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Treatments

Back Clinic Treatments. There are various treatments for all types of injuries and conditions here at Injury Medical & Chiropractic Clinic. The main goal is to correct any misalignments in the spine through manual manipulation and placing misaligned vertebrae back in their proper place. Patients will be given a series of treatments, which are based on the diagnosis. This can include spinal manipulation, as well as other supportive treatments. And as chiropractic treatment has developed, so have its methods and techniques.

Why do chiropractors use one method/technique over another?

A common method of spinal adjustment is the toggle drop method. With this method, a chiropractor crosses their hands and pressed down firmly on an area of the spine. They will then adjust the area with a quick and precise thrust. This method has been used for years and is often used to help increase a patient’s mobility.

Another popular method takes place on a special drop table. The table has different sections, which can be moved up or down based on the body’s position. Patients lie face down on their back or side while the chiropractor applies quick thrusts throughout the spinal area as the table section drops. Many prefer this table adjustment, as this method is lighter and does not include twisting motions used in other methods.

Chiropractors also use specialized tools to assist in their adjustments, i.e., the activator. A chiropractor uses this spring-loaded tool to perform the adjustment/s instead of their hands. Many consider the activator method to be the most gentle of all.

Whichever adjustment method a chiropractor uses, they all offer great benefits to the spine and overall health and wellness. If there is a certain method that is preferred, talk to a chiropractor about it. If they do not perform a certain technique, they may recommend a colleague that does.


Sciatica Motor Vehicle Crash

Sciatica Motor Vehicle Crash

Sciatica motor vehicle crash. After an automobile crash/accident, symptoms of pain and discomfort can immediately follow the force of impact, indicating an injury. Many injuries and symptoms appear right away, like:

  • Pain from high-impact trauma and cuts.
  • Bone fractures.
  • Dislocations.
  • Neck whiplash.
  • Back pain.

The sciatic nerve is the largest in the body, and any damage can cause pain in one or both sides of the body. Pressure and compression on the nerves, ligaments, and muscles accompanied by weakness or numbness in the lower back, legs, or feet could cause delayed sciatica symptoms hours, days, even weeks later. It is critical to meet with a doctor and auto accident chiropractor after any type of accident, large or small, to develop a thorough personalized treatment plan.

Sciatica Motor Vehicle Crash

Sciatica Motor Vehicle Crash

Sciatica can be brought on by a pinched nerve, which is often the result of the spine shifting out of place, causing herniation and compression on the sciatic nerve. The trauma from a motor vehicle accident can cause the spinal discs to be knocked out of place, rupture, and leak out, irritating the surrounding tissue and nerve endings. Back injuries are among the most common forms of damage/injury resulting from a motor vehicle accident/crash that can lead to sciatica. Broken and/or fractured vertebral, hip, or pelvis bone fragments can compress the sciatic nerve. Even when the initial result of the impact does not result in sciatica, over time, an untreated back injury could lead to sciatica symptoms.

Symptoms

Motor vehicle crashes often activate or aggravate pre-existing conditions like asymptomatic degenerative disc disease, affecting the sciatic nerve causing discomfort and pain. Common symptoms include:

  • Mild discomfort or achiness.
  • Tingling sensations from the lower back and down the back of the leg.
  • Weakness, numbness, or difficulty moving the leg and foot.
  • Inability to bend the foot upward at the ankle- known as foot drop.
  • Constant pain in one side of the buttocks or leg.
  • Sharp pain that makes it difficult to stand up and walk
  • Difficulty sitting.
  • Burning or tingling in one leg can worsen when sitting.
  • Intense pain.
  • Sharp burning and/or what feels like shooting electricity pain.

Diagnosis

A spine doctor and chiropractor will use diagnostic imaging tools like X-rays, and CT scans to see the scope of the injured area.

  • An X-ray will show a detailed image of the spine and affected bones in the area.
  • A CT scan will include a 3D image that shows the surrounding musculature, tissues, and nerves that could be damaged/injured.

Treatment

The doctor and chiropractor will then develop an appropriate and personalized treatment plan that could utilize various methods and techniques.

  • Chiropractic is commonly the first treatment to realign the spine and relieve pressure on the nerve.
  • A pain management specialist or physical therapist will be brought in for rehabilitation/recovery as adjustments progress.
  • Orthopedists and neurologists may be brought in for less conservative treatment in more severe cases, including surgical options.
  • Other treatments can include steroid injections or anti-inflammatory medicines to relieve nerve pressure.

