Lower Back Pain During Pregnancy

By Victoria Arcadi

One of the most common complaints during pregnancy is lower back pain. In my experience, lower back pain can be the first sign that a woman may be pregnant, especially when there has not been a trauma or any other reason for back pain to appear.

My patients always give me a surprised sort of smile when I ask them if they might be pregnant. A large percentage of them are pregnant. Whether newly pregnant or very pregnant, lower back pain in pregnancy can be very uncomfortable and frustrating, especially when their medical doctor tells them that it is "normal." Actually, studies have reported lower back pain in half of all pregnant women.¹ These suffering women are told by their doctors that they need to wait until they have the baby to get relief. Meanwhile, there is no known medical treatment.

I have been specializing in treating pregnant women for over nine years, and from clinical experience I am here to tell you that there is much that can be done for these women who suffer from sometimes debilitating lower back pain. Chiropractic adjustments have been shown clinically to be successful in relieving this discomfort in a large majority of cases, and usually with only one adjustment. In a recent paper published in Obstetrics and Gynecology, January 1988, "Low back pain during pregnancy,"² 862 pregnant women participated in a study in the community of Linkoping, Sweden answered detailed questionnaires in the 20th, 30th, and 35th week of pregnancy. All women had symptoms of low back pain. Seventy-nine had such severe pain that they were unable to continue work, and were referred to an orthopedic surgeon for orthoneurologic examination. These 79 were followed from six to 12 months after delivery. The results of this study are important to chiropractors.

Low back pain was caused in 78 percent of the women by sacroiliac dysfunction, resulting from the sacroiliac fixation test also know as Piedallu's sign. The patient is examined and one posterior superior spine is lower than the other. On forward flexion, the position is reversed. The test used was our motion palpation test for a fixation of the SI joints, where the examiner puts one thumb over the PSIS, and the other over the ipsilateral second sacral tubercle. With the patient standing, the examiner asks the patient to flex the knee and hip, bringing the thigh up toward the abdomen. In a moving joint the PSIS of course will move inferiorly with respect to the sacral tubercle. A fixation or reduction of mobility of the joint is indicated if the PSIS fails to move. This would indicate some sort of blockage of the joint.³

Other tests used to diagnose sacroiliac dysfunction were Patrick's test, placing the heel on the opposite knee, supine and rotating the leg outward to elicit pain in either the hip or the SI joint; and Derbolowski's test, in which a change was noted in the medial malleoli in relation to each other, when the patient is either lying down or sitting. Shortening of one leg would indicate rotation backward on the ipsilateral half of the pelvis.⁴

I thought these tests to be the type of testing that chiropractors use every day to diagnose a sacroiliac dysfunction. But what was really interesting was the treatment and results of the study. Of the 79 women treated for severe back pain, 52 were diagnosed with sacroiliac dysfunction. Of 54 patients given a trochanteric belt to restrict the movement of the sacroiliac joints during the pregnancy, 39 experienced relief. Ten women were treated with mobilization of the joints, which was administered by two orthopedic surgeons. They used a technique described by Maitland and Corrigan.⁵ But whichever techniques used, whether Maitland and Corrigan, diversified, etc., seven of these women were totally relieved, and three had only temporarily relief for one to two days: still a good result.

The outcomes from this study support chiropractic adjustments during pregnancy. Complete relief was only found when treatment included adjustments or manipulation as stated in the study. From these results, we can conclude that chiropractic adjustments beneficial and also alleviate back pain in at least 70 percent of all patients from this study, with adjustments to the SI joints.

In my experience adjusting and evaluating pregnant women, I have found that the sacrum seems to be subluxated most commonly when there is severe lower back pain. Later in the pregnancy, especially in the last trimester, the SI joint as well as the buttock muscles seem to be strained and must be treated. Occasionally, a trochanteric belt is necessary to totally relieve the pain and stabilize the joint to reduce edemic infusion into the joint. But as I stated above, chiropractic care has been shown clinically to be extremely beneficial in alleviating lower back pain in pregnancy.

