“Ice vs Heat”. Which one is right?
Ice vs Heat Which One Is Right?
Houston Chiropractor Comments: A common question I get in my clinic is “When do I use heat and when do I use ice?” Unfortunately this question is usually asked after they have already done the wrong one. The patient has usually relied on old information that has been passed down from grandma or what they remember their coach saying 20 years ago.
To understand which one to use, you need to understand the basic physiology of what you are trying to do. Cold therapy with ice is the best immediate treatment for acute injuries because it reduces swelling and pain. Ice is a vasoconstrictor (it causes the blood vessels to narrow) and it limits internal bleeding and swelling at the injury site. Apply ice (wrapped in a thin towel for comfort) to the affected area for 20 minutes at a time. Allow the skin temperature to return to normal before icing a second or third time (about 40 minutes). You can ice an acute injury every hour. It does not matter if the injury was 24 or 48 or 72 hours before, if there is swelling and pain, use ice.
Cold therapy is also helpful in treating some overuse injuries or chronic pain in athletes. An athlete who has chronic back pain or neck pain that increases after exercising may want to ice the injured area after exercise to reduce or prevent inflammation. It’s not helpful to ice a chronic injury before exercise.
The best way to ice an injury is with a high quality ice pack that conforms to the body part being iced. You can also get good results from a bag of frozen peas, an ice massage with water frozen in a paper cup (peel the cup down as the ice melts) or a bag of ice.
Heat is a vasodilator (it causes the blood vessels to get larger) which increases circulation to the area. Heat is generally used for chronic injuries or injuries that have no inflammation or swelling. Sore, stiff, achy muscle or joint pain is ideal for the use of heat therapy. Athletes with chronic pain or injuries may use heat therapy before exercise to increase the elasticity of joint connective tissues and to stimulate blood flow. Heat can also help relax tight muscles or muscle spasms. Don’t apply heat after exercise. Ice vs Heat, after a workout ice is the better choice on a chronic injury.
Because heat increases circulation and raises skin temperature, you should not apply heat to acute injuries or injuries that show signs of inflammation or redness. Safely apply heat to an injury 20 minutes at a time and use enough layers between your skin and the heating source to prevent burns. Leave the heat off for at least 40 minutes before using it again.
Moist heat is best, so you could try using a hot wet towel. You can also use heat producing lotions. I recommend Biofreeze to my patients. Never leave heating pads on for more than 20 minutes at a time or while sleeping to prevent burning.
Because some injuries can be serious, you should see your chiropractor of Houton TX if your injury does not improve (or gets worse) within 48 hours. If no improvement is made you should seek out Houston rehabilitation.
Dr. Ward Beecher practices at his Houston 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!
“Conservative” Treatment for Neck and Back Pain – A Chiropractic Perspective- Part 4 – Exercise
As a practicing chiropractic orthopedist, I am regularly asked what the difference between me and an orthopedic surgeon is. The simple answer is that I look for a conservative treatment option while the surgeon looks for a surgical treatment option. The term “conservative treatment” is used to describe any treatment option that does not involve surgery. This may be as simple as reassuring you that it is not a serious problem, and recommending that you just watch and wait. However, people with recurring back or neck problems should consider preventive measures. This includes learning how to protect your back and neck and exercising to strengthen your back and neck. Conservative treatment approaches include the use of:
Exercise
Exercise is vital to recovery and to maintaining a healthy spine. Consider it part of long-term health management and risk reduction. Regular exercise is the most basic way to combat back and neck problems. However, if you already have an injury or damage to your spine, talk to your doctor of chiropractic before you start an exercise routine, to make sure the exercises you choose are effective and safe for your particular case.
