready for it unknowingly, and the back pain flares up again.

It’s that vicious cycle that oftentimes kills people’s motivation to drive forward into something because they assume that what they were doing didn’t work because the pain returned. But in reality, that’s just the way life is. It’s never a linear improvement where each day is better than the last day, it gets better and better and better and better and it just goes straight up in a straight line. It’s more up and down like a like the waves are a roller coaster. One day may be good, the next thing might be bad.

But as long as you’re following the process of how to fix your back pain problem for the long term, then overall as time goes on, you’ll trend in the right direction and you should be able to take care of your back problem for good.

Number seven expert help will expedite the process.

This is where I want to recommend to you that you get in touch with an expert physical therapist or some specialist that you feel is best suited to handle your problem. Now if you’re looking for a natural solution, I definitely recommend the specialist physical therapist. If you’re seriously considering that your back pain problem might need surgery then please go talk to the orthopedic surgeon or the best person for you.

But if you’re looking to naturally resolve your back problem, an expert physical therapist can guide you on the exercises that you need to do, discuss with you the habits that you have, other aspects of your back pain problem, the history, old injuries that you’ve had, and also do have hands on work to make sure that any joints that are not moving well any muscles, tendons, ligaments, other soft tissues that need to be broken up or freed up, get freed up as fast as possible, so that when you go to do exercises, they’re their most successful for you and you can progress through them as fast as possible.

And going back to number one, it’s a process, not a procedure, so that you can shorten that the length of that process. fixing a back pain problem on your own very well could take you a year or more. Here in the clinic, we whittle it down to a couple of months, sometimes even shorter, depending on the severity and how many other factors are involved that may be longer. So getting in touch with an expert and working with them will tremendously speed up your process in order to get you the outcomes of getting rid of this back pain problem for good.

Well, thanks for listening to our podcast here. I hope that this podcast was helpful for you, I hope that my voice is getting into your head just a little bit. Whether you're running right now, exercising, or driving, or just doing chores around the house, I hope that you might stop to take a few notes and think about what it is that you're doing, and how you're handling your back problem if you've got one.

And if you don't, and you just thought this was helpful for you please share this podcast with somebody that you think needs to hear this. And one more quick request. If you've been listening to this for a while, or even if this is the first episode that you hear, and you thought that it was pretty good, please take a couple of minutes and just give us a five-star rating on the podcast platform that you're listening to this on. Whether it's the iTunes, Stitcher, any other podcast platform that we have out there, we're on all the major ones.

Please give us a review about how this was helpful for you. It helps us a lot so that we can get this podcast into the hands of other people that need to hear it so we can get more visibility or listen ability on this podcast. And as always, if you have any questions, you can call us at 915-503-1314.

If you're interested in working with us, that's a number to call and just begin to tell us a bit about your back problems so that we can see if it's the right one for us to help you with. You can also go to our website at www.EPmanualpt.com and find the cost and availability tab and you can inquire about what it takes to see us and if it's right for you to see us. And if you're just looking for more helpful resources on that same website go to the blog tab and you'll find tons of helpful blogs on how to fix a lower back pain problem in addition to other body parts that we serve as well. Thanks so much for listening and have a wonderful day guys.

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Welcome to the Stay Healthy El Paso Podcast. My name is Dr. David Middaugh, I'm a specialist physical therapist over at El Paso Manual Physical Therapy, and today we're going to be talking about degenerative disc disease and what to do about it.

The reality is that most people don't really know what it is or what it means. And a lot of people in the medical field don't even really know what it is and what it means either. They just know how to diagnose it and help patients that they have it. They will often do an MRI or an X-ray, or some other imaging study, and tell patients that they have degenerative disc disease. Or otherwise known as DDD for short.

Aside from medications and surgery, there isn't a whole lot of other treatment for this. But the good news is that we have a lot of great help that we can give patients that is natural, and they can really have long lasting benefits for the patient, and definite benefits as long as they can keep up a few things.

I'm going to tell you exactly what it's about and what to do about it through this podcast today.

The cool thing about this problem is that it can get better naturally, without having to rely on medications, injections, or surgery. And we help people do this all the time.

