Posts Tagged "lower back pain"

It hurts to run.

Posted by Marc Croker | 0 comments

A 38 year old woman presented to this clinic in July 2010 complaining of lower back pain and right hip pain.  She reported that the pain had started three months prior without any specific injury.  The pain was initially mild but it was getting worse.  It was stopping her from running which is a passion for her – so much so that she had suffered from stress fractures of her right femur and fibula.  In 2006 she had had three pins inserted into her right leg to stabilise the stress fractures in her femur.

Her initial examination revealed a fairly classic presentation of pain with inflammation of the facet joints of L5S1 and obvious muscle spasm of her right gluteal muscles.  There was no restriction of movement of her right hip joint.  There was increased muscle tension in her calf muscles.

Her treatment consisted of chiropractic manipulation to her lower back, specifically at L5S1, to which she reported feeling better.  However after the 4th treatment there was no additional improvement and the pain was returning as soon as she started running.

Further examination revealed that there was no longer any sensitivity of L5S1 on physical examination but there was tenderness on examination of her sacrum (tailbone).  It was discovered that there was pain and restriction of movement when examining the movement of the right side of her sacrum.

Her fifth treatment consisted of manipulation of her sacrum to which she found immediate relief of her pain.  The crucial test of course was to see how she fared while running.

I was delighted to hear on her sixth visit that her pain had significantly subsided and she was able to run for much longer periods before the pain started to return (and this was only mild pain that she felt that she could push through).  After three more chiropractic treatments all of her pain was completely gone and she was able to enjoy her running again without fear of it starting all over again.

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Pregnancy and Chiropractic.

Posted by Marc Croker | 0 comments

One of the most common symptoms that women suffer during pregnancy is back pain. So much so, that if you mention that you are suffering lower back pain during pregnancy to a doctor or an obstetrician they will reassure you that it is a normal symptom of pregnancy. However back pain is not normal. Pain is a sign that something is inflamed and with appropriate treatment your pregnancy can be wonderfully free of lower back pain.

The difference with lower back pain in pregnancy is just that there is extra weight on the joints of the lower back. Once the inflamed joint has been identified and treated the pregnancy can continue without the lower back pain.
The major concern for pregnant women is that chiropractic treatments might have an adverse affect on the unborn baby. Chiropractic manipulation can be safely performed on all levels of the spine throughout pregnancy. This is especially true if you have had chiropractic treatment prior to being pregnant, as your body is already used to being treated and the treatment should only involve a little fine tuning to keep the spine healthy and mobile. If your body has never had any treatment before then it will take time to adapt and respond to the manipulation. Whilst this is not a contraindication to manipulation during the first trimester many women choose to wait until they are past the first three months before beginning treatment. In many cases though your body will be much better for having had treatment and this can only be of benefit to mother and baby.

Pubic symphysis pain and headaches are common symptoms of pregnancy and these symptoms often continue for weeks to months after the baby has been delivered.  The forces applied to the pubic bones can cause misalignment of the pubic bones and even separation of the pubic symphysis.  Recurring headaches are common to women after delivering their baby.  It is not uncommon for the headaches to persist until the pubic pain has subsided.  There are a number of effective chiropractic treatments for misalignment of the pubic bones.

Another common pain during pregnancy is pain around the lower rib cage in the region of the kidneys.  This is often due to pressure from the pregnancy on the lower rib cage towards the end of the pregnancy.  Sore ribs can manifest as either a constant localised ache or it can be sharp catching pain that hurts when breathing.  Certain movements will also cause this pain.

Apart from pain relief during pregnancy, chiropractic manipulation also has the benefit of freeing up restriction in the joints of the pelvis and lower back. This may aid in providing a less stressful delivery as the pelvis is more flexible than it would have been without manipulation.

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Arthritis

Posted by Marc Croker | 0 comments

Most people suffering from back or neck pain are suffering from arthralgia (pain in the joints). Arthralgia is caused by inflammation in these spinal joints. If inflammation remains in a spinal joint over many years it erodes the joint surfaces and results in spinal arthritis (or spinal degeneration). Arthritis literally means “joint inflammation”.

Inflammation in the spinal joints ->  Arthralgia ->  Intermittent back pain + TIME  = ARTHRITIS

Chiropractors identify inflamed spinal joints and endeavor to restore normal function to that segment with the intention of minimising the arthritic process. Arthritis will cause recurring pain and stiffness of that part of the spine.

Spinal arthritis is not reversible. Chiropractic care and a lifetime of healthy living can prevent the arthritic process in the spine.

