Category Archives: Neck Pain

Radiating arm or leg pain? Perseverance pays off

Pinched nerve Beaverton | Chiropractic treatment for sciaticaIf you have had neck and arm pain (cervical radiculopathy) or low back and leg pain (sciatica), you know that it can be debilitating. I see patients with these conditions often and here are some observations I’ve had over the years when treating them.

-It’s not as simple as a vertebra being out of place and causing a pinched nerve. The nerves in your arms and legs originate from the spinal cord at the level of your neck and your lower back, or lumbar spine. Those nerves exit the spinal column through gaps between each vertebrae, and that is where they can become pinched by either bulging discs or bone spurs. Disc bulges and bone spurs are much more complicated problems than a theoretical bone slipping out of place and pinching a nerve. In that scenario, the bone could be put back into place to take pressure off of the nerve and the pain would resolve quite rapidly. Don’t get me wrong, we do get some people better quite quickly. In the case of cervical radiculopathy or sciatica, though, it isn’t often that simple. Some people give up on treatment too soon because they want it to be that simple.

-Even though it is not just a bone out of place, a chiropractor can still help. Adjustments do more than just move bones. Adjustments can decrease the pressure inside the discs, which are soft and squishy and made mostly of water. Chiropractic adjustments can also relieve pressure on the pinched nerve by temporarily opening up the space where it passes between the vertebrae. Perhaps most importantly, adjustments affect the communication of pain signals from your arm or leg to your brain. In essence, getting adjusted can turn the volume down on the pain signal. Adjustments are just one tool in a chiropractor’s tool box. While they might not cure sciatica or radiating arm pain alone, they can help make the rest of your rehab more effective.

-If you end up needing surgery, doing it later rather than sooner shouldn’t affect your outcome. I’ve had patients give up after not seeing results after 1 or 2 treatments, only to consult with a surgeon and move forward with surgery. If the pain is caused by a bulging disc, and it is bearable and you aren’t progressively losing function in your arms or legs, it is safe to wait for surgery while you give conservative care a real chance at helping you. This study shows that even 1 and 2 years after the onset of symptoms, patients have a relatively equal chance of good surgical outcomes as those undergoing early surgical intervention. So when I recommend a trial of care lasting 4 weeks with 2 visits/week, I’m not doing it to pad my pocket book. In my experience, that is giving conservative treatment a fair chance before considering more invasive options. It’s enough time and enough visits to make a change, but not too much time that it could affect your surgical outcome if it comes to that.

If you or a loved one are suffering from cervical radiculopathy or sciatica, give conservative treatment a chance before doing anything more invasive. Contact us with any questions or to schedule a visit. (503) 526-8782

Why sneezes cause back pain

I remember several years ago I was watching Sports Center and the anchor reported that Sammy Sosa was not going to play that day due to back pain caused by a sneeze. It was reported in a way that made light of the subject, and I even got a good chuckle out of it. You may have laughed as well if this had never happened to you, but whether they make the headlines or not, sneezes often result in back or neck pain. As a chiropractor, I see this frequently and my patients are often embarrassed when they tell me how it happened. I believe sneezing is risky for two reasons:

1. When you sneeze you often turn your head in order to aim it away from people near you and to cover it with your arm or hand. Sneezing causes a very violent contraction of the diaphragm and many of the muscles that support the neck and spine. When creating such a violent contraction with your neck twisted, it is easy to see how a muscle could be pulled or even a joint in the spine sprained as the tissues are put under such intense stress.

2. Sneezing causes a rapid rise in intra-abdominal pressure. The pressure builds as all the air taken in during the “ahh” part of the sneeze gets restricted momentarily before the “choo” part. Raising intra-abdominal pressure also causes an increase in intra-thecal pressure, or the pressure inside the spinal canal, as well as the pressure inside the intervertebral discs, the soft cushions between each of your vertebrae. A sudden spike in pressure in these areas can cause a disc injury and/or a pinched nerve sensation in the back or neck.

One way to avoid injury when sneezing is to reduce the stress on your spine by slightly extending your neck and your lower back. As I discuss in the video below, we tend to bend forward when we cough or sneeze. Bending forward can place more pressure on the spine even when not sneezing, so it is best to avoid that position then next time you feel a tickle in your nose. See the video for more details. Until next time, take care and sneeze safely 🙂

-Dr. Thompson

 

Where does whiplash pain come from?

sore neck?

