How can your feet affect your knees, hips and spine?

Your feet are composed of bones, joints, muscles, ligaments, tendons, nerves and blood vessels. The surrounding ligaments and muscles provide support for all the joints of the foot and ankle. They also stabilise the foot while walking. Most importantly for the knee, a hip, spine and pelvis, the foot absorbs shock. Both the foot and anklemust provide shock absorption while at the same time balance the body. They must be able to adapt to varying terrain. They support your body weight and make it possible to walk, run, stand and jump. Therefore, dysfunction at the feet may have serious, consequences for other neighbouring joints and the entire spine.

What causes foot problems?

Foot pain can be due to inappropriate footwear, which lacks support or due to ill-fitting shoes. Any injury especially to the hip, knee, foot or ankle that results in an inability to walk correctly or that results in a limp will also have consequences for the entire spine. Sports injuries, stress fractures to the bones in the foot and recreational overuse can result in compensation in the knee, hip, spine and pelvis.

How can foot problems endanger other regions of the body?

Foot pain can cause you to modify the way you walk, which in turn, places significant stresses on the knees, hips, spine and pelvis. Your body has to compensate and this can lead to limited movement in other regions of the skeleton. Some of the more common problems seen in practice include: plantar fascitis; hallux valgus; pain under the metatarsal joints; heel spur; arch collapse; Achilles tendonitis; recurrent ankle sprain and shin splints.

Absolutely anybody can suffer from foot disorders during the course of their lifetime. Overweight individuals, diabetics, gymnasts, athletes and dancers are more susceptible to foot problems as they place huge demands on their feet.
Gymnasts and dancers are prone to stress fractures and ligamentous/muscular sprain/strain injuries due to their extreme flexibility and ability to move their joints beyond their normal range of motion. Athletic patients must examine the wearing pattern on their training shoes as this may provide clues to various foot deformities. Excessive wear on the outside heel, together with a caved-in appearance of the inside of the shoe would suggest pes planus, or more commonly known as fallen arches/flat foot. The shoe should also be checked for flexibility and shock absorption. The fit of the shoe is also important as it must provide support to the arches and allow sufficient toe room. What is chiropractic?

Chiropractic is the third largest healthcare profession in the western world after medicine and dentistry. The word “chiropractic” is derived from the classical greek and means “done by hand”, or manipulation. Chiropractors specialise in diagnosing and treating disorders of joints, muscles, bones, ligaments and tendons. They pay attention to the spine, as its close relationship to the nervous system can result in head, arm, and trunk and leg pain, numbness or pins and needles.

Orthotics (shoe inserts)

If you are plagued by recurrent foot pain and/or dysfunction, you should consult a chiropractor. Your chosen chiropractor will take a thorough case history; employ a vast number of orthopaedic and neurological diagnostic tests; assess your gait and examine the range of movement in the joints of your feet and ankles.
By employing such a thorough investigation of your foot complaint your chiropractor will identify what is causing your pain and determine the best method of treatment. Your chiropractor will also examine your knees, hips and spine, which may have been affected by your foot complaint. Chiropractors have experience in relieving such pain and preventing it from causing even more problems in other areas of your body.

How can chiropractic help?

Your chiropractor may recommend orthotics to help solve some of your foot problems. Custom-made, flexilile orthotics may be employed in addition to foot and spinal adjustments and prescribed exercise. The need for orthotics is most crucial for patients with knee, foot or ankle disorders that impact on their spine or pelvis. The use of orthotics will often complement and improve the chiropractic adjustment, while assisting the body to return to an improved state of function and health. ]]> http://backtobackchiro.com/b2b_blog/chiropractic/chiropractic-and-ankle-pain/feed/ 0 http://backtobackchiro.com/b2b_blog/chiropractic/torticollis/ http://backtobackchiro.com/b2b_blog/chiropractic/torticollis/#comments Fri, 20 Apr 2012 18:32:27 +0000 admin http://backtobackchiro.com/b2b_blog/?p=221 Continue reading →]]> Introduction

Torticollis is caused by spasm of the neck muscles which causes rotation and tilting of the head.¹ The spasm can be quite severe, not allowing the patient to move his head to a normal posture. But in the doctors office, the spasm can be helped by physical therapy modalities.² We have found that by coupling interferential muscle stimulation with cryotherapy and range of motion exercises, followed by spinal manipulation, patients will enjoy normal motion very quickly. With continued care, the patient can resume normal activities more rapidly than without the above care.