Pregnant women comprise a significant group who can utilize our approach in relieving their discomforts. I would like to see every chiropractor become knowledgeable and confident and excited about treating and helping pregnant women because, after all, we are not only benefitting one life, but two. Think about it.

References 

1.    Mantle MJ, Greenwood RM, Currey HLF: Backache in pregnancy. Rheumatol Rehabil 16: 95, 1977.

2.    Berg et al: Low back pain in pregnancy. Obstetrics and Gynecology 71: 1, 1988.

3.    Maigne R: Sacroiliac joints, the problem of their blockings and strains. Douleurs d'Origine Vertebrale et Traitements par Manipulations, 2nd ed. Paris, Expansion Scientifique, 1972, p.294.

4.    Grieve GP: Common Vertebral Joint Problems. New York: Churchill Livingstone, 1981.

5.    Maitland GC, Corrigan B: Practical Orthopaedic Medicine. London: Butterworths & Co. Ltd., 1983, pp.330-331.

Victoria C. Arcadi, DC 
Sherman Oaks, California

Yours in health,
Dr. Stacey Burke and Dr. Eric Brukwinski 
Doctors of Chiropractic
West Coast Family Chiropractic,
22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 
(08) 9402 8845

Neck Pain: Why Does My Neck Hurt?

Neck pain affects almost two-thirds of the global population at some point in their lives.

Diagnosis and treatment of neck pain conditions is the second largest sector of the chiropractic profession, bested only by low back pain. In much the same way as other spinal complaints, chronic neck pain has a tendency to be hard to diagnose and treat, making life a real challenge for anyone who can't find lasting relief.

Among the many types of neck pain, there are some which stand out as being chronic in nature. These problems may exist due to previous neck injuries, such as whiplash or arthritic degeneration. The most common anatomical issues blamed for causing chronic neck pain are disc pathologies, such as disc desiccation (disc desiccation is abnormal dryness of the discs) and herniations (a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out). The second most commonly implicated painful process is osteoarthritis (degradation of the joint). Other types of neck pain may include spinal postural concerns, such as hyperlordosis (too much curve) or hypolordosis (too little of curve), cervical spondylolisthesis (anterior displacement of a vertebra or the vertebral column in relation to the vertebrae below ) or non-spinal issues, such as thoracic outlet syndrome (compression at the superior thoracic outlet that affect the nerves that pass into the arms from the neck, and/or blood vessels that pass between the chest and upper extremity. In some cases neck pain may be from an acute spasm or one or more of the supportive musculature of the neck region. You may have just "over did it!"

If you have had chronic neck pain, you could begin to develop neurological symptoms. These may include numbness, tingling, or a "pins and needles" feeling. Sometimes this can be felt in the fingertips or up and down the arm. This could be an indicator that the neck problem is becoming worse.

Most people do not realize how much stress is on their neck, with its great degree of flexibility and support of your 12-14 pound head, coupled with the fact that it has the least amount of muscular stabilization in the spine. This is why a "whiplash' type injury can have such severe effects. Neck pain may also arise from many other physical and emotional health problems.

The National Center for Alternative and Complementary Medicine (NCCAM) cites Neck pain as the No. 3 reason why people seek alternative medicine care. Reasons for trying CAM include:

1. it may work well in conjunction with more traditional type treatment

2. other traditional treatments have been tried, with unsatisfactory result

3. CAM is less expensive than traditional treatment

4. conventional medical professionals suggest it.

Treatments for the different types of back pain and neck pain range from doing nothing to taking medication and undergoing procedures, such as surgery. Treatment of neck pain depends on the cause. For the vast majority of people, neck pain can be treated conservatively.

If you have neck pain it may be wise to consult with a chiropractor before going to the extent of something much more serious such as surgery. Chiropractic has been found to be beneficial in both acute and chronic mechanical neck disorders.

