What is spinal stenosis?
Spinal stenosis, or narrowing of the spinal canal, is a condition that can squeeze sensitive spinal nerves. Some people with spinal stenosis may not have symptoms. Others may experience pain, tingling, numbness and muscle weakness. Symptoms can worsen over time.
The most common cause of spinal stenosis is osteoarthritis, the gradual wear and tear that happens to your joints as you age over time. Spinal stenosis is common in older adults because osteoarthritis begins to cause changes in most people’s spines by age 50.
The two main types of spinal stenosis are:
- Cervical stenosis: In this condition, the narrowing occurs in the part of the spine in your neck.
- Lumbar stenosis: In this condition, the narrowing occurs in the part of the spine in your lower back. This is the most common form of spinal stenosis.
Cervical spine (in the neck):
- Numbness or tingling in a hand, arm, foot or leg
- Weakness in a hand, arm, foot or leg
- Problems with walking and balance
- Neck pain
- In severe cases, bowel or bladder dysfunction (urinary urgency and incontinence)
Lumbar spine (in the lower back):
- Numbness or tingling in a foot or leg
- Weakness in a foot or leg
- Pain or cramping in one or both legs when you stand for long periods of time or when you walk, which usually eases when you bend forward or sit
- Back pain
How can chiropractic treatment help with spinal stenosis?
Chiropractic treatment is an all-natural, non-invasive method of helping relieve painful symptoms as well as addressing spinal stenosis directly at the source. Chiropractic approaches spinal stenosis holistically; taking into account your symptoms, the current state of your spine, how your body is feeling, what makes your symptoms better or worse, and what you feel comfortable doing.
To diagnose spinal stenosis, your chiropractor may ask you about signs and symptoms, discuss your medical history, and conduct a physical examination. Then, they may order several imaging tests to help pinpoint the cause of your signs and symptoms. Imaging tests include, X-rays, magnetic resonance imaging (MRI), or CT scan. Spinal manipulation and other manual adjustments are the primary method of treatment.
Chiropractic treatment aims to widen the space available for the spinal cord within the spinal canal. By correcting the displacement of spinal discs, relieving tension held in tight muscles, and removing the pressure from spinal nerves, a patient with spinal stenosis can experience lessened symptoms. Chiropractic care is drastically less invasive than other treatment options such as injections, harmful medications, or open spine surgery.
If you’ve been suffering from spinal stenosis in either the cervical, thoracic, or lumbar spine, or have felt symptoms that you believe can be spinal stenosis, contact us to book an appointment.
Tenosynovitis is the inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon, typically leading to joint pain, swelling, and stiffness. The sheath of the tendon becomes thinner which is caused by the reduced lubrication between tendon and its sheaths due to the excess rubbing movements. Some secondary factors that increase the risk of tenosynovitis is having improper skill and posture when moving the wrist. The 2 common types of tenosynovitis are De Quervain’s Tenosynovitis and Trigger Finger Tenosynovitis.
De Quervain’s Tenosynovitis:
De Quervain’s Tenosynovitis is a condition that affects the tendons in your wrist. Repeating a particular motion may irritate the sheath around the two tendons, causing thickening and swelling that restricts their movement. This condition affects tendons that abduct and extend the thumb necessary for dexterity and manipulation.
The exact cause of this type of tenosynovitis is unknown. However, any activity that requires repetitive hand or wrist movement can aggravate the condition – such as knitting, racket sports, lifting a baby, and walking a pet. Treatments for De Quervain’s Tenosynovitis include wearing a thumb splint to immobilize the thumb, preventing further abduction of the thumb.
Trigger Finger Tenosynovitis:
Trigger finger tenosynovitis is tenosynovitis of tendons that flex fingers. The cause of this condition occurs from repetitive and forceful flexing of fingers. As a result, one of the fingers gets stuck in the bent position due to the bulbous swelling that restricts finger flexion and may lock them in a fixed position. A bump, also known as a nodule, may occur from the inflammation of the tendon sheath. Trigger finger occurs mostly near metacarpophalangeal joints, middle and ring fingers of the dominant hand.
