Pain Between Your Shoulders?
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Houston Area Chiropractor Comments: Patients come into the office complaining of burning pain in their upper back or stabbing pain between their shoulders. Pain in the upper and/or mid back is less common than lower back pain or neck pain in Houston. The upper back is the area between the cervical spine (neck) and the low back (lumbar spine). The upper back is called the thoracic spine, and it is the most stable part of the spine. The range of motion in the upper back is limited because of the spine’s attachments to the ribs (rib cage). This stability plays an important role in holding the body upright and providing protection for the vital organs in the chest.
The primary causes of thoracic pain are muscular problems, joint dysfunction, herniated or degenerative discs, arthritis, vertebral fractures, kyphosis (hunchback) or scoliosis. Muscular problems are the most common and are typically related to poor posture or being in the same posture for prolonged periods of time (ie. on a computer or having large breasts). Joint dysfunction is typically related to spinal subluxations or irritation where the ribs attach to the spine. Degenerated or herniated discs in the thoracic spine are not as common as the cervical or lumbar spine, but can cause pain also. Arthritic changes increase as the person ages. The arthritis can cause aggravation of the joints or irritation of the nerves. Vertebral fractures can either come from compression fractures in people with osteoporosis or from accidents or injuries. Kyphosis (hunchback) can be due to Scheuermann’s kyphosis, ankylosing spondylitis (AS) or simply poor posture. Scoliosis is a sideways curvature of the spine.
Thoracic pain can also be due to secondary causes. Some of the secondary causes of mid back pain are bone cancer, shingles, stomach ulcers, problems affecting the lung (including a Pancoast tumor), stomach, liver, gallbladder and pancreas problems can all cause referred pain in the thoracic spine area.
The key to getting pain free is a proper history and exam so that the correct diagnosis is made. Here at Beecher Chiropractic we have seen hundreds of cases of mid back pain over the last 26 years. We will be able to determine if you simply need to modify your workstation, do you need chiropractic care and/or rehabilitative exercises or do you need to be referred to another provider. Your health is our primary concern.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Spondylolisthesis – What Is That?
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Bay Area Chiropractor Comments: Ashley was competing in a gymnastics tournament last year and during one of her floor routines, noticed a sharp pain in her low back after performing a series of back hand springs. She said she landed crooked on the last of four back hand springs which resulted in immediate pain in the middle of the low back at the beltline. She has had pain in the low back before and initially, didn’t think this was any different from past episodes but when the pain didn’t improve after a week, she asked her parents if she could see their chiropractor for an adjustment. Her chiropractor took her history and was alerted by the mechanism of injury – the rapid onset of pain after bending backwards and landing crooked during her routine. The low back was carefully examined and during the range of motion testing, Ashley’s backward bending test was very painful and limited in motion. When bending backwards at an angle with pressure applied in the low back, sharp pain stopped the test immediately. Her neurological tests were normal and she could bend over and touch her toes – in fact, that felt good. Her chiropractor had a strong suspicion of what had happened and ordered an x-ray to see if the preliminary diagnosis was accurate. The x-rays looked normal but with the history of extreme backward bending and immediate pain onset, a bone scan was ordered which was positive for a stress fracture in the back part of the vertebra. Unfortunately, this meant no gymnastics for 3 months and the use of a low back brace was recommended. The good news is that the back pain was gone within a month and follow-up x-rays 3 months later did not reveal a visible fracture line in the vertebra. Ashley was able to resume gymnastics and competed with success and no low back pain in Houston.