Many patients of this clinic have come in and told me that they have arthritis and that nothing can be done. This couldn’t be further from the truth. Most people with severe arthritis will not complain of pain at the same level as their arthritis. In fact most of the pain that they suffer from is usually a few vertebral segments away from the degenerated level. The reason for this is that the degenerated level is not moving very much and it passes the strain onto neighboring joints. These joints become inflamed because they are doing more work than they should be. Treatment to the degenerated level will depend upon the severity of the arthritis. If there is only mild to moderate arthritis chiropractic manipulation can restore some movement to the degenerated level thus relieving pain and restoring movement. In severe arthritis the pain is usually coming from a different level of the spine and it is this level that is treated and not the arthritis. The take home message is that you can usually get people out of pain regardless of the amount of arthritis. However the greater the amount of degeneration the greater the time it takes to alleviate the pain.

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Managing Lower Back Pain

Posted by Marc Croker | 0 comments

Back Pain and Arthritis

According to the Australia Bureau of Statistics, in 2004-05, 15% of the population of Australia (almost 3 million people) suffered from back pain. Another 15% of the population reported as suffering from arthritis. The ABS reported that 1 in 3 people complained that arthritis and musculoskeletal conditions was their main disabling condition. In 2001-02, $4.6 billion was spent on these conditions. 49% of people over 65 years of age suffered from athritis – a largely preventable condition. Only 10% of people with arthritis consulted a GP or specialist and only 4% visited another health professional. Non-pathological back pain is a condition that can be treated easily. With our understanding of the cause of back pain there is no reason why anyone should suffer.

Managing Back Pain

• Get treatment immediately.  Pain is your body’s way of telling you that something is wrong. Low back pain will often become a cycle of pain-spasm-pain and so delaying treatment can make the problem worse.
• Use ice. Ice reduces swelling and inflammation which is directly responsible for pain. Heat increases the inflammation process and can prolong recovery.
• Don’t stay in one position for too long.  Avoid resting in bed. Immobility weakens the body tissues and can slow the healing process. Resting is good for pain as long as it is interspersed with periods of gentle movement such as walking.
• Avoid sitting during periods of low back pain.  Sitting puts several times more pressure through the disc than when standing.
• Try to avoid positions where the back is bent forward such as ironing and washing up.
• Dont cough or sneeze when your back is bent forward or turned to one side as this can result in a disc protrusion.
• Sleep on your side and alternate between left and right sides during the night. Sleeping on your stomach or back will only make your back worse.
• Eat plenty of fruits, vegetables, breads and cereals which are high in fibre. This will prevent having to strain when you’re at the toilet.
• Limit the use of pain relieving medication.Use analgesics if the pain is intolerable, but only in the short term. Pain killers only cover up the pain while arthritic change continues. Chiropractic care is the best treatment for pain of mechanical origin.

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Grade IV Spondylolisthesis

Posted by Marc Croker | 0 comments

In March 2010 a 58 year old man presented to this clinic with pain in the left sacro-iliac joint (the left pelvis joint) and pain in the left calf muscle.  He reported suffering with lower back pain intermittently for the last 15 years.  The pain that he felt in the left sacro-iliac joint had been worse for the last two months, there was some pain in the left hip and some tingling in the left calf muscle as well.

When I examined him standing his pelvis was tilted so that the right side was lower than the left.  His lower back looked like it had reversed and was curved backwards rather than forwards.  This man was able to perform all movements without any significant pain but found changing positions difficult.  He reported finding it difficult to roll in bed, get out of bed and get up out of a chair.

The examination took on a really interesting turn when I examined his back while he was lying on his stomach.  For a person that was able to move in all directions without any pain his lower back was very sensitive to touch.  So much so that light pressure resulted in a very sharp sensation of pain and his back was reactively spasming.  Now when people have lower back pain they are often very sensitive to touch but his was very jumpy.  Due to the unusual degree of sensitivity and the reversal of his lumbar curve I sent him off for xrays.

The xrays revealed a Grade IV Spondylolisthesis.  What this means is that the very bottom vertebra just above the tailbone had slipped forward to the point where over 80% of the vertebra was in front of the tailbone below.  This is quite rare and in most people the vertebrae sit precisely on top of each other.  To say that his spine was precariously perched was an understatement.

In this image there are three vertebra that run diagonally down the screen from left to right.  One third up the right side of the image is the tailbone.  This is the bone that should be directly below the other vertebra and should be in the bottom right corner of the image not one third of the way up the picture.

Having made a definite diagnosis of this man’s condition it was time to progress to the treatment.  There is a specific chiropractic adjustment for this condition however the question was would he be able to receive the treatment without aggravating the condition.  There is a specific safety test to make sure that the adjustment is not going to worsen the condition and he passed it so we proceeded to gently adjust him.

After two treatments the patient reported feeling better and after four visits he felt significantly better.  This patient received a total of six treatments and is now symptom free.  His last treatment was two months ago and the symptoms have not returned.  Now to qualify the chiropractic adjustments did not “fix” his back as he will always have a grade IV spondylolisthesis  however the treatment was sufficient to clear out the inflammation that was present and remove his symptoms.  He should now get a chiropractic check up every three to six months to ensure that his symptoms do not return.

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