Well it looks like winter has finally beaten back the miserably hot summer we had. That is the good news. The bad news is the miserably hot summer made everything grow and now it will die. Meaning it is now all over your front yard. Of course you can wait until the end of winter but that only kills your grass making more work come spring (not that I don’t do that every year). So it is time to brush off the rake and get out there. You just have to be careful because yard work and raking use completely different muscles than sitting and watching football. Your Woodbridge, Dale City VA chiropractor has a few tips to help you do it safely.
Just as playing football or golf can injure your body, the twisting, turning, bending, and reaching of mowing and raking can also cause injury if your body is not prepared. Like an athlete, if you leap into something without warming up or knowing how to do it, the chances of injury are greater.
What Can You Do?
The American Chiropractic Association (ACA) offers the following tips to help prevent the needless pain yard work may cause.
Do stretching exercises, without bouncing, for a total of 10 to 15 minutes spread over the course of your work. Do knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.
Stand as straight as possible, and keep your head up as you rake or mow.
When it’s still warm outside, avoid the heat. If you’re a morning person, get the work done before 10 a.m. Otherwise, do your chores after 6 p.m.
Wear supportive shoes. Good foot and arch support can stop some of the strain from affecting your back.
When raking, use a “scissors” stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.
Bend at the knees, not the waist, as you pick up piles of leaves or grass from the grass catcher. Make the piles small to decrease the possibility of back strain.
When mowing, use your whole bodyweight to push the mower, rather than just your arms and back.
If your mower has a pull cord, don’t twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.
Drink lots of water, wear a hat, shoes and protective glasses. And, to avoid blisters, try wearing gloves. If your equipment is loud, wear hearing protection. If you have asthma or allergies, wear a mask.
Try ergonomic tools, too. They’re engineered to protect you when used properly.
If you do feel soreness or stiffness in your back, use ice to soothe the discomfort. If there’s no improvement in two or three days, see your local doctor of chiropractic.
A common complaint I see in my Woodbridge, Dale City Virginia area chiropractic office is work related back injuries. Oddly enough most of those complaints come from people who work in an office and sit for largest part of their day. I can remember doing construction when I was in school and wishing my boss would leave so I could sit down for a few minutes. It seems like I had it all wrong. But sitting doesn’t have to feel like a full contact sport. Here are a few tips from your Woodbridge, Dale City Virginia area chiropractor that may help you.
The first step in setting up an office chair is to establish the desired height of the individual’s desk or workstation. This decision is determined primarily by the type of work to be done and by the height of the person using the office chair. The height of the desk or workstation itself can vary greatly and will require different positioning of the office chair, or a different type of ergonomic chair altogether.
Once the workstation has been situated, then the user can adjust the office chair according to his or her physical proportions. Here are the most important guidelines – distilled into a quick checklist – to help make sure that the office chair and work area are as comfortable as possible and will cause the least amount of stress to the spine:
First, begin by sitting comfortably as close as possible to your desk so that your upper arms are parallel to your spine. Rest your hands on your work surface (e.g. desktop, computer keyboard). If your elbows are not at a 90-degree angle, adjust your office chair height either up or down.
Thigh measure
Check that you can easily slide your fingers under your thigh at the leading edge of the office chair. If it is too tight, you need to prop your feet up with an adjustable footrest. If you are unusually tall and there is more than a finger width between your thigh and the chair, you need to raise the desk or work surface so that you can raise the height of your office chair.
Calf measure
With your bottom pushed against the chair back, try to pass your clenched fist between the back of your calf and the front of your office chair. If you can’t do that easily, then the office chair is too deep. You will need to adjust the backrest forward, insert a low back support (such as a lumbar support cushion, a pillow or rolled up towel), or get a new office chair.
Low back support
Your bottom should be pressed against the back of your chair, and there should be a cushion that causes your lower back to arch slightly so that you don’t slump forward or slouch down in the chair as you tire over time. This low back support in the office chair is essential to minimize the load (strain) on your back. Never slump or slouch forward in the office chair, as that places extra stress on the structures in the low back, and in particular, on the lumbar discs.
Resting eye level
Close your eyes while sitting comfortably with your head facing forward. Slowly open your eyes. Your gaze should be aimed at the center of your computer screen. If your computer screen is higher or lower than your gaze, you need to either raise or lower it to reduce strain on the upper spine.