So, what is spondylolisthesis? As depicted in the side view low back x-ray (left), it is the sliding forward of one vertebra over another (see arrow). It occurs in about 7% of the western population and up to 30-50% in cultures that carry their young on their back (like a back pack). It is reported that most people who develop spondylolisthesis acquire this between ages 6 and 16 due to a developmental weakness in that part of the spine, though the cause can be traumatic, like in Abby’s case where rapid, uncontrolled backward bending occurs. It can also gradually occur over time (called “degenerative”), usually not found before age 50-60, where no single event can be recalled by the patient. There is also a congenital type that can be hereditary where one is born with it, though most authorities feel it is acquired at an early age. The good news is that it is often stable and does not require surgery. In the more severe case, the nerves and/or spinal cord can get pinched in which case surgery is necessary. The symptoms would then include leg pain, weakness, and/or numbness with or without significant low back pain. Most cases however, can be successfully managed without surgery and do not compromise the nerves or cord.
Chiropractic has been found to be very successful in managing patients with spondylolisthesis as the pain generator is often above or below the slipped vertebra. In fact, in one report, chiropractic was found to be more beneficial than medical care for this condition (Mierau D, et.al., J Manip Physiol Therap 1987;10:49-55).
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Is It Really Neck Pain?
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Houston Area Chiropractor Comments: A 48-year-old male had left sided neck pain with intermittent left arm tingling, numbness, and aching for 2.5 months. The pain was described as a deep nagging ache on the left side of the neck with a more intense pain in the left shoulder blade that occurred without any specific activity. Also, no particular position of the neck or head changed the symptoms in the neck or left arm. The patient described having periodic episodes of neck and left arm pain/numbness 4 or 5 times over the last 10 years, and he felt that this episode was similar to the previous episodes. He had utilized chiropractic treatment previously with good results and was considering calling for an appointment once again.
Everything “looks and sounds” like a neck condition with an associated pinched nerve causing pain and tingling radiating down the arm – but is it?
After carefully questioning, it was discovered that no specific date of onset could be tied to a trauma (specific injury), over-use activity, or any other identifiable cause. Similarly, he stated that no specific position of the head/neck or arm changed the intensity or length of time the pain lasted. This is unusual for a pinched nerve in the neck as the nerves are stretched when the arm hangs down at the side increasing the pain, and less stretched when the arm is raised over the head resulting in less arm symptoms. Another inconsistent finding was that the whole arm rather than a specific part of the arm was symptomatic. Usually, a pinched nerve follows a specific course down the arm affecting either the 4th and 5th fingers or the thumb side of the hand, but not the whole arm and hand. The physical examination was fairly typical for neck pain sufferers – limited ranges of motion of the neck, neck pain reduction with manual traction and increased with compression tests. However, there were no arm symptom changes during the neck ranges of motion tests, compression tests, or elevating the arm.
These history and examination findings should alert the health care provider of a possible “organic” cause for the symptoms rather than the “pinched nerve” diagnosis. When considering a list of possible “organic” causes, heart disease must be first on the list since it has life threatening potential. In the case presentation above, the patient was indeed having a heart attack where the blood vessels to part of the heart wall were blocked and the blood carrying oxygen to the heart muscle couldn’t get through, thus was causing the “referred pain” to the left side of the neck, shoulder blade and down the left arm. It is important to know that this heart related referred pain pattern never involves the right arm – only the left. Other potential symptoms can include left jaw (TMJ) pain, and the more obvious left sided chest pain, even though these were not present in this case.
We welcome you to contact our office for a thorough evaluation or to answer any questions concerning you, your loved ones, or friends concerning neck pain, with or without arm complaints. The good news is that it is probably your neck and not your heart that is causing the symptoms. Most importantly, rest assured that we ALWAYS consider all possibilities.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Carpal Tunnel and Computer Work
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Clear Lake Chiropractor Comments: Approximately 2/3rds of employees from industrialized countries use a computer on a daily basis and one of five spend at least 75% of their total work time behind a computer. It’s no wonder so many suffer from neck, shoulder, arm pain, including carpal tunnel syndrome (CTS). There are many reasons for the presence of CTS in office workers who utilize a computer. The following is a partial list of causes:
- The computer screen is not positioned correctly in front of the worker forcing the neck to be rotated to the side or the head has to look up or down too far.
- The mouse and/or keyboard is placed on top of a counter, too high to operate without significant bending of the wrist, often against the sharp edge of the counter.
