Also available are 32 3D Back Pain educational videos for a bulging disc and various Back Pain, injuries and conditions such as (1) Sciatica (2) Degenerative disc (3) Herniated disc (4) Facet Joints (5) Scoliosis (6) Kyphosis, Posture (7) Back Pain and Neck Pain Decompression  (they can be found under the listing “Types of Pain” in our  ” Back Pain ” Section ) 

For the management of Back Pain,  at Central Chiropractic and Physiotherapy Clinic we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”. 

Combined Approach to Lower Back Pain

Lower back pain may be caused by a trapped nerve, joint sprain, and muscle strain in the lumbar or pelvic region of the lower back, a “slipped/herniated” disc or a degenerated disc of the lumbar spine.

Single Therapy Approach

Some clinics or practitioners may focus on using one technique/therapy to address your low back pain, and in a certain number of cases that is fine and will good results for that individual at that point in time. The single technique/therapy approach may involve any one of the following therapies; joint manipulation, joint mobilisation, massage, ultra sound, interferential, low level laser therapy or even simple stretches.

Combined Therapy Approach

Depending on your injury/condition and lifestyle your therapist may use some or all of the therapies listed below as part of your recovery programme to get you back on track as soon as possible. In some cases just using one approach may not be enough; therefore a combined approach may be the only way to get you back on the road to recovery!

Joint Manipulation - is based on the philosophy that restricted movement in the spine may lead to reduced function and pain. Spinal manipulation is one form of therapy used to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain.  Therapists manipulate the spine from different positions using varying degrees of force. Manipulation doesn’t need to be forceful to be effective. Therapists may also use massage and stretching to relax muscles that are shortened or in spasm. Some studies have shown spinal manipulation to be as effective and as safe as standard treatments, especially for initial pain relief. The optimal number of treatments depends on each individual case.

Dry Needling - This therapy doesn’t involve the use of Chinese diagnosis. Instead single use sterile acupuncture needles are placed into the areas of muscle spasm to disperse the muscle spasm and relax the muscles.  Pain relief can often be achieved using Myofascial Dry Needling too.

Acupuncture - Like dry needling, single use sterile needles are placed in various points using the Chinese meridian system to stimulate the body, decrease pain levels and encourage the body’s natural healing process to take place.

Low Level Laser - Cold or Low Level Laser Therapy is a modality with a five star rating for pain relief and the acceleration of the healing process.  More information on this modality can be found listed under “Pain Relief” section.

Massage - Massaging tight and restricted muscles can also help to decrease muscle spasm

                             and improve the mobility of the area involved.              

Stretching - The emphasis here is on the individual with the injury/condition. In the early phase of care specific stretches are tailor made for that specific individual. By doing these exercises the individual can gain improved mobility at an earlier stage and speed up the healing process.

Strengthening -  The emphasis here is on the individual with the injury/condition. In the later phase of care specific strengthening exercises are tailor made for that specific individual. By doing these exercises the individual can gradually improve the strength of the weak muscle groups of the body that contributed towards the injury/condition.

Ice Packs -  If an area is inflamed, then one way of reducing inflammation is to use an Ice pack on a regular basis throughout the day. Your therapist can advise you on the correct way to use the ice pack.

Summary-             Depending on your injury/condition and lifestyle your therapist may use some or all of these therapies as part of your recovery programme to get you back on track as soon as possible.

 Please refer to other topics under “Types of Pain” (on our main webpage), to check for specific injuries or conditions.

For the management of Back Pain, here at Central Chiropractic and Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”. 

Back Pain

Bulgimg or Herniated disc 

One of the most common causes of sciatica is a herniated disc. Herniate means bulge or stick out. Intervertebral discs are the soft discs that form a cushion between the vertebrae of the spine. The discs have a though outer layer made of cartilage, with a gelatinous soft centre that acts as a shock absorber. If the outer layer of the disc becomes weak through wear and tear, age or injury, the gelatinous soft centre can bulge out this is known as a herniated or ruptured disc, 

Should any of the 5 pairs of nerve roots that form the beginning of the sciatic nerve are compressed in the spine by a ruptured disc it can lead to pain down the sciatic nerve. However, not only does a herniated disc press on the nerve root, but fluid leaking from the gelatinous soft centre of the disc will irritate the nerve root, resulting inflammation.

Cold laser also known as low level laser therapy/treatment

The lasers used at Central Chiropractic Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Cold or Low Level Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Herniated or Bulging Disc.

Upper and Lower Back Pain, Piriformis Syndrome, Slipped disc, Prolapsed disc,

Also available are 32 3D animated educational videos  for various Back Pain Injuries and conditions such as (1) Sciatica (2) Degenerative disc (3) Herniated disc (4) Facet Joints (5) Scoliosis (6) Kyphosis Posture (7) Back Neck and Pain Decompression  (they can be found under the listing ”Types of Pain” in our “Back Pain” Section).     

For pain management and Back Pain relief  at Central Chiropractic and   Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.    

Back Pain

Complications of sciatica

Although people recover from sciatica, sciatica can potentially cause permanent nerve damage. Depending on what’s causing the nerve to be compressed, other complications may occur,

They included

• Loss of feeling, may affected one or both or legs.
• Loss of movement may affected one or both legs

Pain Managment for Sciatica may include;

Physical therapy for Back Pain and  disc injuries known as “Slipped” Prolapsed, Bulging or Herniated disc - can play a role in your recovery. Once acute pain is reduced and range of movement improves a physical -therapist can design a rehabilitation program to help prevent further injuries.

Rehabilitation includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Physical therapy, exercises should be Started as early as possible.

Prescription drugs most doctors may prescribe an anti-inflammatory medication along with a muscle relaxant. Narcotics also may be prescribed for short-term pain relief. Antidepressants and anticonvulsant drugs can be used in easing chronic pain. They may help by blocking pain messages to the brain or by enhancing the production of endorphins, the body’s natural painkillers.

More invasive treatment

Epidural steroid injections. In some cases, doctors may inject a corticosteroid medication into the affected area. Corticosteroids mimic the effects of the hormones cortisone and hydrocortisone, which are made by the outer layer (cortex) of your adrenal glands; Corticosteroids suppress inflammation around the irritated nerve thus giving pain relief.

Their usefulness in treating sciatica remains a matter of debate. Some research has found that corticosteroids can provide short-term symptom relief, but that these medications aren’t a long-term solution. In addition, corticosteroids can have side effects, so the number of injections you can receive is limited usually no more than four per joint.

Surgery usually occurs when the compressed nerve causes significant weakness, bowel or bladder incontinence, (when this occurs seek medical advice urgently) or you have pain that gets progressively worse or does not improve.

Surgical options include lumbar laminectomy and microdiscectomy. In lumbar laminectomy with discectomy, surgeons remove a portion of a herniated disc that’s pressing on a nerve. most of the disc is left intact to preserve as much of the normal anatomy as possible. Sometimes a surgeon will perform this operation through a small incision while looking through a microscope (microdiscectomy).

Success rates of standard discectomy and microdiscectomy are about equal, but you may have less pain and recover more quickly with microdiscectomy. Discuss which option might be best for you with your doctor, and carefully weigh the potential benefits of surgery against the risks as surgery is not always successful.

(Always get a second opinion).

Prevention

Exercise regularly. This is the most important thing you can do for your overall health as well as for your back. Pay attention to your core muscles the muscles in your abdomen and lower back that are essential for proper posture and alignment. For cardiovascular benefits, try using a exercise bike or treadmill. Swimming is also recommended.

Maintain proper posture when you sit. A good chair should comfortably support your hips, and the seat should not press on the back of your thighs or knees. If the chair does not support the natural curve in your lower spine, place a rolled towel or pillow behind your back.

When working at a computer, adjust your chair so that your feet are flat on the floor and your arms rest on your desk or the chair’s arms, with your elbows bent at a right angle. Take frequent breaks every 20 minutes, even if it’s just to walk around your office a little stretching will also help.

Driving, before setting off adjust your seat to keep your knees and hips level, and move the seat forward to avoid over reaching for the pedals.

Consider using body mechanics. Being aware of how you stand and lift heavy objects and even how you sleep can go a long way toward keeping your back healthy. That’s because poor posture stresses your back, leading to fatigue and stress on joints and nerves. Always hold reading material at eye level instead of bending forward, and if you’re standing for long periods rest one foot on a raised object about the height of a foot stool.

Before you lift something heavy, decide where you’ll place it and how you’ll get it from A to B. Bend at your knees, not your back, so that your legs do the lifting. Carry objects close to your body at about waist level. If possible, set the object down on a surface between shoulder and knee height to avoid lifting objects over your head or bending over too far. Don’t twist at your waist. Instead turn by pivoting your feet.

Be careful moving heavy things when you become tired, Tiredness can cause you to move more awkwardly than normal. Heavy loads are the greatest risk to your spine, so know your limitations. Don’t attempt to lift something that is beyond your normal ability.

