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Dr. Michael Rimlawi Discusses: Why Choose the Minimally Invasive Spine Institute?

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Minimally Invasive Spine Institute BuildingBy: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of the Minimally Invasive Spine Institute in Dallas

Back pain is one of the most common medical complaints among both men and women in the U.S. In fact, as many as two-thirds of adults in the U.S. experience back pain – but nearly 4 out of 10 of those people won’t seek medical treatment for their pain, primarily because they aren’t aware of the non surgical options that are available to them or they mistakenly believe that treatment involves a lot of pain or a long period of recovery.

In the past, many treatment options – specifically surgical options – used to involve long periods of hospitalization and recovery, as well as large incisions and scars. But the fact is, today’s minimally-invasive surgical techniques have changed that, and most people can experience significant relief from their symptoms without long periods of recovery and without significant post-op discomfort.

Feel Better Faster

Minimally-invasive spine surgery uses very small incisions – often just an inch in length – while utilizing special instruments to perform a wide array of spine-related procedures, helping patients get the relief they need without the tissue damage, discomfort, blood loss and potential complications associated with traditional open spine surgery. Most minimally-invasive surgeries can be performed on an outpatient basis, which means patients can return home the same day they have their procedure. And often, those patients are able to return to their jobs within a few days or weeks– not the months required following traditional spine surgery.

Although minimally-invasive surgery has become much more common during the past decade or so, not every medical facility offers these state-of-the-art tools. The key to excellent results is to select a surgeon and facility that offer both advanced treatment options and a skilled, dedicated staff with experience in minimally invasive spine surgery.

Team Approach

I founded the Minimally Invasive Spine Institute to provide patients a full spectrum of treatment options for back and neck pain and related symptoms, from bulging discs and nerve impingement to scoliosis, spinal stenosis and spondylosis. We focus exclusively on the spine and its disorders and diseases so our team of spine surgeons, pain management physicians, nurse practitioners, medical assistants, imaging specialists and patient care coordinators are highly skilled and have decades of experience with treating the spine. Plus, having an on-site team makes it easier for each member of our staff to consult and communicate, which means you can expect coordinated care aimed at helping you achieve optimal results at every step of your treatment journey.

We have helped over 30,000 patients with treatment plans customized to meet each of their needs. If you suffer from chronic back or neck pain, don’t put off getting medical attention. Call the Minimally Invasive Spine Institute at 855-466-6741 and schedule an evaluation today.


Dr. Michael RimlawiMichael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.

Best Sleeping Positions for People with Back Pain

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By: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of the Minimally Invasive Spine Institute in Dallas

Sleep is meant to be peaceful and rejuvenating, but what happens when back pain prevents this? According to the American Academy of Sleep Medicine, “Adults should sleep seven or more hours per night on a regular basis to promote optimal health. Getting less than seven hours of nightly sleep increases your risk of several adverse health outcomes.”

The addition of an extra pillow paired with various doctor-recommended sleep positions can help alleviate lower back pain. To help those suffering from back pain, we have mapped out a few tips to obtain a restful night’s sleep.

  1. Sleep on your side with a pillow between your knees

    Side sleepers

    Photo Credit: Can Stock Photo

    This position isn’t the key to relief, but the added pillow is. By tucking a pillow between your legs, the spine, hips and pelvis are in better alignment.

  1. Sleep on your stomach with a pillow under your lower stomach

    Adding a pillow under the stomach can take pressure off the space between your discs.

  1. Invest in a good memory foam pillow

    Many people research and research their bed but pay little attention to their pillow. Memory foam pillows molds itself around the curve of your head keeping every small bone carefully aligned.

  1. Sleep flat on your back with a pillow under your knees

    According to Health.com, this position takes stress off your pressure points and allows for better alignment of your spine and internal organs.

  1. When traveling, use a seat sleeper pillow

    Sleeping with a neck pillow

    Photo Credit: Can Stock Photo

    Travel pillows come in all shapes and sizes. Supporting your head and neck while seat sleeping is important. Check out Travel +Leisure’s 14 Best Travel Pillows for Every Type of Seat Sleeper to help find a pillow that will  keep the head from being pushed forward when you are sitting.

While sleep positions alone won’t solve back pain, making small adjustments to your sleeping style can make a big difference.

Healthy Sleep Duration

Source: American Academy of Sleep Medicine


Dr. Michael RimlawiMichael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute’s team. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Michael Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.

