Articles in Category: Chiropractic

Correct Sleeping Posture

on Thursday, 31 March 2016. Posted in Chiropractic

Correct Sleeping Posture

By Jakob van Vlijmen

M Chiro, DC

 

As people spend almost one third of their life being asleep, it’s not strange that we get a lot of questions regarding sleep in our practice. More and more people realise that correct sleeping posture and the right mattress are vital for feeling refreshed in the morning. And what is more if done incorrectly; sleeping can be a tremendous strain on your neck and back! The following article will tell you what to look out for and should give you the tools to be able to make sure your sleep is as revitalising as possible.

 

The correct sleeping posture allows for the spine's natural curvature to be maintained. To help explain this we have to look at the spine's anatomy. As some of you may know, the spine is built up of 24 vertebras, a sacrum and a coccyx. The spinal column has a typical S shape with a concave cervical and lumbar curve and a convex thoracic and sacral curve.

 

 upper-extrimities-and-spine-injuries-60-638

During the day the spine is under a lot of stress especially when, during our activities, we are unable to maintain the natural curves of our spine. As discussed in previous articles, correct posture during sitting and lifting is very important to prevent excessive loading of our spines. (For more information on how to sit or lift correctly visit our YouTube channel: https://www.youtube.com/user/sportsandspines) More and more people are becoming aware of this, which is great, however they do not seem to realise the same principles apply at night. An incorrect posture can cause incorrect and excessive loading of our joints. The following pictures should help explain what certain sleeping postures do to your spine.

 

Sleeping on your stomach

Sleeping on your stomach is bad for your spine as the neck is stressed by having it fully rotated and the lower back's curvature is increased causing more load on the lower back. (Image 2)

 

sleeping2 

Even without a pillow the amount of cervical rotation necessary for this position can cause or perpetuate neck pain or headaches. Trying to change your sleeping position can be difficult, but there are some tricks we can teach you to help facilitate your change over to a healthier sleeping position. Ask your chiropractor about this if you want to learn more.

 

Sleeping on your back

When you lie on your back the weight is distributed equally over a large area, this is why this position is deemed best for you. It is important however, that when you lie down on your back you are able to maintain the natural S shape of your spine. At times it is possible that the curvature in the lower back is not sufficiently supported, usually this is the case if the matrass is too hard. To prevent injury and maintain the natural curvature, you can put a pillow or towel underneath your lower back to support it. Another way of de-loading the lower back is sleeping with slightly bent knees by placing the pillow underneath your legs as shown in image 3.

 

sleeping3 

 

When you sleep on your back you need a good pillow to support your head and neck. The height of the pillow is dependent on the curvature of your neck. The pillow needs to support the neck in such a way that the concavity is completely filled up otherwise this may cause a deviation from the necks natural curvature (see image 4). When you sleep on your back, a fairly flat pillow will suffice, however when you sleep on your sides you will need a slightly fatter pillow.

 

sleeping4a  sleeping4b  sleeping4c


Image 4a: pillow is to high                Image 4b: pillow is to low                Image 4c: correct pillow height

 

A pillow that is too hard can cause issues as well as it can create too much pressure on the back of the head. A softer pillow can be more supportive of both neck and head and therefore more suitable, ask your chiropractor if the pillow you are currently using is right for you.

 

Sleeping on your side

Sleeping on your side is a very suitable position, provided you are sleeping on the right pillow and mattress. When lying on your side the neck can tilt sideways due to the width of the shoulders. This is why it is important to have a pillow that is the right size so the head and neck are properly supported. Use one pillow that has the correct height (see image 5) and try avoiding folding a thin pillow up or using 2 stacked pillows.


sleeping5a  sleeping5b  sleeping5c

 

Image 5a: pillow is to low                 Image 5b: pillow is to high             Image 5b: pillow is the correct thickness

 

Orthopaedic Pillows

There are different types of pillows and the ones gaining popularity right now are the orthopaedic ones. We also stock these at IOSAS as they are shaped to perfectly fill up the area underneath your neck and head when you sleep on your side. What is very important when you buy a pillow like this is that you buy the correct size as it is intended to fill up that space and support your neck and head in such a way that your spine is able to remain straight.

