Understanding Pain: Why do we “pick the scab?”

The following information is from a great book meant for the non-physician to help resolve their own back problems. The book is by Stuart McGill PhD and is called “Back Mechanic: The secrets to a healthy spine your doctor isn’t telling you.” I highly recommend the book if you have or are suffering from low back pain. The end goal is to remove the underlying pain and spare your spine with proper movement and strengthening exercises. “Many back pain sufferers would experience a huge breakthrough in their recovery if they only realized that is was their flawed movement patterns that kept them pain-sensitive. Much like a scab forming on our skin, our backs are constantly trying to patch and heal themselves. We, however, by continuing to repeat harmful movement patterns in our daily lives cause re-injury. We are essentially “picking the scab.” It is unreasonable to expect the body to heal if we continue to provoke it in the same way that led to the original injury. Continued provocation of pain sensitizes the nerves so that the pain is triggered with even less stimulation.

Remove the provocative motions and we can find the solution. Here’s how pain sensitivity works: people increase their sensitivity through repeated stressful and painful loading. These muscles and joints are loaded with sensors: pain sensors, pressure sensors, force sensors, chemical sensors. Some detect carbon dioxide; some detect pain, some sense histamine for inflammation. Human joints are packed with sensors that relay position and movement information to the brain. These signals travel along the sensory nerves. Along the highway of nerves, there are checkpoints or “gates,” at junctions. According to the Gate Theory of Pain, the idea is, to flood the checkpoint with “good information,” in other words, signals associated with pain-free movement. In this way, there is no more room for the pain signals as they are crowded out. Try this: close your eyes and find the tip of your nose with your finger like in a roadside sobriety test. You are using kinesthetic sensory organs that run throughout your arm to navigate. These sensors alert the brain as to the position of your forefinger in relation to your nose. The sensation of this simple pain-free motion dominates the information traffic on your sensory nerves with feel-good kinesthetic sensory information that identifies position, length, and force. Finding and repeating pain-free motions in your back will cause the remaining painful activities to hurt less. Read the previous sentence again – it really is that important. By discovering and ingraining positive movements for your back, you will find that the pain often dissipates and then disappears entirely. This is because when we remove pain triggers and stop “picking the scab” we give our tissues a chance to rest, heal and regenerate. Simultaneously our sensors for pain are actually being desensitized. Master this, and you have mastered your back pain.

For those of you that have a known type of injury, a name to attach to your condition, your personal recovery strategy should always begin with avoiding the aggravating posture for your unique spine is key to getting yourself back on track. Various symptoms of back pain have a distinct and known cause (although this information is not widely known making this book uniquely valuable). Injuries can be avoided if we avoid the injury mechanism itself.

Here’s a recap of some pain avoidance strategies, as well as an introduction of some that will be discussed later. The knowledge in this chapter will provide the foundation that will help you: Locate and eliminate the cause of your pain- get an appropriate assessment that provides a specific diagnosis. Increase your consciousness around what movements and postures cause you pain. Develop replacement postures and movement patterns that enable you to function pain-free. Stabilize your torso, core, and spine to remove painful spine joint micro-movements. -Develop a daily exercise plan that includes walking. -Mobilize your hips -Learn to create power at the ball and socket joints (hips and shoulders). -Learn exercises that are based on patterns of movement: push, pull, lift, carry, lunge, squat, etc. -Make healthy spine choices when sleeping, sitting, or engaging in more demanding activities. You’re on your way to learning the secrets of a pain-free lifestyle! Let’s make it happen!

We are injury specialists and would love to help you on your road to a better movement patterns. Located near you in Millcreek, UT.

Give us a call 801-456-0352 to start your road to recovery with Vector Spine and Sport!

Do you have D.O.M.S.?

What is DOMS?

Delayed onset muscle soreness or DOMS. is the pain and stiffness felt in the muscles several hours to days after strenuous or unaccustomed exercise. This soreness is typically felt most strongly 24 to 72 hours after the exercise.

According to the American College of Sports Medicine, symptoms of DOMS to watch out for may include: muscles that feel tender to the touch, reduced range of motion due to pain and stiffness when moving, swelling in the affected muscles, muscle fatigue, short-term loss of muscle strength.

What causes DOMS?

High-intensity exercise can cause tiny, microscopic tears in your muscle fibers. Your body responds to this damage by increasing inflammation, which may lead to a delayed onset of soreness in the muscles. It was once thought that a buildup of exercise-induced lactic acid was to blame for DOMS, but this common misconception has been debunked.

Pretty much any high-intensity exercise can cause DOMS, but one kind in particular, known as eccentric exercise, often triggers it.

Eccentric exercises cause you to tense a muscle at the same time you lengthen it.

For example, the controlled, downward motion as you straighten your forearm after a biceps curl is an eccentric movement. The way your quads tense up when running downhill is also an eccentric movement.

What can be done to treat DOMS?

Massage

2017 review of several studies found that people who received a massage 24, 48, or 72 hours after an intense workout reported significantly less soreness than people who didn’t get a post-workout massage. Getting a massage 48 hours after workout seemed to work best.

Getting a massage after every workout may not be feasible, but you can try self-massage on your:

  • calves
  • thighs
  • buttocks
  • arms
  • shoulders

To massage your muscles, apply some oil or lotion to the area and knead, squeeze, and gently shake your muscles.

Using a foam roller right after a workout may also help head off a bad case of DOMS.

