Oh, My Aching…Leg?
September 11, 2009
Certain low back conditions give rise to more than just low back pain. For example, leg pain can be more intense than low back pain, even though the cause of the leg pain is coming from the low back. When this happens, many patients complain that they have “sciatica,” which refers to radiating pain that starts in the low back and extends down into the leg. When the intensity of leg pain is worse than the low back, it can make patients wonder, “…where is my problem really coming from?”
To understand this better, a short “anatomy lesson” is appropriate. The spine can be divided into two halves, front and back. The structures in the front half include the larger, heavier bones called vertebral bodies and the shock absorbing cushions that lie between the vertebral bodies called the intervertebral disks. The disk is like a jelly donut where the center is liquid-like and the outer portion is a tough, criss-cross pattern cartilage arranged like the rings on a tree stump. There are also ligaments that hold the vertebrae and disks tightly together. The back half of the spine includes the spinal cord, nerve roots, as well as the small joints of the back called facet joints. Every movable joint has a joint capsule that helps lubricate the joint and limits the amount of movement, along with surrounding ligaments. The larger, heavier vertebral bodies and shock absorbing disks carry the majority of the weight (approximately 80%) while the smaller facet joints carry much less weight (only 20%) but are more responsible for guiding the movements of our back.
When leg pain is present, it can be caused by either a pinched nerve, or, an inflamed facet joint.
When a nerve is pinched, the cause is usually from the intervertebral disk where the jelly-like center leaks out and presses on the nerve that goes down the leg, commonly referred to as a “herniated disk with sciatica.” This type of pain is quite specific, easy to describe and often extends below the knee to the ankle or foot. It can include muscle weakness, numbness in certain areas of the leg, and bending forward increases low back and leg pain while bending backwards reduces the leg pain (and sometimes the LBP).
When a facet joint capsule tears (technically, called a “sprain”), the pain is “referred” down the leg in a generalized, non-specific manner, usually described as a “deep ache,” often hard to describe and usually does not go below the level of the knee. Here, it feels better to bend forward and worse to bend backwards, of which neither movement changes or affects the leg in a specific way. Disk related leg pain carries a potential for surgery if all non-surgical approaches fail, while facet joint referred leg pain rarely requires invasive treatments or surgery.
To learn more about Leg and Lower Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
What Is Fibromyalgia and Can Doctors Agree On the Diagnosis?
September 8, 2009
Bayonne and Scotch Plains Chiropractor Comments: Fibromyalgia (FM) has long been considered a condition involving the soft tissues of the body, that is, the muscles, ligaments, tendons and fascia. It is defined as “a chronic, generalized pain condition associated with symptoms of fatigue, stiffness, and sleep disturbance and is characterized by the physical findings of local tenderness in many specific but widely dispersed sites. Fibromyalgia is the most common cause of widespread pain. The prevalence of this disorder in the general population is between 3% and 5%… Most patients with fibromyalgia remain symptomatic for several years, and no cure has been identified.” Disturbances in the central nervous system (CNS) has also been linked to this condition.
In one study, 168 FM patients had the CNS evaluated by hearing tests, eye movement tests, and a test that evaluates balance/dizziness. Abnormal findings were common in the FM patient group compared to non-FM subjects. Another study utilized an electrical current treatment approach through the skull to stimulate part of the brain to see if that would help a group of patients with FM. Two different parts of the brain were stimulated as well as a sham or fake treatment approach. One of two parts of the brain that was stimulated resulted in reductions of pain that lasted for three weeks and mild improvements in quality of life were reported.
