Sciatica

To brace or not to brace!

in Chiropractor  by May 26, 2022 0 comments

It sounds like a good idea to put on a brace to help support your back.  Sometimes it is and sometimes it isn’t.  Your Woodbridge, Dale City VA Chiropractor has some information for you that will help you decide.

So let me give you some background on back braces and do they really help.

The truth is that wearing an elastic or other support around your waist to help your back may be both good and bad.  And whether wearing such a back belt will prevent back problems is controversial.  A new study that found workers who routinely wear these support belts while working at Wal-Mart, were just as likely to injure their backs as those who did not.(1)  However, some previous studies have shown back belts to prevent injuries, such as the UCLA study conducted with Home Depot workers, which found a 1/3 decrease in back injuries due to wearing back belts.(2)

Let’s look at the scientific evidence about whether back belts might help to support the back, whether there are any risks associated with wearing them, and whether such belts should be recommended or not.

How might back belts help to support the back?  They do not hold the back in, as many presume. Back belts function primarily to hold the stomach in, thus increasing intra-abdominal pressure.  This has led some to refer to these belts as abdominal belts rather than as back belts.  But how does increasing intra-abdominal pressure support the spine?  We will briefly review the intra-abdominal balloon theory and a more modern theory.

Intra-Abdominal Balloon Mechanism

It was originally proposed by Bartelink in 1957 that increased intra-abdominal pressure would decrease the compressive load on the spine through the intra-abdominal balloon mechanism.(3)  To begin with, you must think of the abdominal cavity and the abdominal organs as a squishy liquid.  Then realize that the abdominal cavity becomes a closed chamber when we bear down and hold our breath, which we instinctively do when we lift heavy things.  This chamber is closed on the bottom by the anal sphincter and on the top by the diaphragm.  When bearing down, the abdominal contents tend to push outwards.  But if we contract our deep abdominal muscles—the obliques and the transverse abdominus muscles—or we wear a thick belt, the abdominal contents are forced upwards rather than outwards.(4 p.109)  This theoretically provides a decompressive effect on the lumbar spine.  Since the crura of the diaphragm is attached to the first 3 lumbar vertebrae, when the diaphragm is pushed upwards, it exerts a traction force on the lower lumbar spine (L4 and L5).  It was also theorized that since this balloon mechanism makes the spine more rigid, it would decrease the amount of work required of the erector muscles to prevent us from falling forwards.   Kapanji estimated that this abdominal support mechanism acts to reduce compression forces on the L5/S1 disc by 30% and reduces the force required by the erector spinae muscles by 55%. (4, p.198).

But more recent scientific evidence fails to support some of these theoretical assumptions.  Such recent studies reveal that an increase in intra-abdominal pressure actually results in an increase (rather than a decrease) in compressive force on the lower spine.(5,6) And there is no decrease in the amount of work required of the lower back muscles.(7)  However, by stiffening the trunk, increased intra-abdominal pressure may prevent the tissues in the spine from strain or failure from buckling.  Such intra-abdominal pressure may also act to reduce anterior-posterior shear loads.(8)  In other words, support for the spine is provided, without reducing compression to any appreciable degree.

Belts may also help to protect the spine by limiting the range of motion that occurs when bending or twisting, though this effect is less than expected.(9,10)  However, since when the spine bends more, it is more vulnerable to injury, if these belts reduce extreme bending at all, they may be beneficial.

Are there any risks associated with wearing a back belt?

The main risk associated with wearing a back belt is that during the period of wearing it, the supportive spinal muscles—the deep abdominal and back muscles—that normally support your spine will become weaker.  These muscles are less active while your spine is being artificially supported by the belt.  Muscles need to be consistently exercised in order to stay strong.  If these muscles become weaker, when you stop wearing the belt, you may be more likely to hurt your back.  And at least one study seems to suggest this.  In this study, there was an increase in the number and severity of back injuries following a period of belt wearing.(11)

Another risk associated with wearing a back belt is that it causes an increase in both blood pressure and heart rate.(12)  This may pose a problem for those individuals with existing cardiovascular disease or risk factors, such as hypertension.