Now, there are a lot of facets to a degenerative disc disease problem. It's kind of an accumulation of several different little causes that all come together to form degenerative disc disease. I'm going to go through all that with you, so that you can have a better understanding of what it is and what to do about it.

First off, let me tell you about the signs and symptoms of this. That way you can see if this is what you have or not. And most people with a degenerative disc disease are 50 and up. It tends to affect people later in life. And it's a combination of arthritis, bone spurs, disc problems, shrinking disc height, and pinched nerves all coming together at the same time.

Now the process of accumulating all these problems happens gradually over time. So it's not like it all happens all of a sudden, it's slowly over years and that's why this tends to affect people later in life.

One of the biggest complaints of this is back pain, stiffness, especially in the morning when waking up, they have stiffness when getting up and moving around. It commonly takes people 20 minutes, 30 minutes, sometimes even up to 60 minutes to free the back up and get to a working place, where it's not that bad, and they can move around.

Oftentimes, the back pain gets worse whenever they're lifting something heavy or carrying something for a long period of time. Even just standing for long periods of time can affect the problem and make it worse. Many times, people with degenerative disc disease get the sensation of their back gives out, or they just all of a sudden get a bunch of back pain and are kind of out of commission for at least a few hours, sometimes as long as a few days. In worst cases, it can take weeks or even months to get better from a flare up like that.

They would have overdone it somehow, typically they would have walked too much, or stood too much or picked up some heavy stuff. Oftentimes when we get patients here in the clinic, they're doing housework and they just overdid it. Or they went on a trip and were on their feet too much. And when they returned from their trip, or finished with their housework, their yard work, then they paid for it as well. They often say I knew I was going to do all that stuff and would have to pay for it the next day.

But as the degenerative disc disease gets worse, the length of time of the flare ups tends to get longer and longer and longer. Usually when they are in their 50s, they say, “Well, you know what I can deal with the flare up that lasts just a day or two, I take some pain medication, and I'm good. I can get on with my life. There's always that low level of back pain, but nothing that stops me from being able to work and take care of my home and my family and do everything that I need to do.“

But as the years go by, it worsens and worsens and what was a one or two day flare up, now turns into a five to seven day flare up, and they are out for a while, they are moving a lot less. They're usually getting less healthy on other fronts, because they can't exercise as much as they like to, they can't walk as much as they like to. They're just not as active as they were in younger years. Because the back pain is just debilitating them slowly over time.

And if it's bad enough and goes on long enough, people often experience losses of balance, they begin to feel like they need to hold on to walls to walk around or furniture people, they need to have a hold of somebody's arm, just to make sure that their balance is okay. And this tends to happen because if the problem goes on long enough, it can begin to affect the nerves that come out of the low back, that go into the legs and provide the nerve supply to the muscles of the legs.

It also helps with the balance systems within the legs. So if that begins to get affected over time, then you start to have some balance issues and that sets you up for some other potential problems, falls, fractures, those kinds of things. The people that go get x rays or MRIs, or other imaging studies are often told that they have decreased disc height. The discs that are between the bones of the spine are shorter than they should be. They also find bone spurs on the vertebrae on the bones in the spine. And they'll often find disc herniations as well.

There are parts of the disc that might be bulging out. And oftentimes there might be stenosis, as well as. Stenosis is where there's a narrowing of the spaces for the nerves to travel through the spine. And sometimes they'll say that they've got a pinched nerve sensation. And sometimes off the imaging, they'll tell the patient that they've got a pinched nerve in an area of the spine, and the patients often feel it, they'll feel that back pain or that radiating pain.

Oftentimes, it can feel like sciatica, where there's pain going down the leg from the back. In rare cases, there isn't much back pain, maybe a low level of it, but the pain going down into the legs is much more severe and stops people from being able to do what they want to do. But when they do the imaging studies on their lower back, they'll find that they've got this degenerative disc disease like we're talking about.

Some other findings that will be on the imaging will be arthritis, osteoarthritis, and then they'll talk about facettes arthropathy which just means the facettes, so arth arthropathy. arth means joint, pathi means disease. So there's some joint disease in the facettes. It's usually arthritis that they're talking about.