Case history

A 23-year-old Caucasian male presented at our office seven days post-injury with his chin approximating his right shoulder. He had severe pain worsened with any cervical spine motion and was unable to raise his head to a neutral position. He was the driver of a vehicle which was broadsided on the left side of his car by another vehicle. He was treated by paramedics at the scene and taken home by a friend. His symptoms worsened to the point where he presented for treatment.

Examination and Radiographic Findings

Cervical spine range of motion and orthopedic testing was deferred due to the severe restriction of movement and the presenting attitude of the neck in right lateral flexion and right rotation. Deep tendon reflexes and dynamometer readings were unremarkable. the neck pain was concentrated on the left side with radiation as far as the AC joint.

Plain film radiographs were taken with the neck as straight as the patient could bear, to rule out fracture. A severe rotational deformity was visualized on the x-ray films. Following treatment, five cervical radiographs were taken on the same day. He still had a loss of cervical lordosis, as well as aberrant motion of the midcervical spine, but he had significantly better posture than previously viewed.

Course of Treatment

Treatment directed at the patient’s cervical symptoms consisted of interferential muscle stimulation to the patient’s cervical spine and upper thoracic spine with ice. He was seated and instructed to move his neck very slowly, as far as possible, into flexion, extension, lateral flexion, and rotation bilaterally. Following 30 minutes of this therapy, his range of motion had improved to the point that he could straighten his neck and guardedly moved it through at least 50 percent of normal range of motion. At this time five radiographs of the cervical spine were taken.

He was seen four times during the first week and was re-examined on the fourth visit. At that time his range of motion had increased to 80 percent of normal into flexion, extension, and left rotation; 90 percent into right rotation; and 70 percent in lateral flexion bilaterally. He had returned to work after the second visit. The pain had greatly diminished. The patient was treated for six weeks at which time he was asymptomatic and able to participate in all preinjury activities, including competitive basketball. He was placed on a home stretching regimen and advised to return for maintenance care. After six months he remains asymptomatic.

Discussion

In a car accident where there is a deceleration injury or the patient is broadsided, the forward momentum of the free shoulder results in combined flexion and rotation toward the secured shoulder.³ The result is a stiff neck caused by contraction of neck muscles drawing the head to one side.⁴

We have used interferential muscle stimulation because of its ability to relax the muscle spasm and ease the pain. Also, with interferential muscle stimulation, higher doses can be obtained within the body without surface discomfort and there is less risk of a burn.⁵ The biologically most effective stimulation is created within the body, in the depth of the tissue, with a higher intensity than under the electrodes.⁶ In an acute patient such as this, the settings we normally use are 80-150Hz and 80-100Hz in order to stimulate the muscle without irritating it, with a slower pulsing 0-10 or 0-15 Hz current. The ice is used to help decrease swelling and to promote analgesia. With the neck muscles being stimulated and cooled, we have noticed a quick increase in motion as the patient actively moves his head through the normal ranges of motion, stopping when the pain increases. This allows us to specifically adjust the patient following therapy. We have found this approach to work on several patients with acute torticollis, as well as most patients with whiplash injuries.

