Newsletter’s
Take care of your feet
Feet are complicated. Immobilizing feet by squeezing them into tight fitting shoes and standing on them all day can causes the muscles to shorten and cramp. When the arches drop the joints, fascia, tendons and ligaments to get over stretched, thicken with scar tissue, stiffen, become brittle and painful. By the time someone experiences plantar fasciitis they have a drop in one or more of the arches, stiffening of some of the joints of the feet and a 50% thickening of the plantar fascia ligament, figure 2.
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Low back pain is the number one cause of disability
In 2013 the Lancet medical journal rated severe low back pain (LBP) as the number one cause of disability world wide. After LBP related disability, the top causes of disability were major depression (mental health), iron deficiency, HIV, diabetes and war. Back in 1961 heart disease was the number one cause of disability followed by neurological disorders, mental health, cancer and low back pain. This newsletter grapples with the increased incidence of LBP related disability, the predictors and preventers of LBP disability.
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Your Brain and Pain
Chronic low back pain (LBP) is associated with reduced brain grey matter and impaired cognitive function as compared to normal pain-free subjects. In simple terms, the longer you suffer low back pain the more likely you will develop a reduction in the size of your brain and its capacity to process attention demanding tasks.
The brain controls motion. The brain develops abnormal muscle recruitment and sequencing patterns in response to pain. In other words people in pain recruit the “wrong muscles in the wrong order” as compared with people who have no pain.
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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
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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Three Steps to Strong Healthy Feet
As we age we lose strength in our feet and lower limbs first. This predisposes us to a higher incidence of foot, knee and hip pain, and falls, which lead to an increased incidence of hip and lumbar spine fractures. They are all things that we would like to do without, especially as we age. How we treat our feet as children and teenagers significantly determines the health and vitality of our feet as adults. The prescriptions we followed from health care practitioners further contributed to the problem.
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