When the cervical spine (neck) is subject to whiplash, there is usually a combination of factors that contribute to whiplash pain in the neck and back, and ultimately need to be addressed individually by a chiropractor, who maintains a “holistic” view of the patient’s whiplash pain. This article explains how chiropractors approach treating neck pain, back pain, and/or other whiplash symptoms, and help patients prevent chronic whiplash pain.

Whiplash Pain Management for Joint Dysfunction

Joint dysfunction from whiplash occurs when one of the joints in the spine or limbs loses its normal joint play (resiliency and shock absorption). A chiropractic technique called motion palpation gently moves the joint in different directions and assesses its joint play. When a joint develops dysfunction, its normal range of movement may be affected and it can become painful.

Muscle Dysfunction from Whiplash Injuries

When joint dysfunction develops, muscles are affected by becoming tense and overactive or inhibited and underactive. In either case, these muscles can develop trigger points that may necessitate whiplash treatment involving muscle relaxation or stimulation. Trigger points are areas of congestion within the muscle where toxins accumulate and can irritate the nerve endings within the muscle and produce pain. This whiplash pain can occur in the muscle itself or can be referred pain (perceived in other areas of the body). The muscle can also send abnormal neurological signals into the nervous system, which can then cause disruption of the ability of the nervous system to properly regulate muscles in other parts of the body, leading to the development of faulty movement patterns.

Faulty Movement Patterns and Whiplash Pain

It is thought that the intense barrage of pain signals from a traumatic whiplash injury to the cervical spine can change the way the nervous system controls the coordinated function of muscles. The disruption of coordinated, stable movement is known as faulty movement patterns which cause increased strain in the muscles and joints, leading to neck pain and back pain. They can involve the neck itself or can arise from dysfunction in other areas of the body such as the foot or pelvis. Instability is also considered part of faulty movement patterns. There are two types of instability that can occur in whiplash: Passive—the ligaments of the neck are loosened, making it more susceptible to whiplash pain; and Dynamic—the nervous system disruption causes a disturbance in the body’s natural muscular response to common, everyday forces. Instability can cause even mild, innocuous activities difficult to perform as they often exacerbate the whiplash pain.

Whiplash Pain from a Herniated Disc

The force of whiplash can cause injury to the discs between the vertebrae, and small tears can develop. If the gelatinous middle of the disc seeps out, it can irritate the nerve endings in this area. This is known as disc derangement. Occasionally, the gel can seep all the way out and press on a nerve root exiting the spinal cord behind the disc, known as disc herniation. A herniated disc may involve whiplash pain in the neck as well as sharp, shooting pain down the arm and possibly neurological symptoms such as numbness, tingling and muscle weakness.

Chiropractic Treatments for Whiplash

Each case of whiplash is different so it’s not possible to generalize about the chiropractic whiplash treatment. Chiropractors commonly employ different chiropractic treatments for whiplash, often including:

  • Manipulation
  • Muscle relaxation and/or stimulation
  • Various exercises
  • Ergonomic and lifestyle changes.
Preventing Chronic Pain from Whiplash

After sustaining whiplash injuries, it is fairly common for people to suffer from chronic neck pain. Chiropractors can detect certain factors in a patient’s history and chiropractic exam to better determine patients who may be more susceptible to chronic pain from a whiplash injury. This process will identify when aggressive preventative measures should be taken for patients who may be at a greater risk of developing chronic neck pain from whiplash injuries.

Research update: Which neck pain treatments work?

Which chiropractic treatment works best for neck pain

Research shows chiropractic care relieves both chronic and acute neck pain

Manipulation, or chiropractic adjustments, of the neck are a polarizing topic. There are some in the medical profession who denounce it as unnecessary and unsafe. On the other hand are the millions of chiropractic, osteopathic, and physical therapy patients who have benefitted greatly from cervical spine (neck) adjustments. The good thing is that as the chiropractic profession advances, more and more research is coming out to give scientific backing to the millions of personal anecdotes of successful treatment of neck pain with chiropractic care. There is already a plethora of evidence regarding the safety of chiropractic adjustments to dispute the claim that it is unsafe. Thankfully there is also mounting evidence, such as the study above, to prove that it actually works. The great thing about this paper is that it is a systematic review. In the hierarchy of scientific evidence, the systematic review is the top dog. What I find significant are two things in particular:

