Wellness Center

Stages Of Care

The typical patient will encounter 3 stages of care. The first stage focuses on symptomatic relief such as reduction of pain and other discomforts. The following stage addresses tissue healing and function normalization. The final stage consists of periodic spinal care to prevent the formation of new injuries, minimize future flare-ups of old injuries, and prevent degenerative spinal processes from occurring.


Relief Care

Relief care is the first stage of care for most patients. The primary goal during this initial stage is to provide the individual with symptomatic relief. Treatments focus on those techniques and therapies which most quickly and effectively reduce pain and other discomforts. This will allow the majority of individuals to continue their activities of daily living. Patients are generally recommended to “take it easy” but are encouraged to stay mobile and functional so long as there is not a risk of further injury or tissue damage. Therapies that reduce inflammation and muscle spasm are also used during this stage when present.

Corrective Care

The second stage of care consists of correcting the problems which caused and contributed to the condition and healing and rehabilitating the injured tissues. Unless these events take place, a favorable outcome is unlikely and future recurrences of the problem are likely. It is extremely important that the patient comply with and follow the instructions given by the doctor during this stage of care. Tissues and structures that are not fully healed and rehabilitated are prone to future problems. Sticking to appointments, complying with home exercises and instructions and following all other recommendations will help insure this occurs. Patients should also be aware that once pain and discomfort have subsided, tissue healing and functional correction is many times still incomplete and will often require additional treatments.

Wellness Care

Once the spinal tissues are healed and spinal biomechanics have normalized the patient will be recommended to continue with periodic spinal checkups. For some this might mean once per year, for others this may mean once per month or more. Chiropractic spinal checkups provide similar benefits to the spine that dental checkups provide to the teeth. Namely, catching minor problems and disturbances before they have the opportunity to cause pain, discomfort and irreversible tissue changes. Just like with cavities and heart attacks, irreversible tissue damage has generally occurred before the symptoms of spinal pain and discomfort become apparent.

THE SPINAL COLUMN

The spinal or vertebral column is a collection of 24 vertebrae plus the sacral bone. These bones provide support and mobility for the torso while also protecting the nervous system.

There are 4 distinct and different regions of the spinal column – the cervical, thoracic, lumbar and sacral regions. Each contains a different number of vertebrae which are structurally unique. These structural variations make certain regions of the spinal column more flexible while making other regions more stable and less susceptible to injury.

When viewed from the rear the spine normally appears vertically straight . When viewed from the side, however, 4 separate spinal curvatures should be present. Both the cervical and lumbar regions naturally have a “C” shaped curvature, while the thoracic and sacral regions possess a reversed “C” shaped curvature. The angles of these curves play a crucial role in minimizing spinal biomechanical stresses which lead to spinal pain and greatly accelerated spinal degenerative processes.

The chiropractic doctor is an expert in spinal evaluation and rehabilitation. He or she is trained to identify even the slightest spinal abnormalities. Eliminating pain, inflammation and biomechanical stresses while increasing overall health and quality of life is what chiropractic care is all about.

Doctors of chiropractic are the only health care professionals whose primary training centers around the detection, treatment, and rehabilitation of spinal column disorders.

THE SPINAL VERTEBRAE

The vertebrae are the small bones which the spinal column is comprised of. These individual functioning units are the basis of motion in the torso. They connect to and glide on each other by way of a spinal disc and 2 facet joints. Spinal muscles and ligaments attach to each vertebrae to permit movement.

Located in the rear of each vertebrae is a hollowed out portion called the spinal canal which encases the spinal cord as it descends from the brain, much like beads on a string. At each vertebral level, spinal “nerve roots” peel away from the spinal cord. Small openings formed by adjacent vertebrae provide a pathway for these delicate nerve roots to exit to the rest of the body. These openings are referred to as the intervertebral foramen or IVF and are a common location for nerve irritation.

When a vertebrae becomes misaligned or fixated in relation to neighboring vertebrae, chiropractors call it a vertebral subluxation. In addition to pain, reduced range of motion and muscle spasms, these subluxations may also produce nerve irritation and interference either by mechanical pressure or inflammatory biochemicals.

Doctors of chiropractic are the only health care professionals trained to detect and treat subtle vertebral abnormalities which occur in the spine.

THE INTERVERTEBRAL DISCS

The intervertebral discs are a prevalent source of lower back pain as they are one of the most frequently injured spinal structures. The discs connect adjacent spinal vertebrae together and provide a degree of shock absorption in the torso.

Disc Structure

The structure of the spinal disc resembles a jelly filled doughnut. The inner aspect of the disc contains a gel-like substance called the nucleus pulposus. Surrounding the nucleus are tough fibrocartilagenous fibers called the annulus fibrosis. These annular fibers contain the inner nuclear material similar to a basketball skin containing the air within.

Causes of Disc Injury

Disc injury occurs when the annular fibers of the disc are torn. Because the inner regions of the annulus lack “pain” innervation, injuries contained to the inner annulus occur without one’s knowledge.

