Hip Pain

Ouch! My Back Went Out!

~ 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 vertebrae. A disc is made up of two basic components. 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 lumbar disc lesion means that your disc has been damaged.

Disc lesions start when the outer fibers of the disc become strained or frayed. If enough fibers become frayed, this can create a weakness and when the disc is compressed, the outer fibers may “bulge” or “protrude” like a weak spot on an inner tube. If more fibers are damaged, the nucleus of the disc may “herniate” outward. Since the spinal cord and nerve roots live directly behind the disc, bulges that are accompanied by inflammation will likely create lower back pain that radiates into the buttock or the entire lower extremity. This condition is called sciatica. If the disc bulge is significant enough to create a mechanical compression of your nerve, you may also experience loss of your reflexes and weakness. Be sure to let our office know if you notice progressive weakness or numbness, any numbness around your groin, any loss of bowel or bladder control or fever.

Surprisingly, disc bulges are present without any symptoms in about 1/3 of the adult population. Another one third of adults will experience pain from a lumbar disc at some point in their lifetime. The condition is more common in men. Most lumbar disc problems occur at one of the two lowest discs- L5 or L4. Smokers and people who are generally inactive have a higher risk of lumbar disc problems. Certain occupations may place you at a greater risk, especially if you spend extended periods of time sitting or driving. People who are tall or overweight have increased risk of disc problems. The condition is uncommon in children and is most common between the ages of 40 and 60.

Researches have shown that disc bulges and sciatica may be successfully managed with conservative care like the type we will provide.

Put the shovel down and read this!

~ Dr. Robert Speirs DC ~ Leave a comment

Your low back consists of 5 individual vertebrae stacked on top of each other. Flexible cushions called “discs” live between each set of vertebrae. A disc is made up of two basic components. 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 a tough ligament that wraps around the inner nucleus much like a ribbon wrapping around your finger.
Your low back relies on discs and other ligaments for support. “Discogenic Low Back Pain” develops when these tissues are placed under excessive stress, much like a rope that frays when it is stretched beyond its normal capacity. Most commonly, disc pain is not the result of any single event, but rather from repeated overloading. Your lumbar discs 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.

Approximately one third of adults will experience pain from a lumbar disc at some point in their lifetime. The condition is more common in men. Most lumbar disc problems occur at one of the two lowest discs- L5 or L4. Smokers and people who are generally inactive have a higher risk of lumbar disc problems. Certain occupations may place you at a greater risk, especially if you spend extended periods of time sitting or driving. People who are tall or overweight have increased risk of disc problems.

Symptoms from disc pain 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.

Repeated injuries cause your normal healthy elastic tissue to be replaced with less elastic “scar tissue.” Over time, discs may dehydrate and thin. 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. Light aerobic exercise (i.e. walking, swimming, etc) has been shown to help back pain sufferers. 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.

Trigger points and fibromyalgia

~ bryancobb ~ Leave a comment

Myofascial pain syndrome (trigger points) and fibromyalgia are often confused to be the same condition and while there is a lot of interrelatedness between the two they are not quite identical. The clinical definition of a trigger point is “a hyper irritable spot associated within a taut band of skeletal muscle that is painful on compression or muscle contraction, and usually responds with a referred pain pattern distant from the spot”. Trigger points form from an overload trauma to the muscle tissue. This is contrasted with fibromyalgia which is defined as “a medical condition characterized by chronic widespread pain and a heightened pain response to pressure. Other symptoms include tiredness to a degree that normal activities are affected, sleep problems and troubles with memory. Some people also report restless leg syndrome, bowel and bladder problems, numbness and tingling and sensitivity to noise, lights and temperature. It is also associated with depression, anxiety, and post traumatic stress disorder”. Fibromyalgia will also present with localized tender points which are often mistaken for trigger points. Where these two conditions become somewhat interrelated is via the nervous system. Fibromyalgia patients suffer from a super-sensitization of the nervous system causing hyperirritability and pain. Myofascial trigger points can be caused by,or be the cause of, super sensitization. An active trigger point will irritate the sensory nerves around it eventually leading to super-sensitization. Trigger points have also been showed to form of become active due to super-sensitization. Both of these conditions can perpetuate the other, leading to layers of pain and symptoms. This being the case, trigger point therapy can have a very positive effect on decreasing the severity of pain and symptoms in patients suffering from fibromyalgia.

