Many of us experience back and neck pain. But when is it the right time to see a chiropractor for a diagnosis or treatment? And can they really help? The answer is yes.
Chiropractors have been around for a hundred years, and are licensed doctors who are required to pass a series of four national board exams and are regulated by state licensing boards. They are medical professionals who diagnose and treat musculoskeletal and nervous system disorders.
A chiropractor can use many different techniques to relieve pain, including applied pressure, massage, and hands-on manipulation (adjustment) of the vertebrae and joints. They may also order X-rays, MRI studies, and lab work. Chiropractors don�t prescribe medications, but they do recommend such things as therapeutic and rehabilitative exercises and nutritional and lifestyle counseling to help the body heal itself.
Chiropractors believe one of the main causes of back or neck pain is subluxation. Subluxation occurs when your vertebrae become misaligned. Treating subluxations can help to alleviate pain associated with a myriad of conditions, including:
headaches
sciatica
trauma, such as whiplash
scoliosis
leg pain
sports injuries
bursitis and tendonitis
fibromyalgia
spinal arthritis (spondylosis)
Sometimes chiropractic care (eg, an adjustment) can cause mild soreness or aching but that usually resolves itself within 12 to 48 hours.
Chiropractic Tests
When you visit your chiropractor for the first time, he/she will probably ask you to perform a series of simple tests to evaluate your posture and range of motion. You may be asked to bend forward,� backward or side-to-side. The chiropractor will also check the way you walk and how your posture looks sitting down and standing up.� Other tests may include:
Piriformis Test: The patient flexes and bends the knee while lying down.
Straight Leg Raise: One leg at a time is raised in a locked-knee position to check the sciatic nerve and flexibility of the hamstring muscle.
Measuring the length of each leg helps determine if there is a discrepancy in leg length or if the pelvis is out of balance.
Hand strength (grip)
Evaluation of reflexes and muscle testing
Sometimes you might hear a pop while the chiropractor is testing or adjusting you, which is perfectly normal. This is caused by small pockets of air or bubbles in the fluid that surrounds your joints. When joint tissues are stretched, those pockets of air �pop,� which creates the cracking sound you hear.
Diagnosis
Once the chiropractor identifies the problem, he/she can recommend treatment options, and explain how many chiropractic visits are necessary to reach an expected outcome (eg, resolution of pain). He/she may also suggest improvements to your diet and lifestyle, such as quitting smoking or increasing/modifying certain activities. A chiropractor may also recommend certain types of exercises in conjunction with chiropractic treatment to stretch and/or strengthen the back and neck.
Adjustment Techniques
A chiropractor is educated in dozens of ways to treat pain. Here is a sampling of the different techniques that may be used.
Toggle Drop � The chiropractor presses down firmly on a particular area of the spine followed by a quick and precise thrust.
Lumbar Roll � With the patient on his/her side, a quick thrust is applied to the misaligned vertebrae.
Release Work � The chiropractor uses gentle pressure with the fingertips to separate the vertebrae.
TENS (Transcutaneous electrical stimulation) � This device sends stimulating pulses across the surface of the skin and nerve strands to block pain signals along the nerves and release endorphins which are natural painkillers.
Cold/Heat Treatment � Chiropractors may alternate between ice and heat therapy to treat back or neck pain. Ice packs are used to reduce inflammation (swelling) for 15 minutes at a time. A heating pad (or other heat source) helps increase circulation and may promote faster healing.
Table Adjustments � The patient lies on a special table with a �drop piece� then a quick thrust is applied when the table drops.
Instrument Adjustments � Instead of hands-on manipulation, the patient lies on the table face down while the chiropractor uses a spring-loaded activator instrument to perform the adjustment.
Manipulation Under Anesthesia � This is performed by chiropractors certified in this technique. The treatment is performed in a hospital outpatient setting.
Keep in mind that chiropractic care is not a cure-all for your back and neck pain! However, it is considered by many to be a safe and effective way to help relieve pain and improve spinal function. Many physicians and surgeons recommend chiropractic care to their patients.
What Is Neck Pain (Cervical Pain)?� The cervical spine is a marvelous and complex structure. It is capable of supporting a head weighing 15 or more pounds while moving in several directions. No other region of the spine has such freedom of movement. This combination however, complexity and mobility, make the neck susceptible to pain and injury.
Quick Cervical Spine Anatomy Lesson
This complex structure includes 7 small vertebrae, intervertebral discs to absorb shock, joints, the spinal cord, 8 nerve roots, vascular elements, 32 muscles, and ligaments.
The nerve roots stem from the spinal cord like tree branches through foramen in the vertebrae. Each nerve root transmits signals (nerve impulses) to and from the brain, shoulders, arms, and chest. A vascular system of 4 arteries and veins run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.
Neck mobility is matchless. It is capable of moving the head in many directions: 90� of flexion (forward motion), 90� of extension (backward motion), 180� of rotation (side to side), and almost 120� of tilt to either shoulder.
