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How to Have Health Avengers That Will Heal Your Back

How to Have Health Avengers That Will Heal Your Back

How  to have health avengers that will  heal your back isn’t some promo for a new Avengers movie.

 It’s simply recognizing, with a little tribute to a fun movie, that older adults often seek help from multiply providers  who may not coordinate  their  treatments. 

Tips on Avengers as a team
Avengers as a team

This often lengthens  recovery time, but when the opposite is true older patients heal faster and better.

How is massage integrated into chiropractic treatment to help you heal your back?

Let’s take the example of chiropractic and massage therapies. They are not only compatible, but they are actually complementary.

 For example, “massage is often recommended before spinal adjustment because it relieves muscle tension that may be pulling joints out of alignment, and makes it easier for the chiropractor to move them back into place.

Tips on using massage for back pain
Using Massage for Back Pain

 Alternatively, many patients who seek pain relief from massage therapists but find that their discomfort persists experience more lasting relief by adding chiropractic care to their health regimen.”[1]

Using Chiropractor for back pain
Alternative Therapy

Linking providers and patients for better back health

In short, the chiropractor works to relieve the structural problems and the massage therapist works to resolve the soft tissue problems. The end result is speeding up recovery and making it a lot easier to heal one’s back.

What we can learn from the Avengers about team work that will help you heal

 Before proceeding, let’s expand our conversation  about The Avengers.  Strength comes in numbers, so when Earth faces a supersize threat, a sextet of superheroes teams up to save the planet. That’s the premise of Avengers Assemble. 

 A big takeaway from the movie, after all the adrenaline rush antics are over, is that “When you’re part of a team–a truly cohesive unit that functions with a single purpose–you can accomplish wonders. A single team can do more in a few days than one person can do in a month, or a bunch of individuals can do in a week.” [2]

A call to action for your own team to ensure better healing

Just as one can imagine a team of super heroes coming together  to save mind kind from destruction, then one can also imagine a team of medical providers, from different disciplines, working as ONE for the benefit of a patient.

What the team looks like as it carries out its mission to help you heal better

  An example of such case management is from an osteopathic physician and a chiropractor who commented on their shared treatment with a mutual patient who had a personal goal to stop smoking, a known risk factor for back pain:

“There was one case that comes to mind…our participant was involved in smoking cessation and the medical physician and I worked together on that with different approaches, so I think we enhanced each other.” [3]

The challenges of super heroes to become a collective

One of the many successes of the movie is showing how reticent our heroes are to in fact become a team. 

“Tony  Stark (Iron Man) has his bristling ego, Thor just wants to collect his brother  Loki and deal with him back on their planet, and Mark Ruffalo’s Bruce  Banner (The Hulk) wants to hide away in peace and quiet… Only  Steve Rogers…is willing to buckle down and follow orders.” [4]

Part of the fun of watching the movie is seeing how this collection of diverse personalities come together as  ONE.

The challenge of health providers to coordinate their treatments so you will heal better

let’s go back to our earlier discussion about medical providers who work together  and how that benefits their patient. In contrast, “clinicians who had not participated in interprofessional education reported they would likely not refer older patients for spinal manipulation because they had not developed a working relationship with a chiropractor.

 Another practice challenge was that the providers worked in different settings:

Normally, people that are working together are in the same building, and even in the same wing…trying to get each other on the phone has been impossible. “[5]

The trick to letting the health providers become a team that will help you heal better

The first thing that has to happen is that all the clinicians have to understand a common problem  that needs to be solved. The Avengers came to understand that  there was a threat to Earth and put together  a plan of action.


The clinicians  have to recognize older adults often prefer multidisciplinary approaches to complex conditions such as back pain. “The most prominent request was for a multi-disciplinary approach. [Patients] wanted both practitioners to be working at the same time, they didn’t want just one or the other. They felt the combination had an added benefit to them.” [6]

Respecting each other’s ability to help heal better

Just as each super hero has individual capabilities that make the team stronger, so too must the health providers respect each other’s ability to help their patient.

 For example, the family doctor must acknowledge that there is evidenced based support for spinal manipulation  in the treatment of low back pain. On the other hand, the chiropractor  and massager therapist need to acknowledge the evidenced based support for medications in treatment of low back pain.

On with the mission of healing

Once that is done they can all go on with the mission of using medications, exercise, and spinal manipulation to help  older adults who suffer from low back pain.

