Who Needs an X-ray?

Troublesome Hips!

Whilst it is fair to assume as a chiropractor I see lots of people with neck pain and back pain I also see lots of patients with hip pain. Hip pain itself is a common problem and can affect patients of all ages.

The first job is to identify whether the pain is actually coming from the hip joint. This may sound obvious but pain around the hip area can be as a result of inflammation of the sacroiliac joint or referred pain from the joints of the low back. A detailed case history and physical examination should be able to identify the specific cause of pain.

So it is the hip joint…now what?

A lot depends on the age and activity levels of the patient as different conditions are more common amongst different groups of the population. For example, somebody under 40 who is particularly active may in fact only have trigger points in the gluteal musculature and this can be restricting normal hip range of motion. Tightness in hip flexors around the front of the pelvis can cause similar problems. In those who are over 60 who display pain and restricted movement of the hip joint osteoarthritis is one of the most common causes. Arthritis UK estimates that over 650,000 people in the UK have painful osteoarthritis in one or both hips.

What does a chiropractor do to treat the hip?

Chiropractic treatment for hip problems will primarily mobilise the hip joint with manual therapy techniques. If joint movement becomes restricted this is usually a response to try and prevent further damage and irritation to the joint. Whilst this is okay in the short term, if the joint remains restricted it often becomes more stiff and painful and so you have to get it moving again .My job as a chiropractor is to slowly mobilise the joint and loosen associated muscles, ligaments and other soft tissues to restore normal joint movement. As a chiropractor I try and view the body as a whole and so treatment for hip problems will often include mobilisation and/or manipulation of the pelvis and low back in addition to working on the hip joint. This is because when you move the hip, the joint does not move in isolation and foot, knee and hip movement all affect pelvic and spinal motion.

How many treatments will it need?

The question everybody asks first! Whatever the cause of hip pain, a course of chiropractic treatment can often resolve symptoms or at least offer some level of improvement. The number of treatments required depends on the cause, activity levels and lifestyle factors of the patient but as a rough guide, 6-8 treatments for younger patients and 8-10 treatments for older patients will usually bring good results. Of course some patients do respond to care faster than this and after a full case history and examination I can give a more accurate estimate of the number of treatments required.

The Queen Visits Leeds : no sign of back pain for this pair!

So I happened to be in Leeds city centre today and was fortunate to see the Queen and Prince Philip on their visit to Leeds. I was struck by just how well they both look given their respective ages of 86 and 91. I’m no royalist but what an inspiration to see Queen Elizabeth “working” and looking so fit and mobile. Whether you love the royal family or not, how many of us can say that when we are 86 and 91 years old we could manage the same thing?

I don’t know what the secret is in their case but it is certainly something we should all strive for. A healthy lifestyle consisting of a balanced diet and regular exercise really can go a long way to keeping our bodies fit and mobile. Chiropractors are not just here to help with back pain and neck pain but we also try to encourage patients to lead a healthy and active lifestyle. The news this week has been full of the recent research from Harvard University that questioned whether lack of exercise was comparable to smoking in terms of risk factors more major diseases. The evidence really is stacking up now and we need to go beyond the fad of dieting and artificially low fat and low sugar foods and start eating properly and exercising regularly. And with the Olympics now so close what more inspiration do you need to start ?

Exercises for Back Pain 5 : The Quadruped

This is another great exercise to help with low back pain from Leeds chiropractor Alison Eaves at Revive Chiropractic.

This one is the quadruped, great for working the gluteal muscles and working the trunk muscles (core) to give you strength and control to maintain correct posture. You can either watch the video “Exercises for Back Pain 5 : Quadruped” by clicking on the link or read the instructions that follow. Some people like to read how to do something, others understand better with visual examples and either is fine.

1. On the floor get into an all fours position with your knees underneath your hips and the crease of your wrists directly underneath the shoulders with the fingers pointing forwards.

2. Engage your core and abdominal muscles by gently pulling your belly button towards the middle of the back but allow the spine to stay relaxed. You can think of it as a corset or belt tightening around your waistline.

3. Slowly lift the opposite arm and leg off the mat. Straighten your leg out behind you and bring the alternate arm straight forwards in front of your face.

4. Repeat slowly on the other side. Aim to keep the pelvis as level as possible; the only movement should be from the arms and legs.

5. Aim to stay as relaxed as possible ensuring you are looking down at the floor and the neck is relaxed.

6. Repeat 8 times on each side.

Tips

If you keep falling over you may be trying to lift the arm and leg on the SAME side, remember it is left leg and right arm, right leg and left arm!

If you are still having difficulty then don’t lift the arms and legs so far off the ground, you can start with small movements and slowly build the movement.