Common causes of annular disc tears include:

  • uncorrected spinal misalignments
  • prolonged sitting
  • poor postural habits
  • poor lifting habits
  • improper workstation setup and ergonomics
  • improper lifting techniques
  • extended periods of vibratory forces (truck and auto
  • drivers, jack hammer operators, etc.)

Other factors have been shown to increase the susceptibility of disc injury:

  • inadequate diet and nutrition
  • smoking
  • obesity
  • lack of physical activity
  • Types of Disc Injury

There are 3 main types of disc injuries. The first disc injury consists of annular fiber tears which do not extend to the outer aspects of the disc. Thus, the inner nuclear material is prevented from completely escaping the disc.

The second type of disc injury, commonly referred to as a disc herniation, consists of annular tears which run from the innermost aspects of the annulus (where the nucleus is) to the outermost aspects of the annulus. In this type of injury, the pressurized nuclear material can squeeze through the tears in the annulus and escape to the outside of the disc. When this occurs, the nuclear material may come in contact with nearby spinal nerves and even the spinal cord.

In the third type of disc injury, referred to as a disc bulge, the inner nucleus loses hydration; common in those with prolonged spinal stress and the elderly. This results in “bulging” of the disc much like a tire “bulges” when it contains inadequate amounts of air. Similar to the previous injury, the nearby spinal nerves and spinal cord may become impinged from the bulging disc.

Symptoms of Disc Injury

The symptoms of disc injury depend upon the location of the disc tears and whether or not the spinal nerves or spinal cord are affected.

When tearing of the annulus occurs within it’s inner portion only, generally pain is not experienced. As previously stated, this is because the inner regions of the annulus lack pain receptors. When tearing of the annulus occurs in the outer annular fibers, mild to excruciating pain is felt in a generalized manner. If a lumbar disc is affected, for instance, diffuse low back pain with associated paraspinal muscle spasm is typical.

When numerous partial tears coalesce to form tears which run clear through the thickness of the annulus, the gel-like nucleus is able to escape the disc. If a spinal nerve or the spinal cord is contacted the individual may experience symptoms of pain, numbness, tingling and/or weakness within either or both lower extremities. In rare cases patients may lose the ability to control bowel and bladder functions. If this occurs, immediate medical intervention is required as the condition can become permanent.

Treatment of Disc Injuries

Disc injuries respond favorably to chiropractic care. This is because chiropractic treatments focus on the dysfunctional spinal segments and not just the symptoms of the disc injury. Pain killers, anti-inflammatory and muscle relaxants do nothing to treat the cause of disc injuries and have been shown to induce further injury.

Chiropractic treatments provide fast, effective, safe and long lasting relief from disc injuries. This is because the chiropractor’s approach focuses on restoring spinal alignment, spinal function and overall spinal health, which are the primary factors responsible for the development of disc injuries.

Chiropractic doctors are experts in maintaining proper spinal alignment and function, both of which play a critical role in minimizing spinal stresses – the stresses that are responsible for injury and accelerated degenerative processes in spinal discs.

THE FACET JOINTS

Many spinal experts actually consider the facet joints to be the most common source of spinal pain and discomfort.

Each vertebrae possesses 2 sets of facet joints – one set for articulating to the vertebrae above and one set for the articulation to the vertebrae below. In association with the spinal discs, the facet joints allow for movement between the individual vertebrae of the spine.

The facet joints are under a constant load from the weight of the body and are involved in guiding general motion and preventing extreme motions in the trunk. Repetitive or excessive trunkal motions, especially in rotation or extension, can irritate and injury facet joints or their encasing fibers. Also, abnormal spinal biomechanics – similar to a wheel out of alignment – and bad postural habits can significantly increase spinal stresses and thus greatly accelerate the wear and tear on the facet joints.

Chiropractic doctors identify and treat facet joint abnormalities and stresses along with other spinal abnormalities to keep backs and bodies healthy and free from pain.

THE SPINAL MUSCLES AND LIGAMENTS

Spinal muscles and ligaments attach to the vertebrae, ribs, and pelvis to permit and manage various trunkal motions including – forward and backward bending, side to side bending, and rotation or twisting. When a spinal motion occurs in excess or a muscle is worked beyond its capacity whether suddenly or gradually over time, injury occurs.

Sprains and strains of the muscles or ligaments upset the normal balance of the spine. Spinal structural alignment and biomechanics can be significantly altered. These alterations make the spinal components (discs, facets, vertebrae, nerves, etc.) increasingly prone to injury and degenerative processes.

Doctors of chiropractic rehabilitate spinal muscles and ligaments to prevent spinal imbalances. Proper spinal alignment and spinal biomechanics can only occur with healthy muscles and ligaments.

THE SACROILIAC JOINT

The sacroiliac joint is another spinal component which undergoes very large spinal stresses. Either the ligaments supporting the joints or the actual joint surfaces can be a source of low back pain and even refer pain into the lower extremities.