Armrest
Adjust the armrest of the office chair so that it just slightly lifts your arms at the shoulders. Use of an armrest on your office chair is important to take some of the strain off your upper spine and shoulders, and it should make you less likely to slouch forward in your chair.
My Woodbridge, Dale City Virginia Chiropractic office treats patients with headaches on a daily basis. Headaches have become almost as common as any other back complaint. This should be no surprise based on the fast paced way we live. On top of that add in the computers and devises we use during the day and a headache seems almost unavoidable. Avoid the headache may be hard but there is something you can do about them.
If you have a headache, you’re not alone. Nine out of 10 Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.
Research shows that spinal manipulation – one of the primary treatments provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.
Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.
Headache Triggers
Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems. The remaining 95 percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease; the headache itself is the primary concern.
The greatest majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.
If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.
What Can a Doctor of Chiropractic Do?
Your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:
Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.
Doctors of chiropractic undergo extensive training to help their patients in many ways beyond just treatment for low-back pain. They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.
As a chiropractor in the Woodbridge, Dale City VA area I see patients for all sorts of reasons. Of course one of the main reasons people seek out a chiropractor is for back/neck pain. In fact, 31 million Americans experience low-back pain at any given time.1
A few interesting facts about back pain:
Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.
Back pain is one of the most common reasons for missed work. In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.
One-half of all working Americans admit to having back pain symptoms each year.2
Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3
Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.
Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4
The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.
Manipulation as a Treatment for Back Problems
Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.
Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5
In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6
A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7
More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8
A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9
The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.
Tips to Prevent Back Pain
Maintain a healthy diet and weight.
Remain active—under the supervision of your doctor of chiropractic.
Avoid prolonged inactivity or bed rest.
Warm up or stretch before exercising or physical activities, such as gardening.
Maintain proper posture.
Wear comfortable, low-heeled shoes.
Sleep on a mattress of medium firmness to minimize any curve in your spine.
Lift with your knees, keep the object close to your body, and do not twist when lifting.
Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.
Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.
References:
Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.
Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
Ibid.
In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.
Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.
With this cold snap we are having and people needing to be active I am seeing a lot of stiff necks in my Woodbridge, Dale City Virginia area Chiropractic office. The problem comes from the muscle being cold and the blood supply to it being decreased from the cold. Than you do some activity and the muscle isn’t ready for it. Leading to pulling of the muscle and the spasm to follow. The levator scapulae muscle is the most common one for those of you who want to google it!
The muscle runs from the top medial part of your shoulder blade up in to your neck. So the way to stretch it is to separate those two structures. You can do the stretch standing or sitting.
Lengthen the muscle by raising the elbow above the shoulder on the side to stretch.
In this position, first rest the elbow against a door jamb. This rotates the outside of shoulder blade up and the inside of it down, which lengthens the levator scapula muscle.
Second, turn the head away from the side that is stretching and bring the chin down, stretching the back of the neck .
Third, place the fingers of the other hand on the top of the head and gently pull the head forward increasing the stretch slightly.
Hold this for about 30 seconds to a minute.
If this helps great you got some relief before going to your chiropractor. If they didn’t call for an appointment because it won’t usually improve on its own.
Ahhhhhhh Virginia is the only state I know that has to keep relearning that water plus cold equals ice. Leaving my chiropractic office in the Woodbridge, Dale City Virginia area last week to take my 25-minute commute home I realized they had to relearn it again. What should have been 25 minutes took 2 hours. I thought I had it bad, until I was complaining to patients the next day. Some took 7 hours to do 40 minutes… I quickly shut up. Then I thought let’s all relearn some way to deal with stress because I am sure VDOT will probably get surprised again this winter. Definitely next winter so keep these handy.
Think Positively
“Adopting the right attitude can convert a negative stress into positive,” said Hans Selye, author of the groundbreaking work around stress theory. When optimism is hard to muster, cognitive-behavioral therapy, which trains people to recognize negative thinking patterns and replace them with more constructive ones, can also help reduce the risk of chronic stress and depression.
Get Out and Enjoy Nature
While modern civilization has made our lives more convenient, it has deprived us of an essential source of stress relief—connection with nature. Studies show that interacting with nature can help lessen the effects of stress on the nervous system, reduce attention deficits, decrease aggression, and enhance spiritual well-being.