Why exercise? Scientific studies show that people who exercise regularly have far fewer problems with their spine. Exercise helps strengthen the muscles in your back that connect to your spine. Exercise can reduce your risk of falls and injuries. It can also strengthen your abdomen (your belly), arms, and legs, which reduces back strain. Stretching reduces risk of muscle spasms. In addition, weight bearing exercises help prevent loss of bone mass caused by osteoporosis, reducing your risk of fractures. Aerobic exercise, the type that gets your heart pumping and pulse rate up, has been shown to be a good pain reliever as well. The natural chemicals of the body that combat pain — called endorphins — are released during exercise and actually reduce your pain.
Exercises will help maximize your physical abilities including:
- Flexibility — exercises that increase flexibility help to reduce pain and make it easier to keep your spine in a healthy position. Flexibility exercises are helpful for establishing safe movement. Tight muscles cause imbalance in spinal movements, which can make it easier to injure your spine. Gentle stretching increases flexibility, eases pain, and reduces the chance of re-injury.
- Stabilization — “core” muscles are the muscles located closer to the center of your body and act as stabilizers. These key muscles are trained to help you position your spine safely and to hold your spine steady as you perform routine activities. These muscles form a stable platform, which allows you to move your arms and legs with precision. If the stabilizers are not doing their job, your spine may be overstressed by daily activities.
- Coordination — strong muscles need to be coordinated. As the strength of the spinal muscles increases, it becomes important to train these muscles to work together. Learning any physical activity takes practice. Muscles must be trained so that the physical activity is under control. Spine muscles that are trained to control safe movement help reduce the chance of re-injury.
- Conditioning — improving your overall fitness level will help you recover from spine problems. Fitness conditioning involves safe forms of aerobic exercise. The term aerobic means “with oxygen.” When using oxygen as they work, muscles are better able to move continuously, rather than in spurts. Examples of aerobic exercise include:
- Swimming laps
- Walking on a treadmill
- Using a cross country ski machine
- Using a stair stepper
If you decide you want some extra conditioning, always check with your doctor of chiropractic before beginning a program on your own. It is important that you choose an aerobic activity you enjoy. This will help you stick with it, so you reap the long-term benefits that come with a well-rounded exercise program.
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!
“Conservative” Treatment for Neck and Back Pain – A Chiropractic Perspective- Part 3 – Functional Training
As a practicing Houston chiropractic orthopedist, I am regularly asked what the difference between me and an orthopedic surgeon is. The simple answer is that I look for a conservative treatment option while the surgeon looks for a surgical treatment option. The term “conservative treatment” is used to describe any treatment option that does not involve surgery. This may be as simple as reassuring you that it is not a serious problem, and recommending that you just watch and wait. However, people with recurring back or neck problems should consider preventive measures. This includes learning how to protect your back and neck and exercising to strengthen your back and neck. Conservative treatment approaches include the use of:
Functional training
DC’s use functional training when you need help doing specific activities with greater ease and safety. Examples of functional training include:
- Posture — healthy posture keeps your spine in safe alignment, reducing strain on the joints and soft tissues around your spine. The time and effort you take to use good posture are vital to spine care, and will help to prevent future spine problems. As you regain strength and control, proper posture and body alignment will be easier to remember and apply with all your activities.
- Body Mechanics — think of body mechanics as putting safe posture into action. It is one thing to sit or stand with good posture, but another to keep safe posture as you actually move with activity. You want to keep your body in its safest alignment as you go about your daily tasks, such as getting out of a chair, taking out the trash, getting clothes out of the dryer, brushing your teeth, and lifting. Safe body movement is especially important during lifting. To avoid extra spine strain when lifting, use these safety tips:
- Plan and prepare for the lift
- Make sure you have good footing
- Straddle your feet with a wide base of support
- Keep the load close to your body
- Keep your spine stable and aligned
- Do not twist or pivot with your feet
- Ergonomics — Ergonomics looks at the way people do an activity. It is possible that even minor changes in the way you do your work or hobby activities could keep your pain and symptoms in check, while protecting your spine from further injury. Ergonomics doesn’t usually involve expensive changes. Even minor adjustments in the way you do your activities can make a huge difference in easing your pain and preventing further problems.