References

1. Rahway NJ: Spasmodic Torticollis. Merck Manual ed 5. Merck & Co. Inc., 1987.
2. Rahway NJ: Spasmodic Torticollis. Merck Manual ed 5. Merck & Co. Inc., 1987.
3. Foreman & Croft: Whiplash Injuries. Baltimore, Williams & Wilkins, 1988.
4. Torticollis, Tabers Cyclopedic Medical Dictionary, ed 10. Philadelphia, F.A. Davis Company, 1968.
5. Kinsman AJ: Clinical Effects and Uses of Interferential Current Therapy. Presented at Australian Physiotherapy Association Congress, Sydney, August 1975.
6. Nippel FJ: Interferential Current Therapy, An Advanced Method in the Management of Pain, presented at the annual conference of the American Physical Therapy Association, Atlanta, June 9, 1979.

· Significant loss of movement
and shoulder pain.
· Pain that can last from weeks
to many months.
· Loss of movement that can
last months to years.

Fortunately, you can take steps to control the pain and regain full range of motion.
Anatomy of Frozen Shoulder A ligament is a soft tissue structure made up of connective
tissue. Ligaments attach bones to bones. The shoulder joint capsule is a loose bag of tissue that completely surrounds the shoulder joint. This joint capsule is made up of ligaments that form a water tight bag. Inside the bag is a small amount of joint fluid that lubricates the joint surfaces. The joint capsule bag has a considerable amount of slack, loose tissue that allows for unrestricted shoulder movement.

Causes of Frozen Shoulder

Frozen shoulder can be caused by many situations, including shoulder injury, cumulative
trauma, diabetes, thyroid problems, and heart or lung conditions. One theory is that the condition may be due to an autoimmune reaction in which the body’s defence system (which normally protects the body from infection) mistakenly begins to attack parts of
the body. The immune system thinks that the tissue it is attacking is foreign material.
This causes an intense inflammatory reaction in the tissue that is under attack,
and causes the shoulder to “freeze up”.

Active Release Technique® (ART®)
ART is a relatively new, and highly successful approach, for the treatment of injuries to muscles, tendons, fascia, nerves, and surrounding soft tissues. ART has proven to be very effective for the treatment of Frozen Shoulder, with a success rate exceeding 90%. ART provides a means to diagnose and treat the underlying causes of soft tissue injuries. The goal of ART is to:
· Restore optimal texture and motion.
· Restore the function of the soft tissue.
· Release any entrapped nerves or blood
vessels.

This is accomplished through the removal of adhesions in the soft tissues through the application of specific ART protocols. Conventional vs. ART Conventional treatment of Frozen Shoulder can be frustrating, slow, and very painful. Conventional treatment uses an indirect approach that uses shoulder joint motions to stretch the shoulder capsule
ART’s more direct approach, working with ALL the affected soft tissues, decreases the required treatment time and results in rapid and improved results.

What should I expect during
an ART treatment?
During an ART session, we examine tissue texture, tension, and movement to identify the location of abnormal inflammation and adhesions. The process of breaking up the adhesions treatment can be uncomfortable to the patient, but the results are immediate. Once the soft tissue has returned to its normal state, the ART practitioner prescribes specific
exercise to strengthen the tissue and prevent reoccurrences of the injury.

What is a herniated disc? 
The disc is a circle of cartilage between each vertebra in the spine that acts as both a shock absorber and a shock distributor. If you jump up and down, imagine what would happen to the stack of bony vertebra that make up the spine without the cushioning of the discs. Move your back side to side. Again, you can visualize the give and take of the discs between the vertebrae. Without discs, the spine simply could not function.

Discs don’t really “slip”. Instead, they bulge, herniate, or rupture. Discs are made up of concentric circles or rings of fibrous material with a tough gelatinous center (nucleus pulposus). When cracks or fissures occur in the fibrous rings, the gelatinous material in the center can begin to push out.