- The shape of the keyboard is flat, forcing the hands and wrists to pronate (roll inwards) too far. This places more pressure on the nerves in the forearms.
- The use of a mouse usually requires the entire arm to move, frequently running off the mouse pad requiring repositioning.
- Paper work data that needs to be entered in the computer is placed too far off to the side and sustained neck rotation is required during the data entering process.
- The chair and computer desk do not fit the person’s height (either too high or too low) and/or the feet don’t touch the floor.
- There is too much glare from windows or overhead lighting making it difficult to see the screen.
- In the aging worker, poor eye sight requires the use of magnifiers which can be quite distorting when the head is moved, even a small amount.
- There are often other medical conditions that the computer operator may have that increase the likelihood of developing CTS such as obesity, hormone replacement therapy, diabetes mellitus, hypothyroid, the use of birth control pills, and others.
Blogging? flickr photo by Anonymous Account shared under a Creative Commons (BY) license
Therefore, the treatment of CTS must be multi-factorial and sometimes address one or more additional health issues that may co-exist. There are also frequently, many similar overuse types of conditions present in addition to CTS such as neck strain, thoracic outlet syndrome, nerve compression at one or more locations such as the neck, shoulder, elbow, forearm as well as at the carpal tunnel of the wrist. Each patient’s case is unique and a careful history is usually needed to uncover these potential contributing conditions so they can all be properly managed in addition to CTS. Because we spend a lot of our daytime hours at work, a careful work related history is important to identify potential “ergonomic” (design) culprits that can be fixed with simple workstation adjustments. These may include mouse/keyboard placement to an under the desk pull out tray to eliminate the need to overly bend the wrists and eliminate the pressure from the counter top edge. Raising a chair and placing a box under the feet while sitting (for shorter workers), switching to a track ball mouse so only thumb movement is needed to move the pointer (or a touchpad as found on most laptops), an ergonomic keyboard (curved, not flat), moving the screen in front and slightly down from eye level, prop paperwork on a stand-up tray close to the screen so only eye movement is needed, wearing appropriate quality eye glasses possibly with bi- or trifocals, are some potential work station remedies. Treatment that addresses all the contributing issues frequently includes neck, mid-back, shoulder, elbow, forearm, and wrist/hand. Chiropractic care is especially well suited to address these issues because of the whole body treatment approach utilized. We are also well trained in evaluating the work related and will work with your employer to cooperatively improve problems that may be perpetuating the condition. If you or a loved one is suffering with carpal tunnel syndrome, sharing this information may be one of most significant acts of kindness that you can give to those that you care about.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with your houston chiropractor by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Does the Use of a Low Back Support or Brace Really Make a Difference?
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Clear Lake Chiropractor Comments: “Do you think a back brace will help my condition?” This is a question that is frequently asked of many health care providers who treat low back pain. The answers typically vary, as there is support for and against the use of a brace when low back pain is present.
The use of back braces had been considered a “standard” in the treatment of patients with LBP for many years. One argument against using back braces centers around becoming “dependent” either physically or mentally on its use and this has long been a concern among health care providers. Braces are particularly helpful when the patient cannot stop performing needed activities, such as work. The brace helps to reinforce proper bending and lifting by minimizing rotation and side bending. The patient needs to also take breaks from the brace when it is not needed or during periods of rest. Ultimately most people will not need the brace as the problem is resolved and supporting muscles are developed to prevent aggravation.
