Common Conditions

Chronic neck pain (Repetitive stress is the cause of the majority of chronic neck pain) Neck pain is a very common condition affecting 30-50% of the population. While some neck pain is acute (i.e., caused by an injury or torticollis), most neck pain is caused by repetitive physical stresses such as prolonged poor posture during sitting, standing, working, and even incorrect lifting techniques or sleeping positions. Pain resulting from these chronic stresses is usually chronic, leading to nagging neck pain, the heaviness of the head and shoulders, and eye strain. Some patients may also experience dizziness, with or without numbness down the arm. Obtaining a proper diagnosis is paramount to determine the best course of treatment for neck pain. The chiropractor will take a full medical history and a physical examination, including observing your posture, range of motion, and physical condition. He or she would palpate the spinal curvature, the vertebral alignment, and muscle spasm. A neurological examination also will be performed to test the patient’s reflexes, muscle strength, sensory and motor changes, and pain distribution. In some cases, an x-ray might be ordered. It can reveal narrowing of disc space, fracture, osteophyte formation, and osteoarthritis. If there are neurological symptoms that are thought to be caused by bulging discs and herniations, referral for MRI examination may be required. Most patients with neck pain respond well to non-surgical treatments. Less than 5% of neck pain patients will need surgery. There is a comprehensive range of non-surgical options for treating neck pain, including chiropractic, physical therapy, and acupuncture.

Problems in the cervical spine which result in altered proprioceptive input into the brain can also be a cause of dizziness proprioceptive input into the brain can also be a cause of dizziness) Recurrent and episodic dizziness typically occurs when moving the neck or head to certain positions can be cervicogenic dizziness. Dizziness is a chronic condition commonly seen in primary healthcare practice, such as chiropractic. In the United States and the United Kingdom, its prevalence is 25% and 40%. Most people believe that dizziness is related to disorders involving only the visual, auditory, and central nervous system. Less known is that problems in the cervical spine (neck) could also contribute towards dizziness. Researches have shown that articular changes of the upper cervical spine (C1 and C2) are potentially the cause of cervicogenic dizziness. The upper cervical spine and deep cervical muscles contain a high density of proprioceptors responsible for a sense of balance and other neurological reflexes. Therefore, factors such as trauma or physical stress can alter neurological proprioceptive input to the vestibular system, resulting in dizziness.

Incorrect breathing techniques using the neck muscles and not the diaphragm can cause your chronic neck and back pain. The diaphragm is the primary muscle for breathing, and it stabilizes the spine and prevents the overuse of other muscle groups. According to studies, a faulty breathing pattern positively correlates to the development of neck pain. It may increase the episodes and level of neck pain and may lead to chronicity. Consequently, mid and lower back pain may also develop secondary to the compensatory pattern as the spine is not stabilized. Diaphragmatic breathing improves gas exchange in the lungs and is associated with an optimal blood oxygen level.

A recent study found that more than 75% of pregnant women experience pregnancy-related low back pain, pelvic pain, or a combination of both. The pain increases as pregnancy progresses. Chiropractic is a safe, effective, and drug-free way to manage these and other musculoskeletal symptoms during pregnancy. The physiological, biomechanical changes that occur with pregnancy can lead to discomfort/pain during pregnancy and labor. These changes include weight gain, a shift of the center of gravity, increased lumbar lordosis, increased laxity of lumbopelvic ligaments, postural changes, and altered gait patterns. Many obstetric healthcare providers are unaware that the resulting musculoskeletal conditions and their related symptoms can be managed and improved with chiropractic care and patient education. Pain conditions commonly associated with pregnancy include sciatica, sacroiliac pain, pubic symphysis pain, round ligament pain, etc. A misalignment in the pelvis can typically result in these pain symptoms. Another significant complication is that a mal-aligned pelvis can reduce the space available to the developing fetus inside the womb, causing intrauterine constraint, hindering the growing fetus’s movements.

Intrauterine constraint can make it more difficult for the baby to move into the head-down and rear-facing optimal birthing position. In some cases, this can affect a woman’s ability to have a natural and non-invasive delivery and result in a longer and more complicated delivery. A well-trained chiropractor specialized in the field of pregnancy chiropractic can help address those problems. For pregnant women, the trained chiropractor will use adjusting tables to accommodate their growing bellies. And the techniques used to treat pregnant women will not put any pressure on the abdomen or cause any discomfort. The chiropractor will also demonstrate effective stretches and home exercises for relieving tension and easing discomfort. Chiropractic care can help manage pain during pregnancy and help improve pelvic balance, providing the baby with as much space during pregnancy, leading to faster, more comfortable labor and delivery.