Body Composition


Injury Rehabilitation Phase

Current in-clinic methods of measuring the composition of an injured body are indirect, while medically advanced techniques limit the frequency of testing. InBody provides cost-effective, comprehensive, and timely measurements that identify areas of weakness from damage, injury, or recent surgery and develop a customized rehabilitation program to improve functional status.

During the rehabilitation phase, increased sedentary behavior and/or immobilization causes muscle loss in the injured or operated region. By independently evaluating lean mass in each segment of the arms, legs, and torso, a chiropractor or physical therapist gathers baseline information on the body segments with restricted mobility.

InBody can help provide further insight into an individual’s body composition to analyze long-term health risks and develop a personalized exercise intervention to improve overall health and reduce health risks. This provides beneficial information for identifying potential imbalances related to muscle loss post-injury/surgery that can be targeted and improved. Identifying these imbalances allows the therapists to increase functional fitness and mobility, helping the individual reduce the risk of re-injury or new injuries.

References

Defouilloux, B et al. “A propos de trois observations chez des polytraumatisées de la route présentag une fracture du bassin associée à des signes neurologiques” [Apropos of 3 cases of multiple traffic injuries presenting pelvic fractures associated with neurologic signs]. Journal de radiologie, d’electrologie, et de medecine nucleaire vol. 48,8 (1967): 505-6.

Noble, J et al. “Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries.” The Journal of trauma vol. 45,1 (1998): 116-22. doi:10.1097/00005373-199807000-00025

Walsh, K et al. “Risk of low back pain in people admitted to hospital for traffic accidents and falls.” Journal of epidemiology and community health vol. 46,3 (1992): 231-3. doi:10.1136/jech.46.3.231

Sleeping With A Bulging Disc

Sleeping With A Bulging Disc

Sleeping with a bulging disc can be challenging for the body to achieve the proper rest. And sleeping in an awkward position can add stress to the spine, making the bulge worse, which can cause tingling, numbness, pain, and digestive problems. This can disrupt the sleep cycle and prevent proper healing of the spinal injury.

Sleeping With A Bulging Disc

Sleeping With a Bulging Disc

When sleeping, most back pain occurs in the lumbar or lower back, in one of two places where the spine meets the pelvis. Around 95% of lower back herniations happen in the L4-L5 spinal segment or the L5-S1 Lumbosacral joint. Any back pain can turn into a vicious cycle of:

  • Inconsistent sleep
  • Chronic pain
  • Chronic fatigue
  • Irritability
  • Work/School performance
  • Obesity
  • Diabetes
  • High blood pressure
  • Immune system compromisation
  • Mental health problems
  • Depression

Sleeping with a bulging disc requires maintaining the ears, shoulders, and hips aligned to keep the spine aligned.

Sleeping on The Back

Back sleeping done correctly is the best way to sleep for the spine’s health. The important thing is to ensure the entire back is supported when sleeping. If there is a gap or space between the mattress and the back, the weight and gravity force the spine to lower in an unnatural way to fill the space. This can cause back muscle soreness, injury, and sciatica. A thin pillow, blanket, or towel can be used to fill the space, giving the spine the support it needs. Back sleepers can also benefit from a pillow or two under the knees to elevate the legs and help maintain the natural curve of the pine.

Sleeping on The Side

Side sleepers can try pulling the legs up toward the chest, and placing a pillow between the knees can provide relief when sleeping with a bulging disc. Pulling the legs up in the fetal position can relieve pressure on the discs. It is recommended to switch sides to keep the spine balanced. This helps maintain hip alignment, which helps keep the spine in a neutral position.

Sleeping On The Stomach

It is recommended to avoid sleeping on the stomach. This pulls the spine down into an unnatural curve that can cause and exacerbate back pain. For individuals that naturally stomach sleep, it is recommended to place a pillow under the hips and lower abdomen to prevent unnatural spinal positioning.

Chiropractic Relief

Utilizing the right sleeping position can provide pain relief and thorough rest. However, sleeping with a herniated disc is far from what is needed to get back to a normal healthy sleeping pattern. This depends on the location of the bulging disc, severity, and cause. A chiropractor can:

  • Determine the cause.
  • Relieve the pain.
  • Help heal the bulging disc.
  • Realign the spine.
  • Maintain long-term relief without recurrence.
  • Help the individual develop an optimal sleeping routine and positioning.

