Sciatica

Sciatica is a common presentation to the chiropractor. We often hear a patient saying they have a ‘pinched nerve’, but sciatica is normally not that simple as there are a number of factors that can cause it.

We will start of with some simple anatomy – The sciatic nerve arises from several segments in the lower back, in the lumbar and sacral spine, joining together to form one big nerve which travels through the hip, buttock and all the way down to the toes, branching out as it goes.

sciatic-nerve

Symptoms are often varied, although the main one is pain down the leg, with the ‘classic’ sciatica causing pain in the calf and foot. Other symptoms can include pins and needles, numbness and weakness of the muscles. Very rarely, losing function of the bowel and bladder can occur, which requires urgent medical intervention.

Causes: There are a number of causes for sciatica, here are the most common ones:

  • Disc – A herniation or rupture to a disc can cause leakage of disc contents into the spinal canal and thus place pressure on the nerve. Furthermore, inflammation associated with the injury can also irritate the nerve.
  • Bony growths – These can narrow the canal of where the nerve exits the vertebral column, reudcing the amount of space for the nerve to exit
  • Piriformis syndrome – In a small percentage of individuals, the sciatic nerve passes through the middle of the piriformis muscle (gluteal region). When it is tight it can compress the nerve
  • Joint strain – Inflammation from a joint sprain can irritate the nerve
  • Spondylolistesis – A forward slippage of the vertebra which can compress the spinal cord or exiting nerves

Sciatica causes

Diagnosis – Here at Mona Vale Chiropractic Centre we will perform a thorough history and examination involving orthopaedic and neurological testing to come to a diagnosis. If we believe you require imaging such as x-ray or MRI this can be arranged and we will refer accordingly. Communication with your GP will also occur and if we feel chiropractic treatment is not appropriate for your condition, a referral to the appropriate healthcare professional will be done.

Treatment – There are a number of different treatment options, some of the ones we use include: Adjustments and mobilisations, muscle releases, dry needling, stretching and rehabilitation exercises. The treatment will be aimed to address the cause of the sciatica through improving movement, decreasing inflammation and strengthening surrounding muscles.

What can be done in the meantime for sciatica? Keep moving is the simple answer! Avoid aggravating movements such as bending,twisting and prolonged sitting. Moving encourages blood flow through the joints and muscles to reduce the chances of the lower back from tightening up. Heat is recommended if the injury has been longer than 24 hours.

Mitchell Roberts – Chiropractor

Lumbar Supports

Lumbar supports are a great idea for the office, car or airplane for that time when you know you will be sitting for an extended period. The good thing about lumbar supports is that you can use something simple – an inflatable lumbar cushion, a small pillow or even a rolled up jacket or towel.
The best position to place the support in is not the same for each individual, as it varies due to the curvature of your spine.The aim is to lengthen the muscles/tissues of the lumbar spine and try to feel that your spine is in a neutral position. Placing it directly onto your lower back may cause too much extension through the lumbar spine, so therefore start off by trying these 2 places:

  • At the bottom of your rib cage
  • Place it just below the belt line

Play around with the position of the support and vary it throughout the day. Also don’t forget to try it on the lounge at home for when you are watching television or reading!

Mitchell Roberts – Chiropractor 

 

Our sedentary lifestyle

When we think about it, we do sit a lot. From watching TV, driving to work, to using the computer in the workplace and then using our computer at home – we sit for a very long time each day. It is estimated we sit for around 10-15 hours per day.

seats

So, just how bad is all this sitting? It has often been termed that ‘Sitting is the new smoking’. Dr James Levine from the Mayo clinic in the USA suggests that there are over 34 chronic diseases that are associated with excess sitting. These include type 2 diabetes, heart disease and even cancer.

What happens to our body during prolonged sitting? Our metabolism slows due to our cells not needing as much energy, our blood sugar levels and blood pressure both increase. When we are not moving, our muscles are not contracting. When muscles contract, it forces the sugar in our blood to be forced into the muscles to provide a fuel source for contraction. This is the reason type II diabetes occurs – our muscles are not using up the sugar in our blood stream.

How to minimise our seating:

Keep moving at work:

  • Get up and move for 10 minutes of every hour
  • Stretch your back and legs often
  • Walk over to your colleagues instead of emailing or calling
  • Use the stairs
  • Use a standing desk
  • Conduct walking meetings

Reduce the number of hours we watch TV, use tablets/laptops!

Making frequent posture changes is very important. Prolonged sitting does encourage more rounded shoulders, an increase in thoracic kyphosis (ie, hunchback) and a forward head carriage posture (head positioned in front of the shoulders). Breaks as short as 1 minute can even help with posture, you just need to change your static position!

A quick postural exercise:

Brugger’s postural exercise – Start by sitting on the edge of your chair with your arms hanging by your side, palms facing forward. Now rolls your thumbs out and back. As you do this, try and get your shoulder blades to touch each other in the middle of your spine. Add in a chin tuck, by tucking the chin straight back.

bruggers-postural-relief

 

Hold this position for roughly 10 seconds and perform 2-3 times. You can perform this exercise as many times as you want throughout the day. Also don’t forget to include this into your routine of getting up out of the chair and moving!