Topical analgesics

Topical analgesics are products meant to help relieve pain. Menthol-based topical analgesicsTrusted Source and those with arnica may help ease the pain of DOMS. These products can be applied topically to the area that’s sore. Always following packaging instructions about how much and how often to apply.

Cold bath

2016 review of studies found that a 10- to 15-minute full-body immersion in a cold water bath (50–59°F or 10–15°C) lessened the degree of DOMS.

Cold baths have become a popular self-treatment for competitive athletes.

Warm bath

Does an ice bath sound extreme? Try a soak in a warm tub, instead. Moist heat wraps or a warm bath trusted source ease the pain and stiffness that come with DOMS.

Anti-inflammatory foods

More research is needed, but some trusted source suggest that eating certain foods or taking certain supplements may help ease DOMS. Some of the supplements being Tart cherry juice 1oz. per day or 1000mg of vitamin C can help reduce the length and intensity of the muscle soreness.

Learn what kinds of foods to eat after a workout to support optimal muscle recovery.

Do over-the-counter pain relievers help?

According to research published in 2000, nonsteroidal anti-inflammatory (NSAID) medications, such as ibuprofen (Advil), don’t do much to relieve DOMS pain.

When to seek medical help

DOMS rarely requires a trip to the doctor. But the American Council on Sports Medicine recommends you see a doctor or nurse practitioner if the pain from DOMS stops you from doing your normal daily activities.

You should also seek medical attention right away if:

  • your DOMS lasts longer than 7 days
  • your urine becomes abnormally dark
  • you have severe swelling in your arms and legs

Sharp pain, muscle spasms, and numbness and tingling are different from the dull ache of muscle soreness. Talk with your doctor right away if you feel any of these symptoms after working out.

Here at Vector Spine and Sport we work with you to recover from pain and injuries that happen to all athletes weather you are just getting into it or if you are a seasoned pro. We love to give you the tools recover and get back to doing what you love. We are your local Millcreek, UT chiropractor. If you have any questions please feel free to contact us or give us a call at (801) 456-0352.

Do You Have Knee Pain?

Knee pain is a common problem. The location of the pain, as well as what activities aggravate the knee pain are very important in proper diagnosis and treatment of the pain you are experiencing.

Not only can knee pain affect your ability to walk, run, or carry out your usual activities. Knee pain can also really affect your sleep. There may be general aches, leg pain with movements, restricted movements, swelling, sharp pain etc.

So let’s talk about some of the more common causes of pain by location

Back of the Knee pain

Bakers Cysts

Swelling that develops in the popliteal bursa at the back of the knee. This is one of the most common causes of pain behind the knee.

What are the symptoms of a bakers cyst? Small bulge (like a water balloon) behind the knee, tightness and pain behind the leg, pain while walking and kneeling.

Knee Sprain

Knee sprains happen commonly form over stretching one or more of the ligaments or tendons, which can result in a full or partial tear of the tissue.

What are the symptoms of a knee sprain? pain, swelling, bruising, decreased knee movement, pain with passive movements.

Posterior Meniscal Tear

A tear in the meniscus cartilage at the back of the knee. Causes are sudden twisting, a force through the knee or a gradual wear and tear type of injury.

What are the symptoms of a posterior meniscal tear? swelling, locking, pain behind the knee with extension, pain with walking, running, squatting & going up stairs.

Deep Vein Thrombosis (DVT)

A DVT is a blood clot in the deep leg veins. If it breaks off it can lead to a heart attack or stroke. Causes are prolonged inactivity, certain medications, pregnancy, obesity, and genetics.

What are the Symptoms of a DVT? Pain behind the knee or in the calf, swelling, redness, warmth usually only in one leg.

Warning! A DVT is a potentially life-threatening condition. If you are showing symptoms or suspect you might have a DVT seek immediate medical attention.

Hamstring Injury

Overstretching the hamstring muscles can cause pain in the back of the knee. It may also tear the muscles. Causes can be sudden and fast movements such as springing, lunging and jumping.

What are the symptoms of hamstring injury? aching behind the knee or thigh, sharp pain behind the knee. Worse when bending the knee or with acceleration of deceleration movements.

Front of the knee

Runners Knee

This is the most common cause of knee pain from running the diagnosis that is most commonly associated with this is patellofemoral pain syndrome. The problem is that the patella is having problems with its tracking. Most commonly the patella tracks laterally.

What are the symptoms of “Runners Knee”? Gradual onset and come and go depending on your activities. It can feel sharp at times, dull ache, Stabbing, Burning all worse with movements.

Iliotibial Band Syndrome (ITB Syndrome)

One of the most common causes of lateral (outside) knee pain. Usually due to tightness, friction and inflammation of the IT band, which is a thick band of connective tissue on the outside of the thigh.

What are the symptoms of Iliotibial band syndrome? Lateral knee pain on the outer side of the knee that radiates up the thigh.

Jumpers Knee

This is the common name for infrapatellar tendonitis. Which is tiny tears and resulting inflammation of the infrapatellar tendon from overuse. The infrapatellar tendon sits below the patella as the name suggest.

What are the symptoms of infrapatellar tendonitis? the area just below the patella “knee cap”, stiffness and knee pain after running, jumping and other ballistic activities.

Knee Bursitis

Around the knee there are a number of bursa, which are small fluid filled sacs that sit between tendons and boney spots to prevent friction. these can get irritated from repetitive actions, which leads to inflammation and pain.