Body Composition


Sleep and Growth Hormone In Children

Growth, in all ages, is primarily controlled by growth hormone. The hormone is regulated by the hypothalamus and pituitary gland which plays an important role in sleep. Growth hormone has been found:

  • It peaks during the beginning of deep sleep.
  • There are multiple smaller peaks during the other stages of sleep.
  • Those who have a delay at the beginning of deep sleep have delayed rises in growth hormone levels.

For children to grow they need to have proper levels of growth hormone. This means they need to have the proper amount of sleep for proper body composition. Research has found that increased levels of sleep resulted in less overall fat mass and a reduced percentage of body fat allowing their bodies to grow.

References

Al Qaraghli MI, De Jesus O. Lumbar Disc Herniation. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560878/

Desouzart, Gustavo et al. ‘Effects of Sleeping Position on Back Pain in Physically Active Seniors: A Controlled Pilot Study. 1 Jan. 2016: 235 – 240.

Kose, Gulsah et al. “The Effect of Low Back Pain on Daily Activities and Sleep Quality in Patients With Lumbar Disc Herniation: A Pilot Study.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 51,4 (2019): 184-189. doi:10.1097/JNN.0000000000000446

Sener, Sevgi, and Ozkan Guler. “Self-reported data on sleep quality and psychologic characteristics in patients with myofascial pain and disc displacement versus asymptomatic controls.” The International Journal of prosthodontics vol. 25,4 (2012): 348-52.

Cancer Back Pain

Cancer Back Pain

Back pain and soreness are widespread conditions that affect all genders, races, and lifestyles. The causes for back pain are varied from injury, poor posture, arthritis, age, overuse, etc. If back pain is frequent, perhaps the last assumption is that the pain could be caused by cancer. While it’s far from the most common causes, cancer back pain is possible, which makes consulting a doctor that will figure out the root cause, especially if there are other non-related symptoms, and treat the back pain very important.

Cancer Back Pain

Cancer Back Pain

Back pain that could be caused by cancer usually occurs with other symptoms and include:

  • Back pain that is not related to movement.
  • Pain does not get worse with activity.
  • Back pain usually presents at night or early in the morning and fades away or improves as the day progresses.
  • Back pain persists even after physical therapy or other treatments.
  • Changes in bowel movements or blood in urine or stool.
  • Unexplained, sudden weight loss.
  • Unexplained fatigue/exhaustion.
  • Weakness, tingling, or numbness in the arms or legs.
  • Back pain does not have to be severe to be cancer, as it can range in severity.
  • Having a family history of cancer and these symptoms can increase the risk.

Types of Cancer That Can Contribute To Back Pain

Types of cancer that can form around, in, and near the spine can cause back pain. These include:

Spinal Tumor

  • A spinal tumor can grow in the spinal bone or the membranes around the spinal cord.
  • The spine is a common source for bone metastasis, where cancer starts in one location and spreads to others.
  • 30 to 70 percent of individuals with cancer spreads to the spine, according to the American Association of Neurological Surgeons – AANS.

Lung

  • Lung cancer is one of the most common cancers that can spread to the spine.
  • A lung tumor can press on the spine, affecting nerve transmissions.
  • An individual with lung cancer may notice becoming tired/fatigued more easily, shortness of breath, coughing up blood, and back pain.

Breast

  • Rare but possible breast cancer symptom.
  • Breast cancers can metastasize to the back.
  • Like lung cancers, some breast cancer tumors can press on nerves connected to the spine, causing discomfort and pain.

Gastrointestinal

  • Cancers of the stomach, colon, and rectum can cause back pain.
  • The pain radiates from where the cancer is to the back.

Tissue and Blood Cancers

Blood and tissue cancers like:

  • Multiple myeloma
  • Lymphoma
  • Melanoma
  • Can cause back pain.

Diagnosing Cancer and Back Pain

Medical treatments for back pain-related cancer depend on its type and how advanced it is. A doctor will consider symptoms and medical history when diagnosing possible back pain causes. Because cancer is a rare cause of back pain, a doctor may recommend various treatments before a full cancer work-up. The doctor may order imaging studies and blood testing if the pain persists after chiropractic, physical therapy, or anti-inflammatory medications. These tests will help identify potential cancer markers causing back pain.

