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Moving Toward Better Health

The official blog of Konicki Schumacher Chiropractic

02
Jan
0

What is a Herniated Disc?

Posted by Dr. Tom Konicki
Dr. Tom Konicki
Dr. Thomas Konicki earned his B.S. in Biology at the University of Cincinnati and then went on to the Los Ange...
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in Orthopedic Conditions/Injuries

The vertebrae of your spine are separated from one another by pads of cartilage called discs. Their job is to keep bones from rubbing together, keep pressure off your nerves as they exit the spine and absorb pressure and jolts along your spine. A disc is like a small donut. The outer portion is called the annulus and has fibers wound around in a circular manner. This allows your disc to move as well as support your spine. The inner portion of the disc is called the nucleus pulposus. This is a soft interior designed to absorb shock and pressure along the spine. When your disc herniates, it is like a jelly donut squirting the jelly out.

This occurs when the outer fibers tear or weaken. Most of the time, discs are damaged gradually. Small tears occur in the outer fibers as a result of too much stress, such as repetitive lifting. Surprisingly, smoking causes damage to your disc as well. The disc is fed by small blood vessels called capillaries, which are choked shut when you smoke. This causes your discs to degenerate faster. My smoking patients often have spines that look 20 years older than they should!

Once the outer fibers weaken, it often does not require much trauma or force to cause the inner portion to squirt out. You may simply bend over or lift a light item wrong and cause the disc to rupture. A less common way for disc injury is significant trauma such as a car wreck or a hard fall. There are many terms to describe disc injuries, which are confusing. They can be described as bulging, protruding, ruptured, slipped, herniated, extruded, sequestered, contained and non-contained. The most common region to have a herniated disc is in your low back. This can pinch nerves as they exit your spine, causing leg pain, numbness and weakness.

In much more extreme cases, a disc can pinch the nerve that operate your bladder and/or bowels, causing incontinence and loss of control. This is called Cauda Equina Syndrome and may require immediate back surgery by a spinal surgeon. The second most common site of disc herniation is in your neck. If this occurs, this can pinch the nerve into your arm causing pain, numbness, tingling or weakness anywhere along your shoulder down to your hand. Most disc problems can be treated conservatively, without surgery. This includes chiropractic care, medication, physical therapy and injections.

Chiropractors routinely treat disc problems safely and effectively. We use manipulation, traction, ultrasound, electrical muscle stimulation and ice treatments. We expect to see your condition improve in 4-6 weeks, but it can take months to heal completely. Surgeons should be involved in your care if your condition does not improve or worsens, such as progressive weakening of your leg or arm. The best way to diagnose a disc problem is MRI. CT scans can also do this, but the picture may not be as well-defined. Myelograms are rarely used


Copyright © 2008 - Konicki Schumacher Chiropractic. All rights reserved.

Dr. Tom Konicki is a board certified chiropractic orthopedist and has practiced for many years in South Dayton. You can reach him at www.kschiro.com or mail your questions to Ask the Chiropractor, 2165 Miamisburg-Centerville Road, Dayton, Ohio 45459.

02
Jan
0

What is sciatica?

Posted by Dr. Tom Konicki
Dr. Tom Konicki
Dr. Thomas Konicki earned his B.S. in Biology at the University of Cincinnati and then went on to the Los Ange...
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in Orthopedic Conditions/Injuries

Question: I have pain shooting down my leg and was told I might have sciatica. What is that and can a chiropractor help this?

Answer: There are several causes for leg pain. However, shooting pain may indeed be sciatica (pronounced sigh-a-ti-ka). The sciatic nerve originally begins in the low back, branches off the spinal cord and then groups into a rather thick nerve that runs through your buttock, down the back of your leg and into your calf and foot. This nerve gives you both feeling and strength. Shooting pain down your leg can be a typical symptom. Also burning, tingling and numbness, aching and weakness are other common symptoms. This type of pain can become extremely severe and limit your ability to walk.

The nerve typically becomes inflamed due to some sort of compression. This can happen from a disc in your low back that compresses the nerve. This is possible with a disc protrusion, herniation or degeneration. The nerve also exits between two bones and can be pinched as it passes through the nerve hole, called a foramen. If there are misalignments in the spine, this can pinch the sciatic nerve. Arthritic spurs can compress the nerve. Lastly, there is a muscle in the buttock called the piriformis that is capable of pinching your nerve. Regardless of the cause, your pain can range from very mild to extremely painful.

Your sciatica may be diagnosed through examination, x-rays, MRI or EMG. An EMG is an electromyogram, which tests the function of your muscles and the health of the nerve. Some nerve diseases may effect this nerve and the EMG will help determine this.

