Using Exercise to Help Your Back - Patients' Advice: Part III

Nothing works as well as walking. Even though I live in a cold climate I walk 20-30 mins each day. Also do some stretching exercises I learned a few years ago that I could not lift anything as it aggravated my DDD bulging discs--no weight at all--not even a heavy purse. If I walk every day, do stretching exercises and do not lift anything I am now fairly comfortable. Any lifting or bad movement will set off pain again so I am just very careful. Not an ideal way to live but better than before by far. Also do not ever sit or drive for more than 30 mins. As you all know sitting causes more stress on the lower back than almost anything. I stand as much as possible in meetings, church or any place else.

From: Jill

Stabilization exercises help my recovery from back surgery

After surgery for a L5-S1 herniated disc and debilitating sciatica, I found great relief by strengthening my abs/back by doing STABILIZATION exercises such as the modified/full plank, side planks, bridges, back extensions, walking, and the stretches as recommended by my physical therapist. These included piriformis, hamstrings, hip flexors, and especially strengthening the TVA (transversis abdominus) muscles and being mindful of appropriate lifting techniques. I do use a stability ball for many exercises, believe in the value of good nutrition and drink lots of water throughout the day. Relaxation, stress management, and a positive attitude also work wonders.

From: J. Marie – Virginia, USA

I take control of my back pain, by doing regular Taichi. I was so impressed with the relief it gave me that I eventually became a Taichiinstructor. It taught me to correct my posture and gave me some low impactexercise.

From: Ros

I would like to respond in part to the person who said listen to your body. That is some of the best advice you can get! I just went through Physical Therapy after my horse fell on me. I tore my collateral lateral ligament in my right knee and after that healed discovered my lower back pain that is hanging on. What has helped more than anything is exercise. But as the Physical Therapist said "Listen to your body". That has been the most helpful piece of advice! The wrong exercise can bring more pain, but the right exercise helps greatly. Try different things to strength your abs and back muscles, but do it. Journaling to keep track of what works and what doesn't may also help. I hope this is helpful to someone.

From: Judy - USA

After reading the comments from others about their struggles, pitfalls, successes with back pain I wanted to share my own current status. I am an "older"!!! athlete who has competed in over 20 marathons, done serious triathlons (26 run + 100 ride + 2 swim), exercised always, have 4 children, work at a computer and attribute my fractured, herniated, degenerating discs to all of the above! I have had 3 back surgeries which I regret. I have tried yoga, massage, narcotic drugs (use daily still), constant exercise and still struggle with constant pain. However, I just recently started Pilates and for the first time in years I feel there is a good chance I can find a way to control the intensity of my pain. I still exercise both regularly and excessively because the only way I can alleviate the pain is by moving, yet my fear is that one day I will awake paralyzed - literally - so rather than repeat surgery (won't do that) or have the shots (won't do that) I am looking for Pilates to relieve and help cure this "situation". I was heartened to read the advice of others who also found Pilates and truly appreciate the honest information.

From: Bella – Colorado, USA

I am now 45 years old. Four years ago I fell in the house and fractured T12. I was very disappointed when after being released from 3 months in a corset, I had terrible pain and could not return to my normal life. Two years ago, I was very lucky in discovering Feldenkrais ATM (group) lessons. I also did a series of over 20 FI (indvidual Feldenkrais lessons) with my teacher. I have recovered most of my range of movement. Although I do experience pain sometimes, I no longer feel crippled. The FI lessons helped me know myself better, understand my limitations, and expand those limitiations a little at a time . I experienced great happiness during the ATM lessons when I began to perform movements that I hadn't been able to do for years.

From: Gail - Israel

For the past 10+ years I have suffered from back, hip, and neck pain. Chiropractic (Palmer method) had always given me relief yet I never felt like I was moving forward. A year and a half ago I combined Chiropractic with doing Pilates on the Reformer equipment - - it has totally changed my life!!! I am 43 and last September I ran my first 10K in 20 years and now live a generally active and less painful life! When my busy schedule takes me away from my Pilates routine my body quickly reminds me to get back. I must say Pilates has been a miracle for my body.

