Extracorporeal shockwave therapy (ESWT)
What is ESWT? It is a non-invasive treatment that uses high energy acoustic waves (shockwaves) to stimulate healing and reduce pain
How does the chiropractic adjustment affect the nervous system?
Many people are sceptical about the effectiveness of Chiropractic Adjustment Therapy (CAT). I think perhaps because they have never been told how or why it works. A wealth of research has however confirmed Chiropractic as the best treatment for neuro-musculo-skeletal problems such as back and neck pain, headaches and other pain syndromes when measured in terms of effectiveness, cost effectiveness, safety and patient satisfaction. The most recent study is called the BEAM trial and can be found in the British Medical Journal (Nov 19, 2004: 1-8)
The CAT works in two ways, firstly it eliminates subluxations in the spinal joints and secondly it stimulates proprioceptors in the spinal joints.
Spinal subluxations in the Chiropractic sense can be stated as anything that interferes with or impedes the communication of the central nervous system (CNS) i.e. the brain and spinal cord, with the peripheral nervous system (PNS) that essentially controls all body functions.
Since the CNS is housed within the spine it follows that any disruption to the spine must have a consequential effect on the CNS and PNS leading to the sub-optimal functioning of the systems of the body, most notably the immune system.
Proprioceptors are receptors that occur in the joints of the body, (80{41c39975514381bad900de5857f081e360abda3ef5565ddbb7a4c56510fbe555} occur in the spinal joints). Their main purpose is to inform the CNS as to the position of all the joints in time and space so as to co-ordinate movement. Recent research however has discovered that stimulation of the proprioceptors has a direct impact on the CNS that has the effect of balancing the autonomic nervous system!…. so how does that help us?
The autonomic nervous system (ANS) is comprised of two parts that should always be in balance or homeostasis. They are the sympathetic nervous system (SNS) and the parasympathetic nervous system (PSNS).
The SNS is our fight or flight response that floods our system with chemicals that enable us to escape danger and is triggered by stress. The chemicals produced during this period (most notably adrenalin) are destructive to our organs if allowed to remain in circulation indefinitely. Once the stressor has passed, the PSNS is designed to bring down the sympathetic high state and restore homeostasis to protect our organs and systems.
Our modern lifestyle however is fraught with stressors, Job, finances, personal problems etc. the socio-economic pressures just seem endless. These stressors keep us in a constant sympathetic high state and consequently undermine our mental and physical health and wellness.
Chiropractic adjustments firstly remove subluxations and the pain syndromes that accompany them whilst opening the nervous communication channels. At the same time the proprioceptors are stimulated restoring homeostasis and your health and wellbeing.
This is why regular Chiropractic Adjustive Therapy is important. It is not just a painkiller, it is a restorer and maintainer of health and wellness.
Intervertebral Disk Pathology
Intervertebral disk (IVD) pathology is basically of two kinds, the “slipped disk” and the degenerated disk.
The IVD is a very tough cartilaginous disk with a liquid centre (nucleus pulposus) that separates successive disks in the spine and provides mobility to the spine. It also absorbs shock loading and compressive loading through the hydraulic action of the nucleus pulposus (NP).
The term “slipped disk” is misleading since the disk is securely tied into the vertebral bodies and cannot slip out. What does slip out is the liquid NP due to excessive mechanical forces. This can take the form of a bulge (protrusion), a herniation, or a sequestration all of which can place pressure on the spinal cord and/or the nerve roots that exit the spine and cause extreme back pain and/or sciatic referral symptoms.
In the past the treatment of choice was traction which has been tried in various forms for centuries with little or no success. The focus consequently turned to drug therapy and surgery neither of which has proved much more successful than traction and, being invasive by nature, carry far more risks.
The theory behind traction therapy is that by stretching the disk a vacuum is created in the disk that can draw fluid back into it. The reason for the earlier failures of traction was the static application of the traction. When the spine is stretched by a static force the surrounding muscles protect the spine by resisting the force and preventing the required vacuum from forming and the disk can’t re-hydrate.
Modern thinking and technology however has solved the problem. A relatively new technique called Decompression Traction has been developed whereby a computer controlled traction device applies a rhythmic traction to the disk that prevents muscle resistance by applying a gentle traction that does not induce the protective muscle response before releasing and starting again in a cyclic rhythm. This rhythmic traction also soothes the muscles and reduces spasm.
