Winnipeg Chiropractor

Trigger points in the multifidus muscle.

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The multifidus muscle is a long muscle that travels the length of the spine. It has different actions on different parts of the spine. It extends and laterally flexes the cervical and lumbar spine, and rotates the thoracic spine. Trigger points in this muscle are common due to poor posture and bad movement mechanics. Trigger points in the lumbar area area are a common cause of low back pain. These lower points can also refer into the abdomen. Points that form in the cervical region will refer pain down the neck into the shoulder blade area.

How Does Laser Work? 

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Over 2000 published research studies demonstrate:

• Laser therapy improves blood flow and lymphatic drainage
• Laser therapy has a strengthening effect on tissue repair
• It is an effective means of relief for many pain syndromes
• It can improve immune response
• Enhanced nerve regeneration & function
• Increased microcirculation & vasodilation
• Increased lymphatic flow
• Increased collagen production
• Increases the speed, quality and tensile strength of tissue repair
• Reduced inflammation
• Enhanced angiogenesis (creation of new blood vessels)

 

Call us today for more information about Class IV laser therapy and how it can help you!

 

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Trigger point referral patterns.

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Myofascial trigger points form in a muscle due to overload stress. A portion of muscle fibers lock up into a knot. Once formed these points will irritate sensory nerves that are in proximity to the knot. When this happens,

trigger points have the capacity to refer pain along specific distributions or patterns that are well mapped out. sometimes pain may be felt at a great distance away from the actual point itself.

Trigger points.

~ bryancobb ~ Leave a comment

Trigger points are knots of contracted muscle or connective tissue that form as a result of overload stress. Once formed these points will produce pain, refered pain, weakness, and stiffness. Trigger points can also mimic other conditions such as Carple tunnel syndrome and sciatica. Trigger points will on go away on their own, they must be manually released.

Trigger points in the trapezius muscle.

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The trapezius muscle is a large diamond shaped muscle located in your back. This muscle is often overloaded due to poor sitting posture or excessive exercise. When this occurs trigger points will form. These points can cause back, neck, and shoulder pain. Trigger points in the upper traps are a leading cause of headache.

Fibromyalgia and Sleep

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Is there a connection between fibromyalgia (FM) and sleep disturbance? Let’s take a look!

FM is a condition that causes widespread pain and stiffness in muscles and joints. Patients with FM often experience chronic daytime fatigue and some type of sleep problems like getting to sleep, staying asleep, and/or feeling restored in the morning upon waking. The National Institutes of Health estimates between 80-90% of those diagnosed with FM are middle-aged women, although it can affect men and happen at any age. As little as 10-20 years ago, it was hard to find a doctor who “believed” in FM, and it was common for the patient to be told that their pain “was all in their head.” FM has now been studied to the point that we know it is a real condition, and it affects between 2-6% of the general population around the world.

It is well established that sleep disturbance frequently occurs after surgery, which usually normalizes as time passes. One study used a group of healthy women who were deprived of sleep (particularly slow wave sleep) for three days to see if there was a link between sleep disturbance and pain. Results confirmed that the women experienced a decrease in pain tolerance and increased levels of discomfort and fatigue after three days—the same symptoms found among FM sufferers!

Fibromyalgia may have NO known cause, or it can be triggered by other conditions such as repetitive stress injuries, car crash injuries, and other forms of trauma. FM also appears to run in families though it’s still NOT clear if this is a true genetic link or caused by shared environmental factors. Some feel FM is a rheumatoid condition, and though FM is NOT a true form of arthritis, it has been found that people with arthritis are more likely to have FM.

FM sufferers frequently suffer from conditions such as irritable bowel syndrome, chronic fatigue syndrome, migraine headaches, arthritis, lupus, and major depressive disorders. Approximately 20% of FM patients have depression and/or anxiety disorders, and a link between chronic pain and depression exists and seems to play a role in people’s perception of pain.

Because conditions such as sleep apnea can result in symptoms similar to FM, it’s recommended that patients suspected of FM keep a sleep/sleepiness diary in order to rule out sleep apnea as a cause for their condition.

There are many “tips” for improving sleep quality, which we will dive into next month, as these may prove VERY HELPFUL in the management of FM!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Trigger points in the gluteus Maximus muscle.

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The gluteus Maximus muscle makes up your buttock. It’s is a powerful hip extensor and thus used heavily during activities such as walking, running, and climbing up stairs. Most atheletes abuse this muscle. When overworked trigger points will form, and these points will cause pain to be felt in the hip, sacrum and the as well as deep in the gluteal area. Litterally a pain in the butt!! Trigger points won’t release on their own and require interventions like trigger point massage.

How can I make my WRD less severe?

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WRD 2

Whiplash is really a slang term for the rapid back and forth whipping of the head on the neck, usually associated with motor vehicle accidents. The title “Whiplash Associated Disorders”, or WAD, describes it best because it includes ALL of the MANY signs and symptoms of the disorder.

WAD basically comes in three sizes based on the degree of injury. A WAD I is present when there is pain but no physical examination findings; WAD II occurs when there are exam findings but no neurological loss (numbness or weakness); and WAD III includes loss of neurological function.  There is also a separate WAD level that includes fractures and dislocations (WAD IV).

