Low Back Pain

Can Chiro help me?

~ Dr. Robert Speirs DC ~ Leave a comment

Adjust

​Chiropractic is the most widely accepted and most frequently used type of “alternative” healthcare in the United States. This is largely due to the fact that it works, and because of that, there has been a steady increase in acceptance by the public, third-party payers, and the Federal government. Since the mid-1990s, a number of outside (non-chiropractic) observers have suggested that chiropractic has now entered mainstream healthcare.

One can position chiropractic as being BOTH alternative and mainstream. It is “alternative” since it approaches healthcare from an entirely different direction compared to the primary care medical profession. Chiropractic is non-surgical and promotes diet and nutritional approaches vs. drugs and surgery. Chiropractic is also arguably “mainstream” as it has evolved into a strongly utilized form of primary care through popular acceptance and utilization by the public.

So, what role does chiropractic play in today’s health delivery system? This question is still being debated, but there appears to be three camps: 1) Specialist—limited to musculoskeletal (MSK) complaints on an interdisciplinary primary healthcare team; 2) Primary healthcare “gatekeepers” that focus on ambulatory MSK complaints; 3) Generalist primary healthcare provider of “alternative or complementary” medicine that manage and/or co-manage both MSK AND non-MSK conditions.

Looking at this from the patient or “consumer” perspective, chiropractic already plays an important role in the healthcare delivery for many patients. In 1993, a report claimed 7% of American adults had received chiropractic care during the prior year. According to a 2015 Gallup poll (that included 5,442 adults, aged 18+, surveyed between 2/16/15 and 5/6/15) entitled, Majority in U.S. Say Chiropractic Works for Neck, Back Pain, “Chiropractic care has a positive reputation among many US adults for effective treatment of neck and back pain, with about six in 10 adults either strongly agreeing (23%) or agreeing somewhat (38%) that chiropractors are effective at treating these types of pain.”

The “highlights” from this Gallup poll include: 1) Two-thirds say chiropractic is effective for neck and back pain. 2) Many adults say chiropractors think of the patient’s best interest. 3) More than 33 million adults in the United States (US) saw a chiropractor in the twelve months before the survey was conducted. That means roughly 14% of U.S. adults saw a chiropractor in the 12 months prior to the survey (vs. 7% in 1993). An additional 12% who responded to the Gallup pollsters saw a chiropractor in the last five years but not in the last 12 months. Overall, 51% of those polled had previously seen a chiropractor.

Whether or not you have personally utilized chiropractic, the educational process, licensing requirements, public interest, third-party payer systems, and interprofessional cooperation ALL support firm ground for which you can comfortably and confidently seek chiropractic care for your complaints.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care, we would be honored to render our services.

Where should you turn when back pain strikes?

~ Dr. Robert Speirs DC ~ Leave a comment

Shrug

Where should you turn when back pain strikes?

https://tribunecontentagency.com/article/where-to-turn-for-low-back-pain-relief/

Chiropractic should be a first line defence when back pain strikes. We are special trained to recognize the cause of back pain and treat when appropriate. When the cause is outside the scope of our practice, we are able to educate you on where you should go next.

Is there an actual cure all?

~ Dr. Robert Speirs DC ~ Leave a comment

​Exercise Tip

No; but exercise seems to be as close as we will ever get! 

Some of you may have heard about how a modified form of boxing is helping patients with Parkinson’s disease (PD). If you haven’t, it’s been observed that people with Parkinson’s disease (PD) who engage in this boxing-like exercise routine can enhance their quality of life and even build impressive gains in posture, strength, flexibility, and speed. Proponents of the program report that regardless the degree of severity of PD, participants have a happier, healthier, and higher quality of life.

But must it be boxing? Maybe not. A report presented at the International Congress of Parkinson’s Disease and Movement Disorders in San Diego in June 2015 found that patients with Parkinson’s disease who began regular exercise early into the PD process had a much slower decline in their quality of life when compared with those who started exercising later. The researchers found just 2.5 hours per week of exercise is needed to improve quality of life scores. According to the report, it didn’t matter what exercise the participants did — simply getting up and moving for a total of 2.5 hours/week was reportedly enough (that’s only 20-25 minutes / day)!

Looking beyond Parkinson’s, other chronic conditions also benefit from adding exercise into a person’s lifestyle. Studies show that regular exercise as simple as walking helps reduce one’s risk for memory loss, and it slows down functional decline in the elderly. Incorporating aerobic exercise into one’s lifestyle can also improve reaction time in people at ALL AGES. Exercise has also been shown to improve both physical and emotional well-being in those afflicted with Alzheimer’s disease with as little as 60 minutes/week of moderate exercise! Patients with multiple sclerosis (MS) have also reported less stiffness and less muscle wasting when using exercise machines, aquatic exercise, and/or walking.