People whose work or hobbies require repetitive gripping actions are at higher risk of developing trigger finger tenosynovitis. Additionally, those with health problems such as rheumatoid arthritis and diabetes are at higher risk.
Tendons and ligaments are fibrous bands of connective tissue that help stabilize body structures and facilitate body movements. The main difference between tendons and ligaments is that they connect different parts of the anatomy. Tendons connect muscles to bones, while ligaments connect bones to other bones.
Ligaments and tendons are made of 2 types of protein fibers: collagen and elastin. Collagen fibers have a small deformation range and high strength. Since collagen has such a high strength, they require more force to break down. Contrarily, elastin fibers have a large deformation range with low strength, meaning they are very weak and can break more easily. Ligaments such as the neck and wrists have more motion and movement because they consist of more elastin and less collagen.
Ligaments and Tendon Injury:
Repetitive motions with inadequate recovery periods are the cause of occupational ligament and tendon injuries due to the constant loading and unloading of force with no rest. Loading is the process of physical stresses acting on the body or on anatomical structures within the body.
A ligament injury occurs during the chronic process of loading and unloading, the tissue becomes longer and more fragile and eventually a small amount of force can easily fracture. In addition, cumulative loading can result in a decrease in bone density which increases the vulnerability of a ligament or tendon getting injured. An example of constant loading is by having improper posture for long periods of time which eventually leads to lower back injury.
Stages of Ligament Healing:
- Acute inflammatory phase – The first stage consists of the formation of blood clot within the damaged region.
- Proliferative phase – New blood vessels are formed while fibroblasts are recruited from circulation to produce new collagen.
- Tissue remodeling phase – The third stage starts after 3 weeks of the injury occurrence. During the wound healing process, there is a progressive maturation of collagen fibers in response to loads experienced by the ligaments. If force is applied in the wrong direction, there can be permanent damage of the ligaments.
A shockwave is an intense, short energy wave that travels faster than sound. By introducing these high-energy waves into the body, shockwave therapy can speed up the healing process through stimulating the metabolism and enhancing blood circulation. These processes help regenerate damaged tissues at the injured areas. When human body fails to heal itself on its own, shockwave therapy could be a great solution.
Why Shockwave Therapy?
Shockwave therapy is an affordable non-surgical procedure that effectively speeds up the healing process after 1 to 2 treatments. Each treatment is rather short, usually takes 20 to 30 minutes. It is effective on treating many conditions such as calcific rotator cuff tendintis, plantar fasciitis, Achilles tendinopathy, scar tissue treatment, tennis elbow, jumper’s knee, stress fractures and non-healing ulcers.
Chiropractors will precisely locate the area to be treated by palpation. Then, sufficient amount of gel will be applied to the area for efficient and smooth transfer of the sound wave. The shockwave applicator will be slightly pushed against your skin, and the sound waves will be fired.
Here’s a link to a video illustrating the process of the treatment: https://youtu.be/rXj6ugQuYps
MRI is a technique that uses magnetic field and computer-generated sound waves to obtain detailed images of organs and tissues in our body. The magnetic field inside the MRI machine temporarily realigns water molecules in your body. The aligned molecules produce faint signals with radio waves, and create cross-sectional MRI images. 3D images can be produced with MRI by viewing the organ or tissue in various angles.
This noninvasive imaging technique gives high-resolution images of our body tissues which helps identify different health issues. MRI is the most frequently used method to obtain images of the brain and spinal cord. Other common organs and tissues imaged with MRI include heart, blood vessels, internal organs (liver, kidney, pancreas etc.), bones and joints, as well as the breasts.
However, since MRI uses powerful magnets to generate a strong magnetic field, any presence of metal in your body can be attracted to the magnet and can be a safety hazard. Metal can also distort the MRI image. Tattoos or permanent makeup might contain metal and might affect the MRI result. Report to the doctor if you are pregnant or breast-feeding, as the effects of the contrast material that has to be injected are still not well understood.
