Lower back pain is common among population. Prior to treatment by health care professionals, it is useful to have an understanding on different diagnostic categories of lumbar discs terminology.
Defines discs that are morphologically normal, without the consideration of the clinical context and not inclusive of degenerative, developmental, or adaptive changes that could be considered clinically normal (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.3).
Includes discs that are congenitally abnormal or that have undergone changes in their morphology as an adaptation of abnormal growth of the spine, such as from scoliosis or spondylolisthesis (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.3).
Includes subcategories of annular fissure, degeneration, and herniation
Annular fissure refers to separations between the annular fibers or separation of annular fibers from their attachments to the vertebral bone (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.3).
Degeneration refers to all of the following: desiccation, fibrosis, narrowing of the disc space, diffuse bulging of the annulus beyond the dis space, fissuring, mucinous degeneration of the annulus, intradiscal gas, osteophytes of the vertebrae apophyses, defects, inflammatory changes, and sclerosis of the end plates (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.4)
Herniation refers to a localized r focal displacement f disc material beyond the limits of the intervertebral disc space. The disc material may be nucleus, cartilage, fragmented apophyseal bone, annular tissue, or any combination thereof (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.4).
Herniated disc may be classified as protrusion or extrusion, contained or uncontained (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.5-6).
- Protrusion is present if the greatest distance between the edges of the dis material presenting outside the disc space is less than the distance between the edges of the base of that disc material extending outside the disc space
- Extrusion is present when, in at least one plane, any one distance between the edges of disc material beyond the disc space is greater than the distance between the edges of the base of the disc materials beyond the disc space or when no continuity exists beyond the disc space and that within the disc space
- Contained refers to if the displaced portion is covered by outer annulus fibers and/or the posterior longitudinal ligament;
- Uncontained when absent of such covering
Includes disruption of the disc associated with physical and/or imaging evidence of violent fracture and/or dislocation and does not include repetitive injury, contribution of less than violent trauma to the degenerative process, fragmentation of the ring apophysis in conjunction with disc herniation, or disc abnormalities in association with degenerative subluxations (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.6-7).
Includes infections, infection-like inflammatory discitis, and inflammatory response to spondyloarthropathy. Includes inflammatory spondylitis of subchondral end plate and bone marrow manifested by Modic Type I MRI changes and usually associated with degenerative pathological changes in the discs (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.7).
Refer to primary or metastatic morphologic changes of disc tissues caused by malignancy (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.7).
Miscellaneous paradiscal masses of uncertain origin
Refer to a paradiscal mass or an increase in the size of herniated disc material may be created by epidural bleeding and/or edema, unrelated to trauma or other known origin (Fardon, Williams, Dohring, Murtagh, Rothman & Sze, 2014, p.7).
Fardon, D. F., Williams, A. L., Dohring, E. J., Murtagh, F. R., Gabriel Rotheman, S. L., & Sze, G. K. (n.d.). Lumbar disc nomenclature: Version 2.0 Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. The Spine Journal. doi:https://doi.org/10.1016/j.spinee.2014.04.022
Link to the article: https://ruperthealth.com/research/lumbardisc.pdf
The physical results of stress:
Stress can have a negative impact on our physical health and cause things such as headaches, stiffness, muscle aches, and pains. Additionally, tight muscles can lead to posture issues and poor sleep, which can end up creating more stress.
To avoid stress affecting your physical health, make sure to always adjust your posture especially at times when you are feeling stressed. Having improper posture frequently can lead to problems with your back and spine overtime. If you are clenched up and feeling stressed, check your posture and adjust your posture so that you are sitting up tall and straight. To make sure you are maintaining a straight back position, it is best to sit on a chair with back support or have your back against a wall.
The importance of mindfulness:
Mindfulness meditation is a common technique used to combat stress, anxiety, chronic pain, depression, and headaches. Add mindfulness to your everyday routine; even as little as 10 minutes can make a big difference in our overall sense of well-being. Meditation is easy to implement to anyone’s lifestyle, as it is a cost saving practice that involves low physical and emotional risk and has the potential to empower people to be more actively engaged in their mental health.
Some significant health benefits of mindfulness are insignificant improvements in pain, anxiety, overall well-being, and the ability to participate in daily activities. Incorporating mindfulness frequently has also been found to improve your overall mood and reduce stress.
Ways to practice mindfulness:
What is Ergonomics?