If you have had an X-ray or an MRI that talks about all this stuff that I'm discussing, it can be overwhelming, and you hear all these big medical terms. I wouldn't get too concerned about it. It's just a lot of medical jargon. The reality is we've had people in here that have some terrible looking MRIs and x rays, and through our treatments here as specialist, we can actually get them to balance better, to walk better, to have less back pain and be able to live a life without constantly worrying or thinking or stopping or adjusting their schedule to their back problem.

We help people do that all the time, even with severe degenerative disc disease, that the most common treatments. People with degenerative disc disease get recommended is of course pain medications. They will start some sort of oral pain medication. They might also do injections where they stick pain medication into the spine using a needle. And then in some cases, doctors might recommend surgery to open up the holes for nerves and put space in more discs they can replace discs now these days.

They look to do that, and the surgery is dependent on age and strength and other health factors that that the surgeons have to take into consideration. But what you have to realize with surgery is, once they go in and do that, they can't really undo it and there's risks with surgeries, infection, the surgery not even working oftentimes with degenerative disc disease. There are so many components to this.

Like I described that when a surgeon goes in there fixing one of those components, usually maybe two, if they can wing it, but to fix arthritis, the disc problem the pinched nerve, the stenosis, all these issues that I talked about, it's really challenging to fix with surgery.

The other recommendations that are out there are weight loss sometimes. If the individual with a disc problem is a little bigger and could stand to lose some weight that can help. Oftentimes, it does help to some degree. But what needs to be addressed even in people that are heavier is the strength. Because we get people in here all the time that are not obese or not heavy, they really don't need to lose any weight, but they're still dealing with a degenerative disc problem.

And what we find the root is oftentimes is a muscle imbalance, the way that they're moving, some strength issue, some joint that is stuck, some muscles that are stuck as well. And that's something that needs to be checked hands on in the clinic, and talked about with the patient, and a plan needs to be formed so that we can have a process to fix this degenerative disc problem gradually over time, for the long term.

That's exactly what we do here at El Paso Manual Physical Therapy.

Thanks for listening to this podcast, I hope that it was helpful for you. If you'd like to learn more about how we might help you in your back problem, you can visit our website at www.EPmanualPT.com or you can just google El Paso Manual Physical Therapy, that tends to work pretty well as well.

You'll find more helpful videos in our blog, or you can look into the podcast. We have tons of videos on YouTube as well, just hit subscribe to our YouTube channel, you can follow us on Facebook.

And if you want to get direct help, if you're interested in hiring us, and you're in the El Paso area, and you want us to take a look at you and see if it's possible for us to help you directly, then give us a call at 915-503-1314 so that we might begin to help you out. Thanks, and have a wonderful day. Thanks for listening to the stay healthier pestle podcast. Bye.

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Hey there welcome to the stay healthy El Paso podcast. I'm your host Dr. David Middaugh. Specialist, physical therapist over at El Paso Manual Physical Therapy and today I'm going to cover nine natural remedies for headaches and migraines.

Headaches and migraines are so common in our culture today, with the use of computers, desk jobs, we got screens in our house and the wall TVs, we got screens in our pockets, our mobile devices. And then we hop on computer at home all the time too.

Headaches and migraines can definitely plague just about any American at any given time of our lives. So I'm going to cover the nine natural remedies for headaches and migraines with you today.

These types of headaches, we are experts at helping people out and they often are taking pain medications regularly, they may go see a specialist to get specialized pain medications. Sometimes they get injections for it. Oftentimes they're missing work or they're just not able to function daily and be their normal self because of this darn headache and migraine problem.

If you've got some combination of those issues that I just described, you're going to want to hear these nine remedies that you can try at home right now so that you can begin to calm down your headache or migraine problem.

Number One, Ice And Heat

I put these two together because one may work for you and one may not. And a third option is neither may work for you, it's just an option to try out. So using ice on your head, like grab a bag of ice, in a Ziploc bag or put a towel around. You have to find the best method for you. There are ice packs that are out there that are gel and they can conform to your head or body part wherever you want to use it. You can buy those at the grocery store or warehouse stores as well. And just put that wherever you feel like your headache is bothering you.

