Back Pain Rhode Island Chiropractic Clinic - Chiropractor Services for lower back pain relief
Back Pain: Lower Back Pain, Upper Back Pain, Spine Pain Relief
While there are many causes of lower back pain, most cases of low back pain can typically be linked to either a general cause - such as muscle strain - or a specific and diagnosable condition, such as degenerative disc disease or a lumbar herniated disc.
In the US, lower back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience it at some point in their lives.
Ironically, the severity of the pain is often unrelated to the extent of physical damage. For example, muscle spasm from a simple back strain can cause excruciating lower back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can actually be completely painless.
Types of Low Back Pain
Low back pain is typically classified as either acute or chronic:
- Acute back pain is short term, generally lasting from a few days to a few weeks. Some acute pain syndromes can become more serious if left untreated.
- Chronic back pain is generally defined as pain that persists for more than three months. The pain may be progressive, or may occasionally flare up and then return to a lower level of pain. With chronic pain, the exact cause of the pain can sometimes be difficult to determine.
Lower Back Anatomy
The causes of low back pain can be very complex, and there are many structures in the spine that can cause pain. Any of the following parts of spinal anatomy are typical sources of low back pain:
- The large nerve roots in the low back that go to the legs and arms may be irritated.
- The smaller nerves that innervate the spine in the low back may be irritated
- The large paired lower back muscles (erector spinae) may be strained
- The bones, ligaments or joints may be damaged
- The intervertebral disc may be damaged
Sometimes there is a neurological component, such as leg or foot weakness or numbness, as well.
It is important to note that many types of low back pain actually have no known anatomical cause; but this doesn’t mean that the pain doesn’t exist. The patient’s pain generator may not be identifiable, but this does not necessarily signify that the pain is all psychosomatic. Actually, an estimated 90% of patients with pain will not have an identifiable cause of their pain.
Estner Chiropractic Clinic’s program of treatment provides effective relief for back pain and many back pain related conditions such as pregnancy related chiropractic treatment, Sciatica, Disc Herniation, Disc Bulge/Protrusion, lumbar pain, treatment of l1, l2, l3, l4, l5, SI Joint pain, Sacroilitis using such methods as Traction and Decompression therapy. Chiropractic treatment requires no hospitalization, surgery, or medication. Chiropractic care, which is the first step in treatment, utilizes the body's inherent recuperative powers and the relationship between the spinal column, nervous system and the rest of the body to restore and maintain good health.The Rhode Island Chiropractic clinic of Dr. Stephen Estner provides injuries using Physical Therapy, Occupational Medicine, and other treatment methods for injuries including (Click on a topic below for more information):
- Herniated Disc
- Disc Bulge & Protrusion
- L1,L2, L3,L4,L5
- SI Joint Pain (Sacroilitis - Sacroiliac Joint Dysfunction)
- Chiropractic Care during Pregnancy
Doctors of Chiropractic medicine regularly treat sciatica as a result of a sports or work injury. Sciatica is characterized by pain that originates in the low back or buttock that travels into one or both legs. Sciatic nerve pain varies in intensity and frequency; minimal, moderate, severe and occasional, intermittent, frequent or constant.
Pain is described as dull, achy, sharp, toothache-like, pins and needles or similar to electric shocks. Other symptoms associated with sciatica include burning, numbness and tingling sensations. Sciatica is also called radiating or referred pain, neuropathy, or neuralgia. A misconception is that sciatica is a disorder - however, sciatica is really a symptom of a disorder.
Sciatica is generally caused by sciatic nerve compression. Disorders known to cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral body/ies), herniated or bulging discs (slipped discs), pregnancy and childbirth, tumors, and non-spinal disorders such as diabetes, constipation, injury, or sitting on one's back pocket wallet.
One common cause of sciatica is Piriformis Syndrome. Piriformis syndrome is named after the piriformis muscle. The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible to injury from a slip and fall, sports injury, work injury, hip arthritis, or a difference in leg length. Such situations can cause cramping and spasm to develop in the piriformis muscle, thereby pinching the sciatic nerve and causing inflammation and pain.
Sciatic nerve compression may result in the loss of feeling (sensory loss), paralysis of a single limb or group of muscles (monoplegia), and insomnia.
Contact a Rhode Island Sciatic Relief Chiropractor today at 401.275.2225 or EMAIL US NOW
Herniated Disc, Disc Bulge & Protrusion
Chiropractic Care and Back Pain: Non-Invasive Treatment for Bulging, Ruptured, or Herniated (Slipped Discs)
What is a "slipped" 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. Saying a disc has "slipped" does suggest that something has "slipped out" and is not where it's supposed to be, which is what happens in disc injuries.