What are the symptoms of knee bursitis? The symptoms are varied depending on which bursa is affected. Typically they include pain swelling, redness and limited knee range of motion.

What Treatments are there?

Chiropractic

Chiropractic care is a great non-surgical avenue to pursue to knee pain. As musculoskeletal specialists, chiropractors have great results with treating this type of conditions. Through the use of chiropractic adjustments, massage therapy or muscle work, deep tissue laser therapy and therapeutic exercises we are able to greatly reduce and in some cases eliminate the symptoms.

Acupuncture

Acupuncture is another great option that is used to treat sciatic pain. The goal with acupuncture is to calm the central nervous system as well and release tension in the muscles surrounding the spine. Acupuncturists seek to balance the flow of energy pathways in the body through pathways called meridians and reduce inflammation which is can aggravate many conditions.

Physical therapy 

Physical therapy helps to reduce pain through specific exercises to stabilize the knee, hip and ankle and increase function. Here in the office we use rehabilitation exercises to help fix the issues so you can get back to having fun. If we do not have the tools to get you better we have the contacts that do.

Steroid injections 

Steroid injections can be beneficial for short term reduction in pain when it comes to sciatic pain. This can be expensive and is not a good long term option as their are increased risks associated with multiple injections with steroids.

Activity modification 

Activity modification is another way to reduce pain as well as stay out of pain. In modern day society in general we do not move as much as we should. Making simple changes throughout our day can make huge differences. Research suggests that we should be taking micro breaks through our day so that we are not in one position too long. This can be as simple as standing up and walking around our desk at work or shifting the hips side to side and forward and back while driving in the car.

We at Vector Spine and Sport are committed to helping you get feeling better and fixing the issue if we are able to. If you have questions or concerns please contact us at (801) 456-0352.

Shoulder pain.

When it comes to the shoulder the most common injuries or conditions are sprains and strains, rotator cuff tears, tendonitis, bursitis, arthritis.

The shoulder is made up of three bones: your upper arm (humerus), your shoulder blade (scapula), and your collarbone (clavicle). The upper arm bone fits into a rounded socker on the shoulder blade called the glenoid. The combination of muscles and tendons keeps humerus centered in your shoulder socket. These tissues are call the rotator cuff which are made up of 4 muscles: Supraspinatus, this holds your humerus in place and helps you lift your arm. Infraspinatus, This in muscle lets you rotate and extend your shoulder. Teres Minor, this is the smallest rotator cuff muscle and is used to assist with external rotation (rotation away from your body). Subscapularis, This holds your upper arm to your glenoid and helps rotate your arm, hold it straight out and lower your arm.

These shoulder muscles like every other muscle work in combination with one another in all the ranges of motion and keep the joint where it is supposed to be. Sometimes there is a miscommunication or injury that causes you to change the way the muscles fire and how you move. This can cause chronic issues and irritate the soft tissues that support the shoulder.

What are these conditions conditions?

Tendinitis

A tendon is the tissue that connects muscle to bone. Most tendinitis is a result of inflammation in the tendon. Generally, Tendonitis is one of two types: Acute, from excessive ball throwing or repetitive motions can lead to this type. Chronic, this is typically characterized by degenerative diseases like arthritis or repetitive wear and tear due to age, can lead to chronic tendonitis.

Bursitis

Bursae are small, fluid filled sacs that are located around joints throughout the body. they act as cushions between bones and the overlying soft tissues and help reduce friction between the gliding muscles and bone. Sometimes overusing the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the scapula known as the acromion.

Arthritis

Shoulder pain from arthritis can often cause people to avoid shoulder movements in an attempt to lessen the pain. this sometimes leads to a tightening or stiffening of the soft tissue parts of the joint, resulting in a painful restriction of the joint. Osteoarthritis , may be related to sports or work injuries, or chronic wear and tear. other types of arthritis can be related to rotator cuff tears, infections, or inflammation of the joint lining.

Sprains/Strains/Rotator cuff tears

Splitting and tearing of tendons and muscles may result from acute injury or degenerative changes in the tendons and muscles due to aging, long term-overuse, or sudden injury. The tears could range from minimal strains and sprains to partial and complete tears. In most complete tears, the tendon is pulled away from its boney attachment. The rotator cuff and biceps tendon injuries are among the most common of these injuries.

What treatment options are out there?

Chiropractic care is an option for treating these conditions, in the more serious conditions such as partial or complete tears of the muscle or tendon surgical repair of the damage might be the better option at first. Chiropractic care can use a few modalities to improve pain and function with these through the use of laser therapy, instrument assisted soft tissue mobilisation, Cupping, and rehabilitation exercises.

Acupuncture is another great option and or co-treatment to help reduce inflammation, increase blood flow and reduce muscle tightness and soreness.

Rehabilitation is what is used to correct the movement patterns as wells as weak or inhibited muscles. Using specific exercises to improve muscle strength and coordination, reduces the chance of reinjury and improves the long term outcomes for the condition.

Do you have a Sprained Ankle?

What is an ankle sprain?

Ankle sprains are injuries that occur when the ankle is rolls, twists and or turns and the body is not prepared or is not able to correct the movement. This can over stretch or tear the tough bands of tissue called ligaments that help stabilize and hold the ankle together.

Ligaments help stabilize joints, by preventing excessive movement. A ankle sprain occurs when the ligaments are forced beyond their normal range of motion. The most common type of ankle sprain cause damage to the lateral or outside of the ankle.

