The Back Facts
The epidemic of back pain is enormous: It's a $44 billion industry, it's the leading workers' comp injury, it's the leading reason for disability for people under the age of 45, it will strike 90% of all American adults, it's the second-leading surgical procedure, and it's only getting worse.
Now, the Good News!
Throughout the first half of the 20th Century, the chiropractic profession was criticized for not proving the effectiveness of its treatment through scientific research. In the 1960's the profession responded by turning its attention to elevating entrance requirements and bolstering the doctorate programs at chiropractic colleges across the country. The result was an improvement of the profession's image and the beginning of a research base.
Two decades of effort led to the publishing of a series of scientific studies in respected medical journals, bringing significant attention to chiropractic treatment. Insurance companies and employers, seeking cost-effective and safe methods of treatment to incorporate into their plan offerings, became interested in what chiropractors were offering. The Federal Government also turned its attention to the rapid pace with which alternative care was growing and, as a result, funded the AHCPR study. The panel was composed of physicians and other scientists who reviewed over a thousand studies on back pain and a variety of treatment methods. Chiropractic got high marks in the panel's summary. The outcome of the AHCPR study has increased interest within the scientific community in the effectiveness of spinal manipulation.
Below is a short list of the important studies that have contributed to the growth of chiropractic treatment:
Other Internet Resources:
Causes of Back Pain
Back pain can be caused by many different diseases and conditions. Some of these conditions can be very serious but fortunately they are for the most part uncommon. These serious conditions include; cancer, tumors, neoplasm, inflammatory arthritis and infection. Several common conditions that can cause back pain are listed below.
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There are many types and causes of headaches. This has produced a huge market for medications that cover up the symptoms of headaches. Powerful drugs can numb your nervous system so the pain doesn't register. While these approaches may be convenient, they can cause adverse effects and kidney or liver damage. Worse, they don't correct the underlying cause of the headache.
A cause of headaches can be from spinal bones in the neck that aren't supporting your head properly. They're not moving right. This can affect nerves, muscles and even the blood supply to your head.
Chiropractic doctors locate areas of the spine that aren't moving properly. They notice spinal curves. They look at your posture and your ability to turn and bend. These and many other examinations can help determine if you are likely to benefit from chiropractic care.
Spinal stenosis is a condition where the size of the spinal canal is reduced. This may lead to compression of the spinal cord. Symptoms often include pain, numbness, tingling and weakness. Severe cases may actually cause loss of function and may even lead to disability. Spinal stenosis is more common in patients over fifty years of age. Many factors can cause stenosis including injury and degenerative change.
What is Fibromyalgia?
The figures display the location of the tender points that comprise the 1990 American College of Rheumatology criteria for fibromyalgia.
Fibromyalgia is similar to rheumatism, which is a chronic condition in which the joints, and soft tissue, experience pain. Like rheumatism, fibromyalgia cause significant pain and fatigue. Fibromyalgia sufferers experience pain and tenderness at multiple, and specific places on the body (see diagram), and pain in response to even very slight pressure.
In addition to pain and fatigue, people who have fibromyalgia may experience
What Causes Fibromyalgia?
Fibromyalgia is believed by many to be caused by stressful or traumatic events, such as automobile accidents. Others connect it to repetitive injuries, or think it's related to lupus, or other auto-immune diseases. The actual cause is not known, and there is no cure.
For a fibromyalgia diagnosis, a person must have 11 or more tender points. One of these predesignated sites is considered a true tender point only if the person feels pain upon the application of 4 kilograms of pressure to the site. People who have fibromyalgia certainly may feel pain at other sites, too, but those 18 standard possible sites on the body are the criteria used for classification.
While there is no cure for fibromyalgia, chiropractic may be able to relieve some of the symptoms, in some cases. To find out if you can be helped, call our office today to make an appointment for a free consultation and analysis.
