When you think of low back pain, you may visualize a person half-bent over with their hand on the sore spot of their back. Since many of us have experienced low back pain during our lifetime, we can usually relate to a personal experience and recall how limited we were during the acute phase of our last LBP episode. However, when the symptoms associated with LBP are different, such as tingling or a shooting pain down one leg, it can be both confusing and worrisome – hence the content of this month’s article!
Let’s look at the anatomy of the low back to better understand where these symptoms originate. In the front of the spine (or the part more inside of the body), we have the big vertebral bodies and shock absorbing disks that support about 80% of our weight. At the back of each vertebrae you’ll find the spinous and transverse processes that connect to the muscles and ligaments in the back to the spine. Between the vertebral body and these processes are the tiny boney pieces called the pedicles. The length of the pedicle partially determines the size of the holes where the nerves exit the spine.
When the pedicles are short (commonly a genetic cause), the exiting nerves can be compressed due to the narrowed opening. This is called foraminal spinal stenosis. This compression usually occurs later in life when osteoarthritis and/or degenerative disk disease further crowds these “foramen” where the nerves exit the spine. Similarly, short pedicles can narrow the “central canal” where the spinal cord travels up and down the spine from the brain. Later in life, the combined effects of the narrow canal plus disk bulging, osteoarthritic spurs, and/or thickening or calcification of ligaments can add up to “central spinal stenosis.”
The symptoms associated with spinal stenosis (whether it’s foraminal or central) include difficulty walking due to a gradual increase in tingling, heavy, crampy, achy and/or sore feeling in one or both legs. The tingling in the legs associated with spinal stenosis is called “neurogenic claudication” and must be differentiated from “vascular claudication”, which feels similar but is caused from lack of blood flow to the leg(s) as opposed to nerve flow.
At a younger age, tingling in the legs can be caused by either a bulging or herniated lumbar disk or it can be referred pain from a joint – usually a facet or sacroiliac joint. The main difference in symptoms between nerve vs. joint leg tingling symptoms is that nerve pinching from a deranged disk is located in a specific area in the leg such as the inside or outside of the foot. In other words, the tingling can be traced fairly specifically in the leg. Tingling from a joint is often described as a deep, “inside the leg,” generalized achy-tingling that can affect the whole leg and/or foot or it may stop at the knee, but it’s more difficult to describe by the patient as it’s less geographic or specific in its location.
Chiropractic management of all these conditions offers a non-invasive, effective form of non-surgical, non-drug care and is the recommended in LBP guidelines as an option when treating these conditions.
Pregnancy is a beautiful experience, and we all want to provide the best environment for both mom and baby. The question of whether or not chiropractic care is safe during pregnancy is frequently raised by the newly-expectant mother as she plans for a healthy pregnancy. Chiropractic care during the nine-month time frame is a common practice, as many moms require professional care for biomechanical complaints (most notably back pain) or they simply want to feel “their best.”
A “normal” pregnancy is defined as “about 40 weeks, ranging between 37 and 42 weeks from the point of fertilization to delivery.” It’s the “norm” NOT to know exactly when fertilization happens, so we typically calculate the expected gestation period from the point of the woman’s last normal menstrual period. During the first trimester (the three-month period starting on the first day of the last menstrual period through the thirteenth week), the fertilized egg implants into the womb. This period of time is usually asymptomatic unless morning sickness occurs. Because the mom is often unaware of being pregnant, medication use and alcohol intake should be carefully watched FROM THE MOMENT SHE STARTS TRYING TO BECOME PREGNANT!
During the second trimester (the fourteenth to the twenty-seventh week), most women feel GREAT! No more morning sickness, increased energy, and by now, fetal movements are a pleasured sensation! Ultrasound during this time will be able to detect any problems, as well as identify the child’s sex.
The third trimester starts at the twenty-eighth week and finishes with the birth of the child. As the baby grows to fill the womb, the mom usually becomes more uncomfortable, especially in the last two to three weeks when the contractions begin that are needed to move the child down into the birth canal in preparation for birth. A vaginal delivery usually occurs within 24 hours of labor, and if labor does not occur by week 42, it may be induced by using medications that purposely initiate labor (such as pitocin).
