Take a look at this x-ray. Can you see how uneven the pelvis is? This is caused by an anatomical short leg. The spine is showing signs of degeneration (arthritis) as well as the left hip.
Frontal x-ray taken standing. The left side is the low side. Posted with permission.
So can a short leg cause back pain? The answer is yes. I have seen this multiple times in my practice. There are two major causes of a short leg. One can be functional. A function can be from twisting of the pelvis or tight or weak muscles. An example of this would be standing in a hole with one leg. There is no difference in the bone length in the leg but the pelvis can be uneven. The second can be an anatomical. This occurs when the one of the leg bone is a different size then the corresponding one. Think of a table with one leg a shorter then the others. Both can be treated with chiropractic care and home exercise but the way they are treated is different.
This patient had an accident when he was young that effected his Tibia (shin bone). This causes one of his legs to become a different length and cause an uneven pelvis. Years of walking and daily actives with a severely uneven pelvis lead to arthritis, disc degeneration and chronic pain.
Posted with permission. The left tibia is the one with injury. Posted with permission.
Things that happen to our legs/feet can effect our spine. The body is great at compensating until it can’t. A broken bone that heals shorter than the opposite one will lead to changes in how the body moves causing increased biomechanical stress leading to break down. The break down can be of the muscle, bone, cartilage or disc.
I want to thank the patient for permission to post these picture.
New research has re-affirmed that weakness of one cervical muscle group is closely tied to chronic neck pain. This unit is also implicated as a provocative factor for cervical radiculopathy, cervicogenic headache, and cervicogenic vertigo.
A 2020 JMPT study re-affirmed that weakness of the deep neck flexors is common in cervical radiculopathy patients:
“Current results confirmed the presence of cervical multifidus and longus colli muscle atrophy in subjects with chronic radicular neck pain.” (1)
The deep neck flexors include four muscles that lie behind the trachea on the front of the cervical spine. The group includes the longus colli, longus capitis, rectus capitis, and longus cervicis. Due to their proximity to the spine and their short length, the muscles are primary stabilizers of the cervical spine.
If you’re experiencing neck pain contact the office! We help ease neck pain every day.
Amiri-Arimi S, Bandpei MA, Rezasoltani A, Javanshir K, Biglarian A. Asymmetry of Cervical Multifidus and Longus Colli Muscles Size in Participants With and Without Cervical Radicular Pain. Journal of Manipulative and Physiological Therapeutics. 2020 Mar 1;43(3):206-11.
Sitting all day in front of a computer can negatively effect your health. We sit much more than we have ever done. Sitting can effect your spine by placing pressure on the muscle, tendons, and disc. I see many patients who have pain from sitting in a bad position ( poor posture) all day.
Another way sitting effects our health is through muscle activity. When we sit our muscles turn off because the body is at rest. This leads to reduced muscle metabolism. This effects lipid (fats) and glucose metabolism and blood flow. Muscle required glucose and lipids to work.
Human physiology is not well adapted to prolonged periods of inactivity, with time spent sitting increasing cardiovascular disease and mortality risk. Health risks from sitting are generally linked with reduced levels of muscle contractions.
Standing some part of the day will help improve our health. When you stand it requires some muscle activation(contraction). Higher levels of muscle activation can improve your health.
In short, sitting all day can cause you to have poor posture and increase your risk of diabetes and heart disease.
A new study that looked at 216 people with COVID-19 found that 80 percent didn’t have adequate levels of vitamin D in their blood.
The study also found that people who had both COVID-19 and lower vitamin D levels also had a higher number of inflammatory markers such as ferritin and D-dimer, which have been linked to poor COVID-19 outcomes.
A different study found that COVID-19 patients who had adequate vitamin D levels had a 51.5 percent lower risk of dying from the disease and a significant reduced risk for complications.
Medical experts theorize that maintaining adequate vitamin D levels may help lower risk or aid recovery from severe COVID-19 for some people, though more testing is needed.
A Little Information about Vitamin D.
The major natural source of the vitamin D is synthesis of cholecalciferol (precursor to Vitamin D) in the lower layers of skin epidermis through a chemical reaction that is dependent on the SUN. Cholecalciferol is then convert to the active form of Vitamin D.
Did you know that Vitamin D is a hormone and not a vitamin. Hormones are chemicals that the body produces to control how the body is functioning. Hormone are signaling molecules that can turn on and off cells and organs .
