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Back pain is one of the most common afflictions. Every year, up to $200 billion dollars are spent treating back pain. However, one of the most effective treatments for back pain is also free: walking.

While walking may not help all forms of back pain and may not be suitable for every patient, it is an easy way to help heal and prevent back pain. A recent study has found that 20 to 40 minutes of aerobic walking was as effective for low back pain as physical therapy.

How does walking decrease pain?

Walking encompasses nearly every muscle in the body. It also promotes the release of endorphins in the brain. As the brain processes these movements and the surge of endorphins, it is distracted from the sensation of pain. This is called the “Gate Theory of Pain Control”.

How to walk properly?

Before starting a new exercise program, always consult your physician. If you have not exercised in a while, start slowly. As you gain strength, increase the duration of your walks.

Walking does not mean strolling. You should be walking at a speed where singing is difficult. Your heart rate should be slightly elevated.

Two Way to Make Your Walks More Enjoyable

Regular exercise can be difficult to stick with. If you don’t enjoy exercise, try to make walking a habit that you can look forward to.

1. Walking could become a shared experience with you and your friends. In fact, catch up with friends with walking instead of lunch or dinner. Everyday, schedule to walk with a different friend. You can even start a walking group!

2. Listen to podcasts while you walk. Long walks give you a chance to enjoy an audiobook. Make a rule to go on a walk if you want to find out what happens in the next chapter.

One trail I particularly enjoy is the Dry Creek trail in Clovis.



“Walk” Indoors

If the weather is bad (like right now) or you prefer to stay indoors, you can still fit in your steps by walking up and down any stairs at home or in your apartment building.


Spice things up by doing a step aerobic workout. Step up and down from the landing to the first step, trying to see how quickly you can go. Mix things up by turning to one side or the other as you step up and down.


Dancing in your living room is another option. Whether it’s free-form movement to your favorite song or waltzing around your living room with a partner, dance does wonders for your physical and mental health. You can burn anywhere from 250 to 500 calories per hour dancing, depending on the style.


Dance can also improve memory, sharpen your focus, and help you pay attention. Just make sure you clear a space that’s big enough for you to move freely.

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Chronic pain is not just a physical sensation. It comes with feelings of loneliness and isolation. These feelings may be further exacerbated by the social distancing during COVID-19.


Why do we feel this way?


People in chronic pain often feel trapped by their bodies. They find it difficult to explain their feelings to those who do not suffer. These inward-turning feelings can increase social isolation and loneliness.


Even loved ones can sometimes fail to understand the devastating side effects of this “invisible illness”.


Chronic pain can dramatically change a person’s life. What they once took for granted no longer come easily. Before, they may be running marathons or chasing after grandkids. Now, they can barely get out of bed. They may no longer be able to attend events and feel guilty for missing important celebrations.


What are the effects?

Pain is an individual experience, but humans are social creatures.


Loneliness causes physical and mental deterioration in older adults. The level of isolation directly correlates with the level of pain. Isolation can create a reaction in the body that mimics the pain response. The lonelier someone is, the more pain and negative feelings they feel.


How to cope?

Chronic pain and loneliness may go hand in hand, but knowing how to cope with chronic pain and loneliness can help relieve both.


1. Let yourself be heard

Talk candidly with your family and friends about how you feel. Let them know how they can better support you.


2. Reach out to people

One of the most challenging aspects of chronic pain and loneliness is being separated from people and events.


You don’t need to plan a party with 20 guests. Re-connect with a simple phone call and avoid the pain that occurs after overexerting yourself.


3. Go online

The online community can be a supportive place. Find Facebook groups or forums based around your interests. It can also help relieve boredom and keep your mind off your pain.

  • PsychCentral Forums. PsychCentral is one of the leading websites for connecting patients with therapists around the world. Further, they act as a hub for information about all things mental health. This amazing website also offers access to a great free therapy forum. Each of their forums are centered around a specific topic, such as addiction or anxiety, and are available 24/7/365. This can be a great option if you suffer from insomnia and need to reach out to someone in the middle of the night, or can’t leave the house.

Their forum also hosts weekly chats, social chats, forums for relationships and communication issues, areas for people to talk about school or work, and virtual kudos and hugs for when you need it the most.

  • Huddle. Huddle is a free iOS app that uses video sharing to connect with other people around the world in shared safe spaces. While it’s not direct therapy, many find that they can find their support system through this app, with dedicated groups for depression, anxiety, LGBTQ+ groups, physical disability, addiction, and many more.

4. Turn to therapy

Cognitive behavioral therapy has been shown to be particularly effective in relieving chronic pain. While you may not want to physically go see a therapist during COVID-19, there are many alternative options.

For people who need to vent and get a sympathetic ear while maintaining anonymity, Blah is a great way to go. Clients can go online at any time and either vent in general or sign up for a chat, all for free. Wait times may vary for the chat, but there is nearly always someone available.