  1. It found a moderate-strong recommendation through a search of 41 high quality random trials that both chronic and acute neck pain respond well to chiropractic adjustments. This is significant because it has long been believed (I don’t know why) that only acute neck and back pain respond well to manipulation. This search found that chronic neck pain may even be more likely to improve with treatment.
  2. It’s not all about the adjustment. It lists other common treatments of neck pain, which can all be performed our chiropractor in Beaverton, Oregon! Even more awesome is that it lists which ones have shown good evidence of effectiveness and which have not. Many of you may recognize these therapies and have received them on multiple occasions, and it may surprise you that some of them are not effective! You’ll be happy to know that those therapies found in the “Weak Recommendation” or “No recommendation” are not therapies that we use much at Catalyst Chiropractic and Rehabilitation. The ones we use the most, and excel at, are those in the moderate-strong recommendation categories. They are not flashy, fancy, gimmicks, but they are tried and true methods that will get you out of pain and keep you feeling better for the long term.

Please contact us if you have questions about how we can help you find relief from your acute or chronic neck pain. 503-526-8782

How to Support Your Back Every Day

Bad posture

When you’re living with chronic back or neck pain, your daily routine can get complex – appointments, insurance paperwork, time off work, treatment regimens to follow, etc. While these are important aspects of managing your pain and recovery process, there are simple things you can do (or stop doing) on a daily basis to help your condition.

Good posture and body mechanics (the way you perform your activities all day, everyday) can substantially improve the way you feel at the end of your day.

Support your spine while sitting at your desk or in your car

Sitting for prolonged periods of time can be a major cause of back pain. Sitting is a static posture, which can add a tremendous amount of pressure to the back muscles and spinal discs. Additionally, sitting in a slouched-over or slouched-down position can overstretch the spinal ligaments and increase the pressure on your spinal discs.

Sitting with your back relatively straight and with good support is essential to minimize the load (strain) on your back. Especially when you sit for prolonged periods of time, you need to provide your lower back with support for the inward curve of the lumbar spine (lordosis). Here are a few tips for good posture and support for your lower spine while sitting at a desk or while driving:

  • Make sure your chair is set up so your knees are bent at about a 90 degree angle. Two fingers should slip easily between the bottom of your thigh and the chair.
  • The backrest of your chair should push your lower back forward slightly. Place a small pillow, rolled up towel, or orthopedic support on your chair to accomplish this or get a new office chair that provides support if you can.
  • Your buttocks should be pressed against the back of the chair, and your back should be straight.
  • It’s a good idea to have arm rests on your office chair that place your elbows at a 90-degree angle.
  • Place some support under your feet to elevate them slightly and take some of the load off of your lower spine. Sit with your knees slightly higher than your hips to eliminate much of the pressure on your lumbar spine.
  • Don’t sit on anything that would throw your spine out of alignment (i.e., a wallet in your back pocket).
  • Don’t slouch or slump in your office or car seat; this puts extra pressure on your spine and stress on the lumbar discs. Use the back of the chair to provide support for your back.
  • Sit up straight and keep your chin pulled in (avoid keeping your chin and head thrust forward).
  • Sit as close to your desk as possible.
  • Your computer screen or reading materials should be at eye level.

Some people prefer furniture that promotes more muscle activity, such as a Swedish kneeling chair, standing desk, or a Swiss exercise ball, rather than a chair that provides complete support. Purchasing a good ergonomic office chair that provides optimal back support may also be helpful.

On the phone a lot?  Consider investing in a headset to take the strain off your neck, or try using the speakerphone. Avoid cradling the phone on your shoulder.

If you are in a great deal of pain, try to avoid driving. If possible, have someone else drive, and lie down in the back seat with your knees slightly bent. You can place a blanket or pillow under your knees to support them, as well as a small pillow under your head.

Move about during the day

A healthy body can only tolerate staying in one position for relatively short periods of time. You may have noticed this on an airplane, at your desk, or at a movie theater when sitting is uncomfortable after just a short time. Even with correct posture, holding the same position slowly takes the elasticity out of the tissues, and stress builds up and causes discomfort.