Yoga Stretching

Best Yoga Stretches for Lower Back Pain

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By: Dr. Mike Shah. Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, The Minimally Invasive Spine Institute in Dallas

One of yoga’s most attractive qualities is that it’s good for the mind, body and soul. This holds true for people with back pain. There are a variety of yoga poses that you can do that are very beneficial when it comes to relieving back pain. Next time your back is acting up, try these yoga poses.

DOWNWARD DOG

Downward dog yoga pose

Photo Credit: Can Stock Photo

This stretch reaches the entire body and stretches the large muscles that form the lower back.

CHILD’S POSE

Childrens Yoga

Photo Credit: Can Stock Photo

Child’s pose provides the back with a deep stretch.

TRIANGLE POSE

Triangle Pose

Photo Credit: Can Stock Photo

Great for strengthening the back, triangle pose helps lengthen muscles and stretch muscle fibers.

CAT AND COW POSE

Cat Pose

Photo Credit: Can Stock Photo

Not only does this pose do wonders for an aching back, it also loosens back muscles and can be used as a warmup in any workout.

When first starting yoga, be prepared for your body to be a little sore. For a person with weight issues, a lack of exercise can greatly increase the risk of back pain. Inactivity combined with extra weight puts pressure and strain on your joints and spine, putting you at a greater risk for sciatica, herniated disks and pinched nerves.

Many people suffering from chronic back pain, for whatever reason, are under the impression they will be less likely to hurt their back if they limit the amount of activity or exercise they participate in. However, regular activity helps with lower and upper back pain relief as well as other types of chronic pain. Physical activity activates the exchange of nutrients between spinal disks, keeping the spine healthy.

Because yoga uses a variety of postures and techniques, it is important that you stretch properly before and after each yoga program. Stretches where your body doesn’t leave the floor and stretch the lower back are helpful. However, it’s important to communicate your pain with your doctor before starting any new exercise routine. It is also important that you learn how to properly perform yoga’s postures and techniques to avoid potential injury.

The American College of Sports Medicine recommends that you see your doctor before engaging in vigorous exercise if two or more of the following apply:

  • You’re older than 35 years.
  • You have a family history of heart disease before age 60.
  • You smoke or you quit smoking in the past six months.
  • You don’t normally exercise for at least 30 minutes, most days of the week.
  • You’re significantly overweight.
  • You have high blood pressure or high cholesterol.

You have type 1 or type 2 diabetes, or you have impaired glucose tolerance (also called prediabetes).


Dr. Mike ShawMike Shah

Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, Minimally Invasive Spine Institute

Dr. Shah is a Harvard-trained physician in Physical Medicine and Rehabilitation who has been dedicated to the eradication of pain in the Dallas area since 2003. He received a Bachelor of Science in Biology from Duke University and his medical degree from Tulane University School of Medicine in New Orleans, Louisiana. Dr. Shah also received a master’s in Pharmacology from Tulane and a Master of Public Health from Tulane University School of Public Health. Following this, he completed his Physical Medicine and Rehabilitation residency at Harvard’s Spaulding Rehabilitation Hospital in Boston, Massachusetts, consistently recognized as one of the Top 5 Pain Management Hospitals in the country by U.S. News and World Report.

Everyday things that cause Back Pain

Everyday Things that Cause Back Pain

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By: Dr. Mike Shah. Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, The Minimally Invasive Spine Institute in Dallas

According to the American Chiropractic Association, In the United States, more than three million people experience back pain each year. Lower back pain can be described as a problem in any part of the spine and can range from annoying to excruciating. As the single leading cause of disability worldwide, back pain is one of the most common ailments adults face.

Understanding your back pain:

For many, back pain can be as simple as a muscle strain or sprain. This is the most common form of back pain, and the most treatable. This kind of back pain is referred to as “self-healing”, which means it does not require treatment. Other kinds of back pain can be symptoms of a more severe condition, for which it is often necessary to seek out the advice of a back doctor.

Causes of back pain:

There are many different causes of back pain. Most commonly, back pain is caused by overuse or wear and tear as opposed to one isolated event. While overuse is not always preventable, there are several ways to change your daily routine that can significantly decrease the risk of back pain.

  1. Back Pain for Chairs

    Photo Credit: Can Stock Photo

    Take a break.

    For a lot of people, working includes sitting at a desk or in an office for up to eight hours a day. A the most common contributors to back pain is remaining sedentary for long periods of time. In fact, sitting can put up to 40 percent more pressure on your spine than standing. Taking breaks and going for short walks or doing stretches every hour or so can alleviate pressure on your spine. If taking breaks and stretching possible during a busy day at work, try investing in a chair that supports your back and does not cause you to hunch over your desk.