With this as a foundation, chiropractic offers the pregnant mom many benefits. First regarding safety, a 2009 literature review found 33 references on this subject and concluded the results revealed a favorable outcome regarding the use and safety of chiropractic care throughout pregnancy. The authors concluded that chiropractic is a safe and effective means of treating common musculoskeletal complaints that often affect pregnant women. The use of chiropractic includes (but may not be limited to): making the pregnant mom feel more comfortable during her pregnancy, helping to facilitate an uncomplicated labor and delivery process, and to help control low back, mid back, and/or neck pain during the nine-month process. They reported that 50% of all pregnant women experience back pain during their pregnancy and 50-75% experience back pain during labor. The study points out that only 21% of pregnant women with back pain consult their medical physician about it. More than seven out of ten expectant mothers in a study who sought chiropractic treatment for back pain benefited from care. There are also special techniques some chiropractors are certified in such as the “Webster Technique” in which pediatricians and midwives will frequently refer the pregnant mother to a certified DC to move the fetus from a breach position to a head down (proper) position.
Backpack safety sounds like something an over-protective mother would worry about. However, the weight of a child’s backpack is a big deal. We see them hanging in the stores right when Back to School season begins. They come in all shapes, sizes, colors, and come covered in your child’s favorite characters.
They are amazing tools that are incredibly helpful when they are used correctly. They are better than shoulder bags, messenger bags, or purses, because they use the strong muscles from the back and abdominals to support the weight. When they are worn correctly, weight is distributed evenly, preventing shoulder and neck injuries.
However, when weighed down with too many books, papers, and supplies, these handy bags can strain muscles and joints, causing pain. Doctors and physical therapists recommend that kids only carry backpacks that weigh no more than 10-15% of their body weight. Sadly, many kids carry much more than that.
This kind of weight carried year after year causes damage. When worn incorrectly on the shoulders, the weight can pull your child backward. To compensate, many kids bend forward at the hips or arch their back. This makes the spine compress unnaturally and can lead to issues in the shoulders, neck, and back. Wearing the backpack over just one shoulder forces your child to lean to one side to offset the weight of the backpack. This leads to strain on the upper and lower back, placing unnatural strain on the shoulders and neck.
So, we at Pinto Chiropractic & Rehabilitation encourage you to advocate for your child. If you feel that your child is carrying too much in their backpack, talk to them. Find out if they are making the choice to carry unnecessary items in their bags. If their teachers or administration has unrealistic expectations of what your child should carry, advocate for them.
Your child has a bright, beautiful future. Protect it!
If you have questions or concerns, feel free to reach out to us at Pinto Chiropractic & Rehabilitation below, or call our office at 757-645-9022.
Many people seek chiropractic care when their back goes out or their neck tightens up. But how does this form of care actually work? What are the benefits of receiving chiropractic care for nerve dysfunction compared with other healthcare options? Let’s take a look!
First, let’s discuss how the nervous system “works.” We have three divisions of the nervous system: the central, peripheral, and autonomic nervous systems. The central nervous system (CNS) includes the brain and spinal cord, and it’s essentially the main processing portion of the nervous system. The spinal cord is like a multi-lane highway that brings information to the brain for processing (sensory division) and returns information back to the toes, feet, legs, and upper extremities from which the information originated (motor division). For example, hiking on a mountain trail or simply walking requires constant input to and from the CNS so we can adjust our balance accordingly and not fall. These “sensory-motor pathways” are essential and allow us to complete our daily tasks in an efficient, safe manner as information is constantly bouncing back and forth between the brain and the rest of the body.
The peripheral nervous system (PNS) includes a similar sensory/motor “two-way street” system relaying information back and forth from our toes/feet/legs and fingers/hands/arms to the spinal cord (CNS). And if this isn’t complicated enough, we also have “reflexes” that, for example, allow us to QUICKLY pull our hand away from a hot stove to minimize burning our fingers.
Reflexes allow the information to “skip” the brain’s processing part so quicker reactions can occur. The autonomic nervous system (ANS) includes the sympathetic and parasympathetic divisions that basically “run” our automatic (organ) functions like breathing, heart rate, digestion, hormonal output, and more. There is constant communication between the ANS, PNS, and CNS that allow us to function in a normal, balanced way… unless something disrupts them.
