Jeff Fine

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back pain symptoms causes solutions


TotalSelf Considered podcast icon

Most of us, 9 out of 10 people, have experienced back pain at least once in our lives. But why? Is it just an unavoidable fact of life?

In this episode of the TotalSelf Considered, Jeff Fine interviews Erika Muraski, physical therapist extra-ordinaire. Erika was a competitive ice-skater until she had a career ending injury. She had always wanted to be a physical therapist and the experience of getting hurt and having to give up the sport she loved has made her highly attuned and compassionate to the needs of her patients.

Jeff and Erika discuss back pain and treatment approaches from multiple perspectives: first, Erika explains the physical structure of the spine and surrounding soft tissue, and the related “mechanical” issues or imbalances that can lead to back pain. After going over the symptoms of various types of back pain, and when one should seek medical attention, Jeff and Erika delve into the impact of lifestyle factors, particularly the role that our sedentary lifestyles and stress have for so many of us experiencing back pain.

There’s an overwhelming amount of recommendations out there to reduce back pain – core strengthening, zero drop shoes, standing desks, stretching, ice, heat, doing more, doing less, laser therapy – but which of these actually help?

Listen to this episode of the TotalSelf Considered podcast to find out.


Summary of Episode

  • How Erika used her experiences she gained from her accident to help other people work through their injury
  • Listening to the patient key to understanding the injury
  • Visit time with physicians have been droppping –  current average is 6 minutes!
  • What exactly is meant by “back pain” – what areas of the body are affected
  • Symptoms and causes of back pain  – muscle spams, irritations, sprains…
  • Referred pain – numbness, tingling, weakness
  • Functional issues – can’t stand or can’t move properly
  • Causes: 95% are mechanical reasons – linked to the movement of the back or mechanics of the spine
  • Structure of the spine: discs, ligaments, muscles, vertebrae, facet
  • When is it advised to see a medical doctor or a physical therapist, red flags for medical intervention
  • Direct access in NY state: people can see a PT without a referral from a physician
  • How long it takes to get back to normal functioning when working with a PT
  • Getting ahead of injuries: tackle them before it starts to fester
  • Compensation issues – adjustments to avoid pain become problematic
  • Chronic pain vs acute pain – what causes pain to become chronic
  • Unhealthy lifestyle factors: sitting too long, technology, spending too much time in bed
  • Sleep hygiene: the right type of mattress is individualized for body type – soft vs firm mattress, number of pillows…
  • Relationship between sedentary lifestyle – increased back pain
  • Exercising too hard and pushing until overly fatigued has negative affect
  • Education and awareness can make a big difference: understand your body and cues, make adjustments in daily life
  • Standing desks
  • Dangers of sitting: compression forces are exponentially higher when sitting – deweighting your spine makes a big difference
  • Key is variation throughout the day – change positions often
  • When back is injured, people’s inclination is usually to do less, which isn’t always helpful
  • Ice vs heat?
  • Zero drop shoes
  • Emotional factors and stressors that affect back pain
  • Erika’s top five recommendations to maintain a healthy back
  • Erika’s Class 4 laser: helps increase blood flow, reaching where typical infrared heat doesn’t reach – ideal for releasing muscles that are in spasm and too tender to touch


“I tend to always think from their perspective. How horrific is it to wake up and the moment they move they’re in immediate pain. It’s horrible. Understanding that component of it and then giving them even five minutes of relief… it makes a difference.”

Erika Muraski

“When we’re upset, there are physiological and hormonal and chemical changes in the brain and the body that contribute to how muscles are functioning. They can become tighter, more brittle just from being in this fight or flight kind internal experience.”

Jeff Fine

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2 Responses

  1. Very interesting and informative podcast. One discussion that I found interesting is how people’s lifestyle choices can contribute to back pain. Thanks for sharing.

    1. Thanks Jeff for interviewing Erika. I suffer from daily back pain and the information she provided was extremely helpful. I gained valuable insight into a technique that might help my chronic pain.

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