Treatments for ankle sprains depends on the severity of the injury. Self care measures and over the counter pain medications may be all you need, a medical evaluation might be necessary to reveal how badly you have injured your ankle and determine the proper course of treatment.

Brief video of the anatomy of the ankle

What helps speed up recovery?

The P.O.L.I.C.E. principle is one of the newer approaches to acute injury treatment in general. For many years R.I.C.E. principal to manage acute injuries was the go to, Rest, Ice, Compression, and Elevation. A couple of problems with the
R.I.C.E. treatments are that it really hasn’t been proven to work like we think, some experts suggest that ice being applied initially after an injury actually impedes the normal healing process. another problem is that many people take the “rest” phase too far. often after acute injury, a little bit of rest is necessary. But you may feel compelled to rest your injured muscle or joint for far longer than is actually necessary. Long periods of immobilization can lead to decreased muscle strength and flexibility. which could lead to delays in normal functional mobility and activity.

So what does P.O.L.I.C.E. stand for?

Protection: During the first few days after an injury, you should certainly rest the injured joint, ligament, or muscle. After a few days, gentle motion can be started while you still maintain a level of protection for the injured area.

Optimum Loading: While you are protecting your injured body part, gentle motion can, and should, be started. For example, after a ankle injury, you should be able to progress from a few days of rest to passive range of motion, active ranges of motion, and finally, This progressive loading of your injury can help promote optimal healing of the injury, and it can prevent delays in returning to normal due to joint and muscle tightness or muscle atrophy.

Ice: Applying ice may help to manage the swelling around your injured muscle or joint, and ice can help decrease some of the acute pain that you may be experiencing. The research suggests that no more than 20 minutes at a time is most beneficial.

Compression: While applying ice, compression can be added using an ACE bandage.

Elevation: Elevation is simple for some body parts. An injured ankle or knee can be placed on a stack of pillows while you are lying down. An injury to your elbow or wrist requires that you elevate your entire arm on something.

The P.O.L.I.C.E. principle deviates slightly from the R.I.C.E. method. Sure, ice is still used, but there no rest component. Rather, optimal loading and movement are used. This creates early motion, decreases stiffness, and may help you quickly get moving again.

Rehabilitation

Range of motion exercises

Range-of-motion exercises begin right after your injury. Try doing these exercises then putting ice on your ankle, up to 5 times a day. These are easy to do while you are at a desk or watching TV.

Try the following simple range-of-motion exercises:

  • Trace the alphabet with your toe, which encourages ankle movement in all directions. Trace the alphabet 1 to 3 times.
  • Sit in a chair with your foot flat on the floor. Slowly move your knee side to side while keeping your foot pressed flat. Continue for 2 to 3 minutes.

Towel curls. While sitting, place your foot on a towel on the floor and scrunch the towel toward you with your toes. Then, also using your toes, push the towel away from you. Make this exercise more challenging by placing a weighted object, such as a soup can, on the other end of the towel.

Strengthening exercises

Talk to your doctor or physical therapist about the timing of strengthening exercises for the ankle. Typically you can start them when you are able to stand without increased pain or swelling.

Do 8 to 12 repetitions of these exercises once or twice daily for 2 to 4 weeks, depending on the severity of your injury.

  • Start by sitting with your foot flat on the floor and pushing it outward against an immovable object such as the wall or heavy furniture. Hold for about 6 seconds, then relax. After you feel comfortable with this, try using rubber tubing looped around the outside of your feet for resistance. Push your foot out to the side against the tubing, then count to 10 as you slowly bring your foot back to the middle.
  • While still sitting, put your feet together flat on the floor. Press your injured foot inward against your other foot. Hold for about 6 seconds, then relax.
  • Next, place the heel of your other foot on top of the injured one. Push down with the top heel while trying to push up with your injured foot. Hold for about 6 seconds, then relax

Balance and control exercises

You can usually start balance and control exercises when you are able to stand without pain. But talk to your doctor or physical therapist about the exact timing. Also, don’t try these exercises if you could not have done them easily before your injury. If you think you would have felt unsteady doing these exercises when your ankle was healthy, you are at risk of falling when you try them with an injured ankle.

Practice your balance exercise at least once a day, repeating it about 6 times in each session.

  1. Stand on just your injured foot while holding your arms out to your sides with your eyes open. If you feel unsteady, stand in a doorway so you can put your hands on the door frame to help you. Balance for a long as you can, working up to 60 seconds. When you can do this for 60 seconds, try exercise number 2.
  2. Stand on your injured foot only and hold your arms across your chest with your eyes open. When you can do this for 60 seconds, try exercise number 3.
  3. Stand on your injured foot only, hold your arms out to the sides, and close your eyes. If you feel unsteady, stand in a doorway so you can put your hands on the door frame to help you. When you can do this for 60 seconds, try exercise number 4.
  4. Stand on your injured foot only, hold your arms across your chest, and close your eyes. Balance for a long as you can, working up to 60 seconds.

Stretching exercises should be continued on a daily basis and especially before and after physical activities to help prevent reinjury. Even after your ankle feels better, continue with strengthening exercises and balance and control exercises several times a week to keep your ankles strong.

Stretching exercises

Start exercises to stretch your Achilles tendon as soon as you can do so without pain. The Achilles tendon connects the calf muscles on the back of the lower leg to the bone at the base of the heel. Try the towel stretch if you need to sit down, or try the calf stretch if you can stand.