“Smell the Roses” for Better Mood
Aromatherapy, or smelling essential plant oils, recognized worldwide as a complementary therapy for managing chronic pain, depression, anxiety, insomnia, and stress-related disorders, can help you unwind. Orange and lavender scents, in particular, have been shown to enhance relaxation and reduce anxiety.
Relax with a Cup of Tea
During stressful times, coffee helps us keep going. To give yourself a break, however, consider drinking tea. Research shows that drinking tea for 6 weeks helps lower post-stress cortisol and increase relaxation. Habitual tea drinking may also reduce inflammation, potentially benefiting your heart health.
Laugh It Off
Humor relieves stress and anxiety and prevents depression, helping put our troubles in perspective. Laughter can help boost the immune system, increase pain tolerance, enhance mood and creativity, and lower blood pressure, potentially improving treatment outcomes for many health problems, including cancer and HIV. Humor may also be related to happiness, which has been linked to high self-esteem, extroversion, and feeling in control.
Build a Support System
Relationships are also key to health and happiness, especially for women. Women with low social support, for example, are more likely to increase blood pressure under stress. Loneliness may also contribute to stress in both men and women, also leading to poorer outcomes after a stroke or congestive heart failure. On the other hand, active and socially involved seniors are at lower risk for dementia and Alzheimer’s disease. Social support also helps cancer patients to boost the immune system and maintain a higher quality of life.
Employ the Relaxing Power of Music
Music, especially classical, can also serve as a powerful stress-relief tool. Listening to Pachelbel’s famous Canon in D major while preparing a public speech helps avoid anxiety, heart rate, and blood pressure, which usually accompany public speaking.
Singing and listening to music can also relieve pain and reduce anxiety and depression caused by lowback pain. Group drumming also showed positive effects on stress relief and the immune system. Music therapy can also elevate mood and positively affect the immune system in cancer patients and reduce fatigue and improve self-acceptance in people with multiple sclerosis.
To help people deal with stressful medical procedures, music can help reduce anxiety before surgery. When played during surgery, it can decrease the patient’s post-operative pain. Aiding recovery, a dose of calming music may lower anxiety, pain, and the need for painkillers.
Calm Your Mind
In recent decades, many forms of meditation have gained popularity as relaxation and pain relief tools. Focusing on our breath, looking at a candle, or practicing a non-judgmental awareness of our thoughts and actions can help tune out distractions, reduce anxiety and depression, and accept our circumstances. In cancer patients, meditation-based stress reduction enhances quality of life, lowers stress symptoms, and potentially benefits the immune system.
Guided imagery, such as visualizing pictures prompted by an audiotape recording, also shows promise in stress relief and pain reduction. Based on the idea that the mind can affect the body, guided imagery can be a useful adjunct to cancer therapy, focusing patients on positive images to help heal their bodies.
Enjoy the Warmth of Human Touch
Just as the mind can affect the body, the body can influence the mind. Virginia Satir, a famous American psychotherapist, once said that people need 4 hugs a day to help prevent depression, 8 for psychological stability, and 12 for growth. While asking for hugs may not work for some, massage can help us relieve stress and reduce anxiety and depression. Massage has also been shown to reduce aggression and hostility in violent adolescents, to improve mood and behavior in students with ADHD, and to lead to better sleep and behavior in children with autism.
Massage has other therapeutic properties, as well. Regular massage may reduce blood pressure in people with hypertension and may lead to less pain, depression, and anxiety and better sleep in patients with chronic low-back pain. Compared to relaxation, massage therapy also causes greater reduction in depression and anger, and more significant effects on the immune system in breast cancer patients.
Give Exercise a Shot
To get the best of both worlds, affecting the mind through the body while getting into good physical shape, try exercise. In one study, a group of lung cancer patients increased their hope due to exercise. Exercise can also reduce depression and improve wound healing in the elderly. Tai chi, which works for people of all ages, may enhance heart and lung function, improve balance and posture, and prevent falls, while reducing stress.
I see sacroiliac injuries in my Woodbridge, Dale City Virginia Chiropractic office almost as frequently as any other spinal injury. People often come in complaining of what they consider hip pain. Once the injury is examined it is more often than not the SI joint. It is also the cause of unilateral low back pain. Patients will complain of lower left or right side low back pain. Same thing, once you examine the area it is the SI joint. Doroski Chiropractic Neurology in the Woodbridge, Dale City Virginia area has some helpful information for you on the SI joint.