Once your pain is controlled, your range of motion has improved, and your strength is returning, you will be able to continue your therapy on your own at home. Your DC will review some of the ideas listed above to help take care of any soreness at home. You will be given instructions to help you keep working on your range of motion and strength. Before you are done with therapy, more measurements may be taken to see how well you are doing now compared to when you first started therapy.
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!
“Conservative” Treatment for Neck and Back Pain- Part 2 – Pain Control
Houston Chiropractor Comments: As a practicing Houston chiropractic orthopedist, I am regularly asked what the difference between me and an orthopedic surgeon is. The simple answer is that I look for a conservative treatment option while the surgeon looks for a surgical treatment option. The term “conservative treatment” is used to describe any treatment option that does not involve surgery. This may be as simple as reassuring you that it is not a serious problem, and recommending that you just watch and wait. However, people with recurring back or neck problems should consider preventive measures. This includes learning how to protect your back and neck and exercising to strengthen your back and neck. Conservative treatment approaches include the use of:
Pain Control
To control pain and symptoms, your DC may recommend the following physical activities/modalities:
- Rest — resting painful joints and muscles helps calm soreness, giving your spine time to heal. If you are having pain with an activity or movement, it should be a signal that there is still irritation going on. You should try to avoid all movements and activities that increase the pain. In the early stages of your therapy, your chiropractic doctor may have you wear a brace to limit movement.
- Specific Rest — specific rest allows safe movement of the joints and muscles on either side of a painful area while protecting the sore spot. If a lumbar brace was prescribed, you may be instructed to take it off a few times each day so you can do some gentle and controlled exercises.
- Positioning — your DC will help you find positions for your spine that are most comfortable while sleeping or resting. He or she may also suggest positions to reduce stress on your spine while you are at work.
- Ice — ice makes blood vessels constrict or get smaller, which decreases the blood flow. This helps control inflammation, muscle spasm, and pain.
- Heat — heat makes blood vessels dilate or get larger, which increases the blood flow. This helps flush away chemicals that cause pain, and also helps bring in healing nutrients and oxygen.
- Ultrasound — ultrasound uses high-frequency sound waves to reach sore muscles and other tissues that are over two inches below the surface of your skin. As the sound waves pass through your body they vibrate molecules, causing friction and warmth. This heating effect helps flush the sore area and brings in a new supply of blood that is rich in nutrients and oxygen.
- Electrical Stimulation — electrical stimulation gently stimulates nerves as the current passes through pads applied on the skin. Some people say it feels like a massage on their skin. Electrical stimulation can ease pain by sending impulses to your brain that are felt instead of pain. Once the pain eases, muscles begin to relax, letting you move and exercise with less discomfort.
- Soft Tissue Massage — DC’s frequently refer patients for different forms of soft tissue massage. Massage has been shown to reduce pain and spasm by helping muscles relax, by bringing in a fresh supply of oxygen and nutrient-rich blood, and by flushing the area of chemical irritants that come from inflammation. Soft tissue massage can help tight muscles relax, getting them back to a normal length. This will help you begin to move with less pain and greater ease.
- Spinal manipulation — your DC will apply specific pressures and movements to your joints to help lubricate joint surfaces and prevent adhesions. This will ease stiffness and help you begin moving with less pain. As your pain decreases, different manipulations may be used to lengthen tissues around the joint in order to restore better movement in your spine.
- Traction — sore joints and muscles often feel better when traction (pull) is used. DC’s apply traction with their hands or with a traction machine. There are also traction devices that you can use at home. The amount of pull that is needed will depend on your condition. A gentle on/off pressure may be better early on to help control arthritis pain. More vigorous traction can help take away pain if a spinal joint is mildly sore or tight.
Dr. Ward Beecher practices at Beecher Chiropractic Clinic at 1001Pineloch,Ste700 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!
