"Pillows come in different sizes and shapes, with varying thickness and contour. It is often difficult to choose the ideal pillow, especially to avoid neck pain, and no study has determined definitively the best type of pillow to use," explained Dr. Baxi. Though he highlights the importance of keeping "your ears aligned with your shoulders" to keep your spine properly aligned. "If you’re waking up with neck pain, it may be time to evaluate your sleeping position and your pillow," said Dr. Baxi.

Read the full article at goodhousekeeping.com. 

While cycling can absolutely be a helpful part of someone’s weight loss strategy, it’s not as straightforward as you might think.

Of course, when you’re training for a race, efficiency is a good thing, shared Dr. Baxi. It’s what allows you to work harder without expending as much energy. But when weight loss is the goal, you want inefficiency because that helps drive caloric burn, he said.

If you don’t combine cycling with resistance training, “it’s just hard to lose weight,” Dr. Baxi continued.

Read the full article at bicycling.com. A subscription is required to access. 

Even if you manage to snooze straight through the night, sleeping on your stomach can have you feeling stiff—and cranky—when your eyes flutter open in the morning. “Stomach sleeping is the least ideal position, compared to back and side, when it comes to neck and low back pain,” said Naimish Baxi, MD, physiatrist at HSS. 

When looking for a mattress,  Dr. Baxi explained, “For stomach sleepers, the firmer the better.  A firm mattress will help with optimizing your spine position, keeping it as neutral as possible.”

This coverage originally appeared in self.com. The original article is no longer available online.

Dr. Baxi notes that a good mattress is the foundation for good sleep. An uncomfortable or unsupportive mattress might distract you from falling asleep, or it might wake you up as you’re sleeping. 

"It is important to switch out a mattress that’s giving you pain, especially if you feel less achy and better rested every time you sleep in a bed at a hotel or someone else’s home. “This is especially true if your body has changed since you bought your mattress.  For instance, if you’ve gained some weight over the years, you may need a mattress with more support,” said Dr. Baxi.

He also advised to match your pillow to your sleep position. “The right one stabilizes your neck in a neutral position and aligns it with the rest of your body. For instance, if you’re a side sleeper, the pillow should be thick enough to cover the distance between your ear and shoulder on the side you’re lying on." If you’re a back sleeper, choose a pillow lofty enough to cradle your head but not so high that it strains your neck, he added. 

Read the full article at consumerreports.org. 

Dr. Baxi explained, “Stomach sleeping is the least ideal position (compared to back and side) when it comes to neck and low back pain.”

He noted, “For stomach sleepers, the firmer the better. A firm mattress will help with optimizing your spine position, keeping it as neutral as possible.”

Dr. Baxi said all standard types of mattresses can provide the kind of relief that stomach sleepers need and it is mainly a matter of personal preference.

Dr. Baxi advised avoiding mattresses that are too thin, as this can make them less supportive. “I recommend using a mattress that’s at least 10 inches or thicker for stomach sleepers,” he added.

Read the full article at Self.com.

Dr. Rodeo noted that regenerative medicine has the potential to revolutionize patient care, but the field is still in its early stages. He added, more research is needed to identify what types of treatments work best for a particular condition and for a given patient.

Dr. Rodeo explained, “We can potentially use regenerative medicine therapies for conditions that don’t heal well on their own, such as osteoarthritis, chronic tendonitis, degenerative disc disease in the spine and other injuries. I tell patients these types of treatments can work well for pain relief. However, in terms of regenerating damaged tissue such as cartilage, we’re not there yet.”

Some studies have shown platelet-rich plasma (PRP) treatment to be effective in the treatment of chronic tendon injuries and mild to moderate knee osteoarthritis. Dr. Baxi explained, “Although the exact mechanism of action is unclear, evidence suggests that the platelets amplify growth factors that promote tissue repair and healing.”

He continued, “Patient selection is key. For someone with severe bone-on-bone arthritis, for example, PRP may not be the most effective treatment option.” He added that a thorough patient history, a discussion of symptoms, and diagnostic imaging tests such as x-rays, MRI and ultrasound are critical to make the diagnosis and determine if PRP would be a good option.

Dr. Rodeo underscored vigilance when considering regenerative medicine treatment options. He explained, “The marketing is ahead of the science. Unscrupulous providers and clinics are marketing largely unproven treatments, targeting patients who hope to find relief for a difficult-to-treat problem. People sometimes pay exorbitant sums of money for these unregulated and potentially harmful treatments, possibly delaying a proven treatment that could be beneficial.”

At HSS, a number of regenerative medicine studies are under way and enrolling patients. Dr. Rodeo is leading one such clinical trial to see if the injection of certain cells contained in adipose (fat) tissue during rotator cuff surgery can enhance healing. He believes regenerative medicine research at legitimate centers around the country will bring significant progress over the next five years.

This article appeared in the Spring 2022 print edition.
 

 Dr. Baxi recommended applying heat first. He explained that warmth brings blood flow to the area, which brings oxygen and nutrients, helping to alleviate the contracted muscle.

Leg cramps aren’t typically a cause for concern, but if they occur frequently (and not as a result of exercise) and are very severe, then check with a health care provider. Dr. Baxi noted that it could be due to a medication - which likely could be adjusted - or they may be a sign of a more serious condition that merits investigation.

Read the full article at Livestrong.com.

“Posture is probably the biggest contributing factor to scapular pain,” said Dr. Baxi. How you sit and stand all day can definitely lead to discomfort between the shoulder blades and around the scapula, particularly if you’re in a forward-leaning position for hours.

