Headache and Whiplash
A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.
Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.
Neck – Cervical
Your doctor of chiropractic will also do physical and neurological exams. In the physical exam, your doctor will observe your posture, range of motion, and physical condition, noting movement that causes pain. Your doctor will feel your spine, note its curvature and alignment, and feel for muscle spasm. A check of your shoulder area is also in order. During the neurological exam, your doctor will test your reflexes, muscle strength, other nerve changes, and pain spread.
In some instances, your chiropractor might order tests to help diagnose your condition. An x-ray can show narrowed disc space, fractures, bone spurs, or arthritis. A computerized axial tomography scan (a CT or CAT scan) or a magnetic resonance imaging test (an MRI) can show bulging discs and herniations. If nerve damage is suspected, your doctor may order a special test called electromyography (an EMG) to measure how quickly your nerves respond.
Chiropractors are conservative care doctors; our scope of practice does not include the use of drugs or surgery. If your chiropractor diagnoses a condition outside of this conservative scope, such as a neck fracture or an indication of an organic disease, we will refer you to the appropriate medical physician or specialist. We may also ask for permission to inform your family physician of the care you are receiving to ensure that your chiropractic care and medical care are properly coordinated.
A neck adjustment (also known as a cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness.
Of course, your chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilization, massage or rehabilitative exercises, or something else.
Back Pain – Thoracic – Lumbar – Sacrum
Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5
In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research—a federal government research organization—recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6
A patient information article published recently in the Journal of the American Medical Association also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.
Tips to Prevent Back Pain
- Maintain a healthy diet and weight.
- Remain active—under the supervision of your doctor of chiropractic.
- Avoid prolonged inactivity or bed rest.
- Warm up or stretch before exercising or other physical activities, such as gardening.
- Maintain proper posture.
- Wear comfortable, low-heeled shoes.
- Sleep on a mattress of medium firmness to minimize any curve in your spine.
Lift with your knees, keep the object close to your body, and do not twist when lifting.
- Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
- Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.
Shoulder Joint and Rotator Cuff
The rotator cuff, as all doctors of chiropractic know, is actually composed of four separate muscles: the supraspinatus, the infraspinatus, the teres minor and the subscapularis. Most of the approximately 2 million people who seek care for rotator cuff injuries in the United States every year have injured the supraspinatus, but the involvement of at least one of the other muscles is more common than was previously thought, says Dale Huntington, DC, owner of the Huntington Chiropractic Clinic in Springdale, Ark. “We used to think these tears were just in the super-spinatus 90 percent of the time. Now we’re realizing that, in the converging of these tendons, the infraspinatus is often being torn as well.”
And many people, especially athletes, may be walking around with small rotator cuff tears (a full tear usually requires surgery) without realizing it, because they’ve become so used to working or playing through the pain.
There are two main types of soft-tissue injuries: focal lesions and global lesions, according to Michael Schneider, DC, PhD, assistant professor in the University of Pittsburgh’s School of Health and Rehabilitation Sciences and postgraduate faculty member at several prominent chiropractic colleges. Focal lesions are localized to one tissue area. An example of a focal lesion is tennis elbow. “Tennis elbow consists of very discrete pain in a particular area—not the entire arm,” Dr. Schneider explains. There are three types of tissue affected by focal lesions: muscle, tendon and fascia.
Wrist and Carpal Tunnel
CTS typically occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is especially common in assembly-line workers in manufacturing, sewing, finishing, cleaning, meatpacking, and similar industries. Contrary to the conventional wisdom, according to recent research, people who perform data entry at a computer (up to 7 hours a day) are not at increased risk of developing CTS.
CTS is a problem of the median nerve, which runs from the forearm into the hand. CTS occurs when the median nerve gets compressed in the carpal tunnel—a narrow tunnel at the wrist—made up of bones and soft tissues, such as nerves, tendons, ligaments, and blood vessels. The compression may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm. CTS is the most common of the “entrapment neuropathies”—compression or trauma of the body’s nerves in the hands or feet.
Chiropractic joint manipulation and mobilization of the wrist and hand, stretching and strengthening exercises, soft-tissue mobilization techniques, and even yoga can be helpful. Some medications can help with pain control and inflammation. Studies have shown that vitamin B6 supplements may relieve CTS symptoms.
