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Interventional Chronic Pain Management Treatments | Central Chiropractor

Chronic pain is known as pain that persists for 12 weeks or even longer, even after pain is no longer acute (short-term, acute pain) or the injury has healed. Of course there are many causes of chronic pain that can influence any level of the spine, cervical (neck), mid back (thoracic), lower spine (lumbar), sacral (sacrum) or some combination of levels.

What treatments do interventional pain management specialists perform?
Oftentimes, early and aggressive therapy of chronic neck or back pain can earn a difference that is life-changing. But remember that knowledge is power: Be certain that you know your choices. There are various treatment procedures and treatments available for chronic pain, each completed by a treatment specialists. Interventional pain management specialist treatments may be a fantastic solution for some people with chronic pain symptoms.

Interventional Pain Management Specialists
Interventional pain management (IPM) is a special field of medicine that uses injecti…

Core Stability & Body Slings: Science Based

Simple twisting movements, performed correctly, can develop significant core power. Core chiropractor, Dr. Alexander Jimenez explores body care slings.

Core stability training has come in several of guises over the years, according to whatever modality occurs to be the style of the moment. Most Swiss ball programs, Pilates and other core workouts deliver useful benefits in the physical preparation and injury management. They offer you a whole lot of variety -- and there are some things you can do to a Swiss ball or Pilates Reformer which you simply cannot do on any other apparatus.

As the flow of new fads in equipment and training styles reveals no sign of slowing, it's helpful to return to fundamentals and gain a little education about how the low back (lumbo-sacral backbone) and its encouraging muscle system work. This article introduces some important research done lately that helps us gain a much clearer practical understanding of how the lower back and pelvis work, and therefore what types of training are most likely to have a positive impact on core stability and strength. This research introduces the anatomical concept of 'myofascial slings'.

Myofascial Slings

The idea of myofascial slings comes out of the work done by Andre Vleeming as well as many others on sacro-iliac joint (SIJ) stability. Unlike what rheumatologists will inform say, the sacro-iliac joints -- which link the fused section of the lower spine (the sacrum) to the pelvic/hip bones on each side -- do have to move during regular daily activities such as walking and running.

It's both necessary and desirable that the sacro-iliac joints proceed, since they will need to act as shock absorbers between the lower limbs and spine, and also as a way of providing proprioceptive (body positioning awareness) feedback to get co- ordinated movement and control between the back and lower limbs.

Since the SIJ is capable of movement, that movement has to be properly controlled, much like any of the body's joints. Some hands comes through the pure architecture of the low back and pelvis, but more is possible by employing the surrounding muscle, ligament and connective tissue system (myofascial slings) to provide compression on the joints. This is important since we can help influence the effectiveness of the compression through exercise and retraining following injury. The 3 muscle systems or 'slings' that help to stabilize the pelvic girdle are known as:
  • The posterior oblique sling;
  • The anterior oblique sling; and
  • The posterior longitudinal sling.

Key Training Principles

1. Stay Upright

Maintain the compression load vertical: as most athletic endeavors and functional daily activities are done upright, the majority of the 'core' training function also needs to be performed upright. It is likewise very important to stand, rather than sit, so that you have the ability to transmit load through the legs. Ground reaction force if standing is transferred up the upper leg bone (femur), into the hip along with the pelvic bones. This is fulfilled by the downward force of gravity acting on the trunk. This lets the SIJ to be held stable by using its natural structure when standing, as the sacrum sits nicely into the corresponding surface of the pelvis/hip in this position.

Additional the shock-absorbing intervertebral discs of the lower (lumbar) spine favor the compression power that standing provides, rather than shear (sliding) force or tensile (pulling) force. Most damaging shear force occurs when the vertebrae slide against each other and shear the adjoining intervertebral disc -- as occurs when the body is horizontal (the position used for several Swiss ball exercises). Tensile force occurs when the lumbar spine is bent forwards or backward (flexed or extended).

2. Work In Neutral

Keep the spine in neutral. The most frequent way to harm intervertebral discs would be to get the spine flexed, as you do when bent over. In this position the pressure within the disc increases significantly; with additional compression this place can cause discs to bulge. So it's important to keep the spine away from full flexion and extension positions, to avoid repeated micro injury to disks, vertebrae and ligaments.

3. Learn To Contract Stomach Muscles

Maintain the upper abdominals (rectus abdominis) at static contraction. Many elite athletic endeavors require that the abdominals work statically (isometrically). This permits the stomach muscle to present a stable anchor for the potent side trunk (oblique) muscles to generate force. The rectus anchors the obliques via lateral tendons and this layout allows power to be transferred across to the oblique muscles.

Training The Myofascial Slings

With close attention to good strategy, the easy twisting exercise in the diagram (see below) is a good way of training the myofascial slings. The key principles are as follows:
  1. The exercise is performed standing up.
  2. Bend slightly at knee and hip. This will pre-tense the buttocks (gluteus maximus) and front of thigh muscles (quadriceps), which in turn will help to create a chain of stability and tension through the posterior oblique sling.
  3. Adopt a slightly forward leaning position with a gentle forward pelvic tilt. This activates the deep short muscles of the lower back (part of the posterior longitudinal sling).
  4. There is trunk rotation against resistance. This activates the side stomach muscles (part of the anterior oblique sling). The upper stomach muscle must be statically contracted to provide a stable base for the obliques to work from. It is also important to activate the lower stomach muscle (the transversus abdominis) in a ‘hollowing’ action.
  5. The broomstick sits on the shoulders, and is pulled into the shoulders to help secure the stability of the posterior oblique sling.

How To Perform The Exercise

This exercise was originally developed at the Australian Institute of Sport in Canberra. The diagram and points 1 to 5 above will guide you on correct form. Tape or otherwise fix the resistance bands firmly to the broomstick. An appropriate level of resistance (band strength and length) should allow you to perform 3 sets x 10 reps without great difficulty. Progress from there. Watch out for the following points to maintain good technique:

  •  Keep the front of thigh and buttock muscles tight
  •  Keep lower stomach (transversus) hollow and tense the upper stomach (rectus abdominis)
  •  Don’t rotate the pelvis, just the trunk. If you have trouble achieving this, perch your buttocks on the back of a chair, which will help you to keep your hips stable while you get used to twisting through the trunk alone
  •  Maintain a slight arch in the lower back (neutral position)
  •  Keep looking straight ahead, do not allow your head to turn as your trunk rotates
  •  Keep the broomstick firm on your shoulders.


Note: one full repetition of this exercise involves rotating from X degrees backward trunk rotation to X degrees forward trunk rotation, and then returning to the backward start point.


  • Use a single band.
  • Move through a small range of rotation 10 degrees to10 degrees each direction (total arc of 20 degrees).
  • Perform 3 sets of 10 reps each direction (band at left, then band at right).


  • Use two bands, one either side of the broomstick.
  • Rotate through 20 degrees to 20 degrees
  • Perform 3 sets of 10 reps in each direction


  •  Can double up number of bands (or more, and/or use tougher bands etc), depending on your rotation strength
  •  Extend range of rotation up to 45 degrees to 45 degrees.
  •  Perform 3 sets of 10 reps in each direction.


  1. Place one foot on a step to increase the range of hip flexion. This is particularly effective for sports requiring stability in positions of hip flexion, eg: rowing and cycling.
  2. Decrease the width of the base of support by adopting a lunge stride position

The information contained in this publication is believed to be correct at the time of going to press. Whilst care has been taken to ensure that the information is accurate, the publisher can accept no responsibility for the consequences of actions based on the advice contained herein.

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