There are many things that can be done by the patient to assist in the healing process for WAD. The first well-studied recommendation is to “continue with your usual activities.” Try to keep active and not change your routine. The good news is that WAD (especially types I and II) usually resolves without complication, and recovery is even more likely to occur if you don’t deviate much from your routine.

For those whose symptoms are more severe and/or not resolving, mobilization and manipulation of the neck and back are very effective treatment options. In addition to treatments you’d receive in a chiropractic office, there are MANY things you can do at home as “self-help strategies.” Some of these include (“PRICE”):

1)  PROTECT: Though it’s important to continue with your usual daily activities, this is dependent on both the degree of tissue injury and your pain tolerance. So do as many of your usual daily activities as possible, but AVOID those that result in a sharp, lancinating type of pain or those where recovery from the pain is delayed.  Therefore, this category may require modifying your ADLs (activities of daily living). A cervical collar (hard or

soft) should NOT to be used UNLESS you have an unstable injury (fracture or a grade III sprain).

2)  REST: Doing too much is like picking at a cut (which can delay healing) and doing too little can lead to a delayed healing response as well. Staying within reasonable pain boundaries is a good guide.

3) ICE > HEAT: Ice reduces swelling, and your doctor will typically recommend it over applying heat, especially on a recent injury. Heat draws fluids in, and while it may feel good, it can make your symptoms worse.

4)  COMPRESS: We can basically ignore this when referencing neck pain. This pertains better to wrapping an ankle, knee, wrist, or elbow with an elastic compression orthotic or brace.

5)  ELEVATE: This too is meant for the acute stages of an extremity injury like a foot or ankle.

Exercises unique for neck pain in the acute, subacute, and chronic stages of healing are perhaps the most important of the self-help approaches. In the ACUTE phase, try these…

1)  Range of Motion: Once again, stay within “reasonable pain boundaries” as you move your head forwards, backwards, side to side, and rotate left and right. These can be done either with or without LIGHT resistance applied using one or two fingers placed against your head. Limit the repetitions to three slow reps in each direction and emphasize the release of the movement.

2)  Chin/head Glides: Tuck in the chin (think of creating a double or triple chin) followed by poking the chin/head out.

In the SUBACUTE and CHRONIC phases of healing, the importance of strengthening the deep neck flexors cannot be over emphasized. Please refer to last month’s article for a description of this (see #3 of the 6 recommendations listed).

MRI Truths & Myths

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Arthritis

Low back pain is a very common complaint. In fact, it’s the #1 reason for doctor visits in the United States! The economic burden of LBP on the working class is astronomical. Most people can’t afford to be off work for one day, much less a week, month, or more! Because of the popularity of hospital-based TV dramas over the past two decades, many people think getting an MRI of their back can help their doctor fix their lower back problem. Is this a good idea? Let’s take a look!

Patients will often bring in a CD that has an MRI of their lower back to a doctor of chiropractic and ask the ultimate question, “….can you fix me?” Or, worse, “…I think I need surgery.” Sure, it’s quite amazing how an MRI can “slice” through the spine and show bone, soft tissues, disks, muscles, nerves, the spinal cord, and more! Since the low back bears approximately 2/3 of our body’s weight, you can frequently find MANY ABNORMALITIES in a person over 40-50 years old. In fact, it would be quite odd NOT to see things like disk degeneration, disk bulges, joint arthritis, spur formation, etc.!

Hence, the “downside” of having ALL this information is the struggle to determine which finding on the MRI has clinical significance. In other words, where is the LBP coming from? Is it that degenerative disk, bulged disk, herniated disk, or the narrowed canal where the nerve travels? Interestingly, in a recent review of more than 3,200 cases of acute low back pain, those who had an MRI scan performed earlier in their care had a WORSE outcome, more surgery, and higher costs compared with those who didn’t succumb to the temptation of requesting an MRI!

This is not to say MRI, CT scans, and x-rays are not important, as they effectively show conditions like subtle fractures and dangerous conditions like cancer. But for LBP, MRI is often misleading. This is because the primary cause of LBP is “functional” NOT “structural,” so it’s EASY to get railroaded into thinking whatever shows up on that MRI has to be the problem.

Here is how we know this, when we take 1,000 people WITHOUT low back pain between ages 30 and 60 (male or female) and perform an MRI on their lower back, we will find up to 53% will have PAINLESS disk bulges in one or more lumbar disks. Moreover, we will find up to 30% will have partial disk herniations, and up to 18% will have an extruded disk (one that has herniated ALL the way out). Yet, these people are PAIN FREE and never knew they had disk “derangement” (since they have no LBP). When combining all of these possible disk problems together, several studies report that between 57% and 64% of the general population has some type of disk problem without ANY BACK PAIN!

Hence, when a patient with a simple sprain/strain and localized LBP presents with an MRI showing a disk problem, it usually ONLY CONFUSES the patient (and frequently the doctor), as that disk problem is usually not the problem causing the pain!  So DON’T have an MRI UNLESS a surgical treatment decision depends on its findings. That is weakness, numbness, and non-resolving LBP in spite of 4-6 weeks of non-surgical care or unless there is weakness in bowel or bladder control. Remember, the majority of back pain sufferers DO NOT need surgery!

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 for back pain, we would be honored to render our services.