Sciatica The sciatic nerves are the largest nerves in the body--about as big around as your finger. They start in the lower spine, pass behind the hip joint, and go down the buttock and back of the leg to the foot. Pain from this nerve, called sciatica, may be felt from the hip to the big toe. What causes sciatica? Sometimes the nerve is pinched between vertebrae, or its passageways are narrowed by arthritis or swelling of a sprained ligament in the area, and it becomes irritated and tender. A disk (the cushion between the vertebrae) may bulge out of place and press on the nerve. Rarely, an abscess, blood clot, or growth may push on the nerve. At imes, no exact cause is found, but a movement that is normally harmless (such as bending over) suddenly brings on violent pain. Is sciatica different from back pain? Yes, although low back pain often comes with it. Usually, sciatica affects only one side. Pain often radiates down the buttock or leg. It can range from a tingling, burning, pins-and-needles feeling to excruciating, shooting pain that makes standing up nearly impossible. Coughing, sneezing, and sitting make the pain worse. Your leg or foot may be numb or weak and have odd sensations in it. You may be unable to move your foot or bend your knee. What can I do for sciatica? The first thing you should do if experiencing these symptoms is seek chiropractic care. Unfortunately, sciatica tends to recur. You may be prone to it if this or other back problems are common among your relatives. If so, you should take special care to avoid injuring your back.   Tips on avoiding sciatica Lift with your back straight, bringing yourself up with your hips and legs and holding the object close to your chest. This goes for anything, no matter how light. Strengthen back and abdomen muscles that support your spine with swimming, walking, or exercises recommended by a physical therapist. Use good posture to relieve pressure on your lower back. Avoid sitting for long periods. Consider occupational therapy or job retraining if your work requires lots of heavy lifting or prolonged sitting (such as long-distance trucking).  This information is not a substitute for medical treatment. Back to top

BACK PAIN

About 57% of American women and about 53% of men will suffer at least one bad backache this year.

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SCOLIOSIS

1. PRIMARY (idiopathic) - the cause is not known and it is most frequently found in young females

    

2. SECONDARY (compensatory) - the result of a readily identifiable cause such as poor posture, subluxation, different leg lengths, injury or disease.

How To Detect It

If your child has not had a chiropractor examine their spine, it would be wise to arrange that by the time they reach age 12. This would include a detailed physical examination, and if warranted, x-rays. In the meantime here are several things to look for.

• while standing behind your child, check the level of the ears, shoulders and hips. Each pair should be approximately equal.
• have the child bend forward. The spine should be straight as they bend, not veer to either side and both sides of the rib cage should be at approximately the same level.

Pay attention to any symptoms your child reports such as "growing pains", fatigue, or back or leg pain. Scoliosis may not cause any symptoms so a thorough chiropractic examination may be required.

What Can Be Done?

Chiropractic care maintains the mobility of the joints of the spine and allows the spine to develop normally. Proper treatment can prevent progression of the curve and may help reduce it. With scoliosis particularly, an ounce of prevention is worth a pound of cure.

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Chiropractic Treatment for Headaches

One third of Americans suffer from tension headaches. These headaches can be felt on both sides of the head as a dull, steady pain that often becomes intense at the end of the day. Unfortunately, traditional medicine has little to offer chronic headache sufferers. Pain medicine and muscle relaxants will ease the pain. Stress reduction, relaxation and exercise can improve wellness and perhaps prevent the occurrence of the headache.

A recent study has suggested, however, that chiropractic treatments can decrease the frequency and length of headaches as well as the number of painkillers needed for relief. Dr. Niels Nilsson of Odense University in Odense, Denmark, and Dr. Geoffrey Bove of Beth Israel Deaconess Medical Center and Harvard Medical School, have studied the impact of chiropractic treatment on headaches. They have found that chiropractic treatment can work, but accurate diagnosis of the headache is key to efficacy.

The diagnosis of tension headaches relies on very general symptoms. Unfortunately, these symptoms can mask a headache of a different nature: cervicogenic headaches. Dr. Nilsson estimates that 15-20 percent of all recurrent headaches are cervicogenic.