Discs are made up of concentric circles or rings of fibrous material with a tough gelatinous center. When cracks or fissures occur in the fibrous rings, the gelatinous material in the center can begin to push out. A number of different factors may cause the disc to "slip".
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 outcome of disturbances elsewhere in the body.
Disturbed mechanics from lack of muscular support or muscular imbalance are important because discs can come under more stress from weak abdominal muscles, or too much weight around our abdomen. The resulting hyperextension can cause a wedging of the discs.
The opposite condition, hyperflexion, is caused when we round our low back because of weak back muscles or poor sitting habits. This causes stress on the disc in the opposite direction. Finally, if we put too much load on the back over a period of time, or occasionally in one dramatic episode, we can add another significant factor.A "slipped disc" most often occurs when a number of these and other factors act together to cause disc injury. For example, a middle-aged accountant who sits for long periods, suffers from disc dehydration, and has poor mechanics from weak abdominals, 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. Bingo. A slipped disc.
Chiropractic Treatment of Slipped Discs
How does the chiropractor determine whether this is a "slipped disc"?
Careful history taking, vital signs, and orthopedic and neurological testing are standards of practice in chiropractic offices. Are the reflexes intact? Is there loss of muscle strength or signs of muscle wasting? Is there loss of sensation along an area supplied by a particular nerve? These are vital questions that the orthopaedic and neurological exam can help answer.
Chiropractors utilize other diagnostic procedures that are unique to chiropractic and establish the foundation for a program of care. Chiropractors look carefully at posture and perform a postural analysis of the patient. They use techniques such as motion and static palpation to determine exact areas of restrictions in spinal joint motion. They palpate muscles and perform muscle testing, as well as perform tests for pelvic balance and determine whether there is a "short leg". X-rays of the low back are taken, or the chiropractor might send the patient to an x-ray facility for these films. Depending on the findings, the chiropractor may call for an MRI or other imaging study of the back.
Chiropractic Care of Low Back Disc Conditions
After analyzing this information, the chiropractor determines if the patient has suffered a disc injury. The crucial diagnostic question is, "what type of disc injury has occurred?" It is the answer to this question that will determine the chiropractic approach to treatment or referral.
There are some patients who are not good candidates for conservative chiropractic care. For example, if there is suspicion of a cauda equina syndrome in which loss of bladder control accompanies a disc injury, this is a medical emergency not treated by chiropractic. If there are unusual neurological findings with advanced loss of strength, sensation, and reflexes, the chiropractor will refer the patient to a spine surgeon (spine specialist) prior to initiating conservative care.
Most disc conditions do not fall into these more extreme categories. The great majority of disc injuries involve some degree of bulging of the disc. The "slipped" disc can be a slight, even temporary, push against the nerve or the spinal cord, or it can be a more definite mild, moderate, or marked bulge. Frank herniated discs occur when a fragment from the central part of the disc breaks completely through the fibrous rings.
Whatever the category of disc bulge, the low back pain, leg pain, and muscle spasms require examination and, in most cases, a period of conservative, non-surgical care prior to any consideration of surgical intervention.
What is chiropractic "Flexion-Distraction" technique?
Flexion-distraction technique has become the most widely used approach to treating symptomatic disc injuries involving back pain and the often-accompanying leg pain. Flexion-distraction involves the use of a specialized table that gently distracts or stretches the spine and which allows the chiropractor to isolate the area of disc involvement while slightly flexing the spine in a pumping rhythm. There is no pain involved in the treatment.
Theoretically, the tractioning or distraction of the disc combined with isolation and gentle pumping of the involved area allows the central area of the disc, the nucleus pulposus, to assume its central position in the disc. Flexion-distraction is thought to improve disc height.
These actions move the disc away from the nerve, reducing inflammation of the nerve root, and eventually the associated pain and inflammation into the leg.
Flexion-distraction is applied in a series of treatments combined with adjunctive physiotherapy, supplementation, and home instructions. Eventually, specific exercises for low back disc conditions are introduced. Patients are evaluated and monitored throughout the treatment program.
In flexion-distraction technique, chiropractors follow a "50% rule": if a patient has not improved objectively and subjectively by 50% at the end of 12 sessions, then imaging studies are assigned and spine specialist referral is considered. If there is substantial worsening at any time during treatment, imaging and neurosurgical referral are the standard of care.
Contact a Rhode Island Herniated Disc Chiropractor today at 401.275.2225 or EMAIL US NOW
Rehabilitation of the lumbar spine is a complex process that bridges both physical and emotional factors underlying chronic, recurrent, and postsurgical low-back and leg pain complaints. To understand the appropriate context for the use of chiropractic manipulation during rehabilitation, it is useful to examine the aims of the treatment plan as a whole.