To read the first part of this post, click here
“Conservative” Treatment for Neck and Back Pain – A Chiropractic Perspective. Part 1
Clear Lake City TX Chiropractor Comments: As a practicing chiropractic orthopedist, I am regularly asked what the difference between me and an orthopedic surgeon is. The simple answer is that I look for a conservative treatment option while the surgeon looks for a surgical treatment option. The term “conservative treatment” is used to describe any treatment option that does not involve surgery. This may be as simple as reassuring you that it is not a serious problem, and recommending that you just watch and wait. However, people with recurring back or neck problems should consider preventive measures. This includes learning how to protect your back and neck and exercising to strengthen your back and neck. Conservative treatment approaches include the use of:
Chiropractic Therapy
If chiropractic care is recommended, your Doctor of Chiropractic (DC) will start by asking you questions about your spine condition. You may be asked questions about when your pain started, where you hurt, and how your symptoms affect your daily activities. Your answers will help your DC focus on the source of your problem and what he or she will need to do to help relieve it. Your DC will then do an exam that may include some or all of the following checks.
- Posture — imbalances in the position of your spine can put pressure on sore joints, nerves, and muscles. Improving your posture can often make a big difference in relieving pain.
- Range of motion (ROM) — measurements are taken of how far you can move in different directions. Your ROM is recorded to compare how much improvement you are making with each treatment.
- Nerve Tests — your DC may check your reflexes, sensation, and strength. The results can help determine which area of the spine is causing problems and the types of treatment that will be best for you.
- Manual Exam — your DC will carefully move your spine in different positions to make sure that the joints are moving smoothly at each level. Muscle and soft tissue flexibility is also tested.
- Ergonomics — ergonomics involves where and how you do your work or hobby activities. By understanding your ergonomics, your DC can learn whether the way you do your activities may be making your pain worse. Sometimes even simple corrections can make a big difference in easing spine problems.
- Palpation — your DC will feel the soft tissues around your spine to check for changes in temperature or texture, which may indicate that you have inflammation or nerve irritation. Palpation also checks whether there are tender points or spasms in the muscles near the spine.
Your DC will evaluate your answers and your exam results to decide the best way to help you. He or she will then prepare a plan of care, which lists the treatments to be used and the goals that you and your DC decide on to do your daily activities safely and with the least amount of discomfort. The plan also includes a prognosis, which is your DC’s idea of how well the treatments will work and how long you will need care in order to get the most benefit.
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 Pain – Non-Surgical Treatment Options
Clear Lake City Chiropractor Comments: There are many treatment options for those suffering from neck pain. There is conventional medical care where the family doctor will usually prescribe a muscle relaxant, anti-inflammatory, and/or pain killer to help patients through episodes of acute neck pain. However, many patients with neck pain have been through the process of treatments associated with medications and simply cannot tolerate the adverse side effects of stomach pain common with anti-inflammatory drugs such as ibuprofen (Advil, Nuprin, Mediprin, etc.), Aleve (Naproxen), or aspirin. Others don’t like the groggy, drunk-like feelings associated with pain killers or the sleepiness associated with muscle relaxants. Therefore, these patients often turn to complementary / alternative care.
As noted in the May, 2009 issue of Consumer’s Report for low back pain, chiropractic was the most sought after form of treatment, but there has been no extensive review of neck pain regarding evidence-based treatment approaches – at least not until February, 2008. An international “team” representing 9 countries screened over 31,000 titles of articles published between 1980 and 2006, reviewed more than 1200 articles and eventually reported on 552 studies in their final report. Their findings included the following:
- In the US, 54% utilized complementary (alternative) treatment approaches compared to 37% that obtained conventional medical care.
- Neck pain was the 2nd most common reason Americans obtained chiropractic care.
- Chiropractic was found to be the most frequently reported form of treatment for upper back or neck pain (ahead of massage therapy, relaxation therapy, acupuncture).
- Those who obtained complementary AND conventional medical care were much more likely to perceive the complementary/alternative therapy as being helpful (61% vs. 6.4% for neck conditions and 39.1% vs. 19% for headaches).
- Women more commonly obtained care than men for neck/shoulder pain (29% vs. 18% men) over a 4-6 year time frame.