Osteoporosis is commonly called the "fragile bone disease." It is due to loss of bone density caused by a deficiency in such bone-building nutrients as calcium, vitamin D and other vitamins and minerals. The most common complication of osteoporosis is compression fracture. In people with advanced osteoporosis, compression fractures can occur as the result of simple daily activities such as bending, carrying heavy loads, or a minor fall.
Osteoarthritis, also called degenerative joint disease (DJD), is the most common type of arthritis. OA can occur in almost any joint of the body but most commonly occurs in the fingers, hips, knees and spine. Over time changes occur within the smooth cartilaginous surfaces of the joint. These changes lead to a loss of elasticity and the cartilage becomes stiff or brittle making it susceptible to injury. This will lead to stiffness, pain and crepitation at the joint. Advanced cases may actually result in significant damage to the bone itself.
Spondylolisthesis occurs when one vertebrae slips forward (translation) in relation to the adjacent vertebrae. Stability is inversely proportional to the degree of translation. The ability of a vertebrae to "slip" in relation to its neighbor can be caused by many factors, including facet or disc degeneration, trauma or a defect in a region of the vertebrae called the pars interarticularis. Severe cases may result in spinal cord or nerve compression and can require surgical intervention.
Sprains and strains are two of the most common causes of back pain. They can be caused by trauma, overuse, lack of conditioning, and improper body mechanics. The term sprain is used when this injury occurs in a ligament. Conversely, strain is used when the affected tissue is muscle or tendon. Typically, patients will complain of increased pain with activity and relief at rest. Treatment will often include a period of rest followed by a therapeutic exercise program to increase flexibility and strength.
Compression fractures can occur in any vertebra (spinal bones) and is described as a collapse of the vertebra.
Symptoms – The first symptom of a compression fracture may be sudden and severe back pain that remains in one local area. Some persons may experience numbness/tingling, or weakness in the arms or legs if the spinal cord or nerves leading away from the fracture have been compressed. If multiple fractures occur in an area of the back, the person will develop a forward hump-like curvature to the back.
Causes – There are many possible causes of compression fractures. Car accidents, falls, and weakening of the bone due to pathology (i.e. cancer), or Osteoporosis are common.
Diagnosis – The diagnosis is based on observation of the aforementioned symptoms and x-rays of the spine. Additional tests (i.e. bone scan, blood tests) may be needed to diagnose the actual cause of the compression fracture.
If you have severe back pain, it is natural to wonder whether or not the pain might be a sign of cancer. Tumors in the spinal column may cause pain from expansion of the bone or from weakening the bone, which in turn can result in spinal fractures, compression (pinching) of the nerves, or spinal instability.
You're working at your desk, trying to ignore the tingling or numbness you've had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. Just a passing cramp? More likely you have carpal tunnel syndrome, a painful progressive condition caused by compression of a key nerve in the wrist.
What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move. The carpal tunnel - a narrow, rigid passageway of ligament and bones at the base of the hand houses the median nerve and tendons. Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and causes the median nerve to be compressed. The result may be pain, weakness, or numbness in the hand and wrist, radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.
What are the symptoms of carpal tunnel syndrome?
Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.What are the causes of carpal tunnel syndrome?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; overactivity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal. In some cases no cause can be identified.
There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome. Repeated motions performed in the course of normal work or other daily activities can result in repetitive motion disorders such as bursitis and tendonitis. Writer's cramp — a condition in which a lack of fine motor skill coordination and ache and pressure in the fingers, wrist, or forearm is brought on by repetitive activity — is not a symptom of carpal tunnel syndrome.
Who is at risk of developing carpal tunnel syndrome?
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that directly affect the body's nerves and make them more susceptible to compression are also at high risk. Carpal tunnel syndrome usually occurs only in adults.