  • Towel stretch. Sit with your leg straight in front of you. Place a rolled towel under the ball of your foot, holding the towel at both ends. Gently pull the towel toward you while keeping your knee straight. Hold this position for 15 to 30 seconds, and repeat 2 to 4 times. In moderate to severe ankle sprains, it may be too painful at first to pull your toes far enough to feel a stretch in your calf. Use caution, and let pain be your guide.
  • Calf stretch. Stand facing a wall with your hands on the wall at about eye level. Put the leg you want to stretch about a step behind your other leg. Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg. Hold the stretch for 15 to 30 seconds. Repeat 2 to 4 times. Repeat the exercise with the back knee bent a little, still keeping your back heel on the floor. This will stretch a different part of the calf muscles.

Chiropractic Adjustments

After an ankle sprain having the ankle adjusted can decrease pain and may improve your recovery time and function. After spraining your ankle the joint might can be misaligned and a simple adjustment can help increase mobility and improve your pain free range of motion.

Plantar Fasciitis

What is plantar fasciitis?

It is one of the most common causes of heel pain according to the Mayo clinic. It involves inflammation of the plantar fascia, which is a band of thick tissue that runs across the bottom of the foot connecting your toes to your heel and turning into the achilles tendon and calf muscles.

Plantar fasciitis commonly causes a stabbing pain that normally occurs with the first steps in the morning. After getting up and moving more, the pain will normally decrease. But it may return after standing for long periods of time or going from sitting to standing. It is more common in runners, other risk factors are being overweight, inadequate foot support, standing for long periods of time, dancing or ballistic jumping activities.

Complications

If ignored plantar fasciitis could result in chronic heel pain that hinders or changes your regular activities. Changing the way you walk to minimize your foot pain could lead to foot, knee hip and or back pain as compensation.

Treatment options

Orthotics- You might be able to find relief by having custom made or fitted arch supports (orthotics) to help disperse pressure through your feet more evenly. In the office we offer Foot levelers orthotics.

Deep tissue laser therapy- Laser therapy is a non-invasive, drug-free, and surgery-free way to treat the body and decrease pain & inflammation. It is a technologically advanced treatment that uses light energy to accelerate your body’s own natural healing processes to help speed recovery.

Lightforce class IV laser

Exercises- Using specific exercises to strengthen the foot can help long term in correcting the biomechanical problems in the foot. One of the main causes of plantar fasciitis is weak foot muscles, causing the arch to collapse which increases tension and irritation to the plantar fascia.

Extracorporeal shock wave therapy- This procedure uses sound waves directed at the area of heel pain to stimulate healing. It shows excellent
results, reducing the swelling and pain in the treated area.

TRT shockwave

Injections- Steroid medications injected into the tender areas may provide a temporary pain relief, but it is NOT a good long term option due to the risks associated with multiple injections such as weakening of the plantar fascia and bones of the foot. platelet rich plasma (PRP) under ultrasound guidance, could be another option with less risks of tissue rupture.

Soft tissue therapy- This can be done multiple ways. There is massage therapy, Instrument assisted soft tissue mobilization, Cupping etc. This works by reducing scar tissue.

9 Common Types of Neck Injury

Neck injuries vary in severity and type, they can be caused by accidents, trauma to the area, falls, sleeping in off positions, degenerative changes or a combination of things.

Neck Injuries Affecting Soft Tissue

This category would include damage to one or more anatomical part in your neck. The soft tissue include the muscles, tendons, ligaments, and nerves. These work together to hold your head up on your bones. usually when there is a trauma there will be several diagnoses for example in whiplash can include muscle strains, ligament sprains, joint dysfunction, disc injuries and even bone fractures.

The good news is that most of the time neck injuries that mainly affecting the soft tissue are very treatable with conservative care.

Muscle Strain

A neck muscle strain is and injury to any of the muscles that attach to and move the head and upper part of the spine known as the cervical spine. The symptoms include reduced range of motion, muscle spasm, increased pain during active range of motion.

With a Grade II neck strain, the injury is limited to the muscle only. Like a Grade 1 strain, your neck pain is likely not indicative of other types of structural damage. But when it comes to Grades III and IV, it is. According to the Quebec Task Force on Whiplash-Associated Disorders, Grade III neck strain is associated with nerve damage. In this case, you may, among other things, get weak and/or feel electrical sensations down one arm. With these injuries, making an appointment with your doctor as soon as possible will likely give you the best chance of a full recovery.
Needless to say, Grade IV neck strains are the most serious of all. The Quebec Task Force says these are related to fracture or vertebral dislocation. This injury requires immediate medical attention.

Neck Sprain

Sprains are injuries to ligaments. (Ligaments are strong bands of connective tissue that hold bones together.) Neck sprains can be caused by falls or sudden twists that overload or overstretch one or more joints in your cervical spine. Another cause is repeated stress to the joint. These are common in sport injuries and auto accidents alike, and are treated in chiropractic offices every day.

According to the American Academy of Orthopedic surgeons (AAOS), symptoms of a neck sprain can be very varied but may include pain at the back of your neck that gets worse when you move, pain that comes on slowly and peaks after about 24 hour hours.

Neck sprains can also bring on less structural type symptoms, including a sore throat, mood changes, difficulty concentrating or sleeping and more, the AAOS says.