Comparing 287 general practitioners (GPs), 160 orthopedists, 160 physiatrists, and 160 rheumatologists, evaluating a patient injured in a motor vehicle crash, those most likely to diagnose FM were rheumatologists (83%) with physiatrists and GPs in the middle at 60% and 71%, respectively. Orthopedists were least likely at 29%. There were five factors found to be important in the respondent’s agreement or disagreement with the FM diagnosis:
1. The number of FM cases diagnosed weekly by the respondent (strong predictor).
2. The patient’s gender (females > males was a strong predictor).
3. The force of the initial impact (least important).
4. The patient’s psychiatric history before the trauma (more important).
5. The initial injury severity (least important).
This information is important as the shift from considering FM to be strictly a condition of the muscles and other soft tissues to being a condition of the central nervous system will affect our future treatment strategies. Obtaining multiple opinions from various types of practitioners will most likely result in a variety of opinions. Previous reports of treatment benefit utilizing chiropractic approaches, exercise, and strategies to facilitate sleep restoration remain strong in the management process of FM.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
Whiplash and Muscle Weakness
September 7, 2009
Scotch Plains and Bayonne Chiropractor Comments: Whiplash involves the stretching of nerves, muscles, and ligaments. The forces are so great during even low speed collisions, that the muscles cannot resist the forces. The injury of whiplash produces inflammation to repair the damaged tissues. During this time, fast movements of your head and neck will result in pain, so most patients become overly cautious and move their neck very little. Unfortunately over time, because of the lack of muscle use, you become weak. This sets up the difficult combination of both damaged ligaments and weak muscles. Now there is little strength and support for the neck. This may make you very vulnerable to a future injury. Even slight movements can produces flare-ups when the muscles are too weak. The patient may feel their head to be heavy. Sometimes patients’ injuries can be so severe that dizziness develops due to the asymmetrical muscle and nerve activity. This is called cervicogenic vertigo. If you get dizzy when you move your head, then you may have this condition.
While it may seem intuitively obvious that addressing weak neck muscles are important to a full recovery, few patients will do them unless prompted and explained by their doctor. Specific muscles need to be strengthened in a way that does not cause further damage to the ligaments. If the muscles are tight in certain areas, then stretching or deep tissue massage, or trigger point therapy, can help to loosen areas and decrease pain.
But the most important thing you can do on a daily basis is to keep exercising. Studies have shown this to be effective in whiplash treatment when there is a mechanical neck disorder. A specific exercise program can be prescribed by a doctor of chiropractic Special attention should be made to your posture and x-rays, and how specifically you were injured. Only in this way, will the treatment be effective and not risk further trauma.
Exercises such as rolling the head around the shoulders should be avoided since the neck is not a ball and socket joint like the shoulder. In some directions, the joints will have excessive laxity and the muscle exercises should be done in the neutral position versus at the end range or limit.
Because the ligaments are so badly damaged in whiplash, it’s important to maintain the supporting muscles (both strong and flexible), to keep the spine stable and pain free.
To learn more about Whiplash and Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Eric Chludzinski services both Hudson County as well as Union County, both in New Jersey.
Self-Management Approaches For Your Headache
September 1, 2009
Scotch Plains and Bayonne Chiropractor Comments: One of the reported causes of both migraine and tension headache is cervical muscle tension and spinal joint abnormalities in the neck. When considering treatment for headaches, whether it’s a tension-type or migraine, there are many choices available. The question is, which of the many options offer the best benefit?
One study compared the effectiveness of physical therapy (PT) to that of relaxation and thermal biofeedback (RTB). Both groups were treated using one of these approaches, and if at least a 50% improvement was not achieved, the other form of treatment was then utilized. Results were calculated at 3, 6, and 12 month timeframes. The PT group of 30 females used standard physical therapy approaches that included:
• Posture correction for alignment of head and spine
• Cervical range of motion for neck and shoulders
• Isometric strengthening of the neck
• Flare-up management techniques
• Active self mobilization of the spine
• Whole body stretching
The goal was to target muscular abnormalities and those in this group were to perform the above twice per day for 30 min. The RTB group were instructed in relaxation and thermal biofeedback (RTB) treatment that focused on muscle relaxation, breathing exercises, and the use of a thermal feedback device that determines when the subject’s temperature changes telling them if they are successfully relaxing. The participants were to practice at home and utilized audiotapes for relaxation and monitor success with the portable biofeedback unit.