There are obvious conditions that interfere with this communication process that include (but are not limited to) diabetes (with neuropathy), frost bitten or burned fingers, peripheral nerve damage from conditions like carpal/cubital tunnel syndromes, thoracic outlet syndrome, and/or pinched nerves in the neck, mid-back, low-back spinal regions, as well as conditions such as multiple sclerosis (MS), Guillain-Barre Syndrome, after a stroke (spinal cord or brain), and after trauma with resulting fractures where nerve, spinal cord, and/or brain damage can occur. These are “obvious” reasons for delayed or blocked neurotransmission.
There are many other less obvious injuries or conditions that can result in faulty neuromotor patterns and nerve transmission of which chiropractic services can benefit. The “subluxation complex” is a term some chiropractors use to describe the compromised nerve transmission that may occur if a nerve is compressed or irritated due to faulty bone or joint position along the nerve’s course. Reducing such nerve compression typically allows for a restoration of function. A good illustration of this is a patient who suffers from a herniated disk in the neck with numbness and tingling down the arm to the hand. The goal of treatment (for all healthcare professionals) is to remove the pinch of the nerve.
To realize this goal, doctors of chiropractic utilize spinal manipulation and mobilization in addition to other non-surgical, non-drug approaches that may include exercises, nutritional advice, home-care such as a cervical traction unit, and other anti-inflammatory measures (ice, modalities like low level and class IV laser, electric stimulation, pulsed magnetic field, and more). Given the minimal side-effect risks and well-reported benefits, it only makes sense to try chiropractic FIRST and if you’re not satisfied, your doctor will help you find the next level of care.
The new school year is well into action. It’s a time of joy, new beginnings, and possible new injury risks. Here are some tips to stack the odds in your family’s favor.
Healthy school lunches and healthy exercise together are an opportunity to protect your child’s heart, decrease future diabetes and arthritis risks. Healthy exercise can be as simple as a daily walk, and innovative communities have established safe walking routes to and from school. Children should travel in groups, and need to be aware of traffic and potential human hazards. Should your child choose more intense forms of exercise such as recreational or organized sports, be sure they do so safely.
Another major risk to your children’s safety is right behind them: their backpacks. Heavy backpacks can cause growing frames to experience temporary backaches, joint pain, even muscle strains and headaches; and some children may begin a lifetime of these problems. Here’s a simple tip: Weigh your child, and then weigh his or her backpack. Only 4% of parents do this simple test, yet the children of those “4 percenters” carry the lighter backpacks. If you care about your child’s health and well-being -- and you know you do -- pull out the scale, and use it. A child’s daily backpack shouldn’t weigh more than 10% of total body weight, and some sources suggest a maximum of 5-10%. Simply put, your 100 pound child’s backpack should weigh under 10 pounds. For a 150 pound child, 15 pounds is the recommended maximum. For a 75 pound child, 7 1/2 pounds is the most he or she may be able to safely carry on their back.
In addition to stressing young frames and growing structures, heavy backpacks cause acute injuries. In fact, a study in Pediatrics showed that emergency room visits associated with backpacks are most highly correlated with tripping, with the head and face being the most commonly seriously injured body parts. Why not protect your kids with a simple device that most of us already own-- specifically, the bathroom scale?
Please, do take advantage of the opportunity to live… well… with chiropractic care. Our role is to help you feel and FUNCTION at your best — whether you are in pain, feeling better, or feeling great. If you're ready to work toward living a pain-free life, schedule an appointment and ask us how we can help. Call us at 757-220-8552 to schedule an appointment today. Click here to request an appointment online.
Work. It’s a part of modern adult life, and it can be a pain—literally. Neck pain, back pain, wrist pain, headaches, obesity, and worse—all can be related to your work habits. What is ergonomics, and how can that science help you get your daily work done, without compromising your health? Here are some facts and tips, courtesy of the Unified Virginia Chiropractic Association.
Work ErgonomicsYour employer has strong incentives to keep you healthy and pain-free at work. No, not just for safety – but to keep you on the job, focused and productive. A study of American workers demonstrated that 13% had decreased on-the-job productivity due to common pain conditions such as arthritis, back pain, headaches, and “other musculoskeletal” conditions (carpal tunnel syndrome, sprains/strains, etc.). As many as 5.4% of all workers suffered decreased on-the-job productivity due to headaches, with back pain not far behind.