Neck Pain Causes
The causes of neck pain are as varied as the list is long. Consider a few examples:
Injury and Accidents: Whiplash is a common injury sustained during an auto accident. This is typically termed a hyperextension and/or hyperflexion injury because the head is forced to move backward and/or forward rapidly beyond the neck’s normal range of motion. The unnatural and forceful movement affects the muscles and ligaments in the neck. Muscles react by tightening and contracting creating muscle fatigue resulting in pain and stiffness.
Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease are known to affect the spine.
Osteoarthritis is a common joint disorder causing progressive deterioration of cartilage. The body reacts by forming new bone termed osteophytes (bone spurs) that impact joint motion.
Spinal stenosis causes the foramen, small neural passageways, to narrow possibly compressing and entrapping nerve roots. Stenosis may cause neck, shoulder, and arm pain and numbness when these nerves are unable to function normally.
Degenerative disc disease (DDD) can cause the intervertebral discs to become less hydrated, resulting in decreased disc elasticity and height. Over time, a disc may bulge or herniate causing upper extremity pain, tingling, and numbness.
Everyday Life: Poor posture, obesity, and weak abdominal muscles disrupt the spine’s balance often causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract resulting in pain and stiffness.
Other Disease Processes: Although neck pain is commonly caused by strain, prolonged pain and/or neurologic deficit may be an indication of something more serious. These symptoms should not be ignored. Spinal infection, spinal cord compression, tumor, fracture, and other disorders can occur. If head injury has been sustained, more than likely the neck has been affected too. It is wise to seek medical attention promptly.
Neck Pain Diagnosis: Figuring Out What is Causing Your Pain
Obtaining a proper diagnosis is paramount to determine the best course of treatment for neck pain. You have to know what spinal condition is causing your neck pain before you can know how to treat it.
The physician will take the your medical history. The oral segment of the examination often includes many questions such as:
When did the pain start?
What activities preceded the pain?
What have you tried to relieve the neck pain?
Does the pain radiate or travel into other body parts?
What makes the pain less or greater?
A physical examination includes observing the your posture, range of motion, and physical condition. Any movement generating pain is carefully noted. The physician will palpate or feel the curvature of the spine, vertebral alignment, and detect muscle spasm.
The neurological examination tests the patient’s reflexes, muscle strength, sensory and/or motor changes, and pain distribution.
Radiographic studies may be ordered. An x-ray can reveal narrowing of disc space, fracture, osteophyte formation, and osteoarthritis. Bulging discs and herniations, often responsible for neurologic symptoms, are detected using MRI.
If nerve damage is suspected, the physician may order a special test to measure how quickly nerves conduct impulses. These tests are termed nerve conduction studies and/or electromyography. Typically these studies are not performed immediately because it may take several weeks for nerve impairment to become apparent.
Common Questions About Neck Pain
I woke up with neck pain. What can I do?
Daily life (and night life) can take its toll on your neck. You may have slept wrong last night, causing your neck muscles to tighten. The best thing to do is give your body time to heal on its own. To get through the day without letting the pain interfere with your normal activities, you have a few options.
Gently stretch your neck.
Take over-the-counter pain medications, such as Tylenol or Advil.
Alternate between heat and ice treatments on your neck: 20 minutes of heat followed by 20 minutes of ice should help the pain and the healing process.
Will I need surgery?
Most patients with neck pain respond well to non-surgical treatments (such as medication), so cervical spine surgery is seldom needed to treat it. In fact, less than 5% of neck pain patients need surgery. However, there are situations when you may want to go ahead with spine surgery.
Non-surgical treatment is not helping�that is, you’ve tried a combination of chiropractic care, physical therapy, medication, massage, exercises, and more, and you’re still in pain.
You experience progressive neurological symptoms (numbness, tingling, weakness) involving your arms and legs.
You’re having trouble with balance or walking.
You are otherwise in good health.
Generally, surgery is done for degenerative disc disease, trauma, or spinal instability. These conditions may put pressure on your spinal cord or on the nerves coming from the spine.
Typically, surgeons use 2 surgical techniques for cervical spine surgery.
Decompression, where they remove tissue pressing against a nerve structure
Stabilization, where they work to limit motion between vertebrae
There are different types of decompression procedures such as discectomy, corpectomy, and TransCorporeal MicroDecompression (TCMD).
Discectomy: The surgeon removes all or part of a damaged disc.
Corpectomy: The vertebral body is removed to access whatever is compressing the spinal cord or nerve.
TransCorporeal MicroDecompression (TCMD): The surgeon accesses the cervical spine from the front of the neck. TCMD is performed through a small channel made in the vertebral body to access and decompress the spinal cord and nerve.
Your surgeon will determine what’s best for your condition.
Stabilization surgery is sometimes�but not always�done at the same time as a decompression surgery. In some forms of decompression surgery, the surgeon may need to remove a large portion of the vertebra or vertebrae. That results in an unstable spine, meaning that it moves in abnormal ways, and that puts you more at risk for serious neurological injury. In that case, the surgeon will restabilize the spine. Commonly, this is done with a fusion and spinal instrumentation, or implantation of an artificial disc.
Some patients are at high-risk for poor bone healing or unsuccessful fusion. Smoking and diabetes are two of several risk factors that impede bone healing and fusion. A bone growth stimulator may be recommended and prescribed for patients with certain risk factors.