There are 2 sacroiliac joints formed by the articulation between the sacrum and 2 ilium bones of the pelvis. Like the other spinal structures, the sacroiliac joints can be injured through acute trauma, repetitive movements, and poor posture, to name a few.

Symptoms include lower back pain with the pain occasionally extending down the back of the leg. Additionally, hip pain, knee pain as well as foot and ankle pain may be present due to increased stress in those joints as a result of an alteration of pelvic biomechanics.

Sacroiliac problems are extremely common in pregnancy. During this time, the pelvis experiences many physical stresses due to weight and hormonal factors. Chiropractic care throughout pregnancy is essential in minimizing pelvic and spinal stresses. A study published in the journal Obstetrics and Gynecology found 7 out of 10 women obtained sacroiliac pain relief from chiropractic spinal manipulation.

A simple but surprisingly effective way to identify pelvic misalignments is to check for uneven leg lengths. Lay on a flat surface then have friend or family member compare the bottom of both heels for symmetrical length. If there is any discrepancy between leg lengths you may have a pelvic or lower back misalignment.

Chiropractic adjustments are frequently applied to the ilium and sacrum to successfully normalize and restore sacroiliac joint position and biomechanics.

THE NERVOUS SYSTEM

The nervous system is the master controller of all cells, tissues and organs. Nerves control the heart, lungs, immune system, endocrine system, as well as our thoughts and other cognitive processes. Effectively, the nervous system is in charge of directing and overlooking all bodily functions – keeping us alive and healthy, fighting off diseases and infections, and healing us after we have sustained injury.

Many people are surprised to learn that the spine plays a key role in protecting the nervous system. In fact, the main function of the spinal column (in addition to providing movement for the torso) is to encase and protect the spinal cord and nerve roots. Without this protection it’s unlikely that we would survive a relatively small slip and fall injury.

As the spinal cord descends from the brain, spinal nerve roots peel away from the spinal cord at each vertebral level and exit through openings made by adjacent vertebrae. These small protective pathways are called intervertebral foramen or IVFs and permit safe exit of the delicate nerve roots to the rest of the body. Because of the location of the IVF, herniated or bulging spinal discs, subluxated vertebrae, arthritic bony growths, and inflammatory biochemicals from nearby injured tissues commonly irritate or impinge upon the spinal nerve roots.

When there is irritation and interference to a nerve, messages or impulses traveling along that nerve can get scrambled. Some signals become only slightly altered while others may completely fail to reach their destination. As this process continues, those cells, tissues and organs which depend on the affected nerves for communication become less effective in performing their many important tasks and become less able to maintain their optimal health. Ultimately, the affected tissues can deteriorate, degenerate and become nonfunctional and diseased.

This model of disease helps explain why so many patients under chiropractic care have noted dramatic improvements with many seemingly “non-spinal” conditions such as dizziness, ulcers, ear infections, asthma, menstrual pains and low energy levels, to name a few. While its not prudent to claim chiropractic treatments may eliminate or treat such conditions, many patients have experienced phenomenal relief.

Chiropractors are the only doctors trained to detect and treat vertebral misalignments and fixations as well as many other common spinal abnormalities which cause nerve irritation and interference. Correcting nerve irritation and interference allows the body to function the way it was meant to.

ERGONOMICS

Ergonomics is the applied science of designing and developing equipment, workstation layout and work strategies to best suit and protect the human body. The goal of ergonomics is to minimize fatigue, discomfort, injury and emotional stress.

It’s important to recognize that even the most ergonomically correct environment will not prevent repetitive stress injuries if the body is simply overworked. The body has limitations with what it can withstand. Surpassing those limitations will most definitely result in injury.

CHOOSING THE RIGHT CHAIR

Prolonged sitting is a frequent cause of back and neck pain. And while extended periods of sitting are best avoided, for many, it’s a fact of life.

When sitting, it’s important to keep the back straight, knees bent, and head centered over the shoulders. Slouching forward may be comfortable and allow the spinal muscles to relax but gradually overstretches spinal ligaments, leading to back and neck pain among other problems. We always encourage patients to maintain a “neutral spine” position at all time is ideal.

Seat Backrest – The proper chair has a backrest which slightly inclines backwards. This has the effect of relaxing the spinal musculature and decreasing spinal discal pressure.

Armrests – Armrests provide support for the arms which helps to reduce the work load and stress on the trapezius and shoulder muscles. The armrest height should allow the forearms to comfortably rest while being low enough to go underneath tables or desks in the work area.

Lumbar Support – Having a lumbar support either built into the chair or inserting a portable lumbar support helps to maintain your natural lower back curve. These small supports are quite handy, effective and relatively inexpensive.

Seat Bottom Angle – The seat angle relative to the floor is more of a personal preference than an exact science, as long as a neutral spine can be maintained in comfort. In general, the more the seat bottom tilts forward the more extension of your lower back will occur to keep you in a neutral position.

Seat Height – The height of the seat should be so that it allows you to sit all the way back in the seat while your feet are still able to reach the floor. If they can’t and you’re stuck with the chair, use a footrest to remedy the problem.