Ergonomics is the science of fitting workplace conditions and job demands to workers’ capabilities. For example, the size data of human bodies to design chairs, tables, and walkways. While many people are adjusting to working from home, it is important to create an environment that is ergonomically friendly, especially for those who are sitting at a desk for long periods of time. Creating a proper ergonomic workspace is crucial to keep you comfortable at work and can prevent injuries from occurring overtime.
Creating the Perfect Ergonomic Workspace
Consider following these tips when creating a suitable workspace:
1. Choosing the right chair
- Adjust your chair’s height to make sure that your feet rest flat on the ground. Make sure that your hips, feet and elbows are bent at 90 degrees. Use a footrest to support your feet if needed. Armrests of your chair should be adjusted so that your arms can rest on them with ease, ensuring that your neck and shoulders are relaxed downwards.
2. Adjusting your desk and monitor height
- Position your computer monitor to the height of your eye level and at least an arm’s length away to reduce any strain on your neck or eyes. A good height would mean you shouldn’t have to hunch over or tilt your head up to see the computer screen. If you are using a laptop, adjust the height by using a laptop stand when typing to reduce strain and tension.
3. Organizing your desk space
- Keep frequently used tools within close proximity to minimize reaching. For instance, keep your keyboard mouse, pen and notepad, and telephone nearby to avoid repeatedly twisting to reach for these things. Make sure that there is clearance under your desk for your knees, thighs, and feet and try to not store items under your desk.
4. Having good posture
- To reduce strain, ensure your shoulders are relaxed and placed back. Align your head with your shoulders, and keep your hands at or below elbow level. Continue to be aware of your head position and posture throughout the day, as we often forget about our posture from concentrating on the computer too long.
5. Taking regular breaks and stretching
- Follow the 20-20-20 rule: After every 20 minutes of looking at your computer screen, give your eyes a 20 second break by looking at something else that is at least 20 feet away. Sitting at a desk for long periods of time can cause tight muscles and long-time compromise for pain in your back and neck. It’s crucial to remember to take stretching breaks every 30 minutes to relieve some tension and avoid pain overtime. Below are some stretches you can follow. Alongside with stretching, take a few minutes to go on a short walk to get your body moving and reduce eyestrain from starring at a computer for a long time.
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.
Plantar Fasciitis is one of the most common causes of heel pain. When the plantar fascia, the flat band of tissue connecting your heel bone to your toes, is strained, it gets inflamed and swollen, and causes pain at the bottom of your foot or at your heel.
Most people with Plantar Fasciitis experience pain when they take their first step after sitting for a long time or getting out of bed. The stiffness and pain might reduce after a few steps. Some might also feel painful after climbing stairs and standing for a long time.
To treat Plantar Fasciitis, you have to give your foot a rest. Cut back from exercises and activities that make your foot hurt. You can also try to put ice on the affected area to ease the inflammation. Toe stretches, calf stretches and towels stretches are excellent stretching exercises to do to relief the pain. It’s always a good idea to get yourself a pair of orthotics to adjust how your shoes fit you.
Start your treatment soon! With the right treatment, you will experience much less pain in a few weeks, but it usually takes at least a few months to a year for the pain to go completely.
Excessive texting or mobile device use can cause stress injury to the neck, commonly known as the text neck. Symptoms associated might include pain in the neck, upper back and/or shoulder, forward head posture, rounded shoulders, headache, increased pain when neck flexion and reduced mobility.
A lot of extra pressure is put on your cervical spine when our head is bent. The unnatural posture can lead to stresses on the spine and surrounding supportive soft tissues.
Here are some tips to avoid text neck:
- Raise the phone to eye level to minimize bending of neck
- Take breaks from time to time while using your phone
- Stretching exercises during breaks to release tension in the neck and to ease muscle pain
If neck pain keeps returning or is accompanied by severe headache, one should seek medical attention for the right treatment.
Carpal Tunnel Syndrome (CTS) is a chronic condition in the wrist area that can affect the arm and hands. An individual with CTS may experience numbness, tingling, and weakness in the affected hand. CTS is caused by the compression of the median nerve due to inflammation which runs through “carpal tunnel”. The carpal tunnel consists of the carpal bones (wrist bones) which create the base of the “tunnel” and the transverse carpal ligament that creates the roof.
Compression of the median nerve can be caused by many different aspects, most commonly due to the overuse of the wrist in an overextended position. Many individuals spend most of their time typing on the computer either due to work or gaming, the position the wrist is in when typing is in this overextended position and are more at risk for CTS. It is important to take notice of your hand position and make sure there aren’t long periods of time in the overextended position. If you are in this position due typing, ergonomic keyboards or rests for your wrist can help with the positioning.