 

Mattress

Buying the correct mattress is very important, sadly there is no such thing as the perfect mattress as each one has their pros and cons. And some of these considerations are purely personal. A mattress, depending on the quality, should last about 10 years. The weight of the body distributed differently across the mattress, as you are lying on your side there will be different forces acting upon the hips than on the neck or chest. If the mattress is too soft, too much pressure can be exerting on the spine and it can sink through, as a hammock does (see image 6a). This can lead to neck or back injuries. A mattress that is too hard firstly doesn't provide enough comfort but can also cause neck and back injuries (image 6b). The drawback from sleeping on your side is that the bodies’ contours play a big part; the pressure is higher in areas where the body is wider. In places where the body is narrower it needs more support from the mattress. There are mattresses that are able to give varying degrees of support to keep the spine straight.


sleeping6a  sleeping6b  sleeping6c


Image 6a: Mattress too soft              Image 6b: Mattress too hard      Image 6c: Mattress has correct firmness

 

Lying on your side, on a good mattress with the arms besides the pillow and the legs tucked in slightly with a pillow in between the knees is the sleeping position that causes the least load on the spine and neck (see image 7)

 

sleeping7

 

If you are wondering if your pillow or mattress is right for you, ask your chiropractor about it during your next visit. If you can, bring in your pillow for them to have a look at and ask the team at IOSAS about the mattresses and pillows we sell.

Dizziness: What are the causes and when can Chiropractic help?

on Wednesday, 11 November 2015. Posted in General Health, Chiropractic

Dizziness: What are the causes and when can Chiropractic help?

By Jakob van Vlijmen

M Chiro, DC

 

There are very few complaints as difficult as dizziness. Even though most types of dizziness do not have a sinister cause, they can lead to certain risks. As you can all imagine, being in a car or on the top of a flight of stairs are dangerous places to become dizzy. The following article will discuss the different causes of dizziness, the different ways it can present and when a visit to the chiropractor can be helpful.

 

Light headed or vertigo?

Dizziness is used to indicate a sense of instability, movement insecurity or light headedness. The term vertigo indicates a sense of spinning or whirling when the patient isn't actually moving. Light headedness is usually caused by low blood pressure, especially when it comes on after getting up too quickly. Low blood sugar however can also be a cause. If you experience these kinds of dizziness on a regular basis it might be a good idea for you to discuss this with your GP.

 

The 3 systems involved in processing movement information.

To be able to explain the different causes of dizziness we will have to discuss some of the mechanisms responsible for our sense of balance, the ability to register movement and our sense of positioning. These are the 3 different systems we need to discuss:

The Eyes - Among other things we use horizontal and vertical lines within our surroundings to determine our position and register movement.

 

The Organs of Balance - Situated deep within the ear. These organs are specialised in registering movement, acceleration and the position of the head.

 

Proprioception - This is information concerning the position of joints, the length of muscles and the force exerted by muscles.

 

By gathering and analysing the information from these systems numerous of times per second our brains can determine if anything or anyone is moving, what needs to be done to achieve movement and if we are in a balanced position.

 

Perfect collaboration between the 3 systems is required.

It is important to realise that these 3 systems have to work together in sync to prevent problems occurring. For example, when you turn your head to the left, the balance organs in your left ear is moving backward relatively speaking and the one in the right ear is moving forward. At the same time the position of several neck vertebra change, certain muscles are active in order for you to perform the movement and the eyes are registering the change in your surroundings. As long as all the information that your brain receives aligns with each other things will go smoothly, but if there is a discrepancy in the signals the brain receives it can lead to dizziness.

 

Different types of dizziness.

With the use of this background information a lot of common causes of dizziness can be explained.

 

Labyrinthitis (inflammation of the balance organ) With Labyrinthitis one or both of the balance organs becomes inflamed, most often this is caused by a virus infection. The afflicted organ is sending abnormal or incorrect information to the brain that doesn’t correspond with the other balance organ and other systems. This cause’s severe acute dizziness often accompanied with nausea and vomiting, sometimes the patient also experiences deafness or tinnitus. The symptoms can be so severe that the patient becomes bed ridden as every movement aggravates the symptoms. No real effective treatment exists but luckily most symptoms subside after a few days, although full recovery can take several weeks.

 

Meniere’s disease is an affliction of the inner ear, in which both the hearing organ and the balancing organ are affected. Meniere’s disease causes dizziness, tinnitus and deafness. These symptoms can come in waves and can persist for any length of time from a few hours to days. In some cases the deafness can be permanent. Meniere is usually treated with medications, but the success the medication has varies greatly case to case.

 

Benign Paroxysmal Positional vertigo (BPPV) The balancing organ registers the position and movement of the head with the use of 5 fluid filled canals. Movement of the head causes these fluids to move which is registered by little hairs within the canals. BPPV occurs when tiny particles break loose and fall into the canals stimulating the nerves that detect head rotation. The brain receives the message that the head is spinning when this isn’t the case. BPPV usually comes on after a fast head movement and disappears after 15 to 30 seconds. BPPV usually comes on at a later stage in life after an ear infection or bump to the head. Your chiropractor will be able to determine if the dizziness that you are experiencing is indeed BPPV by taking a full history of your complaint and performing several tests. If you indeed have BPPV it can usually be treated successfully within 2 to 3 treatments. During these treatments your chiropractor will be moving the head in a very specific manner in an attempt to relocate the particles that have broken off. Of all forms of vertigo BPPV is probably the most easily treated.