Now, if you've got a lot of sensitivity to the cold, because that does happen to some people with headaches, then an alternative would be to try heat out if the ice doesn't work out for you and you've tried it out. Great. Scratch that off the list. Now go get heat. So sometimes the same ice packs that you purchased at the store can be heated up in the microwave or some other method. A hot water bottle works really well as well. Those are a little older, but you can use a rice pack, they can heat up in the microwave and put it on over you.

Another option is a towel, just get a small hand towel, dampen it in the sink with some water and microwave it for 30 seconds and it gets nice and steamy. So steamed towel and just put that over your head or wherever you feel like it bothers you. And that's an easy way to get heat onto your head.

Now if you try both of those options and they're not really working for you or they don't work consistently for you, then you just may not be a heat or ice person, I would just scratch it off the list. But oftentimes, ice or heat may be effective enough to bring the headache or migraine pain down just a bit so that you can avoid taking a pain medication, or maybe even avoid going to the doctor and keep it under control so that you can be a little nicer with people around you.

Number Two, Drink Water

Oftentimes, people don't realize how much water they're not drinking. And especially if you have a desk job and you're busy at work and you just are busy with your work and you don't really feel thirsty until the end of the day, it's already kind of late by then you've already become dehydrated. So what you can begin to do moving forward is make sure to get plenty of water and generally 80 ounces or more is good. There are all kinds of measurements out there. What I found is that if you get about five water bottles ranging in size from 16 ounces to 20 ounces or more.

If you make it a point to drink all five of those water bottles every day, you're definitely going to be hydrated. You'll be going to the bathroom a bit more. That's okay though. If your headaches are going away, it's a much better life experience, your quality of life will improve tremendously. And you'd be surprised what difference it could make in your headache and migraine problem.

Number three, reduce screen time.

We are surrounded by screens, they live in our pockets, we are attached to screens a lot. And it does something to your head. There are all these research studies that have been coming out lately about the different shades of light that are coming off of like mobile devices, phone screens, or even television screens, and how they can affect our eyes and our brains that are right behind our eyes.

And with that type of light coming in, it can set off headaches. We've seen trends where kids that are on computers more, using mobile devices more, tend to get more headaches and migraines. And part of it is postural as well, which we'll get into. But if you can reduce your screen time, if it's possible for you to print out that document that you're working on, and handwrite something on it or read a book instead or reading something on a mobile device or on a Kindle or something like that. Don't watch as much TV as you've been watching, find alternative methods to using the screen.

Literally having cut off times where you say I'm only going to be on my phone for this one task. And then that's it. I'm going to stay off of social media which might suck you in, get on to doing different things besides using the screen if you feel like you're using the screen too much, or have screens around you too much, you're probably right and you need to start cutting back on that because of the light that enters your eyes, it could be setting off those headaches and migraines.

And just another side tip about that. If you have to use screens, look at dimming your screen, see what amount of brightness you can bring it down to and still see what you need to see and do what you need to do. And then also there are more settings coming out of computers that control the types of light so that you can get rid of the blue light which is thought to make the which is thought to contribute to headache problems.

Number Four Posture Related To The Screen Time, Consider Your Posture

Whenever you're at a desk looking at a computer or using the mobile device or watching television, if you're slouched over, your head is sticking out particularly this part where your chin is sticking out and you're bent through your neck forward like that. Chances are your postures not good. And you need to find a way to sit up more or recline back onto something with your head, ideally resting on a pillow or some sort of head rest.

Recliners are excellent for this. If you can lean back and the recliner has a head support, that's probably going to be the most comfortable option for you if you're at work using a computer. Ideally, if you had a desk chair that had head support that would be beneficial for you as well. Now, if you don't have either of those options available to you, it's okay you can still improve your posture.

One of the easy things that you can do to improve your posture at a desk or any other time that using the computer screen is to get rid of this head sticking out forward by aaking a baby double chin. Let me just take you through that real quick. If you make a max double chin, okay, nobody's looking just you and me. Do this all the way, make a big double chin and what you should feel are those muscles behind your throat tightening.