Try the following measures:

• Cold packs.  Initially, using cold packs may be able to reduce inflammation and relieve discomfort. Wrap an ice pack in a thin towel and apply to the painful areas for 15 to 20 minutes at least 7 times a daily.
• Stretching.  Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid or sudden movements and twisting during the stretch and try to hold the stretch as long as possible. Around 40 seconds per stretch if possible
• Medications.  Pain killers (analgesics) fall into two categories those that reduce pain and inflammation and those that only treat pain. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and acetaminophen (Tylenol,) will be helpful for sciatica.Although they provide real relief, both types of medication have a limit to how much pain they can reduce. If you have moderate to severe pain, exceeding the recommended dosage will not provide any additional benefits. In addition NSAIDs can cause side effects such as nausea, stomach bleeding or ulcers, and acetaminophen can cause liver problems.If you’re using these medications, you should talk to your GP so that you can be monitored for any arising problems. Periodically reassess whether you still need drug treatment or not. Exercise, stretching, massage and other none drug treatments can often provide the same benefits without side effects.
• Regular exercise.  It may seem counter-intuitive to exercise when you’re in pain, but regular exercise is one of the best ways to combat chronic discomfort. Exercise prompts your body to release endorphins chemicals that prevent pain signals from reaching your brain. Exercise in moderation.In the early stages of sciatica, swimming or other low-impact exercise such as an exercising bicycle will help you stay active without worsening your symptoms. Later, as you improve and the pain becomes less combining aerobic activity with strength training and core stability exercises that improve the strength of your back muscles can help limit the effects of degenerative changes in your spine.Start out slowly and progress to at least 45 minutes every day to prevent further injury, learn proper lifting techniques.

Also available are 32 3D animated educational Videos  for various Back Pain, injuries and conditions such as (1) Sciatica (2) Degenerative disc (3) Herniated disc (4) Facet Joints (5) Scoliosis (6) Kyphosis Posture (7) Back Pain and Neck Pain Decompression  (they can be found under the listing ”Types of Pain” in our “Back Pain” Section).  

For pain management and Back Pain Relief at Central  Chiropractic and Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”. 

Back Pain

What is a Herniated or Slipped disc?

A slipped disc occurs when the outer part of the disc ruptures, allowing the glutinius inside to bulge and protrude outwards from in between the vertebrae. The damaged disc can put pressure on the whole spinal cord or on a single nerve fibre. This means that a slipped disc can result in pain both in the area of the protruding disc and into any part of the body that is controlled by the nerve the disc is putting pressure on.

A Herniated or Slipped disc occurs most frequently in your lower back, but any disc can rupture, this also can occur in any level of the spine.

 Herniated  or Slipped disc

One of the most common causes of sciatica is a herniated disc. To herniate means to bulge or to protrude through. Intervertebral discs are the soft discs that form a cushion between the vertebrae of the spine. The discs have a tough outer layer made of cartilage, with a soft gelatinous centre that acts as a shock absorber. If the outer layer of the disc becomes weak through wear and tear, age or injury, the soft gelatinous centre can bulge out this is what’s known as a herniated or ruptured disc. Should any of the 5 pairs of nerve roots that form the sciatic nerve become compressed in the spine by a ruptured disc it can cause pain down the sciatic nerve. Not only does a herniated disc presses on the nerve root, but fluid leaking from the soft centre of the disc will irritate the nerve root, results in inflammation. 

Also available are 32 3D animated educational Videos  for various Back Pain, injuries and conditions such as (1) Sciatica (2) Degenerative disc (3) Herniated disc (4) Facet Joints (5) Scoliosis (6) Kyphosis Posture (7) Back Neck and Pain Decompression (they can be found under the listing ”Types of Pain” in our “Back Pain” Section).   

For pain management and Back Pain Relief at Central Chiropractic and Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.  

Back Pain 

Disc Degeneration

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc degeneration.

The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. Tears in the annulus heal by scar formation weakening the tissue. The repetitive annular tears which heal by scar formation lead to a disc that begins to degenerate.

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone sours or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic or lumbar.

For the management of Back Pain, here at Central Chiropractic and Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.   

Back Pain

Mid-Back Pain.

Chest & Ribs. Put your hands alongside your chest and sides and you can easily feel your boney ribs.  In  the front they attach to your breastbone  or sternum and in the back they attach to your spinal bones or vertebrae. Ancient anatomists thought your ribs looked like the bars of a cage so they called them, with their attachments, your “rib cage.” 

What is in that cage? Some very important organs are protected there: your heart, lungs, major blood vessels, diaphragm and other structures. It’s important to keep this “cage” in alignment and balanced. A misaligned rib cage can put unnatural pressure on its vital inhabitants affecting their proper functioning. 

Thoracic Subluxations 

Thoradc subluxations can affect the heart, lungs and other organs in your chest cavity, preventing the proper draining of lymphatic fluids from your head, brain, throat, chest, abdomen and legs. Subluxations can also restrict your breathing, and can also affect your sympathetic nerves which influence the function of your internal organs, senses and brain itself. Two types of thoradc subluxations have a special name: Thoracic Outlet Syndrome and T4 Syndrome. 

Thoradc Outlet Syndrome (TGS) affects your brachial plexus, a collection of nerves that go from your spine to your arms, hands and shoulders. TGS is characterized by pain in the head, neck or upper extremities, paresthesia (strange nerve pains) and other symptoms. 

Symptoms of T4 Syndrome, caused by a vertebral subluxation of the 4th thoracic, may include heaviness and swelling in one or both upper extremities; “creepy crawly” feelings of the shoulders. arms or hands; feelings of a tight band around the upper arm and feelings of heat or cold in one or both hands. Because the sympathetic system can be involved, patients with these syndromes may feel heart-like pain in the chest and left upper extremity and think they are having a heart attack. These conditions can also be confused with Carpal Tunnel Syndrome. 

Are You Subluxated? 

The ribs may get subluxated from trauma-sports, accidents, injuries and even birth stress. However, the thoracic spine moves differently from the neck (cervical) and lower back (lumbar) areas since it is attached to the ribs. 

Special spinal adjustment techniques have been developed for this area. When a thoracic vertebra becomes subluxated, the ribs and the sternum (breastbone) are affected. Some chiropractors adjust the ribs and sternum directly while others adjust the vertebrae so the connecting structures will then realign. Why not ask your chiropractor how he/she addresses this? 

When your chiropractor releases subluxations or spinal nerve pressure in this area the benefits can be both physically and psychologically profound. Everyone should see a chiropractor for a checkup to ensure their mid-back, ribs and the rest of their body are in proper alignment and balance. 

Thoracic Vertebrae 

The thoracic spine contains 12 medium sized vertebrae all of which form articulations (joints) with 2 opposing ribs. Like the other spinal vertebrae, the thoracic vertebrae act as attachments for muscles and ligaments in the mid spine and also encase and protect the median aspect of the spinal cord and thoracic nerve roots. 

Because the thoracic vertebrae form relatively strong articulations with the ribs, the mobility of the thoracic spine is less than that of the cervical and lumbar spines. However, this same characteristic also protects the thoracic spinal discs and facet joints from the wear and tear experienced by these structures in the other areas of the spine. 

Common vertebral problems in the thoracic spine include vertebral subluxations, a condition where the vertebrae of the thoracic spine become statically misaligned and/or function abnormally resulting in pain, muscle spasm, and sometime nerve malfunction. 

Rib Articulation 

The thoracic is unique in that each of its vertebrae attaches to a pair of ribs. There are 12 thoracic vertebrae and thus, 24 ribs (12 ribs on the left and 12 ribs on the right). Just like adjacent connecting vertebrae can misalign and biomechanically malfunction, so too can the thoracic vertebrae and it’s adjacent ribs. When ribs “go out” or misalign in relation to their connecting vertebrae, the individual will often experience sharp pains in the area of the misaligned rib head, especially on twisting movements of the torso. 

The thoracic spinal nerve roots exit openings formed between adjacent thoracic vertebrae termed the intervertebral foramina or IVF. The spinal nerves from the thoracic spine innervate the many muscles of the back as well as the many visceral organs and tissues of the chest and abdominal regions. 

Spinal nerve root irritation or compression in the thoracic region commonly leads to intercostal pain (between the ribs). Sharp shooting pains are often experienced along the path of the ribs. Additionally, an increased susceptibility to herpes zoster or “shingles” in some individuals (generally the elderly or immunocompromised) is thought to occur when the thoracic spinal nerves are irritated or compressed. Herpes zoster involves infection to an area of the nerve root, the dorsal root ganglion, with the herpes virus. 

Thoracic Spinal Musculature 

The paraspinal muscles of the thoracic spine are numerous. They are responsible for the majority of trunkal movements as well as a number of upper extremity movements and are a common source of injury and pain. 

Over exertion of the muscles from lifting and pulling and poor posture are the major contributors in mid back strains. Pain originating from these muscles characteristically produces a dull generalized ache. 

