sciatica -- pain in the butt
Sciatica is a Latin term that means irritation of the sciatic nerve. The sciatic nerve is the large nerve bundle that runs from your buttock, down the back of your thigh and into your calf - all along the way branching nerves to control muscles and feeling in different parts of the leg. It originates from the spine (combined from several different spinal levels) and is a bundle of many individual nerves, each serving a different area or function. Sciatica results from either compression or inflammation of the individual nerve roots or of the sciatic nerve itself.
True sciatica can take many different forms, making the diagnosis difficult. Depending on which portion of the nerve is affected the pain can radiate to different locations in the leg. The pain is usually described as a sharp pain shooting down the leg, often right down to the foot. It can also present as a severe cramping in the leg, an area of numbness, tingling, or even as weakness in the leg muscles. "Sciatica" is just a descriptive diagnosis, so it is important to diagnose the underlying cause. Most cases of sciatica are caused by compression of the nerve roots as they exit the spine, either from a disc herniation or from stenosis.
With a disc herniation the soft disc between the vertebrae tears and bulges out into the space normally occupied by the nerve, compressing the nerve root and triggering sciatica. Stenotic nerve compression results from reduced space between the vertebrae for the nerves. Typically the available space has been gradually taken up by degenerative changes in the surrounding vertebrae, as the discs compress and the joints become arthritic.
There are many other problems that can cause similar, intense, leg pain. Injury to the lumbar discs, the muscles or joints can all refer pain into the leg without affecting the sciatic nerve. When your brain receives an overflow of pain signals from an area of injury, it may be unable to clearly decipher the signals. The brain can mis-interpret the location and source of the pain, causing a sensation of leg pain when in fact it is actually your lower back that was injured.
Muscle strain is a common cause of leg pain. The muscles of the hip and buttock classically refer pain down the back or side of the thigh and lower leg when injured, while the muscles of the lower back will refer pain into the hips or buttocks. Muscle pain often comes with predictable "trigger points" - localized areas of spasm in the muscles, which if compressed, will reproduce the pain referral. Piriformis syndrome, often mistaken for sciatica, is an irritation of the piriformis muscle in the buttocks - and usually refers pain down the posterior leg to the heel.
Disc injuries can also cause pain referral, as the disc itself is also pain sensitive. As previously noted a disc bulge or herniation can compress a nerve root and cause radiating pain. A tear of the inner disc structure will typically cause lower back pain and can refer pain into the hips and legs. Usually the pain does not progress past the knees, and is commonly aching or a sharp pain with no tingling or loss of strength.
Straining the joints in the spine and their surrounding ligaments will also refer pain into the legs. While very similar in presentation to disc injuries, joint injuries should not cause a loss of strength or loss of feeling in the leg.
These problems can be differentiated from sciatica with a thorough understanding of the anatomy, proper orthopeadic testing methods and the normal pain referral patterns. Accurate diagnosis of the pain source is important in order to allow treatment to focus specifically on the injury site rather than just addressing the pain symptoms.
If you are suffering from sciatica or back and leg pain, remember chiropractors are trained to diagnose and treat these problems.
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.
living with fibromyalgia
By Dr. Mark Bodnar, B.Sc., D.C.
Do you ever wake up in the morning feeling more fatigued than when you went to bed? Do you feel like your whole body aching? If so, you may be experiencing a little understood disorder called Fibromyalgia.
What is Fibromyalgia?
The word fibromyalgia means - pain originating from the muscle and fibrous (tendons) tissues. Patients with fibromyalgia typically experience wide spread pain (both sides of the body), daily fatigue, morning stiffness, sleep disturbances and many other associated symptoms.
Fibromyalgia was originally thought to be either an inflammatory arthritic condition or a psychiatric illness, however, no evidence of inflammation or arthritis has been found capable of explaining the widespread pain. The depression frequently associated with fibromyalgia is more likely a result of the chronic pain rather than a cause. Fibromyalgia has also been observed to run in families, suggesting a possible inherited predisposition.
Due to the wide variety of symptoms and complaints related to fibromyalgia some individuals may feel that it is just an 'excuse' for hypochondriacs or whiners. The recent surge of chronic pain complaints including fibromyalgia, chronic fatigue syndrome and myofascial pain syndrome have led to a wealth of new research investigating causes and solutions for these disorders. With new information, fibromyalgia can be defined as a true physical disorder with some very specific diagnostic criteria and characteristics related to this condition. A specific diagnosis can be made by finding pain with palpation in 11 out of 18 specific tender points on the body and by testing for abnormal brain wave forms that interrupt deep sleep.
What causes Fibromyalgia?