Working from the same location to better complete the mission

Avengers Tower is a high-rise building towering over New York City  and is currently the base of operations for the Avengers.

tips on Avengers Tower
Avengers Tower

This makes it a lot easier for the Avengers to interact with one another. [7]

So one of the things that has to be done, and that the patient has no control over, is the  sharing of office space for medical and chiropractic providers to support collaboration.


The Earth may not face a super size threat that threatens  to wipe out the planet, but it is clear that older adults are increasingly demanding that a multi-disciplinary approach be used to treat their low back pain. Medical providers and community health organizations could learn a valuable lesson from The Avengers on how this could be done.

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How to Embrace Self-Compassion and Heal Better

How to Embrace Self-Compassion and Heal Better

What is the role of self-compassion in well- being as people age? I am intrigued  by this question because there’s now growing evidence that seniors who are high in self- compassion will think of stressful events such as back injury in a way that will predict faster recovery. In short, they have learned  how to embrace self- compassion and heal better.

Tips on self-compassion
What Compassion Looks Like

To fully illustrate  what I’m talking about I will examine ambivalence  that  some elderly persons feel about aiding the healing process of their own back pain. I will explore why a senior with low self- compassion  may be resistant to being proactive in their own recovery while a senior with high self- compassion would gladly embrace it.

Before we jump in, let’s first describe what we mean by self- compassion. Self-compassion involves treating oneself compassionately—with caring, concern, and kindness—when problems arise in life, much like people treat loved ones who experience difficulties. [1]

Feel For Yourself What You Feel For Others and Heal Better

Tips on self-compassion
what self-compassion looks like

Kristen Neff, a well respected authority in the field of educational psychology, points out that “In the West, compassion is usually conceptualized in terms of compassion for others, but in Buddhist psychology, it is believed that it is as essential to feel compassion for oneself as it is for others.

 The definition of self-compassion, moreover, is not distinguished from the more general definition of ‘’compassion.’’ 

Understanding The Meaning of Your Own Suffering so You Can Heal Better

Thus, she defines self-compassion as “being open to and moved by one’s own suffering, experiencing feelings of caring and kindness toward oneself, taking an understanding, nonjudgmental attitude toward one’s inadequacies and failures, and recognizing that one’s experience is part of the common human experience” [2]

Learning to Let Go of Negative Emotions in Order  to Heal Better

This  is important because researchers in aging  have noted that many older people become self-critical and angry, castigating themselves, and bemoaning their inability to function as they once did.[3]

The good News About Learning to Heal

Studies have come out and  found that older people who were higher in self-compassion were more willing to ask people to repeat themselves when they could not hear what they said, and among people who had difficulty walking, those who were higher in self-compassion were more willing to use a walker. [4]

The Bottom Line

People who are high in self-compassion are more accepting of their physical limitations and more willing to take steps to maintain their well-being.[5]

This means that they are more willing to embrace any medical or non-medical therapy that will help them become more pain free.

Perceiving The Power to Heal Your Self Better

Tips on Learning to heal your self
Learning to Heal Your Self

This brings us to our the issue we hinted at in the beginning  of the post: how older persons  perceive the power they have or not have in terms of achieving recovery from an injury or condition such as back pain.

 We can now address how high and low self-compassion elderly make decisions about whether  the’ll be compliant when using interventions, such as balancing therapies and exercises, to speed up recovery or just give up in despair.

The Vital Elements of Self-Compassion

The 3 elements of Self-compassion That Will Make You Heal better

  1. Extending kindness and understanding to oneself rather than harsh self-criticism and judgement.
  2. Seeing one’s experience as part of the larger human experience rather than as separating and isolating
  3. Holding one’s painful thoughts and feelings in balanced awareness rather than over-identifying with them. [6]

What Self-compassion is Not

Before we go on, you should be clear about something: self-compassion is not based on performance or evaluating how good you are at reaching an ideal goal such as making more money, becoming smarter, or becoming  more liked. In short, it has nothing to do with narcissism or self-centeredness. It’s just a way to learn to heal yourself by extending to yourself  the same kind of understanding and support that you give to others.

The Implications of Using Self-Compassion to Heal Better

Here are The Implications  Using Self-Compassion to Heal Better

Tips on learning to heal
Learning to heal can be electrifying

Once you stop beating yourself up with negative emotions  you’ll allow room for positive emotions  to take over. Thus instead of thinking “I seem to have bigger problems than most people do” and “Why do these things always happen to me?” You’re more likely to  think something like “This isn’t any worse than what lots of other people go through.” [7]

Learning to Get Rid of Toxic Thoughts so You Can Heal Better

This allows you to experience  a mindfulness that  detaches you from self-judgement, and most likely  all the toxicity that goes with it.  For example it’s a known fact that  stress hormones secreted when a person is upset take hours to become reabsorbed in the body and fade away.