To see the video that accompanies this post either click on 5) “Quadruped” on the right or copy and past the following link:

Little Direct Evidence for Use of Drugs to Treat Sciatica

As a chiropractor, lots of my patients come and see me saying they have got sciatica. However it is a term that is often misunderstood and misdiagnosed.

What is sciatica

In its truest sense sciatica refers to low back pain and accompanying leg pain. It is caused by compression of spinal nerve roots as they emerge from the spinal canal. The most common cause for this is the herniation of a lumbar disc but compression can also be caused by spondylolisthesis (where one vertebra slips forward on anther) or degenerative bony spurs. In all three cases the aim of chiropractic treatment is to improve the biomechanics of the low back to try and relieve the compression of the nerve root and calm inflammation in surrounding tissues.

Will paracetamol or ibuprofen help my sciatica?

A recent study looked at how effective the current treatments for sciatica were and found that drugs are of little use in helping the condition. Commonly prescribed drugs include paracetamol, non-steroidal anti-inflammatories (NSAID’s) as well as antidepressants and muscle relaxants. However it was found that they were generally no better outcomes on pain or function over taking a placebo (a sugar pill with no therapeutic effect).

So make an appointment and come and see a chiropractor!!

Other causes of leg pain

The hip joint, sacroiliac joint and the muscles of the buttock and hip region can all refer pain into the leg. As a chiropractor it is my job to thoroughly examine the area of complaint and work out which structures as responsible for the pain.

Study published in BMJ 2012;334:e487

Exercises for Back Pain 4 – The Side Bridge

Exercises for Back Pain

4 : The Side Bridge

This is another great exercise to help with low back pain from Leeds chiropractor Alison Eaves at Revive Chiropractic.

What is a side bridge?

This one is the side bridge, so called as you lie on your side, push your bum/pelvis into the air and make a bridge. Like the other low back exercises, it works on your core strengthening but specifically the quadratus lumborum(QL) muscle, one of the deep back muscles. The QL muscle is very important in spinal stability and so the side bridge should be an essential component of any low back rehabilitation plan. The side bridge is also a great catch all exercise for working a variety of upper and lower back muscles.

You can either watch the video “Exercises for Back Pain 4 : The Side Bridge” by clicking on the link or read the instructions that follow. Some people like to read how to do something, others understand better with visual examples and either is fine.

How to do a side-bridge:

1. Lie on your side on the floor/mat supporting yourself on your elbow. Make sure your elbow is under your shoulder and the forearm is perpendicular to the body.

2. Engage your core and abdominal muscles by gently pulling your belly button towards the middle of the back but allow the spine to stay relaxed. You can think of it as a corset or belt tightening around your waistline.

3. With your knees bent to begin with, raise the hips upwards so that there is a straight line from your hips to your ankles.

4. Hold for a couple of seconds and then lower to the starting position and repeat.

You should perform this exercise 10 times on each side. As you get stronger you can increase from one set of repetition up to 3 sets on each side.

Finding the exercise too easy?

Then straighten the legs! This will make the muscles work harder.

To see the video that accompanies this post either click on 4) “Side Bridge” on the right or copy and paste the following link:

Exercises for Back Pain 3 : Shoulder Bridge

Exercises for Back Pain

3: Shoulder Bridge

This is another great exercise to help with low back pain from Leeds chiropractor Alison Eaves at Revive Chiropractic.

This one is the shoulder bridge, great for relieving tension and loosening up the spine. You can either watch the video “Exercises for Back Pain 3 : Shoulder Bridge” by clicking on the link or read the instructions that follow. Some people like to read how to do something, others understand better with visual examples and either is fine.

1. On the floor lie onto your back making sure your weight is evenly distributed between both hips and shoulders

2. Engage your core and abdominal muscles by gently pulling your belly button towards the middle of the back but allow the spine to stay relaxed. You can think of it as a corset or belt tightening around your waistline.

3. There should be a slight gap of a couple of centimetres between the floor and the base of your spine.

4. Gently contract your gluteal muscles (your bottom!) by squeezing your buttocks together.

5. Then push your hips up from the floor until your make a straight line with your torso. Make sure your bottom leaves the floor first, and slowly lift off vertebra by vertebra moving up the spine.

6. The exercise is called a shoulder bridge as that’s the position your body should make. No sagging bridges or wonky bridges!

7. Hold for a count of 5 seconds

8. Gently return to the start position taking care to roll each vertebra back down to the floor from the middle of the back and finishing with the buttocks.

To see the video that accompanies this post either click on 3) “Shoulder Bridge” on the right or copy and past the following link:

Exercises for Back Pain 2 : Cat-Camel

This is another great exercise to help with low back pain from Leeds chiropractor Alison Eaves at Revive Chiropractic.

This one is the cat-camel, great for relieving tension and loosening up the spine. You can either watch the video “Exercises for Back Pain 2 :Cat Camel” by clicking on the link or read the instructions that follow. Some people like to read how to do something, others understand better with visual examples and either is fine.