From: Jen - Washington, USA

To all of my back pain suffers how has gone through some unpleasant experience with your back that caused you pain, I can only wish you the best. Twenty plus years ago when I was only 24 years old, my doctor (then) told me that, a back surgery may not help me. Needless to say, I canned that doctor and found what I would say was the best thing to happen to me in helping me with my condition known as Central L4 Disfuson...In other words, the doctor didn't know what was going on either. So, once I found my new doctor, I got immediate relief. First, he advised me of what the problem was and how he could correct it. From that day forward, I've never looked back. After having L4-L5 disc removed and L4-L5-S1 fusion I had no problems. The key to being pain free is exercise...Even if it hurts, a lot of which is scar tissue, work through it.

From: Ray - Maryland, USA

2 years ago, when I was only 16, I fractured my L2 vertebra in a biking accident. My hips were also completely thrown out of alignment in addition to the compression fracture. My chiropractor immediately had me taking almost 20 vitamins per day. That, I believe, was part of why the fracture healed so quickly. After a few months, once I was able to slowly begin moving again, I began Pilates on DVD from home. In a matter of weeks, I felt a tremendous difference. Pilates focuses on strengthening your core (torso area) and from that concept, it strengthens and tones the entire body. My back became stronger, my hips didn't go out nearly as much, and overall I felt great. I would very highly recommend Pilates for anyone, but especially people with back pain/injuries. The Pilates allows you to only do what your body is able to do, but it still pushes you to use all your muscles to the max and slowly build up to the higher level positions. Pilates combined with some walking/jogging for cardiovascular exercise has been a great combination to get the perfect workout without needing to go to the gym or spend a lot of money. A year and half later, I was once again snowboarding and horseback riding with absolutely no pain or discomfort. It was definitely well worth the one time cost of $40 for the DVD and mat.

From: Rebekah – Oregon, USA

I have had leg and buttock pain for 4 months. I have tried massage, chiropractic, exercises, but nothing seemed to cure it, then I found Spine-health.com. I have been doing the exercises for piriformis syndrome for two days and have noticed a great difference in the pain. The thing is to first find out what is actually causing the pain and then find out the exercise for it - this is what I did with my pain with the help of Spine-health.com advice. Sometimes you can be doing the wrong exercise, which is what I had been doing for the past two months to no benefit.

From: Nasreen – England, UK

I began to suffer from extreme lower back pain after teaching too many vigorous aerobic exercise classes. Some of this was precipitated by martial arts and the use of hips related to stance, kicks and motion in general. Most of these motions are unnatural to the average human body. After being told I would never run again, I underwent cortisone injections which I found to be of little help. I pushed for strong sports-related physical therapy. I agree that one of the strongest preventions is exercise in accordance to what a person can do and how great their pain is. "No pain no gain" is out-dated. I started with mild abdominal exercises with form and posture that forced my lower back flat on a floor, not raised to allow space in between. I also recommend beginners' pilates that works overall to strengthen your "core" muscles, meaning torso from abs to hips. It is important to ensure that hip flexor muscles and tendons are NOT used, but to force the abs and lower back to do the work. Perfect spinal form and posture is essential, not just during exercise, but 24/7!! I am a former licensed and accredited fitness and strength trainer. I am retired now, but am willing to lend what I know to anyone interested. Losing weight for anyone that is overweight is difficult, but will help eliminate symptomatic pain. Exercise and nutrition is relevant to each individual. Maintaining proper posture is essential overall.

From: Penny D – California, USA

I was a varsity athlete in college. In the summer of 1990 or 1991 I was lifting weights at the University gym with a friend whose lower body was stronger than mine and whose upper body was weaker than mine. We used to push each other. I got up to the squat rack, saw five plates on either side and figured I could do a set. Boom. I felt it happen, put the weights down and left the gym.

I rowed for two years after that, and won national medals. When I retired from national training, I got a job and as soon as I got medical insurance, I scheduled a doctor’s appointment. "I need an MRI!!"

L3L4 & L4L5 herniations. Rather than opt for experimental laser surgery, I opted to rehab myself using linear cardiovascular exercise. It worked great for 12 years or so.

In 2004 I ran 3 triathlons, 6 half marathons, and the NYC Marathon. Afterwards, I took some time off from working out. Approximately 6 months. I felt better some days, but ended up taking four more months off. After a recent trip to London/Paris, I had no feeling in my left foot. Sure enough, L4L5 herniation. Over the last three months, there have been occasions when I have been disabled with pain.