Cervicogenic headaches are characterized by pain on one side of the head with associated neck pain on the same side. A patient with these headaches perceives pain in the head, but the actual source of the pain lies in the cervical spine.

This distinction is important, because cervicogenic headaches improve upon chiropractic spinal manipulation. Dr. Nilsson says, "My 1997 study showed that a group of cervicogenic headache patients who received spinal manipulation and soft tissue therapy did significantly better than a similar group which received only soft tissue therapy. Spinal manipulation in itself has a significant effect on cervicogenic headaches."

The most recent study indicates that, in contrast to cervicogenic headaches that respond specifically to spinal manipulation, tension headaches respond to chiropractic intervention regardless of whether or not spinal manipulation was performed. Dr. Bove says, "This study shows that tension-type headaches do respond to hands-on therapy, but that cervical spinal manipulation is unlikely to be the factor that affects change."

Dr. Norman Harden, director of the Center for Pain Studies at the Rehabilitation Institute of Chicago, believes the study was well designed. "All in all a very good study, considering the impossibility of blinding a chiropractic procedure. This study, a very vast amount of anecdotal and empiric evidence and now some legitimate studies such as this support the use of chiropractic treatment for tension-type headaches," he says.

Most chiropractic patients have yet to realize the contribution chiropractic intervention can make to headache improvements. Only about two percent of patients visit a chiropractor for headache relief.

Mary Crane is an example of the typical patient who turned to chiropractic treatment for her sore back. She was pleased to discover that the treatment could also eradicate her headaches. "I began to see a chiropractor for my back problems," she says. "During the treatment for back pain, I brought up the issue of my daily tension headaches. She recommended lifestyle changes and performed spinal manipulations. I haven't had any notable headaches now for five to 10 years."

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Spinal Discs are blamed for many painful conditions and have a reputation for bringing little else but trouble. Yet, were it not for these vital intervertebral "pads," we could not move about with the ease and flexibility that we do. Discs are cushions. There is one between each two vertebrae (bones) of the spinal column. They are the spine's shock absorbers, and when they are healthy they do a magnificent job. Discs have few nerves; they of themselves cannot be painful. It is only when they bulge or "slip" due to weakness or wedging, along with misalignment of the vertebrae above and below them, that they press upon the spinal cord or nerves, thus producing pain. A side view of a normal spine shows that it is not as straight as perhaps generally supposed. There are curves which give the spine additional shock absorbing properties. A jolt or bump to any part of the body is diffused to the spine and it is principally the discs which absorb the impact, even in such everyday jolts as those created by walking.