What are some non-surgical options for treating my neck pain?
Less than 5% of neck pain patients will need surgery, and there are a lot of options for you to try before surgery.
Sciatica specifically refers to pain, weakness, numbness, or tingling in the leg, along the distribution of the the sciatic nerve down the back of the leg. Most commonly however, people will refer to any condition that causes back pain in association with leg symptoms as sciatica.
Common Causes:
True sciatica occurs when there is pressure on, or damage to, the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. This nerve controls the muscles of the back of the knee and lower leg and provides senation to the back of the thigh, part of the lower leg and the sole of the foot.
As previously mentioned, the term “sciatica” is often used by patients to describe any condition where there is back pain together with associated leg symptoms. This being the case, there are a number of other conditions that will actually mimic sciatic nerve pain. Sacroiliac joint irritation (sacroiliac joint syndrome), lumbar facet joint irritation (lumbar facet joint syndrome), and piriformis syndrome all frequently produce leg symptoms, and are therefore commonly mistaken for sciatica.
Common Symptoms:
Sciatica pain can vary widely. It may feel like a mild tingling, a dull ache, or even a burning sensation, while in other cases, the pain can be servere enough to make movement practically impossible. Most commonly, sciatica effects only one leg.
Treatment:
Treatment begins with first determining whether a patient is suffering from true sciatic nerve involvement, or if they are actually suffering from one of the other conditions that frequently mimics sciatica. From there treatment is directed towards reducing inflammation, pain, and spasm, while restoring movement and function to the effected spinal levels. Once normal spinal mechanics are restored, patients are given a simple home exercise program in order to help maintain normal function and to help prevent re-occurances.
What is sciatic nerve pain? Sciatic nerve pain is one of the most tough [ https://www.youtube.com/watch?v=FUcGA-BvmIQ dolore sciatica] problems for physicians, also those experienced in treating back pain as well as sciatica patients, to determine as well as treat. Sciatica usually presents itself as a prickling and/or numbness, like the sensation one may experience with a pulled hamstring muscle mass, the biceps femoris at the back of the leg. The experience could be plain, almost an ache, with durations of prickling and/or tingling happening throughout specific activities. The prickling and/or numbness experienced, if not dealt with, may develop into a full-on constantly [ https://www.youtube.com/watch?v=SrFQWAtJtZU click resources] severe phase with discomfort capturing throughout the butts and also radiating down the leg. Sciatic nerve pain might influence one or both legs, typically one, starting as a pain radiating from some point in the lower back, the lumbar spine, after that throughout the gluteal muscle mass (the buttocks), as well as ultimately down the rear of the leg. In innovative instances, sciatic nerve pain gets to right right into the feet as well as toes, triggering discomfort as well as an eventual loss of feeling.
Remarkably, sciatica is not a details condition, it is just a catch-all clinical term put on a constellation of symptoms in order to explain a state the back pain victim remains in. In this instance, sciatic nerve pain is utilized to define a patient’s complaint of pain radiating across the butts, down the leg, and also right into the feet and toes … along with the connected tingling and/or feeling numb. Sciatica could be brought on by a variety of conditions, from stress and anxiety and trauma at a particular area on the spinal column, the reduced back or back curvature, to a much more general condition such as obesity or pregnancy. There are a number of other problems associated with sciatica, all needing varying degrees of clinical intervention and also treatment. A few of the conditions likely to present with sciatica are:
1. Osteomyelitis: An infection of the bone or bone marrow. Osteomyelitis might be debilitating and also in severe cases may also create death. It is tough to identify as well as might go undetected for a long period of time unless appropriate blood examinations are purchased and also the doctor is well trained in contagious diseases influencing the bones.
2. Growths on or near the spine: Lumps, particularly tumors or abnormal growth (e.g., scar tissue) affecting the nerves or nerve roots as they exit the spinal canal and intervertebral foramen, will certainly sciatic nerve pain or sciatic nerve pain.
3. Degenerative Disc Disease: Again, degenerative disc condition is not an illness anymore than sciatic nerve pain, called sciatica, is a specific problem. Degenerative disc condition is a break down of the IVDs, the intervertebral discs, and also is generally an effect old combined with the any or every one of the 5 primary elements influencing the spine as we age.
o Excess weight and/or obesity
o Muscle weakness
o Muscle Imbalance
o Poor nourishment and also diet plan
o Poor hydration or dehydration
4. Herniated (i.e., burst) or protruding disc: This problem might be particularly bothersome if the herniated disc or bulging disc is extending posteriorly (to the back) and right into the spine canal, or impinging on the nerve origin at the intervertebral foramen, hence putting pressure on the spine and/or nerve root; and, sciatica is the result in lots of instances.
Rheumatoid arthritis is the most prominent autoimmune arthritis. It is caused by a defective immune system that causes your defense system to target your joint linings. It affects the wrist and small joints of your hands, including the knuckles, other joints in your fingers and can eventually spread to your knees too.
