Pain. What is Pain? Why do I have it?

Neuroscience of Pain
Neuroscience of Pain

Here is a topic that in my recent years of practicing realized the SIGNIFICANT IMPORTANCE of teaching my patients on the science of pain-what it is, why it’s happening and what they can do to either to get ride of or to manage it. Keep in mind that the principles of pain the I am about to talk about does not only limit to lower back pain.

I learned about the science of pain after my mentor encouraged me to follow Adriaan Louw a renown author, scholar and a physical therapist on his research of neuroscience of pain. I have to say that after taking courses and reading many research articles, that the way I practiced has only gotten better and my patients were my proof.

It made a world of difference to talk about this and I believe that when you have a better understanding of your situation you feel more hopeful and start to take back control of your body and your life, which is empowering!

Many researches show that when people living with pain learn about the science behind it, it eases their hesitancy to moving again-getting back to activities that you once enjoyed and pain intensity itself can lessen.

So lets start the journey of understanding the science of pain. Trust me it will be eye opening and I get so pumped about talking about this. So lets begin shall we?

The first thing I would like to say is that pain is normal and very real, it is our body’s system of protection and very critical our survival. We need pain and here’s why.

Lets say that you accidentally step on your kids Lego on the floor and quickly you jump off the Lego muttering a 4 letter word. It’s your brain that tells you, “Hey, take your foot off that ASAP or you’re going to keeping hurting yourself!” Another prime example is that instinctive reaction of taking taking your hand off that hot pot you accidentally touched. If you didn’t experience pain, would you continue to burn your hand?

While to experience pain is normal and needed, to live with chronic pain is not. The tissues in our body are meant to heal and they probably have. Surprisingly it isn’t the tissue that are the culprit of pain but the brain and let me explain why.

The brain is the control center where details are assessed, such as the “hows, why and what” you’re physically feeling. Nerves of and surrounding area of the injured body part send “danger signals”, NOT pain signals (there is not such thing as “pain signals”) up the spinal cord to the brain.

Once danger signals reach the brain it is there that the concept of “pain” is actually established and the brain decides the next course of action to protect that area.

So let’s go back to the Lego example. You step on Lego that your kid left in the middle of the floor. That pressure on your foot spikes the nerve electric impulses of that area sending important “danger signals” to the brain. The brain then orders you to take your foot on the Lego and to blurt a 4 letter word(s), all in the matter of milliseconds. Once you remove the foot, the electrical impulses return to normal, low and steady state.

The problem lies when the nerve impulses don’t calm down to it’s normal state even when the object that caused danger signals is no longer there.

High electric impulses of nerve = constant signaling to the brain”danger, danger, danger x100.” The is overwhelming to say the least.

Over time, the impulses that stay high become extra sensitive. That extra sensitivity is what leads to not wanting to move as much, release of stress hormones, emotional and psychological changes because of frustration, lack of sleep, etc. All in all, your quality of life starts to diminish.

So you see, prolonged pain does not necessarily mean that your tissues are more damaged because tissues heal! Rather the nerves in the area and surrounding areas are overwhelmed.

Also know that nerves have all these cool characteristics about them. For example, does your pain get worse in cold weather? Can you not move as much or as well as you did before? Does you pain level go up when you’re stressed out or when you’re sick? There’s an explanation for all this.

Nerves are made up of different sensors detecting temperature changes, stress hormones, physical movement, immunity and blood flow constantly relaying info to your brain just to let it know how it is doing.

But if your nerves are already on high alert, these sensor also stay on high alert very attentive to temperature, movement, stress, etc as you have probably noticed.

I know what you’re thinking. You’re asking, so what can I do to desensitize my nerves? I would suggest 2 things but in the book you can find Louw suggest various things.

First, read Why Do I Hurt by Adriaan Louw. He does a PHENOMENAL job of breaking the science of pain and provides with much more details that are very relevant to your pain . THIS IS A MUST READ! It will be 30 min well spent!

Check it out on Amazon.

Second, consult with movement specialist to getting to back to moving again! You want to make sure that you get back to moving safely and correctly.