Since a vertebra cannot become misaligned without involving one or more discs to some degree, it is easy to see why these innocent discs get blamed for causing trouble more often than they deserve. Nature placed these cushioning discs between the spinal segments for a most special and serviceable purpose. They act as hinges between the vertebrae and it is their elasticity which gives the spine whatever mobility it has. BACK PAIN Any kind of persistent back or neck pain indicates a serious health problem. Like your teeth or almost any other part of your body, your vertebrae and spinal discs may be in trouble long before you experience pain or discomfort. A normal, healthy spine can withstand a tremendous amount of stress and strain without breaking down and without pain. But when a severe pain follows a slight accident or incident of stress or strain, you may be sure your spine was already weak and in trouble, perhaps for months or even years before the pain was felt. Yet even a healthy spine can succumb to unusual stress, accidents, or jolts; the damage to the spine, as well as to surrounding muscles and joints, can produce spinal misalignments, disc problems, back pain, and continuing back disorders. SLIPPED DISCS The term "slipped disc" is really a misnomer. Discs are firmly attached to the vertebrae above and below and, as such, cannot "slip". They can, however, become wedged or "bulged" due to misalignment of one or both of their neighboring vertebrae. This condition is often termed a "slipped disc". A common cause of such wedging-and one which can cause indescribable pain-is a sudden injury to the spine from a fall, an auto accident, whiplash, strain from lifting, a blow to the neck or back area, etc. The effects of disc injuries may be very extensive and painfully distressing. There may be limited motion with severe symptoms, or even organic dysfunction resulting from pressure* on the nerves that pass between the vertebrae and are adjacent to the disc, thus altering nerve supply to organs and parts of the body located away from the spine itself. *The word "pressure" is used for clearer understanding. The scientific term is "irritation" RUPTURED DISCS True herniation - or rupturing - of a disc is quite rare. More often than not, back conditions thought to be ruptured discs are really the result of a bulging disc due, primarily, to a spinal misalignment (called "subluxation"). When such a misalignment is corrected by chiropractic methods, the disc can return to its original, natural position and resume its normal function, thus relieving the nerve pressure and accompanying pain. However, in severe cases a disc can actually rupture. Such conditions are always extremely painful and are generally caused by one of the following: (1) Tremendous traumatic force, such as a fall from a high level or perhaps an auto accident, (2) Pathological weakness of the disc resulting from prolonged altered nerve supply to surrounding supporting areas, which may have been caused by a vertebral subluxation, and (3) Pathological weakness coupled with trauma. When pathological weakness is present, complete recovery is not possible until the disc can regain its natural and normal toughness. Such pathological weakness is usually preventable or correctable through proper chiropractic care of the vertebrae and discs. DIAGNOSIS Diagnosis is essentially naming the condition. Medical treatment is primarily dependent upon knowing the name of the condition, then administering drugs or perhaps performing surgery to alleviate the symptoms. However, many medical theories about back pain are not supported by scientific proof. The concept of this common problem of back-or disc-injury often is restricted in scope and unsound in theory. The average medical doctor does not have the specialized knowledge, training, and skill needed to properly analyze and treat back problems as effectively as a Dr. Greenberg can, though he may be thoroughly trained and qualified in other specialties. And surgical statistics factually report that up to 90% of all back operations fail to bring complete relief. Powerful drugs may relieve back pain, but they often cause other conditions to develop, and are dangerously deceptive. Pain-killing medication masks useful diagnostic symptoms and hides the signs of destructive processes which may continue unabated. Such drugs interfere with the body's natural recuperative processes and can cause harmful delay in proper chiropractic treatment to correct the underlying causes: usually misalignments of spinal vertebrae and discs, rather than a true ruptured disc. CHIROPRACTIC ANALYSIS AND CARE Dr. Wilkerson  is a specialist in the area of spinal and disc conditions and related bone and nerve problems. 8 years of nerve-muscle-skeletal specialization and additional experience of obtaining results in all types of back problems enable the Dr. Wilkerson to analyze each patient's unique disc problems with an expertise found only through this chiropractic training. Your disc problem may be unique, but your symptoms will be similar to thousands of others because the general symptoms of most back disorders are similar. A simple label of "slipped disc" or "pinched nerve" is useless as a diagnosis unless the correct spinal and disc adjustments are given to solve the problem. Dr. Wilkerson diagnosis and analysis is designed to locate the real cause of your back problem. Dr. Wilkerson has the special knowledge, training, and skill to correctly find and eliminate the cause of back pain in probably 80% of disc conditions. Chiropractic is based on the sound and tested principle that "the nervous system controls and coordinates all organs and structures of the human body" (Gray's Anatomy, 29th Ed., page 4). This theory and practice is thereby corrected in the only way that really counts: chiropractic corrects the causes of "bad backs" and stops pain! PROTECT THOSE PRECIOUS DISCS While medical diagnosis uses "slipped disc" as a cover name for most back problems, including those few true ruptured discs, a false impression is given that most all back problems are due to disc problems. This simply is not true and statistics and results prove it. The fact is that most back problems, including disc involvement, can be corrected through specific application of chiropractic spinal adjustment. Most medical treatment for this fairly common back problem consists of powerful and therefore dangerous pain-killing drugs, prolonged and repeated uncomfortable bouts of traction, generally while the patient is hospitalized, or disc surgery, usually involving the removal of the accused disc(s) and fusion of the involved vertebrae, thus rendering the patient permanently inflexible in that area of his spine. Even though these procedures may on rare occasions be necessary, absolutely no one should submit to this possibly paralyzing operation without first giving Dr. Wilkerson a very thorough opportunity to help! If you suspect, or have been told, that you have a disc condition, try Dr. Wilkerson  first, drugs second, and then surgery only as a last resort. Tens of thousands of disc-problem patients have avoided drugs and surgery by first getting chiropractic treatments. You may very well be another! Back to top

