Author: Dr. Robert Speirs DC

The Thoracic Disc Lesion

~ Dr. Robert Speirs DC ~ Leave a comment

Your spine consists of 24 individual vertebrae stacked on top of each other. Flexible cushions called “discs” live between each set of vertebra. A disc is made up of two basic parts. The inner disc, called the “nucleus” is like a ball of jelly about the size of a marble. This jelly is held in place by the outer part of the disc called the “annulus,” which is wrapped around the inner nucleus,

much like a ribbon wrapping around your finger. The term “thoracic disc lesion” means that one or more of the 12 discs in the center section of your spine has been damaged.

Disc problems start when the outer fibers of the disc become strained or frayed. If enough fibers become frayed, the disc weakens and when compressed, may “bulge” like a weak spot on an inner tube. If more fibers are damaged, the nucleus of the disc may “herniate” out of the disc.

Surprisingly, thoracic disc bulges are present without any symptoms in almost half of the adult population. Disc bulges that cause pain commonly occur in the neck or lower back but are relatively infrequent in the thoracic spine – accounting for less than 1% of all symptomatic disc problems. The condition is most common between the ages of 40 and 60. Certain occupations or activities place you at greater risk, especially physically demanding activities that involve repetitive twisting, awkward postures.

Pain can range from dull, localized discomfort to sharp, radiating pain. Your symptoms may change unpredictably. If the disc bulge is bad enough to compress your nerve, you could experience sharp, burning, or shooting pain in a band-like distribution around your rib cage. Thoracic disc herniations commonly mimick other conditions like heart or lung problems. Be sure to let our office know if you notice chest pressure; shortness of breath; pain radiating into your arm, face, or jaw; pain with deep breathing; clumsiness; loss of bowel or bladder control; unexplained weight loss; night sweats; pain that awakens you at night; fever; indigestion; nausea; flu-like symptoms or if you notice a rash following the margin of one of your ribs.

You should avoid excessive bed rest while recovering. Researchers have shown that disc bulges may be successfully managed with exercise and conservative care, like the type we will provide.

The Most Common Work Injury We See? This Might Be It…..

~ Dr. Robert Speirs DC ~ Leave a comment

Your “lumbar spine”, or low back, is made up of five bones stacked on top of each other with a shock-absorbing disc between each level. Your low back relies on muscles and ligaments for support. “Sprains” and “strains” are the result of these tissues being stretched too hard or too far, much like a rope that frays when it is stretched beyond its normal capacity. The term “sprain” means that the

tough, durable ligaments that hold your bones together have been damaged, while “strain” means that your muscles or tendons that move your trunk have been partially torn.

Most people experience low back pain at some point in their lifetime, and 70% of those patients can attribute their symptoms to sprain/strain injuries. Lumbar sprains and strains may result from sudden or forceful movements like a fall, twist, lift, push, pull, direct blow, or quickly straightening up from a seated, crouched, or bent position. Most commonly, sprains and strains are not the result of any single event, but rather from repeated overloading. The spine can generally manage small isolated stressors quite well, but repetitive challenges lead to injury in much the same way that constantly bending a piece of copper wire will cause it to break. Examples of these stressors include: bad postures, sedentary lifestyles, poor fitting workstations, repetitive movements, improper lifting, or being overweight.

Symptoms from a sprain/strain may begin abruptly but more commonly develop gradually. Symptoms may range from dull discomfort to surprisingly debilitating pain that becomes sharper when you move. Rest may relieve your symptoms but often leads to stiffness. The pain is generally centered in your lower back but can spread towards your hips or thighs. Be sure to tell your doctor if your pain extends beyond your knee, or if you have weakness in your lower extremities or a fever.

Sprain/strain injuries cause your normal healthy elastic tissue to be replaced with less elastic “scar tissue.” This process can lead to ongoing pain and even arthritis. Patients who elect to forego treatment and “just deal with it” develop chronic low back pain more than 60% of the time. Seeking early and appropriate treatment like the type provided in our office is critical.