The risk of developing carpal tunnel syndrome is not confined to people in a single industry or job, but is especially common in those performing assembly line work - manufacturing, sewing, inishing, cleaning, and meat, poultry, or fish packing. In fact, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel. A 2001 study by the Mayo Clinic found heavy computer use (up to 7 hours a day) did not increase a person's risk of developing carpal tunnel syndrome. During 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome. Half of these workers missed more than 10 days of work. The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.
How is carpal tunnel syndrome diagnosed?
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder, and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis, and fractures.
Physicians can use specific tests to try to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute. Doctors may also ask patients to try to make a movement that brings on symptoms.
Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging can show impaired movement of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.
How can carpal tunnel syndrome be prevented?
At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible. Workstations, tools and tool handles, and tasks can be redesigned to enable the worker's wrist to maintain a natural position during work. Jobs can be rotated among workers. Employers can develop programs in ergonomics, the process of adapting workplace conditions and job demands to the capabilities of workers. However, research has not conclusively shown that these workplace changes prevent the occurrence of carpal tunnel syndrome.
Exhaust Conservative Treatment Before Considering Surgery
Before you resort to surgery, make sure you actually have carpal tunnel syndrome. The source of your problem may be far simpler than your doctor thinks it is. Your hands, wrist pain and numbness may have nothing whatsoever to do with a problem with your wrist. Before you submit yourself to surgery or taking a long regimen of drugs, consider conservative chiropractic management. Recent studies have demonstrated favorable outcome with conservative management to include FDA Approved Cold LaserTherapy in the management of carpal tunnel syndrome. Your local chiropractor may also advise you on carpal tunnel splints, nutritional supplements, exercises, stretches, and proper desk mechanics.
Call today to make an appointment for free consultation, you have nothing to lose!
Connection to Back Pain
The spine is designed to carry the body's weight and distribute the loads encountered during rest and activity. When excess weight is carried, the spine is forced to assimilate the burden, which may lead to structural compromise and damage (e.g. injury, sciatica). One region of the spine that is most vulnerable to the effects of obesity is the low back; the lumbar spine. Lack of exercise and bodily conditioning leads to poor flexibility and weak muscles in the back, pelvis, and thighs. This can increase the curve of the lower back causing the pelvis to tilt too far forward. Further, this is detrimental to proper posture and as posture weakens, other regions of the spine (neck) may become painful.
You may try to dismiss the cause of some of these spinal disorders to the process of normal aging. It is true that with age body tissues can cause changes to spinal anatomy (2). However, if you are overweight or obese, chances are you have, or will have, back pain.
Stability to the spinal column can be compromised when bony elements are injured or there is disruption to soft tissues such as ligaments. Instability causes the back to become unable to successfully carry normal loads, which can lead to permanent deformity, severe pain and in some cases catastrophic neurological injuries. Most often the instability comes from a fracture in one of the bony parts of the vertebra, specifically the vertebral body, the lamina or the pedicles.
In the case of trauma, dislocations and fractures happen simultaneously and can result in a very unstable spinal column. They can occur in any region of the spine and are associated with a degree of neurological injury. A surgeon needs to restore the mechanical stability of the spine to try and prevent more neurologic injury, progressive deformity or prolonged incapacitation pain.
Introduction to back pain during pregnancy
Addressing back pain during pregnancy
Low back pain of long duration (several weeks or months) during pregnancy is a predictor for post partum back pain (pain after birth). For this reason, pregnant women are encouraged to seek appropriate treatment for back pain during pregnancy.
Likewise, any post partum pain that lasts longer than six to eight weeks should be treated in order to avoid chronic or recurring back problems.
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Scoliosis is defined as a side-to-side deviation from the normal frontal axis of the body. Although traditional, this definition is limited since the deformity occurs in varying degrees in all three planes: back-front; side-to-side; top-to-bottom. Scoliosis is a descriptive term and not a diagnosis. As such, a search is made for the cause. In more than 80% of the cases, a specific cause is not found and such cases are termed idiopathic, i.e., of undetermined cause. This is particularly so among the type of scoliosis seen in adolescent girls. Conditions known to cause spinal deformity are congenital spinal column abnormalities, neurological disorders, genetic conditions and a multitude of other causes. Scoliosis does not come from carrying heavy things, athletic involvement, sleeping/standing postures, or minor lower limb length inequality.