1.On the floor get into an all fours position with your knees underneath your hips and the crease of your wrists directly underneath the shoulders with the fingers pointing forwards.

2. Engage your core and abdominal muscles by gently pulling your belly button towards the middle of the back but allow the spine to stay relaxed. You can think of it as a corset or belt tightening around your waistline.

3. the upward phase: as you breath out gently stretch and arch your spine upward using your abdominal muscles to gently push the spine up towards the ceiling.

4. hold for a few seconds and relax back to neutral

5. the downward phase: using abdominal and low back muscles gently tip the tailbone up towards the ceiling and allow your abdominals to sink slightly towards the floor. Your shoulder blades should be pulled downward slightly towards the lower part of the back.

NB If you are experiencing mid back pain it is okay to use the whole of the spine in this movement and not just the very lower part of the back. You will fund that on the upward phase you can flex the head and neck gently so the chin is moving towards the chest and this will increase the stretch. Any questions about modifying this stretch just ask!

To see the video that accompanies this post either click on 2) “Cat-Camel” on the right or copy and past the following link:

Exercises for Back Pain 1 : Pelvic Tilts

Leeds chiropractor Alison Eaves is on hand to offer help with back pain. This is the first exercises in a series designed for you to help manage low back pain in a simple and effective way alongside usual chiropractic care.

This is the exercise I normally start with for patients with low back pain or poor core stability. The exercise works to strengthen the abdominal musculature and serves as a good introduction to the basics.

You can either watch the video “Exercises for Core Stability 1 : Pelvic Tilts” by clicking on the link or read the instructions that follow. Some people like to read how to do something, others understand better with visual examples and either is fine.

1) Stand with feet hip width apart and bend the knees slightly.

2) Ladies contract your abdominal muscles by drawing up through the pelvic floor, gents you draw up from your testicles! About a 10% muscle contraction is all you need so you should still be able to easily move, talk and most importantly breathe. Draw your belly button inwards towards the middle of your back.

3)So now you are in position and ready to go! Simply rock the pelvis forwards and backwards. The trunk should remain still and only the pelvis rotates. Keep the knees slightly bent and don’t let the legs move.

Do not worry if you find this very strange and quite difficult to begin with. Practice and you will get used to it.

Useful Tips: Imagine you have a set of headlights on the front of your pelvis and they are alternating from shining at the floor to straight ahead of you.

To see the video that accompanies this post either click on "1) Pelvic Tilts" on the right or copy and past the following link:

http://www.youtube.com/watch?v=_rInZX7PEVk&feature=channelis and they are alternating from shining at the floor to straight ahead of you.

Putting a Spring in Your Step

So the New Year resolutions of a better diet, less alcohol and more exercise have faded?! I’m here to tell you that it is not too late to start making positive changes today and how to achieve an active and healthy lifestyle for 2012. Firstly you need to start to take some responsibility for your health and fitness. Visiting a chiropractor is one of the positive steps you can take to improving your health and wellbeing and live life day to day with less pain.

So how can a chiropractor help?

I’m going to concentrate on is getting you looser, more mobile and increasing spinal stability. This will help in several ways but ultimately it will reduce pain levels by helping to restore normal joint movement and the biomechanics of the spine and pelvis.

How are we going to achieve this?

I’m going to post a series of stretches and spinal stability exercises with links to You Tube videos that I have made. So you get a video of me working with a patient to demonstrate the exercises and explanations of what each specific exercise achieves.

So first we deal with “stiff joints and tight muscles”

If you are stiff then the exercises I’m going to post will help you to loosen up. A lot of pain can be generated by tightness and adhesions in the myofascial structures. Myofascia is connective tissue that surrounds muscles (and organs) : think of it like fascia is the plastic bag with your shopping in it (mucles). It keeps everything in place! Big improvements can be made just by moving joints through their full range of motion. We are not designed to be idle and sit still all day.

There will also be articles coming on how increasing spinal stability (even if you think you are fit, healthy and can do 100 sit ups!) will help movement patterns and can lead to improved sporting performance.

Do I still need to book an appointment with you or can I just watch the videos?

The videos and upcoming blogs are designed to complement my chiropractic care, not replace it. I would advise anyone suffering any back or neck pain to call me and discuss it further on 07828 686026. I have clinics across Yorkshire in Leeds City Centre and North Leeds. Of course you have to be careful about starting exercises if you are in pain and so always see a qualified health professional such as a chiropractor, osteopath or physiotherapist for a full examination before starting any new exercise routine.

To see the video that accompanies this post either click on "Introduction" on the right or copy and paste the following link http://www.youtube.com/watch?v=4Tedgbpr0DU&context=C4e368d0ADvjVQa1PpcFP5VV4gaZAsR8IWWyRLois7R3B_l4BuJQA=