Your chiropractor will ask a number of questions in his or her initial consultation then they will perform a physical examination. The examination will consist of chiropractic tests, orthopedic tests, and a neurological examination. He or she may also perform xrays or other diagnostic imaging tests to gather as much information as possible. This entire process will allow the chiropractor to get to the cause of your problem and allow him or her to come up with a treatment plan and recommendations for your specific condition.

One thing about neck pain to remember is: the spinal cord runs directly through the middle opening of the vertebrae. It sends signals to every muscle, organ, and system of the body. Between each pair of cervical vertebrae, the spinal cord sends out a nerve that runs anywhere from your neck and upper back down to the hands and fingers. This means that if you get pain, numbness, tinging, cold or other symptoms in your hand and arm, it can actually be a problem in your neck! This can often mimic and can be confused with carpal tunnel syndrome, which causes a similar pain in the wrist and hand.

But we'll save that for another day! Thanks for reading!

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Yours in health,
Dr. Stacey Burke and Dr. Eric Brukwinski 
Doctors of Chiropractic
West Coast Family Chiropractic,
22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 
(08) 9402 8845

What Is Chiropractic?

Chiropractic is a professional, valuable and natural treatment option offered to all Australians to improve quality of life. The primary focus of Chiropractic is the restoration of function. Chiropractors assess and diagnose the problem, then plan and administer treatment programs that aim to restore function or minimise dysfunction after disease or injury.

Chiropractors strive to improve an individual's quality of life by physical means. A combination of manual and gentle manipulative therapy, movement training and exercises all help to achieve this. Chiropractors also offer you personal advice on stretching and strengthening exercises, posture, diet, lifting procedures and stress management.

Adequate education provided to Australians will lead to the prevention of many physical problems and this is a priority area for Chiropractors. 

Your Chiropractor
Australian Chiropractors are registered health care professionals with tertiary qualifications.

Chiropractors assess, diagnose and treat people with movement problems. Chiropractors also help people avoid injuries and maintain a fit, healthy body.

Chiropractic includes a wide range of specialities that meet the health needs of different people such as babies and children, sports people, pregnant women, injured workers and senior citizens.

Chiropractic programs are based on practical goals agreed between the Chiropractor and the client. Chiropractors help people gain as much movement and physical independence as possible so they can resume their normal job or lifestyle.

When necessary, Chiropractors will consult with a client's doctor to ensure the best possible treatment outcomes.

Choosing a Chiropractor
All Chiropractors registered to practise in Australia are qualified to provide safe, effective health care.

What can you expect from a Chiropractor?
You can expect your Chiropractors to:

• deliver a professional service
• discuss your treatment options and agree on some treatment goals with you
• provide information about your Chiropractic program
• explain specific treatments to you
• respect your rights, dignity, privacy, feelings and cultural customs
• respect the confidentiality of your professional relationship
• communicate with your doctor if necessary

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Yours in health,
Dr. Stacey Burke and Dr. Eric Brukwinski 
Doctors of Chiropractic
West Coast Family Chiropractic,
22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 
(08) 9402 8845

ICPA - Why Chiropractic Care For Kids?

Read more "Is Chiropractic Care Safe For Adults And Children?"




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  Dr. Stacey Burke and Dr. Eric Brukwinski 
Doctors of Chiropractic
West Coast Family Chiropractic,
22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 
(08) 9402 8845

Body, Mind and Chiropractic

By Christopher Kent, DC, Esq.

The scope of chiropractic is as broad as the scope of influence of the nervous system. Although many chiropractors tend to focus on disorders associated with the physical body, particularly musculoskeletal pain syndromes, abnormal nervous system function may also affect emotional and psychological health.