It is considered one of the most disabling forms of arthritis as it affects both sides of the body, making it different from other forms of arthritis. It can also affect skin, eyes, lungs, heart, blood and even your nerves which is why it is one of the most feared forms of arthritis.
Over the years, several ways of treating rheumatoid arthritis have been discovered. Although there is still no cure for the condition, the treatment can significantly heal those that are newly diagnosed and can slow down the process that in the patients that have been suffering from the condition for a while.
When your immune system attacks your own body, certain chemicals lead to pain and inflammation on your joints. Medical experts are still unclear about what is the exact cause of inflammation in joints. Some suggest that is due to genetic make-up of the individual while other blame environmental factors such as cigarette smoke and infections.
New treatments have been introduced by rheumatologists to suppress the pain and reduce the inflammation caused by this condition. A major reason for why the inflammation needs to be controlled is because of its effect on your heart health. Inflammation can lead to the buildup of plaque in the walls of your arteries. People with this form of arthritis are advised to consult with their doctors regarding the prevention of heart disease.
Other than medication, regular exercise, specific foods and drinks also help you treat rheumatoid arthritis.
A Virginia-based rheumatologist, Mahsa Tehrani has found that certain organic teas help with the reducing of inflammation caused by rheumatoid arthritis.
�Tea has fantastic�anti-inflammatory properties�which can theoretically help with the underlying inflammation,� she claims.
Here�s a list of teas Tehrani recommends:
Ginger Tea
Ginger tea is known for helping with healing the digestive system but an Italian study in 2016 found that patients that were given regular doses of ginger reported a better quality of life and significant improvement in pain. To make the tea, just slice up some ginger root and let it steep in boiling water for 10minutes. Note that ginger can act as a blood thinner, so if you�re already on blood-thinning medication, opt for a different tea.
Green Tea
Amongst the many benefits of green tea, is its ability to block the effects of RA without impacting cellular function. According to medical experts, green tea can be considered an alternative to medicine in the future for those suffering from RA.
Rose Hip Tea
Rose hip tea is not as common as other teas. The rose hip is the fruit of the rose plant that appears when the plant is not flowering. The fruit is a concentrated source of vitamin C and is regularly used in home remedies. A study published in Australian Family Physician in July 2012 found that the composition of nutrients found in the rose-hips have anti-inflammatory properties which benefit those with arthritis.
Black Tea
The box of regular black tea bags is loaded with quercetin, a bioflavonoid which has anti-inflammatory effects. However excessive amounts of black tea can have adverse effects, the high caffeine content can leave you feeling jittery and can reduce the impact of medication.
Willow Bark Tea
Willow bark tea is an ancient Chinese remedy. Its effects are similar to those of aspirin and several medical studies have found that it helps with joint pain and osteoarthritis. The study revealed that willow bark extracts have anti-inflammatory and pain-killing effects. That being said, willow bark extracts should not be consumed with people on many medications, pregnant women and those younger than 16.
Nettle Leaf Tea
Nettle leaf has been used in Europe to relieve muscle, joint pain, and arthritis for many years. A study published in 2015 found the antioxidant activity in the nettle leaf extracts hinders one of the main enzymes responsible for inflammation. Nettle is easily available in most grocery stores. Pregnant women and those with kidney and bladder issues should are advised not to consume nettle.
Rheumatoid Arthritis may be the most disabling forms of arthritis and it may not be curable, however, early detection and proper treatment can help mitigate its effects. Medication significantly reduces the symptoms of RA but those suffering can look for alternative solutions as well.
About the Author:
Rachael Everly is an undergraduate student who loves to write on the topics related business, finance, health, lifestyle and education. Follow @Rachael Everly for further updates.
Let�s chat about chiropractic and pregnancy. For those of you that didn�t read my last post, What I Wish I Would�ve Known the First Time Around, I am the daughter of a chiropractor. My dad, Dr. Robert J. Natusch, Jr, DC, recently retired after near 40 years with offices in Northern New Jersey. My brother and sister-in-law are both licensed chiropractors at their family owned and operated practice, Upper Valley Chiropractic in Lebanon, New Hampshire (you can find them on Facebook).
Chiropractic � a Lifestyle of Health
My two siblings and I grew up vaccine-free, drug-free, and antibiotic-free. We never took over-the-counter pain meds or pills, even for headaches. If we had an issue, my dad would give us an adjustment and my mom gave us an herbal or holistic remedy and sent us on our way. To me, that was normal!
I was born at home. Those in attendance for my birth aside from my mom and dad? My older brother (21 months older) and my aunt, to tend to my brother while my mom and dad labored with me. I was mere minutes old when I received my first adjustment. It was our way of life and continues to be for my husband, our two sons, and I. It is our weekly preventative healthcare maintenance. Dr. John Tenpenny is our �primary� care doctor and if you�re in Florida, I highly recommend him.
Why the Two Go Together
Since you�re reading this, I�m guessing you�re curious how chiropractic care and pregnancy can be in the same sentence. Some feel those two are taboo and many were shocked when I told them I�d continue to see my chiropractor weekly through my 9 months of pregnancy. The gasps came when I told them my chiropractor adjusted me while I was in labor with my childrenand he came to my house again after my children were born to give them their first adjustments, too! I�m sure I�m a smidge biased, but thankfully, this has become much more mainstream. And personally, I feel moms and babes are all the better for it!