Vitamin D is a hormone that controls blood calcium concentration and impacts the immune system. Many studies point to the beneficial effect of vitamin D on the immune system, especially regarding protection against infections.
Robust evidence suggests that vitamin D is protective against respiratory tract infections. Data from 25 randomized controlled trials from around the world demonstrate that daily or weekly supplementation of vitamin D reduced the risk of acute respiratory infection by more than 50 percent in people with low baseline vitamin D levels.
Low vitamin D levels have been associated with an increase in inflammation and can increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in COVID-19.
Having your Vitamin D levels tested is not a bad Idea. This way you wont be guessing on your levels. Once you know your levels it will give you a better understanding if you need to supplement with Vitamin D.
Ibuprofen is a common over the counter nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.
Ibuprofen has many side effects such as stomach bleeding, and even increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease.
These side effects and others are the reason someone should not take more than your recommended dose.
Here’s another reason not to take Ibuprofen. A study showed that ibuprofen use in men led to (i) elevation of LH; (ii) a decreased testosterone/LH ratio and, to a lesser degree, a decreased inhibin B/FSH ratio; and (iii) a reduction in the levels of the Sertoli cell hormone AMH. The decrease in the free testosterone/LH ratio resulted primarily from the increased LH levels, revealing that testicular responsiveness to gonadotropins likely declined during the ibuprofen exposure.
That sound pretty scary. A over the counter can effect a males sex hormones. What man wants lower testosterone?
If you have pain that requires taking over the counter medication pain killers for a long time , you might want to try so else. Chiropractic is a safe drug free approach. Call our office and make an appointment .
I love when a study confirms what I’ve been telling patients. I recommend fish oils to most of my patients.
This study confirms the importance of fish oils. A meta-analysis of 40 clinical trials found that supplementation with fish oil is associated with a 35% reduced risk of fatal heart attacks, a 13% reduced risk of heart attacks, and a 9% reduced risk of fatal coronary heart disease.
Specifically, the study found that EPA+DHA supplementation is associated with a statistically significant reduced risk of:
The study found that cardiovascular benefits appear to increase with dosage. The data showed that adding an extra 1000 mg of EPA and DHA per day decreased the risk of cardiovascular disease and heart attack even more. For example, the risk of cardiovascular disease events decreased by an additional 5.8% and the risk for heart attack decreased by an additional 9%.
Continue to take your fish oils supplement or even increase the dosage. It might help save your life!
If you have questions on where to begin, please call the office. Not only can Dr. Steve get you on the right track with supplements but we have them for sale.
The following information is from a great book meant for the non-physician to help resolve their own back problems. The book is by Stuart McGill PhD and is called “Back Mechanic: The Secrets to a Healthy Spine Your Doctor Isn’t Telling You.”
I highly recommend the book if you have suffered or are suffering from low back pain. The end goal is to remove the stressors and spare your spine with proper movement and strengthening exercises.
“Many back pain sufferers would experience a huge breakthrough in their recovery if they only realized that is was their flawed movement patterns that kept them pain-sensitive. Much like a scab forming on our skin, our backs are constantly trying to patch and health themselves. We, however, by continuing to repeat harmful movement patterns in our daily lives cause re-injury. We are essentially “picking the scab.” It is unreasonable to expect the body to heal if we continue to provoke it in the same way that led to the original injury. Continued provocation of pain sensitizes the nerves so that the pain is triggered with even less stimulation. Remove the provocative motions and we can find the solution.
Here’s how pain sensitivity works: people increase their sensitivity through repeated stressful and painful loading. These muscles and joints are loaded with sensors: pain sensors, pressure sensors, force sensors, chemical sensors. Some detect carbon dioxide; some detect pain, some sense histamine for inflammation. Human joints are packed with sensors that relay position and movement information to the brain. These signals travel along the sensory nerves. Along the highway of nerves, there are checkpoints or “gates,” at junctions. According to the Gate Theory of Pain, the idea is, to flood the checkpoint with “good information,” in other words, signals associated with pain-free movement. In this way, there is no more room for the pain signals as they are crowded out.