Using the PT approaches, only 13% reported a successful outcome compared to 51% in the RTB group. In the follow-up of 3, 6 and 12 months, both groups reported continued benefit. When the subjects reported less than 50% benefit with either method, they were given the other treatment option, and the PT approach achieved a 47% success rate and the RTB 50%. These findings suggest that treatments that focus on muscle tension reduction (such as the RTB group) might result in a better outcome compared to only addressing posture, range of motion and flexibility. However, as illustrated in the follow-up group, PT did have a positive beneficial effect. An important point – the subjects in the RTB group demonstrated the ability to reduce migraine pain and the associated disability by using a self-applied form of care. When teaching the patient to self-manage their condition by instruction and training, the greater the likelihood is for a successful outcome.
To learn more about Headaches, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Hudson County and Union County.
Prompt Treatment for Better Carpal Tunnel Syndrome Results
August 31, 2009
Bayonne and Scotch Plains Chiropractor Comments: Many people suffer from CTS (Carpal Tunnel Syndrome) and unfortunately, often ignore the initial symptoms of numbness or tingling in the hand(s). These early symptoms are typically not too alarming and hence, they often do not raise the level of concern until more intense symptoms occur; such as waking up from sleep due to numbness, dropping items, difficulty buttoning clothing, needing to switch hands when driving, difficulty writing, typing, knitting, as well as work related pain. There may also be fear of job loss associated with CTS, especially in these hard economic times with frequent layoffs, prompting CTS sufferers to postpone initial care. Unfortunately, delaying treatment is associated with a longer recovery time when compared to prompt management which usually results in a quicker, less complicated and more satisfying recovery.
There are many causes and contributing factors of CTS. The most prevalent cause is mechanical irritation from simply moving the hands too fast for too long, without enough rest. Another risk factor is age (over 50 years old). In this era of an aging workforce, this may be a significant issue. Fast, repetitive movements of the arms and hands are often a direct cause and can be appreciated by watching someone knit rapidly and/or performing line work using fast, repetitive movements. If the hands/wrists have to bend in awkward positions to accomplish a work task, or if a tool that is frequently used places pressure in the palm of the hand, these can also contribute to the onset or perpetuation of CTS. Other conditions can also contribute to CTS including inflammatory arthritis like rheumatoid, diabetes, pregnancy, the use of birth control pills, obesity and hypothyroidism.
The management of CTS is case specific, and is dependent on which of the above mentioned causes or contributors are present. Management of any metabolic disorder such as diabetes or hypothyroid is important, especially compliance with taking appropriate medication, when indicated. The management of weight, hormone replacement therapy, and fluid retention all play a role in CTS management. Ergonomic or job-related management strategies are very important and can include work station modifications so that unnecessary awkward arm/wrist/hand positions can be avoided. This may require moving the item being worked on to a less stressful position, using a different type of tool handle (screw driver, etc.), changing the height or reach distance at which the material is worked on, and taking “mini-breaks” every ½ to 1 hour when the lack of rest is a contributor.
To learn more about carpal tunnel syndrome, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services both Union county and Hudson County.
Where Can I Find Information About Fibromyalgia?
August 25, 2009
Bayonne and Scotch Plains Chiropractor Comments: Fibromyalgia (FM) is a very common condition that affects approximately 5% of the female population. A partial list of symptoms associated with FM include widespread pain and includes fatigue, non-restorative sleep, generalized stiffness, memory problems, poor balance, headache, numbness/tingling, painful muscle cramps/spasms, depression, anxiety, back pain, jaw pain, and hypersensitivity to: noise, lights, odors (perfumes), and weather changes. It is important to note that FM is NOT a psychiatric disorder, and can be diagnosed and treated, though promising a cure is not realistic.