While you may experience pain or injury in a particular area, such as a knee or a hip, the root of the problem may lie somewhere else. Injuries of this nature are not regional, or isolated, but systemic. A problem in the foot or ankle can create an imbalance in every step, leading to discomfort or injury that moves to the knees, hips, low back, or elsewhere. If you suffer from pain beyond typical muscle soreness, your doctor of chiropractic can diagnose and treat your pain or injury and get you back into the swing of your walking routine. Your doctor of chiropractic can also help customize a wellness program that is right for you and has the expertise to help keep you in the mainstream of life.
Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.
Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.
Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.
What are the symptoms of sciatica?
The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.
Some patients also report:
- A pins-and-needles sensation, most often in the toes or foot
- Numbness or muscle weakness in the affected leg or foot
Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.
How is sciatica diagnosed?
Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.
In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.
What are my treatment options?
For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.
Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.
An Ounce of Prevention Is Worth a Pound of Cure
While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.
- Maintain a healthy diet and weight
- Exercise regularly
- Maintain proper posture
- Avoid prolonged inactivity or bed rest
- If you smoke, seek help to quit
- Use good body mechanics when lifting
Shin splints are caused by microfractures on the front surface of the tibia (shin bone). This is most often seen in runners, although other athletes can also be affected.
Ankle sprains are one of the most common ankle injuries. In fact, “in the United States alone, 23,000 people sprain their ankles each day.”1
Athletes, in particular, are susceptible to ankle sprains. A 2007 study published in the Journal of Sports Medicine looked at 43 different sports and found that the ankle sprain was the most frequent injury in 33 of those sports. Additionally, Tom Hyde, DC, DACBSP, CCSP, notes that the anterior talofibular ligament (in the ankle) is the most commonly torn ligament in the body.
What is an ankle sprain?
Sprains occur when a ligament is stretched or torn. Eighty-five percent of all ankle sprains involve ligaments of the lateral ankle, according to John Stites, DC, DACBR, FACO, director of community clinics at Palmer College of Chiropractic. The injury often happens when you make a quick movement with a planted foot—your ankle rolls one direction while your foot turns in the opposite direction.
Dr. Stites explains that sprains can range from mild to severe depending on the damage to the ligaments and how many ligaments are involved. A mild, or Grade 1, sprain occurs when the ligaments are stretched and some of the ligaments’ fibers are damaged. The ankle will be tender and swollen, but it can typically bear weight causing only mild pain. A moderate, or Grade 2, sprain involves some ligamentous tearing and will cause notable swelling and bruising. A severe, or Grade 3, sprain, consists of a complete ligament tear and generally requires a surgical consult. In this case, the ankle will also show signs of instability, bruising and will not be able to bear any weight.
Plantar fasciitis, also called “heel pain syndrome,” affects approximately 2 million people in the United States each year. Plantar fasciitis can come on gradually as the result of a degenerative process or sudden foot trauma. It can appear in one heel or both. It is generally worse on taking the first few steps in the morning or after prolonged sitting or non-weight-bearing movement. Symptoms can be aggravated by activity and prolonged weight bearing. Obesity, too, is hard on the feet—it can cause plantar pain or it can make that pain worse.
The plantar fascia connects the calcaneal tubercle to the forefoot with five slips directed to each toe respectively. Other conditions, such as calcaneal fat pad atrophy, calcaneal stress fracture, nerve entrapment, and rheumatoid arthritis may also cause foot pain. These conditions may be found in combination with plantar fasciitis, or separate from it. A blood test can help pinpoint the cause(s).
Improper footwear can bring about plantar fasciitis. Such footwear may allow excessive pronation or under-pronation, as well as impaired shock absorption. Pronation is part of a normal gait. The ankle rolls slightly inward after heel strike. Then, the ankle rolls outward as you toe-off from that step. Your foot overpronates, however, when it rolls too far inward. That can stress the foot’s soft tissues.
Compensation is a problem with plantar fasciitis. We are “compensating” when we get into the habit of moving the body in a new way to avoid pain. It’s possible to bring on plantar fasciitis as a result of compensating for conditions such as chronic Achilles tendinosis, calf strains, and tibialis posterior dysfunction. On the other hand, persistent pain from plantar fasciitis itself may get you to shift your weight to the outside of the affected foot, or you may try to land on the toes. Any of these pain-avoiding strategies throw the body out of alignment—and can lead to stressed joints and new pain in other parts of the body. Symptoms may increase to the point where you are no longer able to bear weight on the affected foot.
Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.
Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.