Conditions Treated

Facet Syndrome

The facet joints are the articulations of the spine that allow each vertebra to move securely with respect to the vertebra above and the vertebra below.  There are 24 vertebrae in the body, each with articulations (facet joints) on the left and the right.  The left and right facets and the vertebral disc make up a three pronged weight-bearing structure that is replicated at all 24 levels of the spine.  Therefore, these three entities (left and right facet joints and the disc) of the spine help to maintain the upright posture in humans.

Facet syndrome is the term given to the complex of symptoms experienced when these facets are jammed one upon the other.  These facet joints are lined with cartilage (allows ease of movement and provides cushioning) and surrounded by a capsule.  Problems arise when the facet joints get swollen and irritated (inflamed) as a result of being restricted or not moving well (subluxated).  Subluxations are often the result of poor posture, everyday wear and tear, or the trauma of lifting or bending incorrectly.  The joints don’t move properly and they are irritated which affects surrounding nerves and soft tissue.  The patient will complain of localized low back pain with some referral into the hip/buttock or leg pain above the knee.  Often the patient may also report an increase with pain when sleeping/lying on their belly and/or bending backwards.  Facet syndrome responds extremely well to chiropractic.  The adjustment will help free the facet and reduce muscle spasm and nerve irritation.

Disc Herniation

As discussed before, there are 24 vertebrae in the spine.  The bottom 5 are called lumbar (low back) and are prone to having injury in their built-in shock absorbers (discs).  Disc injuries can be as simple as an irritation or as serious as a bulge or a disintegrating disc (sequestered).  All of these can be very painful if they press on a spinal nerve.  The nerves they press against often lead to one of the hallmarks of disc herniation, leg pain.

Disc injuries may be from chronic poor posture or from various injuries usually involving flexion (bending forward) or rotation.  Excessive loads can also cause damage.  Usually bending forward or sitting cause a worsening of the symptoms.  Some injuries resolve with exercises and therapy, others may need medication and, rarely, some need surgery.

Sciatica

Sciatica is the inflammation of the sciatic nerve (the largest and longest nerve in the body).  It is often described as burning, sharp or shooting pain in the back, the buttock, the back of the thigh or the leg.  In my own clinical experience, I find the farther down the leg the pain travels, the worse the injury is.  Often it is compared to the “worst toothache” possible.  There are three common areas of injury that lead to sciatica.

1. The lower back (facet joints) may become restricted, irritating the sciatic nerve
2. A sacroiliac joint (pelvic joint) subluxation may irritate the sciatic nerve
3. The deep muscles of the buttock may compress or irritate the sciatic nerve

Chiropractors can help reduce or eliminate sciatica.

Sacroiliac Joint Dysfunction

The sacroiliac joint lies next to the spine and connects the sacrum (tailbone) with the iliac crest (pelvis).  The joint is very strong.  It transmits all the forces of the upper body to the pelvis, hips and legs.  It acts like a shock absorber and its movements assist walking and sitting.

Dysfunction of the sacroiliac joint is a cause of low back and/or leg pain.  The pain can be similar to the symptoms caused by lumbar disc herniation.  Too little movement, hypo mobility or fixation of the joint is often the cause of this dysfunction.  The pain typically radiates on one side of the low back or buttocks and may go down the leg.  The pain usually remains above the knee but may refer to the foot or heel.  Some people present with a short leg on the side of the dysfunction as the postural back muscles go into spasm.

Sacroiliac joint adjustments can often normalize the motion at this joint and reduce spasticity and pain.

Thoracic Fixations

The thoracic spine is the middle of the back and consists of 12 of the 24 vertebrae.  These 12 vertebrae correspond with the 12 pairs of ribs that we have.  The ribs start at the back where they articulate with the spine.  They then curve around to the front and attach to the sternum (breast bone) or cartilage, protecting the internal organs.

Thoracic joint sprains result in local pain and tenderness and reflex muscle spasm.  The intercostal nerves may become irritated which can lead to pain in the back (adjacent to the spine) or it may follow the rib around to the front.  It is often worsened with bending backwards, to one side or rotating your middle back (as in swinging a golf club, a bat or a hockey stick).

Rib Fixations (subluxations)

These injuries can be quite aggravating often leading to sharp or severe pain.  Sneezing, coughing or taking a deep breath can aggravate the pain.  The pain is usually on one side of the spine and the onset is usually rapid following a fall, push, misstep, stretch, sneeze or cough.  Muscle spasm often occurs in the region of the rib fixation.  Some rib fixations can cause pain to radiate down the arm. The pain can also be limited to just beside the spine, it can radiate from the back to the front, or in some individuals it feels as if the have been stabbed from the back and right through to the front.  People with scoliosis often have rib, thoracic spine restrictions or both.  Chiropractic care can greatly help with thoracic and rib subluxations. The adjustment unlocks the restriction allowing proper joint movement and eliminating the pain.