- Manual therapy (mobilization, manipulation, stretching) was associated with greater pain reduction in the short-term among patients with acute whiplash when compared with usual medical care, soft collars, passive modalities, or general advice.
- For non-whiplash neck pain (without arm radiating pain), manipulation or mobilization, exercise, low level laser therapy (LLLT), and “…perhaps acupuncture…” were reported as more effective than no treatment, sham, or other alternative interventions.
- For both whiplash and non-traumatic neck pain, supervised exercise with or without manual therapy was favored over usual medical care or no care.
What does all this mean? Simple! Everyone who is suffering from neck or upper back pain should seek chiropractic care which includes manipulation, mobilization, exercise training, and activity modifying advice, as these approaches have been found to be more effective than usual medical care! Why waste time with a “wait and watch” with or without drug intervention approach when the evidence favors chiropractic related interventions. If you, a friend, or a loved one is struggling with neck or upper back pain, we will properly assess your condition and administer the appropriate care that is required. We will coordinate care with other health care services when necessary. This recommendation may represent one of most significant acts of kindness you can offer those that you truly 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!
Joints Cracking?…What is that noise?
Houston Chiropractor Comments: Ever since I became a chiropractor in the late 1980’s, one of the most common questions I hear about spinal adjustments is “What is that cracking noise?” Patients have the perception that the sound is coming from the bones, but it is in fact coming from the joints. The audible sound is due to release of oxygen, nitrogen and carbon dioxide from the synovial fluid which is a joint lubricant. The joint cavitations or pressure change occurs when the connective tissue is stretched. This increases the volume and subsequently decreases the joint pressure. The gases that were originally dissolved in the synovial fluid become less soluble and are allowed to form bubbles which can ultimately “pop”, thus making the noise you hear. The change is rapid and the pressure ultimately rises again as the gas is again dissolved in the synovial fluid.
After the adjustment there is typically an increase in joint mobility due to the stimulation of the Golgi tendon organs. The increase motion of the joint along with proper follow-up exercises and stretches help allow you to reach your body’s maximum potential. Another important thing to know is that the joint cavitations do NOT cause any arthritis or damage to the spine. That is just an old wives tale.
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!
Prompt Treatment of Carpal Tunnel is Best!
Clear Lake City, TX Chiropractor’s Comments:
Many people suffer from CTS (Carpal Tunnel Syndrome) and unfortunately, often ignore the initial symptoms of numbness or tingling in the hand(s). These early symptoms are typically not too alarming and hence, they often do not raise the level of concern until more intense symptoms occur; such as waking up from sleep due to numbness, dropping items, difficulty buttoning clothing, needing to switch hands when driving, difficulty writing, typing, knitting, as well as work related pain. There may also be fear of job loss associated with CTS, especially in these hard economic times with frequent lay offs, prompting CTS sufferers to postpone initial care. Unfortunately, delaying treatment is associated with a longer recovery time when compared to prompt management which usually results in a quicker, less complicated and more satisfying recovery.
There are many causes and contributing factors of CTS. The most prevalent cause is mechanical irritation from simply moving the hands too fast for too long, without enough rest. Another risk factor is age (over 50 years old). In this era of an aging workforce, this may be a significant issue. Fast, repetitive movements of the arms and hands are often a direct cause and can be appreciated by watching someone knit rapidly and/or performing line work using fast, repetitive movements. If the hands/wrists have to bend in awkward positions to accomplish a work task, or if a tool that is frequently used places pressure in the palm of the hand, these can also contribute to the onset or perpetuation of CTS. Other conditions can also contribute to CTS including inflammatory arthritis like rheumatoid, diabetes, pregnancy, the use of birth control pills, obesity and hypothyroidism.