Figure 1. Spinal Anatomy		Figure 2. Disc Degeneration

How does such a simple movement cause a disc bulge/herniation? 
A disc bulge/herniation is almost always the result of a process. Factors that precede the pain and symptoms of disc injury include disc dehydration, unusual stress on the disc secondary to altered mechanics, and too much load on the disc due to weak core musculature.  As is often the case with joint and spinal injuries, the problem starts small and then builds until it becomes symptomatic. Surely you’ve heard the phrase “the straw that broke the camels back”.  For a disc bulge/herniation this can truly be the case.

For example, a middle-aged accountant who sits for long periods, suffers from disc dehydration, and has poor mechanics from weak core musculature, then lifts a heavy piece of furniture and experiences acute low back and leg pain. Or perhaps many months after lifting the piece of furniture, he experiences no pain at all until he sneezes. However, the sneeze didn’t cause the disc bulge, but it does represent the final “straw” in a very lengthy process.

Discs depend on water to keep their height and perform efficiently. When we’re young, discs have their own circulation that helps keep them hydrated. As we get older, this circulation ends and the spine must move so that water can be drawn into the discs. If discs become dehydrated and lose their height, they become more vulnerable to cracks and fissures.

Discs are integral parts of our body’s mechanical system that allows us to move. Chiropractors are especially interested in seeing how injuries in one part of the body relate to the mechanical system of the body as a whole. Chiropractors look at injuries specifically, but they also try to determine in what way an injury is the result of dysfunctions elsewhere in the body.

The spine functions as a whole, so if we have mechanical dysfunctions in one part of the spine, even as far away from the low back as the neck, it can influence conditions in another area of the spine. Imbalances in the pelvis, problems in the sacroiliac joints, low back facet fixations, as well as joint restrictions in the mid-back and neck, can contribute to the process of disc degeneration and eventual injury.

Mechanical dysfunctions due to muscular imbalance are very important to detect and correct because of the abnormal stresses placed on discs and other soft tissues that are not designed to withstand such stresses.  The dysfunctions can be a product of poor posture, excessive sitting, improper exercise, etc.

Often times in a chiropractic office a patient will present with symptoms that would lead to a preliminary diagnosis of a disc bulge/herniation.  Unfortunately, this can only be confirmed by MRI.  A trial of care is usually the first step in treatment.  If no results are seen, the next step is advanced imaging with MRI to confirm the severity of the problem.  At this point the doctor can focus more specifically on the involved area.  Unfortunately, even at this point there are some cases in which the body no longer has the ability to heal itself and more invasive procedures are needed.  In this case it is the doctor’s responsibility to decide which referral is most necessary for your condition.  Otherwise, you are in the right place.  At this time chiropractic is the only profession that focuses on restoring proper joint mechanics and muscular balance to the body.

Guy Hains, DC, François Hains, DC 

Private practice of chiropractic, Trois-Rivières, Quebec, Canada

OBJECTIVES:   To provide preliminary information on whether a regimen of 30 chiropractic treatments that combines ischemic compression and spinal manipulation effectively reduces the intensity of pain, sleep disturbance, and fatigue associated with fibromyalgia. In addition, to study the dose-response relation and identify the baseline characteristics that may serve as predictors of outcome.

DESIGN:   Subjects were assessed with self-administered questionnaires taken at baseline, after 15 and 30 treatments, and 1 month after the end of the treatment trial.

SETTING:   Private practice. METHODS: Participating subjects were adult members of a regional Fibromyalgia Association. Participating subjects had fibromyalgia for more than 3 months. They received 30 treatments including ischemic compression and spinal manipulation. The 3 outcomes being evaluated were pain intensity, fatigue level, and sleep quality. A minimum 50 improvement in pain intensity from baseline to the end of the treatment trial was needed to include the patient in the respondent category.