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7 Best Lower Back and Hip Stretches During Pregnancy

Experiencing lower back and or hip pain during your pregnancy? No worries, I got you covered. I put together a list of stretches that my pregnancy patients got the most symptom relief from and loved. Please keep in mind that stretching is only suppose to feel like a stretch, NEVER PAINFUL.

Before starting your stretching regimen, consider these helpful and safety tips.

  • Stretching should never be painful as mentioned. You are always win control of intensity of the stretch so if it is painful trying backing off on the pressure you are applying. Still painful after you modified your pressure, then don’t keep doing the stretch, it’s is not the one for you.
  • Research also shows that holding a stretch for 30 sec duration results in the best stretch aka the stretch actually takes place. I also suggest 2-3 reps at a time unless specified otherwise.
  • Research also shows that completing them on frequently basis is a factor to effectiveness.
  • If you have known issues, please consult with your MD or a physical therapist first to make sure these will not cause or irritate existing symptoms.
  • Important to breathe while holding your stretches. If you are having difficulty breathing, count out loud.

Now I introduce to you the 7 Best Stretches for Lower Back and Hip Pain During Pregnancy! These stretches come in various positions so try them both to see which ones you like best.


  1. Piriformis Stretch ( Seated and Lying Down)
  •   Seated: Sitting up nice and tall in your chair, place the foot on top of the other knee to make “Figure 4”. You can either push down on the knee of the leg that is crossed over or bend your trunk forward from your hips (not slumping forward) to feel the stretch.  (example: If you want to stretch your right piriformis, place the right foot on top of the left knee and push down on the right knee. You should feel the stretch in your glut region.)

    Seated Piriformis Stretch
    Seated Piriformis Stretch
  • Lying down: Lie on your back and bringing one ankle to the top of the other knee. With a towel or your hands grasp around the uncrossed leg pulling to tolerance. You should feel the stretch on the side that the is crossed over.
Supine Piriformis Stretch
Supine Piriformis Stretch


2. Lateral Hip stretch (Standing or Lying Down)

Lying Down: Lying on your back. Bend one knee and keep the other one straight against the surface then with hand opposite of the bent knee pull that knee across to the opposite side (example: if the right knee is bent, you are going to pull the right horizontally to the left with the left hand.)

Lateral Hip Stretch Supine
Lateral Hip Stretch Supine


Standing Lateral Hip Stretch: Find a wall or a chair. Stand next to the wall with the painful side of the lower back or hip closest to the wall. Use the arm closest to the wall to support yourself and help keep balance while taking a step away from the wall with the leg closest to the wall. Then cross the opposite leg over and let the hip just slowly lean towards the wall/chair.

Standing Lateral Hip Stretch
Standing Lateral Hip Stretch


3. Standing Hamstring Stretch

I think this is easiest with a chair or a step/box to support the leg you want to stretch. Just place the leg up there and slowly bend forward bending at the hips, not slumping forward. You should feel the pull in the back of the thigh.

Standing Hamstring Stretch
Standing Hamstring Stretch


4. Sidelying Trunk Rotation

I think this is my favorite. While this stretch is not directly targeting your lower back or hips it does help lower back and or hip pain during pregnancy. This stretches helps improve the mobility of the mid back ( aka your thoracic spine) which means less demand on your lower back and consequently your hips.

So start by ling on a side, doesn’t matter which side because you would want to do both. Bend both knees to chest to at least 90 degrees with your hands together as the first picture shows. The with your top hand open like a book, head and neck following hand, just as the second picture shows. You should feel a good stretch in the mid to upper back. I recommend about 15 reps on each side nice and slow.

Thoracic Mobility Stretch
Thoracic Mobility Stretch







5. Modified Child’s Pose Stretch

Here is the picture of your typical version of Child’s Pose but depending on the size of the belly, you may not be able to complete the stretch this way.

Lower Back or Hip Pain During Pregnancy
Childs Pose

So try this instead. Sitting in a chair with your knees apart and reach for the floor straight forward. You can also isolate stretching the left or right side of the lower back  by reaching for the opposite foot. For example, say you want to stretch your right lower back, the reach with both hands to the left foot.