I don�t have many official references for this post, except what I�ve heard my dad repeat in his lectures my entire life.
�It is vital for moms to get adjusted through their pregnancy and beyond. Since you�re gradually adding weight to your abdomen, that causes lower back stress. Your whole posture and skeletal structure slowly alters for the duration of the pregnancy. This can amplify current misalignments.�
But, let�s get a little more in depth as to why this is important while you�re growing another human being inside you.
(Please remember, I am not a licensed chiropractor. This post is not intended to diagnose, cure, or treat any disease or health concern. This information is for educational purposes only.)
This image shows a few vertebrae within your spine. The vertebrae are your bones. The blue and red slivers are your sponge-like discs that cushion your vertebrae so your bones don�t rub on each other and cause pain. The yellow parts are the nerves nestled safely in between your vertebrae which send and receive signals to and from your brain to your organs. When that perfect structure is altered by things like bad posture, carrying your baby on your hip, sleeping on a pillow, crossing your legs, tripping, falling, carrying a purse on one shoulder, car accidents, sports, etc., etc. those messages are not able to be sent or received properly. It�s like a garden hose with the water on full blast, but there�s a kink in the line. The water won�t be at its fullest potential because there is a blockage.�
That�s the red nerve and disc within this picture. The organs which are connected to that nerve are not sending and receiving the complete message to and from the brain because the vertebra is putting pressure (a kink) in that nerve. That causes pain which may even be felt elsewhere in the body and not felt within the spine. You may treat the symptom of pain unsuccessfully until you get to the source which lies within the spine.
Just think for a moment, does that nerve have anything to do with the organ that helps grow your baby? Maybe it�s the one that represents your uterus. If left unadjusted, your body is not able to operate to its fullest potential and ability when growing your little one. Messages are not being sent or received fully. The consequences of not rectifying the issue may not reveal itself until delivery!
A simple adjustment (or series of adjustments depending on the severity and years of your life without chiropractic care) can aid in rectifying the issue and allowing your body to operate at its fullest potential and health while growing your baby.
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How The Pelvis Benefits From Chiropractic
Let�s take a moment to look at how God designed our birthing pelvis.
Our pelvis is designed with a cartilage substance to connect our pubic (pubis) bone. During pregnancy, labor, and birth, the body sends signals to control that cartilage. When it softens, it�s time for the baby to soon make his arrival! If there is a communication kink somewhere within the spine, those signals would not be clearly communicated. You�d be so much better off addressing the misalignment (know as a subluxation) now � well before delivery day � so your body can relax in its designed location.
When people ask me if it�s safe to be adjusted during pregnancy, the analogy of the kinked water hose comes to mind. Our female bodies are created and designed to grow and carry a baby. A chiropractor�s job is to keep my spine in the correct alignment so my body can function to its fullest potential. During the most spine-altering 9 months in my life, I would never think to neglect my weekly chiropractic adjustments! That�s like deciding to stay home from the grocery store when you need food.
Every parent can say they only want the best, optimal health for their child once they are born. Being under a chiropractor�s care allows you the ability to give your child the best, optimal health while they are in your womb.
Though the most visible kinesiology tape users might be professional athletes, Olympians, or weekend warriors � a much smaller clientele is also proving the advantages of this unique treatment. With a special line designed for sensitive skin and playful prints and colors that will speak to the sticker and Band-Aid loving child, it�s not surprising that kinesiology tape is quickly becoming more than an athlete�s aid.
While the uses and applications of kinesiology tape for pediatric treatment are growing daily, here is a quick run down of how kinesiology tape is being used in pediatric care today:
Pain &�Swelling Relief
� When kinesiology tape is applied to an injured or inflamed area, children can enjoy some relief without having to take pain medication or sit through icing and therapy treatments.
Orthopedic Treatment
� Children often don�t understand the purpose behind rehabilitation exercises, so kinesiology tape provides an additional or alternative treatment for children with orthopedic injuries, weak or underdeveloped muscles, gait abnormalities, paralysis � even poor posture.
Neuromuscular Disorders
� Kinesiology tape has proven effective to activate weak muscles and inhibit overactive muscles.� With a simple and safe taping application, children suffering from neuromuscular conditions like cerebral palsy, or muscular dystrophy could see improvements in symptoms and movement ability. It has also been shown to improve muscle tone in genetic disorders like Downs Syndrome and other conditions causing either spasticity, atrophy or poor muscle tone.
For children dealing with serious medical conditions, a colorful and painless treatment that can be worn for several days, even while playing and bathing, can make a big difference in their comfort level.
Interested in learning more about pediatric kinesiology taping? Dr. Kenzo Kaze, the creator of Kinesio Tape, provides step by step guidelines for taping infants and children in his manual, Kinesio Taping in Pediatrics available at Theratape.com.
For a list of successful case studies where kinesiology tape has provided improvement for children, check out Theratape�s research compilation as well as this case report (pdf) from Novel Physiotherapies. Hopefully, as more and more case studies document positive results, the use of kinesiology tape in pediatric care will continue to expand and increase.