RESULTS:   Fifteen women (mean age 51.1 years) completed the trial. A total of 9 (60) patients were classified as respondents. A statistically significant lessening of pain intensity and corresponding improvement in quality of sleep and fatigue level were observed after 15 and 30 treatments. After 30 treatments, the respondents showed an average lessening of 77.2 (standard deviation = 12.3) in pain intensity and an improvement of 63.5 (standard deviation = 31.6) in sleep quality and 74.8 (standard deviation = 23. 1) in fatigue level. The improvement in the 3 outcome measures was maintained after 1 month without treatment. Subjects with less than 35 improvement after 15 treatments did not show a satisfactory response after 30 treatments. A trend, determined as not statistically significant, suggests that older subjects with severe and more chronic pain and a greater number of tender points respond more poorly to treatment.

CONCLUSION:   This study suggests a potential role for chiropractic care in the management of fibromyalgia. A randomized clinical trial should be conducted to test this hypothesis.

From the Full-Text Article: 

Discussion

The results of this study suggest that chiropractic care combining ischemic compression and spinal manipulation may help patients with fibromyalgia. A total of 60% of this sample reported a mean improvement of 77.1% in pain intensity in addition to a 63.5% improvement in the quality of sleep and a 74.8% improvement in fatigue level. The causes of poor quality of sleep and high fatigue levels reported in fibromyalgia are poorly understood. The observed improvement in this study may suggest that these symptoms were aggravated, at least in part, by the presence of pain. The reduction of pain may have led to the improvement in the quality of sleep and fatigue observed in this study. These symptoms may be part of a vicious cycle caused by pain. [6, 7]

The lessening of pain was maintained throughout the follow-up period of 1 month, suggesting that chiropractic care may help patients beyond the actual provision of care. This effect was not observed in the different drug trial, which tested the efficacy of amitriptyline and cyclobenzaprine for the treatment of fibromyalgia. [15] These drugs were not shown to be effective after stopping medication intake.

Side effects were not monitored during the trial. However, compliance was excellent, and no patient dropped out of the treatment section of the study. This compliance suggests that patients were satisfied with the care received and did not have side effects or complications sufficiently intense for them to withdraw from the study. The opposite problem was encountered; two subjects in the nonrespondent group requested to continue treatment during the 1-month follow-up period because of a recurrence of the original symptoms. For ethical reasons, these patients were excluded from the follow-up section of the study and remained under active care.

Previous drug trials with fibromyalgia have reported a strong placebo response. [15, 22, 23] The decision to require a minimum 50% improvement after 30 treatments to classify subjects as respondents was an attempt to exclude subjects whose response to treatment was more likely to be attributed to this effect. On its own, such a placebo effect would be unlikely to produce the magnitude of improvement noted in this group of respondents and even less likely to produce a sustainable improvement 1 month after the end of the treatment trial. In addition, the more treatment patients received, the less symptoms they reported. This dose-response relation supports the hypothesis that the observed improvement may be caused by the physiologic effect of the treatment itself. [24]

Cost effectiveness is important when considering the use of a new treatment approach. This sample showed a progressive improvement in outcome during the treatment trial, suggesting that the course of 30 treatments was adequate. The sustaining of the effect at the 1-month follow-up assessment also suggests that this chiropractic approach may have a prolonged benefit.

It may also be possible to identify which patients are most likely to respond positively to chiropractic care. In our sample, some not statistically significant trends that warrant attention in a larger clinical trial were observed. For instance, older subjects with a more chronic illness and a greater intensity of symptoms who have more tender points at baseline assessment appeared to respond more poorly to treatment. In addition, the percent lessening of pain intensity after 15 treatments was significantly inferior in the nonrespondents. Subjects who showed > 35% improvement after 15 treatments did not show a satisfactory response after 30 treatments. This observation suggests that a minimum 35% improvement in pain intensity must be observed after 15 treatments or it may no longer be appropriate to pursue this form of treatment.