6. Cat and Cow

Here is the starting position, both hands placed under shoulders and knees under hips. Start by rounding your upper back and moving the head down then slowly start to arch your lower back while looking up as pictured in the second picture. Take nice slow deep breaths are you change between the 2 positions. I recommend 10 reps per position.

Quadruped Cat and Cow
Quadruped Cat and Cow

 7. Single knee to chest

Lying on your back, grab behind one knee and pull towards your chest.

Lower back and Hip Pain During Pregnancy
Single Knee to Chest

3 Best Sleep Positions for Lower Back Pain

Happy Monday, I hope everyone had a great Thanksgiving. Ok so let’s get down to business. In my last blog I gave you the 411 on importance of sleep and now I am here to guide you through them. Here they are…3 BEST sleep positions for lower back pain so grab 2-3 pillows and follow along.

#1 Sleeping on your back 

Sleeping On Your Back With Less Lower Back Pain
Sleeping On Your Back With Less Lower Back Pain

Ok, so the 2-3 pillows you have are going to be supporting your legs. Place the first pillow up to your gluts, not under your gluts horizontally. Then the second pillow goes on top of the first pillow but starting mid thigh, again horizontally. Last, the third pillow goes under the knee fold. Some people like the added height of the third pillow while some feel comfortable with just two. Generally you want to use at least two pillows, one pillow doesn’t seem to be enough. Play with it the number of pillows to see what feels most comfortable to you.

#2 Right and/or Left Side Sleeping

Side Sleeping with Less Lower Back Pain
Side Sleeping with Less Lower Back Pain

You will definitely need 2 pillows or a body pillow. If you have 2 separate pillows try this. First, place a pillow between your legs vertically supporting from mid thigh to feet. Then depending on which side you are laying on, you are going to place a pillow under the arm. For example, if you are laying on your right side, you left arm hugs on the pillow.

Why the pillow under the arm? It there to limit rotating your top shoulder and trunk towards the bed as the night goes on. When your upper body rotates or leans forward it can contribute to the lower back rotating as well, adding unnecessary stress. Remember when your body is in pain, your body is more sensitive to minor changes.

The same principles apply for body pillow. You place it between the knees and hug at the arms, like the picture shows.

# Stomach Sleeper

Again, for sleeping on your stomach you can use 2 pillows or a body pillow. I generally find body pillows to be more comfortable and supportive.

The main difference between sleeping with pillow support in sidelying vs. on your stomach is your leg placement. When you are sleeping on your side, the legs are stacked on top of each other with a pillow in between whereas sleeping on your stomach, the bottom leg does support the top leg. The top leg is only supported by the pillow.

I promise for a picture to come for visual assistance. None of the pictures did the positioning justice.

So try this if you have 2 pillows or a body pillow. Just like in sidelying you are hugging the pillow at the top arm and the top leg is supported by the pillow placed vertically as much of the leg the pillow allows. The bottom leg is positioned naturally and comfortably.


  • Do not try to change your favorable sleep position. Try the giving your body more of a pillow support then if that does not work then trying a new sleep position.
  • It should take you less than a few minutes to get comfortable once you get your self set up. If you takes you longer than that, having someone like your friend or significant other look at your alignment. Sometimes having someone else see you in different views help make alterations that you may not notice.
  • These sleep modification are designed to help you sleep better with less frequency of waking up in the middle of the night, help you fall asleep quicker with less discomfort, or help you wake up with less pain.


Hope these tips helped. If you have any comments and or questions please leave me a comment.

Sciatica During Pregnancy

Sciatica during pregnancy
Sciatica during pregnancy

This is a HOT TOPIC! Sciatica during pregnancy is probably one of the most common, if not the #1 complaint of lower back pain when pregnant. Fear not, I am here to provide some solutions as best as possible. There are things you can do such as as core stabilization exercises, sciatic nerve stretches (or some may call sciatic nerve glides), hip stretches and improving posture to address sciatic nerve pain so keep reading.

Sciatic nerve pain during pregnancy can occur either on the right or left side of the buttock with sharp, burning and or even shooting pain down the back of leg. It is most common in second and third trimester. Why does this happen you may ask?! Without getting too technical, sciatica occurs because the nerve is compressed.