Cervical Facet Syndrome

The facet joints are the articulations of the spine that allow each vertebra to move securely with respect to the vertebra above and the vertebra below.  There are 24 vertebrae in the body, each with articulations (facet joints) on the left and the right.  The left and right facets and the vertebral disc make up a three pronged weight-bearing structure that is replicated at all 24 levels of the spine.  Therefore, these three entities (left and right facet joints and the disc) of the spine help to maintain the upright posture in humans.

Facet syndrome is the term given to the complex of symptoms experienced when these facets are jammed one upon the other.  These facet joints are lined with cartilage (allows ease of movement and provides cushioning) and surrounded by a capsule.  Problems arise when the facet joints get swollen and irritated (inflamed) as a result of being restricted or not moving well (subluxated).

Subluxations are often the result of poor posture (head forward or rotated), prolonged hyperextension (looking up), trauma (whiplash, etc), everyday wear and tear or even a bad nights sleep.  The cervical spine has seven vertebrae with left and right side joints connecting each vertebra with the one above and below.  If the joints in the neck become restricted (subluxated), the person will have a complaint of localized neck pain with possible referral into the head (headaches), the upper back or even the upper limb.  Turning the head to one or both sides may aggravate the pain, as does extending the neck (looking up).

The pain is relieved when the joint begins to move properly (after being adjusted) and the muscles relax.

Cervicogenic Headache

The International Headache Society developed diagnostic criteria for cervicogenic headache.

a) Pain localized to the neck and occipital region may project to the forehead, orbit, temples or ears
b) Pain is precipitated or aggravated by specific neck movements or sustained neck posture
c) Also included were; abnormal tenderness, change in neck muscle contour or tone and response to stretching.  Other criteria    
    involving x-rays were also noted.

Cervical headaches are associated with movement abnormalities in the cervical intervertebral segments (joints in the neck).  The painful intervertebral segment most often involved is between C2 and C3 (the second and third neck vertebrae).

Years ago a French medical professor by the name of Robert Maigne came to believe that many headaches originated with a structural problem in the neck.  It was not until 1995 when a team of medical doctors at Syracuse University established neck problems as the cause of many headaches with scientific, anatomical proof.  Chiropractors have believed that headaches can result from neck injuries for decades.  The development of the widely accepted concept of cervicogenic headache has opened a new door for chiropractic.  It is expected that a large percentage of headache sufferers will fall into this category and chiropractic has much to offer as first line care for cervicogenic headache.

Whiplash and Chiropractic

Whiplash is not a disease like arthritis or high blood pressure but a description of how an injury occurred.  When a person suffers a whiplash injury their spine (usually their neck) was hurt by being thrown around in a certain manner.

Whiplash Mechanism
Whiplash usually occurs when the head and neck are unexpectedly or suddenly thrown very quickly in one direction and then rebound in the opposite direction.  In a rear-end injury the first thing that occurs is the body is thrown forwards but the head is thrown backwards and the neck is hyper-extended.  A front-end collision, or sudden stopping of a car leads to an initial hyperflexion (forward bending) of the neck.

No matter what movement is dominant, in almost all whiplash type injuries there is a certain amount of hyperflexion and hyperextension.  That is because the muscles react to the initial injury by pulling or rebounding in the opposite direction.  The rebound can and often does cause injury.  There is more to whiplash than hyperflexion and hyperextension.  Usually the head is rotated a slight bit, either to the right or left when an accident occurs and this complicates the effects of the injury.

Factors Affecting Injury
All whiplash injuries are a little different because there are so many things that change from accident to accident:  how the driver was facing, his/her age, amount of warning or state of preparedness, the health of their bones, muscles, ligaments and discs, the direction of the impact and the speeds involved, road conditions and vehicle sizes or design.

Unfortunately wearing a seatbelt has little effect on whiplash injury protection.  Headrests, however, which are fairly standard these days, do offer some protection in the hyperextension aspect of the injury.

Whiplash Symptoms
Whiplash symptoms may start as neck soreness or stiffness, perhaps accompanied by a headache immediately or within a few hours of the accident.  Along with these symptoms there may be pain and/or numbness, tingling, or a pins and needles feeling between the shoulder blades, arm and hand.  Some people may experience ear ringing or dizziness.  Sometimes the eyes can be affected and there may be pain behind the eyeballs, blurred vision, sensitivity to light or other visual symptoms.

Chiropractic Care for Whiplash Victims
Any kind of accident or trauma may (and usually does) cause spinal subluxations.  In other words the vertebrae are restricted or jammed and are “pinching” or more accurately, “impinging” or interfering with nerves.  Often this is a painless condition, but in whiplash-type injuries to the neck, the vertebral restrictions, because of the neck anatomy, are often quite painful.  Chiropractic adjustments to normalize joint motion combined with soft tissue therapy and exercise give the patient the best chance to make a full recovery.