My personal experience with this technology in Asia and South Africa over a five year span allows me to offer this service with very high confidence.
The degenerated disk usually results from spinal abuse over many years and is therefore most often encountered in the older person but does also occur in younger people who have suffered some sort of traumatic injury to the disk that has not been effectively treated.
Loss of fluid is also a characteristic of the degenerated disk, causing it to become flattened. This allows the intervertebral space to narrow and place compressive forces on the exiting nerve roots resulting in pain symptoms similar to those of the slipped disk . Fortunately, degenerated disks also respond exceptionally well to Decompression Traction treatment.
In both cases, slipped and degenerated disks, the distribution of forces changes such that the facet joints (see diagram below) at the back of the spine are forced to bear more weight. This causes them to become inflamed, misaligned and restricted in their movement leading to severe pain. The Chiropractic adjustment has been shown by a wealth of research to be the best approach for relieving this pain and restoring mobility to the spine.
How does posture affect spinal health and general wellness?
Posture refers to the positioning of your body whilst engaged in an activity, thus we have seated, standing, lying, lifting, carrying postures etc. all of which contribute to spinal abuse if not properly executed.
Posture also refers to the shape of your spine and the net effect that it has on your other postures and general wellbeing. It is this description of posture that I will be discussing in this article. The former description will be covered in another article
The curves of the spine
Looked at from the side the ideal healthy spine has four curves. The forward curving parts are called lordoses and occur in the cervical spine (neck) and lumbar spine (low back). The backward curving parts are call kyphoses and occur in the thoracic spine (mid to upper back) and the sacrum & coccyx (tailbone). These curves are very important as they provide flexibility to the spine and enable it to absorb gravitational forces and reduce shock loading through the disks. The ideal spine also allows for the muscles (front and back) to be in balance thereby expending the least amount of energy in maintaining an upright posture.
Deviations from the ideal spinal shape lead to unnatural postures such as shown in the diagram below. Looking at the diagram from right to left it can be seen how postural deviations place additional stresses on both the spine and its supporting musculature. This causes the muscles to work excessively hard all the time and places abnormal stresses on the spine and intervertebral disks, leading to disk degeneration and spinal subluxations that impede communication between the central nervous system and the body resulting in an imbalance in the autonomic nervous system, depressed immune system, poor health/wellness, pain syndromes and accelerated aging.
SACROILIAC JOINT DYSNFUNCTION – A MAJOR CAUSE OF BACK PAIN
One of the most frequent causes of back pain is called sacro-iliac joint dysfunction (SIJD). The sacrum is the triangular bone that your spine rests on and is situated between your two hip bones, more specifically between that portion of the hip bones known as the ilia hence the name saro-iliac.
Together these bones form the bony portion of the pelvis. The large hip bones join each other in the front just below the belly button and join to the sacrum at the back at the sacro-iliac joints (SIJ)
Clearly the pelvis, being the foundation on which the spine rests, should always be level and the movement at the SIJ’s, although extremely small (about 2 degrees) must nevertheless be present in order to allow for correct gait and general pelvic mobility.
Many of our lifestyle habits interfere with the correct alignment and functioning of the SIJ’s leading to pain symptoms that can range from mild discomfort to extreme back pain and disability that closely mimics lumbar disk pathology and sciatic pain referral. It fortunately seldom involves significant pathology and is relatively easily corrected by Chiropractic techniques.
The lifestyle factors that most often cause this condition are posture and trauma and sometimes a combination of both.
The seated posture is the one most likely to cause this problem, particularly motor vehicle seats which are designed such that your knees are higher than your hips and your right leg is extended whilst the left leg is flexed and periodically applies an eccentric load on the pelvis when changing gears. This leads to a distortion of the pelvis that puts pressure on the SIJ’s causing them to become dysfunctional. Long distance driving in this cramped, trapped position also contributes significantly.
Our modern lifestyle has many of us seated for more than half the day. Poor ergonomics at the workstation and at home (computer station or watching TV) are major contributors to the problem adding little bits of micro trauma daily that sooner or later culminate in a pain episode. This also explains why the condition tends to be recurrent.
The trauma component contributing to the condition is also not obvious, it includes actions like getting in and out of motor vehicles with a twisting motion or sitting at work and twisting and bending to get something out of the bottom drawer of the desk and many more daily activities too numerous to mention here. Direct trauma such as occurs in sports activities is also a contributor.