Research is providing chiropractors with information about how the stress response is mediated by the autonomic nervous system¹ and how afferent input from the spine affects brain function.^2-3

Rome published a two-part series reviewing neurovertebral influence on visceral and autonomic function.^4-5 This is the most comprehensive review I have seen on the topic, featuring more than 1,100 references. Rome notes: "Attempts have been made to classify conditions addressed by spinal manipulation into Type M (musculoskeletal) and Type O (organic). However, it seems that this is the only area in the health sciences where such a classification has been suggested. If categorization is necessary at all, then virtually all conditions should be basically 'Type N' (neurological) as nominated by Leach, as essentially all conditions would have a neurological element ... the weakness of a Type M/Type O classification renders it superfluous, if not meaningless. A 'Type N' designation would highlight the importance of total body considerations in such an extensive and integrated model of health care, as well as the encompassing influence and the integrative action of the nervous system."

Among Rome's conclusions: "It is the emphasis on a localized ANS connection with the spine which would differentiate the chiropractic health care profession from others in the manipulative and manual therapies field. It must be appreciated that this association implies more than a musculoskeletal connection, and thereby may have the potential to influence neurophysiology and consequently homeostasis, which could contribute to overall patient well-being."⁵

There is a small, but growing body of evidence concerning the relationship of the spine, vertebral subluxation, chiropractic care, and psychological and emotional health. The following sampling is not a comprehensive review; it is merely to whet your appetite on the subject. A systematic review examined psychological outcomes in randomized controlled trials of spinal manipulation. The study concluded: "There was some evidence that spinal manipulation improved psychological outcomes compared with verbal interventions ... The clinical implications are that physical treatments, such as spinal manipulation have psychological benefits."⁶

Genthner, et al.,⁷ reported on a series of 15 patients with a history of depression. The Beck Depression Inventory II was used to measure the baseline level of depression and any post-care changes following orthospinology care. A paired t-test demonstrated significant improvement in depression test scores.

Other articles addressing mental health issues and chiropractic care have been published, ranging from single case reports to randomized clinical trials. Favorable responses were reported in persons with conditions including addiction,⁸ depression,⁹ ADHD,¹⁰ autism,¹¹dyslexia and learning disabilities.¹² Additionally, published papers report changes in general health measures in chiropractic patients using the RAND-36 and Global Well Being Scale (GWBS),¹³ changes in domains of health-related quality of life among public safety personnel undergoing chiropractic care,¹⁴ and chiropractic care for patients with cancer-related traumatic stress symptoms.¹⁵

More than 38 years ago, my first chiropractor explained that everything we experience is processed through our nervous system. When our perception of the world is distorted by nerve interference, it compromises our ability to respond appropriately. He noted that in addition to damaging our physical health, it could result in impaired psychological and emotional function as well. Finally, he opined that when this happened to a significant number of people in a society, a sick society would result.

The distinction between Type O (organic) and Type M (musculoskeletal) disorders is illusory. Chiropractic care is concerned with the totality of the human experience. By analyzing and correcting vertebral subluxations, a patient is placed on a more optimum physiological path. This brings the individual closer to the definition of health promulgated by the World Health Organization: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."¹⁶

References

1.    Lee R. "The New Pandemic: Superstress?" Explore, 2010;6(1):7-10.

2.    Carrick FR. Changes in brain function after manipulation of the cervical spine. J Manipulative Physiol Ther, 1997;20(8):529-45.

3.    Kelly DD, Murphy BA, Backhouse DP. Use of a mental rotation reaction-time paradigm to measure the effects of upper cervical adjustments on cortical processing: a pilot study. J Manipulative Physiol Ther, 2000;23(4):246-51.

4.    Rome PL. Neurovertebral influence upon the autonomic nervous system: some of the somato-autonomic evidence to date. Chiropr J Aust, 2009;39(1):2-17.

5.    Rome PL. Neurovertebral influence on visceral and ANS function: some of the evidence to date, part II: somatovisceral. Chiropr J Aust, 2010;40(1):9-29.

6.    Williams NH, Hendry M, Lewis R, et al. Psychological response in spinal manipulation (PRISM): a systematic review or psychological outcomes in randomized controlled trials. Complementary Therapies in Medicine, 2007;15:271-283.