  2. Stop smoking.

    It’s no secret that smoking is bad for you. Everyone is aware of the effects smoking has on the lungs and heart, but not everyone realizes the damage it can cause to other parts of the body, specifically the back. Smoking has been linked to lower back pain and lumbar spondylosis, a disease in which the cartilage of the disks and joints degenerate. Quitting smoking is an effective way to improve your overall health and decrease the risk of lower back pain.

  3. Switch out your mattress.

    If you can’t remember the last time you switched out your mattress, it’s probably time to invest in a new one. For those who already have back pain, the right mattress can make a difference. Professionals recommend finding a mattress that has a medium firmness, or placing a pillow between the knees or under the stomach to relieve pressure. Not only can it decrease back pain, but it may also improve the quality of sleep.

  4. Eating healthy

    Photo Credit: Can Stock Photo / Choreograph

    Eat healthy.

    Following a healthy diet is an effective preventative measure to easing back pain. The key to creating a “back-healthy” diet is eliminating foods that cause inflammation. Avoiding added sugar, processed foods, caffeine, red meat and alcohol and introducing more grains, lean proteins, vegetables and fruit can decrease inflammation and improve circulation throughout the body.

  5. Stretch.

    One of the effective forms of alleviating pre-existing back pain is doing preventative and therapeutic stretches. Other methods, such as low-impact exercises and yoga can prevent back pain from occurring by keeping off excess weight and keeping the joints limber. Yoga not only promotes physical strength and muscle relaxation, but also promotes deep breathing and mindfulness. Try asking an instructor to adjust specific poses to target the lower back.

  6. Back pain from Heels

    Photo Credit: Can Stock Photo / YuriV

    Take off the heels.

    No one will ever say that walking in heels is easy or comfortable. High heels force the back to arch and the spinal muscles to work in overdrive. Try trading in high heels for shorter ones or even sneakers occasionally, and even consider investing in gel inserts for shoes to provide more stability and relief.

  7. Walk when you can.

    Much like sitting at a desk, sitting in a car for long periods of time can negatively affect your spine. Hunching over the steering wheel or slumping in the seat causes unnecessary pressure on the back. Simple steps such as sitting upright and purchasing a supportive lumbar pillow can ease pain, but the most effective method is simply stopping often to walk and give your spine a break.

The American Association of Neurological Surgeons state, “An estimated 75 to 85 percent of all Americans will experience some form of back pain during their lifetime. Although low back pain can be quite debilitating and painful, in about 90 percent of all cases, pain improves without surgery. However, 50 percent of all patients who suffer from an episode of low back pain will have a recurrent episode within one year.” Because back pain is so common and can have significant negative effects on daily life, it’s worth taking the time to consider the changes you can make to take care of your spine.

For more information on back pain, common conditions and treatments, please visit www.mispinerelief.com. If you are suffering from chronic or severe back pain, contact the Minimally Invasive Spine Institute at 855-297-7242 to schedule a consultation with one of our specialists.


Dr. Mike ShawMike Shah

Interventional Pain Specialist & Pain Management Board Certified Physical Medicine & Rehabilitation, Minimally Invasive Spine Institute

Dr. Shah is a Harvard-trained physician in Physical Medicine and Rehabilitation who has been dedicated to the eradication of pain in the Dallas area since 2003. He received a Bachelor of Science in Biology from Duke University and his medical degree from Tulane University School of Medicine in New Orleans, Louisiana. Dr. Shah also received a master’s in Pharmacology from Tulane and a Master of Public Health from Tulane University School of Public Health. Following this, he completed his Physical Medicine and Rehabilitation residency at Harvard’s Spaulding Rehabilitation Hospital in Boston, Massachusetts, consistently recognized as one of the Top 5 Pain Management Hospitals in the country by U.S. News and World Report.

Man using phone

Back pain? There’s an app for that.

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By: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of the Minimally Invasive Spine Institute in Dallas

According to one of the leading statistics companies, Statista, as of March 2017, there were 2.8 million apps to choose from on Android and 2.2 million apps on the Apple App Store. There is pretty much an app for almost everything, including apps that help you manage back pain.