Depending on the severity of your injury, you may need to limit your activity for a while, especially bending, twisting, and lifting, or movements that cause pain. Bed rest is not in your best interest. You should remain active and return to normal activities as your symptoms allow. The short-term use of a lumbar support belt may be helpful. Sitting makes your back temporarily more vulnerable to sprains and strains from sudden or unexpected movements. Be sure to take “micro breaks” from workstations for 10 seconds every 20 minutes. Following acute injuries, you can apply ice for 15-20 minutes each hour. Heat may be helpful after several days or for more chronic origins of pain. Ask your doctor for specific ice/heat recommendations. Some patients report partial relief from sports creams.

A weak lateral chain will stop you in your tracks.

~ Dr. Robert Speirs DC ~ Leave a comment

One very important job of your hip muscles is to maintain the alignment of your leg when you move. One of the primary hip muscles, the gluteus medius, plays an especially important stabilizing role when you walk, run, or squat. The gluteus medius attaches your thigh bone to the crest of your hip. When you lift your left leg, your right gluteus medius must contract in order to keep your body from tipping toward the left. And when you are standing on a bent leg, your gluteus medius prevents that knee from diving into a “knock knee” or “valgus” position.
Weakness of the gluteus medius allows your pelvis to drop and your knee to dive inward when you walk or run. This places tremendous strain on your hip and knee and may cause other problems too. When your knee dives inward, your kneecap is forced outward, causing it to rub harder against your thigh bone- creating a painful irritation and eventually arthritis. Walking and running with a relative “knock knee” position places tremendous stress on the ligaments around your knee and is a known cause of “sprains”. Downstream, a “knock knee” position puts additional stress on the arch of your foot, leading to other painful problems, like plantar fasciitis. Upstream, weak hips allow your pelvis to roll forward which forces your spine into a “sway back” posture. This is a known cause of lower back pain. Hip muscle weakness seems to be more common in females, especially athletes.

You should avoid activities that cause prolonged stretching of the hip abductors, like “hanging on one hip” while standing, sitting crossed legged, and sleeping in a side-lying position with your top knee flexed and touching the bed. Patients with fallen arches may benefit from arch supports or orthotics. Obesity causes more stress to the hip muscles, so overweight patients may benefit from a diet and exercise program. The most important treatment for hip abductor weakness is strength training. Hip strengthening is directly linked to symptom improvement. Moreover, people with stronger hip muscles are less likely to become injured in the first place. The exercises listed below are critical for your recovery.

What does a shoulder separation actually mean?

~ Dr. Robert Speirs DC ~ Leave a comment

Impingement

The term “acromioclavicular sprain” means that you have damaged the strong fibrous bands (ligaments) that hold the end of your collarbone (clavicle) to the tip of your shoulder blade (scapula). Another term sometimes used to describe this injury is “shoulder separation.” 40-50% of all athletic shoulder injuries involve the acromioclavicular (AC) joint. AC injuries are common in adolescents and young adults who participate in contact sports, like hockey and football. Males are affected five times more often than females.

Injuries may range from mild fraying of a single ligament to complete rupture of all of the supporting ligaments. Significant tears can allow your collarbone to move upward, out of its normal position, creating a raised bump under your skin. AC joint injuries are categorized (Grade 1-Grade 6) based upon the amount of damage. Grade 1 injuries are tender without joint separation. Grade 2 injuries may be accompanied by a slight separation of the joint. Grade 3 and above will show significant joint separation.

Injuries typically occur following a fall onto the point of your shoulder, while your arm is at your side, or by falling onto your outstretched hand. You will most likely feel pain and swelling on the very top of your shoulder. More significant injuries may produce bruising or a visible “bump” beneath the skin. Moving your shoulder will likely be painfully limited for a while.

Your treatment will vary, depending upon the severity of your injury. Grade 1, 2, and most Grade 3 injuries are best managed conservatively. A sling may be used only when needed to control painful movements. Initially, you will need to limit activity, especially reaching overhead, behind your back, or across your body. The exercises described below are an important part of your rehab and should be performed consistently to avoid long-term problems. Using an ice pack for 10-15 minutes each hour may help to limit swelling and pain.

Some mild separations will heal by themselves within a week or two. More significant injuries can take longer, and disabilities typically range between one and eight weeks. Patients who have suffered a significant amount of ligament damage may have a permanent bump on their shoulder, regardless of treatment. This bump does not usually cause ongoing problems.

