BACK PAIN – THE MUST HAVE NUTRIENTS

back---- Golfswing2 (thumb)

As a practicing chiropractor I hear people’s complaints about their joints every day. It might be: Doc, I can’t play golf anymore or Doc, I was in the garden for 20 minutes and now my back is killing me.   Whether back ache, sciatica, stiff neck, knee pain, hip pain or any other joint issue for that matter, these problems have several features in common: bone, cartilage, muscles, ligaments, tendons and inflammation.  These are the tissues and issues to focus on when dealing with pain. 

To do this we must: strengthen the muscles which support the area involved, enhance the movement and flexibility of the joints and provide healthy nutrition and targeted supplementation to support the joints and surrounding connective tissues.  If we do this effectively, we are going to see improvement in most cases. 

Strengthen and Stretch the Surrounding Muscles

Unfortunately, as we get older, we also get weaker and stiffer.  Beginning at some point in our 20’s, we lose 5-7 lbs of lean muscle mass every decade1.  At the same time, because of the natural aging process, we are becoming more rigid. Unfortunately, this is the exact opposite set of circumstances that would be desirable for healthy, youthful joint motion and function.  

Which naturally leads us to the following conclusion:  We must exercise and stretch if we are to maintain the healthy, youthful joint flexibility which we desire to remain active, strong and comfortable.  To enhance the strength of your neck and back you can watch the following videos on my website: Core Exercise, Posture-neck,  Posture-back and Get Strong.  In addition do some more research and add a few additional exercises and stretches of your own.  If you need assistance, hire a good trainer for 6-10 sessions.  He/she will teach you a good routine to enhance your strength and flexibility.  Also remember to keep switching it up.  Don't get "stuck" in one never changing routine.

A note on Chiropractic Care: ---- adjustment-female-hands on back (large)
In many cases joints can become stuck and/or misaligned to the extent that exercise and stretching just aren’t enough. Chiropractic adjustments (also referred to as manipulations) help to enhance function, motion andalignment of stiff, uncomfortable joints.  This reduces inflammation and wear and tear over time, taking pressure off delicate neural structures and reducing degenerative changes in the joints.  The results of good adjustments tend to be quick pain relief with improvement in posture and overall spinal - joint function.   Ask your friends and associates who they use and find the chiropractor with the “magic hands” in your area.  A good chiropractor can work miracles for your spine and joints.  Make sure that he or she recommends home exercises and stretches so that you can strengthen your problem areas at home, restoring normal function and resiliency.

Nourish Your Joints

---- Fancy Grapes (large)Healthy nutrition for your joints is similar to proper nutrition for the rest of your body.  Make sure to eat 5-9 servings of fruits and vegetables per day which will naturally reduce inflammation and fuel all of the cells, tissues and organs in your body.  Eat wild (not farm raised) fish 2-4 times per week.  Fish are naturally high in heart and joint healthy omega 3 fatty acids in addition to being excellent sources of muscle building protein. Stay away from sugary foods and sodas, fried foods and trans fats as they are all unhealthy and promote inflammation in the body.  Read labels; if you see partially hydrogenated fats listed, don’t eat it.  In addition, try to include healthy nuts, seeds and berries in your diet (raw if possible).  If you know that you don’t get enough fruits and vegetables, you can add a phytonutrient drink to you daily regime.  I have created several excellent mixtures with purity products such as Triple Greens, Perfect Purples and Super Reds.  These are freeze dried fruit and vegetable powders which you simply add to your favorite juice, protein shake or water.  They have the phytonutrient and antioxidant equivalent of 5-10 servings of fruits and vegetables per scoop.  This is a great way to insure that you are getting the healthy fruit and vegetable nutrients that you would otherwise be missing.  I personally consider my phytonutrient drink a "daily essential" and make sure that I have one every day.

SUPPLEMENT YOUR JOINTS---- Vitamins (large)

When it comes to supplements for enhancing joint health we want to focus on 3 key areas: first we address common nutrition deficiencies which may slow the creation of, or speed the breakdown of, critical joint cartilage; next we control inflammation; last we rebuild and protect joint cartilage.

ADDRESS COMMON NUTRITIONAL DEFICIENCIES:
The 3 most common nutritional deficiencies in the American diet are magnesium, vitamin D and the essential Omega 3 fatty acids EPA and DHA.  We must address these deficeincies if we want our joints, muscles, ligaments and the rest of our body to function optimally.