Perhaps you bent the wrong way while lifting something heavy. Or you�re dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they�ve had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.
Sometimes, it�s clearly serious: You were injured, or you feel numbness, weakness, or tingling in the legs. Call the doctor, of course. But for routine and mild low back pain, here are a few simple tips to try at home.
Chill It
Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. �Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes,� she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice � take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
Keep Moving
�Our spines are like the rest of our body � they�re meant to move,� says Reicherter. Keep doing your daily activities. Make the beds, go to work, walk the dog. Once you�re feeling better, regular aerobic exercises like swimming, bicycling, and walking can keep you � and your back � more mobile. Just don�t overdo it. There�s no need to run a marathon when your back is sore.
Stay Strong
Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. �They help you maintain the proper posture and alignment of your spine,� Reicherter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.
Stretch
Don�t sit slumped in your desk chair all day. Get up every 20 minutes or so and stretch the other way. �Because most of us spend a lot of time bending forward in our jobs, it�s important to stand up and stretch backward throughout the day,� Reicherter says. Don�t forget to also stretch your legs. Some people find relief from their back pain by doing a regular stretching routine, like yoga.
Think Ergonomically
Design your workspace so you don�t have to hunch forward to see your computer monitor or reach way out for your mouse. Use a desk chair that supports your lower back and allows you to keep your feet planted firmly on the floor.
Watch Your Posture
Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.
Wear Low Heels
Exchange your four-inch pumps for flats or low heels (less than 1 inch). High heels may create a more unstable posture, and increase pressure on your lower spine.
These could be signs that you have a nerve problem or another underlying medical condition that needs to be treated.
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Are Functional Orthotics Part of Your Wellness Protocol?
Most Chiropractors advertise pain relief without drugs and care for injuries. Recently, some doctors and practices have begun labeling and promoting themselves as Wellness Centers. A wellness practice is focused on both maintaining a pre-existing level of musculoskeletal balance and postural health and preventing conditions that might alter this state of health. The challenge is, how can healthy patients be protected from problems that might arise in the future? The answer is simple: custom-made orthotics. Custom orthotics may be traditionally seen as a preventative measure, but so are most treatments of old. They are the perfect, foundational support your patients will never want to go without.
Wellness is a great concept�one of those �win-win� situations for doctor and patient. Orthotics are the perfect way to implement this concept and help establish a �preventative� approach, in addition to the traditional reactive ones, if need be. Let�s take at a look at the foundation of the body, and see just how useful they can be.
Look To The Feet
The feet are the foundation of the body. By age 40, nearly everyone has a foot condition of�some sort, many of which eventually contributing to health concerns farther up the Kinetic Chain (Figure 1). Therefore, it�s in the best interest of healthy patients to be offered a wellness program which stresses preventative care for normal, healthy feet, in order to prevent foot problems from occurring later in life.
�Pictured above, patient with severe bunions, or Hallux Valgus.
Figure 1. While 99% of all feet are normal at birth, 8% develop troubles by the first year of age, 41% at age 5, and 80% by age 20 (Fig. 1).�By age 40, nearly everyone has a foot condition of some sort.
How Can Orthotics Help?
Patients who participate in Chiropractic wellness programs can benefit from custom-made orthotics nearly as much as patients who seek Chiropractic care for musculoskeletal injuries and conditions. Foot Levelers� custom orthotics have been shown to effectively support the pedal foundation for both categories of patients, and can prevent problems well into the future with static and dynamic support.
Static support.Static support. A 1999 study using radiographic measurements found that custom-made, flexible orthotics can significantly improve the alignment of the arches when standing.2 In the wellness-practice concept of orthotic use, custom-made, flexible orthotics can be used to maintain a properly functioning arch alignment.
Dynamic support. During gait, the foot undergoes substantial changes and must permit a smooth transfer of the body�s center of mass over the leg in order to conserve energy and keep the work expenditure to a minimum.3 This requires a flexible, yet supportive orthotic that accommodates varying weights and forces and allows proper movement and function of the foot, while supporting all three arches�in order to prevent eventual arch collapse.
Postural benefits. Since the entire body structure is balanced on one foot at a time when walking and running, improving foot alignment can help maintain knee, hip, pelvic and even spinal postural alignment,4 and prevent joint degeneration (of the hip, knee, or spinal joints). A pelvic or spinal tilt or recurrent subluxations will often respond rapidly to orthotic support of the arches in the feet.
Orthotics For Everyone
Custom-made, flexible orthotics have long been recognized as a valid adjunct to Chiropractic care for many musculoskeletal conditions. In the wellness model of Chiropractic care, Foot Levelers� custom-made, flexible orthotics (Fig. 2) can be utilized as a preventative modality for the preservation of optimal arch support and the postponement or prevention of joint imbalances in later years. Therefore, orthotics are appropriate for virtually all Chiropractic patients.
If you want to reduce the number of opioid prescriptions and pills being used, and potentially misused, you need alternative pain management. And chiropractors say that�s what they�ve been providing for decades.
