Articles in Category: Chiropractic

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.

How Long will it take to Get Better?

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 23 September 2015. Posted in Massage, General Health, Sporting Injuries, Acupuncture, Training and Performance, Chiropractic

How Long will it take to Get Better?

By Don Williams

B.Sc., M.Chiro., ICSSD., PG Dip. NMS Rehabilitation Cert DNS. Memb: FICS, CEA

 

One of the most common questions that we get asked every day in practice is, “How long will it take to get better?” Unfortunately there is no short answer to this question, however, in this article I will try to outline some of the contributing factors and delineate some guidelines and ideas which may help answer this question for you.

 

Everyone is an individual, and in that sense, how different people respond and heal from different injuries does vary somewhat, some injuries are particularly unpredictable, shoulders are particularly problematic in identifying how well or how quickly they will respond to treatment. However with most injuries, there are general time frames in which most healing will occur.

 

Most people who have ever had an injury and minor procedure which required stitches will remember that the stitches generally come out in around 7 days and this time frame is a good indication of how long a cut or trauma takes to “bond” back together, however, the general healing process generally takes around 21 days. This is the timeframe for the body to lay down a “callus” or matrix of fibres around the injury and develop new connections and bridges to stabilise the injury and repair. But this timeframe is dependent on good blood flow and environment for repair, additionally, just because the injury is stabilised, does not mean that it is fully healed and fully function. This healing process and time frame is specifically relevant for muscle and skin.

 

Areas of the body that receive poorer blood supply take longer to recover. Tendons and particularly joint cartilage and ligaments receive a lower direct blood supply and take longer to heal. We normally expect that tendon and ligament injuries will take 6 weeks to start to repair well and 3 months to be stable.

 

Bones fractures also take longer to heal. Interestingly, the ratio of cortical bone (the dense outer “shell”) to cancellous bone (the “spongey” inner core) also affects the healing rate. So when we look at bones like the tibia (the larger of the two lower leg bones) they take a particularly long time to heal (up to 4 months).

 

The other interesting thing to note is that an injury is not always something that is readily assessable via an x-ray or scan and often, the severity of the pathology on the scan can be very unrelated to the amount of pain. For example, someone with severe degenerative changes noted on an x-ray may not have any pain, and in contrast, someone with very severe pain may have really good looking x-rays.

 

It is also important to note that many people use pain as a guide to where they have a problem or not. This is a situation which has been reinforced with dodgy advertising commercials by big pharmaceutical companies suggesting that all of our aches and pains can be targeted and resolved with a little tablet.  At times pain killers can be helpful, but it is important to realise that, contrary to the advertising campaigns, and the statements of the celebrities fronting these commercials, these drugs do not “target” the source of pain. They work globally in the system to mask the pain. In fact anti-inflammatories drugs can actually slow the healing process and all of these drugs have potential for complications and side effects, some of these can be severe.

 

But pain is only the tip of the iceberg. Pain exists as an indicator that something is going wrong in our system. We have an area that is under duress or load which is unhappy or injured. Sometimes there are weaknesses or imbalances or inappropriate actions which have caused this problem to develop. Getting rid of the pain is a good start, but addressing the underlying dysfunction or causative factors is also important to reach a good long term outcome.

 

Part of our goal in assessment at Institute of Sports and Spines is to try to assess the contributing factors which caused your problem to develop in the first place and help you to eliminate or address these issues.

 

Another complicating factor as eluded to, early in the article is the individual nature of response.

Sometimes we will see muscle spasm problems which are very severe and painful, which is not related to severe pathology. At times these issues will respond very quickly to treatment and at other times they will be a little stubborn and take a little longer. Generally, the response to treatment gives a more accurate prediction of how quickly the issue will settle. Further to this, if you have had previous episodes of the same problem, the previous response rate is generally a reasonable indicator of the response rate for future episodes.

 

So as a general time line for healing rates:

  • Early tissue healing occurs in around 7 days

  • The majority of soft tissue healing takes around 21 days.

  • Early bone healing takes 6 weeks (up to 4 months so large, long bones)

  • Cartilage and Ligament issues take around 6 weeks to 3 months

  • Re-education and retraining takes a minimum of 3 months

  • Remodelling can take up to 1 year.

 

In a perfect world things can progress more quickly. The addition of complicating factors can drag these times frames out.  The better that problems are managed and treated increases the probability of a good resolution and good long term outcome.

 

Later in this newsletter and over the next few additions we will outline more specifically injuries of the neck, back, knee, hip, shoulder and tendonopathies.

 

If you have any further questions then talk to the team and we will help you out with more specific advice.

 

Fracture Healing -

 

Fracture Healing

 


Wound Healing -

 

Wound Healing