Anatomy of the Sciatic Nerve
Anatomy of the Sciatic Nerve

Still not sure, if you’re pain is due to sciatica other than the fact you have pain in the buttock and down the leg, try these two things.

#1 – Push your glut region where you feel the pain. Does that reproduce the pain down the leg? Likely, you are pushing on the piriformis muscle where the nerve can commonly get compressed from.

#2 – I am going to guide you through the sciatic neural tension test to further confirmed that the nerve indeed is affected.

First step, find yourself a bath towel, a long dog leash or a belt .

Second, lay on your back with both knees bent and feet on surface that you are laying on. Don’t worry, I know laying on your back is uncomfortable but you’ll be there for another a few minutes. While in this position, loop the belt/dog leash/bath towel behind the of the painful leg.

Third, you are going to pull the weight of the leg with the strap with both hands and pull that knee towards you, letting go of all the weight of the leg in the strap.

Forth, straighten you knee. What do you feel? Do you feel the exact pain that you complain of? If so, you are screening positive for sciatic nerve irritation. If you are not sure than  continue to the next step.

Fifth step, complete # 4 again and add pointing your toes towards your nose. What do you feel? The exact pain that you complain of? If yes, then again confirmation of sciatic nerve involvement.

If you are testing positive for both screening or just one you, are likely having sciatica.

SO NOW WHAT? Ok, here comes the good stuff, symptom relief with piriformis stretching and nerve glides!

Piriformis stretching can be completed a a few different ways. Check out my video on various stretching performs stretches.

Then you have the neural tension test you completed above. Use those exact movements to gently stretch the nerve for relief. Watch me!



For the nitty, gritty details on sciatica, visit my sciatica page.

4 Posture / Sitting Tips To Prevent Lower Back Pain

Hello everyone! This is a FANTASTIC day to talk about sitting posture. Want to prevent lower back pain while sitting at work?! Here are 4 best ways to improve your sitting posture and decrease your lower back pain.

Sitting Posture
Sitting Posture

#1: Get up every 30-45 minutes, this is very, very critical! Set an alarm on your cell phone and after 30-45 minutes alleviate the pressure throughout the spine by standing, stretching and or walking for 1-2 minutes then get back to work. I understand, you can get so caught up in your tasks throughout the day then not realize that you have been sitting for so long but that is what the alarm is for.

#2: Adjust your seat height so that your hips are angled slightly higher than you knees while being able to maintain both feet comfortably flat on the floor. You can do this by playing with the seat height- adjust that lever under that seat or investing in chair wedge.

#3: Adjust your computer monitor. Most of the time I have to suggest making minor adjustments to the computer set up itself. First see if your eye level naturally and easily is positioned to middle of the computer screen. Next see if your shoulders are nicely relaxed with hands on keyboard. Your shoulders should not bee shrugging toward your ears. If this is sounds like you, you may have to raise or lower your computer monitor, or adjustment of the seat height without changing too much the position discussed in #2.

#4: Invest in a lumbar support. I have to say that my favorite and what I have recommended to almost all my patients with lower back pain is the McKenzie Super Roll (especially for my bulging disc patients-found on Amazon) to place in your work chair to assist with improving your sitting posture. Remember just because you are using a lumbar support does not allow you to sit for hours without pain. It should be use for support. Sometimes a bed pillow will do the trick too- placed vertically to support the curvatures of the mid to lower spine, taking some stress away from the muscles.

Hope these tips are helpful! Try these out and let me know how it worked for you. If you have any other questions, leave me a comment.

Lower Back Pain During Pregnancy

Lower Back Pain During Pregnancy
Lower Back Pain During Pregnancy

Hello all you glowing pregnant ladies out there! Let me guess…you are either at the end of your second or in your third trimester experiencing lower back pain due to pregnancy? Not comfortable right?

Feeling lots of pressure in your pelvic region and your feet are swollen or even pain shooting down your leg? No worries, this is  ALL VERY COMMON amongst preggers! As you have noticed, your body goes through so many drastic changes to accommodate that growing baby. For most women, the lower back pain, hip pain, the uncomfortable pressure in your pelvis, the swollen feet, etc will go away after you give birth! But for some, the lower back pain does not go away so let me explain.