I have faith that good core exercise and respect for the injury will get me through. I've done it before. Cross your fingers for me people. We share an unfortunate bond. You know what it feels like.

From: Peter - New Jersey, USA

I'm a 42 male diagnosed three years ago with herniated L4/L5 and L5/S1 discs. The pain, immobility and isolation was indescribably bad. After all conservative approaches failed, I was offered 'lateral recess' decompression surgery eight months later. The surgeon also separated an adhesion of disc material to the nerve root. He was unwilling to touch the discs as he believed that they would ‘re-mould’. I now swim 4x1000 metres, and walk 25 km per week. I can dance, but I can’t jump. I can drive a car but I can’t ride a bike. The pain has diminished but has never gone. Is my glass half full or half empty?? If it was half empty I'd be pushing up daisies by now… Your attitude is everything!

From Brian - Australia

I have severe degenerative disc disease, along with a constant state of inflammation in my joints that has resulted in eight separate surgeries to remove bone in order to relieve impingements. I currently have 3 herniated discs in my lumbar region. I had a cervical spinal fusion at C5 about a year ago. I have to admit, it seems futile to me, but I try to keep moving as much as I can. Obviously, I have had to get a handicapped parking permit, since any quantity of steps cause pain. I am still working full time in a hospital lab, on my feet for 8 or more hours a day. I think that the time is soon coming that I will not be able to continue working. I strongly believe that even though there is pain, I need to do some kind of exercise daily to keep what movement I do have. I am considering laser disc decompression for the herniated discs, and will then regain a lot of extremity feeling and movement that I haven't had in a long time. I guess a positive attitude is the key, take every day as it comes. Don't push yourself too hard, do what you can, but definitely DO SOMETHING!!! Every day !!!!

From: Lori - Connecticut, USA

Am 41 years old now and have a 21 year history of lumbar injury and associated pain. Original injuries occurred at the ages of 19 and 21, although I understand my condition may be genetic. MRI, CT, and discogram all indicate significant DDD from L1 through S1. L5/S1 almost bone to bone. Doctors have been impressed that my pain is not much worse and that I am able to do the things I do and to the extent I am able. Have managed with diet and exercise to have a good QOL and have avoided surgical intervention even though I have been a candidate according to the films for years. The plan that works for me is strong core muscles (ab exercises (daily), swimming, CYCLING), non-aggressive stretching, minimal extra body weight, healthy balanced diet, and rest. Absolutely NO impact (running, tennis, etc). Any activity must be introduced and implemented SLOWLY. I am in predictable discomfort if I increase any activity suddenly, or participate in an activity to which I am unaccustomed. I am just now contemplating surgery but have beat the condition for many years. Am able to avoid regimented medications, but take ibuprofen or COXII on occasion. As far as I can tell exercise is the analgesic of the gods - for the body and mind.

From: Darin – Alabama, USA

I have had severe back pain and pain in my legs for 4 to 5 years now. I work on computer for long hours. Recently, I joined a gym where I walk briskly for 30 min and do little bit of stretching which helps me a lot.

From: Habeeb - Saudi Arabia

I have a strong arch in my lower back and have had backaches ever since I was a teenager. Mostly lower back pain, sometimes the pain travels up and I have pains in the midriff.

Now I'm in my mid 30s and have taken up Pilates about 2 years ago: It's the ONLY thing that ever helped me! Doing Pilates Mat in my gym 2-3 times a week has strengthened my core to a point where my own body holds up its own weight and my back, stomach and side muscles in my upper body work like a natural girdle to support itself. I am maybe 30 pounds overweight and have a little pudgy in the belly area but it is amazing that when I tighten my belly and side muscles they are hard like iron (no kidding and no bragging). About two weeks into the Pilates routine I felt improvement already. I would be able to do the sit-ups more easy and the other very Pilates specific exercises. Mr. Pilates (long deceased) had a back injury and invented the routines to heal himself. I don’t know much about him, but they really HELP!

From: Sarah - New York, USA

At age 39 I herniated a disc, did the conventional route - meds, therapy - no help- had partial laminectomy and discectomy which relieved all neurological symptoms but resulted in non-specific low back pain of a chronic nature. Tried therapy again, steroidal injections, chiro, acupuncturist, no help. Finally, had a 3 level fusion, L3-Sacrum. After a 9 month period in back brace, I went back to therapy and swimming. One year after surgery I was doing well. 2 years later I was back to most of my activities. For 11 years I was in pretty good shape but in the last year I have regressed, in spite of therapy and daily exercise on stairmaster along with stretching, core program, swiss ball etc. My surgeon believes that I need the next level of my lumbar spine fused but I want an alternative.