If you or someone you know suffers from this condition, call our office today. Our doctors are experts at relieving many types of pain including shoulder injuries.

AC Joint

Diet & Exercise Tip Of The Month

~ Dr. Robert Speirs DC ~ Leave a comment

Exercise Tip

Have you ever started a new exercise program and then suddenly gained a few

pounds? Don’t fret. It’s normal! Exercise is a stress on your body, which creates micro

tears in your muscles, and the inflammation from those tears will cause you to retain

more water. Your body will also start to store more glycogen in your muscles to make

sure you have plenty of fuel to burn during your next workout. Those two things will

cause a temporary weight gain when you first start working out. A better way to track

your progress will always be to take measurements. If you’re losing inches, you’re

winning!

“I Popped A Rib”

~ Dr. Robert Speirs DC ~ Leave a comment

You have 12 pair of ribs that attach to the “thoracic” region of your spine. The ribs serve to protect your heart, lungs, and other vital organs. Each rib is shaped much like a “bucket handle” arching from your spine to your breastbone (sternum) in front. Your ribs must move freely when you breathe, bend, twist, and reach. The term “costovertebral dysfunction” means that one or more of your ribs has become restricted or slightly malpositioned from it’s attachment to the spine.

You can visualize this as imagining one of your bucket handles is misaligned and not moving in sync with the others.

Rib problems can develop in many ways. Sometimes they are brought on by an accident or injury; other times, they develop from repetitive strains or poor posture. Rib malpositions are common during pregnancy or after a whiplash injury.

Symptoms sometimes begin following a sudden or explosive movement, like coughing or sneezing, reaching, pushing, or pulling. Other times, a specific cause cannot be recalled. Rib dysfunction may cause pain near or slightly to the side of your spine with possible radiation of symptoms along your rib, sometimes all the way to the front. Some patients feel as though they were “shot by an arrow.” Rib problems are a frequently overlooked source of chest and abdominal pain.

Be sure to tell your chiropractor if your symptoms include any unusual cough, indigestion, nausea, vomiting, fever, flu-like complaints or if you notice a rash developing along the border of your rib. Seek immediate medical treatment if you notice chest “pressure” or “squeezing”, symptoms that radiate into your arm and jaw, or if you have chest pain or shortness of breath with exertion, as these are possible symptoms of heart problems and must be addressed immediately.

Most patients report rapid relief following chiropractic care. Our office can provide several tools to help ease your pain. To speed your recovery, you should avoid activities that increase your pain. Initially, you may need to limit reaching, pushing, and pulling. Women may benefit by temporarily switching to a sports bra to help better diffuse pressure over irritated ribs. Some patients report relief by using sports creams, NSAIDs, or applying ice for 15-20 minutes directly over the painful area.

Its a syndrome; that must be bad, right?

~ Dr. Robert Speirs DC ~ Leave a comment

Your lower back is made up of five blocks of bone (vertebra) stacked on top of each other with a shock absorbing “disc” in between each level for flexibility. The larger front of the vertebra is called the “body”. The back of each vertebra is formed by two smaller bony columns (one on each side), capped with smooth joints called “facets”. Each vertebra rests on the one below in a “tripod” sort of fashion with the disc in front, and the facet joints in the back. The diagnosis of “facet syndrome” means that your facet joints have become irritated and inflamed. This problem can arise from sprains, strains, or joints that are not moving properly. Patients are more likely to develop facet syndrome if they have suffered an injury, overuse their back, have arthritis, or are overweight.
When a facet is irritated, you will likely notice pain on one side of your back that may radiate into your flank, hip, and thigh. The pain may come and go. Your pain may increase when you arch backwards or return to an upright position after bending forward. Many patients report relief when they lie down. Symptoms of facet syndrome do not usually radiate past your knee. Be sure to tell your chiropractor if your symptoms include any radiation of pain below your knee, weakness, groin numbness, changes in bowel or bladder function, or if you have a fever.

Long-standing irritation to the facet joint is thought to cause arthritis. Fortunately, our office can help. To speed your recovery, you should wear supportive shoes and avoid activities that increase your symptoms. Be sure to take frequent breaks from sitting. Your doctor may provide specific recommendations about using heat or ice at home. You may need to limit heavy physical activity, but you should avoid complete bed rest. Yoga has been shown to help back pain sufferers, so consider joining a class or picking up a DVD.