Connected to The Human Family

When you have high self-compassion you’re less likely  to live in isolation because you understand that you’re not the only one suffering from a condition like chronic back pain. You’re more likely  to reach out to others and that will give you the emotional  support that you need to boost your healing.

Avoiding Catastraophizing Your Condition so You Can Heal Better

The term catastrophizing is the process in which anxious people with a health condition dwell on the most extreme negative consequence conceivable. The bottom line is that pain is treated as being extremely threatening. Thus, for example, a person who has fallen won’t venture out of the house out of fear that they’ll fall again and experience  pain. A person with high self-compassion is less likely to have catastrophizing thoughts.


When thinking about self-compassion one may be tempted to think this is just another way of taking about self-esteem. Those were my initial thoughts, but I was wrong. Self-compassion is not judgmental. This means just it can not produce a narcissistic individual by exaggerating one’s sense of importance, it can not also build one’s ego by some type of emotional  pep talk. Self-compassion is purely  about extending compassion to yourself.

A logical question than is whether self-compassion downplays or ignored negative facts about a stressful condition such as back pain. No, it just treats those facts in a compassionate  way.

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The Gerontologist, Volume 54, Issue 2, 1 April 2014, Pages 190–200


Neff K. D. (2003a). The development and validation of a scale to measure self-compassion. Self and Identity , 2, 223–250. doi:10.1080/ 15298860309027


Mirowsky J. Ross C. E . (1992). Age and depression. Journal of Health and Social Behavior , 33, 187–205.


Allen A. B. Goldwasser E. R. Leary M. R . (2012). Self-compassion and well-being in older adults. Self and Identity , 11, 428–453.


Leary M. R. Tate E. B. Adams C. E. Batts Allen A. Hancock J . (2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology , 92, 887–904.


7 Ibid

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How to Relieve Back Pain at Work and Win

How to Relieve Back Pain at Work and Win

How to relieve back pain at work is a question that more and more people are asking themselves. Perhaps you are one of them. This post will help you find the answer.

Tips on Back Pain at Work
Back Pain at Work

However, before I go on I want to ask you another question. Are you familiar with BDRQ? If not, let me start by defining it for you: It refers to The Back Disability Risk Questionnaire for Work-Related, Acute Back Pain.

 The BDRQ is “a brief (16-item) patient questionnaire that provides a self-assessment of factors related to prognosis for work-related back pain. Factors include background demographics, physical health risks, workplace factors, pain, mood, and expectations for recovery.” [1]

What This Means to You in Learning How to Relieve Back Pain at Work

The reason I wanted to define it and  why you need to know about this is, as I said,  work related back pain is a growing concern that might  effect you or someone you care about. You need to be aware of tools, such as the BDRQ, that can  help you understand factors that are associated  with return to work among people with back pain.

Here’s what I mean:

Imagine that you have a great job, and then out of no where you have the bad fortune of suffering from back pain.

Freaking mind game, that’s like being stuck in a hotel with all the people that you can’t stand  in your life and there’s no way out. So, it’s bad enough that this condition is messing with your head and it’s literally  a pain—if not in the butt, close enough. Now you have to mange it so it doesn’t risk your job. How are you going to do that?

Here is Where The BDRQ Comes in

It will help you assess if you’re on the brink of chronic pain and disability. This is a big deal because it means you can stop things from becoming worse by a change in behavior. It can mean the difference between  having an annoying back problem which you can manage and keep working or something that can put you out of commission and a job.

Tips on Back Pain at Work
When Back Pain at Work Becomes Disastrous

This is How it Works to Relieve Back Pain at Work

It is designed to be administered within the first 14 days after pain onset, and takes into consideration all work place factors with a 3 month follow up. This way concerns about stress, re-injury, RTW( return to work) that might increase the risk of persistent  back pain can be addressed. For more information on RTW check out:

Consider these examples:

Not reporting injury.  Hesitance to report a work-related pain problem out of concerns of unfair treatment or diminished opportunities for advancement.