The management of CTS is case specific, and is dependant on which of the above mentioned causes or contributors are present. Management of any metabolic disorder such as diabetes or hypothyroid is important, especially compliance with taking appropriate medication, when indicated. The management of weight, hormone replacement therapy, and fluid retention all play a roll in CTS management. Ergonomic or job-related management strategies are very important and can include work station modifications so that unnecessary awkward arm/wrist/hand positions can be avoided. This may require moving the item being worked on to a less stressful position, using a different type of tool handle (screw driver, etc.), changing the height or reach distance at which the material is worked on, and taking “mini-breaks” every ½ to 1 hour when the lack of rest is a contributor. Frequently, the combination of pinching a phone between the head and shoulder, typing data into a computer where the monitor is positioned too high or off to one side, and excessive arm motions using a computer mouse can contribute to pinching the nerve in the neck and/or arm, resulting in CTS. Remedies for this situation include the use of a head set, repositioning the computer monitor so that it is in front of the worker, and using a trackball type of mouse to eliminate arm motion can be extremely helpful. Treatment strategies offered by chiropractors include the use of manual therapy to the wrist and the tight muscles in the front of the forearm, as well as other nerve constriction areas such as the elbow, shoulder, and neck, manipulation of the joints in hand, wrist, elbow, shoulder, and/or neck, depending on what is unique and needed for that patient, and the use of physiological therapeutics such as low level laser light therapy, electrical stimulation, and/or ultrasound have all been shown to offer beneficial effects. Nutritional recommendations include Vitamin B6 (150mg/day), magnesium, calcium, Co-Q10, omega 3 fatty acids and vitamin D3. Reducing glutens (wheat, oats, barley, and rye) is also very important due to the inflammatory response of these foods. Surgery is typically, the last treatment resort and is appropriate, “when all else fails.” We welcome you to our clinic and are proud to offer you a non-drug, non-surgical solution for CTS and its disabling symptoms.
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!
Chiropractic’s Role in National Healthcare – Houston, TX Chiropractor Comments
Clear Lake City / Houston TX Chiropractor Comments: In the 20 years that I have been a Houston chiropractor, I rarely have talked politics in the office, but the times are different. As it looks more and more like some type on national healthcare will be enacted by the government, I have decided to write this blog. To help ensure that Congress, insurance and managed care companies do not restrict your access to the essential chiropractic services that you have enjoyed and benefited from, I ask you to visit www.ChiroVoice.org. According to ChiroVoice.org., they are a chiropractic advocacy network is a dedicated group of national volunteers who educate policymakers about the value of chiropractic and work to positively impact any legislative efforts to reform the current national health care system. Through the chiropractic advocacy network, patients and chiropractic supporters can stay informed about important health care issues and help ensure that:
Congress does not restrict your ability to access essential chiropractic services.
Congress does not limit – but instead expands – coverage for services provided by Doctors of Chiropractic within Medicare.
Insurance and managed care companies do not deny patients’ access to the essential chiropractic services they need.
Your involvement makes a tremendous difference.
Each active member of the chiropractic advocacy network brings us one step closer to our goal of assuring full-scope access to chiropractic services. Chiropractic patients and supporters who are interested in serving as advocates may sign-up to receive special e-mail alerts about advocacy issues and important legislation. Network members will also receive a monthly e-newsletter.
On another note, since so many of our patients are active duty and retired military, I would urge you to call your national representative (ours is Pete Olson) and ask them to sponsor the bill HR 484. This will help to develop and implement a plan to provide chiropractic health care services and benefits for certain new beneficiaries as part of the TRICARE program.
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!
Oh, My Aching…Leg? Sciatica Causes and Relief
Clear Lake City, TX, Leg Pain & Sciatica Specialist: I have been practicing in Clear Lake City, Texas since 1990 and my patients are always surprised to learn that certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back. When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg. When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks. The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments. The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.
When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.
When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot. It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).
When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way. Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.
The good news is that both of these sources of low back and leg pain are very treatable with chiropractic care in my office! The important point to remember is that obtaining prompt treatment, when symptoms first appear is best – as waiting and hoping it will subside on its own often results in a longer treatment course and is less satisfying for all concerned.
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!