In addition to the suggestions provided above, it’s important to:

be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching
take mini breaks on a regular basis when in a prolonged position and remember to stretch
have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture and keep a lumbar support in your car for “chair crises”

ADJUSTING YOUR MONITOR

Maintaining the correct monitor height will prevent many problems with your eyes, neck and upper back. A monitor improperly positioned can irritate neck musculature, alter the normal spinal curves, induce eyestrain and even initiate migraine headaches.

Monitor Distance – The monitor should be located directly in front of the area where you’re positioned to view the monitor. The preferred distance from your eyes to the actual screen varies with the size of the monitor and the current resolution settings. A 17 inch monitor should be located no less than 20 inches away. For smaller monitors you may need to be a little closer and for larger monitors a little farther away.

Monitor Settings – In conjunction with setting up the ideal distance between you and your monitor you may additionally need to alter the monitors resolution, contrast and brightness settings. This will allow characters and images to display clearly preventing squinting and eyestrain. The settings will vary depending on the distance you are from the monitor, the background you have on your active screen, the amount and type of lighting at your workstation, and the quality of your vision.

Lighting and Glare – Improperly positioned lighting can also wreak havoc on your ability to comfortably view your monitors display. Solutions include moving your monitor, moving the lighting, closing blinds or curtains, adjusting your monitors brightness setting, installing an anti-glare screen on your monitor, changing your background color to a lighter color, or even taping paper or cardboard along the edges of the monitor to act as a “visor”.

Monitor Height – The proper monitor height is vital in preventing gradual neck and upper back strain. The most effective way to determine correct monitor height is to sit correctly in your chair or where ever you view your monitor. Next, close your eyes and position your body and head in a neutral and comfortable position – your spine should be straight and head centered over your shoulders. Then, open your eyes and note at which point your eyes are initially focused on. This area should correlate to the center of your monitors screen or the part of the screen you view most frequently.

PROPER TELEPHONE TECHNIQUES

Spending prolonged periods of time on the telephone can lead to chronic neck, shoulder and upper back pain disorders. Using the proper techniques and equipment is key in preventing these problems from developing.

Phone Location – The telephone should be located close to the main working area such that it is easily reached without having to twist, bend or overly stretch.

Shoulder Rests – For individuals who like to have their hands free when on the telephone we highly recommend not using a shoulder rest extension on your receiver. This still requires you to cock your head in order to keep the receiver next to the ear. This position places stress on the supporting structures of the neck and can throw the neck out of alignment. Rather, purchase a headset device. They have become plentiful and fairly inexpensive.

Speaker Phone – Using a speaker phone allows for maximum flexibility to work while talking. However, for some this may not be appropriate such as during times that clarity, volume and professionalism are required. If this is the case, look into purchasing a headset.

Headsets – Headsets are the most versatile telephone utility. They enable you to work uninhibited while on the telephone and keep your body in an ergonomically safe position.

Writing Materials – Be sure to keep a pen and pad of paper near your telephone so messages can be immediately taken without changing position or straining to grab the appropriate materials.

SETTING UP YOUR WORKSTATION

Having a well planned, ergonomically designed workstation increases productivity, minimizes repetitive stress injuries, increases employee morale, and increases the bottom line. Since everybody has different tasks and different body types, no one workstation setup is ideal for everyone. There are, however, some basic guidelines that should be abided by when designing a workstation.

Space – There needs to be adequate space for you to comfortably accomplish all tasks required of you. If you’re constantly running into others or cannot properly function due to lack of adequate space physical and emotional stress increases while productivity decreases.

Equipment – Having the proper equipment which has been designed for the task at hand is essential. Equipment should be compatible with other equipment and be ergonomically designed to conform to your specific duties. Chairs should move freely in the work area and fit under desks and tables, lighting should fully light all work areas while not reflecting off of monitor screens, and computers and monitors should fit desks properly so screens can be read in comfortable positions and computer discs can be inserted without getting on all fours under the desk.

General Layout – Plan ahead. If you know what tasks you will be performing and what equipment you need, draw a floor plan and include equipment, furniture and accessory placement. Be sure keep those items used most frequently within reach are nearby to minimize strain and twisting. Commonly used equipment and other materials should be within reach from your primary workstation position.

Accessories – Add stackable document holders, have your rolodex nearby, purchase telephone headsets and any other items which can help to organize your workstation and keep all important and frequently used materials within your reach.

TAKING MINI-BREAKS AND STRETCHING

Taking small periodic breaks doesn’t just allow you to have a mini-mental vacation from the constant reins of work, it’s also an important opportunity to reduce built-up physical tension by stretching out your contracted and tensed body. Every 30 to 40 minutes your body needs to move, stretch and get out of any position that it’s been stuck in.

Assuming that your working position is in the seated posture, the following stretches can be performed throughout the day, everyday, to keep your body happy and healthy. All stretches should be held for 15-30 seconds and performed 1-3 times, depending on the amount of time you have. Hold the stretch in a position in which you can feel the muscles comfortably stretch.

