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  • Chiropractic is a safe, conservative approach to managing neuromusculoskeletal conditions and the symptoms resulting from mechanical dysfunction of the spine, muscles and joints. Chiropractic employs manual treatments, including spinal manipulation, mobilization, soft tissue therapy, rehabilitation through exercise, and other conservative techniques.

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PrevalencePrevalence

Over 10 million people a day are experiencing low back pain in North America. Chiropractic care is effective.

SafetySafety

Cervical (neck) manipulation is safe, effective and appropriate for the treatment of acute and chronic neck pain.

HeadachesHeadaches

Chiropractic care is effective in treating migraines, tension-type headaches, and cervicogenic headaches.

OrthoticsOrthotics

Suffer from recurrent foot, ankle, knee, hip or back pain? Ask if custom orthotics are right for you.

Author Archives: Bigness

Snow, Shovelling and Back Pain

The frigid temperatures have hit Windsor, Ontario. Along with weather-related joint and muscle stiffness comes the physical demand of shovelling the new fallen snow. Every year I see an influx of Chiropractic clinic traffic due to shovelling-related injuries. The Ontario Chiropractic Association is working to create informative posts regarding common, preventable injuries.

Please review the “Lift Light To Shovel Right” link if you plan on participating in any manual snow removal this season. It is easy to let bad habits result in pain and discomfort. I speak from experience!

http://www.chiropractic.on.ca/lift-light-to-shovel-right-your-back-health#.VNJLV1XF92c

Be well,

Dr. Andy

 

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Is It Really "Sciatica"?

sciaticaPatients often present to the clinic and report that their “sciatica is acting up”,  or they are experiencing back and buttock pain and refer to it as “sciatica”. Is it really “sciatica”?

I suppose it depends on how you define the term “sciatica”.  Many health practitioners throw the term around carelessly, which leads to clinical confusion.

It’s important to note that “sciatica” is a description of pain, not a diagnosis.  So, in this sense my patients are usually correct in the description of their pain.  This is a good place to start when assessing these complaints.

According to Mayoclinic.org, a top Google search result for “sciatica definition”, “Sciatica refers to pain that radiates along the path of the sciatic nerve — which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body”.

Therefore, in order to be experiencing a true sciatica you would expect that the cause of the pain is something that is affecting the sciatic nerve – such as a disc herniation, spinal stenosis, piriformis syndrome or advanced spondylolisthesis.  These conditions all have one thing in common – compression, irritation, or traction of the sciatic nerve or the nerve roots that eventually form the sciatic nerve.  This presentation is also known as “radicular pain” or a “radiculopathy”.  Pain can be intense, deep, and is often described as electric or burning.  The pain can often be traced with a pen along the path of the sciatic nerve, and it may be associated with other neurological signs and symptoms – such as numbness, tingling, muscle weakness, and loss of deep tendon reflexes.

Does that mean that all pain referring from the back to the leg is “sciatica”?  No!  There is what is known as “referred pain”, or pain caused by “sclerotogenous referral”.  What’s the difference?  The short answer is that tissues (bone, muscle, skin, connective tissue) that share the same embryonic cell lineage have the ability to share pain with one another because they all share one common nerve supply.  Therefore, “referred pain” from the back to a leg is NOT the result of compression, traction, or irritation of the sciatic nerve.  Referred pain is often described as dull, achy, and diffuse or hard to localize.  The pain does NOT follow the path of a nerve root (dermatome) and typically does not go beyond the knee.  For example, an inflamed lumbar facet joint may refer pain to your buttocks.  By definition this is not sciatica.  An irritated sacroiliac joint may refer pain to your lateral thigh.  By definition this is not sciatica.

So, is any of this important or is Dr. Bigness just hung-up on semantics?  Yes, it IS important!  There are many different causes of pain travelling into your leg.  It is paramount that you are given the correct diagnosis so that the correct management or treatment can be applied.  Treatment for a disc herniation causing “radicular pain” or “sciatica” will be different than the treatment for sacroiliac joint irritation causing “referred pain” to the leg.

The take away message here is to always have your complaints assessed properly to determine the cause of your symptoms.  If a health professional tells you that you “have sciatica” without a physical assessment there is a chance you are being mismanaged.  A thorough history and physical examination can determine if you are really experiencing a condition causing sciatica.

Keep well until next time!

 

Dr. Andrew R. Bigness, B.Sc., D.C.

Genesis Health Centre

Cabana Court Chiropractic

Windsor, Ontario

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Acute Strain vs. DOMS

runblogPatients regularly ask me about the difference between a strain and delayed onset muscle soreness. (DOMS)

At times I have patients presenting to me with DOMS that they have mistaken for an acute strain. In today’s post I will explain the differences between acute strains and delayed onset muscle soreness.

Delayed Onset Muscle Soreness (DOMS)
DOMS is the stiffness and discomfort felt in a muscle typically 24-72 hours after strenuous exercise or change in physical routine, such as gardening or home renovation. The pain is caused by microtrauma to the muscle fibres after repetitive muscle lengthening under load, such as a negative repetition during a weight lifting exercise. Muscle lengthening or stretching will recreate the pain, however, there should be little to no pain while at rest. DOMS, although uncomfortable, usually resolves on its own within five days. Treatment is not necessary, however, if management is desired there is some evidence to suggest that increasing the blood flow to the area via light exercise, hot packs, massage or sauna may help speed up the recovery.

Acute Strain
Acutes strains are damage to muscle or tendons caused by a sudden lengthening of the tissue. The tissue may or may not be under load at the time of the injury. Pain and stiffness is usually felt instantly or shortly after the incident. Examples include pain in the hamstring while attempting a hurdle, or lower back pain while lifting a couch. The extent of tissue damage is greater than that resulting in DOMS, and depending on the degree of strain there may be some associated bruising. There may be pain at rest, however, any general use of the injured muscle will recreate the symptoms. The natural history (general recovery time) of an acute strain is typically 6-8 weeks. These injuries should be assessed by a musculoskeletal professional before treated. Rest, ice, compression and elevation are usually prescribed, however, mobilization may be required in order to establish functional scar tissue. Muscle rehabilitation or reconditioning may also be required. Consult your physician if you are considering the use of pain killers or non-steriodal anti-inflammatories.

So, next time you experience muscle pain or stiffness please consider the onset of the symptoms. Did the pain and stiffness start the next day and intensify the following day? If yes, then you are likely experiencing DOMS. Consider light exercise, massage, hot packs or sauna for relief. Did the pain start during or shortly after the activity? If yes, then you have likely strained something. Consult your chiropractor, physical therapist or physician for management.

Keep well until next time!

Dr. Andrew R. Bigness, B.Sc., D.C.
Genesis Health Centre
Cabana Court Chiropractic
Windsor, Ontario

 

 

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