When the hip joint is spoken of, it is typically thought of as a vague area that may encompass anywhere from the iliac crest, the sacroiliac joint or the point at which the femur articulates with the acetabulum. The latter is the actual hip joint. Lower back pain that radiates more laterally to the pelvic area over the acetabulum, groin, and upper lateral thigh is not necessarily definitive of an L4/L5 disc syndrome. Pain in this region may also be secondary to a facet syndrome. Sometimes, pain to the lower abdominal and groin region may be a part of the symptomatology presented by a patient. The differentiation between the L/4/L5 disc and facet syndrome is that the disc with the radiculopathy will generally follow a known dermatome, while a facet syndrome follows a dermatomal pain pattern. Doctors of chiropractic usually find and treat articular lesions of the sacrum, ilium or lumbar spine, for a period of time, without cessation of symptoms or improvement of these complaints. One other consideration would be for a tear of the labrum in the hip, which may result in pain in the SI joint, gluteus area and even anterially into the groin.
Complaints in these more lateral areas are often due to a problem in an area that many doctors don’t check—the femoral head. The femoral head may need to be assessed for the need for manipulation or mobilization. This in turn may cause deep pelvic muscle spasms, which may become chronic. I believe that every day activities, from subtle movements like turning in bed to more repetitive activities like bearing more weight on a pronated foot time and time again, may cause misalignment to the femoral head. This area should be checked and adjusted for recovery, in my opinion.
Drawing upon an example from personal experience: I would open the car door and throw my right leg into the car and then sit down. I would experience a subtle “click” in the acetabulum area, followed by pain and irregular walking gait, pulling of the leg when weight bearing, causing deep spasms of the upper thigh and lower abdominal muscles, pulling the leg forward instead of pushing the leg forward, as in a normal walking gait. This caused a transition of weight-bearing muscle function to muscles not usually used in normal walking. (A compensatory walking gait is developed.) This caused me pain and spasm in adjacent muscles.
All too often, I believe that this problem is missed or misdiagnosed, resulting in unnecessary surgery, hip replacement, repetitive chiropractic adjustments, physical therapy and muscle massage, and none of them address the underlying cause of the condition.
Examination for Hip Joint Dysfunction
Place the patient in supine position, with your superior hand holding the ilium to the table with light A-P downward Force (near the ASIS) to ensure the ilium will not rise off the table during motion of the leg. Holding the ilium on the exam table, grasp the ankle and rotate the foot medially. The big toe should touch the table. Full rotation indicates no hip joint dysfunction. If the ilium rises off the table during this action, this indicates improper function of the femoral head/acetabular articulation.
Corrective Procedure
Ascertain (through the examination described above) the side of restriction. Place the patient in lateral Syms position (Syms is performed by having a patient lie on the left side, left leg extended and right leg flexed) as in a side roll. Place your superior hand under the armpit of the patient, holding the humerus and ribs, with your inferior hand reaching over the patient cupping the femoral head. Proceed with the side-roll-type procedure with this exception: The inferior hand (cupping the femoral head) is driven directly forward (anterior).
If correction has been obtained, the leg now should move freely in a medial direction smoothly and completely, with immediate Improvement of pain. Occasionally the patient may experience residual muscle soreness. Over the course of my practice, I have found that these patients have a tendency to walk around for a while with a displaced femoral head and a compensatory walk, the surrounding muscles are sprained and inflamed, and soreness may continue for days until the patient returns to a normal walking gait. Generally, I find the quicker the patient returns to a normal walking gait, the quicker the syndrome is alleviated. I feel it is important to re-address with the patient what is a normal walking gait and this may lengthen the post-correction period.
Low back pain and sciatica are very common reasons to see your Woodbridge, Dale City VA Chiropractor. We often diagnose patients with a small muscle in your buttock as being the cause of their big pain. The piriformis muscle can cause low back pain, buttock pain and sciatica. The piriformis muscle can cause all sorts of problems. Doroski Chiropractic Neurology in the Woodbridge, Dale City VA area wants to provide you with some information on piriformis syndrome.