From: Anonymous - Illinois, USA

I am finding that exercise is truly benefical. I am walking 20 minutes a day on a tread mill. I am also taking a joint solutions vitamin that has greatly made a difference in a short period of time.

From: Anonymous - Missouri, USA

I come from a family of disc problems. Average time for recurrent herniation L4-5, L5-S1 in 10%-15% patients is 7 years. Due to loss of the excised annulus and formation of scar tissue in it's place, the disc is never the same. 10 months ago I started a core building program and low impact elliptical 1 hr/day. I lost 30 lbs of fat, and gained 10 lbs of muscle around the core (18% body fat). Flexibility came first with proprioceptive neuromuscular facilitation and then advanced to full range of motion exercises using cable/resistance technique with core stabilization. Completely eliminated all back pain day and night.

Then at age 44 yo I advanced my program to spin classes (bad for the disc), hand stand pushups, did rotational ball throws, curls and presses while kneeling on the excercise ball with a trainer. I caution people with previous discectomies, avoid fusion because it stresses other normal or abnormal discs. As everyone ages your disc lose water and lose height, this can stabilize these narrowed disc spaces. Rarely does a disc herniation occcur after 60 yo. I am now rehabing for a redo 2 level microdiscectomy. Having had done all the core work over the past 10 months, rehab under supervision will be easy except longer due to a revision. I had warning signs but ignored them; back pain jump roping, hyperflexion on spin bikes, back hyperextension jumping off chin ups. I found a great spine surgeon with great long term advice. Get second opinions.

From: Anonymous

I damaged my back lifting heavy objects and was in constant pain, could not stand without tilting to one side, had pain in my left hip shooting down to my ankle, had numbness in the left foot and severe pain. I find yoga (cat pose, fish pose, cobra, etc.) helpful. I recently bought a back roller; a four feet dense styrofoam piece, about 8 inches in diameter, that I put under my back and roll back and forth on massaging my spine. Swimming is also helpful. Whatever you do, try to stay active. It maybe painful in the short run but will help in the long term. Still have pain in my left leg and stand crooked after 6 months, but getting better, I hope!!

From: Mo – California, USA

I have spondylolisthesis (grade 2) and 2 bulging discs. The pain got so bad after my commute changed (I went from taking a train to driving) that I had to take about 8 months off from work, after which time we fortunately relocated to the west coast and I was able to resume working. I have been using the Egoscue Method (postural therapy) for over a year and I am amazed by the results. It makes much more sense than the typical responses you'll get from orthopedic surgeons as it actually explains how the dysfunction occurs instead of blaming it things like aging, and it gets to the root of the problem rather than utilizing a possible fix (surgery) which ultimately may do more harm than good.

From: Erin

I have been suffering from back pain on and off for more than 10 years now. A girl friend recommended a book called The Backsmart Fitness Plan. I just started the ball exercises and I can tell I am very weak in my core area. Overall I highly recommend this book to anyone trying to get into shape and who wants relief from their pain.

From: No More Back Pain - Ohio, USA

I can't believe I'm out of pain and it is because of a Pilates Therapist by the name of Natalie Mirsky!!! I have 3 herniated discs and my doctor recommended spinal fusion. I heard of Natalie Mirsky through a friend of mine (she also helped her back) and the results have been miraculous! I have not felt this good since I was in my 20's.

From: Debbie – California, USA

After developing extreme pain in my right leg and serious foot drop I had a discectomy at L4/L5 one year ago. The surgery took care of the leg pain and the foot drop is almost gone but I continue to suffer from "degenerative disc disease." Like most chronic back pain sufferers, I tried everything imaginable and was sure life as I knew it was over. Although I am physically fit and eat well, I finally got serious about exercise and stumbled onto a physical therapist that really helped. I focus mostly on stretching and pilates and yoga based exercises that involve extension. I do these three times per week, about 45 minutes worth. I think the key is to choose a routine that you know you will do. I still have back pain but it's not the sole thought running through my head every day. I can actually go snowboarding, ride off-road motorcycles and play golf. These must be approached with common sense but I never dreamed I'd be able to do these things again. I also am sure to take Ibuprofen when my back begins really hurting. This is mostly to take my mind off the pain because, after all, back pain is just as much a mental struggle as a physical one.