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Back Injury, Causes of Back injury and Pain

Muscles/Ligaments

Among the many causes of back pain, the most common by far is a sprain or strain of muscles or ligaments. Muscle spasm can occur after twisting or bending awkwardly, or following  a simple sneeze or a cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, also cold laser therapy. (View  our cold/low level laser therapy section ). 

Discs

Disc Degeneration

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc degeneration.

The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. The splits and tears in the annulus heal by scar leading to a weakening of the tissue thus atarting degenerative changes.

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone spurs or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic, or lumbar.

Slipped Disc

Slipped Disc also known as a  Bulging Disc, Protruding Disc, Prolapsed Disc, Herniated Disc, Extruded disc.

The above terms generally describe a disc that is displaced beyond the limits of the intervertebral disc space i.e. the borders of annulus fibrous (the outer fibrous part of the disc)

Disc prolapse or herniation is the protrusion of the central portion of the disc through a tear in the outer annular wall of the disc. If disc prolapsed results in the compression (direct or indirect) of the nerve root it would cause symptoms of pain, numbness, or weakness. In some individuals however, disc protrusions will not cause any symptoms. A disc extrusion is a severe version of a disc protrusion in which a large portion of the nucleus pulposus is displaced through the wall of the disc.  A disc extrusion is almost always would result in the symptoms of nerve root compression.

Facet Joints

Facet joints irritation is another cause of back pain. Facet joints are small pairs of joints on the back of the spinal column where the vertebrae meet. Facet joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. 

Inflammation of facet joints can occur from injuries, excessive stress put on the spine or as a form of arthritis. Facet joint problems are functional problems and would not be visualised on the x-rays of the MRI scan.

Spinal Stenosis

The term stenosis describes any narrowing of the spinal canal. Among many causes of spinal stenosis the most common one is degenerative changes or oseoarthritis of the spine, which occurs almost inevitably as a part of the aging process.

Canal stenosis can be caused by many factors such as enlargement of the facet joints due to degenerative changes; hypertrophy (enlargement) of the ligamentum flavum – the main ligament of the spinal canal; the protrusion or herniation of intervertebral discs into the canal and forward slippage of vertebrae in a condition called spondylolisthesis – all contribute into narrowing of spinal canal on their own or in conjunction with each other.

Tje main symptoms of spinal stenosis of lumbar spine is the pain in the back and legs aggravated by standing and walking and relieved by sitting or stooping forward. Legs pain induced by walking is known as neurogenic claudication (from the Latin claudico, to limp). Neurogenic claudication must be distinguished from is vascular claudication, or leg pain on walking caused by insufficient blood flow to the legs. The features which help to distinguish neurogenic from vascular claudication are following:

In neurogenic claudication pain occurs after varying amounts of exercise, with standing, or with coughing. Vascular claudication is reliably produced with a fixed amount of exercise, such as walking a certain number of blocks, and is rare at rest. The main distinguishing feature of neurogenic claudication and vascular claudication is the pain relief with sitting and stooping in cases of neurogenic claudication while vascular claudication pain is usually quickly relieved by resting in a standing position.

Spondylolysis and Spondylolisthesis

Spondylolysis and Spondylolistheses are the most common causes of lower back pain in adolescents. Spondylolysis is a fracture in one or both pedicles of the vertebrae that make up the spinal column. It usually affects either the fourth or the fifth lumbar vertebra in the lower back. The fracture site is called  pars defect.

If the bone is unable to maintain its proper position, the top vertebrae can shift forward on top of the bottom vertebrae. This condition is called spondylolisthesis.

For adults, spondylolisthesis is normally caused by degenerative changes. When too much movement or slippage occurs, the bones may begin to press on nerves and surgery may become necessary to correct the condition.

Causes such as genetic, overuse or degenerative changes can contribute to development of spondylolisthesis. 

Sacroiliac Joints

Another very common cause of lower back pain is a dysfunction of sacro-iliac joints. The sacroiliac joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest).

The inflammation of sacroiliac joint can result from an acute injury or from chronic postural abnormalities such as undue stress on the joint following lower back fusion surgery, degenerative changes of the hip and knee joint as well as from fallen arches of the foot.  Dysfunction of sacroiliac joint would give you pain in the the lower back, buttock/hip, abdomen, groin or legs.

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory condition affecting the spine. With ankylosing spondylitis, the joints and ligaments that normally permit the spine to move become inflamed and stiff turning into the bones with time and causing the spine to become rigid and inflexible.

Coccygodynia

Pathophysiology

The word coccyx comes from the Greek word for cuckoo, the name apparently having been derived from the tailbone’s shape, which resembles that of a cuckoo’s beak. The coccyx is the terminal end of the spine, just inferior to the sacrum. The human coccyx is composed of 3-5 individual segments (coccygeal vertebrae), with variations occurring with regard to the number of segments, the overall angulation (curve) of the coccyx, and the degree of articulation versus fusion between the individual segments. In 85% of patients, the coccyx is made up of 4 coccygeal vertebrae. The human coccyx is often considered to be  a remnant or corollary of a tail; thus, the coccyx is colloquially referred to as the tailbone.

Anatomy and function of the coccyx

In humans, the coccyx serves important functions, including as an attachment site for various muscles, tendons, and ligaments. Physicians and patients should remember the importance of these attachments when considering surgical removal of the coccyx.

Muscles inserting on the anterior coccyx include the levator ani, which is sometimes considered as several separate muscle parts, including the coccygeus, iliococcygeus, and pubococcygeus muscles. This important muscle group supports the pelvic floor (preventing inferior sagging of the intrapelvic contents) and plays a role in maintaining fecal continence. Muscles originating on the posterior coccyx include the gluteus maximus, which is the largest of the gluteal (buttock) muscles and which functions to extend the thigh during walking.

The coccyx serves as somewhat of a weight-bearing structure when a person is seated, thus completing the tripod of weight bearing composed of the coccyx and the bilateral ischium. The coccyx bears more weight when the seated person is leaning backward; therefore, many patients with coccydynia sit leaning forward (flexing at the lumbosacral and hip regions), which shifts more of the weight to the bilateral ischium rather than the coccyx . Alternatively, patients with coccyx pain may sit leaning toward one side so that the body weight is exerted mainly on one ischial tuberosity or the other, with less pressure on the coccyx.

The base of the coccyx articulates with the sacral apex via the sacrococcygeal junction. The sacrococcygeal articulation and intracoccygeal articulations contain fibrocartilaginous discs, comparable to the intervertebral discs present at other spinal levels. The apex (distal tip) of the coccyx is typically rounded but may be bifid.

Muscle Spasms and Trigger Points

As 60% of body is made up from nerves, muscles and bones, it should come as no surprise that chronic pain, strain, spasm, irritation, inflammation, trigger points or other neuro-musculoskeletal (nerve-muscle-bone) conditions are so common. In fact, many of the millions of people who visit their doctors of chiropractic do so because of these problems.

 Do Injections And Physical Therapy Work?

For standard medicine, how to best deal with the symptoms of muscle spasm, trigger points and similar problems is a mystery. Medical treatments such as novocaine, procaine and xylocaine injections, cooling sprays, muscle relaxant drugs, cortisone injections and other drugs have been tried with mixed results. Heat, massage and other modalities have had limited success.

The Cause

The cause of this mystery illness, may, at least in part, be spinal trauma. In one study, adults with neck injuries had a 16 % increase of neuromuscular pain and fibromyalgia within one year of their injury. Others have found similar associations.

The Chiropractic Approach

Those suffering from muscle spasm, trigger points, neuromuscular pain and problems, fibromyalgia and similar symptoms are seeing chiropractors in record numbers because they are getting results. For example, in one study 10 men and 20 women, aged 13 to 70 with chronic fatigue syndrome, trigger point pain and fibromyalgia, who had been suffering for years began chiropractic care. After a series of spinal adjustments, every patient was able to resume normal activities including full time work and maintained their improvements one year later at follow-up. The authors of the study write:

“Improvement in symptoms was achieved in both these syndromes”

In another study of   trigger points, muscle pain and fibromyalgia experienced moderate to greater improvement under Chiropractic care while anti-depressant medication benefited only around 30% and exercise helped 25% In another study, 55% of patients had at least a 45% reduction in pain symptoms with chiropractic. Similar results were found with those suffering from fibromyalgia with tender trigger points, numbness, tingling and pain.

Trigger Points

How do you feel in the morning?                                                              

Do your muscles feel “tight,” especially in the morning? Do you always need to stretch with constant aches and pains in your neck, low back and hips? Do you feel old and stiff with morning fatigue, sleeping problems and many tender spots (trigger points)?

Trigger Points

Trigger points are tender, sensitive areas that when pressed, stuck, heated or cooled can be exquisitely painful. You may first discover trigger points when you are surprised by someone pressing a seemingly pain-free area. Trigger point pain may also be referred to other areas of the body. Trigger points are common in chronic muscle spasm, myalgia, myositis, fibrositis, strain and sprain, and other muscle and joint problems.