�It gives people options, and that�s probably the most important thing right now is to give people options for treatment,� Dr. Mark Stagnone, president of the New Hampshire Chiropractic Association said.
At its annual meeting, the association is pointing to a trio of recent studies showing that chiropractic care cuts down on the use of opiate pain medicines.
In one of the studies, a former Dartmouth doctor analyzed 33,000 cases of lower back pain in a New Hampshire database.
�His preliminary research is indicating that there�s about a 56-57 percent reduction in opioid use when chiropractic care has been utilized in a patients treatment,� Stagnone said.
James Vara, the governor�s adviser on addiction and behavorial health, said the state needs more alternative pain management.
�It becomes a question of what insurance covers it and how long they cover it for, and that�s certainly something I�ve looked at and will continue to,� said Vara.
The Current Insurance Model Puts Patients On A Path To Prescription Drugs
�The problem that it produces is that the average individual who�s trying to treat a condition is faced with paying a high co-pay to visit a chiropractor or paying a considerably lower one to see a primary care physician,� Stagnone said.
Changing that dynamic will require legislation that has failed in the past. But chiropractors said in this ongoing addiction crisis, it�s time for adjustment.
Chiropractic care is covered under the New Hampshire Health Protection program, or expanded Medicaid. And if the program lapses, so does that coverage.
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Painkillers Sometimes Increase Chronic Pain
We’re facing an opioid addiction crisis in America. Opioid (narcotic) pain medications killed an estimated 14,000 people in the U.S. in 2014 through overdose. A further 14,000 people overdosed on heroin, another opioid that many people turn to when they can’t access prescription painkillers.
This epidemic is why physicians and pharmacists are increasingly raising the bar on who can receive opioid medications, how much, and for how long. It’s not just the addiction risk that calls for caution when using opioids to treat chronic pain though�long-term use of opioids can actually make pain worse.
Becoming addicted to pain medication is a disease. This is because these painkillers (oxycodone, hydrocodone, methadone, fentanyl) cause a change in your brain chemistry that is not under your control.
Most people who take opioids for more than 2 to 4 weeks will develop a tolerance to the medication. Tolerance means your body may need an increased dosage to feel the same effect. Opioid tolerance can cause withdrawal symptoms when the medication is stopped. This is a natural process, and it is not to be confused with addiction.
In his recent blog on the subject, Dr. Ullrich explains: “Pain medication addiction is a more complicated process. It involves manipulative behavior to obtain narcotic medications and a refusal to discontinue a medication even though it is no longer being used for a medical purpose. Some, including those at significant risk of overdosing, will go to multiple doctors to get medications.”
For those who are addicted to opioid medications, a detoxification program is often needed. Painkiller addiction is a chemical, physical disease, one that requires expert medical treatment in a safe, humane environment.
Most people know that painkillers can be addictive, but they don’t know that taking opioids over a long period of time may in fact increase a patient’s sensitivity to pain (hyperalgesia). This happens because long-term use of opiate painkillers causes a decrease in your ability to tolerate pain and an increase in sensitivity to pain. In fact, people taking opioids long term may keep having pain, or may see their pain increase, long after the original cause of pain has healed.
Stopping opioid use can solve this problem�but it may not seem as if the pain is gone at first, because the discomfort of withdrawal can mimic the original pain. Dependency is not easy to deal with, but it shouldn’t be an excuse to stay on the opioid medication and raise the risk for addiction. This is why physicians are encouraged to only prescribe opioids for short durations and be cautious when using them to treat chronic pain.
Since long-term use of opioid painkillers is a risky option for controlling chronic pain, patients are often advised to focus on other safe, proven methods for managing chronic pain, such as:
Exercise to maintain motion and release endorphins
Cognitive therapy to develop coping techniques
Relaxation and meditation techniques to distract the brain from pain
Six Things Every Chiropractor Should Know About Opioids
Men health concept. Portrait of 50s mature Asian man reading the label on bottle medicine, sitting on sofa at home.
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
1. What Are Opioids?
Opioid medications are prescribed to reduce pain; however, they are addictive and can be dangerous. Although some suggest there is �no safe dose� for opioids, these drugs may be helpful for people with severe pain, such as those experiencing pain from cancer. However, over the past several decades, more patients have been prescribed opioids for musculoskeletal pain, such as back or neck pain, instead of being provided with nondrug therapies.
As with any drug, opioids have side effects and may �adversely affect respiratory, gastrointestinal, musculoskeletal, cardiovascular, immune, endocrine, and central nervous systems.�1 �As the dose increases, the risks for overdose and health concerns also increase, including �fractures, addiction, intestinal blockages, and sedation.�1 If too high a dose is consumed or if opioids are taken with certain other drugs or alcohol, death may result.
2. Why Is Opioid Use / Overuse Problematic?
Since 1999, prescription opioid sales have increased fourfold, along with a surge in the use of opioids as a first line for pain management, rather than only for severe cancer-related pain. This trend has led to burgeoning opioid prescribing in the U.S.:2
? One in five people with non-cancer pain have been prescribed opioids.
? More than 165,000 prescription opioid-related deaths occurred between 1999 and 2014.