  • Treatments usually include chemotherapy and radiation to shrink a tumor.
  • A doctor will recommend surgery to remove a tumor.

Chiropractic

Cancer patients have found chiropractic treatment to be effective for:

  • Pain management.
  • Flexibility improvement.
  • Mobility improvement.
  • Strengthening muscles.
  • Helping to reduce stress.
  • Helping the body function more efficiently.

Chiropractic physiotherapy benefits patients undergoing chemotherapy, as it helps the body withstand the debilitating effects of the treatment based on the whole-body approach.


Body Composition


Don’t Hate Dieting

Individuals hate dieting, usually because they go about it the wrong way. Individuals do not need to starve themselves and live at the gym. Reaching quick weight loss goals might sound appealing; however, going through it for an extended time can make individuals feel:

  • Tired
  • Depressed
  • Unmotivated

Individuals can find a nutrition plan/exercise balance that works for them and their lifestyle. For some individuals, dieting alone is effective, but more than likely, they have increased metabolisms. Trying to lose fat by only cutting calories can be difficult for individuals with smaller metabolisms. The goal is to find a balance between diet and exercise. This does not mean having to go on an extreme diet, skip meals, or cut out entire macronutrient groups like fat or carbs, as the body needs both of these nutrients. Finding a sustainable long-term nutrition plan takes planning and support. A dietician, nutritionist, or health coach can offer a variety of nutrition and exercise plans customized to the individual.

References

Downie, Aron et al. “Red flags to screen for malignancy and fracture in patients with low back pain: a systematic review.” BMJ (Clinical research ed.) vol. 347 f7095. 11 Dec. 2013, doi:10.1136/bmj.f7095

Mabry, Lance M et al. “Metastatic cancer mimicking mechanical low back pain: a case report.” The Journal of manual & manipulative therapy vol. 22,3 (2014): 162-9. doi:10.1179/2042618613Y.0000000056

Vasser, Melinda, and Matthew Koroscil. “When Back Pain Turns Deadly: An Unusual Presentation of Lung Cancer.” Respiratory medicine case reports vol. 29 101009. 28 Jan. 2020, doi:10.1016/j.rmcr.2020.101009

Verhagen, Arianne P et al. “Red flags presented in current low back pain guidelines: a review.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,9 (2016): 2788-802. doi:10.1007/s00586-016-4684-0

Sciatic Nerve Injury

Sciatic Nerve Injury

Sciatic nerve injury happens from trauma to the nerve and can cause numbness, tingling, loss of muscle power, and pain. The traumatic experience can be a muscle spasm that pulls and/or pinches the sciatic nerve, force/pressure impact injury, over-stretching injury, or a laceration/cutting injury. A slipped disk, or herniated disk, is the most common cause of irritation on the sciatic nerve. A slipped disk occurs when one becomes slightly dislodged, pushing out from the spine. This places pressure/compression on the sciatic nerve.

Sciatic Nerve Injury

Sciatic Nerve Injury Causes

Trauma

  • Hip dislocation
  • Acetabular fracture
  • Trauma to the lower back, buttocks, or leg from an automobile accident, sports injury, work injury.

Medical treatment causes:

  • Direct surgical trauma.
  • Total hip replacement surgery can cause nerve compression and stretch during the procedure, causing damage to the sciatic nerve resulting in dysfunction.
  • Faulty positioning during anesthesia.
  • Injection of neurotoxic substances.
  • Injection injuries via intramuscular injection in the gluteal region. This is a situation where there is a loss of movement and or lack of sensation at the affected lower extremity with or without pain.
  • Injection palsy can begin suddenly or hours following damage to the sciatic nerve.
  • A misplaced intramuscular injection at the gluteal region is the most common cause of injury. It is attributed to frequent injections or poor techniques resulting from inadequately trained or unqualified staff.
  • Tourniquet-Induced Sciatic Nerve Injury.
  • Dressings that are too tight.
  • Casts that impinge the nerve.
  • Faulty fitting orthotics.
  • Post radiation treatment can cause acute and delayed muscle damage.

Clinical Presentation Symptoms

The common symptoms are pain and abnormal walking gait. Other clinical symptoms include:

Medical History

  • Complaints of radiating pain in the leg, which follows a sensory nerve pattern.
  • Pain radiates below the knee, into the foot.
  • Complaints of low back pain, which is often less severe than leg pain.
  • Report of electrical, burning, numbing sensations.