Vertebral Subluxations

Chiropractors locate and correct vertebral subluxations, a spinal condition that affects nerves, muscles, fascia, meninges and other tissues. Subluxations can alter the concentration of enzymes and other chemicals necessary for skeletal muscle health which may play a role in muscle diseases. Compression of a nerve interferes with impulse transmission, causing muscle paralysis, vasodilation and trophic ulcers.

Chronic hyperactivity of sympathetic nerves is detrimental to the tissues and organs which they innervate and musculoskeletal dysfunction in the spinal area.

Vertebral subluxations cause joints to “freeze” or lose normal movement, causing damage to the involved area. Movement is essential for the prevention of contracture and adhesion formation within the joint.]

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very I:nild one that happened years ago; a
bad sleeping position; poor posture; fatigue; dental work; a difficult birth; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could “set” in your body over time–coming on so gradually that you
won’t be aware you have one.

Conclusion

Doctors of chiropractic spend thousands of hours and many years learning  how to correct vertebral subluxations using the art of the chiropractic spinal adjustment. The chiropractic adjustment removes severe stress from the spine as well as related nerve and other tissues including the muscles, bones, joints, ligaments and other soft tissues. This permits your body to heal itself better. After your spine is adjusted your head is more balanced in relationship with gravity, your hips and shoulders are more level and stress is taken off the joints and muscles throughout your body. Because less of your energy goes into supporting an unbalanced spine and skeleton, you may immediately discover more energy, greater ease in movement and improved relaxation.

Other rare causes of back pain include:

Benign or malignant tumors of the spine or spinal cord , poblems with the digestive tract, genitourinary or gynaecological problems can cause referred low back pain infections.

Sciatica

The sciatic nerve is the longest nerve in your body. It runs from your pelvis, through your hip area and buttocks and down each leg. The sciatic nerve branches into smaller nerves as it travels down the legs providing feeling to your thighs, legs, and feet as well as controlling many of the muscles in your lower legs. The term sciatica refers to pain that radiates along the path of this nerve.

What causes Sciatica?

Sciatica is actually a sign that you have an underlying problem putting pressure on a nerve in your lower back. The most common cause of this nerve compression is a bulging or herniated lumbar disc. Piriformis syndrome is another common cause of sciatica. The piriformis is a muscle that lies directly over the sciatic nerve. If this muscle becomes tight or if you have a spasm in this muscle, it puts pressure directly on the sciatic nerve. Occasionally, sciatic pain in men is caused by sitting on a wallet.

How do I know if I have sciatica?

Pain that radiates from your lower (lumbar) spine to your buttock and down the back of your leg is the hallmark of sciatica. Sciatica may be accompanied by numbness, tingling, and muscle weakness in the affected leg. This pain can vary widely, from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. Sciatic pain often starts gradually and intensifies over time. It’s likely to be worse when you sit, cough or sneeze.

How is Sciatica Treated?

The vast majority of the time, sciatic pain can be relieved through a combination of stretches, deep tissue massage of the piriformis muscle and chiropractic care. Occasionally, in cases where chronic spasm of the low back or piriformis muscles is causing the sciatic pain, it may be necessary to do a procedure called a trigger point injection, where a medical pain specialist injects a small amount of anaesthetic directly into a spasmed muscle to break the spasm cycle.

(View our Cold/Low Level Laser Therapy Section.)

Complementary and alternative medicine

Complementary and alternative medicine (CAM) refers to medical and health care systems, practices, and treatments that aren’t currently part of conventional medicine, i.e. the care you receive in your primary care doctor’s surgery. Many of these therapies and treatments are being studied intensely, and some have proved to help alleviate back pain.

• Chiropractic is a system of treatments which is based on the philosophy that restricted movement in the spine may lead to reduced function and pain. Spinal adjustment (manipulation) is one form of therapy chiropractors use to treat restricted spinal mobility. The goal is to restore spinal movement and, as a result, improve function and decrease pain.Chiropractors manipulate the spine from different positions using varying degrees of force. Manipulation doesn’t need to be forceful to be effective. Chiropractors may also use massage and stretching to relax muscles that are shortened or in spasm.Some studies done on spinal manipulation have found it to be as effective and safe as standard treatments, especially for initial pain relief, though the optimal number of treatments depends on individual case.

Recent research has shown that 75% to 80% percent of patients suffering with chronic sciatica benefit from chiropractic treatment

• Massage. To conduct an objective clinical trial in massage can be difficult due to variances in practitioners and in massage types however, studies that have been conducted suggest that massage may ease low back pain symptoms by reducing muscle spasm.

Risk factors

The greatest risk factors for sciatica include:

• Age related changes in the spine are a common cause of sciatica. You’re likely to have some deterioration in the discs in your back by the time you’re in your late 20s, and most people who develop herniated discs are in their early 30s and 40s and. Previous injuries from sport and work related activities are also common factors.
• Occupation jobs that requires you to twist your back, and carry heavy loads, driving a motor vehicle for extended periods makes you more prone to develop sciatica.
• Prolonged sitting People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than people with active lifestyle.
• Diabetes. This condition, which affects the way your body uses blood sugar, increases your risk of nerve damage.

When to seek medical advice

Seek immediate medical treatment if:

• You experience sudden, severe pain in your low back or ether or both legs and numbness or muscle weakness in either or both of the legs
• The pain follows a injury, from a traffic or work related accident
• You have trouble controlling your bowels or bladder.   Seek medical advice urgently.

Screening and diagnosis of sciatica;

To help diagnose sciatica and pinpoint which nerves, if any, are affected, your chiropractor will ask about your medical history and perform a thorough physical exam, paying special attention to your spine and legs.

You’re also likely to have some basic tests that check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, and, while lying on your back, lift your legs one at a time straight in the air. Pain that results from sciatica will usually become worse during this examination.

If your pain lasts longer than four weeks or is very severe, or you have another serious condition such as cancer, you may have one or more imaging tests to help identity why the sciatic nerve is compressed and to rule out other causes for your symptoms.

The other tests include:

• Spinal X-ray. Because ordinary X-rays can’t detect herniated disc problems or nerve damage, they’re not usually helpful for pinpointing the cause of sciatica. A spinal X-ray can show most cancers affecting the bony structures of the spine, narrowed discs and spondylolisthesis, however, and can help rule out other causes of nerve root impingement.
• Magnetic resonance imaging (MRI). This is probably the most sensitive test for assessing sciatic nerve pain. Instead of X-rays, MRI uses a powerful magnet and radio waves to produce cross-sectional images of your back. The test can detect damage to your discs and ligaments as well as the presence of tumors. MRI is non-invasive and has no harmful side effects.During the test, you lie on a movable table inside the MRI machine, which is essentially a large magnet. If you have a hard time lying still for the required period of time or you’re anxious about the enclosed space, you may be given a sedative. Some MRI units may be wider, shorter or open on all sides, which may be more comfortable for you, although the quality of images taken with these systems may vary.
• Computerized tomography (CT) scans. This test uses a narrow beam of radiation to produce detailed, cross-sectional images of your body. When CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the Digit – X-rays are taken a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan.

Complications of sciatica

Although people recover from sciatica, sciatica can potentially cause permanent nerve damage. Depending on what’s causing the nerve to be compressed, other complications may occur,

They included

• Loss of feeling, may affected one or both or legs.
• Loss of movement may affected one or both legs
• Loss of bowel or bladder function

Different Treatment of Sciatica Include;

Physical therapy  for  disc injuries known as “Slipped” Prolapsed, Bulging or herniated disc - can play a role in your recovery. Once acute pain is reduced and range of movement improves a physical therapist or Chiropractor can design a rehabilitation program to help prevent further injuries.

Rehabilitation includes exercises to help correct your posture, strengthen the muscles supporting your back and improve your flexibility. Physical therapy, exercises should be Started as early as possible.

Prescription drugs most doctors may prescribe an anti-inflammatory medication along with a muscle relaxant. Narcotics also may be prescribed for short-term pain relief. Antidepressants and anticonvulsant drugs can be used in easing chronic pain. They may help by blocking pain messages to the brain or by enhancing the production of endorphins, the body’s natural painkillers.

More invasive treatment

Epidural steroid injections. In some cases, doctors may inject a corticosteroid medication into the affected area. Corticosteroids mimic the effects of the hormones cortisone and hydrocortisone, which are made by the outer layer (cortex) of your adrenal glands; Corticosteroids suppress inflammation around the irritated nerve thus giving pain relief.

Their usefulness in treating sciatica remains a matter of debate. Some research has found that corticosteroids can provide short-term symptom relief, but that these medications aren’t a long-term solution. In addition, corticosteroids can have side effects, so the number of injections you can receive is limited usually no more than four per joint.

Surgery usually occurs when the compressed nerve causes significant weakness, bowel or bladder incontinence, (when this occurs seek medical advice urgently) or you have pain that gets progressively worse or does not improve.