Try this: close your eyes and find the tip of your nose with your finger like in a roadside sobriety test. You are using kinesthetic sensory organs that run throughout your arm to navigate. These sensors alert the brain as to the position of your forefinger in relation to your nose. The sensation of this simple pain-free motion dominates the information traffic on your sensory nerves with feel-good kinesthetic sensory information that identifies position, length, and force. Finding and repeating pain-free motions in your back will cause the remaining painful activities to hurt less. Read the previous sentence again – it really is that important.
By discovering and engraining positive movements for your back, you will find that the pain often dissipates and then disappears entirely. This is because when we remove pain triggers and stop “picking the scab” we give our tissues a chance to rest, heal and regenerate. Simultaneously our sensors for pain are actually being desensitized. Master this, and you have mastered your back pain.
For those of you that have a known type of injury, a name to attach to your condition, your personal recovery strategy should always begin with avoiding the aggravating posture for your unique spine is key to getting yourself back on track.
Various symptoms of back pain have a distinct and known cause (although this information is not widely known making this book uniquely valuable). Injuries can be avoided if we avoid the injury mechanism itself. Here’s a recap of some pain avoidance strategies, as well as an introduction of some that will be discussed later. The knowledge in this chapter will provide the foundation that will help you:
Locate and eliminate the cause of your pain- get an appropriate assessment that provides a specific diagnosis ( you will be able to obtain your own by reading chapter 6).
Increase your consciousness around what movements and postures cause you pain.
Develop replacement postures and movement patters that enable you to function pain-free.
Stabilize your torso, core, and spine to remove painful spine joint micro-movements.
Develop a daily exercise plan that includes walking.
Mobilize your hips
Learn to create power at the ball and socket joints (hips and shoulders).
Learn exercises that are based on patters of movement: push, pull, lift, carry, lunge, squat, etc.
Make healthy spine choices when sleeping, sitting, or engaging in more demanding activities.
You’re on your way to learning the secrets of a pain-free lifestyle! Let’s make it happen!”
Decreased sleep duration is associated with obesity, diabetes and cardiovascular disease
Controlled laboratory studies have shown that decreased quantity and quality of sleep negatively affects glucose regulation and alters food intake and energy balance.
Experimental sleep restriction alone or in combination with misalignment, and decreases in sleep quality negatively affect glucose regulation. Sleep curtailment alters energy expenditure, weight regulation, gene-expression, and inflammatory cytokine levels.
Below is a cool chart from the study. It’s amazing what a lack of sleep can effect.
this image is from the study.
Besides eating right, exercising and chiropractic care, getting 7-9 hours of sleep a night is necessary for a healthy life style.
Wrist pain. Hand pain. Maybe you’ve felt this condition while sitting at the computer typing out work assessments, during a long session of playing video games, or swiping left or right on a phone or tablet screen repeatedly. Perhaps you lift weights and experience it in the middle of an intense workout, or while holding heavy construction tools. Whatever the cause may be, whether it’s from typing for long periods of time, holding a phone for a long time, or holding a jackhammer, the immediate conclusion people think of is a condition known as carpal tunnel syndrome.
But what is this syndrome? Is all wrist pain automatically carpal tunnel syndrome, or is it possibly something else?
Carpal tunnel syndrome (CTS) is an entrapment neuropathy.1 Think of a pinch in a hose line caused by stepping on it, and you can visualize a similar compression of the nerve as it travels down through the wrist and into the hand. The nerve, in particular, known as the median nerve, travels through a bony area in the wrist called – you guessed it – the carpal tunnel.
The carpal tunnel itself is a narrow passageway inside your wrist surrounded by bones and ligaments. Compression, or pinching, of the median nerve, can create symptoms including numbness, tingling, and weakness in the hand, wrist, and arm.2
Carpal tunnel is the most common of neuropathies, or nerve conditions, with over 90% of neuropathic cases being from carpal tunnel compression.1
Typing with poor wrist position is a cause of wrist pain.
Carpal tunnel can be caused by a variety of circumstances and conditions as well. CTS is more likely to occur in people who hold vibrating tools or work in an assembly line, engage in work that requires repetitive flexing of the wrist such as typing, take certain medications, have inflammatory conditions, or have poor wrist and hand ergonomics.2
The most common causes of carpal tunnel syndrome include genetic predisposition, history of repetitive wrist movements such as typing, or machine work as well as obesity, autoimmune disorders such as rheumatoid arthritis, and pregnancy.1 However, repetitive motions are a high-risk factor in developing carpal tunnel symptoms due to the repetitive activities inflaming the tendons that run through the carpal tunnel. This inflammation can lead to compression of the median nerve.3
Symptoms usually start gradually, in one or both hands during the night, with frequent numbness or tingling in the fingers.4 Some people report their hands and fingers even feel useless, clumsy, and unresponsive or even feel swollen, although little or no swelling is apparent!