Diagnosis

A detailed subjective and objective physical examination is necessary to figure out the severity of the sciatic nerve injury. Diagnostic studies include:

  • X rays
  • Electromyography
  • Magnetic Resonance Imaging

Chiropractic and Physical Therapy Management

Conservative treatment is the first-line approach for managing a sciatic nerve injury.

Pain Management

Exercise and Stretches

  • Chiropractic and physical therapy exercises and stretches improve nerve regeneration after nerve damage.

Electrical Muscle Stimulation

  • TENS and Electroacupuncture have been shown to help enhance nerve regrowth.
  • Bio-laser stimulation can help with nerve nutrition and regeneration.

Joint or Soft Tissue mobilization

  • Helps to retain muscle, nerve, and soft tissue flexibility and prevent deformity.

Balance Training

  • Coordination, strength, and flexibility exercises help to restore balance.

Splinting

  • In the early stages after a sciatic nerve injury, bracing may be needed to prevent deformity and new injury or re-injury risks.
  • Ankle Foot Orthosis – AFO can help prevent foot drop, muscle damage, and falls risk.

Body Composition


Optimize Diet for Fat Loss

Individuals that want to lose fat need to create a calorie deficit. Individuals need to consistently eat less than they need for Total Daily Energy Expenditure – TDEE. The safest way to handle a caloric reduction is to reduce calorie intake in small doses like 200-300 calories, for example. After a week or two, perform a body composition analysis. If Fat Mass numbers begin to drop or not, adjust calorie needs accordingly. Restricting calories is the most common way, a deficit can also be created by increasing calorie needs through exercise.

References

Kline, D G et al. “Management and results of sciatic nerve injuries: a 24-year experience.” Journal of neurosurgery vol. 89,1 (1998): 13-23. doi:10.3171/jns.1998.89.1.0013

Schmalzried, TP et al. “Update on nerve palsy associated with total hip replacement.” Clinical Orthopedics and related research,344 (1997): 188-206.

Shim, Ho Yong et al. “Sciatic nerve injury caused by a stretching exercise in a trained dancer.” Annals of rehabilitation medicine vol. 37,6 (2013): 886-90. doi:10.5535/arm.2013.37.6.886

Suszyński, Krzysztof et al. “Physiotherapeutic techniques used in the management of patients with peripheral nerve injuries.” Neural regeneration research vol. 10,11 (2015): 1770-2. doi:10.4103/1673-5374.170299

TMJ: Jaw Disorders

TMJ: Jaw Disorders

The temporomandibular (tem-puh-roe-man-dib-u-lur) joint TMJ acts as a sliding hinge that connects the jawbone to the skull. There is one joint on each side of the jaw. TMJ jaw disorders are also known as temporomandibular disorders – TMD. These disorders affect the connecting point between the jaw and the skull that causes swelling and pain in the joint and the muscles that control movement. The disorder can be caused by a combination of factors, like stress, genetics, arthritis, or injury. The symptoms, pain, and discomfort are often temporary and can be relieved with self-care and nonsurgical treatment like chiropractic.

TMJ: Jaw Disorders

Jaw Disorders

If the jaw is not moving correctly or becomes imbalanced, it can stress the temporomandibular joint. If this happens, the jaw muscles and the neck and shoulder muscles can tense up and over time become fatigued as they overwork to compensate and keep the jaw balanced. The bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disc to maintain smooth movement. Jaw disorders can happen if:

  • The disc erodes or moves out of alignment.
  • The joint’s cartilage is damaged by arthritis.
  • The joint is damaged by impact trauma like hitting the head from a fall or sports accident.
  • Individuals that have been in an automobile accident.

Other factors include:

Symptoms

Symptoms of TMJ vary from case to case. These symptoms might include:

  • Problems with opening or closing the mouth
  • Difficulty or pain while chewing
  • Pain or tenderness of the jaw
  • Pain in one or both of the temporomandibular joints
  • Aching facial pain
  • Neck and shoulder pain
  • Headaches
  • Aching pain in and around the ear
  • Dizziness
  • Locking of the joint
  • Clicking sound
  • Grating sensation

Chiropractic Relief

Chiropractors can help with TMJ by alleviating tension and dysfunction in the shoulder, neck, and jaw. Once the dysfunction is relieved, it reduces the pressure on various nerves. Treatment includes:


Body Composition


The Glycemic Index

Not all carbs are equal, with some having a more significant effect on insulin levels than others. For individuals with diabetes or insulin resistance, this is important. A food’s Glycemic Index – ranging from 0 to 100 – indicates how a particular carbohydrate will affect blood sugar and insulin levels.