Surgical options include lumbar laminectomy and microdiskectomy. In lumbar laminectomy with diskectomy, surgeons remove a portion of a herniated disc that’s pressing on a nerve. most of the disc is left intact to preserve as much of the normal anatomy as possible. Sometimes a surgeon will perform this operation through a small incision while looking through a microscope (microdiskectomy).

Success rates of standard diskectomy and microdiskectomy are about equal, but you may have less pain and recover more quickly with microdiskectomy. Discuss which option might be best for you with your doctor, and carefully weigh the potential benefits of surgery against the risks as surgery is not always successful.

(Always get a second opinion).

Prevention

Exercise regularly. This is the most important thing you can do for your overall health as well as for your back. Pay attention to your core muscles the muscles in your abdomen and lower back that are essential for proper posture and alignment. For cardiovascular benefits, try using a exercise bike or treadmill. Swimming is also recommended.

Maintain proper posture when you sit. A good chair should comfortably support your hips, and the seat should not press on the back of your thighs or knees. If the chair does not support the natural curve in your lower spine, place a rolled towel or pillow behind your back.

When working at a computer, adjust your chair so that your feet are flat on the floor and your arms rest on your desk or the chair’s arms, with your elbows bent at a right angle. Take frequent breaks every 20 minutes, even if it’s just to walk around your office a little stretching will also help.

Driving, before setting off adjust your seat to keep your knees and hips level, and move the seat forward to avoid overreaching for the pedals.

Consider using body mechanics. Being aware of how you stand and lift heavy objects and even how you sleep can go a long way toward keeping your back healthy. That’s because poor posture stresses your back, leading to fatigue and stress on joints and nerves. Always hold reading material at eye level instead of bending forward, and if you’re standing for long periods rest one foot on a raised object about the height of a foot stool.

Before you lift something heavy, decide where you’ll place it and how you’ll get it from A to B. Bend at your knees, not your back, so that your legs do the lifting. Carry objects close to your body at about waist level. If possible, set the object down on a surface between shoulder and knee height to avoid lifting objects over your head or bending over too far. Don’t twist at your waist. Instead turn by pivoting your feet.

Be careful moving heavy things when you become tired, Tiredness can cause you to move more awkwardly than normal. Heavy loads are the greatest risk to your spine, so know your limitations. Don’t attempt to lift something that is beyond your normal ability.

Try the following measures:

• Cold packs. Initially, using cold packs may be able to reduce inflammation and relieve discomfort. Wrap an ice pack in a thin towel and apply to the painful areas for 15 to 20 minutes at least 7 times a daily.
• Stretching. Stretching exercises for your low back can help you feel better and may help relieve nerve root compression. Avoid or sudden movements and twisting during the stretch and try to hold the stretch as long as possible. Around 40 seconds per stretch if possible.
• Medications.Pain killers (analgesics) fall into two categories those that reduce pain and inflammation and those that only treat pain. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and acetaminophen (Tylenol,) will be helpful for sciatica.Although they provide real relief, both types of medication have a limit to how much pain they can reduce. If you have moderate to severe pain, exceeding the recommended dosage will not provide any additional benefits. In addition NSAIDs can cause side effects such as nausea, stomach bleeding or ulcers, and acetaminophen can cause liver problems.If you’re using these medications, you should talk to your GP so that you can be monitored for any arising problems. Periodically reassess whether you still need drug treatment or not. Exercise, stretching, massage and other none drug treatments can often provide the same benefits without side effects.
• Regular exercise.It may seem counter-intuitive to exercise when you’re in pain, but regular exercise is one of the best ways to combat chronic discomfort. Exercise prompts your body to release endorphins chemicals that prevent pain signals from reaching your brain. Exercise in moderation.In the early stages of sciatica, swimming or other low-impact exercise such as an exercising bicycle will help you stay active without worsening your symptoms. Later, as you improve and the pain becomes less combining aerobic activity with strength training and core stability exercises that improve the strength of your back muscles can help limit the effects of degenerative changes in your spine.Start out slowly and progress to at least 45 minutes every day to prevent further injury, learn proper lifting techniques.

Mid-Back Pain. Chest & Ribs. Hyper-Link to Back Pain. Back Injury.Lower Back Pain.

Put your hands alongside your chest and sides and you can easily feel your boney ribs. In the front they attach to your breastbone or sternum and in the back they attach to your spinal bones or vertebrae. Ancient anatomists thought your ribs looked like the bars of a cage so they called them, with their attachments, your “rib cage.”

What is in that cage? Some very important organs are protected there: your heart, lungs, major blood vessels, diaphragm and other structures. It’s important to keep this “cage” in alignment and balanced. A misaligned rib cage can put unnatural pressure on its vital inhabitants affecting their proper functioning.

Thoracic Subluxations

Thoradc subluxations can affect the heart, lungs and other organs in your chest cavity, preventing the proper draining of lymphatic fluids from your head, brain, throat, chest, abdomen and legs. Subluxations can also restrict your breathing, and can also affect your sympathetic nerves which influence the function of your internal organs, senses and brain itself. Two types of thoradc subluxations have a special name: Thoracic Outlet Syndrome and T4 Syndrome.

Thoradc Outlet Syndrome (TGS) affects your brachial plexus, a collection of nerves that go from your spine to your arms, hands and shoulders. TGS is characterized by pain in the head, neck or upper extremities, paresthesia (strange nerve pains) and other symptoms.

Symptoms of T4 Syndrome, caused by a vertebral subluxation of the 4th thoracic, may include heaviness and swelling in one or both upper extremities; “creepy crawly” feelings of the shoulders. arms or hands; feelings of a tight band around the upper arm and feelings of heat or cold in one or both hands. Because the sympathetic system can be involved, patients with these syndromes may feel heart-like pain in the chest and left upper extremity and think they are having a heart attack. These conditions can also be confused with Carpal Tunnel Syndrome.

Are You Subluxated?

The ribs may get subluxated from trauma-sports, accidents, injuries and even birth stress. However, the thoracic spine moves differently from the neck (cervical) and lower back (lumbar) areas since it is attached to the ribs.

Special spinal adjustment techniques have been developed for this area. When a thoracic vertebra becomes subluxated, the ribs and the sternum (breastbone) are affected. Some chiropractors adjust the ribs and sternum directly while others adjust the vertebrae so the connecting structures will then realign. Why not ask your chiropractor how he/she addresses this?

When your chiropractor releases subluxations or spinal nerve pressure in this area the benefits can be both physically and psychologically profound. Everyone should see a chiropractor for a checkup to ensure their mid-back, ribs and the rest of their body are in proper alignment and balance.

Thoracic Vertebrae

The thoracic spine contains 12 medium sized vertebrae all of which form articulations (joints) with 2 opposing ribs. Like the other spinal vertebrae, the thoracic vertebrae act as attachments for muscles and ligaments in the mid spine and also encase and protect the median aspect of the spinal cord and thoracic nerve roots.

Because the thoracic vertebrae form relatively strong articulations with the ribs, the mobility of the thoracic spine is less than that of the cervical and lumbar spines. However, this same characteristic also protects the thoracic spinal discs and facet joints from the wear and tear experienced by these structures in the other areas of the spine.

Common vertebral problems in the thoracic spine include vertebral subluxations, a condition where the vertebrae of the thoracic spine become statically misaligned and/or function abnormally resulting in pain, muscle spasm, and sometime nerve malfunction.

Rib Articulation

The thoracic is unique in that each of its vertebrae attaches to a pair of ribs. There are 12 thoracic vertebrae and thus, 24 ribs (12 ribs on the left and 12 ribs on the right). Just like adjacent connecting vertebrae can misalign and biomechanically malfunction, so too can the thoracic vertebrae and it’s adjacent ribs. When ribs “go out” or misalign in relation to their connecting vertebrae, the individual will often experience sharp pains in the area of the misaligned rib head, especially on twisting movements of the torso.

The thoracic spinal nerve roots exit openings formed between adjacent thoracic vertebrae termed the intervertebral foramina or IVF. The spinal nerves from the thoracic spine innervate the many muscles of the back as well as the many visceral organs and tissues of the chest and abdominal regions.

Spinal nerve root irritation or compression in the thoracic region commonly leads to intercostal pain (between the ribs). Sharp shooting pains are often experienced along the path of the ribs. Additionally, an increased susceptibility to herpes zoster or “shingles” in some individuals (generally the elderly or immunocompromised) is thought to occur when the thoracic spinal nerves are irritated or compressed. Herpes zoster involves infection to an area of the nerve root, the dorsal root ganglion, with the herpes virus.

Thoracic Spinal Musculature

The paraspinal muscles of the thoracic spine are numerous. They are responsible for the majority of trunkal movements as well as a number of upper extremity movements and are a common source of injury and pain.

Over exertion of the muscles from lifting and pulling and poor posture are the major contributors in mid back strains. Pain originating from these muscles characteristically produces a dull generalized ache.