Many patients with fibromyalgia have been found to have abnormal brain waves in the delta phase of sleep (deep restorative phase). One theory suggests that interrupting this deep restorative phase of sleep interferes with the body's ability to properly heal and recover from normal day to day strains and stresses thereby resulting in aching and sore muscles. Another theory blames the low levels of growth hormones found in patients with fibromyalgia. Growth hormone, helpful in maintaining and healing muscle and soft tissue, is usually produced during deep sleep. Evidence supporting fibromyalgia as a result of deep sleep disturbance comes from scientists ability to reproduce fibromyalgia like symptoms in normal volunteers, just by depriving them of deep sleep for a few days.
Personal experience, in my office, leads me to believe fibromyalgia likely results from a combination of different causative factors. Often, prior to the onset of fibromyalgia, the individual is very busy. Never enough time to sit still, pushing their body to it's limits until the body finally gives up. For someone prone to fibromyalgia, they may trigger the syndrome with severe injury, stress overload or prolonged sleep disturbance, the proverbial "straw that breaks the camel's back". After which, due to ongoing sleep disturbance and reduced healing capacity the body is unable to recover from accumulated stress and strains.
How is Fibromyalgia treated?
Successful treatment requires active involvement by the patient and a long term plan to resolve the condition.
-Daily enjoyable, gentle aerobic exercise combined with stretching is a must. Not only will exercise encourage the body to build muscle and produce more growth hormone but it will also result in increased fatigue and a possible deeper sleep.
-A variety of medications are available, each aimed primarily at improving deep sleep and reducing muscular pain. Since everyone responds differently to medication, the fibromyalgic patient frequently needs to try several different medications and combinations for maximum benefit.
-Dietary supplements of Magnesium, malic acid, manganese and thiamin may help stimulate the bodies metabolism and reduce tenderness.
-Many individuals with fibromyalgia also find it helpful to maintain regular sleeping hours to remove any possible disturbance to the deep sleep cycle.
-Avoid excess physical and emotional stress. Pushing too hard and trying to clean an entire house or yard in one day may result in a several days of pain. Physically, it is better to break the task up into smaller segments, completing each one separately.
What else can I do?
While Chiropractic care will not "cure" fibromyalgia, proper treatment, focused on reducing muscle and joint pain so an individual can increase activity levels may speed recovery. Many patients find Chiropractic care helpful by accelerating recovery from the occasional flare-ups and activity related soreness.
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.
headache statistics
By Dr. Mark Bodnar Bsc, DC, FCCRS(c)
Headaches have been in the news lately. New studies have turned up some answers to some old questions. Where do headaches come from? and Why do we get headaches? For headache sufferers this new information is long overdue.
To start, let's examine some statistics concerning headaches. A research study in 1992 found that 14% of Canadians suffer from migraine headaches, 36% suffer from chronic tension headaches and 14% suffer from both types of headaches. The same study estimated that in Canada alone roughly 7 million working days are lost due to headache disability. Current estimates suggest that 27% of women and 14% of men suffer from severe headaches.
Headaches come in several different forms: migraine, tension, cervicogenic, just to name a few major categories. When dealing with headaches it is important to properly diagnose the root of the problem, 90% of headaches pose no imminent danger other than ongoing pain and disability to the headache sufferer, but a small percentage of headaches are of a more sinister nature with an underlying disease or illness.
To determine a proper diagnosis your Doctor of Chiropractic will use a battery of neurological, orthopaedic and Chiropractic tests to pinpoint the underlying cause of the condition. Proper diagnosis leads to a more effective treatment plan.
Why do we get headaches? Usually a headache is our body's response or warning of some form of irritant. Irritants can be enviromental such as noxious fumes, pollen, bright lights, or come from foods, stress and a variety of other causes. While we have determined several headache triggers, the real reason we get headaches has eluded health researchers for many years.
What is a headache? Traditionally it was thought a migraine headache arose from dilated and inflamed blood vessels within the brain. Tension headaches where blamed on chronic muscle contractions and tightness in the upper neck. While traditional theories may explain some headaches, recent findings argue that many chronic headaches start in the neck.
New hope for headache suffers comes from recent research, with scientific and anatomical proof that many headaches are actually caused by damaged structures in the neck. The idea that headaches originate in the neck is not truly new, Chiropractors have been voicing that opinion for over 100 years; now there is some solid medical research supporting that view.
Damage, originating even years prior, from whiplash, a fall or sports injuries may cause headaches. 'Pinching' the trigminal nerve as it descends into the upper neck interferes with proper nerve function, sending pain signals to the brain. Called a 'cervicogenic headache' (cervico - spine in the neck and genic -originating from) the pain signals from the trigminal nerve are interpreted, by the brain, as a headache.
Physician Peter Rothbart, in Toronto, concedes -"...Chiropractors have been saying headaches originate in the neck for many years". Dr. Rothbart says that about 80% of the patients coming into his clinic diagnosed with tension headaches are actually having headaches which are coming from the neck.
This new anatomical information may help explain why Chiropractic care, addressing the structural condition of the neck, has been so effective at treating headaches. As specialists in the structural function of the spine, Chiropractors are fully qualified to diagnose and treat many types of headaches.
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.
chiropractic care
Why a Chiropractor?