  • Foods that digest quickly are high on the index.
  • Foods that digest slowly are lower on the index.

Foods high on the GI scale, include potatoes and white bread, are quickly broken down. This is what happens when going through a sugar rush that comes crashing down minutes later. Foods low on the GI scale, include sweet potatoes and whole oats, are digested gradually. This results in a steady rise in blood sugar levels. The following factors may influence the GI scale:

Food processing

  • The more processed the food, the higher the GI.

Fat and acid content

  • Foods high in fat, acid, or carbs eaten with fat or acid tend to have a lower GI.

Fiber content

  • Fiber slows down the rate of digestion, leading to a gradual, healthy rise in blood sugar levels.

Ripeness

  • Ripened fruits tend to have a higher GI than unripened fruit.
References

Alcantara, Joel et al. “Chiropractic care of a patient with temporomandibular disorder and atlas subluxation.” Journal of manipulative and physiological therapeutics vol. 25,1 (2002): 63-70. doi:10.1067/mmt.2002.120415

DeVocht, James W et al. “A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder.” Journal of the American Dental Association (1939) vol. 144,10 (2013): 1154-63. doi:10.14219/jada.archive.2013.0034

Pavia, Steven et al. “Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series.” Journal of chiropractic medicine vol. 14,4 (2015): 279-84. doi:10.1016/j.jcm.2015.08.005

Rubis, Lisa M et al. “A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report.” Journal of chiropractic medicine vol. 13,1 (2014): 55-61. doi:10.1016/j.jcm.2013.10.003

Musculoskeletal Disorders

Musculoskeletal Disorders

Musculoskeletal Disorders, or MSDs, are injuries, conditions, and disorders that affect the body’s musculoskeletal system. It includes the muscles, tendons, ligaments, nerves, discs, blood vessels, bones, and joints. MSDs are common, and the risk of developing them increases with age. The severity of an MSD can vary. They cause discomfort, recurrent pain, stiffness, swelling, and aching that interfere with everyday activities. Early diagnosis and treatment can alleviate symptoms and improve long-term health. Common disorders include:

  • Tendonitis
  • Tendon Strain
  • Epicondylitis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Radial Tunnel Syndrome
  • DeQuervain’s Syndrome
  • Rotator Cuff Tendonitis
  • Muscle strain
  • Ligament Sprain
  • Rheumatoid arthritis – RA
  • Osteoarthritis
  • Tension Neck Syndrome
  • Thoracic Outlet Compression
  • Mechanical Back Syndrome
  • Degenerative Disc Disease
  • Ruptured Disc
  • Herniated Disc
  • Fibromyalgia
  • Digital Neuritis
  • Bone Fractures

Musculoskeletal Disorders

Musculoskeletal Disorders Discomfort and Pain

The term musculoskeletal disorder is used as it accurately describes the injury or condition. Other terms used are repetitive motion injury, repetitive stress injury, and overuse injury. When individuals are exposed to MSD risk factors, they begin to fatigue. This can start a musculoskeletal imbalance. With time, fatigue completely overtakes recovery/healing, and the musculoskeletal imbalance continues, a musculoskeletal disorder develops. The risk factors are broken into two categories: work-related/ergonomic risk factors and individual-related risk factors.

Ergonomic Factors:

  • Force
  • Repetition
  • Posture

High Task Repetition

  • Many work tasks and cycles are repetitive and are typically controlled by hourly or daily production targets and work processes.
  • High task repetition combined with other risks factors like high force and/or awkward postures can contribute to the formation of MSD.
  • A job is considered highly repetitive if the cycle time is 30 seconds or less.

Forceful Exertions

  • Many job tasks require high force loads on the body.
  • Muscle effort increases in response to high force requirements. This increases associated fatigue.

Repetitive or Sustained Awkward Postures

  • Awkward postures place excessive force on joints, overload the muscles and tendons around affected joints.
  • The joints of the body are most efficient when they operate close to the mid-range motion of the joint.
  • The risk of MSD is increased when the joints are worked outside of this mid-range repetitively for sustained periods without a proper amount of recovery time.

