Articles in Category: General Health

Is My Scoliosis a Reason for Concern?

on Wednesday, 06 March 2019. Posted in Newsletters, General Health, Ergonomics, Chiropractic

Scoliosis

I’m sure most of us know or have heard of 'SCOLIOSIS’ but for those of you where this word is foreign, scoliosis is a term used when your spine is not straight or is curved to the side.

Now that we know what scoliosis means, did you know that there are different types/causes of scoliosis? Rather than bombarding your brains with too much information, we will discuss the two most common types of scoliosis; Adolescent Idiopathic Scoliosis and Degenerative Scoliosis.

1. Adolescent Idiopathic Scoliosis

Adolescent Idiopathic Scoliosis is by far the most common form of scoliosis affecting children between the ages of 10 to 18 years old. Unfortunately, we still have no idea what the single cause is however we know sometimes this form of scoliosis can be correlated with lower back pain.

Not all children with scoliosis will have pain/symptoms so these are some of the signs to look out for:

1.One shoulder is higher than the other

2.One hip is higher than the other

3.Their head will not look centred with the body

4.When bending forward, a hump is obvious

Scoliosis

2. Degenerative Scoliosis

Degenerative Scoliosis or also known as Adult Onset Scoliosis; is a type of spinal deformity that progresses overtime when we are adults. Therefore, people who don’t have a history of adolescent scoliosis can develop it from spinal degeneration (wear and tear of the spinal bones), Osteoporosis (loss of bone density) or Osteomalacia (softening of bones).

Unlike Adolescent Scoliosis, there is usually no obvious physical deformity. You are likely to experience more back pain (probable to be from the degenerative spine) and numbness/tingling down the arms/legs that initiates patients to have it checked by a health practitioner.

A QUICK ASSESSMENT (ADAM's SIGN)

If you are questioning whether you or your child may have scoliosis, this is a simple test to perform and identify it at home:

1.Start with the person in a standing position.

2.Have the person bend forward from the waist until the back is in a horizontal plane.

3.Keep the feet together, knees extended and arms at the side.

If a rib hump is visible while the person is bending forward, it is an indication of scoliosis.

Scoliosis 2

Physical examination is just the initial testing for scoliosis. Ideally an X-ray is required to have a better idea of the severity/degree of the deformity. Moral of the story is if you aren't sure; have it checked out by a professional!

 

Written By Iris Tan

B.App Sc (Chiropractic) M.Clin Chiropractic

Reference:

Low Back Pain (LBP) associated with Leg Pain/Discomfort

on Thursday, 14 February 2019. Posted in Newsletters, General Health, Ergonomics, Chiropractic

Low Back Pain (LBP) associated with Leg Pain/Discomfort

Practitioner: “Can you please describe your problem for me?”

Patient: “Yes. I have this Chronic Lower Back Pain that if it triggers, I can feel in my leg(s) as well. I start work from 9am, the pain will start crawling in after an hour of sitting, and then I can feel the pain down into my leg(s) after that. But, if I stand up and walk around a little bit, the pain will ease. This is why I have been putting treatment off for so long.”

 

Does this sound familiar?

The question is why does the LBP sometimes follow with leg pain? If the LBP is already a pain in the backside, why does the leg pain love to join the party?

If we look into the User’s Manual for the human body – lower body in particular, the question can easily be answered.

 

The difference between disc origin and muscular origin is if the pain travels below the knee. This is the reason why most practitioners are critical to the pain below or above the knee. If the pain travels below the knee, it is suggested to be disc lesion. If the pain does not travel below the knee, it is suggested to be muscular-related. Unfortunately, there is a User’s Manual 1.1 that specifies that each person is unique, and there could be an occasional case where the above situation differs.

 

Studies have shown that younger patients experience more discomfort in a sitting position due to increased disc pressure, but gain relief by standing up and walking (Souza, 2014). Whereas older patients have trouble when walking or standing due to gravity pull with a compressive effect that applies pressure onto the posterior (back) aspect of the region (Souza, 2014).

 

The patient sometimes describes the pain only in one leg or both legs at the same time. The difference between the two is disc-related pain for one leg and stenosis-related (narrowing) leg pain for both legs.

 

Pain below the knee is suggested to be caused by a disc lesion; chiropractic treatment usually has a beneficial effect and is able to achieve a good result.

 

Pain above the knee is suggested to be muscular-related. A trigger point is a term used to describe a tender area of the body that is irritated by a particular muscle group and has created a referral pattern to another area of the body. An example such as, an iliopsoas trigger point can cause referral pattern down to the front of the thigh, a piriformis trigger point can cause referral pattern down to the back of the thigh, or a Tensor Fascia Lata (TFL) can cause referral pattern down to the side of the thigh. These three muscles are located either deep inside our lumbar region or on the side of our hip region, which can mimic LBP. If by adding trigger point patterns into the equation, we have a lower back pain associated with leg pain/discomfort symptom.