Important Note: Do not perform any exercise or stretch without the recommendation of a licensed health care professional. If performing exercises or stretches at the recommendation of a licensed health care professional, immediately discontinue and seek professional medical assistance should unusual or abnormal pain and/or discomfort arise. Any and all exercises, stretches or similar contained within or available from this website are meant only for active patients of our office who have been specifically advised to perform said exercises, stretches or similar.

Basic Neck Stretches

Eyes To The Sky – Extend your head backwards while allowing your mouth to open. Allowing your mouth to open allows for a greater stretch to the muscles of the anterior neck. If you experience any balance problems, stretch the neck in the seated position only.
Ear To Shoulder – With your head centered over your shoulders, drop one ear to the same side shoulder. You should feel the opposite side of your neck stretch. You may increase the stretch by applying pressure to the top of the head with your hand. Repeat on the opposite side.

Chin To Chest – Drop your head forward while tucking your chin in towards your neck. Place one hand on the top of the head and gently apply added pressure if you wish to increase the stretch. This stretch affects the posterior cervical musculature.

Lateral Torso Stretch – While seated, grasp the lateral thigh or armrest of the chair with your opposite side arm and rotate your torso by pulling with the hand. Repeat to the opposite side.

Anterior Torso Stretch – In a seated or standing position with your hands interconnected place them behind your head and neck. Then, squeeze your shoulder blades together and extend your back slightly.

Posterior Torso Stretch – In the seated position with your buttocks on the forward edge of the chair, spread your legs apart and lean your torso forward, between your legs. If your back and hamstring muscles are tight, you will feel them stretch during this movement.

These are just some of the many stretches which can and should be performed frequently.

PROPER LIFTING TECHNIQUES

The Squat Lift – Ideally, objects should be lifted via the squat lift. With the back relatively straight, the knees are bent so that low back stress is minimized. While this does not seem as easy or natural as simply bending forward at the waist it significantly minimizes the lower spinal stress which can lead to numerous injuries including intervertebral disc herniation. Also, keep the feet wide apart when lifting the object and be sure to keep the object as close to your body as possible.

When Bending The Knees Is Difficult – For individuals who cannot fully bend the knees in order to pick up objects some bending of the spine may be necessary. In these cases, be sure the object being lifting is not heavy and most importantly, be sure to keep the object as close to the body as possible. The farther the object is away from the body the greater the stress on the spine.

The Golden Rule of Lifting – As stated above, be sure to keep objects as close to the body as possible during the lifting and carrying of objects.

Repetitive and Heavy Lifting – Even when proper lifting techniques are used repetitive stress injuries to the spine will occur if objects are too heavy or lifting is done continuously to the point that the spinal musculature becomes fatigued.

Never lift heavy objects alone – get assistance or use a dolly. Never lifting continuously to the point that spinal muscles become fatigued. This will dramatically increase the odds of sustaining spinal injury.

POSTURE

Posture plays a significant role in the development of chronic conditions such as chronic back and neck pain. Poor posture is responsible for overstretching ligaments and other supportive spinal structures as well as exhausting spinal musculature, all of which quickly leads to the development of chronic spinal pain.

Learning and practicing proper postural habits will help reduce the likelihood of acquiring back and neck injuries, reduce spinal degeneration, and help keep your spine and body happy and healthy.

Proper posture simply refers to maintaining the body in a position which protects against excessive stresses which cause injury, while requiring a minimal amount of muscular effort to maintain. In other words, a comfortable position which will not irritate your spinal tissues.

PROPER SEATED POSTURE

Prolonged sitting is a frequent cause of back and neck pain. And while extended periods of sitting are best avoided, for many, it’s a fact of life.

When sitting, it’s important to keep the back straight, knees bent, and head centered over the shoulders. Slouching forward may be comfortable and allow the spinal muscles to relax but gradually overstretches spinal ligaments, leading to back and neck pain among other problems. We always encourage patients to maintain a “neutral spine” position at all time is ideal.

Seat Backrest – The proper chair has a backrest which slightly inclines backwards. This has the effect of relaxing the spinal musculature and decreasing spinal discal pressure.

Armrests – Armrests provide support for the arms which helps to reduce the work load and stress on the trapezius and shoulder muscles. The armrest height should allow the forearms to comfortably rest while being low enough to go underneath tables or desks in the work area.

Lumbar Support – Having a lumbar support either built into the chair or inserting a portable lumbar support helps to maintain your natural lower back curve. These small supports are quite handy, effective and relatively inexpensive.

Seat Bottom Angle – The seat angle relative to the floor is more of a personal preference than an exact science, as long as a neutral spine can be maintained in comfort. In general, the more the seat bottom tilts forward the more extension of your lower back will occur to keep you in a neutral position.

Seat Height – The height of the seat should be so that it allows you to sit all the way back in the seat while your feet are still able to reach the floor. If they can’t and you’re stuck with the chair, use a footrest to remedy the problem.