During pregnancy there are LOTS of changes, physically, hormonally, emotionally, etc. as you may have experienced for yourself. BUT no worries there are things you CAN DO to help manage the pain in terms of exercises, sleeping positioning and sitting posture.

Exercises mainly focus on stretching of tight hip and lower back muscles, and gentle core stabilization to take some pressure off your lower back. Here are some exercises {COMING SOON} that may help!

Another great alternative to help your lower back pain during pregnancy is walking in water at the pool! The buoyancy of the water will take some pressure off you lower back and hips.

In regards to posture, listen up ladies! First thing is first. If you have not already, please invest in a good PREGNANCY body pillow to help you comfortably sleep through the night. The body pillow designed for pregnancy is better designed to support your body compared to the “non-pregancy” body pillow. If you don’t have a body pillow, let me show you how you can mimic the body pillow by using 3-4 regular pillows. Click here for the video link {COMING SOON.} 

Second, when sitting a few things to remember. First, sitting on a hard surface will be more aggravating than soft surface so if you have to carry around a seat cushion (can be a folded fluffy bath towel or a bed pillow) so be it. Second, using a lumbar support in your chair will be your second best friend. My favorite lumbar roll is the McKenzie Lumbar Super Roll. Trust me you never sit the same after using this. I even strongly recommend this to my non-pregnany patients with lower back pain and they love it!

Another alternative to a lower back support while sitting, is using a bed pillow, nothing too fluffy and here is how. Make sure you are sitting with your hips slightly higher than you knees and you can adjust by the chair lever or sitting on a seat cushion and the pillow should be placed long way all the way you seat and you sit back upright to the chair back. Try adding a folded bath towel also in your lower back if you need more support. To see what I mean, check out this video {COMING SOON.}

SIDE NOTE: If you are experiencing sciatic nerve pain due to pregnancy, I wrote another blog about it so check it out!

The Importance of Addressing Sleep Posture for Lower Back Pain

Having difficulty sleeping through the night?Is your lower back pain is waking you up in the middle of the night or you are having a hard find a comfortable position? Sleep and lower back pain is probably my favorite topic to talk about!

I love sleep, who doesn’t? Sleep is so critical to our health for many, many reasons such a cognitive functioning, emotional state, cellular changes, etc. In fact, during sleep is when the most healing occurs within our body but here is the catch….

Most people (not all) suffering from lower back pain can’t sleep through the night because either they have difficulty falling asleep and or waking up in the middle of the night constant due to pain. And, when you wake up in the AM you start the day off with heightened pain. So let me try to help you to sleep with less lower back pain.

You are probably wondering…..”Is there such thing as good” vs. bad sleep position?” The answer to that is, YES, YES, YES.  Sleeping on your stomach is the least favorable position because the amount of stress that puts on your lower back and not to mention your neck. Sleeping on your back and either sides is suggested over sleeping on your stomach.

You mean, I have to change my sleep position? And the answer to that is not necessarily. I totally get it, you’ve been sleep like this for YEARS! Sleep posture is generally not something that people can change easily so no worries.

Instead I teach all my patients how sleep in a better, more supportive position with the use of pillows and many of them. Trust me you may feel like you are being smothered by pillows and your significant others may think you’re crazy, however you will most likely have less pain first thing in the AM, wake up less frequently in the middle of the night and feel more rested.

So let me summarize. Sleep is critical to improving your lower back pain as it is time for your body to rest and heal. Sleep is posture and without addressing painful posture, you are only limiting your body’s capacity to heal.

I always stress this to my patients….all the exercises in the world will only get you so far, and I mean pretty far generally (there are always exceptions to the rules) BUT, if you continue to resume activities and or postures that re-aggravate your symptoms than you start to “undo” what you have trying to work hard with exercises. Lastly, who doesn’t love sleep. We need to sleep.

Ok, now to the good stuff! Check out my video {LINK} and my other sleep blog where I guide you through different positions and bring your pillows!