From: Rocky – Washington, USA

I broke L1 and L4 in a ultralight landing accident and was in a cast for ages. It’s been 2 weeks that the cast is off, and I'm engaged in pilates therapy on the mat 4 x per week. It does miracles for me!

From: Stringer

Homeopathy healed my herniated disc injury. The injury occurred when I and another Nurse lifted a patient. I was in terrible pain, I was advised by an Osteopath not to have surgery. Homeopathic treatment healed the injury.

From: Chris Malton, UK

I had a triple fusion on my lumbar spine. I never thought the recovery period was so long. I attributed it to my age (55) and that's why it took longer. This type of surgery is comparable to "Open Heart" for anyone that is having it done. The pain was horrible and I had a 6 day stay in the hospital. After the brace came off in 3 months, I started a physical therapy program. After 3 months in PT - I had a new spine! At least that is how it feels. You must do your home program in order for your PT to be successful. The best was that after PT and a long 8 months - no more drugs were needed. You just have to be patient and do your exercises to get the muscles moving again!! I had a great Neuro Dr. and a wonderful PT and I thank them every day of my life! Good luck!

From: Sandy

I had a discectomy 12 years ago (L4/L5). It's essential to keep as mobile as possible, because after surgery, things are inevitably out of balance. Sitting or having an unnatural posture for long periods (being a dentist is a classic example) are bad. My advice is to interrupt periods of sitting with regular spells of either lying down or standing. Swimming is good, only no breaststroke - backstroke is best.

From: Richard - Liverpool, United Kingdom

I recently suffered an L5-S1 disc herniation (in August 2004), with significant neural impingement, sciatica and numbness. I have always been very athletic (I sprint triathlons and half marathons) and was training for events this fall when this happened while lifting. Just prior to my second epidural, I began a new therapy: disc decompression therapy with a DRX9000 machine with a physical therapist.

I have since had 22 treatments (covered by insurance), resumed my swimming, using a recumbent bike and elliptical (no running yet) and also lifting. I utilize different methods of exercise to achieve the best results. Most importantly, I have worked specifically on my core muscle groups: abs and low back. I lost over 10 pounds of muscle weight before I could exercise again, so I'm gaining that back, but doing crunches, Roman chair leg-lifts, back rows, back laterals, sitting low back extensions and stretching. I gained the muscle weight back and kept off the extra 10 pounds.

These exercises, specifically abdominal exercises, low back strengthening exercises and cardio exercise coupled with this therapy have helped me gain back significant strength in my left leg. I developed more support for my low back with the additional muscle gain.

My goal is to run the half marathon again next fall and a few sprint triathlons and eventually a full Ironman triathlon in 2006. I wish everyone the best of luck. Keep working hard!

From: Josh

Hi, my name is Paul. I have two slipped disks, L5 & S1, I have pain over my left hip and down my left and right leg and I’m awaiting a laminectomy surgery sometime in the next 5 to 6 months. Exercises that help me are a reclining exercise bike, general back exercises, yoga and Pilates. The best medication I have had is Celebrex, 400mg a day, it helps get me through a full day at work. You could also try Reiki—as a natural healer, it helps me sleep through the night. Good luck!

From: Paul O’connor

I have suffered from chronic back pain for 12 years. There is absolutely no doubt that exercise and being in top physical condition makes a difference. I have been through 3 sports medicine rehab programs. The last one has made all the difference because I have found a way to work it into my daily routine. I always stretch twice a day, usually after a hot shower in the morning. Water is wonderful. Water aerobics for exercise is fun. Did you know that while doing the crawl you can irritate your back? Well, you can, and since I took up back stroke I have enjoyed the water exercise 100% more. I even went cross country and down hill skiing last year! So get moving and exercise. I promise you will feel better.

I have suffered from degenerative disc disease at L4-L5, have arthritis at L4 and have a ruptured disk at L4 leaving no cushion between vertebrae. I had sciatica pain so badly I was ready to have my leg amputated. I'm 46 years old.