A third risk associated with wearing a back belt is that workers may be inclined to lift heavier objects while wearing them.  These belts may be giving workers a false sense of security.  This could result in an increased risk of injury.

REFERENCES:

Wassell JT, Gardner LI, Landsittel DP, Johnston JJ, Johnston JM.   A prospective study of back belts for prevention of back pain and injury.  JAMA.  2000; 284(21): 2727-32.

McIntyre DR; Bolte KM; Pope MH. Study provides new evidence of back belts’ effectiveness. Occup Health Saf.  1996; 65(12): 39-41.

Bartelink DL, “The Role of Abdominal Pressure in Relieving Pressure on the Lumbar Intervertebral Discs,” J Bone Joint Surg, (Br) 1957, 39B: 718-725.

Kapanji, IA. The Physiology of the Joints, Vol. III.

McGill SM, Norman RW.  Reassessment of the role of intra-abdominal pressure in spinal compression.    Ergonomics. 1987; 30: 1565-1588.

Nachemson AL, Anderson GBJ, Schultz AB. Valsalva maneuver biomechanics. Effects on lumbar spine trunk loads  of elevated intrabdominal pressures. Spine. 1986; 11: 476-479.

McGill S, Norman RW, Sharatt MT. The effect of an abdominal belt on trunk muscle activity and intra-abdominal pressure during squat lifts. Ergonomics. 1990; 33:147-160.

McGill S. Abdominal belts in industry: A position paper on their assets, liabilities and use. Am Ind. Hyg. Assoc. J. 1993; 54(12): 752-754.

Lantz SA, Schultz AB. Lumbar spine orthosis wearing I. Restriction of gross body motion. Spine. 1986; 11: 834-837.

McGill SM, Sequin JP, Bennett G. Passive stiffness of the lumbar torso in flexion, extension, lateral bend and axial twist: The effect of belt wearing and breath holding. Spine. 1994; 19(19): 2190-2196.

Reddell CR, Congleton JJ, Huchinson RD, Mongomery JF. An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers. Appl. Ergonomics. 1992; 23: 319-329.

Hunter GR, McGuirk J, Mitrano N, et al. The effects of a weight training belt on blood pressure during exercise. J Appl Sport Sci Res. 1989; 3: 13-18.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Maplink

That is what is causing my back pain?

in Chiropractor  by July 16, 2021 0 comments

This long boring looking band down the side of your leg can get very exciting.  It looks like it serves no purpose at all, until it goes haywire.  Then you get knee pain, butt pain and back pain.  There are also the times it irritates your low back and butt enough to cause sciatica.  Your Woodbridge, Dale City VA chiropractor has some information on the IT band that can help you avoid these complaints.

Symptoms

Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee.

It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill.

Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh. A therapist or trainer may use Ober’s test to assess this. Weakness in hip abduction or moving the leg out sideways is another common sign. Tender trigger points in the gluteal muscles or buttocks area may also be present.

Causes

TFL muscleCertain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius  are also thought to be a significant factor.

Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.

Treatment

Below are outlined a number of treatment options for ITB friction syndrome. See rehabilitation for more details on how the various forms of treatment might be included in a full rehabilitation program.

Rest

Rest is important to allow the inflamed tendon to heal. Continuing to run with ITB syndrome will most likely make it worse. Initially complete rest is a good idea but later activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.

Cryotherapy

Apply cold therapy or ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea to ensure the pain does not return. Once the inflammation has gone then potential causes must be addressed such as a tight ITB or the pain will most likely return.

Medication

A doctor may prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen. This is useful in the early acute stage to reduce pain and inflammation. Long term it is not likely to be of benefit, particularly if it is just being used to mask in injury and not as part of the treatment. Always check with a doctor before taking medication in case you have contraindications which mean they could cause harm, for example asthmatics should not take Ibuprofen.

Stretching exercises

Stretching exercises for the muscles on the outside of the hip in particular are important. The tensor fascia latae muscle is the muscle at the top of the IT band and if this is tight then it can cause the band to be tight increasing the friction on the side of the knee.

Foam roller exercises

Using a foam roller on the IT band and gluteal muscles can help stretch the iliotibial band and remove any tight knots or lumps in the tendon. therefore friction on the side of the knee.