Chiropractors are specialists in neuromusculoskeletal disorders, a fancy name for nerve, muscle and bone/joint complaints. Chiropractic care offers an effective and safe treatment for many complaints – especially important if you’re considering more invasive options like drugs or surgery. A good analogy to answer the question “why a chiropractor?” is to compare your body to a car. Imagine taking your car into the repair shop complaining of a weird noise from the engine. Do you want the mechanic to hand you a set of earplugs or find and fix the cause of the noise?
What does a Chiropractor do?
The Chiropractic approach is to first figure out what’s wrong, and then make a specific repair to the specific problem. Pain is only a symptom that something is wrong, yet many of us disguise this important warning signal with pain killers, designed not to fix the actual problem, but eliminate the symptom hoping the problem will fix itself.
Based on a thorough history and physical examination of your complaints, a Chiropractor can diagnose the underlying cause of the problem. Given an accurate diagnosis, the Chiropractor will formulate an appropriate treatment plan tailored to your specific condition, ideally resolving the underlying problems and therefore relieving the symptoms as well. Using our understanding of bio-mechanics (body motion) Chiropractors can often treat such diverse conditions as upper back, low back/leg pain, neck pain, disc injuries, and headaches as well as complaints stemming from the extremities such as conditions of the feet, hip, shoulder, wrist, knees, fingers and ankles.
What is a Chiropractic treatment?
Treatment can consist of a variety of different modalities including muscle relaxation/massage, stretching, joint manipulation/mobilization, exercise, and Graston soft tissue mobilization, all aimed at restoring normal function to the injured areas and thereby resolving the underlying cause.
Do Chiropractors really “crack backs”?
The principle behind Chiropractic manipulation/adjustments is to restore normal motion and function to the joints. Typically “cracking” the joints, whether its your knuckles or your spine is painless. The sound you hear is cavitaion, when the “vacuum seal” inside the joint releases, not your bones snapping. The effect is similar to pulling a suction cup off a window – you hear the ‘pop’ or release of the suction in the same way as you do with a joint.
What does cracking joints have to do with pain relief?
Manipulation helps restore normal joint mechanics (movement) and has been proven to reduce pain, relax tense muscles and increase range of motion. Many scientific studies have proven the effectiveness, cost effectiveness and safety of Chiropractic care for musculoskeletal complaints.
“My mother always told me that cracking my joints would cause arthritis and big knuckles, is that true?”
Studies of habitual knuckle crackers have not shown joint damage, arthritis or increased size, but that’s not to say cracking your knuckles or other joints yourself is good for you. When a Chiropractor manipulates joints, he/she specifically picks the problem area that is not moving properly and attempts to restore normal function. Habitual cracking (in any joint) is different. Often the joint that ‘cracks’ is already overly mobile leaving other areas tighter than normal. This can actually magnify the complaint that leads to self-adjusting in the first place. While therapeutic joint manipulation is safe, habitual self-adjusting could lead to increased problems and certainly has no benefit.
How long do Chiropractors spend in school?
Similar to Medical Doctors, Chiropractors need three years of University level courses (an undergraduate degree) prior to being accepted to a full four year Chiropractic program. The basic programs of Medicine and Chiropractic are almost identical, especially in the first 2 years. Chiropractic students focus on the muscles, nerves and bones of the spine and body, Medical students focus more on medications, infectious diseases and the internal organs and Dentists focus on the teeth and jaws.
What's the difference between Chiropractors and Physiotherapists?
That can be difficult to discern at times, with Chiropractors and Physiotherapists sometimes using the same therapies (ie. ultrasound, exercises, etc.).
Primarily the difference comes down to the treatment approach. Chiropractors often use manipulation as the first line of treatment on many conditions, using the other modalities like exercise, stretching, heat or ice to assist the adjustment. Typically Physiotherapists do not manipulate the joints, relying instead on stretching and exercise to treat the complaint.
I have heard that once I start going to a Chiropractor I will have to keep going forever.
This is simply not the case. At our clinic we focus on pain management and resolution. Our goal is to free you from pain and give you the tools to keep yourself painfree. While we do have patients who return on a regular basis, we also have patients who go years between episodes. In the end a lot will depend on you, your lifestyle and how well you take care of yourself.
Does the provincial health plan cover Chiropractic?
Unfortunately no, but most private health care plans do have coverage for Chiropractic treatment. We are alble to directly bill many insurance companies on behalf of our patients. It's a good idea to contact your insurance company and ask about your coverage limits and the availablility of direct billing for your plan.
Bedford Chiropractic, based in Bedford, Nova Scotia, offers full-service consultations, diagnosis and treatment plans for a variety of workplace, repetitive and other injuries. We treat pain to the head, neck, jaw, arm, shoulders, upper body, chest, lower back, legs and feet. Contact us today at 902 835-6865. We serve patients in the Halifax Regional Municipality, including Halifax, Dartmouth, Bedford, Sackville and surrounding areas.