There are many websites and articles that one can access through the internet. This is not an endorsement for any one site but rather, a review of one site that is available. The “Fibromyalgia Information Foundation” (www.myalgia.com) offers a lot of information that is very informative and usable. This includes information on the condition, the diagnosis, treatment, exercise advice and more. For example, under “Treatment of FM,” it is stated that there is no “cure” for FM. Rather, the goal of treatment is to teach the patient to gain “control” over the condition rather than to have the condition control the patient. There are four major areas of treatment to concentrate on which include pain management, exercise, sleep, and psyche. For pain management, there are lists of different medications, manual therapies and physical agents that can be of benefit. Exercise is emphasized to be gentle stretching after warming up and not to exercise too aggressively, so as to avoid irritation. In addition to stretching, light non-impacting aerobic exercise such as walking, water exercises, and/or stationary bike are recommended with a gradual increase in dose. Starting out at short 3-5 minute sessions, 2-3 times per day and gradually increase the session duration to three, 10 minute sessions/day, then to 2 -15 minute sessions and eventually one 20-30 minute session/day may be wise.
Regarding sleep, all FM patients complain of interrupted, non-refreshed sleep and improving this pattern is important. If an underlying condition such as whiplash, back, neck, or shoulder pain is the cause of interrupted sleep, that condition should be managed. A sleep study to determine if sleep apnea is an issue and the use of a C-pap unit can be quite helpful in gaining restorative sleep. Multiple medications are listed with dose recommendations that can be shared with your primary care provider. Regarding the “psyche”… Because chronic pain can result in depression, anger, fear, withdrawal and anxiety, management of these issues is important. Early detection and treatment is ideal. Interventions can include activity management such as ergonomic modifications both at work and home such as weight lift/carry limits, computer station re-design, the use of headsets vs. phones, and modifying other irritating postures should be considered. A de-emphasis of medications and long-term health care provision without clear goals is important. Unless an underlying psychological condition is present, counseling may be non-productive. However, biofeedback and some behavior modification may benefit some patients that are having trouble coping with the pain and its effect on their life.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services both Hudson County and Union County.
Head, Neck and Jaw Pain
August 14, 2009
Scotch Plains and Bayonne Chiropractor Comments: Neck pain and headaches can be very disabling and can significantly alter a person’s normal pattern of living. Simple things like reading the newspaper, cooking, driving a car, and/or looking down when feeding a baby, can become almost intolerable. Canceling plans for the day or saying “no” to vacations can be very disheartening and often occurs because of severe neck pain and/or headache making these activities simply, “no fun.” The cause of the headaches associated with neck pain and dysfunction is usually due to the compression caused by the tight neck muscles squeezing the upper three nerve roots in the neck region, resulting in radiating pain into the head. Frequently, light and noise sensitivity, as well as nausea, can accompany a severe headache, which only adds to the activity limitations associated with neck pain. In fact, there are many experts who feel most headaches, even migraines, stem from the neck or are at least are very closely related. Since neck pain affects approximately two thirds of the population at some point during their lifetime, it becomes clear that headaches, in the absence of neck pain, are quite uncommon.
Another interesting and lesser-known relationship is the jaw (frequently referred to as the TMJ) and its association with neck function, especially the upper cervical vertebrae, as well as headaches. The muscles that move the jaw/TMJ are largely innervated by the 5th cranial nerve, also called the trigeminal nerve. Several studies have found that when stimulating structures innervated by the trigeminal nerve, neck and/or jaw pain was created and vice versa. Similarly, patients with jaw problems (temporomandibular dysfunction or, TMD) often report neck pain. When we open our mouth wide, head-neck extension always occurs followed by head-flexion when we close the jaw. Hence, the neck is always moving when we chew, yawn, talk, and clench our teeth. In fact, all of these every day activities result in jaw, head, neck motion extending from the base of the skull and first cervical vertebra and continues down through the entire cervical spine. In order to properly treat these patients, one must focus on multiple regions, not just the neck area. It has been demonstrated when we bite down, there is a corresponding tightening of two important muscles in the neck and upper back region. Similarly, studies show relaxation of muscles in the neck, upper back and TMJ after spinal manipulation to the neck is applied. Injuries to the TMJ are common but often not pursued by patients as often they’ll say, “my jaw clicks and snaps but I don’t think about it much.” .
To learn more about Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic.
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