Cervical Stenosis

Stenosis.jpg Spinal stenosis means that the tube surrounding your spinal cord and nerve roots is too small, and your nerves are being compressed. Stenosis can arise in different ways. Sometimes, people are born with a spinal canal that is too small. Other times, the canal may have been narrowed by surgery or conditions like disc bulges. Most commonly, spinal stenosis arises from chronic arthritic changes that narrow the canal. This type of stenosis usually develops slowly over a long period of time, and symptoms show up later in life. The natural progression of stenosis is generally a slow, steady increase, although some patients’ symptoms remain the same or even improve over time. Symptoms grow in relation to the amount of nerve compression. Initially, most patients notice neck pain, headaches, and possible referral of discomfort into their shoulders and upper back. If the nerves that exit your spine become compressed, you will notice radiating pain, numbness, or tingling traveling into your arm. If the condition grows to the point that your spinal cord is compressed, you may notice loss of the fine motor skills of your hands, which translates to clumsiness, difficulty buttoning shirts, trouble using zippers, and changes in handwriting. Sometimes, pain, numbness, or tingling can radiate into your legs. Be sure to tell your doctor if you: notice leg complaints, have difficulty walking, notice balance problems, or have experienced loss of bowel or bladder control. Likewise, tell us if you notice a fever, unexplained weight loss, flu-like symptoms, or numbness & tingling on your face. Although there is no non-surgical cure for cervical stenosis, treatments are available that may help ease your symptoms. Traction has been shown to help patients with cervical stenosis. If home traction is needed, our office will provide instructions on how this should be performed. You will be taught some stretching exercises to reduce muscle tightness and free up “trapped” nerves. You may also be given exercises to help build strength, flexibility, coordination, balance, and conditioning. You should avoid activities that increase pain, especially looking too far up or down. You may find relief of your symptoms by using ice, heat, or visiting a massage therapist. In severe cases only, surgery may be required to relieve pressure on the spinal cord and nerve roots.
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Having “Arthritis” Does Not Mean You’ll Have Pain

Arthritis

A recent research review found “no correlation” between the intensity of low back pain and the degree of arthritic change. Chiropractic helps address the underlying reason for both the symptoms and degeneration. If you or someone you know is living with pain, call our office today.

Download this infographic showing how structural problems like arthritis may not be the sole cause of your symptoms.

Herlin C et al. Modic changes—Their associations with low back pain and activity limitation: A systematic literature review and meta-analysis. PLoS1 2018 Aug 1;13(8):e0200677.

Arthritis Of The Big Toe

Hallux rigidus is defined as osteoarthritis of the big toe. This condition causes stiffness that limits joint range of motion, in flexion and mainly extension of the hallux, causing an alteration of the normal biomechanics of walking.

A direct trauma to the toe or a deformity of the foot called hallux valgus may increase the symptoms of hallux rigidus.

To date, the exact causes of osteoarthritis have not been fully identified. An exacerbation of symptoms usually occurs during a period when the level of physical activity has been drastically increased.

Treatment of Hallux Rigid consists of Class IV Laser Therapy, management of any biomechanics stresses in the area and exercise rehabilitation to address any weaknesses that can be putting undue stress on the area. 

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Shoulder Impingement Syndrome

Shoulder Impingement Syndrome
Shoulder Impingement Syndrome
Impingement syndrome
Impingement syndrome is an irritation of the structures between the upper portion of your arm and your shoulder blade mainly during overhead arm movements.The rotator cuff is comprised of four muscles that help position the humerus, your upper arm bone, into the shoulder socket during arm movement.The shoulder has great mobility but at the same time is prone to injury during falls or accident, or when there is a lack of motor control (altered biomechanics).Men over 40 performing manual labour are the most affected with this condition. It is also present in young athletes practicing sports involving repeated overhead motion such as swimming, baseball or tennis.

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Structures involved

The tendons of the rotator cuff, ligaments of your shoulder and subacromial bursa are the most commonly affected structures. The subacromial space gets smaller during overhead movements. This can cause, over time, irritation, inflammation and/or a lesion of the rotator cuff tendons.

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Signs & Symptoms that you may experience

Everyone will react differently after an injury and recovery will depend on the severity of it.

Impingement syndrome can cause but is not limited to, pain at the front of the shoulder and localized swelling. Pain or tightness is often felt when you lift your arm overhead or when you lower it from an elevated position. Pain can also be felt around your shoulder blade in your back.

Other early symptoms can include light pain with activities or during rest and in some cases, irradiating pain around your shoulder. In severe cases, you might feel pain at night and a loss of strength or range of motion. Impingement syndrome can lead to rotator cuff tendinitis or shoulder bursitis when left untreated.

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Recovery

Your rehabilitation plan, health, fitness & nutritional status will affect recovery speed. Most of the time, you can expect to recover fully from impingement syndrome. As a rule of thumb, this condition can take up to three months to fully recover.

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▶ WHAT TO DO

Early Stage

Relative rest is a good way to protect your shoulder and prevent further damage, but it’s important to avoid overprotecting your injury. A few days rest where you avoid pain-inducing movement and activities might be necessary. A quick but progressive return to your activities of daily living, light cardiovascular exercise and specific range of motion and strengthening exercises will allow better recovery.

Rehabilitation

Follow your practitioner’s advice. It will help you manage the different phases of the recovery process and will increase the likelihood of successful rehabilitation. Your practitioner will assist you during your rehabilitation program in order to regain your normal range of motion, strength and endurance, optimal motor control and functional status.

As per the principles of rehabilitation for impingement syndrome, movement training through therapeutic exercises is an important part of functional recovery. A progressive exercise program performed over a few weeks period is pretty standard.

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Don’t rely on passive treatment only. Each phase of the rehabilitation process is important. Patients that are actively involved in their treatment plan tend to recover faster. Keep in mind that pain is not always a good indicator of tissue damage. As soon as you feel better and the pain is well managed in collaboration with your therapist, you should reintroduce light strengthening exercises as tolerated.

Pain from trigger points in the supraspinatus muscle.

The supraspinatus muscle makes up part of the rotator cuff. It is responsible for assisting in shoulder abduction as well lateral rotation and stabilizing the shoulder joint. This muscle is often overloaded in labourers and tradesman who have to do a lot of overhead work. Athletes who do a lot of throwing movements will also frequently have Tigger point in this muscle. These trigger points will cause pain to be felt into the shoulder and down the arm, as well as stiffness and weakness.

Trigger point pain and the Teres Major muscle.

The Teres major muscle is located at the back of the armpit. It originates on the posterior aspect of the inferior angle of the scapula, and inserts and inserts on the medial lip of the intertubercular sulcus of the humerus. It’s main function is to assist adduction, internal rotation, and extension of the arm. This muscle only becomes active when there is resistance added to these movements. Trigger point pain from this muscle will cause pain to be felt deep into the posterior shoulder and down the back of the arm.

Pain from subclavius trigger points

The Subclavius muscle is a small muscle on the underside of the clavicle. It originates on the first rib and it’s cartilage, and inserts on the inferior clavicle. It’s main function is to assist in protraction of the shoulder. This muscle is often shortened and tight from poor rounded shoulder posture. When trigger points form in this muscle they can refer pain into the anterior shoulder and down the radial part of the arm. Pain can also be referred into the thumb and first two fingers.