In addition to the suggestions provided above, it’s important to:

  • be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching
  • take mini breaks on a regular basis when in a prolonged position and remember to stretch
  • have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture and keep a lumbar support in your car for “chair crises”

PROPER STANDING POSTURE

Although standing is something we do everyday most of us have never really given “the art of proper standing” a second thought. Many people are actually unaware that their standing habits can contribute to their back and neck problems.

If you’re one of those people, the following “general standing guidelines” should help you out.

General Rules For Standing

  1. Maintain a straight spine rather than slouching to the side avoid slouching forward or hyperextending
  2. Keep the chin up with the head centered over the shoulders keep the feet slightly less than shoulder width apart keep the knees slightly bent wear comfortable shoes and leave the heels at home
  3. Avoid standing still for long periods of time, rather, sit down or move around.

PROPER LYING POSTURE

Approximately 1/3 of our life is spent lying in bed, on the couch, and on the floor. Like other positions, there is a right way and a wrong way to lie. For individuals suffering from pain, modifications may be necessary to obtain a “pain-free” position or a position which does not aggravate the pain.

Lying On Your Stomach

Extended periods of “stomach lying” should be avoided. This is because excessive stress is placed on the joints of the low back and because excessive rotation must take place in the neck. Neck pain, back pain, headaches, dizziness, as well as arm paresthesias are commonly experienced when in this position for an extended period of time. If you must lie in this position to relieve pain or for some other reason, keep one leg bent with the same side arm raised with approximately 90 degrees of flexion at the shoulder and elbow joints.

Lying On Your Back

Most people find lying on their back to be a relatively comfortable position. For individuals suffering from back problems, placing a folded pillow underneath the knees will help reduce tension in the lower back and make this position more tolerable. Some individuals may also find placing a small pillow or towel under their lower back to be helpful. This will help to maintain the natural curve of the lumbar spine.

Lying On Your Side

Lying on your side is a favored position by many individuals. It may also be a comfortable position that provides relief for individuals with back problems. It’s important while in this position to have adequate support for the head and neck. A pillow which fills the gap between the head/neck and the bed should be used to keep the head and neck in line with the rest of the spine. Additionally, placing a pillow between the knees will help reduce lumbar and pelvic torsion. Women with larger hip and small waists will find a small pillow under the waist will prevent lateral bending of the spine while lying on the side.

Choosing A Pillow

Choosing a pillow which supports the cervical spine is extremely important, especially for those with neck or upper back problems as well as those with a history of headaches. There are a number of cervical pillows on the market, however, many of the inexpensive pillows (those under $20) are poorly designed with rigid foam which does not conform to the natural contours of the head and neck. Look for a cervical pillow which will contour to the shape and size of your head and neck while still providing support. Don’t be scared to spend a little extra on a high quality pillow – it’s well worth the money, and besides, it’s something you’ll use everyday.

THE SPINE

Understanding the spine is the key to understanding why chiropractic doctors do what they do and why they obtain extraordinary results with a variety of different conditions.

The spine is a complex structure containing a number of associated muscles, ligaments, joints and nerves which commonly become irritated and injured. 

Extended sitting, repetitive motions, bad postural habits, mental stress, lack of exercise and inadequate nutritional intake are just some of the everyday stresses which accumulate to produce devastating effects on the spinal components.

Doctors of chiropractic are the health care leaders in providing safe, fast and effective relief for most spinal problems.

THE SPINAL COLUMN

The spinal or vertebral column is a collection of 24 vertebrae plus the sacral bone. These bones provide support and mobility for the torso while also protecting the nervous system.

There are 4 distinct and different regions of the spinal column – the cervical, thoracic, lumbar and sacral regions. Each contains a different number of vertebrae which are structurally unique. These structural variations make certain regions of the spinal column more flexible while making other regions more stable and less susceptible to injury.

When viewed from the rear the spine normally appears vertically straight . When viewed from the side, however, 4 separate spinal curvatures should be present. Both the cervical and lumbar regions naturally have a “C” shaped curvature, while the thoracic and sacral regions possess a reversed “C” shaped curvature. The angles of these curves play a crucial role in minimizing spinal biomechanical stresses which lead to spinal pain and greatly accelerated spinal degenerative processes.

The chiropractic doctor is an expert in spinal evaluation and rehabilitation. He or she is trained to identify even the slightest spinal abnormalities. Eliminating pain, inflammation and biomechanical stresses while increasing overall health and quality of life is what chiropractic care is all about.

Doctors of chiropractic are the only health care professionals whose primary training centers around the detection, treatment, and rehabilitation of spinal column disorders.

THE SPINAL VERTEBRAE

The vertebrae are the small bones which the spinal column is comprised of. These individual functioning units are the basis of motion in the torso. They connect to and glide on each other by way of a spinal disc and 2 facet joints. Spinal muscles and ligaments attach to each vertebrae to permit movement.

Located in the rear of each vertebrae is a hollowed out portion called the spinal canal which encases the spinal cord as it descends from the brain, much like beads on a string. At each vertebral level, spinal “nerve roots” peel away from the spinal cord. Small openings formed by adjacent vertebrae provide a pathway for these delicate nerve roots to exit to the rest of the body. These openings are referred to as the intervertebral foramen or IVF and are a common location for nerve irritation.