7.    Genthner GC, Friedman HL, Studley CF. Improvement in depression following reduction of upper cervical vertebral subluxation using orthospinology technique."Journal of Vertebral Subluxation Research, Nov. 7, 2005.

8.    Holder JM, Duncan Robert C, Gissen M, Miller M, Blum K. Increasing retention rates among the chemically dependent in residential treatment: auriculotherapy and (in a separate study) subluxation-based chiropractic care. Journal of Molecular Psychiatry, March 2001;6(suppl 1).

9.    Desaulniers AMJ. Effect of subluxation-based chiropractic care on quality of life in a patient with major depression. Journal of Vertebral Subluxation Research, April 23, 2008.

10. Lovett L, Blum CL. Behavioral and learning changes secondary to chiropractic care to reduce subluxations in a child with Attention Deficit Hyperactivity Disorder: a case study. Journal of Vertebral Subluxation Research, Oct. 4, 2006.

11. Khorshid KA, Sweat RW, Zemba DA, Zemba BN. Clinical efficacy of upper cervical versus full spine chiropractic care on children with autism: a randomized clinical trial. Journal of Vertebral Subluxation Research, March 9, 2006.

12. Pauli Y. The effects of chiropractic care on individuals suffering from learning disabilities and dyslexia: a review of the literature. Journal of Vertebral Subluxation Research, Jan. 15, 2007.

13. Blanks RHI, Dobson M. A study regarding measures of general health status in patients using the Bio Energetic Synchronization Technique: a follow up study.Journal of Vertebral Subluxation Research,1999;3(2):1.

14. McAllister W, Boone WR. Changes in physical state and self-perceptions in domains of health related quality of life among public safety personnel undergoing chiropractic care. Journal of Vertebral Subluxation Research, Aug. 6, 2007.

15. Monti DA, Stoner ME, Zivin G, Schlesinger M. Short term correlates of the Neuro Emotional Technique for cancer-related traumatic stress symptoms: a pilot case series. J Cancer Surviv, 2007;1:161-166.

16. World Heath Organization definition of health.www.who.int/about/definition/en/print.html

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Yours in health,

Dr. Stacey Burke and Dr. Eric Brukwinski 

Doctors of Chiropractic

West Coast Family Chiropractic,

22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 

(08) 9402 8845

Movement Is Life And Chiropractic Delivers!

This may sound a bit strange at first but if you think about it for a moment the truth of this statement begins to become more and more apparent. Without movement you could not sustain life: blood cells that don't move cannot transport oxygen, lungs that don't move can't breath, hearts that don't move can't pump blood, and spines that don't move can't create the motion required for proper joint nutrition, for the activities of daily living, or for the stimulation of the joint-brain pathways required for proper brain and body function.

You heard correctly, movement (especially of the spine) is required for proper brain function for the coordination of activities such as concentration and learning, emotions, motor control, and organ function (including immune organs).1-2 Roger Sperry the recipient of the Nobel prize in 1982 for his work in brain research stated that the importance of movement of the spine in relation to brain function could be equated to that of a windmill that generates electricity for a powerplant. He also stated that the more structurally distorted we are, the less energy we have for metabolism, for healing, and for thinking. 

In fact research has shown that if you cut off the supply of somatosensory information going to the brain, the brain will actually reach a state of coma!! 3 That's right, the brain does not simply control the body, the brain requires constant stimulation; it requires constant input from movement to keep the batteries charged. 

Did you know that over half of all the nerve impulses being sent between your brain and body in your spinal cord are for the delivery of movement stimulation to the brain? 4 Movement charges your brain's battery and makes you able to think better, feel better, and function better. 
Sound a bit too good to be true? Don't just take my word for it, read the work of some of the most prominent neurologists, physiologists, psychologists, and educators in the world. Messages to your brain created by proper movement (especially of your spine) have been called an essential nutrient for brain function and development.5 In fact, research is now showing that people who do not properly stimulate their brain with joint movement have learning, memory, emotional, behavioral, and overall health deficits. 