Those are the deep neck flexors and they help to get better posture through your neck bones. Now back off on going so hard and do it lightly just to the point where you feel like they're turning on. So for me, it's right there, I can feel them just barely wanting to fire and that is better neck posture for me. So now if I can work at the computer like this, or work on my phone like that, rather than do this, it's going to be a much better situation for my neck joints to all be aligned properly and take pressure off nerves that can contribute to those headache and migraine problems.

Number Five, Exercise

If you are doing some sort of regular exercise, at least a few times a week, whether it's going for a walk or maybe you go to the gym or you partake in some sport or physical activity with your family or kids or whoever it may be. It is a big deal! Getting that regular motion where you sweat, where you work up a little bit of a sweat, you move quite a bit and it's consistent over time. And they do it for 15 minutes, or 20 or 30 or more than it is likely a big contributing factor to your headache and migraine problem.

The fact of the matter is that when we move our arms and legs, there are nerves that travel through our arms and legs that move along with our arms and legs and those nerves are connected to our neck and our brain. And if we're not getting adequate movement throughout our entire body and doesn't get the mobility that it needs, you can begin to get mobility issues within your nervous system.

I've seen it time and time again, once people get on some sort of regular exercise program, their headaches and migraines diminish and eventually go away if that's the biggest factor contributing to their headache and migraine problem.

Number Six, A Shrugging Exercise.

Shrugging is a huge deal for taking pressure off the neck joints, and the neck joints are so critical to have good mobility, and for them to not be stuck so that they don't pinch the nerves that go up and innervate the head. An easy quick thing you could do at your desk, or if you are taking long drives and you're in this posture a little too much, is just tuck that chin into that baby chin tuck, and then shrug and go as high as you can, and hold it there for 10, 20, 30 seconds if you can.

What you should feel is these muscles working in that you need to dig down deep and go as high as you can, without letting your chin jet out like that. Make sure you keep it in, and you might actually feel some pops and clicks happen within your shoulders, sometimes even in the neck. As long as it doesn't hurt. That's okay, you're freeing up a stuck joint that might have been contributing to your headache or migraine problem. Doing that shrug exercise throughout the day can be very beneficial for you to reduce the discomfort and avoid taking a pain medication.

Number Seven, Don't Stretch So Much

People come in to our clinic here that have had headaches and migraines and they've been stretching, they've been grabbing their head and pulling it over, looking down and pulling their head over like this, attempting to stretch out their neck joints and neck muscles. And oftentimes, sadly, they've been told to do this by other medical professionals who just don't quite have a good handle on how to treat headaches and migraines.

It tends to overstretch muscles that are already stretched, and it also tends to overstretch nerves that are aggravated. So even though it may feel good in the moment to get that stretch in long term, it keeps the headache and migraine problem their way longer than it should be.

Number Eight, Get Sleep.

If you're not getting enough sleep, whatever that is for you, because it's not an eight hours one size fits all situation. I can tell you for me, I'm more of a six to seven hour a night person. But if you're not getting enough sleep consistently, then work on getting enough sleep. Make sure you get to bed on time, or at a reasonable time for you and try to plan so that you have enough time before you wake up so that you slept enough.

If you don't get enough rest your nervous system, your nerves, which includes your brain, and all the nerves that come off of it that feed into the headache problems are tired and if they just are getting too much stimulus, like from lights from computer screens, from people talking to you, from sunlight coming outside from things, noises that are around you, all that can overstimulate a tired nervous system and contribute to a migraine and headache problem. So make sure that you track your sleep and get enough of it.

Number Nine Seeing An Expert

This is by far this the best recommendation because if you can see somebody who's a specialist in handling headache and migraine problems, you can speed this process up and get much better control of it. All too often. Whenever we get people with headaches and migraines here in the clinic, they've been dealing with them for years. And if we had talked to them, within a month or two after they began to have more severe headache and stuff migraine problems, they would have been done with it and save themselves all those years of trouble and heartache and taking ibuprofen and seeing doctors and getting injections and seeing specialists.