Keep your joints, ligaments, muscles, and tendons loose by moving about and stretching on a regular basis throughout the day:

  • Stand up while talking on the phone. Be sure to stand with one foot slightly in front of the other, or place one foot on something a few inches off the ground; avoid standing straight with your knees locked.
  • Stretch your hamstrings twice each day. To help you remember to do this on a regular basis, link the stretching to a part of your daily routine, such as when you brush your teeth in the morning and evening, or when you first get to work and before you head home. Flexible hamstrings will significantly reduce the stress on your lower back.
  • When you return to your seat after moving around, use an alternate posture for just a few moments and some of the tissue elasticity needed to protect your joints will return.

Paying attention to your posture and movement throughout the day and while sleeping at night will help you manage your pain and maintain good spine health.

Learn more about supporting your back, both day and night. Visit http://www.spine-health.com/blog/new-health-epidemic-sitting-disease

For a personal chiropractic consultation to review your ergonomics and learn about solutions for your back pain, contact us at (503) 526-8782

 

 

A solution for chronic neck pain

Research brief June 2014

Many of our patients come in with pain that they have dealt with for years. Some have had treatment by other healthcare providers, even other chiropractors, that has not resolved their pain and have just gotten used to living with it. Others have written it off as a sign of aging and have just gotten used to it. At some point they throw in the towel or a friend/family member twists their arm enough and they decide to come in to our office for chiropractic care. After years of living with their neck pain or other ailment, they begin to feel better and will commonly tell us “I don’t know why I waited so long to get help for this.”

Ideally, people wouldn’t wait so long to get help. They would call their chiropractor at the first sign of pain. Or better yet, they would routinely visit their chiropractor to maintain optimal function of their spine and prevent back and neck pain. Unfortunately this isn’t always the case, and it is unfortunate because chronic pain can often take longer to resolve than an acute episode of pain. In other words, the longer you have been suffering the more difficult it can be to heal.

Chiropractic research has come a long way in the recent past. It is becoming more mainstream as it gains more and more evidence to support its efficacy and as more people open their minds to other options besides traditional medical care for their spine. This article is valuable because it shows good evidence that chiropractic adjustments can cause significant improvement in chronic neck pain. Much of the research that supports chiropractic care shows that it is effective for acute pain, or pain that began within the past month or so. Evidence for the value of chiropractic care for chronic, or long term pain, has been lacking. In my experience and that of thousands of other chiropractors, though, it seems as though the evidence has not quite caught up to reality. As a case in point, we recently saw a patient in their 20’s who complained of pain from the neck to the low back occurring daily for the last 6-7 years. After three weeks of care this patient reported 85% improvement and was no longer feeling pain on a daily basis. This is not representative of every patient we see, but it does show that chiropractic care may be a great option for you if you are in chronic pain.

 

Can you see pain on MRI or x-rays?

research brief MRI index

 

Historically, studies have shown a poor correlation of MRI findings to subjective reports of pain. In other words, an MRI may find that a disc in your lumbar spine is bulging, but that disc may or may not be the actual cause of your pain. It seems counter intuitive, but in studies that have examined populations of people without symptoms, a significant percentage of them had positive MRI findings (bulging or degenerated discs, arthritis, etc).  Despite this evidence, diagnostic imaging has been overused, leading to unnecessary invasive procedures on conditions that were found on MRI but weren’t necessarily the cause of the patients’ pain.

This is why chiropractic care is such an important component of the health care system. Chiropractors encounter patients with bulging discs and degenerative disease on a daily basis, and the standard of care is to proceed with treatment, as long as there are no serious contraindications. Advanced imaging is obtained only if there is no significant progress with a series of treatments. Often, we’ll see patients in our Beaverton chiropractic office who come in with radiating arm pain or sciatica. From a thorough examination we can often tell if there is a bulging disc compressing a nerve, and at which level of the spine. Do we order an MRI right away? No. We proceed cautiously with care with the assumption that if it doesn’t improve by 50% or so within 4 weeks, then we’ll get an MRI. Guess what happens most of the time, though. The patient gets better before we ever need to order an MRI.