Similar to neck strains, neck sprains can be mild, moderate, or severe and are graded. This may mean, for example, that if you have tingling down one arm, your sprain is a Grade III. Always check with your doctor to be sure.

Whiplash-Associated Disorders (WAD)

Whiplash (WAD) is a set of symptoms following a movement event in which the head is thrown first into hyperextension and then quickly forward into flexion. It’s most often due to car accidents, but may be caused by sports injuries, falls, or trauma.

Like a neck crick, WAD is not a medical diagnosis. It’s an episode that can lead to any number of diagnoses from strain to a herniated disc and sometimes more.

Whiplash may damage joints or discs, which in turn may irritate spinal nerve roots or, more rarely, the spinal cord, causing nerve symptoms.

Depending on the exact nature of the injury, symptoms can include pain, weakness, numbness, tingling, or other electric-type sensations that go down one arm. Stiffness, dizziness, or disturbed sleep are also possible. Note that symptoms may be delayed a few days or even weeks following the whiplash event.

Research suggests that a multi-modal approach to treating whiplash can be effective. This includes chiropractic care, massage therapy, physical therapy, acupuncture, injection therapy.

Herniated Disc

A herniated disc occurs when the soft substance that is normally contained to the inside of the disc (called the nucleus pulposus) starts to push through the annulus fibrosus and create a bulge/herniation into the spinal canal or foramina. This can can compress and irritate a nerve root, you’ll likely feel pain and/or have nerve-related symptoms. Nerve-related symptoms generally includes weakness, numbness, a burning sensation, or electrical shock sensation that go down one arm.

Tears in the tough outer fibers of the disc (called annular tears) may lead to a herniation. Annular tears may be brought on by either repeated or a sudden, forceful stress to the spinal joint. Treatment generally starts with medication and physical therapy but may proceed to surgery as needed.

Herniated discs can happen anywhere along the spine where one of the shock-absorbing cushions are located, including of course, in the cervical spine, or neck, area.

Disc herniations can be symptomatic and asymptomatic, these can be treated successfully with conservative care. Just because you may have a herniation or more does not mean that you will always be in pain. There is hope and we are professionals who specialize in fixing the problem not just masking your symptoms for a time.

Stingers and Burners

Named for the way they feel, stingers and burners are temporary injuries to the spinal nerve. They are common in football players, especially tacklers, as well as other contact-sport athletes.

Stingers and burners may be caused either by an abrupt tilt of the head or when the head and shoulder are forced in opposite directions at the same time. This type of injury is from applying too much traction to the nerve and over stretching them.

Symptoms include burning, stinging, numbness/weakness, or an electrical sensation down one arm. You may feel a warm sensation along with the other symptoms.

If a stinger or burner is severe or lasts longer than a few minutes, see a sports chiropractor or other professional.

Neck Fracture

A is a break in a cervical bone. It may be caused by trauma, a fall, or degenerative changes in the spine. The angle of force at impact often determines the type and severity of the break.

Football players who block with their head are at high risk for cervical fractures. Elderly people with osteoporosis are also at risk, because of their fragile bones. The most serious neck fractures are generally accompanied by a dislocation.

Treatment depends on a lot of things, including your age, other medical conditions, and the extent of damage to your spine.

Cervical Dislocation

Dislocation occurs when a neck bone moves out its normal position, creating spinal instability. When a neck bone is dislocated, either an injury or degenerative changes disrupt the ligaments that normally hold it in place, causing it to separate from the bone below.

When brought on by trauma, a dislocation may be accompanied by fracture.

In the most severe dislocation, the bone is fully displaced forward (called jumping), and it locks in this position. The ligaments rupture completely. Dislocations may damage the spinal cord and/or require surgery.

Less severe forms occur when the bone does not move all the way out, or when only one side fully displaces. Mild dislocations may go back in place on their own.

Spinal Cord Injury

A spinal cord injury (SCI) occurs when a fracture, dislocation, or other neck injury damages the spinal cord. The speed of emergency care and the type of first aid and medical treatment immediately given are especially critical to survival and subsequent quality of life following any serious neck injury. SCI are one of the most most serious and life altering of injuries that could happen in life.

Here at Vector Spine and Sport we treat and co-treat many of these conditions. If you have any questions or concerns what route of treatments would best suit your case, please reach out and give us a call or send us an email. We are always glad to help in any way we can.

5 options for treating Sciatic pain

First off what is sciatic pain or sciatica?

Sciatica is a general term that is used by many to describe symptoms that refer or radiate down the leg or legs. The symptoms can feel like numbness, Tingling, burning, and electrical.

What causes sciatic pain?

The top causes of true sciatic pain are disc herniations, bone spurs, and spondylolisthesis. There are conditions that can mimic sciatic pain such as piriformis syndrome and sacroiliac joint dysfunctions that can refer pain in similar patterns.

How is it treated?

Chiropractic care is a great non-surgical avenue to pursue to alleviate sciatic pain and low back pain in general. As musculoskeletal specialists, chiropractors have great results with treating this type of conditions. Through the use of chiropractic adjustments, massage therapy or muscle work, and therapeutic exercises we are able to greatly reduce and in most cases eliminate the symptoms.

Acupuncture is another great option that is used to treat sciatic pain. The goal with acupuncture is to calm the central nervous system as well and release tension in the muscles surrounding the spine. Acupuncturists seek to balance the flow of energy pathways in the body through pathways called meridians and reduce inflammation which is can aggravate many conditions.