 In other words, someone may not  tell the boss that they  are having problems with their back for fear of being overlooked for promotion. On a cold practical  level this is foolish because most workers’ compensation claims have a deadline by which paper work has to be submitted. On  a more human level there’s some thing very important to consider.


 Most of the time the boss would’ve offered to temporarily reduce the physical demands  of the job and made RTW a lot easier. A BDRQ  would have caught the problem and there’s growing evidence that in most cases the employer would have taken steps to ensure a stressless transition injury to work. Feeling that you are useful is a big step in ensuring a faster recovery.

Relationships with coworkers. One of the things that a BDRQ will pick up is your relationships with supervisors and coworkers who might provide assistance and advice. [2]

A Photo of People, Friends, Fists, Over Desk

 If you have have established  relationships with those that worked with or supervised your pre-injury, they might provide opportunities  for you to have alternative work until your back heals. This is much better than going at it alone and working in pain.  For more details look at the video  above.

Expectations  of Recovery. People  who fear returning to physical work will lead to more serious injury, may develop a similar problem as seniors  who, having fallen, develop a fear of falling and are in greater risk of falling.

 So too may a worker with the fear of injury  increase his or her absence  from work. This may in turn  delay recovery. A BDRQ would detect this emotional  obstacle  to returning  to work and perhaps one would realize that they need help to device a coping strategy that would aid their  recovery.


Tips on getting back to work
Recovering to Get Back to Work

The bottom line is that one needs to be emotionally  invested in  his or her  own recovery and believe that they can in fact get better.

No Experience for Alternative work. It’s great if one is given the opportunity  to do alternative work that is less stressful on their back, giving it time to heal.

 What if one just doesn’t have the experience  to do alternative work? One can ask for the opportunity to train in a new department. 

Most organizations will allow that for a worker in good standing. A BDRQ would have allowed a person to know such a fact as it relates to his or her company.


Going back to work after a back injury is a scary  and confusing thing. Without an intervention  strategy from the time of the initial injury to the  follow up period, usually 3 months, one may not on their own be able to identify  the emotional  factors that will make a transition to  recovery easier or harder.

 A tool such as a BDRQ is  a powerful  and effective way for someone to give themselves the best chance of success because it catches what was missed in the initial  medical diagnosis. It’s not the only tool out there, but it is the one that is focused on showing people  how they can learn to relieve back pain at work.

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Shaw WS, Pransky G, Patterson W, Winters T. Early disability risk factors for low back pain assessed at outpatient occupational health clinics. Spine. 2005;30: 572–580.

2 The Back Disability Risk Questionnaire for Work-Related, Acute Back Pain: Prediction of Unresolved Problems at 3-Month Follow-Up

William S. Shaw, PhD

Glenn Pransky, MD, MOccH Thomas Winters, MD, MPH

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How to win at Alternative Therapy for Pain

How to Win at Alternative Therapy for Pain

I almost couldn’t believe what had happened: My mom’s eyes had swollen to the point where one of her eyelids was almost covering her entire  eye.

Tips on Herb-Drug Interaction
Confused Man


No, it isn’t.

I’m sure you can just imagine how I felt. I was scared. It  turned  out that some herbal tea she had drunk  a few days before had reacted badly with her medication and caused poor mom to look like a one-eyed creature.

Herbal Tea as Alternative Therapy
Cup of Herbal Tea

And that’s the day I realized I needed to find out more about the problem of alternative medication—especially herbal therapies– when mixed with traditional  drugs.

Curious About Herb-Drug Interaction
Curious Man


I’m glad you asked. Here is the scoop.

It took some digging  and a lot of follow up research, but I got the information  that may be useful to you if you are taking care of an elderly person who  wants to know how to win at alternative  therapy like spinal manipulation.

Using Chiropractor for back pain
Alternative Therapy

You see, interactions between herbal medicines and synthetic drugs exist and can have serious clinical consequences.

The good news is that one can learn to better understand the possibility  of herb-drug interactions and come up with a strategy where they can still safely pursue alternative  therapy for back pain. One can learn how to win at alternative therapy for pain.

Let’s jump in…

Nearly One-Third of Elderly Use Alternative Therapy for Pain

Almost one-third of elderly people use some form of alternative medical therapy, according to a  1999 national telephone survey released by The Family Practice News [1]

This confirmed the findings of earlier research . In the USA, one study found that the use of alternative medicine had increased from 34% in 1990 to 42% in 1997. [2]

Here’s more…

The most common therapy used by the elderly  was chiropractic, reported by 11% in the mentioned telephone survey. [3] This will be very important later, but first let’s look at the problem of herb-drug interaction.