Employers and employees alike take heart. Your doctor of chiropractic, with the aid of modern technology and a few simple adaptations, can help decrease, limit, or avoid pain in your body and your wallet.
Be Active as You Sit
The body was designed to move. Despite what mom may have said, sitting up straight for prolonged periods is not good for you. A reclined position and regular postural shifts help eliminate strain, muscle fatigue and back pain. NOTE: If your chair has a recline tension control – and modern ergonomic chairs often do — adjust it so the backrest supports you in both upright and reclined positions.
Avoid Chair Locks
Do not use a recline lock or limiter if your chair is outfitted with one. These devices restrict movement required for spinal nutrition. Motion is life, for both humans and their spines.
Position your mouse close to the keyboard or over the numeric keypad to minimize reaching. Avoid anchoring your wrist on the desk. Instead, glide the heel of your palm over the mousing surface and use your entire arm to mouse.
No, we don’t mean to stop staring angrily at co-workers! You’ll be more productive, and better off, if you position a task light to the side opposite your writing hand. Shine it on paper documents, but away from computer monitors, to reduce glare and potential eyestrain.
Doctors of chiropractic have extensive specialty training in the human frame and nervous system. They’re ideal partners for employers and employees alike who wish to maximize productivity, minimize on-the-job injury, and create a healthier society. Work with a doctor of chiropractic to optimize body mechanics, minimize or eliminate residuals of weaknesses and imbalances and injuries, and learn the rules that allow you to avoid injury and be more effective.
Our role is to help you feel better, heal better, and live better. If you're ready to work toward living a pain-free life, schedule an appointment and ask us how we can help. Call us at 757-220-8552 to schedule an appointment today.
Joint injuries like sprains, strains, and dislocations are common among young and elderly individuals alike. Generally a result of overuse or acute trauma, joint damage often begins as a small (and seemingly insignificant) complication that can compound into a chronic condition known as osteoarthritis or degenerative joint disease. Although joint health is essential for a long and healthy life, few realize the need to correct and manage the effects of joint damage.
How Does Joint Damage Progress?Whether joint damage begins with sudden knee trauma in a skiing accident or years of overuse at work, the injury progresses when scar tissue is created during the healing process.
When an injury occurs, soft tissue is stretched and torn. To heal the damage, the body quickly repairs damaged ligaments, cartilage, and muscle fibers with scar tissue. Unfortunately, scar tissue doesn’t have the same strength or flexibility as healthy, intact tissue. Its inferiority slowly causes a loss of mobility along with chronic pain ranging from mild to severe. This stiff aching eventually forces the joint to find comfort in abnormal, awkward movements that cause extra wear and tear on the body and further encourage degenerative changes.
Long Term Effects of Joint DegenerationEarly signs of joint degeneration include pain, stiffness, and a limited range of motion. Left untreated, these symptoms have the potential to impact more than just the affected joints. Let’s take a look at some of the specific long-term side effects of degenerative joint diseases like osteoarthritis.
Does Chiropractic Treatment Help?Non-steroidal anti-inflammatory drugs are commonly used to treat degenerative joint disease; however they do not stop the disease’s progression. In fact, many health experts believe that these drugs may actually promote the advancement of joint degeneration. Because regular chiropractic treatments are a drug-free way to prevent and/or slow joint degeneration, many patients now choose to put their health in the hands of chiropractors rather than pharmaceutical companies.
Joint damage can have long-term side effects on your physical health and quality of life. Our founder and chiropractor, Dr. Pinto, experienced this reality first-hand prior to studying chiropractic medicine. After enjoying an active lifestyle for years, the compounded effect of spinal trauma at a young age and sport-related injuries as a young adult suddenly caught up and he found himself struggling with severe low back pain. It was his life-changing visit to a chiropractor that made him realize the importance of addressing the underlying causes of his pain, ultimately leading him to become a doctor of chiropractic.
The bottom line is that left untreated, seemingly minor injuries can cause degenerative changes like osteoarthritis. Don’t let the effects of today’s afflictions put a stop to your future - schedule an appointment with us for an evaluation today.
Drs. Anne & Bob
Robert and Anne Pinto started their journey on July 17th, 1989 when they first opened their practice.