Physical therapy is helps to reduce pain through specific exercises to stabilize the spine and increase function. Here in the office we use rehabilitation exercises to help fix the issues so you can get back to having fun. If we do not have the tools to get you better we have the contacts that do.

Steroid injections can be beneficial for short term reduction in pain when it comes to sciatic pain. This can be expensive and is not a good long term option as their are increased risks associated with multiple injections with steroids.

Activity modification is another way to reduce pain as well as stay out of pain. In modern day society in general we do not move as much as we should. making simple changes throughout our day can make huge differences. research suggests that we should be taking micro breaks through our day so that we are not in one position too long. This can be as simple as standing up and walking around our desk at work or shifting the hips side to side and forward and back while driving in the car.

Here at Vector Spine and Sport we like to help you fix the issues that arise as you go through your life. As with many things in life it’s usually not just one thing that causes or solves the problems, it’s a combination of things. That is why we listen to what you say, since you know your body better than anyone else.

If you are curious if Chiropractic care or any of the other options are a good fit for you, please contact us, we are your local Millcreek chiropractor.

Opioid epidemic. What alternatives are out there?


According to the CDC on Drug Abuse, every day, more than 130 people in the United States die after overdosing on opioids (1). The abuse of this classification is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and prevention estimate the prescription opioid misuse alone in the US is around $78.5 Billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement (2). Roughly 21-29% of patients prescribed opiods for chronic pain misuse them (4). of those between 8-12% develop a opioid use disorder.

10 Alternatives to opioids

Chiropractic care

Chiropractors are specialists focused on neruomuscular disorders, who emphasize manual manipulation of the spine and extremities. Studies have shown to be effective at decreasing pain and improving physical function (5).

Acupuncture

Acupuncture is the Chinese practice that involves and experienced practitioner using hair thin needles into the skin at specific points in the body. Through this they are correcting imbalances in the nervous system and muscles. In the Archives of Internal Medicine a review found that acupuncture relieved pain by about 50% in patients (6).

Physical Therapy

A physical therapist specializes in physical medicine and rehabilitation. They may be able to create an exercise program that helps you improve the function of your body mechanics and decrease your pain.

Massage Therapy

Massage therapy is a great tool in combination with chiropractic, acutpuncture and physical therapy wheather it be acute injury such as a car accident or sports injury or chronic problems like low back pain, neck pain etc.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) can help people practice “acceptance theory”, which can lead to behavioral changes and perceptions, and increase patient confidence and self-efficacy for pain management. In a review published in the American Psychologist found that CBT had small to moderate effect on decreasing pain when compares to patients usual treatment, this option was suggested to be best applied in conjunction with a primary care setting (7).

Steroid injections

Seroid injections are a commonly given pain and inflamation releaver associated with certain joints and conditions. Although fequently used, the long term effects are not well established. The short term effects are are established and show a significant reduction in pain and inflamation, but there is a increased risk of bone thinning with the use of some steroid injections (8).

Non-steroidal anti-inflammatory drugs

NSAIDs are the common drugs wich include asprin and ibuprofen. They are used to reduce inflammation as well as lower fevers. Many NSAIDs can be bought OTC, which means they are easy to obtain and relativly inexpensive. But like all drugs should be taken with care and not for extended periods of time due to the increased risk for heart attack and stroke, as well as gastrointestinal bleeding or other problems.

Diet and life style

Diet and life style are one of the most common ways to self-manage chronic and acute pain. The activities very from person to person as to what will work, you need to find what is going to be best for you and what you enjoy. From power lifting, dance, yoga, to running or even going for a walk around the block. The more we move and the better we eat, the better we will feel, it’s as simple as that eat right, move right, feel right (11).

Electrical Stimulation

Electrical nerve stimulation can provide short-term pain relief, especially for various types of muscle pain, by sending low-voltage electrical signals from a small device to the painful area through pads attached to the skin. While researchers aren’t sure why it works, they think it may either interrupt the nerve signals to the brain or stimulate the production of “feel good” endorphins, the body’s natural painkillers (9).

CBD oil

CBD oils are todays go to for many conditions. They are useful in reducing inflamation, relaxing muscles and reducing pain.

In practice I have come across a variety of treatments for acute and chonic pain. If you are in pain see one or more of the specialist listed above you can usually find one in your area that offers a free consultation to see if you are a good candidite for their approach to conditions. There is hope out there you might have to get out of your comfort zone, but that is where growth tends to happen.

1.CDC/NCHS, National Vital Statistics System, Mortality. CDC WONDER, Atlanta, GA: US Department of Health and Human Services, CDC; 2018. https://wonder.cdc.gov.

2. Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care. 2016;54(10):901-906. doi:10.1097/MLR.0000000000000625.

3. “Trends in Opioid Analgesic Abuse and Mortality in the United States | NEJM.” New England Journal of Medicine, Richard C. Dart, M.D., Ph.D., Hilary L. Surratt, Ph.D., Theodore J. Cicero, Ph.D., Mark W. Parrino, M.P.A., S. Geoff Severtson, Ph.D., Becki Bucher-Bartelson, Ph.D., and Jody L. Green, Ph.D www.nejm.org/doi/full/10.1056/NEJMsa1406143.

4. Center for Behavioral Health Statistics and Quality (CBHSQ). 2017 National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2018.