VITAMIN D:  A recent article published in the prestigious Archives of Internal Medicine spotlights a glaring statistic: “nearly three of every four adolescent and adult Americans” have insufficient levels of vitamin D2.   When we couple this with a recent paper in Scientific American which explains that one tenth of the human genome –that’s 2,000 genes- are direct targets of vitamin D, we can see that this is a monumental issue.  Vitamin D supports the immune system, cardiovascular health, muscle strength, joint comfort, brain activity, prostate health, colon health, mood, memory and much more.  In fact our Olympians will be using Vitamin D in the Olympics to support muscle strength, joint health and reaction time.  Nutritional experts are pushing for the RDA for vitamin D to be raised to 1,000 IU’s while many scientists, including Dr Cannell, the head of the Vitamin D council are recommending 5,000 IU’s per day.  I recommend 2,000 to 5,000 IU’s of vitamin D3 per day depending on the season.  You can do this by using a vitamin D supplement or by taking Purity’s Perfect Multi Super Greens formula (my favorite multivitamin) which includes 2,000 IU’s of vitamin D3 (most multi’s have 200-400 IU’s) (remeber: Your body makes vitamin D when your skin is exposed to the sun- to read more on vitamin D click here). 

MAGNESIUM: 61% of U.S. diets are deficient in magnesium 3, with the average diet containing only 50%-60% of the RDA. Magnesium is required for more than 300 chemical reactions in the human body, affecting cardiac function, bowel function, blood sugar control, blood pressure, bone density and joint and muscle health.  Magnesium deficiency increases levels of C-Reactive Protein4 a marker of inflammation in the body.  Symptoms associated with magnesium deficiency include muscle cramps, tingling, numbness, abnormal heart rhythms, confusion, disorientation, loss of appetite, and depression.  Fortunately, magnesium is very inexpensive.  I take 1 Amino Mag per day to maintain healthy levels in the body. Another reason to take magnesium is if you suffer with muscle cramps.  I find that about 75% of my patients with muscle cramps get excellent relief.  To reduce muscle cramps take 3 Amino Mag per day in seperate doses for a week; then reduce your intake to 2 per day for a week; and then go down to 1 as a maintenance dose(You can keep it at 2 if your cramps return a few days after reducing your dosage to 1).  Read on to discover the importance of Omega 3’s.


CONTROL INFLAMMATION

OMEGA 3’S – (EPA and DHA but not ALA):  If you’re not supplementing with fish oil or eating fish at least twice a week, assume that you are deficient.  These essential fats have been systematically removed from the American diet during the past 100 years.  Dr. Artemis Simopoulos points out that evolutionarily our omega 6 to omega 3 ratio was about 1:1, similar to mammals in the wild.  Yet today, because of modern agribusiness, the average American has a ratio of 15 or 20:1 omega 6 to omega 35.  Thus we are woefully out of balance in terms of our essential fatty acids.  The importance of this deficiency in terms of our muscles, ligaments and joints (and all tissues in the body) can’t be overstated.  Omega 3 fats tend to reduce/suppress inflammation while omega 6 fats tend to promote inflammation.  Inflammation is a main cause of painful joints and left unchecked tends to promote arthritis.  In addition omega 3 fatty acids are important for our memory, cognition, healthy heart rhythm, circulation, healthy blood pressure and youthful skin. 

The American Heart Association recommends 500 mgs/day of a combination of EPA and DHA either from fish or supplements for healthy Americans or 1,000 mgs for those with a history (or family history) of cardiovascular disease.  Most studies on omega 3’s for joint health utilize 1,200 to 2,700 mgs of a combination of EPA and DHA from fish oil.  I recommend 1,800 to 2,400 mgs of EPA and DHA for my patients to promote healthy joints.  Click here to view a variety of excellent Omega 3 supplements.

In addition to regular Omega-3 capsules, I take the new Krill Omega Super Formula.  The studies on Krill are nothing short of amazing.  In fact, in a recent study, folks taking krill oil saw a 28% reduction in pain in 7 days and a 38% reduction in pain in just one month!!!  Krill also lowers triglycerides and LDL cholesterol and is wonderful for women who are suffering with dicomfort during their menstral cycle.  For more on Krill read: Krill Oil - Incredible Benefits.