Meralgia paresthetica? Yeah, we know all about it.

~ Dr. Robert Speirs DC ~ Leave a comment

Meralgia paresthetica is an often missed diagnosis for tingling, numbness, and burning pain on the front and outside of your thigh. The condition is caused by a pinching or irritation to the “lateral femoral cutaneous nerve” that supplies sensation to your thigh.
This nerve can be compressed beneath a ligament, tendon or tight muscle in your hip and pelvis. Pregnancy or being even slightly overweight makes this condition more likely. Tight clothing including girdles, compressive shorts, or tight belts may aggravate or cause this condition. Carpenters’ tool belts or police duty belts may compress this nerve. Prolonged sitting or lying in a fetal position may aggravate this problem. Diabetics are at greater risk.

In the early stages of this condition, your symptoms are usually mild and intermittent. Walking or standing may aggravate the symptoms, and sitting tends to relieve them. In more advanced stages, numbness and tingling changes to shooting pain that is unaffected by your position.

The central goal of treatment is to decrease any cause of compression. In some cases, simply wearing looser clothing or belts may help relieve your symptoms. Some men find relief by switching from a belt to suspenders. Avoid wearing a tool belt or duty belt that places pressure over the area. If you are overweight, begin a sensible weight loss program to avoid compression from excessive tissue.

Condition of the Month: A/C Separation

~ Dr. Robert Speirs DC ~ Leave a comment

AC

A/C Separation

The term “acromioclavicular sprain” means that you have damaged the strong fibrous bands (ligaments) that hold the end of your collarbone (clavicle) to the tip of your shoulder blade (scapula). Another term sometimes used to describe this injury is “shoulder separation.” 40-50% of all athletic shoulder injuries involve the acromioclavicular (AC) joint. AC injuries are common in adolescents and young adults who participate in contact sports, like hockey and football. Males are affected five times more often than females.

Injuries may range from mild fraying of a single ligament to complete rupture of all of the supporting ligaments. Significant tears can allow your collarbone to move upward, out of its normal position, creating a raised bump under your skin. AC joint injuries are categorized (Grade 1-Grade 6) based upon the amount of damage. Grade 1 injuries are tender without joint separation. Grade 2 injuries may be accompanied by a slight separation of the joint. Grade 3 and above will show significant joint separation.

Injuries typically occur following a fall onto the point of your shoulder, while your arm is at your side, or by falling onto your outstretched hand. You will most likely feel pain and swelling on the very top of your shoulder. More significant injuries may produce bruising or a visible “bump” beneath the skin. Moving your shoulder will likely be painfully limited for a while.

Your treatment will vary, depending upon the severity of your injury. Grade 1, 2, and most Grade 3 injuries are best managed conservatively. A sling may be used only when needed to control painful movements. Initially, you will need to limit activity, especially reaching overhead, behind your back, or across your body. The exercises described below are an important part of your rehab and should be performed consistently to avoid long-term problems. Using an ice pack for 10-15 minutes each hour may help to limit swelling and pain.

Some mild separations will heal by themselves within a week or two. More significant injuries can take longer, and disabilities typically range between one and eight weeks. Patients who have suffered a significant amount of ligament damage may have a permanent bump on their shoulder, regardless of treatment. This bump does not usually cause ongoing problems.

If you or someone you know suffers from this condition, call our office today. Our doctors are experts at relieving many types of pain including shoulder injuries.

Avoiding Back Pain At Sedentary Jobs

~ Dr. Robert Speirs DC ~ Leave a comment

Some great tips on how to prevent back pain when working a sedentary job from our friends at Silicon Republic. Check out the article below.

How to prevent back pain in the workplace

1. Take regular breaks to stretch and walk around

Try to walk around for between three and five minutes every half hour.

2. Make sure not to hunch over while working

Everyone intuitively understands that hunching over the computer is bad for them, but it’s easy to fall into the most natural and comfortable – albeit unhealthy – sitting position while you’re in the flow of things.

3. Consider a standing desk

A standing desk offers you the opportunity to alternate your position throughout the day.