  1. My Pain Diary offers users a chronic pain and symptom tracker so they can better understand their pain and its patterns. With the app you can do the following:
  • Keep an accurate record of your condition for your doctor.
  • Learn how much you are affected by humidity, barometric pressure, temperature, precipitation and more.
  • Identify triggers, remedies, patterns and trends.
  • Email or print a report for you and your doctors.
  • Track your complex medical condition multiple times a day.
  • Track your simple pain condition as it occurs.Created by a chronic patient after being diagnosed with RSD/CRPS, My Pain Diary strikes the perfect balance between utility and ease-of-use. It is available for purchase in the App Store and Google Play for $4.99.
  1. The #1 Rated Yoga AppDown Dog: Great Yoga Anywhere brings yoga to you! Rated the number one yoga app by The Wall Street Journal, this is a fantastic tool to have in your possession in the fight against chronic lower back pain. With the app you can do the following:
  • Provides a home yoga workout to help relieve back pain.
  • Provides the closest thing to the actual experience of taking a yoga class in a studio.
  • New vinyasa flow sequences every time you log in. You’ll never see the same one twice.
  • 3 sequence types to choose from (full practice, on your feet, and restorative).
  • 4 levels (beginner 1, beginner 2, intermediate, and advanced).
  • Set practice time for between 15-80 minutes.
  • Clear demonstrations of all the poses with easy to follow instructions.
  • This music is tailored to your workout and constantly updated. You’ll never hear the same order twice.
    The app is free to use (with an optional upgrade to a membership of $3.99 per month) and is available for download in the App Store.
  1. The Backache app reminds users to get up and walk around to relieve the back after sitting for long periods of time. With the app you can do the following:
  • Backache app will send you regular notifications when to take a micro break throughout the day.
  • Simply follow the physiotherapist as he shows you which of the 31 exercises to perform.
  • The micro breaks can be performed anywhere as no special equipment is needed.
  • Set up your own schedule to suit your requirements.
  • Backache app includes 31 exercises that target all areas of the body including back, neck, legs, chest, feet, arms and hands.

With so many options, there’s an app for everyone. Some may help you identify issues to discuss with your doctor since back pain can result from a variety of things. However, if you are experiencing severe back pain, consult a doctor immediately.

The most important word of advice I have is don’t try and play Dr. Google and don’t rely on apps or the internet to self-diagnose your pain. If you are experiencing back pain, see a Board-Certified, Fellowship-Trained spine specialist. These apps are not in any way an endorsement or recommendation.


Michael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute’s team. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Michael Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.

Ryan Shazier Injury

Spinal Injuries in Football

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A Closer Look at Ryan Shazier’s Injury

By: Dr. Michael Rimlawi, Board-Certified, Fellowship-Trained spine surgeon and founder of Minimally Invasive Spine Institute in Dallas

Concussions and football are (and will continue to be) hot topics – especially in youth football. However, it’s important to note the other risks associated with the sport. Take for example the Pittsburgh’s linebacker Ryan Shazier who made a head-first tackle in Monday’s game against Cincinnati. Shazier was taken off the field, seemingly unable to move his legs at the time.

On Dec. 7, a press announcement was issued, “Last night, UPMC neurosurgeons and Pittsburgh Steelers team physicians Drs. David Okonkwo and Joseph Maroon performed spinal stabilization surgery on Ryan Shazier to address his spinal injury.”

While the exact type and extent of the injury and subsequent procedure has not been made public, from the video it appears as if Shazier hyper-extended his back. As noted by the grabbing motion to his back immediately after the hit, he may have also fractured, broken or possibly dislocated one or more bones in his lumbar spine. The injury likely centered in his lumbar spine region because he was seen moving his upper extremities immediately after the injury. If the injury extended to his cervical (neck) region, he likely wouldn’t be able to move either his arms or his legs.

When this type of injury occurs, the key concern is the stabilization of the patient’s spine. In cases where the spine is broken and unstable, even the slightest movement can cause the spine to shift, putting pressure on the spinal cord. Pressure on the spinal cord increases the risk of permanent paralysis.

One way to stabilize a spinal break is to fuse the spine together using instrumentation (also known as spinal screws and titanium rods). In laymen’s terms, let’s assume L2 is the injured area, the surgeon will fuse L1 to L3 with screws and rods to hold it in place, creating spinal stabilization. Prior to the fusion, the surgeon will examine the spinal cord for loose bone fragments that could be pressing on spinal cord nerves and remove them. This procedure is called decompression.

Will Shazier recover fully? No one can know the answer right now. His recovery is dependent upon the size and severity of the bone or tissue damage that may have impacted his spinal cord.

It is important to note that not all spinal fractures require spinal stabilization surgery. Various non-surgical treatments are available, depending on the type of spinal fracture. For less serious spinal fractures, non-surgical treatments can include bracing, pain management, physical therapy, medication therapy, activity modification and rest.

If you would like to learn more about minimally invasive spinal procedures to treat spinal fractures, contact us today.