A selection bias may have occurred because subjects volunteered to participate in this study and because of the small sample size. However, the baseline characteristics of our subjects were similar to those in another fibromyalgia trial. [15] The outcome was strictly measured with self-administered questionnaires to minimize the risk that the physician’s expectations might influence the results. Moreover, these questionnaires were completed without the clinician present to limit possible bias related to the desire of the subjects to please the clinician and report an inaccurate improvement. Furthermore, fibromyalgia is a chronic illness that rarely remits, making it unlikely that improvement was related to the natural history of the condition. Although subjects did not report initiating new forms of treatment during the course of the trial, collecting data about the usage of medication, exercise, or other forms of therapy to minimize biases related to cointerventions would have been more appropriate. Finally, the baseline assessment should have included a more rigorous physical and mental health evaluation. For instance, one of the nonrespondents had chronic leukemia and another was psychologically distressed because her daughter had a life-threatening disease. Such conditions may have adversely influenced the effect of treatments.

The small sample size, the use of a single treating physician, and the absence of a control group with appropriate blinding procedures are some of the most significant limitations of this clinical trial. The hypotheses raised in this study need to be tested with a larger sample size, more than one treating physician, and a blinded design. Based on these results and data from drug trials, [15, 22] the sample size requirement of a placebo-controlled randomized clinical trial was estimated at 50 patients per group to be adequate on the basis of an estimated improvement of 50% in the chiropractic group versus 15% in the placebo group. Future studies should be designed with 90% power and a 2-tailed test with a significance level of .05, assuming a 10 dropout rate in future studies.

Conclusion 

This study suggests a potential role for chiropractic care in the management of fibromyalgia. Most subjects with fibromyalgia appear to have responded favorably to a course of 30 chiropractic treatments including spinal manipulation and ischemic compression therapy. Fifteen treatments seem to be an adequate cutoff point to determine if a significant improvement in pain has occurred and if further care is warranted. Chiropractic care appears to provide benefits for at least 1 month after stopping therapy. A placebo-controlled randomized clinical trial is recommended in the near future to test these hypotheses.

IS CHIROPRACTIC CARE FOR PREGNANT WOMEN SAFE?

Chiropractic care is generally safe even when given to pregnant patients, provided that the practitioner is a qualified and experienced chiropractor. The professional should be well-trained in the physical changes that happen inside a pregnant woman’s body.

Chiropractors trained to deal with pregnant patients need to have a special table that adjusts accordingly to the shape and size of a pregnant women, at different stages of the process. Techniques will be incorporated to avoid unnecessary pressure on the abdomen.

It is vital that you get a chiropractor who specializes in the treatment of pregnant women. The professional should be highly competent in meeting the needs of pregnant women, providing stretches and exercises that are generally safe during pregnancy and support any type of adjustment given to the spine.

IS CHIROPRACTIC CARE FOR PREGNANT WOMEN USEFUL?

When a women enters pregnancy, a lot of physical changes and alterations in the endocrine system occurs, which prepare the environment for the growing fetus. The changes can also lead to joint and spine problems as evidenced by pelvic changes, protruding abdomen and more back curve, posture changes, uterus enlargement and uterus expansion forward.

When you create a balance and pelvis alignment, you get to have chiropractic care during pregnancy. Pelvic misalignment often lowers the available room for the baby. The baby may have a hard time getting into the right position just in time for delivery.

The spine also needs to be aligned, so that the nervous system can properly send messages to different systems and organs, thereby making the body work better.

Knowing The Benefits Of Chiropractic Care For Pregnant Women

Pregnant women can benefit greatly from chiropractic care, such as a controlling signs and symptoms such as nausea and headache, keeping a healthy pregnancy, relieving joint, neck and back pain, minimizing the time of delivery and labor and avoiding the possibility of a caesarean section.

Because balance is achieved in the pelvis of pregnant women, unnecessary stress is removed or reduced in the uterus and supporting ligaments. The balanced state then makes it easier for babies to turn naturally.

The risk for having a breech position is lessened significantly. Babies may be presented in the breech position until the 3rd trimester, which is very normal. It is only during the 37th week that experts start worrying about breech position.