Anatomy
The piriformis muscle originates from the anterior (front) part of the sacrum, the part of the spine in the gluteal region, and from the superior margin of the greater sciatic notch (as well as the sacroiliac joint capsule and the sacrotuberous ligament). It exits the pelvis through the greater sciatic foramen to insert on the greater trochanter of the femur. Its tendon often joins with the tendons of the superior gemellus, inferior gemellus, and obturator internus muscles prior to insertion.
The piriformis, pyramidal in shape, lying almost parallel with the posterior margin of the gluteus medius.
It is situated partly within the pelvis against its posterior wall, and partly at the back of the hip-joint.
It arises from the front of the sacrum by three fleshy digitations, attached to the portions of bone between the first, second, third, and fourth anterior sacral foramina, and to the grooves leading from the foramina: a few fibers also arise from the margin of the greater sciatic foramen, and from the anterior surface of the sacrotuberous ligament.
The muscle passes out of the pelvis through the greater sciatic foramen, the upper part of which it fills, and is inserted by a rounded tendon into the upper border of the greater trochanter behind, but often partly blended with, the common tendon of the obturator internus and superior and inferior gemellus muscles.
The piriformis muscle crosses over top of the sciatic muscle and if the muscle spasms it will compress the sciatic nerve and cause pain in to your buttock and leg. Once you have been properly diagnosed by your chiropractor or healthcare provider it is time to start treatment.
Treatment
Now that we know what the piriformis is and how it can cause us pain by compressing the sciatic nerve stretching it is one of the first things you should try. Video
Lie on the back with the legs flat. Pull the affected leg up toward the chest, holding the knee with the hand on the same side of the body and grasping the ankle with the other hand. Trying to lead with the ankle, pull the knee towards the opposite ankle until stretch is felt. Do not force ankle or knee beyond stretch. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
Lie on the floor with the legs flat. Raise the affected leg and place that foot on the floor outside the opposite knee. Pull the knee of the bent leg directly across the midline of the body using the opposite hand or a towel, if needed, until stretch is felt. Do not force knee beyond stretch or to the floor. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
Lie on the floor with the affected leg crossed over the other leg at the knees and both legs bent. Gently pull the lower knee up towards the shoulder on the same side of the body until stretch is felt. Hold stretch for 30 seconds, then slowly return to starting position. Aim to complete a set of three stretches.
These stretches work great for after care and between visits but active care may be needed by your chiropractor to help eliminate any other causes of the sciatic compression.
We have all heard of TMJ or TMD but what is it and could I have it? Lots of people have face pain or headaches and just assume it is face pain or some type of headache. So they take Advil or some type of medication and wait for it to go away. Sometimes it does but sometimes it comes back. If it keeps coming back and nothing is helping it could be your TMJ. Once it is diagnosed correctly it can be treated and the pain stops. Doroski Chiropractic Neurology in the Woodbridge, Dale City Virginia area wants to share with you the ACA checklist on jaw pain.
Does it hurt when you chew, open wide to yawn or use your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it?
If you answered “yes” to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.
Signs may include:
Radiating pain in the face, neck, or shoulders;
Limited movement or locking of the jaw;
Painful clicking or grating when opening or closing the mouth;
A significant change in the way the upper and lower teeth fit together;
Headaches, earaches, dizziness, hearing problems and difficulty swallowing.
For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.
What Causes TMD?
Researchers agree that TMD falls into three categories:
Myofascial pain—discomfort or pain in the muscles of the jaw, neck, and shoulders;
A dislocated jaw or displaced disc;
Degenerative joint disease—rheumatoid arthritis or osteoarthritis in the jaw joint.
Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD.
Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist’s chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, today’s dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment. In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.
While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.
Some conditions once accepted as causes of TMD have been dismissed—moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes.
Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, posture and higher heels.
TMD Diagnosis and Treatment
To help diagnose or rule out TMD, your doctor of chiropractic (DC) may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the balance of the muscles. If you have no problems while doing these things, then the problem is not likely to be TMD. Your DC can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis.
If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, your doctor’s first goal is to relieve symptoms, particularly pain. If your doctor of chiropractic feels that you need special appliances or splints (with the exception of the “waterpack” and other guards against teeth grinding), he or she will refer you to a dentist or orthodontist for co-management.
In addition to treatment, your doctor of chiropractic can teach you how to:
Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.
Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (some hard candies are even called “jawbreakers”—for good reason). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.
Perform TMD-specific exercises. Depending on your condition, your DC may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.