Michael Rimlawi

Minimally Invasive Spine Surgeon, Board Certified, Fellowship-Trained

Spine Surgeon Dr. Michael Rimlawi is director and founder of the Minimally Invasive Spine Institute’s team. Dr. Rimlawi is a board-certified, fellowship-trained spine surgeon who completed unique training in both orthopedic-spine and neurosurgery-spine at the renowned University of California San Diego. Dr. Michael Rimlawi treats all aspects of spinal disease including degenerative and traumatic conditions of the cervical, thoracic and lumbar spine. More than just a back doctor, he is a leader in the field of minimally invasive spine surgery and a pioneer in endoscopic laser spine surgery.

Insurance Coverage Questions to Ask Before Back Surgery

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Insurance-Coverage-Questions-to-Ask-Before-Back-Surgery

When it comes to insurance, most policies (including Medicare) cover back surgery, as long as it is deemed medically necessary by a doctor. But, insurance coverage can be confusing, which is why it’s important for patients to stay informed about their insurance coverage and what it entails.

Each insurance policy differs regarding what is covered and what is not. Additionally, there are a few things that can affect your level of coverage, so it’s important to be familiar with these aspects, to ensure you will have minimal out-of-pocket expenses. Things to keep in mind when reviewing insurance coverage before back surgery:

  • Reason for surgery.

    Some insurance policies will only cover surgery relating to a specific diagnosis, so be sure to read into your policy before scheduling your surgery. If your insurance policy covers back surgery, the surgery will need to be deemed medically necessary for your insurance to cover it.

  • Work-related injury.

    If your back surgery is due to a work-related injury, most insurance companies will require your company’s workers’ compensation coverage to pay for the procedure, rather than your personal insurance.

  • In-network vs. Out-of-network.

    Some insurance policies don not offer out-of-network benefits to members and require diagnosis by a specialist within their network in order for them to cover the procedure. Policies that have both in-network and out-of-network benefits allow their members more flexibility when deciding on where to seek medical treatment for back pain.  Be sure to check with your insurance company whether or not this applies to you.

  • Type of surgery recommended.

    There are certain types of surgeries that your insurance may not cover. Check with the doctor to find out which type of surgery he or she recommends, and then follow-up with your insurance provider to ensure that they cover it. If back surgery is covered by your insurance carrier, your coverage will not change if you choose to have minimally invasive back surgery or traditional open-back surgery.

  • Benefit level covered.

    Depending on your benefit level, some aspects of surgery or postoperative care may not be covered, such as medications and therapeutic medical equipment.

The key to understanding which procedures your insurance will or will not cover is communication. Speak with your insurance company, read the coverage information they send, and follow up with any questions you may have.

Deskercise Tips for Back Pain Relief

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Deskercise-Tips-for-Back-Pain-Relief

Research shows that a sedentary lifestyle can be harmful to a person’s overall health. Unfortunately, with many people sitting behind a desk for eight hours a day, the risk of cardiovascular disease, varicose veins, obesity, type 2 diabetes or back problems is increased. That is why it’s important to incorporate some stretching or light exercise during the workday.

Exercise Tips While Sitting at Work

Stretching exercises at your desk can boost energy levels, improve mood and offer upper and lower back pain relief. Here are some tips to help develop a deskercise routine and make each day a little healthier.

  • The Posture Perfecter:

    Neck and back problems can occur more quickly due to bad posture, so be sure to sit properly in your chair and avoid slouching. Adjust the chair height to make sure your feet, hips, and arms are at 90-degree angles to the floor.

  • The Headshot:

    Stretch your neck by gently lowering your right ear to your right shoulder, holding in place for 5 seconds. Repeat to the opposite side. With each stretch, you may find yourself more flexible, but don’t go further than what is comfortable.

  • The Leaning Tower:

    Stretch your arms and your upper body by reaching your hands above your head, stretching toward the ceiling. Lean at the waist in this position, first to the right side, then the left. Try to keep your shoulders from rising to your ears in order to protect your muscles from tensing up.

  • The Pencil Pinch:

    Roll your shoulders back until the shoulder blades are pinched together and pretend you’re holding a pencil between the scapulas. Hold for 5 seconds, release and repeat.

  • The Spine Rotator:

    Use your chair to stretch! Sit upright with both hands on the right side of the chair. Gently rotate your shoulders to the right until your spine is twisting slightly. Release your hands and repeat on the left side.

  • The Last Man Standing:

    Be sure to stand up and walk around for a couple of minutes every hour. This gives the body a break from sitting and increases blood flow.

Don’t be embarrassed to work out a little at your desk. Stretching throughout the workday can offer some lower and upper back pain relief while ensuring that you live a more active lifestyle.