When a vertebrae becomes misaligned or fixated in relation to neighboring vertebrae, chiropractors call it a vertebral subluxation. In addition to pain, reduced range of motion and muscle spasms, these subluxations may also produce nerve irritation and interference either by mechanical pressure or inflammatory biochemicals.

Doctors of chiropractic are the only health care professionals trained to detect and treat subtle vertebral abnormalities which occur in the spine.

THE INTERVERTEBRAL DISCS

The intervertebral discs are a prevalent source of lower back pain as they are one of the most frequently injured spinal structures. The discs connect adjacent spinal vertebrae together and provide a degree of shock absorption in the torso.

Disc Structure

The structure of the spinal disc resembles a jelly filled doughnut. The inner aspect of the disc contains a gel-like substance called the nucleus pulposus. Surrounding the nucleus are tough fibrocartilagenous fibers called the annulus fibrosis. These annular fibers contain the inner nuclear material similar to a basketball skin containing the air within.

Causes of Disc Injury

Disc injury occurs when the annular fibers of the disc are torn. Because the inner regions of the annulus lack “pain” innervation, injuries contained to the inner annulus occur without one’s knowledge.

Common causes of annular disc tears include:

  • uncorrected spinal misalignments
  • prolonged sitting
  • poor postural habits
  • poor lifting habits
  • improper workstation setup and ergonomics
  • improper lifting techniques
  • extended periods of vibratory forces (truck and auto
  • drivers, jack hammer operators, etc.)

Other factors have been shown to increase the susceptibility of disc injury:

  • inadequate diet and nutrition
  • smoking
  • obesity
  • lack of physical activity
  • Types of Disc Injury

There are 3 main types of disc injuries. The first disc injury consists of annular fiber tears which do not extend to the outer aspects of the disc. Thus, the inner nuclear material is prevented from completely escaping the disc.

The second type of disc injury, commonly referred to as a disc herniation, consists of annular tears which run from the innermost aspects of the annulus (where the nucleus is) to the outermost aspects of the annulus. In this type of injury, the pressurized nuclear material can squeeze through the tears in the annulus and escape to the outside of the disc. When this occurs, the nuclear material may come in contact with nearby spinal nerves and even the spinal cord.

In the third type of disc injury, referred to as a disc bulge, the inner nucleus loses hydration; common in those with prolonged spinal stress and the elderly. This results in “bulging” of the disc much like a tire “bulges” when it contains inadequate amounts of air. Similar to the previous injury, the nearby spinal nerves and spinal cord may become impinged from the bulging disc.

Symptoms of Disc Injury

The symptoms of disc injury depend upon the location of the disc tears and whether or not the spinal nerves or spinal cord are affected.

When tearing of the annulus occurs within it’s inner portion only, generally pain is not experienced. As previously stated, this is because the inner regions of the annulus lack pain receptors. When tearing of the annulus occurs in the outer annular fibers, mild to excruciating pain is felt in a generalized manner. If a lumbar disc is affected, for instance, diffuse low back pain with associated paraspinal muscle spasm is typical.

When numerous partial tears coalesce to form tears which run clear through the thickness of the annulus, the gel-like nucleus is able to escape the disc. If a spinal nerve or the spinal cord is contacted the individual may experience symptoms of pain, numbness, tingling and/or weakness within either or both lower extremities. In rare cases patients may lose the ability to control bowel and bladder functions. If this occurs, immediate medical intervention is required as the condition can become permanent.

Treatment of Disc Injuries

Disc injuries respond favorably to chiropractic care. This is because chiropractic treatments focus on the dysfunctional spinal segments and not just the symptoms of the disc injury. Pain killers, anti-inflammatory and muscle relaxants do nothing to treat the cause of disc injuries and have been shown to induce further injury.

Chiropractic treatments provide fast, effective, safe and long lasting relief from disc injuries. This is because the chiropractor’s approach focuses on restoring spinal alignment, spinal function and overall spinal health, which are the primary factors responsible for the development of disc injuries.

Chiropractic doctors are experts in maintaining proper spinal alignment and function, both of which play a critical role in minimizing spinal stresses – the stresses that are responsible for injury and accelerated degenerative processes in spinal discs.

THE FACET JOINTS

Many spinal experts actually consider the facet joints to be the most common source of spinal pain and discomfort.

Each vertebrae possesses 2 sets of facet joints – one set for articulating to the vertebrae above and one set for the articulation to the vertebrae below. In association with the spinal discs, the facet joints allow for movement between the individual vertebrae of the spine.

The facet joints are under a constant load from the weight of the body and are involved in guiding general motion and preventing extreme motions in the trunk. Repetitive or excessive trunkal motions, especially in rotation or extension, can irritate and injury facet joints or their encasing fibers. Also, abnormal spinal biomechanics – similar to a wheel out of alignment – and bad postural habits can significantly increase spinal stresses and thus greatly accelerate the wear and tear on the facet joints.