Strengthening exercises

Improving the strength of the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the ITB tendon at the knee. In particular strengthening exercises for the tensor fascia latae muscle and gluteus medius such as heel drops, clam exercise and hip abduction are important.

Sports massage

A professional therapist may perform sports massage to help relax and loosen the tissues and use myofascial release techniques which have been shown to be highly effective. Self massage techniques can also be very helpful in correcting excessive ITB tightness, especially where access to a massage therapist on a regular basis is not possible.

Electrotherapy

Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

Acupunture

Dry-needling techniques or acupuncture may be beneficial also. Acupuncture is performed by inserting needles of various lengths and diameters into specific points over the body and in this case around the knee joint. The needle is usually inserted, rotated and then either removed immediately or left in place for several minutes. It is thought to be beneficial in reduce chronic or long term pain.

 

Training modification

Errors in training should be identified and corrected. These can include over training or increasing running mileage too quickly. As a general rule a runner should not increase mileage by more than 10% per week. Running across a slope or camber in the road for long periods or poor foot biomechanics should be considered. When training starts again avoid too much downhill running.

A rehabilitation strategy which includes stretches and exercises to strengthen the hip abductors is important. In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

What is this pain in my leg!

in Chiropractor  by April 9, 2021 0 comments

Sciatica has to be one of the best-known diagnoses for back pain.  I hear it all the time thanks to Dr. Google.  It is very common but the referral into the leg doesn’t always have to mean you have a disc injury.  Your Woodbridge, Dale City VA Chiropractor has some information on how to accurately identify Sciatica.

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

  • A pins-and-needles sensation, most often in the toes or foot
  • Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options?

For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

 

An Ounce of Prevention Is Worth a Pound of Cure

While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.

 

  • Maintain a healthy diet and weight
  • Exercise regularly
  • Maintain proper posture
  • Avoid prolonged inactivity or bed rest
  • If you smoke, seek help to quit
  • Use good body mechanics when lifting

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Pain in your Butt!

in Chiropractor  by February 19, 2021 0 comments

A lot of times the low back gets blamed for your pain when it is actually your piriformis muscle.  This small muscle in your buttocks can cause all sorts of problems.  Your Woodbridge, Dale City VA Chiropractor wants to show you how this could be the cause of your pain.

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.

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.

 

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

What is SI pain?

in Chiropractor  by July 24, 2020 0 comments

As your chiropractor in the Woodbridge, Dale City VA area I see tons of low back pain.  Not all low back pain is the same and the SI injury is a very common complaint.  This is that pain that is to the right or left of your spine along the pant line.  It can also cause pain into the buttock and back of leg.

Chiropractic is all about expression of optimal health and living the best possible life for you. The focus, especially with doctors of chiropractic at The Joint, is about improving the overall quality of your daily life through regular spinal adjustments. An adjustment helps restore spinal movement, which allows the nervous system to function at its highest possible level. Because the nervous system controls everything we do (including breathing, blinking and swallowing), a system operating optimally is extremely valuable. One of the additional perks — the one that often brings people in — is that pain and joint dysfunction often go away. That’s like magic! Many times people are freed to return to activities they love but have struggled participating in, whether it’s skateboarding, surfing, or lifting a little one up over their head. One of the most common issues that chiropractors see is SI joint dysfunction. It’s common enough that many people know what the SI joint is, but if you don’t, don’t worry — just keep reading. I’ll go over a bit of the science and how chiropractic can play a role in resolving SI joint issues.

The Science

SI stands for sacroiliac. You have two SI joints. The joints are on either side of the sacrum and each ilium (you know this as your hip bone). They are at the bottom of the spine and connect the sacrum and ilium on each side. The main motion of the joint is a shearing motion (a sliding motion back and forth between two parallel surfaces, joint facets in this case).

Dysfunction

SI joint dysfunction means the SI joint is not moving the way it’s intended. Perhaps this means its range of motion is limited — either the sacrum or the ilium is literally mal-positioned and stuck — or there is too much motion. Each joint works to transfer weight from the upper body to the lower body; they are designed to allow minimal movement and they have strong ligaments and tendons that support them. The dysfunction can occur as a result of a variety of things. We live in a society in which the average person sits far too much and carries too much weight. This lack of movement doesn’t encourage proper SI joint health and function. Dysfunction can also be a result of stress from overcompensation after prior spinal surgeries. Too much SI joint movement commonly occurs in pregnant women due to ligament-stretching and laxity.