Research has shown just 30 minutes of brisk exercise three times a week can help reduce depressive symptoms in patients with mild-to-moderate depression. In a study involving teenagers, those who engaged in sports reported a greater level of well-being than their sedentary peers, and the more vigorous the exercise, the better their emotion health! In kids 8-12 years old, physical inactivity is strongly linked to depression.

Even anxiety, stress, and depression associated with menopause are less severe in those who exercise! So LET’S ALL GET OUT THERE AND EXERCISE!!!

Hip Abductor Weakness

~ 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.

Chronic Lumbar Disc Pain

~ 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.

Pathophysiology of trigger points.

~ bryancobb ~ Leave a comment

A large number of factors have been identified as causes of trigger point activation. These include acute or chronic overload of muscle tissue, disease, psychological distress, systemic inflammation, homeostatic imbalances, direct trauma, radiculopathy, infections, and lifestyle choices such as smoking. Trigger points form as a local contraction of muscle fibres in a muscle or bundle of muscle fibres. These can pull on ligaments and tendons associated with the muscle which can cause pain to be felt deep inside a joint. It is theorized that trigger points form from excessive release of acetylcholine causing sustained depolarization of muscle fibres. Trigger points present an abnormal biochemical composition with elevated levels of acetylcholine, noradrenaline and serotonin and a lower ph. The contracted fibres in a trigger point constricts blood supply to the area creating an energy crisis in the tissue that results in the production of sensitizing substances that interact with pain receptors producing pain. When trigger points are present in a muscle there is often pain and weakness in the associated structures. These pain patterns follow specific nerve pathways that have been well mapped to allow for accurate diagnosis or the causative pain factor.

Diagnosis of trigger points.

~ bryancobb ~ Leave a comment

Diagnosis of trigger points typically takes into account symptoms, pain patterns, and manual palpation. When palpating the therapist will feel for a taut band of muscle with a hard nodule within it. Often a local twitch response will be elicited by running a finger perpendicular to the muscle fibres direction. Pressure applied to the trigger point will often reproduce the pain complaint of the patient and the referral pattern of the trigger point. Often there is a heat differential in the local area of the trigger point.

What is a trigger point

~ bryancobb ~ Leave a comment

Dr Janet travel coined the term trigger point in 1942 to describe clinical findings with characteristics of pain related a discrete irritable point in muscle or fascia that was not caused by acute trauma, inflammation, degeneration, neoplasm or infection. The painful point can be palpated as a nodule or tight band in the muscle that can produce a local twitch response when stimulated. Palpation of the trigger point reproduces the pain and symptoms of the patient and the pain radiates in a predictable referral pattern specific to the muscle harbouring the trigger point.

Snapping Hip. Not as horrific as it sounds.

~ Dr. Robert Speirs DC ~ Leave a comment

The muscle responsible for flexing your hip toward your trunk, is called the Psoas. This muscle begins on your lower spine and passes through your pelvis to attach onto the top of your femur (thigh bone). Along this course, the muscle travels across the front of your hip socket and over several bony prominences. If the muscle is too tight, its tendon may rub over these “bumps”. This occasionally produces an audible snapping sound, hence the moniker, “snapping hip”, aka “psoas tendinopathy”.
The tendon can be irritated by an acute injury, but more commonly from overuse- particularly repeatedly flexing your hip toward your trunk. The condition is also known as “dancer’s hip” or “jumper’s hip”, as movements associated with these activities are known culprits. Likewise, the condition is frequently seen in athletes who participate in rowing, track and field, hurdling, running (especially uphill), soccer, and gymnastics.

Your symptoms may include a “snapping” sound or sensation when you flex and extend your hip- although many cases are silent. Repeated rubbing causes inflammation and subsequent deep groin pain that can radiate to the front of your hip or thigh. Long-standing problems can trigger weakness or even limping.

The diagnosis of snapping hip is frequently overlooked. In fact, some studies show that identification is often delayed more than two years, while other potential causes are pursued. Fortunately, your problem has been recognized, and our office has several treatments to help you recover.

Psoas problems often start when one group of muscles is too tight, while another is too loose. Your home exercises will help to correct this problem. Depending upon the severity of your condition, you may need to avoid certain activities for a while. You should especially avoid repetitive hip flexion. Prolonged seated positions can encourage shortening of your hip flexors so be sure to take frequent breaks. Patients with fallen arches may benefit from arch supports.

What to expect with a trigger point massage.

~ bryancobb ~ Leave a comment

A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.

The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.

The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.

The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.

Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.

After treatment, it is usually recommended that the client apply moist heat to the area treated.