Chiropractic doctors identify and treat facet joint abnormalities and stresses along with other spinal abnormalities to keep backs and bodies healthy and free from pain.

THE SPINAL MUSCLES AND LIGAMENTS

Spinal muscles and ligaments attach to the vertebrae, ribs, and pelvis to permit and manage various trunkal motions including – forward and backward bending, side to side bending, and rotation or twisting. When a spinal motion occurs in excess or a muscle is worked beyond its capacity whether suddenly or gradually over time, injury occurs.

Sprains and strains of the muscles or ligaments upset the normal balance of the spine. Spinal structural alignment and biomechanics can be significantly altered. These alterations make the spinal components (discs, facets, vertebrae, nerves, etc.) increasingly prone to injury and degenerative processes.

Doctors of chiropractic rehabilitate spinal muscles and ligaments to prevent spinal imbalances. Proper spinal alignment and spinal biomechanics can only occur with healthy muscles and ligaments.

THE SACROILIAC JOINT

The sacroiliac joint is another spinal component which undergoes very large spinal stresses. Either the ligaments supporting the joints or the actual joint surfaces can be a source of low back pain and even refer pain into the lower extremities.

There are 2 sacroiliac joints formed by the articulation between the sacrum and 2 ilium bones of the pelvis. Like the other spinal structures, the sacroiliac joints can be injured through acute trauma, repetitive movements, and poor posture, to name a few.

Symptoms include lower back pain with the pain occasionally extending down the back of the leg. Additionally, hip pain, knee pain as well as foot and ankle pain may be present due to increased stress in those joints as a result of an alteration of pelvic biomechanics.

Sacroiliac problems are extremely common in pregnancy. During this time, the pelvis experiences many physical stresses due to weight and hormonal factors. Chiropractic care throughout pregnancy is essential in minimizing pelvic and spinal stresses. A study published in the journal Obstetrics and Gynecology found 7 out of 10 women obtained sacroiliac pain relief from chiropractic spinal manipulation.

A simple but surprisingly effective way to identify pelvic misalignments is to check for uneven leg lengths. Lay on a flat surface then have friend or family member compare the bottom of both heels for symmetrical length. If there is any discrepancy between leg lengths you may have a pelvic or lower back misalignment.

Chiropractic adjustments are frequently applied to the ilium and sacrum to successfully normalize and restore sacroiliac joint position and biomechanics.

THE NERVOUS SYSTEM

The nervous system is the master controller of all cells, tissues and organs. Nerves control the heart, lungs, immune system, endocrine system, as well as our thoughts and other cognitive processes. Effectively, the nervous system is in charge of directing and overlooking all bodily functions – keeping us alive and healthy, fighting off diseases and infections, and healing us after we have sustained injury.

Many people are surprised to learn that the spine plays a key role in protecting the nervous system. In fact, the main function of the spinal column (in addition to providing movement for the torso) is to encase and protect the spinal cord and nerve roots. Without this protection it’s unlikely that we would survive a relatively small slip and fall injury.

As the spinal cord descends from the brain, spinal nerve roots peel away from the spinal cord at each vertebral level and exit through openings made by adjacent vertebrae. These small protective pathways are called intervertebral foramen or IVFs and permit safe exit of the delicate nerve roots to the rest of the body. Because of the location of the IVF, herniated or bulging spinal discs, subluxated vertebrae, arthritic bony growths, and inflammatory biochemicals from nearby injured tissues commonly irritate or impinge upon the spinal nerve roots.

When there is irritation and interference to a nerve, messages or impulses traveling along that nerve can get scrambled. Some signals become only slightly altered while others may completely fail to reach their destination. As this process continues, those cells, tissues and organs which depend on the affected nerves for communication become less effective in performing their many important tasks and become less able to maintain their optimal health. Ultimately, the affected tissues can deteriorate, degenerate and become nonfunctional and diseased.

This model of disease helps explain why so many patients under chiropractic care have noted dramatic improvements with many seemingly “non-spinal” conditions such as dizziness, ulcers, ear infections, asthma, menstrual pains and low energy levels, to name a few. While its not prudent to claim chiropractic treatments may eliminate or treat such conditions, many patients have experienced phenomenal relief.

Chiropractors are the only doctors trained to detect and treat vertebral misalignments and fixations as well as many other common spinal abnormalities which cause nerve irritation and interference. Correcting nerve irritation and interference allows the body to function the way it was meant to.

Locations

BOCA RATON:
307 Via de Palmas. Boca Raton, FL, 33432

DELRAY:
16244 S. Military Trail Ste #460 Delray Beach, FL, 33484

LAUDERHILL:
7501 W.Oakland Park Blvd, Ste #101, Lauderhill, FL 33319

HOLLYWOOD:
4343 S. SR 7 Ste #108 Ft Lauderdale, FL, 33314

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Royal Palm Chiropractic & Wellness
P. 561.750.5495 | E. info@royalchirowellness.com

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