Chiropractors Blog

Sciatica

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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

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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

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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

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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

Instrument assisted soft tissue mobilisation (IASTM)

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Instrument assisted soft tissue mobilisation is another form of treatment we use at Mona Vale Chiropractic Centre. It is a treatment involving using a stainless steel tool, such as the Edge Mobility Tool:
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The tool allows for the diagnosis and treatment of soft tissue injuries (Muscle, ligament, tendons and fascia). The tool effectively breaks down scar tissue and adhesion’s within the soft tissues. The tool causes a micro-trauma to the tissues, resulting in a local inflammatory response. This in turn results in an increased vascular response leading to a remodeling of the collagen fibre matrix and a reduction in scar tissue.
Studies have shown an increase in range of motion, strength and a decrease in pain following IASTM treatment. (Melham, 1997)

IASTM is very effective for:

  • Neck and back pain
  • Plantar fasciitis
  • Tennis elbow (lateral epicondylalgia)
  • Shoulder pain / Rotator cuff injuries
  • Knee pain
  • Ankle Pain
  • Shin splints

References:
Melham, TJ, Sevier, TL, Malnofski,fckLRMJ, Wilson, JK, and Helfst, RH, Chronic ankle pain and fibrosis successfully treated with a new non-invasive augmented soft tissue mobilization (ASTM): A case report.fckLRMed Sci Sports Exerc.fckLR1997;fckLR30:801-804

Mitchell Roberts – Chiropractor

 

Another Year, Another Christmas

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Christmas is a wonderful time of year where we can see the family, take some time off and enjoy the summer. I’m not the only one who thinks that the most wonderful thing about an Aussie Christmas is a swim on Christmas Day.

As we all know, Christmas can take a toll on our bodies, affecting our spine and nervous system. Christmas is a mixed experience of over indulging in Christmas cheer as well as lugging heavy presents around – not to mention the stress of getting everything ready for the big day. Not suprising that Christmas is a stressful period on the body in many ways. Here are a few Christmas survival tips;

If you are planning on doing lots of physical things during the holidays like renovations or taming the garden, take it easy. Listen to your body for warning signs that indicate subluxations such as strains, reduced range of motion, stiffness pain and soreness.

Remember your posture and good lifting techniques while working around the house, garden and garage (bend your knees not your spine & be careful of any combined bending/twisting action).

Anxiety, stress and depression are very common during the festive season. Take time out for you and your family and enjoy. Whether this be a holiday, hobby or just potting around. This is all good for your health and wellbeing.

Get enough sleep. Plan for some mid-day naps or early nights to help you cope with the “silly season”

Watch the alcohol intake and don’t overdo it. Alcohol will dehydrate you and is a depressant which will have negative effects of tiredness. The same thing applies to too much food. Have a salad or just fruit for a few meals each week.

Keep moving, plan for some walks, swimming and gentle exercise. If you are looking forward to the annual game of golf, tennis of a surf, remember start slowly. If you haven’t done that activity for a while take it easy and don’t over do it.

Keep your spine adjusted and subluxation free. Have a Chiropractic treatment or enjoy a massage to make sure that you are well prepared for the Christmas season.

Have a wonderful Christmas and a joyful New Year
From all of us at Mona Vale Chiropractic Centre

Voodoo Floss Compression Bands

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Chiropractic treatments often involve alot more than you may initially expect. I have found that a new technique from the USA called voodoo floss banding gives great results.
Voodoo Floss Banding involves using a compression band wrapped around joints and muscles to improve range of motion and decrease swelling. It is very effective for ankles, knees, wrists, elbows, shoulders and strained muscles that have reduced motion, stiffness and pain. The compression and movement creates a shearing effect which restores sliding-surface function to the underlying tissues. Once the band is released, blood flows into poorly saturated joints and tissues.
It is also great for acute injuries where swelling is involved. Swelling can put a lot of pressure on nerve endings, reduce the joints range of motion and cause acute pain. The compression pushes the swelling into the lymphatic system where it can be drained. A lot of relief is felt immediately after.
Mitchell Roberts – Chiropractor

Why Do Horses Suffer Back Pain?

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Horses are a unique animal. They are very large and can weigh 400kgs or more. Horses are also able to stand all day and night . Their incredible anatomy has a mechanism called the “Stay Apparatus” which allows the horse to switch on its’ Triceps muscle in the forelimbs and stabilise itself permitting it to sleep while standing with minimal muscular Activity. In fact horses can have remarkably little muscular tension.

Horses however do suffer with back problems and this can lead to lameness and gait difficulties . A phrase often used is “Cold Backed” . As we can all imagine for a horse with a sore back having a saddle and a rider on it’s back can be particularly uncomfortable. Chiropractic can help.

Animal Chiropractors are trained to assess animals for spinal lesions and joint and muscle lesions and injuries. Chiropractors can adjust the horses joints and vertebrae, plus release muscle tightness and strains. The result can be very dramatic as when a horse is treated you can often see the improvement immediately. This can give the horse a huge relief, particularly if he has to carry a saddle and rider . Horses are always quick to Thank-you for their adjustment with a grateful lick and shake.
Neil Gregory – Certified Animal Chiropractor

Ilio-Tibial Band Syndrome (ITBS)

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ITBS affects many people who exercise regularly and is very common in long distance runners. It occurs from the band compressing against the lower part of the femur (the bone just above the outside of the knee) As every body is unique, I have found that a co-ordinated approach with Chiropractic treatment and appropriate rehabilitation focussed exercise gives the best results. Consequently any treatment for ITBS should involve a multi-modal approach that looks at areas above and below the site of pain and not just the source of the pain.

Firstly, a biomechanical assessment of the lumbar spine, hips, knees and ankles is essential in determining the cause of ITBS. Muscle length and strength testing is performed to determine areas of tightness/weakness.

Chiropractic adjustments of the lumbar spine, hips and ankles can be used to ensure free movement is occurring at surrounding joints. Through releasing and strengthening certain muscles that act on the IT band, we can reduce the tension on the band. Stretching and home rehab exercises work in tandem with the treatment provided by the Chiropractor to help manage and prevent the injury from returning.

Mitchell Roberts – Chiropractor

Scenar helps heal scars

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I have been treating the multiple scars that I have inherited from my recent wrist operations and have been amazed at how Scenar not only reduces the scars, but also softens the skin tissue surrounding the scar, increasing plasticity of the skin.

If you have unslightly and irritating scars you will know that with scars you usually get celloid formations (lumpy tissue around the scar) Scenar works on scars by stimulating blood flow and nerve supply to promote and speed up the healing process. Scenar improves your lymphatic flow which will always be benificially to your circulation and general health. A further benefit that patients have reported is a reduction or even total loss of the pain, numbness and sensitivity that is associated with scaring.

Neil Gregory – Chiropractor