Mitchell Roberts – Chiropractor 

 

 

 

Hamstring strains

At Mona Vale Chiropractic Centre, we treat more than just the spine. We see and treat daily things like ankles, knees, hips, shoulder and muscle/ligament injuries.

Hamstring strains are a very common injury we see in the clinic. There are many mechanisms as to how they occur, the most common being running, jumping and sports such as rugby, tennis and soccer.

The hamstring consists of three muscles located at the back of the thigh. Its function is to extend the hip and to bend the knee.

Hamstring-Muscles
The 3 muscles of the hamstring

Muscle overload is the main cause of a strain. This happens when the muscle is stretched beyond its capacity. There are several risk factors for hamstring strains:
• Previous hamstring strain
• Muscle imbalance (Quadriceps / hamstring ratio)
• Poor conditioning
• Muscle fatigue

Management and treatment of hamstring strains varies depending on the type of strain. A type 1 strain can take 1-4 weeks to heal, while a grade 3 tear (complete tear of the muscle) can take up to 6 months to heal.

Symptoms include a sharp & intense pain at the back of the thigh, some initial swelling, possible bruising/discolouration, weakness (especially with stairs/running) and stiffness.

Initial management should follow the RICE protocol – Rest, Ice, Compression and elevation. Following, chiropractic treatment can commence which will involve stretching and strengthening of the hamstring and surrounding muscles. Specific chiropractic adjustments are also used on the lower back and pelvis. Adjustments to this area can improve the biomechanics of running/walking and also ensure that correct muscle recruitment occurs. A rehabilitation program based on best available evidence will also be provided to ensure optimum strength and flexibility is obtained allowing for a return to play.

At Mona Vale Chiropractic Centre, we use a variety of treatment options – Adjustments, myofascial release, acupuncture / dry needling, instrument assisted soft tissue mobilisation (IASTM), ultrasound, kinesiotaping and Scenar.

Mitchell Roberts – Chiropractor

Mona Vale Chiropractic Centre: Summer operating hours

Hi there,

Letting you know that you can now book late evening Chiropractic appointments at Mona Vale Chiropractic Centre.

On Mondays and Wednesdays during the summer months we will be open until 8pm.  Phone on 9997 5773 to make an appointment or make an enquiry.

We are open for Chiropractic and Massage Therapy treatments at other times including Saturdays.

With best wishes,
The team at Mona Vale Chiropractic Centre

I tempted fate blogging about wrist problems

My last blog (a while ago) was about wrist problems – I must have tempted fate.  I had a major fall and broke my distal radius (near the wrist) in 3 places.

At the time I was studying Animal Chiropractic in the USA.  After emergency surgery, I 1-neil clinic 0913came back to Australia where I needed more surgery.

As you can see from the photo, I have external fixation rods and 3 plates to the radius.

Fortunately the team at Mona Vale Chiropractic Centre are on-hand (excuse the punn) to help the healing.

With major surgery like this you often get problems in other parts of your body.

Your movement is so restricted and affected by wearing things such as a sling and often you sleep badly, have extra tension and poor posture.

Chiropractic adjustments has helped stimulate my spinal nerves which has promoted healing. Having regular therapeutic massage has helped me to relax as well as improve movement in my wrist and shoulders.

I have also been treating myself with SCANAR which has dramaitcally improved the inflamation resulting from 2 major operations back to back.

You will be pleased to know that despite the accident I was able to complete my studies and am now a certified member of the International Veterinary Chiropractors Association. Hopefully I will be treating 2 legged and 4 legged patients very soon. Keep reading for updates on my treatment and healing.

One positive that has come from my accident is that the team at Mona Vale Chiropractic  have been forced to become experts in the treatment of chronic wrist problems.

“I recently became a CIA…”

“I recently became a CIA – not a secret agent but a Certified Instrument Adjusting Chiropractor. After doing a course in the USA, I completed the training in Sydney last month. This primarily makes use of an Impulse adjusting device. I have found great success using this technique, especially on foot problems such as heal pain and plantar fasciitis. Sufferers of foot pain know only too well how uncomfortable and debilitating this can be.

I realise that I must be getting old when last week I treated a 20 month old little boy for a hip issue. Not only have I been treating his mother since she was a young girl, but my father, Martin Gregory (who started Mona Vale Chiropractic Centre in 1977) treated her as a baby.

It is certainly a family affair, as the little boys grandparents are both regular patients at Mona Vale Chiropractic Centre. It only seemed liked yesterday that I was treating my own 20 month old son – he is now 25 years old! How time goes past ever so quickly”

Neil Gregory

Mona Vale Chiropractic Centre – A short history

Mona Vale Chiropractic Centre was founded in 1974 by Martin and Christine Gregory (Neil’s parents). It is now the longest running family operated Chiropractic Clinic in the Northern Beaches.

The clinic has been at it’s current location of 1801 Pittwater Road since 1986. Neil and his wife Lynette originally lived at the back of the Chiropractic clinic. As their family grew with three active sons it was time to expand the clinic and move the family.

The building was changed to Professional Suites in 1995 when extra treatment rooms were added. The clinic began providing massage therapy services and other Chiropractors joined Neil in the busy practice.

Clinical Psychologist Gunter Swoboda and Speech Pathologist Lauren Reid have been running their health-care businesses from 1801 Pittwater Road for many years.