The pain arising from this condition can be extreme and sometimes co-exist with lumbar disk pathology that convinces you and your practitioner that extreme measures are required. Before you consider any form of invasive treatment for your back pain let a Chiropractor check it out and confirm. It may save you a great deal of pain and suffering as well as money (Chiropractic has been shown by research to be the safest, most effective and most cost effective treatment for such NMS conditions).
The causes of back and neck pain and what you can do about them
LBP can be caused by muscle spasm, tendon strain, ligament sprain, facet joint dysfunction, sacroiliac joint dysfunction, disruption to the intervertebral disk and/or degeneration of the intervertebral disk (IVD) some of which can cause nerve and/or spinal cord compression leading to sciatic pain referral that can be extreme. Some of these causes co-exist and can be interlinked.
In selecting a treatment option it is vital that a correct diagnosis be made as each of the causes will respond to very different approaches. A single technique approach is therefore seldom fully effective. For example the techniques for treating soft tissue injury would be hopelessly inadequate for treating degenerated IVD’s.
It is therefore important that you seek the help of a practitioner who is well trained and experienced in the diagnosis and treatment of all the abovementioned causes. These conditions are usually referred to as Neuro-musculo-skeletal (NMS)
Research shows chiropractic to be the most effective, cost effective and safest treatment option for these NMS conditions. Chiropractic also rates the highest in terms of patient satisfaction.
There has been a wealth of research into this subject most of which strongly supports the findings of the most relevant research being that of the Canadian RAND report and more recently the BEAM trial published in the British Medical Journal (Nov 19, 2004: 1-8)
Research also reveals that people under Chiropractic care take fewer days sick leave, spend less time incapacitated, use less medication, have less chance of their problems becoming chronic and therefore greatly reduce their risk of requiring later life surgery
Read more articles on this website about the treatment approaches that we offer for the various causes discussed here
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Postural Correction & Maintenance
There are two types of posture. Static and dynamic.
Static: In the static, standing posture there are four curves in the spine when viewed from the side. The neck and lumbar curves are convex forward and the thoracic and sacral curves are convex backwards. These curves provide the spine with a degree of “springiness” that absorbs shock loading and distributes gravitational forces appropriately. In this side view a vertical line from the ear hole should pass through the middle of the shoulder, hip and ankle joints. Viewed from the front the spine should be straight.
Deviations from this ideal posture places abnormal loading on all the structures of the spine, most notably the intervertebral disks and facet joints. The resulting degeneration gives rise to numerous health and wellness problems discussed in more detail in the articles on this website titled posture, Intervertebral disk pathology and the causes of back pain.
Dynamic postures: These are posture that we adopt in our everyday life and includes standing, walking, sitting, reclining, bending, lifting, carrying etc. Few, if any, of us adopt correct dynamic postures (see article titled posture) and even when we do they still impose micro trauma to the structures of the spine resulting in gradual degeneration over time with similar results.
Static postures can and should be corrected and maintained continually to counteract and minimise the effects of the continual degeneration.
Dynamic postures are to a large extent governed by deviations in the static postures and vice versa. The first step in managing dynamic postures then is to ensure that the static posture is maintained. The next step requires discipline as it necessitates a conscious effort on our part to sit correctly, bend, lift, carry etc. correctly, and even then the degeneration will occur albeit at a slower rate.
This form of degeneration is best handled by directly influencing the disks and facet joints through a process called decompression traction described in the articles titled Intervertebral disk pathology and Decompression Traction Therapy (DTT).
Paediatric Chiropractic
A very large proportion of the population are unaware of the benefits of
chiropractic care and even those that are aware of and do make use of chiropractic services assume that it is for adults only.
Firstly it is important to realise that from the moment of birth babies have to contend with living and functioning in gravity, resulting in the exertion of forces in all directions that can lead to spinal misalignments and muscular disturbances that render them just as susceptible to neuro-musculo-skeletal conditions as adults (back pain, neck pain, headaches etc.) that they are unable to communicate to us. Misalignments can also affect the child’s nervous system resulting in syndromes such as colic, crying baby and restless baby.
Secondly, whilst growing, their maturing skeleton is subjected to genetic and/or congenital malformations such as scoliosis, hemivertebrae etc. as well as developmental aberrations resulting from neural imbalance and the effects of gravity.
Chiropractic adjustive therapy has been shown to address many of these
conditions and it is therefore important that babies, toddlers and older children should enjoy the benefits of regular chiropractic assessments and alignments.