This is especially true for children because spinal joint receptor stimulation plays an integral role in the development of the child's brain and nervous system and the effects of decreased stimulation of the brain in childhood have been linked to central motor impairment, developmental impairments, learning disabilities, concentration problems like ADHD, behavioral problems such as violence and increased illnesses such as ear, nose, and throat infections, sleeping difficulties, and colic. 6-7 

"Connectivity is a crucial feature of brain development because the neural pathways formed during the early years carry signals that allow us to process information throughout our lives (Dixon and Shore)." 7 
At first researchers thought that it was just the exercise that improved brain and overall health due to increased blood flow and oxygen supply etc. Further research has shown that aerobic activity is not what is responsible for the amazing benefits of proper movement stimulation of the brain. It is the neurological stimulation of the pathways between moving joints, especially spinal joints, and the brain that are responsible. "At a major neuroscience symposium in Chicago where experts in the field of movement and cognition met the message was clear: Our body enriches our mind". 7 

Chiropractic Delivers!!! 
It should be obvious why it is so important to ensure every child has a properly moving and aligned spine as the spinal joints are the main source of sensory movement stimulation to the brain. If there is subluxation in the spine, movement and therefore essential nutrient delivery to the brain are compromised. 

The upper neck has been found to be particularly important to examine because it is the most easily damaged (birth trauma, falls, poor sleeping postures) and it has by far the most movement receptors to stimulate the brain.4,6 

These findings have been confirmed by clinical studies performed by both chiropractors and medical doctors. In fact after examining thousands of children one medical researcher concluded that "observations of motor development and manual control of the occipito-atlanto-axial (upper neck) joint complex should be obligatory after every difficult birth". He also states that the upper neck "should be examined and, if required, specifically adjusted … (as) the success of adjustment overshadows every other type of treatment." 6 Of course it does, a specific adjustment is the ONLY way to correct a subluxation!!! 

As pediatric chiropractors we are all very familiar with this type of work and have all personally seen great results with the care we provide to children. The problem is that much of society is unaware of the pathogenic potential of subluxation and far too many children are suffering needlessly. It is up to all of us as individuals to disseminate this information and to support organizations such as the I.C.P.A. that are dedicated to educating both the public and the chiropractors in the field. 

I recommend combining specific adjustments with some sound nutritional advice and some fun 'Brain Gym' exercises to ensure that each child gets the best possible chance to have a healthy body and mind. 

Not only does proper spinal movement increase overall health, decrease dis-ease and improve the ability to create feelings of happiness and well-being, it also helps to reduce pain and discomfort and to diminish feelings of anxiety and stress. When it comes right down to it we are creatures designed for virtually constant movement living in a society that involves almost constant sitting. We are also clearly designed to have properly moving and aligned spines and many of our citizens are unknowingly walking around with subluxation in their spines because they have NEVER HAD A SPINAL HEALTH EXAM!! This is not a healthy combination and the result is that we have a population that is much less healthy and much more sick, tired, and dis-ease ridden than is necessary. 

Please get yourselves and the children out and moving around. Everyone will feel better, think better, have a healthier spine, have increased overall health, and enjoy a much greater quality of life. All children (and adults of course) deserve a wonderful quality of life and proper spinal movement is an integral part of this. Motion is lotion, movement is life, and chiropractic delivers so get out there and get those spines moving!!!!


The information in this article is taken from Dr. Chestnut's book "The 14 Foundational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm"  Access references and infowww.icpa4kids.com/chiropractic_newsletter_references.htm
By James Chestnut, 


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Yours in health,
  Dr. Stacey Burke and Dr. Eric Brukwinski 
Doctors of Chiropractic
West Coast Family Chiropractic,
22 Banks Ave, Hillarys, WA 6025, AUSTRALIA 
(08) 9402 8845