Individual Factors

  • Unhealthy work practices
  • Lack of physical activity/fitness
  • Unhealthy habits
  • Poor diet

Unhealthy Work Practices

  • Individuals that engage in poor work practices, body mechanics, and lifting techniques are introducing unnecessary risk factors.
  • These poor practices create unnecessary stress on the body that increases fatigue and decreases the body’s ability to recover properly.

Poor Health Habits

  • Individuals who smoke, drink excessively, are obese, or exhibit numerous other poor health habits put themselves at risk for musculoskeletal disorders and other chronic diseases.

Insufficient Rest and Recovery

  • Individuals that do not get adequate rest and recovery put themselves at higher risk.
  • MSDs develop when fatigue outruns the individual’s recovery system, causing a musculoskeletal imbalance.

Poor Diet, Fitness, and Hydration

  • Individuals who eat unhealthily are dehydrated, at a poor level of physical fitness, and do not take care of their bodies are putting themselves at a higher risk of developing musculoskeletal and chronic health problems.

Causes

The causes of musculoskeletal disorders are varied. Muscle tissue can be damaged with the wear and tear of daily work, school, and physical activities. Trauma to the body can come from:

  • Postural strain
  • Repetitive movements
  • Overuse
  • Prolonged immobilization
  • Jerking movements
  • Sprains
  • Dislocations
  • Falling injuries
  • Auto accident injuries
  • Fractures
  • Direct trauma to the muscle/s

Poor body mechanics can cause spinal alignment problems and muscle shortening, causing other muscles to be strained, causing problems and pain.

Treatment Rehabilitation

A doctor will recommend a treatment plan based on the diagnosis and severity of the symptoms. They may recommend moderate exercise and over-the-counter medications like ibuprofen or acetaminophen to address occasional discomfort or pain. They often recommend chiropractic and physical therapy rehabilitation to learn how to manage pain and discomfort, maintain strength, range of motion, and adjust everyday activities. Different types of manual therapy, or mobilization, can treat body alignment problems. A doctor may prescribe medications like nonsteroidal anti-inflammatories NSAIDs to reduce inflammation and pain for more severe symptoms. For individuals with musculoskeletal disorders like fibromyalgia, medications to increase the body’s level of serotonin and norepinephrine may be prescribed in low doses to modulate sleep, pain, and immune system function.


Body Composition


Types of Pain

Pain can be grouped into three categories:

Early Warning Pain

  • This is most recognizable after having just touched a pan, and the hand jerks away before realizing how hot the pan is, also known as the withdrawal reflex.
  • This is a protective mechanism that helps avoid danger and is vital for survival.

Inflammatory Pain

  • This type of pain happens after an injury or surgery while the body is healing and recovering.
  • Inflammation prevents the body from performing movements to prevent and avoid re-injury.

Pathological Pain

  • This type of pain can happen after the body has healed, but the nervous system has been damaged.
  • This is often the case with individuals who sustain an injury and inform doctors that the injured area is never the same.
  • If the rehabilitation does not correctly heal the nervous system, protective pain measures can generate a false alarm causing pain signals to fire off.
References

Asada, Fuminari, and Kenichiro Takano. Nihon eiseigaku zasshi. Japanese journal of hygiene vol. 71,2 (2016): 111-8. doi:10.1265/jjh.71.111

da Costa, Bruno R, and Edgar Ramos Vieira. “Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies.” American journal of industrial medicine vol. 53,3 (2010): 285-323. doi:10.1002/ajim.20750

Malińska, Marzena. “Dolegliwości układu mięśniowo-szkieletowego u operatorów komputerowych” [Musculoskeletal disorders among computer operators]. Medycyna pracy vol. 70,4 (2019): 511-521. doi:10.13075/mp.5893.00810

Musculoskeletal system diseases. (n.d.). dmu.edu/medterms/musculoskeletal-system/musculoskeletal-system-diseases/

Roquelaure, Yves et al. “Troubles musculo-squelettiques liés au travail” [Work-related musculoskeletal disorders]. La Revue du praticien vol. 68,1 (2018): 84-90.