Muscle Spasms and Trigger Points

The Body is made up of over 60% nerve, muscle and bone, it should come as no surprise that chronic pain, strain, spasm, irritation, inflammation, trigger points or other neuro-musculoskeletal (nerve-muscle-bone) conditions are so common. In fact, many of the millions of people who visit their doctors of chiropractic do so because of these problems.

Do Injections and Physical Therapy Work?

For standard medicine, how to best deal with the symptoms of muscle spasm, trigger points and similar problems is a mystery. Medical treatments such as novocaine, procaine and xylocaine injections; cooling sprays; muscle relaxant drugs; cortisone injections; and other drugs have been tried with mixed results. Heat, massage and other modalities have had limited success.

The Cause

The cause of this mystery illness, may, at least in part, be spinal trauma. In one study, adults with neck injuries had a 16 % increase of neuromuscular pain and fibromyalgia within one year of their injury. Others have found similar associations.

The Chiropractic Approach

Those suffering from muscle spasm, trigger points, neuromuscular pain and problems, fibromyalgia and similar symptoms are seeing chiropractors in record numbers because they are getting results. For example, in one study 10 men and 20 women, aged 13 to 70 with chronic fatigue syndrome, trigger point pain and fibromyalgia, who had been suffering for years began chiropractic care. After a series of spinal adjustments, every patient was able to resume normal activities including full time work and maintained their improvements one year later at follow-up. The authors of the study write:

“Improvement in symptoms was achieved in both these syndromes”

In another study of   trigger points, muscle pain and fibromyalgia experienced moderate to greater improvement under Chiropractic care while anti-depressant medication benefited only around 30% and exercise helped 25% In another study, 55% of patients had at least a 45% reduction in pain symptoms with chiropractic. Similar results were found with those suffering from fibromyalgia with tender trigger points, numbness, tingling and pain.

Lower Back Pain

Eighty percent of people suffer from back pain at some point in their lives. Back pain is the second most common reason for visits to the doctors. In fact, it is estimated that low back pain affects more than half of the adult population each year and more than 15% of all people experience frequent bouts of low back pain.

The susceptibility of the low back to injury and pain is due to the fact that the low back, like the neck, is an unstable part of the spine, unlike the thoracic spine, which is supported by the rib cage. This instability allows us to have a great deal of mobility to touch our toes, tie our shoes or pick something up from ground level, but at the cost of increased risk of injury.

The low back can withstand tremendous forces as long as it is healthy and functioning correctly. However, if the low back is out of alignment or has weakened supporting muscles, something as simple as putting a bag or suit case in and out of the boot of a car, picking something up off the floor, or simply bending down can cause a low back injury.

Studies have shown that when back pain is not treated, it may go away temporarily, and is very to likely return. The importance to take low back pain seriously cannot be stressed enough. The professional chiropractic care is one of the best ways to care for your back.

The Causes of Low Back Pain

Sprained ligaments, strained muscles, ruptured disks, trigger points and inflamed joints are the many of different conditions that can result in low back pain. While sports injuries or accidents can lead to an injury and pain, sometimes even the simplest movements, like picking up a pencil from the floor, can have painful results. In addition, conditions such as poor posture, stress, arthritis, kidney stones and kidney infections, can be the cause of low back pain.

There may be many other things that can cause low back pain, and some of those things can be serious if left untreated. Chiropractors are the experts in diagnosing the cause and determining a proper course of treatment for low back pain. Following are some of the most common causes.

 Subluxations

When a disruption in the normal movement or position of the vertebrae occurs it results in pain and inflammation. In the lumbar spine these occur at the transition between the lower spine and the sacrum. Subluxations can lead to debilitating low back pain, however, subluxations are easily treatable and there is often a significant reduction in pain experienced almost immediately after treatment.

Sprains, Strains and Spasms

Sprains strains and spasms, are the most common source of low back pain. Overworking the muscles or ligaments of the low back may lead to tears in the tissues, which become painful, swollen and may even ache, with a tightening to the area affected.

Stress

When you become stressed, your body responds by increasing the levels of stress hormones leading to the rise of blood pressure and heart rate and tightening up of your muscles. By becoming stressed all the time your muscles will become weak and painful loaded with trigger points.

Chiropractic treatment for the low back has been repeatedly shown to be the most effective treatment for low back pain. Major studies have shown that chiropractic treatment is more effective, and has better long-term outcomes than any other treatment. Why? This makes sense is because chiropractic treatment is the only method of treatment that works to re-establish normal vertebral motion and position in the spine. All other treatments, such as muscle relaxants and pain killers, will only decrease the symptoms of the problem and do not correct the problem itself.

Chiropractic treatment for low back pain is normally straight forward, and simply a matter of adjusting the lower lumbar vertebrae and pelvis to re-establish normal motion and position of your bones and joints. ( View our Cold Laser Therapy Section .)

Disc Herniations

A herniated disc does not automatically mean that you may suffer from low back pain. In one study almost 60% of all adults had at least one bulging or herniated disc, even though they did not experienced any back pain. However, herniated discs can be a source of severe and debilitating pain, which may radiate to other areas of the body. Unfortunately, when a disc herniates, they rarely, completely heal. Further deterioration can be avoided through chiropractic care, but a complete recovery is less common.

Common name Slipped Disc, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back, legs, neck, and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapse) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a Pillow is used to support the neck.

Common Slipped Disc Neck Disc injury signs & symptoms:

• Patients with a slipped disc in the neck may experience severe neck pain.
• Sometimes there is neck and shoulder pain or pain in the arm.
• There may be weakness or a loss of sensation in the arms or hands.

Common, Slipped Disc in the Lower Back signs & symptoms.

 The first symptom would be mild pain along with a tingling, aching affect.  Then the symptoms develop to irritating pain, swelling and heat in the region of rupture.  Muscle weakness and problems in sitting, lying, walking or even standing for long periods. These are the symptoms of this condition. Besides these, some other complications arise if the nerves of some of the respective areas suffer pinching of the discs.

If the Slipped disc presses against the sciatic nerve, the pain from the back will reach into the buttocks and then moves down into one or both legs and to areas like thighs, cuffs, or ankles. The nerves of the bowel and kidneys pass through the lumbar region. The protrusion of any of these nerves can cause bowel irregularity and kidney disorders.

Healthy Disc

A disc has a spongy, gel-like center (nucleus) and a tough outer ring (annulus). The vertebrae rock back and forth and rotate on the discs, allowing you to move easily.

Can Chiropractic Care Help Me?

Your doctor of chiropractic looks at your overall health-focusing not only on your discs but also on your lifestyle. This total approach to wellness helps determine the best treatment for your problem.

You’r Health History

To help find the cause of your disc problem, you and your chiropractor discuss your symptoms. You might have a disc problem, for example, if it’s painful to cough or sneeze. Your doctor of chiropractic also discusses prior injuries, your health history, and your lifestyle, including work-related and leisure activities.

Physical Exam

Physical, orthopaedic (bone and muscle), and neurological (nerve) tests can help reveal the condition of your discs. Your chiropractor gently moves your spine and legs to locate muscle tightness and show how well each vertebra moves.

Tests

X-rays may be done to reveal any problems with your vertebrae. If needed, other imaging tests, such as an MRI (magnetic resonance imaging), may be used to show detailed images of discs, nerves, and other soft tissue.

Diagnosis

Based on the results of your exam and tests, your doctor of chiropractic may recommend a treatment program to help realign your vertebrae, relieve irritation on your spinal nerves, and reduce pain. If needed, your chiropractor also consults with or refers you to other medical specialists.

Call 02476 222002.Registered with BUPA. AXA  PPP. HSA. AVIVA. Simplyhealth. Standard Life. Mercia health. BHSF. Pru health .Cigna Police health care scheme Medicare  Medisure. Medicash and all other healthcare insurers .

Hyper link to sciatica

Trapped  Nerve or “Pinched” Nerve.

Having a  Trapped nerve hurts often ffelng like  severe, sharp, excruciating and intense pain. Trapped nerves could happen nearly anywhere affecting nerves that go to the arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or Trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/Trapped nerves can make  life a misery.

Trapped ?

Do nerves really get trapped? Actually directly trapping the nerve  is quite rare. Much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are: nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual trapping, people like the word because it’s so descriptive. It can really feel like something is being trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s  saying their GP, osteopath, massage therapist referred them because they had a trapped nerve and should visit a chiropractor to get  the trapped nerve freed.

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very small one that happened years ago; a poor sleeping position; poor posture; fatigue; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could  set in the body over time. 

 Trapped Nerves Don’t Normally Hurt

Chiropractors sometimes say that people with painful  Trapped nerves might be considered lucky-they know they have a problem and they (hopefully) will  go to a chiropractor.

 If  You  don,t Experance The pain From a  Trapped Nerve?  What Would Be The Outcome?

Some patients  may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today – educating people about vertebral subluxations and the need for periodic spinal checkups.