Poor posture stems from rounded shoulders and a C-curve in the upper spine. It includes a protracted, rather than retracted scapula, which means your shoulders round forward, instead of down your back and away from your ears. The neck also flexes forward and the shoulders internally rotate, explained Dr. Baxi. “Sitting in this posture for hours a day and weeks on end can cause muscle imbalances,” he noted. Improving your work setup to make it more ergonomic will also help adjust your posture. Dr. Baxi advised the computer screen should be at eye level with the keyboard close enough that you don’t have to reach for it. Elbows should flex about 120 degrees.

According to Dr. Baxi, it’s important to balance stretching the front of the body with strengthening the back of the body. “It’s even more important to strengthen than stretch,” he cited. “You can stretch all day, but you won’t improve posture if you can’t get your muscles to activate on their own.” For strengthening moves, focus on pulling exercises. A rowing machine can help you do this. Or try a reverse fly exercise, which stabilizes the muscles of the shoulders and strengthens the back. You want to perform moves that pull your shoulder blades together, as if you’re trying to hold a ball between them, advised Dr. Baxi.

A nerve-related issue that can lead to pain is scapular winging, a condition in which one or more of the shoulder blades sticks out rather than laying flat against the body. However, this is not very common, stated Dr. Baxi. 

Read the full article at Thehealthy.com.

Dr. Baxi discussed his desk set up, which he keeps his monitor at eye level and the keyboard underneath, to ensure his elbows are flexed at about 100-110 degrees. For those using a laptop, he suggested getting a separate keyboard and mouse to better position the screen, to prevent hunching, which causes rounding of the shoulders and a bent-forward neck (which result in pain, knots and spasms in the neck and upper back).

To prevent neck knots, Dr. Baxi mentioned he does chin tucks and neck rotations to activate the muscles that surround and support the cervical spine. “The stronger these muscles are, the easier time you’ll have holding your head, neck, and back in the right position,” he explained. Additionally, being consistent with performing core exercises that work the abdominals, obliques and hip flexors “is like building stronger scaffolding around your spine, protecting your precious discs,” he cited.

Up to 2 percent of adults are diagnosed with herniated discs each year. Dr. Baxi advised not to rush into surgery right away. Speaking from his personal experience, he never considered surgery as he has been able to recover with treatment. There are a few instances when to undergo surgery - when bladder or bowl function is compromised because the nerves in the lumbar spine are compressed; neurological weakness (like foot drop where you can’t lift your foot or ankle); and debilitating pain that doesn’t respond to physical therapy, injections or treatment.

As a CrossFitter, Dr. Baxi underscored the importance of doing lifts right. The most common error is rounding of the back during moves like deadlifts, kettlebell swings and wall balls. Additionally, lifting too heavy at first is a mistake. “The minute I can’t maintain good form, I change something, whether that’s reducing the load of modifying the movement,” said Dr. Baxi.

Read the full article at Menshealth.com. This article also appeared in the print March 2021 issue. 

Muscle cramps—also known as charley horses can definitely cause pain in the calf. Typically, these occur because your muscles get too overworked too quickly, said Dr. Baxi. “The muscles will tighten up and spasm and then not work the way you want them to.” You’ll know you have a muscle cramp versus another type of pain if it lasts for just a few seconds or minutes, he explained. Often, these cramps resolve on their own.

Overuse injuries, such as plantar fasciitis, though it mostly causes pain in the foot, it can also lead to some discomfort in the calf, as they’re connected, noted Dr. Baxi. People who often do plyometric moves like jumping exercises also have an increased risk of these overuse injuries, he added. To avoid overuse injuries, you not only want to give yourself enough rest time between workouts, but you also want to make sure you warm up properly before a workout and cool down after, according to Dr. Baxi, underscoring the importance of stretching after workouts.

Focus on static stretches (in which you hold a pose for about 30 to 60 seconds), like touching your toes. Another option: Stand about a foot-length away from the wall, facing it. Then, try to get your knee to touch the wall, while still keeping your heel on the floor. This stretches the Achilles and the muscle fibers that surround it, said Dr. Baxi.

Dr. Baxi advised those experiencing persistent pain that lasts for hours or days, to see a doctor. Also, if the pain feels so severe that it affects other areas of your life, that’s a sign to see a professional. For those who experience pain that’s not so severe, but have other comorbidities, like an increased risk of blood clots, it is recommended to see a doctor. “That might not cause debilitating pain, but in the context of other health issues, it’s probably time to get checked out,” said Dr. Baxi. Visible swelling, bleeding, or bruising—especially where a tendon, like the Achilles, attaches to the bone—are also signs you need medical attention, along with problems like weakness or an inability to move a joint, like the ankle, he added. Last, if the pain comes episodically, say every hour, that means it’s time to ring a doctor, too.

Read the full article at Thehealthy.com.

Dr. Baxi explains that while “no study has determined definitively the best type of pillow to use, it’s important that your neck stays ‘neutral’ during sleep”. To keep your neck and shoulders in a neutral position, you will require a pillow that will keep your neck aligned without titling in any one direction,

Read the article at Goodhousekeeping.com. Additional coverage: Goodhousekeeping.com.

"For someone with chronic lower back pain, mattress characteristics can contribute to reduced pain throughout the day," explained Naimish Baxi, MD, physiatrist at HSS who cited studies that have shown that the right mattress can improve pain, stiffness and sleep quality up to 50-60 percent.

Additionally, Dr. Baxi advised to sleep on your back to "help alleviate pressure through the lower lumbar discs" and to avoid sleeping on your stomach which can lead to poor spine alignment.

Read the full article at GoodHousekeeping.com.