There are many types of back braces. Some are narrow and are particularly favored when frequent bending and/or twisting movements are required by a job, sport, or other daily activity. Other braces are taller in the back and taper in the front, which give better support but still allow some bending / twisting movements. Some braces are more rigid and can actually stop movement in certain directions. These types include a hard, rigid surface that is placed in the area of the back where movement is not desired. These are used at times when there are fractures of the spine, after spinal surgery and in scoliosis bracing. Some braces are to be worn low on the pelvis to support that area, while most are placed in the center of the low back region. There are also rib belts sometimes used when ribs fracture, soft and rigid neck braces sometimes used after car accidents, and braces for the arms or legs. The decision to use a brace rests on the degree of injury and the patient’s ability to avoid certain activities or positions. When the injury is significant and/or the patient cannot control his/her activities (such as work), then the use of a brace may be one of the most important treatment approaches for that patient. It’s similar to having stitches when a deep or wide cut occurs. Ask us about the use of supports, braces, or belts if you or your family or friends are suffering with low back pain.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
The Neck and Headache Connection
The Neck and Headache Connection
Clear Lake Chiropractor Comments: Patients with headaches also commonly complain of neck pain. This relationship is the rule, not the exception and therefore, treatment for headaches must include treatment of the neck to achieve optimum results. The term, “cervicogenic headaches” has been an accepted term because of the intimate connection between the neck and head for many years. There are many anatomical reasons why neck problems result in headaches. Some of these include:
- The first 3 nerves exiting the spine in the upper neck go directly into the head. They penetrate the muscles at the top of the neck near the attachments to the skull and therefore, any excess pressure on these nerves by the muscles or spinal joints will result in irritation and subsequent pain.
- The origin or nucleus of the 5th cranial nerve called the Trigeminal, innervates the sensation to the face and is located in the upper cervical region near the origin of the 2nd cervical spinal nerve, which innervates sensation to the back of the head up to the top. Therefore, problems located in the upper neck will often result in pain radiating up from the base of the skull/upper neck over the top of the skull to the eyes and /or face.
- The 11th cranial nerve that innervates the upper shoulders and muscles in the front of the neck arises from the top 5 to 7 spinal cord levels in the neck. Injury anywhere in the neck can result in spasm and pain in these large muscle groups.
- Other interconnections between the 2nd cervical nerve and trigeminal/5th cranial nerve include communication with the 7th cranial / facial nerve, the 9th cranial / glossopharyngeal nerve, and the 10th cranial / vagus nerve. These connections can affect facial muscle strength/movements, taste, tongue and throat movements, and stomach complaints such as nausea from these three cranial nerve interconnections, respectively.
Headache flickr photo by Peter Hellberg shared under a Creative Commons (BY-SA) license
When patients seek treatment for their headaches, a thorough examination of the neck, upper back, and cranial nerves is routinely performed for the above reasons. It is common to find upper cervical movement and vertebral alignment problems present in patients complaining of headaches. Tender points located between the shoulder blades, along the upper shoulders, on the sides of the neck and particularly, at the base of the skull are commonly found. Pain often radiates from the tender point over the top of the skull when pressure is applied in the upper neck/base of the skull area. Tenderness on the sides of the head, in the temples, over the eyes, and near the jaw joint are also common. Traction or pulling the head to stretch the neck is often quite pain relieving and this is often performed as part of the chiropractic visit and can also be applied at home with the use of a home cervical traction unit. Chiropractic adjustments applied to the fixated or misaligned vertebra in the upper neck often brings very satisfying relief to the headache sufferer. Exercises that promote movement in the neck, as well as strengthening exercises are also helpful in both reducing headache pain and in preventing occurrences, especially with stress or tension headaches.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with a Clear Lake chiropractor by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Carpal Tunnel Syndrome (CTS) – Common Issues
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Houston Doctor Comments: You are driving down the road and you notice numbness and tingling in your fingers. You find temporary help by shaking and flicking the fingers, trying to “wake them up.” You’ve also noticed your sleep is becoming interrupted and the need to shake and flick the fingers in the middle of the night is becoming more frequent. If this sounds like you or someone you know, you’re not alone. This condition affects many workers as well as “stay-at-home moms,” as woman are 3 times more likely to develop CTS, or carpal tunnel syndrome, due in part that the carpal tunnel itself is smaller than those in men. Also, women tend to work faster in fast, repetitive jobs, and are often hired specifically for that reason. Further, when workers are paid by the number of pieces they produce, the tendency is to try complete as many pieces as possible so as to make that much more over their base hourly wage.