The successful treatment plan must account for the constellation of factors that define the clinical status of the client when rehabilitation therapy begins. The principal aim of treatment is to address the physical deconditioning that arises from injury and related activity intolerance. Secondarily, rehabilitation offers a means to address residual symptoms fostered by incomplete clinical recovery during the acute care phase of treatment. The specific goals include increased function, reduction of pain levels, and enhanced quality of life; ideally, by promoting a rapid return to a work-ready or pre-injury status. Desirable clinical benefits include individual self-reliance and decreasing dependence on caregivers. The activity of rehabilitation must strike a balance appropriate to the severity of injury and the fitness of the person, versus the pace and intensity of executing the treatment plan.
Notably, experience and recent research suggest that appropriately used spinal manipulation can be an effective means of aiding persons with low-back and leg pain in transition from passive to active care. Manipulation also serves to control symptoms arising from the occasional exacerbations and related musculoskeletal injuries that arise during the course of therapy. The discussion to follow will review the scientific evidence and draw upon practical experience to consider the ways in which chiropractic manipulation can be useful in low-back pain (LBP) rehabilitation.
Contact a Rhode Island Lumbar Rehabilitation Chiropractor today at 401.275.2225 or EMAIL US NOW
SI Joint Pain (Sacroilitis - Sacroiliac Joint Dysfunction)
What are the sacroiliac (SI) joints?
The sacroiliac (SI) joints are formed by the connection of the sacrum and the right and left iliac bones. The sacrum is the triangular-shaped bone in the lower portion of the spine, below the lumbar spine. While most of the bones (vertebrae) of the spine are mobile, the sacrum is made up of five vertebrae that are fused together and do not move. The iliac bones are the two large bones that make up the pelvis. As a result, the SI joints connect the spine to the pelvis. The sacrum and the iliac bones (ileum) are held together by a collection of strong ligaments. There is relatively little motion at the SI joints. There are normally less than 4 degrees of rotation and 2 mm of translation at these joints. Most of the motion in the area of the pelvis occurs either at the hips or the lumbar spine. These joints do need to support the entire weight of the upper body when we are erect, which places a large amount of stress across them. This can lead to wearing of the cartilage of the SI joints and arthritis.
What is sacroiliac joint dysfunction?
There are many different terms for sacroiliac joint problems including SI joint dysfunction, SI joint syndrome, SI joint strain, and SI joint inflammation. Each of these terms refers to a condition that causes pain in the SI joints from a variety of causes.
What are the causes of sacroiliac joint dysfunction?
As with most other joints in the body, the SI joints have a cartilage layer covering the bone. The cartilage allows for some movement and acts as a shock absorber between the bones. When this cartilage is damaged or worn away the bones begin to rub on each other, and degenerative arthritis (osteoarthritis) occurs. This is the most common cause of SI joint dysfunction. Degenerative arthritis occurs commonly in the SI joints just like other weight bearing joints of the body.
Another common cause of SI joint dysfunction is pregnancy. During pregnancy hormones are released in the woman's body that allows ligaments to relax. This prepares the body for childbirth. Relaxation of the ligaments holding the SI joints together allows for increased motion in the joints and can lead to increased stresses and abnormal wear. The additional weight and walking pattern (altered gait) associated with pregnancy also places additional stress on the SI joints.
Any condition that alters the normal walking pattern places increased stress on the SI joints. This could include a leg length discrepancy (one leg longer than the other), or pain in the hip, knee, ankle or foot. Patients with severe pain in the lower extremity often develop problems with either the lower back (lumbar spine) or SI joints. In most cases if the underlying problem is treated the associated lumbar spine or SI joint dysfunction will also improve.
There are many disorders that affect the joints of the body that can also cause inflammation in the SI joints. These include gout, rheumatoid arthritis, psoriasis, and ankylosing spondylitis. These are all various forms of arthritis that can affect all joints.
What are the symptoms of sacroiliac joint dysfunction?
The most common symptom of SI joint dysfunction is pain. Patients often experience pain in the lower back or the back of the hips. Pain may also be present in the groin and thighs. In many cases it can be difficult to determine the exact source of the pain. Your physician can perform specific tests to help isolate the source of the pain. The pain is typically worse with standing and walking and improved when lying down. Inflammation and arthritis in the SI joint can also cause stiffness and a burning sensation in the pelvis.
How is sacroiliac joint dysfunction diagnosed?
The first step in diagnosis is typically a thorough history and physical examination by a physician. The physician will ask questions to determine if there are any underlying disorders that could be causing the patient's pain. This can also help differentiate pain coming from the SI joints, lumbar spine, or hips. There are various tests a physician can perform during the physical examination that can help isolated the source of the pain. Other portions of the examination are to exclude certain possibilities that could mimic sacroiliac disease.