I've even had patients that go see dentists because they think that it's related to their teeth problem and get their teeth pulled out as recommended by a dentist. And then we get him here in the clinic and do some more specific guided strategic treatments and they clear up and then they have the realization that I could have kept my Moeller I could have avoided all those years, I could have had a better relationship with my spouse and family had I just gotten some expert help sooner.

It's a no brainer when you when you look at it that way. So I strongly encourage you to go get some expert help so that you can get really focused on making sure this problem is not something that's just pestering you throughout the day, and ruining relationships in your work quality in your life quality.

Thanks for listening to our podcast, guys. I appreciate your listenership so much. If you found that this podcast was helpful for you, please please please go over to the podcast platform that you're on, whether it's iTunes or Stitcher, Google playlists, any of those and give us a five star review and put a little blurb on there about why it was helpful for you.

If you got to try out the things here or another podcast just say that it helped or didn't help or whatever be honest, of course, ideally, it helped you and you're going to give us five star review and then share it with somebody that you think is needs to hear it there'll be they'll be thankful that you shared it with them.

And it also helps us to get a little more exposure for our podcasts here. Thanks for listening guys. And as always, if you want to reach out to us you can go to our website www.EPmanualPT.com or call us at 915-503-1314 Thanks and have a great day. Bye.

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Hey everyone, welcome to the Stay Healthy El Paso Podcast. I'm your host Dr. David Middaugh, specialist physical therapist over at El Paso Manual Physical Therapy, and today we're covering the top seven tips for lower back arthritis.

Now we see people here with lower back arthritis in the clinic all the time. It's one of the most common things that we help out. And typically, people have a combination of arthritis and stenosis and sciatica. When they're looking for help initially, they don't really know what they have going on. But maybe they've got an X ray and MRI, frequently people bring those in with them. And they'll point out on the MRI or on the X ray where it says Look, look at L-5 or L-4. I have arthritis, osteoarthritis!

When they've got that, then they are concerned because it's like I'm getting older and I've got arthritis, that stuff doesn't go away. It just stays with you for life. And they are always worried about how to begin to get help, and they're not sure who to see, or if they're going to need surgery someday. That's always a huge concern for people, especially once their back starts hurting, then they think, I don't know what to do about this and how am I going to protect this from getting worse, and I've seen my parents, they had arthritis too, and their backs are all messed up and they're on a walker on a cane or they're taking medications all the time getting injections.

If you have any of that stuff going on, you are going to want to hear these seven tips on how to get started on fixing your lower back arthritis problem. Now, just the way this works, it's not really fixing it. I'll tell you more about that here in a second. But arthritis is generally something that comes on as we age, and it can be painless. In some instances, it can be painful in other instances, it just depends if it flares up, but think of it more so as like getting gray hair or wrinkles.

As we age, we get gray hair and wrinkles and they don't really hurt. They don't hurt physically but it might hurt emotionally for some people. But if we look on the inside of our bodies with an X ray or an MRI, then you'll see that as we age and people that are older, they just tend to have more arthritis. And it's okay, it's normal. It's not it's not a bad thing necessarily.

What we're concerned about is when it becomes too severe, when it becomes out of control, that's typically a sign that there's a bad forces going through those joints, there's bad stuff happening. It's usually the way that the muscles are pulling on the joints. That's why there's bad forces on there. That's what makes the Arthritis situation progress faster and become more severe.

But anyways, I'm going to cover those top seven tips for you right now. And that way you can learn about what you can start doing right away at home. Right now, as you're listening to this podcast, you can try out some of this stuff for beak or your plan to stop doing that some of these things, because I'll tell you what to avoid as well. I think this will be helpful for you. So let's get to it.

Let's talk about the top seven tips to help out lower back arthritis.

Tip Number One Core Strengthening Exercises.

A lot of people say just go get exercise, but to be specific, we have to strengthen the core and it's typically the abs muscles, but I would also throw in the glutes, just about every single time. It's pretty rare, I'd say 9 out of 10 times, it's just an ab problem. It's an abs and a glute weakness problem that contributes to a lower back arthritis situation.