5. Goertz, C. M., Long, C. R., Hondras, M. A., Petri, R., Delgado, R., Lawrence, D. J., . . . Meeker, W. C. (2013, April 15). Adding chiropractic manipulative therapy to standard medical care for patients with acute low back pain: Results of a pragmatic randomized comparative effectiveness study. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23060056

6. Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med. 2012;172(19):1444–1453. doi:10.1001/archinternmed.2012.3654

7. https://www.apa.org/pubs/journals/releases/amp-a0035747.pdf

8. Bicket, M. C., Gupta, A., Brown, C. H., & Cohen, S. P. (2013, October 01). Epidural Injections for Spinal Pain:A Systematic Review and Meta-analysis Evaluating the “Control” Injections in Randomized Controlled Trials. Retrieved from http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1918146

9. M., S., B., A., A., & G. (n.d.). Analgesic effects of transcutaneous electrical nerve stimulation (TENS) in patients with fibromyalgia: A systematic review. Retrieved March 04, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/30029964

10. Joseph, L. H., Hancharoenkul, B., Sitilertpisan, P., Pirunsan, U., & Paungmali, A. (2018). Effects of Massage as a Combination Therapy with Lumbopelvic Stability Exercises as Compared to Standard Massage Therapy in Low Back Pain: a Randomized Cross-Over Study. International journal of therapeutic massage & bodywork11(4), 16-22.

11. Hoon, E. A., Gill, T. K., Pham, C., Gray, J., & Beilby, J. (2015). A population analysis of self-management and health-related quality of life for chronic musculoskeletal conditions. Health expectations : an international journal of public participation in health care and health policy20(1), 24-34.

What is CBD oil used to treat?

CBD oils are the hot topic right now, but what does the research say it is effective at helping?

CBD is one of the 104 chemical compounds known as cannabinoids found in Cannabis sativa (1), commonly called marijuana plant or just cannabis. It can be obtained with or with out Tetrahydrocannabinol (THC) which is the main psychoactive cannabinoid found in cannabis. THC is attributed with the sensation of getting “high” with the use of marijuana. However, unlike THC, CBD is not psychoactive.

CBD oil is made by extracting CBD from the plant and then diluting it with a carrier oil such as hemp seed or coconut oil. It has been gaining momentum in the health and wellness world, some of the studies suggest the it may help in a variety of ailments such as chronic pain, anxiety, muscle pain, and inflammation.

Chronic Pain

The human body has a specialized system called the endocannabinoid system (ECS), this is involved in regulation a variety of functions including sleep, pain, immune system response, and appetite (2). The body produces endocannabinoids, which are the neurotransmitters that bind to the cannabinoid receptors in your nervous system.

Studies have show that CBD may help reduce chronic pain by impacting the endocannabinoid receptor activity, reducing inflammation and interacting with the neurotransmitters (3). In another study of patients with multiple sclerosis those treated with Sativex, an oral spray which is a combination of THC and CBD, for one month experienced a significant improvement in pain, walking and muscle cramps when compared to a placebo group (4). Another study found that it improved pain during movement and rest in people with rheumatoid arthritis (5).

In short, CBD oil is showing promise in reducing inflammation in lots of different conditions. We could use these studies to apply this to more acute conditions such as whiplash after an auto injury, or after a sports injury, to reduce inflammation and jump start the road to recovery.

https://www.healthline.com/nutrition/cbd-oil-benefits#section1

Reducing Anxiety and Depression

CBD oil is showing promise in the treatment for both depression and anxiety, as a more natural treatment approach.

The research found that CBD helped reduce anxiety and cognitive impairment and discomfort in a study comparing public speaking anxiety when compared to a placebo group (6). It has also been used in the treatment of anxiety and post-traumatic stress disorder in children (7).

Side Effects?

CBD is generally well tolerated and considered safe, the most common side effects in people are diarrhea, changes in appetite, and some fatigue. CBD is also know to interact with several medications, so before you start using CBD oil it is recommended to discuss it with your prescribing doctor or pharmacist to make sure it is not going to interfere negatively with any medications you are taking.

Summary

CBD oil has the potential to treat a large variety of health conditions from minor to more serious. There is new studies being done all the time on the application and use of CBD and cannabinoids. I am interested to see more research in this field directed towards more acute injuries as an alternative to the use of opiods and other pain relievers with a longer list of serious side effects.

  1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington (DC): National Academies Press (US); 2017 Jan 12. 2, Cannabis. Available from: https://www.ncbi.nlm.nih.gov/books/NBK425762/
  2. Mouslech, Z., & Valla, V. (n.d.). Endocannabinoid system: An overview of its potential in current medical practice. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19675519
  3. Genaro, K., Fabris, D., Arantes, A., Zuardi, A. W., Crippa, J., & Prado, W. A. (2017). Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats. Frontiers in pharmacology8, 391. doi:10.3389/fphar.2017.00391
  4. Mouslech, Z., & Valla, V. (n.d.). Endocannabinoid system: An overview of its potential in current medical practice. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19675519
  5. Blake DR, e. (2019). Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoi… – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16282192
  6. Bergamaschi, M. M., Queiroz, R. H., Chagas, M. H., de Oliveira, D. C., De Martinis, B. S., Kapczinski, F., Quevedo, J., Roesler, R., Schröder, N., Nardi, A. E., Martín-Santos, R., Hallak, J. E., Zuardi, A. W., … Crippa, J. A. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology36(6), 1219-26.
  7. Shannon, S., & Opila-Lehman, J. (2016). Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente journal20(4), 108-111.