Patellar tendonitis, also known as jumper’s knee, is the inflammation of the patellar tendon, which connects your knee cap to your shin bone. This condition can weaken the connective tissue and can possibly lead to tears in your tendon. Possible causes of the inflammation of the patellar tendon include practicing repetitive movements, overusing the tendon or adding too much pressure to your tendon repeatedly.
Knee pain is one of the most common symptoms of patellar tendonitis. If you feel pain especially when jumping, running, stretching and bending your leg; tenderness or swelling at the lower part of your knee cap, it is likely that your patellar tendon is inflame. Some symptoms resemble other medical condition, X-ray is one of the best ways to diagnose patellar tendonitis.
Once diagnosed for patellar tendonitis, it is important to stop the activities that caused the problem until fully recovered. Other treatments such as applying ice packs to your knees helps reduce inflammation, and shockwave therapy speeds up the healing process.
Facet joints are sets of synovial joints between two adjacent vertebrae. There is a pair of facet joints on each vertebra. The joint’s main function is to guide and limit movements and motions such as rotation. Lumbar facet joints also have some minor impact on limiting the range of motion of side bending.
Definition and symptoms of facet syndrome:
Facet syndrome is defined as the unilateral or bilateral backpain that originates from the facet joint and/or its capsule. Though it might not be common, the pain could radiate to one or both buttocks, the sides of groin and/or the thigh, and usually stops above the knee; but in most cases, the pain is localized which helps practitioners easily located its source. Patients would experience more pain when they extend their back (bend backwards) than when they flex (bend forward).
Physical examinations and diagnostic facet joint block detect and indicate facet syndrome, but false positive rate for both diagnostic methods are high. Interventional radiology such as MRI is a more accurate way to detect the syndrome.
Chiropractic adjustments are great ways to treat facet syndrome; the syndrome responds to standard chiropractic treatment procedures like heat and modalities really well. Trainings that can improve time of response and proprioception help with the pain as well.
There are many ways to maintain a good posture and avoid the experience of back pain.
- Pay attention to your standing and sitting posture throughout the day.
- If you are sitting for long periods of time, stand up and move around every 30 minutes to an hour.
- A rolled towel can be used to maintain the normal lumbar curve while sitting.
- Doing physical activity regularly can help build strong abdominal and back muscles.
- Aquatic exercises can help with your strength, posture, and balance.
- Phones or books should be held at eye level.
- Make sure your shoes are comfortable and supportive.
- Consider placing a small pillow under your neck and a rolled towel at your lower back when you sleep.
Poor posture, traumatic injury, strain, or sprain can cause our muscles, ligaments, and tendons to have abnormal tension. This can cause pain, tenderness, and/or movement dysfunctions. Soft tissue therapies are a type of therapy where soft tissues, such as muscles, ligaments, and tendons are pressed and kneaded with the hand or a mechanical device. This can be performed by chiropractors, occupational therapists, physical therapists, or massage therapists. Soft tissue therapy can help relieve pain and inflammation, reduce stiffness and movement dysfunction, reduce spasm, and increase the range of motion of the injured area. Moreover, it can improve circulation by increasing the local blood flow. It can also assist with tissue healing, fix abnormal postures, and help avoid further injury. Overall, soft tissue therapy can help with your pain and musculoskeletal health.
The spine consists of spinal disks and vertebrae and similar to a jelly donut, the disk has a softer “jelly” center. When the “jelly” pushes out through a tear in the tougher exterior, it is known as a herniated disk. Disk degeneration can cause disk herniation in the lower back or in the neck. The water content in the disks decrease as we get older and the flexibility of it decreases. Therefore, a minor strain, twist, and improper lifting can easily lead to a tear or rupture in the disk.
The signs and symptoms that someone will experience includes pain, numbness, tingling, or muscle weakness due to the irritation on the nerves. Pain can be felt in the thigh and calf when the herniated disk is in the lower back. Pain can be felt in the shoulder and arm when the herniated disk is in the neck.
Excess body weight and duties performed on the job that put extra stress on your lower back can increase the risk of disk herniation. A few things that you can do to prevent a herniated disk includes lifting heavy objects properly, strengthening trunk muscles, and maintaining a healthy weight.