Articles in Category: Chiropractic

Osteoarthritis Vs Rheumatoid Arthritis

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

Osteoarthritis Vs Rheumatoid Arthritis

By Jakob van Vlijmen

M Chiro, DC

 

Arthritis is often referred to as a single disease. In fact, it is an umbrella term for more than 100 medical conditions that affect the musculoskeletal system, specifically joints where two or more bones meet. Today we will discuss Osteoarthritis and Rheumatoid Arthritis as they are the most common and there is some confusion about their causes and possible treatment methods.

 

Between the bones and joints of our body sits our cartilage, this cartilage prevents the bones from rubbing against each other and helps joints move with ease. Some wear and tear of this cartilage is a natural process and happens to all of us when we age; this is called Osteoarthritis (OA). Rheumatoid Arthritis (RA) however is an auto immune disease in which the body attacks its own cartilage causing it to break down. The cause of Rheumatoid Arthritis is not clear, it is believed however, to involve a combination of genetic and environmental factors such as smoking, obesity, and heavy drinking.

 

OA most often affects the knees, hips, lower back, big toe of the feet and the small joints in the hand at the very end of the fingers. While RA most often affects the small joints in the hand closest to the body, the feet and the cervical spine, however some bigger joints like the shoulder and knee can be involved. Patients complain of stiff and painful joints, the pain is usually worse on waking or after having been stationary for some time and decreases after movement. It takes a lot longer for the morning pain in RA to subside than it does with OA which usually subsides within the hour. Surrounding muscles can cramp up due to joint dysfunction which can further exacerbate the symptoms and cause difficulties in adjacent areas. For example OA in the lower back can give pain in the buttock area and OA in the hip can cause pain in the groin.

 

In most cases of RA a Rheumatologist may prescribe a number of different medications depending on your symptoms and the severity of your condition. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. The disease-modifying anti-rheumatic drugs (DMARDs) are a special group of medications used to decrease the abnormal function of the immune system that drives Rheumatoid Arthritis. Biological DMARDs are the newest class of Arthritis medication and work to stop the disease progressing by targeting specific molecules in the immune system. Often you may be on a combination of medications. Chiropractic care cannot stop the immune system from attacking the joint so it has a limited role to play in the care of RA. Chiropractic care can help however with symptomatic relief of pain that has a mechanical origin due to compensatory movement patterns caused by the RA. In simple terms if your left hand hurts due to RA using the right one more can cause a strain on it. Chiropractic care can help manage or prevent this.

 

In some cases of OA a joint replacement might be the best strategy however, depending on the degrees of discomfort and the patient’s lifestyle it might be managed with conservative care. In spinal OA conservative management is the only option as spine replacement is not (yet) possible. In this area chiropractic care can be of great service. How well a joint functions is influenced by many different factors; the quality of the articulating bones, the surrounding ligament and the muscles that move the joint. So there are quite a few factors that chiropractic care can influence and this makes a world of differences for some and for others less so. Talk to us today to find out if chiropractic care can help you.

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.

Scoliosis

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

Scoliosis

By Jakob van Vlijmen

M Chiro, DC

 

Scoliosis is a bend in your spine. When viewed from the side your back should have a double S shape. However when viewed from behind the back should be straight. If this isn't the case it is called scoliosis. At least 4% of the world population has scoliosis, however, this figure is likely to be higher, as in many cases the deformity is so minimal that it is missed and it does not cause symptoms.

 

Scoliosis might be present at birth due to a structural abnormality; however, most often it is something that develops during growth. Scoliosis is most likely to become present at the age of 10. Incidentally, it can present later in life.

 

In 10% of cases an underlying illness is the cause of the scoliosis; usually this is an illness affecting the nerves or muscles causing a twist in the spine. However, in over 60% of the cases the cause is unknown. More research in the future will shed some light on possible causes and if family genetics play a role.

 

Children are often not troubled by scoliosis. They are quite flexible and their bodies are able to compensate. At a later stage in life scoliosis can be a possible contributing factor to back pain.

 

When you have scoliosis you might notice some of the following things:

Ø  More tension on one side of your back

Ø  One arm or leg seems longer

Ø  One shoulder blade that sticks out further

Ø  At times the tension in your back can cause headaches or back pain

 

The earlier scoliosis is identified, the earlier treatment can be started and the better the outcome will be. Especially with children it is good to stay vigilant as there is a greater chance for their scoliosis to worsen as they develop and grow. Luckily in most cases the severity of the scoliosis remains limited and surgery or a body cast is not needed. To determine if these measures are needed the angle of the scoliosis must be measured on an X-ray.  When the scoliosis is more than 25 degrees a cast or corset might be needed. If the scoliosis is more than 45 degrees surgical intervention may be indicated.

 

To help prevent the scoliosis and diminish pain there are a few different options. A Chiropractor can help decide which steps are necessary. Furthermore, a Chiropractor can treat the problems that occur as a consequence of the scoliosis such as back pain and headaches. They will also help you become more aware of your posture as this is even more important in patients with scoliosis! Certain exercises can also help. Home exercises can be sufficient; however, some patients, especially children, might need more guidance and can benefit from occupational therapy or physiotherapy. Your chiropractor can advise you on the best course of action.

 

Scoliosis might not be that bad, however, it is imperative to keep an eye on it, especially in children, to make sure it doesn't deteriorate. Remain vigilant and consult a Chiropractor if you have any concerns.