HOW TO TREAT SYMPTOMS USING CHIROPRACTIC CARE FOR WOMEN

Chiropractic care during pregnancy can eliminate several problems such as sciatica, low back pain, headaches, carpal tunnel syndrome and midback and rib pain. Pregnancy associated with low back pain is usually linked to several joint problems in the body.

As women’s bodies become heavier throughout pregnancy, more and more stress and physical conditions can develop. These should be treated immediately with chiropractics.

Subluxation is described as misalignment of joints, thereby triggering irritation to tissues and nerves in the surrounding areas. Hormones also boost quickly during pregnancy with some causing joints, muscles and ligaments to relax.

The pelvis, in turn opens, allowing the baby to pass through the birth canal. Treatment via chiropractics is highly useful in assisting mothers have easier deliveries.

If you are pregnant and considering chiropractic care you now know a lot more about how chiropractic care for pregnant women is safe and won’t harm the baby.

Knee pain is an increasing problem in society and as a result we see more and more patients with knee problems in our practises.

Chiropractic treatment is very effective for many of the problems that cause knee pain and although a condition such as osteoarthritis is not curable, the symptoms can be reduced and the progression of the problem can be helped thanks to our unique approach to treatment. Please read on to find out how!

If knee pain is limiting your day-to-day or sporting activities,

you have been given painkillers and been told to rest with no long-term improvement, or

you have been told you have arthritis and there is nothing that can be done?

Then chiropractic treatment may well be the answer.

The Knee Joint

The knee is a complex joint that relies heavily on ligaments and muscles for stability.The knee is a major weight bearing joint and is composed of:

the tibio-femoral joint (between the thigh and lower leg)

the patello-femoral joint (between the knee cap and the thigh),

muscles and ligaments, which gives active and passive stability to the knee.

two ring shaped cartilage discs in the knee, called the menisci (one meniscus).

Examination of the Knee Joint

When pain is perceived as coming from the knee, all the anatomical components need to be examined and in addition to the knee joint, the low back, pelvis, hip, ankle and foot need to be examined due to the direct influence they have on the knee, and vice versa.

As chiropractors we take a comprehensive medical history and perform a thorough physical and biomechanical examination in order to make an accurate diagnosis – without an accurate diagnosis, the treatment will not be successful.

Our approach of assessing and treating the knee includes the evaluation of the other joints and muscles relating to the knee. This is for several reasons:

Firstly, pain can be referred from other structures in the low back, pelvis and hip into the knee, in certain conditions.

Secondly, if other joints in the lower limb are not working correctly they can put increased stress on the knee joint, resulting in injury over time. Therefore to resolve the knee pain chiropractors may also treat other areas, to maximise long-term improvement.

Chiropractic treatment of knee pain

We have outlined the process of our treatment below to give you an idea of our approach. We would normally modify the treatment to suit each patient and their specific conditions. So the type of treatment that is most appropriate for one person is not necessarily right for another.

Stage 1: Reduce joint inflammation and reduce pain.

How?

Avoidance of aggravating factors, use of a support, sports tape

Ice to reduce inflammation, muscle spasm and pain

Soft tissue healing: laser, ultrasound and interferential therapy

Stage 2: Normalise joint function

How?

Specific chiropractic manipulation and mobilisation techniques to areas of restricted movement in the knee and surrounding joints, to increase movement, improve the function and reduce pain

Deep soft tissue massage, trigger-point therapy and cross-friction.

Stage 3: Rehabilitation exercise programme.

When appropriate we introduce exercises to improve strength, endurance and stability. We also work on improving your balance and your sense of joint position (proprioception). Thi

Chiropractic Care
The American Chiropractic Association defines chiropractic as, “A health care profession that focuses on disorders of the musculoskeletal system and the nervous system and the effects of these disorders on general health.” Chiropractic care restores correct movement to the muscloskeletal system to optimize nerve flow, reduce muscle tension and maximize the body’s healing capabilities.