In managing AIS, the judgment of the surgeon and the participation of informed patients and families are as important in determining treatment outcome as surgical techniques. Decision-making in the management of AIS remains complex despite the availability of data on natural history, prognosis of different curve patterns, brace treatment factors, and surgical innovations.
The management of AIS includes several steps and treatment options:
Sciatica is a severe pain in the leg caused by compression, irritation, or inflammation of the sciatic nerves, which are thick nerves extending down the back of each leg. Each sciatic nerve consists of five smaller nerves extend from the lower spinal column, and then join together and travel down the legs. The sciatic nerves divide into tiny smaller nerves travel to the knee, foot, toes, calf, and thigh. The inflammation of any of these nerves is called sciatica.
People with sciatica can sometimes experience shooting pains down the leg and into the foot and toes, and other times a dull ache or numbness. Sciatica is caused by many things. Sitting at a desk for long periods of time in one position can exacerbate the pain. Exercise can make the pain worse. Tennis or golf and other twisting activities can cause sciatica pain to flare up. Sometimes, the pain may be in both legs, and other times it may alternate from one leg to the other.
Causes Of Sciatica
The sciatic nerve is very long, so there are many places along its length at which the irritation may occur. One place is the lower back. Often, a misaligned lumbar vertebra puts pressure on the nerve, causing the pain. This misalignment is called a subluxation. For further discussion of subluxations, click here.
Disc herniations can also cause sciatica. Discs are the "shock absorbers" between the vertebrae of the spine. They are cartilage-like cushions that occupy the spaces between the vertebrae which allow the back to turn and bend normally. If you've been injured in a car accident, or from a fall, one or more of your discs may now be bulging out one side of the spine. This is what is called a "slipped disk," or disc herniation. Trigger points can accumulate in the piriformis muscle forcing a contraction and strangulation of the sciatic nerve. The tennis ball exercise should be incorporated to help to relax the piriformis muscle. Stretching may be beneficial, but that is more of a "try an see" exercise. Sciatica usually begins as an sharp pain in the lower back. Eventually, the pain stretches down the back of the leg, and gets worse when you sit or stand in one position for a long period of time.
Treatment For Sciatica
Medical doctors normally treat this condition by loading patient up on pain killers, telling the patient that the condition may go away naturally. This seldom happens, and the net result is that the patient's liver, kidney, or stomach lining, are damaged by the long-term use of drugs. The better approach is the chiropractic one.
The doctor will treat your sciatica by finding the location of nerve irritation, and can relieve the pressure on the nerve, allowing the body to heal itself naturally.
Fractures and dislocations can occur anywhere in the body. The vertebral bodies which help support the weight of the upper body can break resulting in a compression fracture. These types of fractures can be very painful and even disabling.
It is important for the physician to determine the nature of these fractures. Some fractures can be caused by dangerous or serious conditions such as cancers, malignancies, or advanced osteoporosis. These are called pathological fractures. Other types of fractures may occur through traumatic events.
A dislocation is a term used to describe a condition where a joint has been disrupted and has separated to the point where the two adjacent bones are no longer aligned or touching. When a joint is dislocated the spine becomes unstable and is unable to protect the spinal cord or nerves.
Whiplash most commonly occurs when the automobile is struck from behind, or else the car comes to a sudden stop.
This causes the head to snap back and the forth, and this in turn cause the spine to travel beyond its normal limits.
The muscles and ligaments supporting the spine may then become torn, and the spinal discs may bulge, tear, or rupture. The nerve roots in the neck can get stretched and irritated. There may have been left on the car only slight damage, but the occupant may nevertheless have suffered extensive damage. Left untreated, the formation of scar tissue can leave the victim with impaired bodily function for life.