So, if you haven't really worked on your abs, and that's something you want to get going on. If you are confused about how to do it, or maybe you have already been trying it out, and it's been hurting your back more than helping your back. Then I encourage you to go over to our playlist on lower back videos in our channel for El Paso Manual Physical Therapy. There are tons of videos in there that talk about specific exercises for lower back problems and start with those. Those tend to be pretty safe and easy to do.

And if you are still having trouble, you need to get some professional help to make sure that you are doing your core exercises correctly. Because it is proven, I see it in the clinic all the time. That's how we help people is by strengthening certain muscles, in addition to all the hands on work that we do, but core strengthening is going to be your number one place to start fixing a lower back arthritis problem at home.

Number two simple stretches.

When I talk about stretches, you want to just stay in this forward and back motion. Like going towards your toes and going backwards can be beneficial. I would, there are certain stretches that I would want to avoid. That's actually tip number three. I'll cover that in a second. But its stretches where you feel like you are bending your back all the way forward or all the way backwards are generally okay to start with.

Now, what I want to point out with stretches is, they can be overdone and can actually become harmful after a while. So use them sparingly, but it's a good way to relieve the backache to relieve some tension off your back and possibly avoid taking pain medication in the short term. Just to kind of get you by for a period of time. But I wouldn't look to do stretches to cure a back problem. It's just going to get you started and allow you to avoid taking the harmful medications.

Number three, avoid twisting motions.

Typically, and this is related to those stretches, avoid twisting motions. Some people like to twist all the way around one way, and the other way, and maybe you enforce a joint to pop or click. And that can be relieving sometimes, but I would avoid it if you have a low back arthritis problem, because chances are, there's a bunch of stiff joints in the lower back because of the arthritis. And there's usually one or two joints that are compensating for all the stiff joints. And you might be over twisting that one joint that's moving way too much in creating a disc problem or a pinched nerve problem later on.

I would avoid the twisting motions. Our spines are just not designed to take a lot of twisting and repetitive twisting. So, make sure you avoid daily twisting motions, as well like twisting while doing little things, at home activities, like chores in the yard at home. If you have to stand with your feet pointed in one direction you twist over one way, or if you are sitting at a desk or cooking in a kitchen and you find that your feet aren't really going with the upper body, make sure to just reposition your feet so that they are in line with the rest of your body so that you avoid twisting through your spine. So, keep away from those twisting motions.

Tip number four drink lots of water stay very hydrated.

Our joints are reliant on our hydration so if you feel like you have not been drinking enough water over the past few months, and you are back arthritis problem is just getting a bit worse, it could very well be affected by your hydration levels. Cartilage is over 60% water up to 70% water and you have tons of cartilage. Discs in your spine are also highly dependent on hydration. And then there's fluid inside the little spine joints. The rosette joints is what they are called in the lower back. And that fluid needs to be there in order to properly lubricate the joint surfaces. So drink plenty of water.

I know the side effect is that you have to get up and go to the bathroom frequently. But I would weigh that if you are having a problem with having to go frequently versus potentially having some surgery some day because this arthritis problem was managed properly. You got to weigh those risks. So just think about that I would I'm always going to lean on the side of drink plenty of water and it's okay if you had to get up every now and then go to the potty. Just make that trip counted as exercise.

Tip number five, avoid shoes with heels.

Now this goes for both men and women. Of course, women are probably the ones that are typically going to wear heels more so than men. But men do wear heeled shoes here and there. You know smaller heals typically with like in boots or dress shoes, but that little elevation even if it's a small amount, it changes the way that your ankles are positioned when you walk, which influences the knees and hips and can translate all the way into the lower back. And generally, the bigger the heal, the more forces are going to be disrupted and affecting your back & neck.

Really, so it just doesn't allow the muscles that control the spine, the lower back to properly operate and give you the stability that is needed for everyday motions. If you have a chronic back problem, if you have arthritis in your back, I would definitely stay away from the heels until that problem gets resolved.

Now, let me put a disclaimer in here. I'm not against heels forever. I think if you are healthy, and if your back is fine, you don't have any other issues that are affected by the heels. Wear heels all you want, and it should be just fine for you. But if you are trying to avoid medications, injections and having a surgery, get off those heels in the short term and let's fix the back problems so that you can get back to her in the heels as you might like want as you want to later on in life.