Let’s talk about Ginkgo and Warfarin

Two herbal supplements in particular, ginkgo biloba and garlic, have demonstrated effects on warfarin

Ginkgo  increases small-vessel and cerebral artery blood flow. It has reputation for enhancing memory and cognition. This is why some older people may want to use it–the same patient population most likely to be taking anticoagulants.

Here’s The kicker:

Ginkgo and garlic, contain naturally occurring anticoagulants (e.g., coumarins) that will increase the anticoagulant effects of drugs like warfarin. [4]

Here’s The Deal:

Warfarin extends the time it takes for blood to clot and inhibits the pathological formation of blood clots within blood vessels by reducing concentrations of factors within the plasma that contribute to clotting.

In plain English this means that Ginkgo combined with warfarin can promote internal bleeding that can lead to a intracerebral hemorrhage.

The Bottom Line is This:

intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts, allowing blood to leak inside the brain. (The name means within the cerebrum or brain). The sudden increase in pressure within the brain can cause damage to the brain cells surrounding the blood. If the amount of blood increases rapidly, the sudden buildup in pressure can lead to unconsciousness or death [5]

You can read more about here:

Consider the following case:

A 40-year-old woman was admitted to the hospital with an acute subdural hematoma. There was no history of head trauma, falls, alcohol abuse, or bleeding disorders… After questioning, it was discovered that she had been taking 40-mg ginkgo tablets twice daily for the past 2 months to assist while studying. Her family continued to give her these tablets while she was in the hospital, saying that they were “just herbs.” Once ceased, the blood results returned to normal, and the patient was discharged more fully informed about adjunct drug therapies. [6]

Now  we know the danger of mixing herbal therapies with synthetic drugs such as warfarin. Lets get back to the notion that the most common  alternative therapy used by the elderly, according to the mentioned study earlier,  is chiropractic.

In other words we are talking about the spinal manipulations. This makes sense because there is  convincing  evidence that  manipulation and mobilization are likely to reduce pain and improve function for patients with chronic low back pain

This is the problem:

According to Dr. Foster of Beth Israel Deaconess Medical Center, Boston:

“The elderly are more likely than younger patients to be taking medications that interact with herbal therapies and are more likely to have skeletal problems that make spinal manipulations more dangerous”. [7]

This simply means that the alternative therapy  of manipulating your spine to relieve pain could instead have disastrous effects if one does it combing drugs with a herbal remedy like Gingko.

It Gets worse:

About half of adults in the United States use an herbal product, and many do not tell their doctors that they do because they believe their doctors would disapprove.[8]

The result is that the doctor, not seeing the patient get better, may increase the dose of the prescription drugs. And then what happens?

You guessed it. The herb-drug interaction worsens the patient’s condition even more.

Here is The Good News:

A Consumer Reports survey found that only about 5% of physicians are against using herbs; indeed, one in four users of an herbal product does so on advice of a doctor or nurse. [9]

This means the key to understanding  how to win at alternative therapy for pain is to simply  get your doctor  or nurse involved and let them guide you as you switch from pills to an alternative therapy like spinal manipulation.


In general I’m an advocate of people using natural remedies  to manage pain when appropriate. If you have  followed my website you know that I have covered many alternative therapies to managing pain.

That said, I see it as my mission to provide honest answers as to the best ways for people to keep their  loved ones and themselves safe and healthy. This means that while I encourage people to embrace the “back to nature” approach I don’t want them to make the mistake of thinking that “natural “ drugs are always better than synthetic drugs.

Most times they are, but sometimes they are not. And certainly mixing both can be a very bad idea. When in doubt check with your doctor. You would be surprised that they too want you to understand how to win at alternative therapy for pain.

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Barbara Baker. “Nearly One-Third of Elderly Use Alternative Care.”

Family Practice News. 29.15 (Aug. 1, 1999): p29.





Walsh, Nancy. “Gingko Raises Risk of Warfarin Bleeds.” Internal Medicine News, 1 Oct. 2001, p. 9.



Evans, Vicki. “Herbs and the Brain: Friend or Foe? The Effects of Ginkgo and Garlic on Warfarin Use.” Journal of Neuroscience Nursing, Aug. 2000, p. 229


Barbara Baker. “Nearly One-Third of Elderly Use Alternative Care.”

Family Practice News. 29.15 (Aug. 1, 1999): p29.