Symptoms and Treatment

As with most conditions, symptoms vary from person to person. It’s common for SI joint dysfunction to present with low back pain or pain in the buttocks. Pain can radiate down the leg or even into the front of the thigh, but generally not past the knee. SI joint pain can mimic many other causes of low back pain. Chiropractors are experts at determining the source of spine pain in patients — and caring for them, too!

Through an adjustment, chiropractors help restore motion in the SI joint and/or associated joints contributing to the problem. I’ve found that SI joint dysfunction typically responds well to chiropractic care and that pain relief can occur quickly after an adjustment. The exact treatment duration and intensity will depend on the person, their lifestyle and the degree of the subluxation.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Leg pain but not sciatica!

in Chiropractor  by June 26, 2020 0 comments

This injury is pretty common with low back injuries.  It sometimes gets confused with sciatica because patients have low back pain and a pain into their leg.  Your Woodbridge, Dale City VA Chiropractor has some information on it to help you tell the difference.  Of course, if you are getting low back pain with pain into your leg it would be a good idea to see your chiropractor.

Symptoms

Symptoms of ITB syndrome consist of pain on the outside of the knee, more specifically at or around the lateral epicondyle of the femur or bony bit on the outside of the knee.

It comes on at a certain time into a run and gradually gets worse until often the runner has to stop. After a period of rest the pain may go only to return when running starts again. The pain is normally aggravated by running, particularly downhill.

Pain may be felt when bending and straightening the knee which may be made worse by pressing in at the side of the knee over the sore part. There might be tightness in the iliotibial band which runs down the outside of the thigh. A therapist or trainer may use Ober’s test to assess this. Weakness in hip abduction or moving the leg out sideways is another common sign. Tender trigger points in the gluteal muscles or buttocks area may also be present.

Causes

TFL muscleCertain factors may make you more susceptible to developing runners knee or iliotibial band syndrome. A naturally tight or wide IT band may make someone more susceptible to this injury. Weak hip muscles, particularly the gluteus medius  are also thought to be a significant factor.

Over pronation or poor foot biomechanics may increase the risk of injury. If the foot rolls in or flattens, the lower leg rotates and so does the knee increasing the chance of friction on the band. Other factors include leg length difference, running on hills or on cambered roads.

Treatment

Below are outlined a number of treatment options for ITB friction syndrome. See rehabilitation for more details on how the various forms of treatment might be included in a full rehabilitation program.

Rest

Rest is important to allow the inflamed tendon to heal. Continuing to run with ITB syndrome will most likely make it worse. Initially complete rest is a good idea but later activities other than running which do not make the pain worse such as swimming or cycling should be done to maintain fitness.

Cryotherapy

Apply cold therapy or ice to reduce pain and inflammation. Ice should be applied for 10 to 15 minutes every hour until initial pain has gone then later 2 or 3 times a day and / or after exercise is a good idea to ensure the pain does not return. Once the inflammation has gone then potential causes must be addressed such as a tight ITB or the pain will most likely return.

Medication

A doctor may prescribe anti-inflammatory medication such as NSAID’s e.g. Ibuprofen. This is useful in the early acute stage to reduce pain and inflammation. Long term it is not likely to be of benefit, particularly if it is just being used to mask in injury and not as part of the treatment. Always check with a doctor before taking medication in case you have contraindications which mean they could cause harm, for example asthmatics should not take Ibuprofen.

Stretching exercises

Stretching exercises for the muscles on the outside of the hip in particular are important. The tensor fascia latae muscle is the muscle at the top of the IT band and if this is tight then it can cause the band to be tight increasing the friction on the side of the knee.

Foam roller exercises

Using a foam roller on the IT band and gluteal muscles can help stretch the iliotibial band and remove any tight knots or lumps in the tendon. therefore friction on the side of the knee.