Tip number six, avoid walking for exercise.

I put this tip in here because a lot of people that I meet here in the clinic and out in public, they say hey, I want to start exercising and stretches, start with walking, right? That's kind of the easiest thing to do. You just get out and put on your walking shoes and go for it. And yeah, it's an easy thing to do and it was pushed a lot back in, in the 90s and even early 2000s as a great way to start exercising. I think it's still generally accepted as a great way to start exercising.

If you don't have any sort of back problem, I'm okay with it. But if you are dealing with back arthritis, lumbar arthritis, it is not a good thing to go walking for 20 minutes, 30 minutes or more to cover many, many miles because there is a decent amount of twisting that happens through the spine when walking. And if your joints aren't moving properly, because you have arthritis in there that's preventing the motion, then you are technically doing a repeated twisting motion over and over again, and it can aggravate the back problem.

We have seen people come in here in the clinic that say, I started walking and it kind of felt better because it's stiff. I understand and my back eased up some. But then it started to bother me as time went on and I just didn't enjoy going for walks. So, if that's you stop the walking right now. There are other exercises that you should be doing. And then walking can begin to happen for regular exercising if you choose to. If you like to go hiking or you are just an outdoors person like to get out every now and then it's not a forever thing kind of like with the heels.

You want to just put a pause on the walking beyond what you'd have to normally do for everyday living, walking within your house and for work. But walking for exercise like where you go on a dedicated walk, I would avoid if you are trying to correct a low back problem, an arthritis problem in the low back.

Tip number seven, get expert help.

This is by far the quickest way to make sure that the lower back arthritis problem gets under control and managed properly. Now the reality of what we've discovered in the healthcare field over the past 20 years is that arthritis in the past, is actually Okay, as we age, it's expected as we age.

Think of it as like rust on a on a car, if you look under an old car like from the 60s or 70s, or even before that time, if there's bits of rust here and there, it's not going to impede the function of the car, your car's still going to run and you can go enjoy a cruise. But if there's a massive hole that is rusted out on the frame or on some important part of the of the undercarriage of the car, then you should get some concern and you should think Am I going to be able to enjoy my rider? Is something going to break or is this crazy? We're going to start then you got a problem. It's the same thing.

If you are looking at the arthritis in your spine, it's all over. It's just there's tons of it. Just like there's a lot of rust on the bottom of a car. You are going to have some likely long-term back issues and you can still get under control and manage it so it's not worse and avoid a surgery or having to rely on medications. But the fact of the matter is, it's just affected more joints, more cartilage in the spine. But if it's just a little bit of arthritis, in other words, if they told you that you have mild arthritis, even moderate arthritis, then I wouldn't get too concerned that's like looking at a 56-year-old car.

And if it just has mild amounts of rust or even moderate amounts of rusting but everything still works, then you have an excellent shot at getting back exactly to what you were doing before, without having to worry about having surgery one day or having to rely on injections or medications.

But getting expert help really just speeds up that process to make sure that you are doing the right exercises that you are not doing the wrong stuff. And that you are thinking about this properly so that you can learn how to take care of your back arthritis for the rest of your life. So I strongly encourage you to reach out to an expert like a manual physical therapists to make sure that your lower back arthritis problem gets under control and handled properly.

Hey guys, thanks for listening, I really appreciate it. If you thought that this podcast was helpful for you, I encourage you to leave us a five star review, that would be super awesome. If you tried some of this stuff and you had a good outcome then please leave us a bit about your story in a review, we'd love to hear that. That's always encouraging that we're helping people that are listening in El Paso, or in the area or even around the world, around the country.

We always love hearing people sharing their stories about how we might have helped them. If you are thinking that we might be able to help you out if you're in the El Paso area, call our clinic if you think that you want to get help by us, our numbers 915-503-1314 and if you just want to learn more, find out about us you can Visit our website at www.EPmanualPT.com and there's tons of free resources on there. Our blog is full of helpful information for back problems and other issues as well. You can go check it out and find more details. But anyways, I hope that you have a wonderful day and we'll talk soon.

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