The next step in diagnosis is often plain radiographs (x-rays). The patient may have x-rays of the pelvis, hips or lumbar spine depending on what the physician finds on the history and physical examination. A computed tomography (CAT or CT) scan may also help in the diagnosis. CT scan gives a more detailed look at the joint and bones. A magnetic resonance imaging (MRI) scan can also be helpful. This provides a better evaluation of the soft tissues including muscles and ligaments. It can also identify subtle fractures that may not be seen on an x-ray. A bone scan can be obtained to help isolate the source of your pain and can be used to identify bony abnormalities. The bone scan can identify areas of increased activity in the bone. This is a nonspecific test and can be positive in cases of arthritis, infection, and fracture or tumors of bone.
Often the most accurate method of diagnosing SI joint dysfunction is by performing an injection that can numb the irritated area, thereby identifying the pain source. An anesthetic material (for example, lidocaine, novacaine) can be injected along with a steroid (cortisone) directly into the SI joint. This is usually performed with the aid of an x-ray machine to verify the injection is in the SI joint. The anesthetic and steroid can help relieve the pain from inflammation that is common with SI joint dysfunction. The duration of pain relief is variable, but this is very useful to determine that the SI joint is the source of the pain.
How is sacroiliac joint dysfunction treated?
As stated above injections into the SI joint can provide both diagnosis and treatment. The duration of pain relief from injection can last from one day to much more long term. The injections can be repeated each month for a total of three each year. Oral anti-inflammatory medications are often effective in pain relief as well. These can be taken long-term if the patient does not have any other medical problems that prevent them from taking these medications.
Physical therapy can be very helpful. Pain in the SI joint is often related to either too much motion or not enough motion in the joint. A physical therapist can teach various stretching or stabilizing exercises that can help reduce the pain. A sacroiliac belt is a device that wraps around the hips to help stabilize the SI joints, which can also help the SI joint pain.
If other treatments fail and pain continues to interfere with normal activities, surgery might be an option. Surgery for SI dysfunction involves a fusion of the SI joints. In this surgery the cartilage covering the surfaces of the SI joints is removed and the bones are held together with plates and screws until they grow together (fuse). This eliminates all motion at the SI joints and typically relieves the pain. This should be considered only if other less invasive treatments have not been successful.
Contact a Rhode Island Sacroiliac Joint Dysfunction (SI Joint) Chiropractor today at 401.275.2225 or EMAIL US NOW
Chiropractic care during Pregnancy
Is chiropractic care safe during pregnancy?
There are no known contraindications to chiropractic care throughout pregnancy. All chiropractors are trained to work with women who are pregnant. Investing in the fertility and pregnancy wellness of women who are pregnant or trying to conceive is a routine treatment for most chiropractors.
Some chiropractors take a specific interest in prenatal and peri-natal care and seek additional training. Below represents designations of chiropractors who have taken advanced steps in working with infertility and pregnancy wellness.
Chiropractors that have been trained to work with pregnant women may use tables that adjust for a pregnant woman's body, and they will use techniques that avoid unneeded pressure on the abdomen.
A chiropractor who is versed in the needs of women who are pregnant will also provide you with exercises and stretches that are safe to use during pregnancy and compliment any adjustments made to your spine.
Contact a Rhode Island Pregnancy Chiropractor today at 401.275.2225 or EMAIL US NOW
Why should I have chiropractic care during pregnancy?
During pregnancy, there are several physiological and endocrinological changes that occur in preparation for creating the environment for the developing baby. The following changes could result in a misaligned spine or joint:
- Protruding abdomen and increased back curve
- Pelvic changes
- Postural adaptations
Establishing pelvic balance and alignment is another reason to obtain chiropractic care during pregnancy. When the pelvis is misaligned it may reduce the amount of room available for the developing baby. This restriction is called intrauterine constraint. A misaligned pelvis may also make it difficult for the baby to get into the best possible position for delivery.
The nervous system is the master communication system to all the body systems including the reproductive system. Keeping the spine aligned helps the entire body work more effectively.
Contact a Rhode Island Pregnancy Chiropractor today at 401.275.2225 or EMAIL US NOW
What are the benefits of chiropractic care during pregnancy?
Chiropractic care during pregnancy may provide benefits for women who are pregnant. Potential benefits of chiropractic care during pregnancy include:
- Maintaining a healthier pregnancy
- Controlling symptoms of nausea
- Reducing the time of labor and delivery
- Relieving back, neck or joint pain
- Prevent a potential cesarean section
Contact a Rhode Island Pregnancy Chiropractor today at 401.275.2225 or EMAIL US NOW