Sciatic pain is extremely common in a chiropractor's office. A chiropractor treats this through manipulating the spine and relaxing tight muscles. He or she may order a lumbar MRI to rule out a disc problem. Chiropractors are trained to recognize the potential need for disc surgery and refer when appropriate. Other forms of treatment for sciatica include anti-inflammatory medication, physical therapy or epidural steroid injections into the low back. It is not healthy for the nerve to have compression and inflammation and can ultimately cause permanent damage. Sciatica that does not go away should be examined by your chiropractor or doctor.

Chiropractic care is natural and safe. It is a very effective way to treat sciatica without the use of drugs or surgery.



Copyright © 2008 - Konicki Schumacher Chiropractic. All rights reserved.

02
Jan
0

What is Tendinitis?

Posted by Dr. Tom Konicki
Dr. Tom Konicki
Dr. Thomas Konicki earned his B.S. in Biology at the University of Cincinnati and then went on to the Los Ange...
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in Orthopedic Conditions/Injuries

Question: What is Tendinitis?

Answer: Tendons attach muscles to bones, while ligaments attach bones to bones. For example, the Achilles' tendon attaches your calf muscles to your heel. Conversely, the medial collateral ligament attaches the femur and tibia on the inside of your knee. Tendons are fibrous, cord-like structures that grow out from the muscle and grow into a bone. This is how muscles are able to move bones and joints. Most tendons are covered by sheaths that help them glide and provide nutrition.

Tendinitis occurs when there is excess stress placed on the muscle and tendon. This may be repetitive overuse, which is the most common way runners get injured. There can be a specific incident, such as rupturing your Achilles' tendon when sprinting too fast. Microtearing of the tendon can occur, causing inflammation. The tendon swells, which makes it more difficult to pass through the tendon sheath. The sheath then becomes inflamed, resulting in tenosynovitis. You may have a crackling sensation over the tendon as it moves which is caused by a collection of fluid between the tendon and the tendon sheath.

Early tendinitis often improves with activity such as running. You are able to pump out some swelling, loosen the muscle and tendon and get things working. However, the muscle and tendon will often tighten and become more painful when you are done with activity. There can be more swelling and the cycle repeats itself. This can progress to chronic tendinitis, known as tendonosis or tendonopathy. This may cause the tendon to become more fibrous, have more scar tissue and result in a weaker tendon. This may lead to complete rupture, requiring surgery. If rupture occurs, it is important not to delay. You have a better chance of repairing the tendon before the torn ends start to retract and atrophy.

The first step to diagnose tendinitis is a physical examination. We test to see if the muscle/tendon is weak, observing for swelling and feeling for tenderness. X-rays may provide some information, but they are limited as they only look at bones. X-rays can be helpful. For example, you may have an avulsion fracture where the tendon literally rips a small piece of bone away. A MRI is the best test to image tendinitis, showing inflammation and possible tearing.

As a chiropractor, I rely heavily on ice treatments to reduce inflammation in the tendon. This may require numerous treatments for 20 minutes at a time with a 40-minute break. If possible, ice your tendon 4-6 times in a day, several days in a row. Ice packs can be used, but certain tendons do better with ice water; this will create a more effective antiinflammatory effect.

Our treatment is then directed to relaxing tight muscles through deep massage and aligning your spine and joints. Cross-friction massage is applied to break up scar tissue in the tendon. Strengthening and proprioceptive exercises are given, with a slow return to running. Other treatments for tendinitis include anti-inflammatory medications, physical therapy and lastly, cortisone injections. You need to be careful with these injections as they can actually weaken the tendon, later causing a rupture.

Runners are prone to tendinitis in their legs because of the repetitive use. Achilles' tendinitis is certainly common. Other areas include adductor tendinitis causing groin pain, patellar tendinitis causing knee pain, anterior and posterior tibial tendinitis causing shin splints and peroneal tendinitis causing pain along the outer lower leg and ankle. You may need to avoid hills and running on the street. Trail running or track running may be in order. Wearing only good shoes and regular stretching are also part of the package. Lastly, don't build your miles too rapidly and cross-train for a break.



Copyright © 2009 - Konicki Schumacher Chiropractic. All rights reserved.

Dr. Tom Konicki is a board certified chiropractic orthopedist and has practiced for many years in South Dayton. You can reach him at www.kschiro.com or mail your questions to Ask the Chiropractor, 2165 Miamisburg-Centerville Road, Dayton, Ohio 45459.