Treatment Of Trapped Nerves

Trapped nerves do not get untrapped by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for trapped nerves or vertebral subluxations and use spinal adjustment techniques to gently realign the spine, release the internal stress and free the body from the trapped nerves.

Chiropractors are heakth care practitioners who are most experienced in freeing body of vertebral subluxations.

Nerves  Travel Through the Body?

Individual nerve fibers are tiny. Although they may be many inches long they are so thin you need a powerful microscope to see them. Nerve fibers are also found in large bundles called nerves. Billions of nerve fibers are bundled inside your spinal cord – an extension of your brain, which passes through the spinal column. Nerves branch off from spinal cord and exit spine through openings between the vertebrae to connect to every cell in the body.

Life without Nerves

Without nerves you couldn’t see, hear, touch, taste or smell or feel hot, cold, pleasure or pain,and no messages could come in and no messages could go out; without nerves no muscles could move.

Nerves Keep The Body Alive and Healthy

Nerve messages also help regulate the body’s activities such as breathing, heartbeat, digestion, excretion,  blood pressure and immune system so that the body can respond to germs, changes in temperature and all kinds of stress. In addition to nerve impulses, nutrients flow over your nerves to nourish the muscles and tissues. If this flow is blocked it may cause your muscles to waste away.

If the nerves are trapped, “impinged” or otherwise interfered with, the flow of messages and nutrients over them can be disrupted and the body can become “diseased” or weakened. When you are diseased you have less energy and vitality and are less able to deal with physical and emotional stress.

Lowered resistance to disease, infection, colds, flu, allergies, ulcers, constipation, diarrhea, asthma, fevers, headaches, seizures, bedwetting, hearing, balance or visual disturbances and many other health problems have been related to an unhealthy nervous system.

How Do Nerves Get Impinged or Trapped

The skeletal system, especially the spinal column, protects the spinal cord and other nerves. If  the spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

Back to Top

Chiropractic treatment for Back Pain and injuries.  Cold Laser Therapy for pain relief, for back injuries such as Bulging, Prolapsed, Herniated or Slipped discs. Disc Degeneration. Spinal Stenosis. Spondylolysis Spondylolisthesis. Sacroiliac joint. Facet Joints. Muscles. Ligaments. Ankylosing Spondylitis.

Causes of back pain  Muscles/Ligaments

Among the many causes of back pain, the most common by far is a sprain or strain of muscles or ligaments. Muscle spasm can occur after twisting or bending awkwardly, or from a simple sneeze or cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, also cold laser therapy, see our cold laser therapy section under “Treatments”. 

Discs.   Disc Degeneration

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc

The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. Tears in the annulus heal by scar formation weakening the tissue. The repetitive annular tears degeneration.which heal by scar formation lead to a disc that begins to degenerate.

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone sours or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic, or lumbar.

Bulging Disc, Protruding Disc, Prolapsed Disc, Herniated Disc, Extruded disc, Slipped Disc.

The above terms generally describe a disc that is displaced beyond the limits of the intervertebral disc space i.e. the borders of annulus fibrous (the outer fibrous part of the disc)

Disc prolapse or herniation is the protrusion of the central portion of the disc through a tear in the outer annular wall of the disc. If disc prolapsed results in the compression (direct or indirect) of the nerve root it would cause symptoms of pain, numbness, or weakness. In some individuals however, disc protrusions will not cause any symptoms. A disc extrusion is a severe version of a disc protrusion in which a large portion of the nucleus pulposus is displaced through the wall of the disc. A disc extrusion is almost always would result in the symptoms of nerve root compression.

Facet Joints

Facet joints irritation is another cause of back pain. Facet joints are small pairs of joints on the back of the spinal column where the vertebrae meet. Facet joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. 

Inflammation of facet joints can occur from injuries, excessive stress put on the spine or a form of arthritis. Facet joint problems are functional problems and would not be visualised on the x-rays of the MRI scan.

Spinal Stenosis

The term stenosis describes any narrowing of the spinal canal. Among many causes of spinal stenosis the most common one is degenerative changes or oseoarthritis of the spine, which occurs almost inevitably as a part of the aging process.

Canal stenosis can be caused by many factors such as enlargement of the facet joints due to degenerative changes; hypertrophy (enlargement) of the ligamentum flavum – the main ligament of the spinal canal; the protrusion or herniation of intervertebral discs into the canal and forward slippage of vertebrae in a condition called spondylolisthesis – all contribute into narrowing of spinal canal on their own or in conjunction with each other.

Main symptoms of spinal stenosis in lumbar spine is pain in the back and legs aggravated by standing and walking and relieved by sitting or stooping forward. Legs pain induced by walking is known as neurogenic claudication (from the Latin claudico, to limp). Neurogenic claudication must be distinguished from is vascular claudication, or leg pain on walking caused by insufficient blood flow to the legs. The features which help to distinguish neurogenic from vascular claudication are the following:

In neurogenic claudication pain occurs after varying amounts of exercise, with standing, or with coughing. Vascular claudication is reliably produced with a fixed amount of exercise, such as walking a certain number of blocks, and is rare at rest. The main distinguishing feature of neurogenic claudication and vascular claudication is the pain relief with sitting and stooping in cases of neurogenic claudication while vascular claudication pain is usually quickly relieved by resting in a standing position. Sensory loss of neurological claudication is in a nerve root distribution, while with vascular insufficiency it is in a stocking-glove distribution. Signs of vascular insufficiency should be absent in neurogenic claudication: diminished pulses, foot pallor on elevation, and decreased temperature of the feet.

Spondylolysis and Spondylolisthesis

Spondylolysis and Spondylolistheses are the most common causes of lower back pain in adolescents. Spondylolysis is a  fracture in one  or both pedicles  of the vertebrae that make up the spinal column. It usually affects either the fourth or the fifth lumbar vertebra in the lower back. The fracture site is called a pars defect.

If the bone is unable to maintain its proper position, the top vertebrae can shift forward on top of the bottom vertebrae. This condition is called spondylolisthesis.

For adults, a spondylolisthesis is normally caused from degenerative changes in the spine. When too much movement or slippage occurs, the bones may begin to press on nerves and surgery may become necessary to correct the condition.

Causes such as genetic, overuse or degenerative changes can contribute to development of spondylolisthesis. 

Sacroiliac Joints

Another very common cause of lower back pain is a dysfunction of sacro-iliac joints. The sacroiliac joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest).

The inflammation of sacroiliac joint can result from an acute injury or from chronic postural abnormalities such as undue stress on the joint following lower back fusion surgery, degenerative changes of the hip and knee joint as well as from fallen arches of the foot. Pain distribution from sacroiliac joint abnormalities is in the low back, buttock/hip, abdomen, groin, or legs.

Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory condition affecting the spine. With ankylosing spondylitis, the joints and ligaments that normally permit the spine to move become inflamed and stiff. with time the bones of the spine may fuse together, causing the spine to become rigid and inflexible.

Other rare causes of back pain include:

Benign or malignant tumors of the spine or spinal cord Problems of the digestive tract, genitourinary or gynaecological problems can cause referred low back pain Infections.

Cold laser Therapy/Treatment

The lasers used at Central Chiropractic and Physiotherapy Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as;

Back pain, lower back pain

Slipped disc, Prolapsed disc, Herniated disc, Bulging disc.

Trapped  nerve.

Hip Pain Sacroiliac joint inflammation 

Athletic InjuriesLower Back Pain
Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic Pain relief, Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections.

Wound Management including Skin Ulcers, Pressure Sores and Burn

Soft Tissue Injuries including Ligaments. Tendons. Sprains. Ruptured Ligaments.

Sprains and Strains, Tendonitis and Haematomas.

Joint Disorders including Arthritic pain relief and Tenosynovitis.

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain.

Whiplash Associated Disorder (WAD) “Whiplash” injury Neck Pain and injuries.

For further in depth information on Back Pain, Sciatica, Lower Back Pain, please go to top left corner under “Pain” or “Conditions”. 

For the management of Back Pain  at Central  Chiropractic and Physiotherapy Clinic we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.

Lower Back Pain

Disc injuries are known by various names, such as Slipped. Bulging, Prolapsed or Herniated Discs. Sprained ligaments, strained muscles, trigger points and inflamed joints are the many of different conditions that can result in low back pain. While sports injuries or accidents can lead to an injury and pain, sometimes even the simplest movements, like picking up a pencil from the floor, can have painful results. In addition, conditions such as poor posture, stress, arthritis, kidney stones and kidney infections, can be the cause of low back pain.

There may be many other things that can cause low back pain, and some of those things can be serious if left untreated. Chiropractors are the experts in diagnosing the cause and determining a proper course of treatment for low back pain. Following are some of the most common causes.

Subluxations

When a disruption in the normal movement or position of the vertebrae occurs it results in pain and inflammation. In the lumbar spine these occur at the transition between the lower spine and the sacrum. Subluxations can lead to debilitating low back pain, however, subluxations are easily treatable and there is often a significant reduction in pain experienced almost immediately after treatment.