 

Cervicogenic dizziness is dizziness cause by problems in the joints or muscles in the neck. As explained earlier the brain also uses the information from muscles and joints (proprioception). Injuries or movement difficulties to the neck can cause dizziness for that reason. A good example is dizziness as a consequence to a whiplash caused by a car accident. This kind of dizziness is often seen in a chiropractic office and usually responds very well to treatment.

 

Sinister Causes

Besides the relatively benign causes mentioned above dizziness can also be caused by more serious afflictions luckily this is rarely the case, however if your dizziness is continuous and present for long periods at a time, uninfluenced by movement and accompanied by other symptoms. Such as headache, vomiting, problems with your eye sight it would be best to visit your GP.

 

 

 

 

Herniated Disc

on Thursday, 03 March 2016. Posted in General Health, Chiropractic

Herniated Disc

By Jakob van Vlijmen

M Chiro, DC

 

A Disc herniation is a protrusion of an intervertebral disc. These shock absorbing discs are situated between 2 vertebra and they allow for more elasticity and mobility of the vertebral column. The anatomy of an intervertebral disc is comparable to that of an onion; multiple layers on the outside and a gel in the centre of the disc. Through repetitive incorrect loading of the disc (i.e. prolonged bad posture or faulty lifting mechanics) the inner gel can press on and partly rupture the outer layers.

 

The back or spine consists of 24 vertebras, the sacrum, the coccyx (tailbone) and two hip bones. To be able to move smoothly our spine has little shock absorbing discs in between the vertebra, we have a total of 23 intervertebral discs.

A hernia in the lower back often causes back pain and always causes pain down one or both legs. A dull ache, pins and needles or a catching pain are common symptoms, when the symptoms worsen there is a possibility of loss of strength or numbness down the leg. Because the intervertebral discs aren't connected to many sensory nerves it is possible that the location of the herniation itself isn't painful meaning that even though the problem might be in the back, the only location where pain is felt is in the legs.

 

There are two possible causes for this. One is that the herniated or bulging disc is pressing against a nerve that travels into the leg, causing it to become irritated and producing a signal to the brain which the brain translates as pain in the leg. Another reason for the nerve to produce a signal is not physical compression but a build-up of chemicals in the area due to overuse and irritation of the IVD. These chemicals inflame the nerve and surrounding tissues resulting in the feeling of pain similar to that of a mechanical compression of the nerve.

 

Symptoms of a disc herniation can be very different from case to case depending on which nerve is being compressed and how severely. Lumber (lower back) disc herniation cause symptoms down the legs such as pins and needles and numbness. A disc herniation located in the neck is called a cervical disc herniation and can cause pain in the neck, pain towards the shoulder blade or into the arm.

 

Usually the disc bulges on the side, however it is possible that the bulge is pressing straight back which can, depending on the location, cause a ''Cauda Equina Syndrome''. This is a medical emergency as compression of the spinal cord in this manner can cause the loss of many bodily functions. Such as muscle control over the legs, bowel and bladder control and sexual function. The chiropractor is excellently equipped to recognise and act on such an emergency.

 

A disc herniation is a common injury to the back, which in only 50% of cases causes any pain at all. As people age the IVD lose their elasticity weakening the IVDs. The average age to have a disc herniation is between 20 and 45 years of age. Men are slightly more likely to have a disc herniation than women. 

 

The ruptures in the IVD happen over time caused by bad posture or incorrect movement patterns. Having a static posture (which is the case with many jobs nowadays) increases your chances to develop a disc herniation as does lifting, repetitive bending and twisting the spine. In rare events a disc herniation can be caused suddenly due to severe trauma. 

 

The chiropractor will be asking you questions about your back pain and general health to determine which factors contribute to your pain. Subsequently the Chiropractor will perform an extensive physical examination in which orthopaedic and neurological tests are used to determine which nerve is compressed. The results of these tests are combined with the information gathered during the interview to create a complete and comprehensive picture. There may be times when the chiropractor might deem it necessary to request further imaging most likely an MRI. This is the image modality of choice to asses a disc herniation, as it does not show up at all on an X-ray.

 

A Disc herniation can be a frightening diagnosis, it is important to know however, that research has shown that in 95% of the cases a disc herniation resolves spontaneously within 12 months. However, as this is quite a long period of time the chiropractor endeavours to shorten it by improving spinal function and helping patients return to optimal health as soon as possible. The Chiropractor uses many different techniques which are all focussed at optimising spinal function and taking some of the pressure off the compressed nerve. Not every disc herniation responds well to chiropractic care and for some of them surgery might be a necessity. If this is the case, your chiropractor will help you asses your additional options.