Basically, CTS is caused by pressure building up in a small confined space through which a nerve (the median nerve) and 9 tendons converge into this tight opening into the hand. When repetitive work/fast movements are performed over hours at a time and day after day, the friction produced by the tendons rubbing against each other results in heat, swelling, pain, and median nerve pinching which produces the classic symptom of tingling/numbness into the 2nd, 3rd and half of the 4th fingers. Hence, those at greatest risk for developing CTS include line workers such as manufacturing, sewing, finishing, cleaning, and fish and/or meat packing. In 1998, 3 of every 10,000 workers lost work time due to CTS of which half missed more than 10 days of work. Considering the increased amount in today’s dollars of medical and disability costs, the average lifetime cost of CTS was estimated at $30,000 for each worker back in 1998.
So, how do you know if you have CTS? The early signs include occasional numbness or tingling in the fingers that you probably wouldn’t think much about since simply shaking your hand or flick the fingers, it goes away. As the numbness becomes more frequent and it does not respond by shaking and flicking the fingers as quickly, you might take notice. Without proper management, difficulty buttoning shirts/cuffs, writing, holding onto small objects, opening jars, all become gradually more pronounced. When sleep becomes interrupted, especially when it becomes necessary to get up and move around before being able to return to sleep, that’s when people usually decide, “I better see someone for this!”
Treatment success is directly related to how fast a person reacts by making a prompt appointment. The best results always occur when care is obtained quickly, when the initial symptoms first appear. In addition, there are sometimes underlying contributors or causes such as diabetes, arthritis, pregnancy, birth control pill use, hypothyroid, obesity, and other conditions that may need proper management in order to relieve the symptoms. Non-surgical care includes the use of wrist splints (especially at night when sleeping), anti-inflammatory measures (medications, gluten-free/paleo diet, vitamin B6 and others such as omega 3 fatty acids/fish oil, vitamin D3 in high doses, calcium, magnesium, CoQ10), work station modifications, forearm exercises, chiropractic manipulation of the neck and arm, acupuncture, and certain modalities such as low level laser/light therapy, can all be helpful.
Surgery should always be considered a “last resort” after all non-surgical approaches have been exhausted. Rarely is there a “medical emergency” that warrants prompt surgical release except in cases of fracture where the carpal tunnel canal is abruptly reduced in size. You need a “quarterback” to help guide you in the treatment/management process. Chiropractors are well trained to manage CTS and offer a non-drug, non-surgical solution to this potentially disabling condition.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with a Clear Lake chiropractor or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Whiplash: Where Is My Neck Pain Coming From?
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Houston Chiropractic Doctor Comments: Last week while driving to work, you’re stopped at a red light and glance in the rearview mirror and notice that a car is approaching from behind way too fast. The next thing you remember is the squeal of the tires and a loud crash with an accompanied sudden jolt as your car is propelled forward by the impact. Your initial reaction is one of shock, wondering is anyone hurt? How bad is my car damaged? Will there be another hit? Should I get out of the car? I’m going to be late for work! Within a few minutes, the police arrive and after about an hour of taking statements from the two drivers and a few witnesses, you decline an ambulance offer to take you to a nearby hospital for an examination as, “…this little stiffness and ache in my neck is no big deal.” Happy you can still drive your car, you arrive at work an hour and a half late. After reviewing the details of the crash with co-workers several times, you begin to notice a headache, your neck stiffening up and movements becoming limited and painful. After another couple of hours and a few Ibuprofen, the neck pain has increased and you now have a whopping headache. You decide, “I better go see my chiropractor to see if something is wrong.”