Scoliosis is a three-dimensional deformation of the spine. The spine is bent to the side, together with torsion. It affects around 2-3% of the population. The incidence also increases with age. About 30% of individuals over 60 years of age have scoliosis. Idiopathic scoliosis during adolescents generally does not have any symptoms, and some patients may not notice the abnormal curvature until a later stage when the curve worsens.

During the early stage of puberty, there is a higher risk of progression for scoliosis. When the curve progress to more than 45 degrees during growth, surgery may be indicated.

Tennis Elbow (Lateral epicondylitis) refers to pain and tenderness on the elbow’s lateral side. It is usually a result of weakness and overuse of the muscles at the back of the forearm. Repetitive activities such as grasping/gripping and flexing fingers and wrists may overtax the muscles and tendons and lead to tennis elbow. Frequent data entry, using smartphones, playing musical instruments, gripping a hammer, etc. can overload the muscles. When a patient presents with such complaints, a chiropractor will rule out other potential diagnoses such as synovitis, osteochondritis dissecans, ligamentous tears, bony fractures, arthritis, or nerve compression syndrome. Upon diagnosis, chiropractic treatment would be provided. Management includes the Active Release Technique, Soft Tissue mobilization, Graston technique, functional kinetic rehabilitation, etc. Sometimes ultrasound therapy, laser, and dry needling may also be used to help reduce inflammation.

Knee Pain/ Patellofemoral Pain syndrome is related to biomechanical abnormalities and mal-tracking of the patella, a common cause of anterior knee pain. It commonly affects the younger physically-active population (13-15 years of age) undergoing strenuous physical activities, 30-50 years old females, and the more aging population above 50 years of age. There is usually no specific history of trauma. The causes of patellofemoral pain syndrome are many. Recent research has shown that the hip external rotator’s weakness would lead to knee (patellofemoral) pain. Hip joint and its surrounding muscles play a crucial role in lower limbs kinematic, such as running. The hip external rotator muscle weakness can rotate the leg internally, which affects the normal knee kinematic and increases the pressure between the patella and femur, leading to anterior knee pain. Muscular tightness of the hamstring and iliotibial band can also cause anterior knee pain. Other biomechanical factors that may also contribute towards knee pain include flat feet, high-arches foot, and increased Q-angle of the knee. These factors can lead to abnormal patellar tracking, increased knee stress, and the wearing of articular cartilage and joint degeneration.

Patellofemoral pain syndrome typically involves pain that is felt deep in the knee and sometimes around the knee cap. It is aggravated during activities that involve knee flexion under loading (e.g., climbing staircase, walking down slopes, squatting, or prolonged sitting). Clicking sounds (crepitus) around the patella may be present during walking or bending the knees.

Treatment of knee pain depends on the cause. Chiropractic treatment includes:

1. Correction of faulty biomechanical chains to improve function,
2. Strengthening hip abductors and external rotators,
3. Knee bracing to stabilize the knee cap,
4. Stretching of tight muscles (e.g., hamstrings and iliotibial band),
5. Abstinence from weight-bearing activities.
6. In some cases, foot orthoses may be indicated.

Osteoarthritis of Knee – generally refers to degenerative osteoarthritis of the knee. It typically affects the anterior or medial side of the knee. Pain from osteoarthrosis of the anterior knee is usually worse when walking up and downstairs. Pain from osteoarthrosis of the medial knee generally comes on even when walking on a flat surface. There are many causes of knee arthrosis, of which the most important cause is an increased medial knee joint loading due to bowing of the legs. Genu varum increases the loading of medial knee joint and predisposes to medial knee joint degeneration.

The onset of knee arthritis is usually insidious. Initially, the patient may complain of occasional medial knee pain when getting up from a chair and with prolonged walking. The pain usually subsides with rest. Yet, with time, the frequency and intensity of pain may increase.

Treatment options for knee arthritis depend upon the degree of degeneration and pain. In the initial stage, when the patient is younger than the age of 50 and the bowing of legs is still mild to moderate, the treatment would include:

1. Using flexible shoes (refrain from wearing shoes with firm heel counter)
2. Unloading knee brace
3. Nutritional support
4. Prescription of corrective foot insoles

Chiropractic care has also been found by studies to be effective for the treatment of knee OA., conservative chiropractic treatment including the use of active and passive modalities, as well as nutritional advice has shown a significant improvement in knee range of motion and pain levels.