Trigger points in the adductor longus and brevis.

~ bryancobb ~ Leave a comment

These muscles are located in the groin. The longus originates on the pubic body just below the pubic crest and inserts on the middle third of the linea aspera.The brevis muscle originates on the inferior ramus and body of the pubis and has its attachment to the lesser trochanter and linea aspera of the femur. Trigger points in these muscles are the most common muscular cause of groin pain. Distal trigger points refer pain to the upper medial knee and down the tibia. Proximal trigger points refer into the anterior hip area.

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.

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.

Bryan Cobb RMT.

~ bryancobb ~ Leave a comment

Since 2005, Bryan has been dedicated to helping all people with chronic and acute pain caused by soft-tissue damage.

His training and experience make him uniquely qualified to treat a wide variety of pain and dysfunction and to give instruction on prevention and self-care.

Bryan is the only Massage Therapist in Manitoba — and one of the few in Canada — to be certified by the Certification Board for Myofascial Trigger Point Therapists (CBMTPT).

Bryan holds a degree as an Advanced Remedial Massage Therapist (ARMT) from the Massage Therapy College of Manitoba.  Course work at MTCM includes
• over 2,000 hours of practice, as well as
• intensive course work,
• a supervised clinical practicum, and
• community outreach placements.

MTCM has a credit transfer affiliation with the University of Winnipeg, ensuring that its courses are held to the highest level.  When Bryan studied at MTCM, the college was the only massage therapy college in western Canada accredited by the Commission on Massage Therapy Accreditation.  Today, the college is a member of the Canadian Council of Massage Therapy Schools.

Bryan is a member in good standing of the Natural Health Practitioners of Canada.

Bryan also has a background in Anatomy, Exercise Physiology, and Sport Sciences from the University of Manitoba, and he has worked as a personal trainer and fitness leader.

He is an avid natural bodybuilder and fitness enthusiast, and has a blue belt in Brazilian jiu-jitsu.

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.

Suddenly my back was killing me!

~ Dr. Robert Speirs DC ~ Leave a comment

Low back pain affects 80% of the population at some point in their life and one-third of the population on a yearly basis. One of the most common causes of low back pain comes from a slightly restricted joint in your spine.
Your lower back is made up of 5 bones stacked on top of each other with a soft “disc” between each segment to allow for flexibility. Normally, each joint in your spine should move freely and independently. Our examination of your spine has shown that one or more of the joints in your low back is slightly misaligned and restricted. We call this condition “lumbar segmental joint restriction”.

To help visualize this, imagine a normal spine functioning like a big spring moving freely in every direction. A spine with a joint restriction is like having a section of that spring welded together. The spring may still move as a whole, but a portion of it is no longer functioning.

Joint restriction can develop in many ways. Sometimes they are brought on by an accident or an injury. Other times, they develop from repetitive strains or poor posture. Several factors may make you more likely to experience low back problems. These include: being overweight, smoking, strenuous work, repetitive bending, twisting and lifting, prolonged exposure to whole body vibration- i.e. operating a motorized vehicle, stress, anxiety, depression, dissatisfaction with your job and even your attitude!

Restricted joints give rise to a self-perpetuating cycle of discomfort. Joint restriction causes swelling and inflammation, which triggers muscular guarding leading to more restriction. Since your spine functions as a unit, rather than as isolated pieces, a joint restriction in one area of your spine often causes “compensatory” problems in another. Think of this as a rowboat with multiple oarsmen on each side. When one rower quits, the others are placed under additional stress and can become overworked.

Joint restrictions most commonly cause local tenderness and discomfort. You may notice that your range of motion is limited. Movement may increase your discomfort. Pain from a restricted joint often trickles down to your hips or thighs. Be sure to tell your chiropractor if your symptoms include any radiation of pain below your knee, weakness, groin numbness or changes in bowel or bladder function.

Long-standing restrictions are thought to result in arthritis – much like the way a slightly misaligned wheel on your car causes premature wearing of your tire.

You should recognize that your problem is common and generally treatable. Chiropractic care has been shown to be the safest and most effective treatment for joint restrictions. Our office offers several tools to help ease your pain. To speed your recovery, you should wear supportive shoes and avoid activities that increase your pain. Be sure to take frequent breaks from sedentary activity. Yoga has been shown to help back pain sufferers so consider joining a class or picking up a DVD.