After the exam and x-rays, the chiropractor shows you a chart and explains the mechanism of injury that usually occurs in a low 
speed rear-end collision. A couple of things that were said really hit home in helping you to understand how such a seemingly minor crash can create so much pain. The first is that it is not possible to voluntarily contract a muscle quick enough and “brace” to prevent the acceleration of the head. Upon impact, as the car is propelled forwards, the head initially goes backwards and then when the muscles in front of the neck are stretched to their limits, the head is then “whipped” forwards in a “crack the whip” type of response and all of this takes less than 600-700 milliseconds! Because of the far limits of neck motion being reached during this process, the ligaments that hold the vertebra together are often stretched and/or torn. This can be appreciated on the bending neck x-rays which shows one vertebra sliding forwards on the one below and the angle created being greater when compared to the surrounding vertebra. The second point of discussion that stands out was the fact that your head was rotated at the time of impact from looking in the rearview mirror places the neck at a greater risk of injury because of the twisting motion that occurs during the “crack the whip” process. Another interesting point: because there wasn’t a lot of car damage, the shock and force of the impact was not absorbed by crushing metal and that energy is therefore transferred to the contents in the vehicle, including the occupants. That is why your briefcase ended up on the floor and your glasses flew off during the crash. Another point of discussion was made concerning the difference between genders and the degree of injury, as women are more likely to be injured more severely because of the less muscular and sometimes longer female neck. The degree of injury is also at greater risk when there is osteoarthritis in the neck that pre-exists the crash. An analogy of how a young sapling branch can bend without breaking verses the “old oak branch” which snaps and breaks when its only bent slightly. So, if you are a middle aged, female with a long slender neck with pre-existing arthritis looking in the rearview mirror prior to impact in a rear-end collision, ligament over stretching / tearing is highly probable.
In summary, it is important to obtain prompt evaluation and treatment by your chiropractor as soon as possible as when time passes without treatment, it is more difficult to bring about a reduction of pain and increased motion and, it will generally take longer. Taking medication for pain only postpones the needed process of restoring movement and function of the neck so that should not be the only treatment. In general, a “wait and watch” approach is not wise in these types of injuries. If you or a loved one is suffering with whiplash, sharing this information may be one of most significant acts of kindness that you can give to those that you care about.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
Neck and Arm Pain – The Herniated Disc?
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Clear Lake Doctor Comments: Patients that present with neck pain along with arm numbness, pain, and/or weakness, often ask, “…what’s causing this pain down my arm?” The condition is often caused from a bulging or herniated disc pinching a nerve in the neck. The cause of this complaint can include both trauma as well as non-traumatic events. In fact, sometimes, the patient has no idea what started their condition, as they cannot tie any specific event to the onset.
The classic presentation includes neck pain that radiates into the arm in a specific area as each nerve affects different parts of the arm and hand. Describing the exact location of the arm complaint
such as, “I have numbness in the arm and hand that makes my 4th and pinky fingers feel half asleep,” tells us that you have a pinched C8 nerve. This nerve can also be pinched at the elbow and make the same two fingers numb. The difference between the two different conditions is when the nerve is pinched in the neck, the pain is located from the neck down the entire arm and into digits 4 & 5 of the hand. When the nerve is pinched at the elbow, the pain/numbness is located from the elbow down to the 4th & 5th digits, but no neck or upper arm pain exists.
Examination findings usually include limitations in certain cervical (neck) ranges of motion (ROMs) – usually in the direction that increases the pinch on the nerve. Another common finding is the arm is often held over the head because there is more stretching on the nerve when the arm is hanging down and pain in the neck and arm increases. Hence, raising the arm over the head reduces the neck/arm pain. To determine where the nerve is pinched, there are a number of different compression tests that can recreate or increase the symptoms. Some compression tests include placing downward pressure on the head with the head pointing straight ahead, bent or rotated to each side. Other compression tests are performed by pressing in areas where the nerve travels such as in the lower front aspect of the neck, in the front of the shoulder where the arm connects to the chest/trunk, at the elbow and at the wrist. If there is a pinched nerve, numbness, tingling and/or pain will be reproduced when pressure is applied to these regions. Other tests include testing reflexes and muscle strength in the arm. When a nerve is pinched, the reflexes will be sluggish or absent and certain movements in the arm are weak when compared to the opposite side. Another very practical test is called the cervical (neck) distraction test where a traction force is applied to the neck. When neck and/or arm pain is reduced, this means there is a pinched nerve. This test is particularly useful because when pain is reduced, the test supports the need for a treatment approach called cervical traction. Other forms of care that can be highly effective include spinal manipulation, spinal mobilization, certain exercises, physical therapy modalities, and certain medications.