The consequence of this damage, besides the pain, are: low back pain, dizziness, blurred vision, shoulder, arm, and hands pain, as well as headaches. The victim will have reduced ability to turn and bend.
The chiropractic approach is to use specific chiropractic adjustments to help return spinal function. After a thorough case history and examination, the doctor will recommend a series of visits to help restore proper motion and position of spinal bones. If caught early enough, inflammation can be reduced and scar tissue can often be minimized.
If you think you may have suffered whiplash, call our office to make an appointment for a free consultation.
As America's love affair with the game continues to grow, the American Chiropractic Association (ACA) has advice on how to take a proactive approach that will prepare your body for many years of pain-free play.
These simple measures will help you avoid back pain or injury and improve your game:
Use equipment that fits you. If you use clubs which are too short, back trouble is sure to follow. And, vice versa. Many women use their husband's clubs, which are usually too long for them, and not flexible enough to accommodate the woman's normally lighter grip.
As in all exercises, it is very important to engage in stretching exercises before beginning. If you have arthritis in your hand, use clubs with specialized grips to prevent injury, and improve your game. Take lessons. Learning proper swing technique is critical. At the end of the swing, you want to be standing up straight; the back should not be twisted.
Wear orthotic shoes, which support the arch and absorb shock. It will also increase the coordination between the swing and your legs. Don't wear shoes with metal spikes; the shock to your legs while walking can cause stress in the back. Use soft spikes for greater motion.
What are TMJ Disorders?
TMJ (temporomandibular joint) disorders affect the joint where your skull meets your lower jaw. Stress, grinding, or clenching your teeth, poor posture, or an injury can cause the joint to become misaligned. You may hear clicking sounds or have pain, stiffness, or a locked jaw.
The TM joint is a sliding ball-and-socket joint. When you open and close your mouth, muscles contract and relax. A cushioning disc allows the skull and lower jaw bone to glide smoothly. Ligaments connect the bones and keep the joint stable.
When the muscles tighten, the skull and lower jaw are pulled closer together (misaligned). This puts pressure on the joint, compressing the disc.
An injury, such as a whiplash, can stretch or tear ligaments, which in turn pull the disc out of position.
Arthritis is a degeneration of the joint, often resulting from an injury. The disc wears away, leaving the bones rubbing against and irritating the nerves.
Treatment for TMJ disorders centers around reducing pain and restoring normal function to the joint, as well as restoring normal function to the joints of the neck, if indicated. Additional treatment can include the use of physical therapy modalities such as laser therapy, heat or ice, massage or jaw exercises.
History of Chiropractic
If you have health conditions, ailments, or pain, but are still uncertain as to whether or not Chiropractic offers a viable alternative for your ongoing health and wellness, perhaps it would help to understand that "Chiropractic" has been around for a very long time—over 4,650 years of recorded history—providing well-documented results for those informed enough and open-minded enough to utilize it for its health benefits and relief of pain.
The first recorded manipulation was found in the Chinese Kong Fu writings dated 2650 BC. Greek history recorded lower back manipulation in 1500 BC.
Following are some notable quotes that you may find of interest in regard to Chiropractic use:
Socrates (469-399 BC) advised,
"If you would seek health, look first to the spine."
Hippocrates, the Father of Medicine (460-370 BC), described manipulative procedures in his monumental work known as the Corpus Hippocrateum. He wrote, "Get knowledge of the spine, for this is the requisite for many diseases."
Claudius Galen (130-202 AD) discovered the relationship between the nervous system of the spine and healing. He wrote, "Look to the nervous system as the key to maximum health." He earned the title 'Prince of Physicians' when he relieved the paralysis of the right hand of Eudemas (a prominent Roman scholar) by careful manipulation of his neck.
"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."
- Thomas Edison
"I probably wouldn't even be here now if it weren't for Chiropractic."
- Merle Haggard-country singer
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