Newsletter’s

Low back and buttock stretches

Stretching?

Stretching exercise have been around for centuries. Yoga, Tai Chi and Pilaties would not thrive today if they were not effective for more than just a blissful sense of wellbeing. Many of my patients have reported feeling better with more flexibility and less pain after regularly attending one of the above stretching classes.

In the last 100 years Western Healthcare has prescribed all manner of exercise for a host of health issues from heart disease to diabetes and back pain. Modern research has been able to analyze when and why some exercise are effective and when they are not. We know  everybody is a bit different and that what works for one person may be ineffective or cause harm for the next. Your chiropractor can advise you on how, when and why to stretch different parts of the body for optimum therapeutic and lifestyle outcomes.

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Sciatica

Sciatica Pseudo-sciatica is common. Fortunately, true sciatica is uncommon. Less than 0.5% of the low back pain sufferers experience sciatica – a pinch or entrapment of a portion of the sciatic nerve root as it exits the spinal column. The sciatic nerve goes down the leg and is made up of 5 nerve roots, the L3 L4 & L5 lumbar nerve roots and the S1 & S2 sacral nerve roots. Any of these nerve roots can get pinched by a herniated disc in the lower lumbar spine and can cause leg pain. Figure 3 illustrates an entrapment of the S1 nerve root by a herniation of the L5-S1 disc. Note the dull ache to shooting pain pattern, figure 4, follows the nerve from the sacroiliac joint, over the hip, down the posterior lateral thigh to the calf and heel. There is an area of numbness to pin prick, figure 5, in the back of the calf and the lateral heel, foot and toe. The ankle jerk reflex is also diminished or absent, figure 6. With pinching of S1 nerve the patient may have difficulty walking on their toes.

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Short Leg Syndrome

Short Leg Syndrome is a diagnostic term referring to pain and disability as a result of having one leg shorter than the other. 90% of the population has one leg 5mm or more shorter than the other. In one study, 2/3 of the people with a leg length inequality (LLI) of 5+mm had a history of low back pain. The greater the LLI the more likely the individual will experience low back pain or notice that they need to get the length of their trousers hemmed to different lengths. LLI is one of many causes of scoliosis, a lateral curve of the spine, figure 1. A scoliosis due to LLI is called a postural or a pelvic tilt scoliosis.

There are two types of leg length inequalities: functional and structural. Functional leg length inequality means the leg bones are the same length but one appears shorter than the other and the body functions as if one leg is short. Functional leg length inequalities are commonly due to pronated feet or twisted spines subsequent to injury.

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Shoulder instability

An injured or inflamed shoulder is often subsequent to injuries/falls on the shoulder or an outstretched arm in young people. In middle aged (age 30 -50) people most of these problems are due to vigorous overuse repetitive activities such as lifting, painting, shoveling, throwing and reaching. In the elderly, rolling over in bed can be enough to tear or inflame the shoulder.

Symptomatically, you may have pain while lying on the affected side, reaching overhead, reaching behind your back, reaching into the back seat of the car, driving or attempting to lift with the arm out away from the body. This type of pain is generally labeled as tendonitis or bursitis.

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Buttock trigger points

Buttock and Leg Pain is most commonly caused by joint dysfunction (abnormal motion) of the joints of the low back, pelvis and hips. Restoring the function (normal motion pattern) eliminates the pain. Functional problems are called syndromes. They are  correctable because disease and pathology are not the cause of the pain.

Dysfunction of the muscles (myofascial trigger point pain syndromes) that attach to and move the joints of the low back, pelvis and hips can also cause low back, buttock and leg pain. Each dysfunctional muscle has a characteristic area of enderness, tightness and referral pain pattern. You will note from the examples below that there is a huge overlap of muscular referral pain patterns so the pain pattern alone is not enough to make a  diagnosis.

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Vertigo

Vertigo is the illusion of a spinning or rotational movement. This sensation is similar to the  feeling that follows doing rapid pirouettes, getting off a rotating chair or a merry-go-round. You can feel as if the environment is spinning around you or that the spinning movement or rotation is within your head. It is normal to experience vertigo when you get off a merry-go-round but it is not normal to experience vertigo when you look up or rotate your head and neck to look behind you or when you roll over in bed.

Vertigo maybe associated with other symptoms as dizziness, light headedness, nausea, vomiting and sweating. While vertigo may be incapacitating and result is lost productivity and quality of life it is generally treatable and rarely the sign of a life-threatening or serious disorder.

 

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