Spinal Stenosis is a narrowing of the central spinal canal or the areas of the  spine where the nerve roots exit (neuro foramina). This narrowing is most often caused by arthritis and therefore is most often found in the older age groups. Spinal stenosis may be caused by other factors such as injuries, infections, tumors or congenital abnormalities.
When the spinal canal or the foramen are narrowed there may or may not be any symptoms. If the narrowing becomes severe enough to put pressure on the sac around the spinal nerves (the cal sac) or the peripheral nerve roots, patients may develop low back pain, buttocks pain, leg pain (usually above the knee) and/or numbness in the above areas. It is common for patients with the spinal stenosis to develop pain in the buttocks or legs while walking. Patients with severe stenosis often are limited to less than one city block before they must stop. Often patients with spinal stenosis feel relief when bending forward.

The jaw joint or TMJ is a common area of injury with whiplash.  The most common symptoms include popping or cracking in the joint that wasn't there before the car accident, pain in the jaw with chewing, and headaches.

Most people have simple sprains of the ligaments in the joint.  A lot of people have problems with the joint because of problems with posture.  A forward head posture after whiplash is common because of straightening of the neck.  When this happens, the muscles of the jaw that were designed for chewing, start trying to hold the head up!  As you might imagine, this hurts! 

Another common syndrome related to TMJ is weakness in the longus colli.  These muscles help stabilize the neck on a segment by segment basis and are frequently injured in a whiplash injury.  When they're weak, they cause the strap muscles and SCM in front of the neck to overwork and pull on the TMJ joint.

A very small number of patients have injuries to the disc inside the joint. When this occurs, it usually means longer term problems.

Treatment can include: a splint made by a dentist, pain meds, physical therapy focused on the jaw and upper part of the neck, chiropractic, acupuncture, trigger point injections, and posture exercises.  The vast minority of patients require surgery.  Get a second opinion before proceeding with TMJ surgery as the results can be everything from great to disastrous.

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Carpal Tunnel

What the Patient Feels
Carpal tunnel syndrome is the most common cause of numbness, tingling and pain in the hand. Typically, they occur in the thumb, index and long fingers. They occur off and on in the beginning but as time passes, they become constant. The symptoms are aggravated at night as the wrist tends to assume bent position in sleep. Keeping the wrist in a straight position with a splint or a brace relieves the symptoms. Very often, but not always, the pain radiates to the elbow, shoulder or the neck. The pain may be sharp, dull, burning, hot or cold. Often the patient says that the hand and fingers feel swollen, tight, like sand paper or like feeling the finger through gloves.

As the patient starts to lose sensation, things start falling out of the hand.

THE HAND IS NOW IN TROUBLE!

What the Doctor Does
The diagnosis is established in most cases with a simple examination of the hand. Making a tight fist for one minute reproduces numbness, tingling or pain. Bending the wrist fully for one minute also reproduces the above symptoms. Finally manual pressure on the nerve at the wrist crease reproduces the symptoms.

Numbness and tingling can be caused by pressure on the nerve along the nerve from the neck to the finger tips. The pressure is usually caused by a tight band of tissue called a ligament. The location of nerve pinching can be confirmed with an office test called nerve conduction test. It measures the speed at which the electricity flows in the nerve. It takes about ten minutes to do. No needles are used when the test is done with the modern machines.

 Treatment
The first line of treatment is splinting and physical therapy. If necessary two to three cortisone injections. The cortisone amount is so minute that it does not cause any side effects. One need not worry about gaining weight with injections. We try this for a month. If the symptoms are distressing, surgery is the last resort.