It appears that, as the above research brief displays, technology is advancing and radiologists are developing methods to more accurately assess spinal disorders for the likelihood that they are the direct cause of pain. My thoughts? This is good news, but even with more accurate radiology assessments, a thorough and accurate physical exam and diagnosis is the first and most important step in forming a treatment plan. In the case of neck and back pain, imaging should be used to confirm that diagnosis in the event that conservative treatment fails and thus guide decision making for more invasive procedures.

Spine Hacks: How to beat “Text Neck”

Chances are, you are reading this blog from either your phone or your tablet. If not then likely your laptop. Stop for a second and think about where your device is in relation to your eye level. You are looking down, aren’t you? Now think about how often you use these devices and you will realize that you spend a considerable amount of time with your head down and neck flexed forward. Do you ever feel muscle tension in your upper shoulders or pain in your neck? Do you get tension headaches? This one piece of advice will go a long way toward helping with those problems: Bring your screen up to eye level. Gravity is hard enough to fight in good posture. Don’t make it harder than it should be.

My chiropractic story

Beaverton Chiropractor
Beaverton Chiropractor, Dr. Kip Thompson

I would venture to say that there are very few children out there who dream of becoming a chiropractor someday, and the ones who do are most likely children or grandchildren of chiropractors. I’ll be the first one to admit I didn’t even know what a chiropractor was until long after I realized my dream of becoming a pro baseball player was just a dream. If you talk to any number of chiropractors you’ll soon realize that most have their own chiropractic story – a turning point where their life was so profoundly affected by chiropractic care that they decided that’s what they wanted to be. So, without further ado, here is my chiropractic story. Please feel free to share yours as well.

Once I gave up on the pro baseball dream (I went as far as playing on the JV squad in high school), if you asked me what I wanted to do with my life I probably would give you a blank stare. It wasn’t until I was 3/4 of the way to a Bachelor’s degree in Neuroscience that I decided on a career. I spent four and half years in undergrad with future medical doctors, dentists, and neuroscientists. For three of those years all I knew about my future career was that it wasn’t going to be one of those. I was not interested in practicing medicine or working on lab rats for the rest of my life. All I knew was that I wanted to make people feel better.

One day I was eating lunch in the quad and perusing the school newspaper. There was an ad for a student discount at the local chiropractic office. Throughout my adolescence and into college, I suffered from frequent tension headaches and occasional bouts of sciatic pain after sitting too long in class or on a car ride. These were both conditions that the chiropractor in the ad said he could treat, so I thought I would give it a shot. I went into my first treatment somewhat skeptical, but also hoping something amazing would happen. I went through an exam that involved him checking my range of motion, poking and prodding in certain parts of my neck and back, and taking some x-rays of my neck. He mentioned that my neck was not aligned particularly well and I likely had been in an auto accident previously (4 to be exact). I then lay down on the treatment table and he went to work.

Starting with my low back, he used a combination of quick thrusts with his hands and some moving parts of his table to make the adjustments he needed. Then he turned me onto my back and with one flick of the wrist, he delivered a neck adjustment that rocked my world. I was speechless. All I could do was smile. I had no idea that so many joints could pop all at the same time. I left the clinic, still smiling, almost in shock because I had never felt anything like that before.  For the next day, to be honest, I felt sore. I questioned whether or not the adjustments had worked because they just seemed to amplify the pain I had gone in with. At the doctor’s advice, I stuck with it through the prescribed treatment plan, which was something like once or twice a week for a month or two. I never got the miracle cure adjustment I had hoped for, but after about a month into the process, I started to realize it had been a while since my last headache. The sciatic pain I occasionally felt after long hours of studying in the library had also not bothered me recently. It was working! It was not a one hit wonder as I had hoped, but a process in which small, incremental changes over time helped my joints and muscles to function more optimally. As a result I felt better, and subsequently decided I wanted to be a chiropractor so that I could make others feel better.

Now, several years into this profession that I now love and am passionate about, I continue to receive regular adjustments to keep my headaches and sciatic pain at bay, and get to see this same process repeat itself in my clients. Nagging problems like neck pain, back pain, and headaches that have persisted for years slowly fade away as we apply the catalyst of chiropractic adjustments and specific corrective exercises to set the body back on the right path. It’s a beautiful thing.

Now let’s hear your story!
In health,
Dr. T