After 12 years of numerous, unbearable painful episodes, I am convinced that nothing prevents another painful episode better than exercise walking 2 to 4 miles up and down hills daily and afterwards, stretching the hamstrings, piriformis muscles and hip flexors. Anti-inflammatory medications can relieve pain to help you start the exercise process after a debilitating episode, but the walking and stretching exercises are what keep me pain free for months. Yoga exercise for back care is fantastic for stretching and maintaining a healthy spine. No matter how badly I am hurting or how slowly I walk, even with my cane, I always walk at least a 2 mile route. I believe exercise walking gently increases the flow of healing properties within our bodies while releasing endorphins to naturally relieve pain.

Even though I have qualified for the new artificial disk at L5 and have been briefed by my surgeon for spinal fusion at L4, he is amazed at how well I am doing (again) from my walking and stretching exercise ritual. He told me to keep doing what works for me and that I didn't need to return to his office anymore. Good news for me! But I know if I quit my exercise program of walking and stretching I will surely have another episode.

I go to a wonderful doctor of chiropractic in Chicago, IL. He has taught me not to concentrate so much on the symptom of pain, but on restoring my maximum range of motion through back exercise. So even when I experience mild or moderate pain I do my back exercises. I have found out that doing my exercises, even if I am in pain, my pain almost always decreases and my range of motion keeps getting better. My favorite exercises are back squats, bridges and partial sit-ups. I have lived with chronic pain for 11 years due to being run over by a truck and thanks to my Doctor, I am finally experiencing true body restoration. I realizedI don't have to live with restricted motion and pain and I am doing this without the assistance of surgery or drugs!

From: Trayce Hicks

I have severe spinal stenosis of the lumbar spine and will be having spine surgery in September. I was first diagnosed with the stenosis 7 years ago and have been able to delay surgery by doing yoga exercises on a regular basis. Yoga enabled me to continue functioning normally until recently. I highly recommend this form of exercise for any kind of back pain but also recommend that people always check with their doctor first. I began doing yoga exercises when I was just 21 years old and I'm now 57. Working with a one-on-one trainer for beginners is ideal, but classes and videos are also readily available in most areas. I am told that after surgery I may not be able to do yoga exercises, but we'll see.

I had spinal decompression and fusion with instrumentation on levels S1, L4 and L5. I wore a back brace for 4 months. Once the brace was off, I started gentle Pilates exercise (Stott series)and some yoga exercises daily.

I’ve been walking every day for exercise for at least 2 hours, but at first I had to seriously practice standing straight. Balancing was difficult for the first 9 months and I had to keep working on exercising my stomach muscles. I went to a Physio for 8 months to receive laser and muscle stimulation. I also used a treadmill for 40 minutes at a moderate pace. I walked and walked. After about 9 months, I started riding a stationary bike for exercise and after 10 months a comfort bike with extra shocks. My back is feeling great, but my neck has continued to be a problem.

From: coralb

I have been dealing with chronic low back pain for 8 years now. I have been diagnosed with a compressed, bulging disk between L5 and S1. In the early years, I would use narcotic pain relievers but I have learned they are not the answer; in fact they prolong the painful episodes I have. My pain program consists of the following, including exercise, stretching and water therapy:

• Start a program of exercise and do not stop. Once you start to feel better, keep up with your stretching and exercise.
• Keep moving. Do not sit, stand or lay down for any lengsth of time, except to sleep. Do not lay around waiting for the pain to go away.
• Use ThermaCare disposal 8-hour heating pads
• Do hydrotherapy in a spa at least 3 times a day. This provides a huge degree of relief. A stretching exercise program in a pool or spa works wonders (also known as water therapy).
• Drink lots and lots of water, for some reason being well hydrated helps me stay moving and exercising.
• Get a good bed and mattress. Try several types of beds and mattresses until you find what is best for you. A Swedish foam mattress works best for me.
• Stretch lightly in bed before you get up.
• Stay happy - at least once a week, treat yourself to something special that makes you happy. You have to control the pain - don't let the pain control you. If you feel you are getting depressed, get help for that.

From: Robert

Communicate with others about exercise for back pain relief

* Note: This page expresses the experiences and opinions of patients, not doctors. The Back-to-Back forum is provided because we think people often have very practical advice and insights to share that can benefit other patients who have similar back problems. This section has not been peer reviewed by our Medical Advisory Board, and is provided for your informational purposes only.

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