The classic Anti-inflammatory herbs:
The 3 classic Anti-inflammatory herbs are Turmeric, Boswellia serrata (AKA Frankincense) and Ginger.  These have all been well studied with very positive outcomes in clinical trials.  My favorite Anti-inflammatory supplement is CTR Support by PhysioLogics(CTR stands for Connective Tissue Repair).  It combines good levels of these 3 along with Devils Claw, Quercetin and Yucca which also have excellent natural anti-inflammatory properties.  I recommend that my patients start with 6 per day in 2 seperate doses (3 and 3 with food) for 2-4 weeks.  As you feel better reduce the dose to 3 per day and keep it there to promote healthy inflammation levels in your joints and all tissues of the body.  Inflammation is one of the main issues that we must deal with in aging bodies.  In addition to causing joint degeneration and arthritis, inflammation is involved in almost of the the major diseases of aging.  I therefore consider CTR Support a daily essential and take 3 every day.

 ---- low back pain woman (thumb)
REBUILD AND PROTECT JOINT CARTILAGE

---- cartilage (large)We do this with Glucosamine and Chondroitin.  Unlike over the counter pain medications, which only mask symptoms, Glucosamine and Chondroitin actually help the cause of joint discomfort.  They have several modes of action including: nourishing and supporting joint cartilage, reducing cartilage degradation, encouraging healthy production of new cartilage, protect the joints from free radical damage and they reduce inflammation.  These two nutrients work so well that they are approved prescription drugs in Europe to protect cartilage and to promote joint health and comfort. 

As we get older, two issues begin to work against our cartilage.  We naturally become more inflamed and our chondrocytes, the cells that make cartilage in our joints, don’t work as well as they did in our youth.  Thus, increased inflammation, signals certain enzymes to break down cartilage at a faster rate while we are making cartilage at a slower rate. The good news is that supplementation with glucosamine and chondroitin seems to slow down cartilage degredating enzymes while at the same time supporting the chondrocytes ability to make cartilage at healthy levels.

Two incredible studies in top journals (The Lancet and Archives of Internal Medicine) showed that not only did glucosamine promote joint comfort and function; it actually stopped the breakdown of cartilage during the 3 year duration of the studies while those taking placebo continued to have cartilage breakdown through the course of the studies.  Five years later, twice as many participants from the placebo group needed total knee joint replacement surgery as those taking glucosamine 7,8.  I recommendGC Flex to my patients because not only does it have the highest quality glucosamine and chondroitin at research grade levels, in addition it has 100 mgs of inflammation fighting 5-loxin. 

5-LOXIN:  This is a powerful inflammation controller from the Boswellia plant.  People have been using Boswellia for hundreds if not thousands of years to help alleviate inflammation.  A recent study published in the Journal: Arthritis Research & Therapy -July, 2008 showed that patients who received 5-Loxin had significantly reduce knee pain, increased function at the knee joint, and improved quality of the synovial fluid (think oil) that bathes the joint.  Participants taking the 5-loxin showed improvement in pain scores in JUST 7 DAYS that continued to improve throughout the 90 days of the trial9.  You can take 5-Loxin separately or just get it along with your glucosamine and chondroitin in GC Flex(I have noticed that if I stop taking GC Flex, my knee pain returns in about 3 weeks.)

Bottom Line---- Cartwheels on Beach (large)

This is a comprehensive protocol for supporting your musculoskeletal system including: joints, muscles, ligaments and tendons.  I estimate that 90+ percent of my patients that follow this protocol achieve excellent, long lasting benefits in terms of physical comfort.  In addition most notice increased energy, and a more positive outlook.  If this protocol seems a bit overwhelming, begin by increasing your exercise, eat more fruits and vegetables, take Omega 3’s and a good Glucosamine/Chondroitin formula.  Then begin to add the additional recommendations slowly. 

Good luck and feel free to contact me with feedback (especially positive) at:
www.drneillevin.com. 

1-      (Forbes 1976, Evans and Rosenberg 1992)
2-      Arch Intern Med. 2009;169[6]:626-632

3-     
http://en.wikipedia.org/wiki/Magnesium_deficiency_(medicine)
4-      Journal of the American College of Nutrition, Vol. 24, No. 3, 166-171 (2005)
Published by the
American College of Nutrition
5-      Omega–6/omega–3 essential fatty acid ratio : the scientific evidence / volume editors,Artemis P. Simopoulos, Leslie G. Cleland. World review of nutrition and dietetics, ISSN 0084–2230; v. 92
6-     
Phytother Res. 2008 Apr; 22(4):518-23.Treatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspects.
7-      Arthritis Research & Therapy July, 2008, 10:R85 (doi:10.1186/ar2461)
8-     
Lancet, 2001 Jan 27;357(9252):251-6
9-      Arch Int Med, 10/14/02: vol 162 no.18