 

Therefore, finding a practitioner with the advanced ability to diagnose this is essential to determine which type of treatment is most suitable for the patient. Once the partitioner is found, it would be wise to stick with them. If the partitioner provides effective treatment, plus a strong ethical view, it is considered hitting the jackpot.

 

 

Written by David Hsu

Dip Remedial Massage, Bachelor Rn. Diploma Osteopathy (Canada)

 

Reference:

Souza, T. (2014). Differential Diagnosis and Management for Chiropractors. Burlington: Jones & Bartlett Learning, LLC.

 

Management of Osteoarthritis with Traditional Acupuncture

Written by Richard McMahon, BSc (Acupunture), Dip Remedial Massage on Wednesday, 11 November 2015. Posted in General Health, Acupuncture, Chinese Medicine

Management of Osteoarthritis with Traditional Acupuncture

By Richard McMahon

BHSc (Acupuncutre), Dip Remedial Massage

Overview of Osteo-Arthritis

Osteoarthritis (OA) is a progressive degenerative joint disease that is characterised by the gradual loss of cartilage and subsequent loss of joint movement and pain. It is a leading cause of disability among adults and is associated with major impacts on physical function and mobility. Diagnosis is based on radiological changes and the clinical presentation of joint pain; including tenderness, limitation of movement, crepitus (crunching sounds), and variable degrees of localized inflammation. The prevalence, disability, and associated costs of treating osteoarthritis are expected to steadily increase due to our aging population. It is estimated that approximately 10% of men and 18% of women aged 60 years or older have symptomatic osteoarthritis worldwide. As there is currently no known cure for Osteo-arthritis treatment focuses on management of symptoms. It is common practice to prescribe non-steroidal anti-inflammatory medication, paracetamol or in severe cases opioid drugs for pain management. These strategies come with potential side effects so alternate strategies may be desired by patients suffering from the condition.

Research

Included is a summary of a meta-analysis of the studies that have been undertaken on the use of acupuncture in the treatment of osteoarthritis. Additionally an individual study performed in the UK notes the response and cost effectiveness of acupuncture. Also of interest is the inclusion of electro acupuncture for patients who are poor responders to traditional acupuncture and suggestions for treatment frequency and duration.

The systemic review and meta-analysis is titled “Pain management with acupuncture in Osteo- arthritis” by Manyanga et al. The stated objective of the review was to identify and synthesize date from previous randomized controlled trials comparing acupuncture to sham acupuncture, usual care, or no treatment, in adults diagnosed with osteoarthritis. Usual care refers to conservative therapy, pharmacological treatments, and rehabilitive exercises. In most trials, acupuncturists employed traditional hand stimulation of the acupuncture points. The most commonly used acupuncture points were ST34, ST36, Xiyan, GB34 and SP9. These are considered local points and belong to the traditional channel network of Chinese Medicine. Please see our previous articles on Sports Medicine Acupuncture to understand the importance of local, adjacent and distal acupuncture in traditional protocols.

The analysis includes 12 trials and a total of 1763 participants. Duration of interventions ranged from two to twelve weeks, with total follow-up durations ranging from four to 52 weeks. Through the review the researchers found acupuncture administered to adults with osteoarthritis to be associated with a statistically significant reduction in pain intensity, improved functional mobility and improved health-related quality of life. Reductions in pain were greater in trials with longer intervention periods. Major adverse events with acupuncture were not reported. The researchers suggest that acupuncture is most effective for reducing osteoarthritic pain when administered for more than four weeks. The researchers also postulate that due to the chronic inflammatory nature of OA it may be necessary for a “threshold dose” to obtain benefits and as such recommend 10 treatments on average with the aim of reversing the pathological changes that may have occurred in the central nervous system in regards to pain modulation.[i]

 

The second study noted above reports on a nurse led acupuncture study with the aim of postponing or avoiding knee surgery for patients with OA of the knee. 90 patients agreed to participate and after 1 month the trial achieved clinically significant improvements in pain, stiffness and function which continued for up to 2 years for over a third of patients. Acupuncture was given at weekly intervals for 1 month, and then reduced progressively to 6 weekly which mirrors common clinical practice. Patients who did not respond to manual acupuncture are given electro acupuncture and treatment was discontinued at 6 weeks if there is still no response. The researchers concluded that the use of acupuncture was associated with significant reductions in pain intensity and an improvement in functional mobility and quality of life. [ii]

Treatment recommendations

As noted in the above studies acupuncture treatment of OA is best performed weekly for 4-6 weeks and then gradually spread out to a maintenance dose as pain and stiffness decreases. Maintenance schedule depends on a patient’s response to treatment which will be determined by the underlying level of degeneration, their tendencies towards inflammation and the amount of activity required in their day to day lives.



 

[i] Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis

Manyanga et al. BMC Complement Altern Med. 2014; 14: 312.

[ii] Group acupuncture for knee pain: evaluation of a cost-saving initiative in the health service, White et al, Acupunct Med. 2012 Sep; 30(3): 170–175.