Where is the Carpal Tunnel?

The carpal tunnel is normally quite snug and there is just barely enough room in it for the tendons and one nerve that have to pass through it. If anything takes up extra room in the canal, things become too tight and the nerve in the canal becomes constricted or "pinched". This pinching of the nerve causes numbness and tingling in the area of the hand that the nerve goes to. The symptoms caused by the median nerve being pinched in the carpal tunnel are called the "carpal tunnel syndrome".

The Median nerve

When a nerve is pinched it sort of "goes on strike". If that nerve provides feeling to the skin, that skin becomes numb till the pressure is relieved. For example, the sciatic nerve passes through your buttock to give feeling to your leg. I am sure you have had the experience of sitting on your buttock and feeling your leg go numb. That's from the pressure on this nerve. If you relieve the pressure on the nerve by getting off your buttock, the feeling in the leg returns in a few seconds. If you keep the pressure on the nerve a little longer before getting up, it takes a little longer for the feeling to return to your leg. In fact if you keep the pressure on your buttock long enough, you could cause enough permanent damage to the sciatic nerve that it may not recover completely when the pressure is relieved. That is what happens in some alcoholics who lie in stupor on top of their arm and can wake up with the arm paralyzed.

When the Median nerve in the carpal tunnel is pinched, it also goes on strike, and you get tingling and numbness in the area that the nerve goes to. That area is the three and a half fingers described above. Notice that it does not include the fifth finger which is supplied by another nerve that does no pass through the carpal tunnel.

What can make the carpal tunnel too tight?

The commonest cause of carpal tunnel is swelling in the tunnel itself and this can be caused by many different things. Inflammation of the tendons in the tunnel because of repetitive use of the hand and wrist causes the tendons to swell and can cause carpal tunnel.

So can fluid retention. For example, fluid retention occurs during pregnancy and it is common to have carpal tunnel symptoms develop during pregnancy. Contraceptive pills also cause fluid retention and so do many other medical conditions all of which can cause carpal tunnel symptoms.

Fractures around the wrist and hand can also cause swelling in the wrist and therefore carpal tunnel symptoms. Fractures can also cause carpal tunnel symptoms in another way because even very slight changes in the shape of the bones around the carpal tunnel as the bones heal can be enough to make the already snug tunnel become too tight for the nerve.

It is important to know that the carpal tunnel changes in size depending on the position of the wrist.. When the wrist and hand are straight in line, the carpal tunnel is at its widest size. When the hand is bent up or bent down at the wrist, the tunnel becomes slightly smaller. Therefore if the tunnel is getting tight for whatever reason, there will be the most room for the nerve when the wrist is kept straight. In this situation, keeping the wrist bent up or down puts more pressure on the nerve and brings out the numbness and tingling.

Carpal Tunnel Syndrome symptoms

If the pressure on the nerve is relieved early enough, the symptoms rapidly disappear. If they are ignored too long, the continued pressure on the nerve can cause irreversible damage.. At that point relieving pressure on the nerve will not provide complete return to normal.

The exercise should be repeated 10 times. Then workers should let their arms hang loosely at their side and shake them for a couple of seconds.

Depending on the type of work, employees should also do a slow isometric and isotonic exercise for posturing and toning of neck and arms, Dr. Seradge said.

In addition to keyboard operators, factory workers, and typists, also at risk for carpal tunnel syndrome are workers whose jobs require holding actions, such as barbers and bus drivers.

In the long run, daily exercises, combined with job modification, will save employers money that they would have had to spend on carpal tunnel syndrome surgery for workers.

Exercises

(at the start of each shift and after each break)

1. Extend and stretch both wrists and fingers acutely as if they are in a hand-stand position. Hold for a count of 5.
2. Straighten both wrists and relax fingers.
3. Make a tight fist with both hands. Then bend both wrists down while keeping the fist. Hold for a count of 5.
4. Straighten both wrists and relax fingers, for a count of 5.

Repeat exercise 10 times, then hang arms loosely at side and shake them for a couple of seconds. Total exercise time: 5-10 minutes.

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