Unfortunately, many cases of the wrist and forearm pain are automatically diagnosed as CTS without truly examining all possible causes of the pain, or even confirming if the painful condition is truly CTS.
The million-dollar question: Is every hand and wrist issue created by an issue with the nerve inside the carpal tunnel? The short answer: no!
Another condition, called Pronator Teres Syndrome (PTS), is very similar to CTS in the way it manifests. PTS causes similar sensations to carpal tunnel syndrome, including weakness, tingling, pain, and numbness.
However, Pronator Teres Syndrome is caused by a muscle in the forearm – it has nothing to do with the carpal tunnel in the wrist and hand!
Pronator Teres Syndrome describes a condition where the median nerve is also compressed, but the cause is distinctly muscular.5 The Pronator Teres muscle in the forearm becomes over-used: think of excessive repetitive motions involved in our usual activities of daily living. Maybe the repetitive motion is from an aspiring college tennis player perfecting her swing daily or someone who works in a kitchen, ladling soup, and washing dishes. Maybe it’s the guy who wants to Do-It-Yourself a new kitchen in his home, and he’s swinging a hammer to break up old kitchen fixtures. Whatever the repetitive cause, the same motions cause scar tissue, adhesions, or muscular restrictions to set up housekeeping inside the muscle and entrap the Median Nerve, causing forearm, wrist, and hand symptoms – much like CTS.
Both syndromes cause similar pain but must be treated differently to achieve the desired results. Imagine being treated for one condition with no change in pain and no results – when you actually have the other and need a different treatment altogether!
What can you do if you have wrist and hand pain? Your first line of defense is a physical examination of the hands, arms, shoulders, and neck by your trained chiropractic physician. He or she can help determine if the person’s complaints are related to daily activities, such as overuse or poor ergonomics, or due to an underlying disorder such as carpal tunnel or pronator teres syndrome.
Many cases of carpal tunnel can be treated conservatively or without surgical intervention. Splinting, changing your daily routine, chiropractic care, soft tissue work, and other forms of treatment exist that safely improve and resolve a painful wrist condition.4
In the meantime, if you’re suffering from wrist and hand pain and you’re waiting for your next doctor’s appointment, here are some basic, easy stretches you can do on your own. Remember, these are a method of prevention, not treatment for any wrist or forearm condition.
Perform each stretch to tolerance (meaning, don’t hurt yourself!) for two sets, with 15-second holds on each arm.
Wrist Flexor Stretch
Begin standing with your arm straightened in front of you at chest level, palm facing down.
Flex arm and stretch fingers down and back with the opposite hand.
Straighten arm while keeping tension on fingers.
Rotate arm by twisting fingers inward.
Thumb Flexor Stretch
Flex the arm.
Extend wrist back, allowing fingers to curl inward.
Stretch thumb back toward the arm.
Did you have fun with those stretches? Did they cause any discomfort, or did it feel good to stretch those hand and forearm muscles?
Keep in mind, there are other conditions that can affect the wrist, forearm, and elbow, and if you are having pain besides carpal tunnel and pronator teres muscles. We only addressed two common causes here. Your local chiropractor is well-versed in extremity conditions that can create discomfort and affect your ability to work and play.
References
Sevy, J.O., and Varacallo, M. (2020). Carpal tunnel syndrome. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Mar.
Monitors should be visible without leaning or straining, and the top line of type should be 15 degrees below eye level.
Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
Keep your shoulders relaxed and elbows bent to 90 degrees.
Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge.
Keep frequently used objects, like your telephone, close to your body to prevent excessive reaching.
Take a 10-second break every 20 minutes: Micro activities include: walking, stretching, or moving your head in a “plus sign” fashion.
Do a micro break.
Another video about the desk set and suggestion on how a workstation should.
Have a question about your workstation? Dr. Steve can help with that! Contact our office so you can make sure you’re workstation isn’t contributing to pain.
Dr. Steve Sikorsky | Chiropractic Care Elgin, Illinois