Villa-Forte A. (n.d.). Diagnosis of musculoskeletal disorders. merckmanuals.com/home/bone,-joint,-and-muscle-disorders/diagnosis-of-musculoskeletal-disorders/introduction

Work-related musculoskeletal disorders (WMSDs). (2014). ccohs.ca/oshanswers/diseases/rmirsi.html

Planks For Spine Support and Back Pain Prevention

Planks For Spine Support and Back Pain Prevention

Regularly doing planks can support/strengthen the spine and prevent back pain no matter the fitness level. It’s estimated that 70% of adults will experience back problems and pain. One of the best ways to keep the spine healthy is by strengthening the core muscles. The more these muscles are built up, the healthier the body will become. The plank position activates the entire core taking the pressure off of the spine.

Planks For Spine Support and Back Pain Prevention

Core Anatomy

The core is the center of the body. It contains all the muscles surrounding the torso. These muscles work together to:

  • Stabilize the body during movement.
  • Prevent injury when engaged in physical activity/exercise.
  • Provide spinal support.

The core is split into two groups of muscles: The inner core and the outer core.

Inner Core

The inner core consists of:

Multifidus Muscles

Quadratus Lumborum

  • The deep abdominal muscle in the lower back sits on either side of the lumbar region of the spine.

Transversus Abdominis

  • Located between the lower ribs and the top of the pelvis.

Pelvic Floor

  • This base group of muscles stretches from the tailbone to the pubic bone.

Diaphragm

  • A dome-shaped muscle that rests below the lungs.

Outer Core

Rectus Abdominis

  • These are more commonly known as the abs.

External Obliques

  • These muscles are located on either side of the rectus abdominis.

Internal Obliques

  • These muscles are located below the external obliques, inside the hip bones.

Erector Spinae

  • These muscles surround the spine and extend up both sides of the vertebral column.

Planks and Back Pain Prevention

When the core is not strong enough, the spine and back muscles overcompensate to keep the body standing correctly. Studies have shown how planks effectively activate the muscles responsible for spinal stabilization. The exercise targets the entirety of the core and strengthens the shoulders and glutes. Strengthening these muscles improves posture, helping to alleviate back problems and pain. However, it’s recommended to talk to a doctor before beginning a plank regimen if back pain is present. If done incorrectly, they could aggravate the back muscles.

Proper Form

Choose an area clear of furniture where the whole body can stretch out. Follow these steps:

  • Begin with hands and knees on the floor.
  • Extend the legs back while keeping the elbows directly below the shoulders and the wrists below the elbows.
  • Keep the head down, looking at the space just above the hands.
  • Engage the abs and keep the body rigid.
  • Imagine a perfectly straight line from the neck to the toes.
  • Hold the position for 10 to 60 seconds, depending on fitness level.
  • Lower the body gently to the floor.
  • Make sure not to curve the back as curving means that the abdominal muscles are being engaged, and tilting the head up can strain the neck.
  • Both can lead to injury, which is why maintaining proper form is essential.

Plank Variations

There are variations of this exercise for different levels of physical fitness. Once the modified and full plank has been mastered, various planks can target other areas of the body. These include:

Side Plank

  • These involve shifting the weight to one forearm while extending the other arm into the air.

One-arm Plank

  • These involve lifting one hand off the ground, then alternating.

Single-leg Plank

Walking Plank

Reverse Plank

Anybody can work up to a plank at any age at any fitness level; it just takes time. Once achieved, it is a great way to keep the body’s core strong, healthy and helps prevent back problems.


Body Composition


Band Lateral Raise

The lateral band raise is an excellent workout for the shoulders. It works out the lateral deltoid, anterior deltoid, and serratus anterior.

  • Grasp one band in one hand.
  • Step on the free end with the opposite foot.
  • Right hand and left foot and vice versa.
  • Slowly extend and raise the arm until they are parallel to the floor.
  • Lower the arms in the same manner.
  • If the shoulders are healthy and strong enough, try adding dumbbells or kettlebells to increase the resistance.
References

Calatayud, Joaquín et al. “Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain.” International journal of environmental research and public health vol. 16,19 3509. 20 Sep. 2019, doi:10.3390/ijerph16193509

World Health Organization. (2013) “Low back pain.” www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf

Youdas, James W et al. “Magnitudes of muscle activation of spine stabilizers in healthy adults during prone on elbow planking exercises with and without a fitness ball.” Physiotherapy Theory and practice vol. 34,3 (2018): 212-222. doi:10.1080/09593985.2017.1377792