Disc Herniations

A herniated disc does not automatically mean that you may suffer from low back pain. In one study almost 60% of all adults had at least one bulging or herniated disc, even though they did not experienced any back pain. However, herniated discs can be a source of severe and debilitating pain, which may radiate to other areas of the body. Unfortunately, when a disc herniates, they rarely, completely heal. Further deterioration can be avoided through chiropractic care, but a complete recovery is less common.

Sprains, Strains and Spasms

Sprains strains and spasms, are the most common source of low back pain. Overworking the muscles or ligaments of the low back may lead to tears in the tissues, which become painful, swollen and may even ache, with a tightening to the area affected.

Stress

When you become stressed, your body responds by increasing the levels of stress hormones leading to the rise of blood pressure and heart rate and tightening up of your muscles. By becoming stressed all the time your muscles will become weak and painful loaded with trigger points.

Chiropractic treatment for the low back has been repeatedly shown to be the most effective treatment for low back pain. Major studies have shown that chiropractic treatment is more effective, and has better long-term outcomes than any other treatment. Why? This makes sense is because chiropractic treatment is the only method of treatment that works to re-establish normal vertebral motion and position in the spine. All other treatments, such as muscle relaxants and pain killers, will only decrease the symptoms of the problem and do not correct the problem itself.

Chiropractic treatment for low back pain is normally straight forward, and simply a matter of adjusting the lower lumbar vertebrae and pelvis to re-establish normal motion and position of your bones and joints.

For pain management and Back Pain at Central  Chiropractic and Physiotherapy Clinic we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.

Cold or low level laser therapy for pain relief and recovery for injuries such as;

Bulging disc, Prolapsed, Herniated, Slipped discs, disc Degeneration, Spinal Stenosis, Spondylolysis, Spondylolisthesis, Sacroiliac joint, Facet Joints, Muscles Ligaments, Ankylosing Spondylitis. 

Causes of Back Pain  

Muscles and Ligaments  

Among the many causes of back pain, the most common by far is a sprain or strain of muscles or ligaments. Muscle spasm can occur after twisting or bending awkwardly, or from a simple sneeze or cough. The majority of muscle spasms tend to get better over time. Severe cases of muscle spasms are treated with medication, physical therapy, also cold laser therapy, 

 Disc Degeneration 

Disc problems are common causes of back pain. After an injury, or as we age, discs lose fluid content and deteriorate in a process called disc degeneration.The earliest form of injury to a disc is in the form of tears or fissures in the annulus fibrosis (outer portion) of the disc. The annulus fibrosis is very much is like a large round ligament that prevents the nucleus pulposus (inner gel-like portion) of the disc from protruding outward. Tears in the annulus heal by scar formation weakening the tissue. The repetitive annular tears which heal by scar formation lead to a disc that begins to degenerate. 

As degeneration progresses the disc becomes stiff, narrow, and losses its ability to act as a shock absorber. Loss of shock absorbing capacity of the disc leads to increased stress being put on the bones of the spine causing formation of bone sours or osteophytes. If bone spurs get large enough, they may cause pressure on nerves in the spinal canal which would present as numbness and weakness in the arms or legs depending on the spinal level being affected. The combination of disc degeneration and bone spur formation in the spine is called spondylosis. Any narrowing within the spinal canal, from bone spur formation or from any other cause such as disc prolapsed of thickening of the ligaments of the spine is called spinal stenosis. Spondylosis or spinal stenosis can occur at any region in the spine: cervical, thoracic, or lumbar. 

Bulging Disc, Protruding Disc, Prolapsed Disc, Herniated Disc, Extruded disc, Slipped Disc. 

The above terms generally describe a disc that is displaced beyond the limits of the intervertebral disc space i.e. the borders of annulus fibrous (the outer fibrous part of the disc) 

Disc prolapse or herniation is the protrusion of the central portion of the disc through a tear in the outer annular wall of the disc. If disc prolapsed results in the compression (direct or indirect) of the nerve root it would cause symptoms of pain, numbness, or weakness. In some individuals however, disc protrusions will not cause any symptoms. A disc extrusion is a severe version of a disc protrusion in which a large portion of the nucleus pulposus is displaced through the wall of the disc. A disc extrusion is almost always would result in the symptoms of nerve root compression. 

Facet Joints 

Facet joints irritation is another cause of back pain. Facet joints are small pairs of joints on the back of the spinal column where the vertebrae meet. Facet joints provide stability to the spine by interlocking two adjacent vertebrae. Facet joints also allow the spine to bend forward (flexion), bend backward (extension), and twist. 

Inflammation of facet joints can occur from injuries, excessive stress put on the spine or a form of arthritis. Facet joint problems are functional problems and would not be visualised on the x-rays of the MRI scan. 

Spinal Stenosis. 

The term stenosis describes any narrowing of the spinal canal. Among many causes of spinal stenosis the most common one is degenerative changes or oseoarthritis of the spine, which occurs almost inevitably as a part of the aging process. 

Canal stenosis can be caused by many factors such as enlargement of the facet joints due to degenerative changes; hypertrophy (enlargement) of the ligamentum flavum – the main ligament of the spinal canal; the protrusion or herniation of intervertebral discs into the canal and forward slippage of vertebrae in a condition called spondylolisthesis – all contribute into narrowing of spinal canal on their own or in conjunction with each other. 

Main symptoms of spinal stenosis in lumbar spine is pain in the back and legs aggravated by standing and walking and relieved by sitting or stooping forward. Legs pain induced by walking is known as neurogenic claudication (from the Latin claudico, to limp). Neurogenic claudication must be distinguished from is vascular claudication, or leg pain on walking caused by insufficient blood flow to the legs. The features which help to distinguish neurogenic from vascular claudication are the following: 

In neurogenic claudication pain occurs after varying amounts of exercise, with standing, or with coughing. Vascular claudication is reliably produced with a fixed amount of exercise, such as walking a certain number of blocks, and is rare at rest. The main distinguishing feature of neurogenic claudication and vascular claudication is the pain relief with sitting and stooping in cases of neurogenic claudication while vascular claudication pain is usually quickly relieved by resting in a standing position. Sensory loss of neurological claudication is in a nerve root distribution, while with vascular insufficiency it is in a stocking-glove distribution. Signs of vascular insufficiency should be absent in neurogenic claudication: diminished pulses, foot pallor on elevation, and decreased temperature of the feet. 

Spondylolysis and Spondylolisthesis. 

Spondylolysis and Spondylolistheses are the most common causes of lower back pain in adolescents. Spondylolysis is a  fracture in one  or both pedicles  of the vertebrae that make up the spinal column. It usually affects either the fourth or the fifth lumbar vertebra in the lower back. The fracture site is called a pars defect, if the bone is unable to maintain its proper position, the top vertebrae can shift forward on top of the bottom vertebrae. This condition is called spondylolisthesis. 

For adults, a spondylolisthesis is normally caused from degenerative changes in the spine. When too much movement or slippage occurs, the bones may begin to press on nerves and surgery may become necessary to correct the condition. Causes such as genetic, overuse or degenerative changes can contribute to development of spondylolisthesis. 

Sacroiliac Joints. 

Another very common cause of lower back pain is a dysfunction of sacro-iliac joints. The sacroiliac joint connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest). 

The inflammation of sacroiliac joint can result from an acute injury or from chronic postural abnormalities such as undue stress on the joint following lower back fusion surgery, degenerative changes of the hip and knee joint as well as from fallen arches of the foot. Pain distribution from sacroiliac joint abnormalities is in the low back, buttock/hip, abdomen, groin, or legs. 

 Ankylosing Spondylitis. 

Ankylosing spondylitis is an inflammatory condition affecting the spine. With ankylosing spondylitis, the joints and ligaments that normally permit the spine to move become inflamed and stiff. with time the bones of the spine may fuse together, causing the spine to become rigid and inflexible. 

Other rare causes of back pain include: 

Benign or malignant tumors of the spine or spinal cord Problems of the digestive tract, genitourinary or gynaecological problems can cause referred low back pain Infections. 

Cold Laser Therapy/Treatment. 

The lasers used at Central Chiropractic and Physiotherapy Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe. 

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle. 

Low Level Laser Therapy (LLLT) is a Handheld, non-invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as; 

Upper and Lower Back Pain. Sciatica. 

Slipped disc, Prolapsed disc, Herniated disc, Bulging disc. 

Trapped  nerve. 

Hip Pain Sacroiliac joint inflammation. 

Athletic Injuries
Knee and Foot Pain
Shoulder Injury
Carpal Tunnel Syndrome
Arthritic pain relief and Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections. 
Wound Management including Skin Ulcers, Pressure Sores and Burn 

Soft Tissue Injuries including Sprains and Strains, Tendonitis and Haematomas. 

Joint Disorders including Arthritic pain relief and Tenosynovitis. 

Chronic pain such as Trigeminal Neuralgia and Chronic Neck and Back pain. “Whiplash” (WAD) injury Neck Pain and injuries