Tag Archives: low back pain

Low Back Pain, Right Here! – Sacroiliac Joint Dysfunction

Many people suffer from Sacroiliac Joint Dysfunction even if they don’t know it by name. Most often people come in complaining of low back pain right along the belt line usually radiating to the glutes. They can usually point to the source of their pain and they point right to the S.I. joint. This is usually Sacroiliac Joint Dysfunction, and it can cause serious pain. It often affects pregnant women more easily than others because of the hormone-induced relaxation of the pelvis along with increased weight and low back stress.

It is usually caused by trauma such as lifting heavy items while bending and twisting at the same time. It can be exaggerated by the same motion such as loading a dishwasher or front loading clothes dryer, or even vacuuming. SI dysfunction will often produce a functional inequality in leg length (one leg appearing longer than the other). This pain is often one sided and also confused with sciatica. If you have S.I. Dysfunction it can produce pseudo sciatica. S.I. Dysfunction is the cause of about 25% of all low back pain.

What can you do if you have S.I. Dysfunction. Chiropractic is the treatment of choice having about a 75% success rate in research (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3804708/). Stretching the hip flexors and gluteal regions can help relieve some of the pain. The best thing to do is to see a chiropractor to restore proper function to those joints. If you have low back pain there is a 1 in 4 chance that it is S.I. Dysfunction.

 

Who’s at risk for RSI

Most vocations are at risk for RSI. That really is the truth. In just about everything that we do there is risk. If you compiled a list of all the scary media stories out there you’d find that just about everything can cause cancer, and everything you do could kill you, but doing nothing could kill you too. It’s important when discussing who is at risk to remember that life is worth living, and we should not stop that which we enjoy or that which supports us merely because there is risk.

“The greatest glory in living lies not in never falling, but in rising everytime we fall.”- Nelson Mandella

So, yes, YOU are at risk of getting a repetitive stress/strain injury, if you don’t already have one. Most people will injure themselves in this way at some point. In fact, though most people don’t realize it most back aches are RSIs. Probably the most common cause for people to visit the chiropractor is facet syndrome (sprain/strain) due to repetitive stress. We use the joints in our back more than any other joint in our body they are constantly under stress, and if one of those joints is not moving properly over and over again, the body will try to compensate, but unless the dysfunction is addressed you guessed it, RSI!

Chiropractors just like medical doctors tend to get into a niche of treatment. Myself I like the niches of pregnant patients and performance artists. I see the upper back and elbow RSIs of violinists, trumpeters, and other musicians. I see the lower back RSIs of dancers, and artists just like I see the carpal tunnel patient who types on their computer 8 hours a day. Just like any other chiropractor I can usually treat anything that walks through my door, but if you’ve had a longstanding condition that you just haven’t been able to rid yourself of you may want to seek out someone with experience. It can be hard to find the right one, because we don’t “specialize” in any particular treatment it’s just what we usually see more of. Ask around and you’ll find the right doc for you. Beyond special cases most chiropractors will be able to treat any RSI you have. The musculoskeletal and nervous systems, after all, are what our training focuses on.

So, if you’re wondering who’s at risk, it’s you. Don’t quit your job or stop playing golf, just be aware, and treat your body with the respect it deserves. I’ll tell you some things you can do to prevent RSIs in my next post. Just be warned, most of it you already know, you’ve just been too lazy to do it.

Sciatica

Our Symptom of the Week this week.

Many people have sciatica, you may have heard someone say, “my sciatica is acting up.”  Sciatica is actually a description of the symptoms experienced when the sciatic nerve or it’s roots become irritated.

Sciatic NerveIt is a group of sciatic pain syndromes.  Sciatica is kind of the Thoracic Outlet Syndrome of the lower limbs.  The tingling, numbness or pain can go from your low back all the way down the leg, or it can be fairly mild and just be in your back.

Your sciatic nerve is actually a large bundle of nerves from your low back that travels through your pelvis, out through the sciatic notch and between the piriformis muscle and the other deep hip rotating muscles.  When this nerve bundle becomes irritated or “pinched” pain ensues and can be present any where the nerve goes.

Sciatic Pain

Sciatic Pain

The actual diagnosis of Sciatica would mean that the nerves are “pinched’ at the nerve root specifically due to a spinal condition.  Degeneration, disc herniation, joint dysfunction, inflammation, etc. may cause this.  However the nerve can be “pinched” in places other than the spine.  Though they are technically termed pseudo sciatica there is nothing pseudo about the pain.  The only real difference is where the nerve gets irritated.

Piriformis Syndrome can cause similar symptoms to sciatica because the same kind of thing is happening.  The sciatic nerve travels through the muscles, if they are abnormally tight then the nerve can become “pinched” and cause sciatica.

Sacroiliac Joint Pain is another diagnosis that can cause pain similar to sciatica.  Though the nerve does not actually pass through the sacroiliac (SI) joint it does travel close enough that problems in this area may affect the nerve.  Problems in the SI joint its self can also cause symptoms that mimic sciatica in that there can be pain all the way down the leg.

The cause of your sciatic pain is very important because it dictates how it should be treated.  Your chiropractor is trained to correctly diagnose and treat the causes of these painful syndromes.  Many treatments may be effectively utilized by your chiropractor, from manipulation to decompression to physiotherapy and exercises.  You can do many things at home to help to.

Piriformis Stretch

Piriformis Stretch

Piriformis stretches are useful, and even if the symptoms are not due to your piriformis it may be tight and adding to the problem.  Talk to your chiropractor if you are having sciatica.