? An estimated 2 million people were addicted to opioids as of 2014.
3. Who Is Addressing This Health Crisis?
Currently, many professions are seeking ways to address this national epidemic. The medical profession has launched various initiatives to help medical doctors (MDs) reduce prescriptions. These include an initiative to remove pain as the 5th�vital sign, and promoting guidelines for when to prescribe and how to better manage patients in pain without the use of opioids.
The Centers for Disease Control and Prevention (CDC) has�released guidelines�to curb opioid prescriptions, with the following categories of recommendations to those who prescribe opioids: 1) determine when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, discontinuation, and assessing risk; and 3) addressing harms of opioid use.
In addition to these efforts, even more focus is needed to assist people who seek help for pain and to provide them with nonpharmacological alternatives.
4. What Can Doctors of Chiropractic Do?
Chiropractic care can be part of the solution. DCs can work with other health care providers and support policy to offer alternatives to opioids for addressing patients in pain, especially chronic non-cancer pain.
Although there are no large trials comparing outcomes of chiropractic care to opioids, we do know opioid use is associated with worse functioning in back pain patients at six-month follow-up3 �and greater disability;4 �and that injured workers whose first health care visit is to a DC have better outcomes.5 �We also know that the per-capita supply of DCs and higher use of manipulative therapy is associated with lower rates of opioid prescriptions among Medicare recipients.6
All this suggests chiropractic care may help reduce the use of and need for opioid prescriptions for back pain sufferers; and may play an important role in reducing the opioid epidemic by helping to prevent patients from ever getting an opioid prescription in the first place.
Important resources DCs should be aware of include:
? Chiropractic: A Safer Strategy Than Opioids:�www.f4cp. com/f4cp_opioid_white_paper.pdf
? Centers for Disease Control and Prevention (CDC): Opioid Overdose:�www.cdc.gov/drugoverdose/ Six Things Every Chiropractor Should Know About Opioids By Claire Johnson, DC, MSEd, PhD, Bart N. Green, DC, MSEd, PhD and Michael Haneline, DC, MPH Reprinted with permission from Dynamic Chiropractic, Sept. 1, 2016, Vol. 34, Issue 15 (www.dynamicchiropractic.com/digital/index.php?i=1220&r=t#19)
5. What Can We Do If a Patient Is Already Taking Opioids?
Most chiropractors take a history and ask patients what medications they are taking. The first step is to recognize that the following are opioid-class drugs: hydrocodone (Vicodin), ultram (Tramadol), oxycodone (OxyContin, Percocet), morphine (Kadian, Avinza) and codeine.7
Once we know a patient is taking opioids, we must first seek to understand the situation before we provide education.
Questions we can ask include:
? For what condition is the patient taking the medication?
? How long has the patient been taking opioids and at what daily dose?
? Who is the provider watching over their prescription? Is more than one provider prescribing opioids?
? When was the last time the patient saw the prescribing physician and when is the next appointment?
? Does the patient have any safety issues? For example, does the patient operate machinery? Is the patient experiencing side effects such as �sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, or respiratory depression�?8
? What is the patient�s level of function? Are there any psychological flags or addictive behaviors?
? Is the patient taking any other substances or drugs that may have deadly interactions, such as alcohol, benzodiazepines and/or other opioids?
As chiropractors, we can discuss treatment goals, such as reasonable functional activity; and pain goals with and without medication. We also can discuss potential adverse events, including the risks for side effects, addiction and death.
We can inform patients of other dangers they may not be aware of, such as the deadly combination of opioids when combined with other drugs that depress CNS activity (e.g., alcohol or drugs for anxiety such as benzodiazepines). We can encourage patients to contact the prescribing provider to discuss reducing and stopping opioid use, and to ask for safer alternatives for pain control, such as chiropractic care, physical therapy, acupuncture and mind-body methods. If a patient is already addicted, we can encourage the patient to seek a specialist provider and addiction care program. (Note that some patients may need to remain on opioids, such as for cancer pain or end-of-life care.)
Most importantly, we can work with the patient and their prescribing provider to offer them nonpharmacological care to help reduce their pain and help them reach their functional goals.
6. How Can We Collaborate More on Solutions?
As DCs, we can work more closely with local MDs and discuss better ways to collaborate concerning patients with pain. Remember that MDs are not the enemy, but are an essential component of the solution to this epidemic. Most MDs are also extremely concerned about the opioid epidemic, and are looking for efficient and cost-effective ways of helping their patients. We should remain professional when speaking about MDs with our patients, as our patients likely have good relations with them.
We can be part of the safety net to help reduce the number of people who become addicted or die from overdose. As we work with other health care professionals and our patients, we can remind them that the first recommendation per the CDC�s�Guideline for Prescribing Opioids for Chronic Pain�is �Nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred for chronic pain.�9 �Thus, through collaboration, the chiropractic profession can be a part of the solution.
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Static support.Static support. A 1999 study using radiographic measurements found that custom-made, flexible orthotics can significantly improve the alignment of the arches when standing.2 In the wellness-practice concept of orthotic use, custom-made, flexible orthotics can be used to maintain a properly functioning arch alignment.
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