Chiropractic Treatment
The primary treatment used by a doctor of chiropractic is the chiropractic adjustment. The chiropractic adjustment is a low amplitude, high-velocity, focused thrust that reestablishes correct motion to a joint. The chiropractic adjustment can be performed on any joint in the body. The foremost location treated with a chiropractic adjustment for the restoration of skeletal movement is the spine.

Anatomy
According to the University of Minnesota Medical Center, the brachial plexus is a network of nerves in the neck and shoulder. The brachial plexus is formed by nerves that branch off the spinal cord in the neck and upper midback. The intricate brachial plexus transmits nervous system communication between the spinal cord and upper extremities. The location of the brachial plexus in the front of the neck, shoulder and chest leaves it susceptible to impingement in several locations.

Thoracic Outlet Syndrome
According to The Ohio State University Medical Center, “Thoracic outlet syndrome occurs when the nerves and blood vessels that come from your chest to your arm are pinched.” Impingement of the brachial plexus can occur in the neck, under the collar bone or underneath the chest muscles. According to the American TOS Association, symptoms of TOS include positional weakness of the arm, tingling and numbness of hands and fingers, difficulty grasping/holding an object, swelling of the hand and/or arm, weakness of the arm and hand, cold sensation in the upper extremity and color changes.

Treatment
The chiropractic doctor performs a thorough consultation and examination to determine the source and accompanying symptoms of your condition. Chiropractic adjustments for TOS focus on the neck, upper midback and upper extremities to reestablish correct skeletal motion. Proper motion in these joints removes nerve impingement and lessens symptoms of TOS. Stretching exercises and muscle work to the neck, chest and shoulders are executed to reduce muscle tension and lessen the nerve impingement.

Whiplash is sustained when a victim’s head is violently hurled forward (hyperextension) and then backward (hyperflexion). Whiplash injury can cause serious injury to the joints, discs, muscles, nerves, and ligaments of the neck and is most serious when a victim’s head is turned to the side during impact. Whiplash car accident back injuries, though common, are sometimes difficult to diagnose. Symptoms of these car accident back injuries can include muscle spasms in the neck and upper back area, increased neck pain with movement, and increasing pain in the base of the neck. There are a variety of other symptoms that a doctor can

Car accident back injuries can also result in a lumbar or lower back sprain or strain. These car accident back injuries result in serious and sometimes debilitating pain in the larger muscles of the lower back. These car accident back injuries can also be difficult to diagnose or may be misdiagnosed if there is an underlying disc injury that has not been identified. Pain from these car accident back injuries can occur on one or both sides of the lower back, may worsen with activity, or may cause nighttime muscle spasms.

Car accident back injuries also include spinal cord injuries. Spinal cord car accident back injuries can be caused by different kinds of trauma including bruising (contusion), excessive pressure (compression), lacerations, and specific damage to the corticospinal tracts in the cervical spinal cord area. Spinal cord car accident injuries can cause serious nerve damage resulting in paralysis, loss of feeling in certain areas of the body, loss of reflex function, and autonomic disturbances. Spinal cord car accident injuries can be very debilitating and can lead to secondary medical problems including infection, sexual dysfunction, muscle spasms, loss of bladder control, and centralized hypersensitivity or pain in certain areas of the body.

There are a number of medical tests that can be performed on a patient who is thought to have sustained car accident back injuries. In some cases, car accident back injuries can be detected through the use of x-rays, though muscle strains and sprains cannot be diagnosed through this medical means. Medical professionals can also use CT or CAT scans, MRIs, myelograms, discograms, electromyograms, and bone scans to determine the nature and extent of car accident back injuries.

If you have suffered car accident back injuries that resulted from a vehicle accident that was caused by another party, you may be eligible to seek compensation for the damages you have endured. Liable parties may be required to compensate victims for medical expenses, loss of income or earning potential, and pain and suffering.