Utah Spinal Care

USClogo2I’m back in Utah.  I have decided that rather than opening up my own private practice that I would instead work at an already established practice.  I am now the primary treating doctor at Utah Spinal Care.  Utah Spinal Care is a family practice office in Sandy Utah just up the road from Rio Tinto Stadium and the South Towne Expo Center.  We are located at 880 E 9400 S Sandy, UT 84094.  For directions, maps, pricing, etc.  please visit the website or our Facebook page.  Come visit us and pass the word along.  If you or anyone you know is in need of some Spinal Care give us a call to set up an appointment at 801-523-0073.

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is in the category of less common diseases that you may not know that your chiropractor can treat.  Don’t worry, you probably don’t have it.  Recently the topic came up and I promised to create a post to provide some basic information on the topic of AS.

AS RibbonFirst let me cover what it is.  AS is an inflammatory disease and can be classified as a type of arthritis.  It causes pain in joints and bones, particularly in the spine with the most common complaint being the low back.  In the most severe cases it can cause bones to fuse together.  It is much less common than your typical  osteoarthritis and is also harder to diagnose because of the similarity of its symptoms to so many other conditions.  When you walk into a doctor’s office complaining of low back pain, they won’t jump to the conclusion that you have AS.

Your chiropractor can diagnose AS using a combination of your health and family history, blood tests and radiologic tests, but they won’t usually go hunting for this condition.  It is more often found after other things are ruled out or discovered incidentally with X-rays for other conditions.  This is a sexist disease usually affecting men, but that doesn’t mean that women can’t have it.  AS is also not an illness that comes on late in life.  It usually makes its self known before the age of 35.  The cause of AS is unknown still, but is likely genetic, meaning that it runs in families.  As with most diseases whose causes are unknown there is no known cure yet.  There are however treatments.

Most medical treatments for AS focus on management of pain and symptoms, but there are some medications that have been found to slow the progress of the disease.  Your chiropractor should be able to help you manage or reduce your symptoms as well as slow down the progression of the disease without medication.  As always he should also keep in close contact with your other providers that may be treating you, most likely your  rheumatologist, and together they should come up with a plan of action specific to you.

Image by Cienpies Design http://www.cienpies.net

Image by Cienpies Design http://www.cienpies.net

The treatment with the best results for AS is improving your range of motion and flexibility with exercise, diet, and joint mobilization.  You can do much of it on your own at home with guidance from your provider.  Your chiropractor should already be using these tools to treat any low back pain, but they will be even more important if you have AS.  Your chiropractor may or may not adjust your spine depending on your condition, but managing your care does not require manipulation if you don’t want it.

In the past some practitioners would recommend not seeing a chiropractor for AS because possible risks were unknown.  No studies have found increased risk to people with AS when treated with chiropractic manipulation, and recent research indicated benefits even at the late stages of the disease.  While most of the research is focused on finding a cure to AS here’s a link to an excellent case study of improvement with chiropractic management of AS.

Lumbar Disc Herniation

Blown disc, slipped disc, herniated disc, bulging disc, etc.  There are many names for a vertibral disc herniation.  This is a hard subject to keep short.  I will attempt to just give basic, simplified information to limit the length of this post.

A disc herniation has various levels as with most injuries.  The worse the herniation the more complicated the symptoms and the treatment.  Most herniations can be resolved and respond well to conservative care such as chiropractic.  In fact most herniations will resolve on their own in 6 months, but no one wants to wait 6 months for their back pain to go away.  With chiropractic treatment the symptoms are often reduced to less than 50% in 6 weeks or less, and can at times be resolved completely in as little as 3 months.

Disc herniations can happen to anyone and they don’t have to just be in the low back.  They can happen due to constant pressure of poor posture, sudden pressure due to trauma, weakened muscles and ligaments or weaknesses you’ve had since birth.

Some of the signs that you may have a herniation are: a sudden onset of low back and possibly leg pain that can go all the way down the leg.  The pain is usually described as a sharp or shooting pain and increases with bending forward, (although this direction of bending is typical it is not universal) or pressure increases such as coughing, sneezing or having a bowel movement.

Image from Spine Universe

Image from Spine Universe

Treatment for disc herniations are many,  the ultimate goal is to get the disc to reabsorb back in.  To understand any treatment you must understand the nature of an intervertebral disc.  (video) It’s kind of like a Jelly donut.  If you squeeze a jelly donut the jelly comes out.  If you only do it a little bit and then take the pressure off the jelly will kind of suck back in.  If you relieve the pressure and the damage isn’t too severe the disc will suck it’s nucleus back in and repair with time.  This is called decompression.  It can be accomplished many ways, and there is still debate as to which method is best.

The big problem with disc herniations is that often the pain is too severe to receive treatment.  So, the initial goal is to reduce pain enough to be able to be treatment.  The sooner you can get up and moving around the better the prognosis is going to be, even though there is severe pain. Some pain control techniques are cold packs, electric stim, mechanical spinal decompression, and if required pain medication.

The next goal is to centralize the pain.  Many patients worry when their back starts to hurt worse, but if the pain is coming out of the legs and centering around the pain generator it is a good thing.  Centralizing the pain means that we are relieving the pressure on the nerve.  After the pain is centralized, treatment becomes more normal and regular.

Once you’ve had a disc herniation you may be predisposed to injury in the future, therefore it is essential that you begin some form of core strengthening routine to build up your muscles so that they can protect from future injury.

Disc herniations can be very painful and can interrupt your life for quite some time.  The good news is that with chiropractic care you can often avoid surgery and be back to normal again relatively quickly.

More info…