Strengthening exercises

Improving the strength of the muscles on the outside of the hip which abduct the leg will help prevent the knee turning inwards when running or walking and therefore help reduce the friction on the ITB tendon at the knee. In particular strengthening exercises for the tensor fascia latae muscle and gluteus medius such as heel drops, clam exercise and hip abduction are important.

Sports massage

A professional therapist may perform sports massage to help relax and loosen the tissues and use myofascial release techniques which have been shown to be highly effective. Self massage techniques can also be very helpful in correcting excessive ITB tightness, especially where access to a massage therapist on a regular basis is not possible.

Electrotherapy

Use of electrotherapeutic treatment techniques such as TENS or ultrasound may help reduce pain and inflammation.

Acupunture

Dry-needling techniques or acupuncture may be beneficial also. Acupuncture is performed by inserting needles of various lengths and diameters into specific points over the body and in this case around the knee joint. The needle is usually inserted, rotated and then either removed immediately or left in place for several minutes. It is thought to be beneficial in reduce chronic or long term pain.

 

Training modification

Errors in training should be identified and corrected. These can include over training or increasing running mileage too quickly. As a general rule a runner should not increase mileage by more than 10% per week. Running across a slope or camber in the road for long periods or poor foot biomechanics should be considered. When training starts again avoid too much downhill running.

A rehabilitation strategy which includes stretches and exercises to strengthen the hip abductors is important. In acute or prolonged cases a corticosteroid injection into the site of irritation may provide pain relief.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

What is Sciatica?

in Chiropractor  by March 20, 2020 0 comments

Sciatica is one of those terms I hear from patients all the time as your Woodbridge, Dale City VA Chiropractor.  It is fairly generic for any pain into the leg.  Dr Google has helped with that overuse of the term.  To help you better understand sciatica and what it is here is some information.  Unfortunately, I am only helping Dr Google but these are the facts.

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

  • A pins-and-needles sensation, most often in the toes or foot
  • Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options?

For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

 

An Ounce of Prevention Is Worth a Pound of Cure

While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.

 

  • Maintain a healthy diet and weight
  • Exercise regularly
  • Maintain proper posture
  • Avoid prolonged inactivity or bed rest
  • If you smoke, seek help to quit
  • Use good body mechanics when lifting

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

SI joint and low back pain

in Chiropractor  by July 19, 2019 0 comments

Sacroiliac or SI pain is one of the most common types of low back pain I see as your chiropractor in the Woodbridge, Dale City VA area.  It is a pain that is on the right or left side of your waist line.  It can cause pain into your butt or leg.  Chiropractic can help with this complaint once the inflammation goes down so I always preach ICE!

Chiropractic is all about expression of optimal health and living the best possible life for you. The focus, especially with doctors of chiropractic at The Joint, is about improving the overall quality of your daily life through regular spinal adjustments. An adjustment helps restore spinal movement, which allows the nervous system to function at its highest possible level. Because the nervous system controls everything we do (including breathing, blinking and swallowing), a system operating optimally is extremely valuable. One of the additional perks — the one that often brings people in — is that pain and joint dysfunction often go away. That’s like magic! Many times people are freed to return to activities they love but have struggled participating in, whether it’s skateboarding, surfing, or lifting a little one up over their head. One of the most common issues that chiropractors see is SI joint dysfunction. It’s common enough that many people know what the SI joint is, but if you don’t, don’t worry — just keep reading. I’ll go over a bit of the science and how chiropractic can play a role in resolving SI joint issues.

The Science

SI stands for sacroiliac. You have two SI joints. The joints are on either side of the sacrum and each ilium (you know this as your hip bone). They are at the bottom of the spine and connect the sacrum and ilium on each side. The main motion of the joint is a shearing motion (a sliding motion back and forth between two parallel surfaces, joint facets in this case).

Dysfunction

SI joint dysfunction means the SI joint is not moving the way it’s intended. Perhaps this means its range of motion is limited — either the sacrum or the ilium is literally mal-positioned and stuck — or there is too much motion. Each joint works to transfer weight from the upper body to the lower body; they are designed to allow minimal movement and they have strong ligaments and tendons that support them. The dysfunction can occur as a result of a variety of things. We live in a society in which the average person sits far too much and carries too much weight. This lack of movement doesn’t encourage proper SI joint health and function. Dysfunction can also be a result of stress from overcompensation after prior spinal surgeries. Too much SI joint movement commonly occurs in pregnant women due to ligament-stretching and laxity.