If you, a friend, or a loved one are struggling with a herniated disc in the neck with associated arm complaints, we will properly assess your condition, run the appropriate tests, and administer the appropriate care that is needed. We also coordinate services with other health care providers when necessary. This recommendation may represent one of most significant acts of kindness you can give to those that you care about.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment at BeecherChiropractic.com or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
What Makes Low Back Pain So Common?
Clear Lake Doctor Comments: Low back pain (LBP) is one of the most common types of pain involving the musculoskeletal system. LBP sufferers may sometimes miss work or be unable participate in desired activities, social outings, and the like. It can be so disabling that out of desperation, they visit the ER.
There are many causes of LBP. Some of the obvious include over lifting/carrying, performing a task for too long or with too many repetitions, and sitting or standing in one position for too long. However, frequently LBP seems to occur for no apparent reason, or at least none that can be clearly identified. One of the most basic causes of LBP is simply standing on two, rather than four legs. When comparing a 4-legged to a 2-legged subject, arthritis of the spine and disc degeneration occurs much earlier in those of us with two legs. This is due partially because 2/3rds of our weight is supported by the low back and pelvis. In addition, vertical loading occurs in the 2-legged subject whereas the load is distributed between four legs in a horizontal fashion in the 4-legged species. Other less obvious causes of LBP include physical characteristics such as flat feet (fallen arches), a short leg resulting in a tipped pelvis, carrying too much weight, being out of shape/weak muscles, as well as hereditary factors. Non-physical characteristics include diet, exercise participation, lifestyle, stress and other psychological conditions such as depression, anxiety, bipolar disorders, and others. Hence, treatment must address the entire person, not just the low back since often, several of the characteristics mentioned here are present and often participating in the cause for LBP.
Because many of these characteristics are not properly attended to, LBP tends to be recurrent, where multiple episodes come and go over time. In years past, health care providers would focus the majority of their attention on the physical characteristics of LBP and when treatment results was ineffective, the blame was placed on the psychological aspects for which little, if any, treatment was offered. However, over the last 20 years, the shift towards treating the whole person or, adopting the biopsychosocial model (bio- = physical, psycho- = mental, and social = how LBP is perceived and affects daily social interaction) has been emphasized as the appropriate approach when managing patients with low back pain. No longer should the psychological aspect be ignored but rather, identified and treated so that this significant barrier to recovery can be properly managed.
Regarding treatment, unless someone presents with a “red-flag” which, for LBP sufferers include cancer, fracture (especially unstable fractures), cauda equine syndrome (spinal cord pinching resulting in bowel / bladder control loss), or infection, immediate/emergent care is not required. A careful health history followed by appropriate tests can usually identify these “red flags.” Otherwise, surgery for LBP is not recommended until at least 4-6 weeks of treatment with non-surgical approaches are first utilized and, an identifiable “lesion” can be identified that clearly is causing the presenting complaints and clinical findings. Chiropractic has an obvious advantage over specialty care when considering non-surgical treatment of LBP. Both physical and emotional issues are identified and a “team” approach with other health care providers when required is ordered. Moreover, all the international guidelines published for treating LBP recommend spinal manipulation BEFORE most of the other non-surgical approaches are tried due to medication side-effects and, the successes reported in many studies where spinal manipulation is performed.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001 Pineloch, Ste 700 Houston, TX 77062. You can schedule an appointment with your Houston chiropractor or by calling (281) 286-1300. If you have any questions regarding this blog, please comment below!