  • iPrevail. iPrevail is free therapy online that follows a peer-to-peer model. Log on to chat with a trained “peer specialist” for support, or fill out a health questionnaire to get more tailored advice. Their peer-to-peer model is completely free.

One thing that sets this system apart from other free online therapy is the evidence. iPrevail conducted a clinical trial of their method and found that it removed barriers to care and provided therapy that was comparable in success rates to face-to-face therapy.


5. Laugh a little.

It may feel difficult to laugh or even smile when you are in pain, but studies show humor increases happiness and satisfaction even when pain persists. Find books, podcasts, movies, tv shows, or even a funny friend to add some laughter to your days. Some comedians like, Maysoon Zayid or Samantha Irby may shine a funny and understanding light on your daily challenges.

6. A little gratitude goes a long way.

This may be a difficult suggestion if you cope with both chronic pain and loneliness, but studies have shown that people who practice gratitude report less pain. The more grateful you are, the less impacted you are by pain. Consider keeping a small journal and write down what you are grateful for daily in your life.


7. Get a pet.

Animals can bring comfort to our lives, especially on our hardest days. If you have the ability to care for an animal, consider adopting a rescue.




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Updated: Jul 1

Many patients have asked me what foods to eat to decrease inflammation.


You may have heard of the term “anti-inflammation diet”. But how does inflammation affect pain? And how do foods affect inflammation?

When you have an infection or an injury, your body releases chemicals to repair the damage. This normal process is called inflammation. Inflammation is crucial for your body to protect itself. But sometimes, too much inflammation causes problems.

When inflammation lasts weeks, months, or years, the chemicals your body releases can attack healthy tissues in your body. Chronic inflammation is associated with many diseases and symptoms, including pain.

The foods that you put in your body have an impact on the inflammation in your body. Modifying your diet to include anti-inflammatory foods can help ease pain and even decrease some of the side effects of medication.

Fiber: Try to consume at least 25 to 35 g of fiber daily. Fiber is linked to lower body mass index (BMI), which in turn is linked to levels of C-reactive protein, a marker of inflammation that circulates in the blood. Fiber also ferments in the gastrointestinal tract, feeding and balancing the “good bacteria” in your gut that is also linked to reduced inflammation. Whole grains are a good source of fiber.

Omega-3 fatty acids: This type of fat found in oily fish such as salmon, herring, mackerel and tuna is known to reduce inflammation.

Extra-virgin olive oil: EVOO contains a phytochemical called oleocanthol, which has been shown to have anti-inflammatory effects similar to those of non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen.

Green tea: Green tea contains EGCG, the most powerful type of antioxidants. Antioxidants fight free radicals that harm your cells and are highly anti-inflammatory.

Spinach: Spinach contains lutein, which is related to vitamin A and beta-carotene. Lutein is an antioxidant that is responsible for many beneficial anti-inflammatory effects.

Mushrooms are rich in anti-inflammatory components, such as polysaccharides, phenolic and indolic compounds, mycosteroids, fatty acids, carotenoids, vitamins, and biometals.


Eating anti-inflammatory foods is easy when you have a delicious recipes. Below is a recipe for Ochazuke. Ochazuke is a Japanese dish and contains all five of the anti-inflammatory foods listed above.


Ochazuke Recipe (1 serving)


  • 1 fillet of salmon

  • Extra-virgin olive oil

  • 1 cup of cooked brown rice

  • 1 tsp shredded nori seaweed (optional)

  • ¼ tsp toasted sesame seeds

  • 2 shiitake mushrooms, sliced

  • 1 cup of spinach

  • 1 scallion, diced

  • 2 tsp green tea leaves or 1 green tea bag

  • 1 cup hot water

  • ½ tsp soy sauce

1. Season salmon fillet with salt and pepper, rub with extra-virgin olive oil. Bake the salmon fillet at 400F degree for 25 minutes. Break up the salmon flesh into flakes. Set aside.

2. Add a dash of olive oil to a hot pan. Add spinach and cook until wilted. Season with salt and pepper. Set aside.

3. Add a dash of olive oil to a hot pan. Add sliced mushrooms and cook until soft. Season with salt and pepper. Set aside.

4. Put tea leaves in the pot. Bring the water to the appropriate temperature for your tea and pour it into the pot. Set aside for 1-2 minutes (follow the directions on your teabag).

5. Now serve the cooked brown rice in the serving bowl. Place the shredded salmon, spinach, mushroom, scallion, nori, and sesame seeds on top.

6. Pour the tea until it covers half of the rice. Add a dash of soy sauce.


Enjoy!

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(During COVID-19, we will be closing as soon as our last patient leaves.)

7152 N. Sharon

Suite 102
Fresno, CA 93720

Phone  559-432-6807
Fax      559-432-6937   
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