Symptoms and Treatment

As with most conditions, symptoms vary from person to person. It’s common for SI joint dysfunction to present with low back pain or pain in the buttocks. Pain can radiate down the leg or even into the front of the thigh, but generally not past the knee. SI joint pain can mimic many other causes of low back pain. Chiropractors are experts at determining the source of spine pain in patients — and caring for them, too!

Through an adjustment, chiropractors help restore motion in the SI joint and/or associated joints contributing to the problem. I’ve found that SI joint dysfunction typically responds well to chiropractic care and that pain relief can occur quickly after an adjustment. The exact treatment duration and intensity will depend on the person, their lifestyle and the degree of the subluxation.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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What is Sciatica?

in Chiropractor  by March 15, 2019 0 comments

Sciatica is a term used to describe almost every type of leg pain out there.  The problem is it is actually a specific diagnosis.  It is essentially the xerox of back/leg pain.  As your Chiropractor in the Woodbridge, Dale City VA area I want to help you understand sciatica.  Here is the information the ACA uses to define sciatica.    Your local chiropractor is a great place to start and if you are in the Woodbridge Virginia area give us a call.

Sciatica describes persistent pain felt along the sciatic nerve, which runs from the lower back, down through the buttock, and into the lower leg. The sciatic nerve is the longest and widest nerve in the body, running from the lower back through the buttocks and down the back of each leg. It controls the muscles of the lower leg and provides sensation to the thighs, legs, and the soles of the feet.

Although sciatica is a relatively common form of low-back and leg pain, the true meaning of the term is often misunderstood. Sciatica is actually a set of symptoms—not a diagnosis for what is irritating the nerve root and causing the pain.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends to develop as a result of general wear and tear on the structures of the lower spine, not as a result of injury.

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that radiates along the path of the sciatic nerve, from the lower back and down one leg; however, symptoms can vary widely depending on where the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burning sensation, typically on one side of the body.

Some patients also report:

  • A pins-and-needles sensation, most often in the toes or foot
  • Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsen after prolonged sitting, sneezing, coughing, bending, or other sudden movements.

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete patient history. You’ll be asked to describe your pain and to explain when the pain began, and what activities lessen or intensify the pain. Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay special attention to your spine and legs. You may be asked to perform some basic activities that will test your sensory and muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination table and lift your legs straight in the air, one at a time.

In some cases, your doctor of chiropractic may recommend diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging may be used to rule out a more serious condition, such as a tumor or infection, and can be used when patients with severe symptoms fail to respond to six to eight weeks of conservative treatment.

What are my treatment options?

For most people, sciatica responds very well to conservative care, including chiropractic. Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment plans will often vary depending on the underlying cause of the problem.

Chiropractic offers a non-invasive (non-surgical), drug-free treatment option. The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasing pain and inflammation. Depending on the cause of the sciatica, a chiropractic treatment plan may cover several different treatment methods, including but not limited to spinal adjustments, ice/heat therapy, ultrasound, TENS, and rehabilitative exercises.

 

An Ounce of Prevention Is Worth a Pound of Cure

While it’s not always possible to prevent sciatica, consider these suggestions to help protect your back and improve your spinal health.

 

  • Maintain a healthy diet and weight
  • Exercise regularly
  • Maintain proper posture
  • Avoid prolonged inactivity or bed rest
  • If you smoke, seek help to quit
  • Use good body mechanics when lifting

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Piriformis Syndrome

in Chiropractor  by February 23, 2018 0 comments

As a chiropractor in the Woodbridge, Dale City VA area low back pain is a very common complaint.   Out of the low back pain I would say more than half of the complaints are the SI joints.  This is low back pain which is on the right or left side of the back along the pant line.  This joint can be injured or cause pain for many different reasons.   One of the most common is the piriformis muscle.  This is a muscle in your buttock which can spasm and cause sciatic symptoms and SI pain.

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.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link