Headaches are one of the most common causes for missed days at work and there are many types. Primary headaches such as tension headaches, migraines and cervicogenic headaches are those that aren’t due to any medical condition. Secondary headaches are caused by an underlying health condition such as infection, tumour, trauma or a result of medication.
Tension headaches are the most common type of headache and are experienced as a constant band like ache. Multiple factors may contribute to tension headaches including stress, poor posture, poor nutrition and disruption to sleep.
Migraines are another commonly experienced headache and have a more complex cause; they are thought to be a result of a change in neurovascular activity in the brain. This causes a severe throbbing pain and can be associated with other symptoms such as visual changes, nausea, vomiting and sensation changes.
Another form of headache commonly encountered in the clinic is a cervicogenic headache. These occur when structures in the neck refer pain into the head. The pain tends to spread from the back of the head over to the temple and eye region and can be associated with other symptoms including sensitivity to light, nausea and dizziness.
There are many more types of headaches. To ensure you receive the correct form of care for your headache, your Chiropractor will ask you a series of detailed questions relating to nature of the headache, aggravating factors and duration. They will then perform an in depth physical examination, looking at your head, neck, shoulders and mid-back. Extra checks may be carried out including blood pressure, nerve function and coordination checks. If we suspect that your headache may have an underlying cause, and that chiropractic care isn't appropriate for you, we will refer you back to your GP.
Manual care is recommended for migraine headaches and cervicogenic headaches including manipulation and massage. Exercise therapy, work station assessment and stress management are also addressed in treatment for headaches.
Most people will experience neck pain at least once in their lifetime. The neck is a complex load bearing structure consisting of joints in between the 7 vertebra, discs, ligaments, muscles and nerves that supply the arms and the spinal cord to innervate the rest of the body.
Neck pain is usually simple in nature. It is commonly caused by a sprain or strain to the joints and soft tissues caused by poor posture or an awkward position. Poor posture can lead to an imbalance of muscles and loss of strength in the neck, increasing the chance of developing a strain or sprain to structures in the neck. Emotional stress can also cause tension in the muscles around the neck resulting in discomfort. Accidents and trauma that cause whiplash type movements can also injure the muscles and joints in the neck.
With age, changes occur in the neck causing the shock absorbing disc in the neck to dehydrate and limit mobility. This may also result in pain in the neck. As the disc undergoes wear and tear it may also develop tears causing the jelly like substance to herniate. This can produce local pain and can also press on neighbouring nerves causing pain, numbness or tingling in the arms.
Chiropractic’s multi-modal approach to care, including manipulation, mobilisation, advice, exercises and massage, is recommended for the treatment of neck pain . Your Chiropractor will compile a thorough case history and carry out an examination to establish with you which combination of treatments is most suitable whilst ensuring that you are comfortable with the plan for managing your neck pain.
The shoulder girdle is a complex system made up of the glenohumeral joint (the ball and socket joint of the shoulder), the acromioclavicular joint (between the shoulder blade and the collar bone) and the sternoclavicular joint (between the collar bone and the chest bone). Normal function of this system is controlled by a carefully balanced muscular system. Imbalance in the muscle groups can result in disruption of the normal movement and an increased chance of tissue damage.
The most common causes of shoulder pain are rotator cuff disorders. Injuries can be acute and traumatic or chronic and related to posture or repetitive strain. In some cases the muscle belly of any of the rotator cuff muscles can become tight and produce painful knots. In others the tendon can become inflamed, torn or be pinched within the ball and socket joint.
Frozen shoulder is a condition leading to restricted motion, pain and disability often without any specific cause. There is a gradual stiffening of the joint capsule that leads to painful motion that is often extremely limited in all directions.
Manual treatment has been shown to result in favourable outcomes for both of these shoulder complaints. As part of chiropractic care, exercises and soft tissue work are used for postural correction and muscle retraining.
LOW BACK PAIN
About 80% of people experience low back pain at least once in their lifetime. Although low back pain can be due to non-mechanical causes such as infection, it is mostly due to mechanical causes where there is a problem with the joints, discs or muscles. This can be a result of major trauma such as a car accident or fall, or repetitive microtrauma such as lifting, poor posture or muscular tension from emotional stress.
The lower back is made up of 5 vertebra (bones) that are separated by shock absorbing discs. These are supported by multiple ligaments and controlled by deep, small and superficial large muscles. The spinal column sits on top of the pelvis which contains 3 main joints – a joint under each buttock and the pubic symphysis in the groin. These joints are also supported by many ligaments and muscles.
Most cases of low back pain are the result of sprains and strains to the joints and ligaments in the spine and pelvis. These occur when they are put under too much strain from incorrect movement or overstretching. This simple low back pain is often caused by injury to a number of the structures that are all located very close together.
Another source of low back pain is the discs in between each vertebra. Discs are made of strong flexible fibres surrounding a soft jelly centre. Through the natural ageing process and other stresses, the discs can develop tears allowing the jelly centre to herniate producing a painful inflammatory response. They also dehydrate causing them to get thinner and alter the way individual joints move.
Research has recently shown how effective chiropractic care is in the management of low back pain. A multidisciplinary approach using manipulation, mobilisation, exercises and education are recommended for the management of low back.
Sciatica is the term used to describe the symptoms that arise from compression of nerves in the lumbar spine such as pain, tingling and numbness. These symptoms are usually felt down the entire leg to the foot. In most cases the nerve compression is caused by a herniated intervertebral disc but in the older population it may also be due to bony degenerative changes which narrow the tunnels that the nerves sit in.
To diagnose sciatica, your Chiropractor will assess the nerve function in different parts of the leg to work out where the nerve may be being compressed, as well as checking the surrounding and associated joints. They will also carry out other tests in order to rule out conditions that can mimic sciatica such as sacroiliac joint problems, piriformis syndrome or non-spinal causes of nerve dysfunction.
Evidence shows favourable outcomes for symptoms related to sciatica when managed by a Chiropractor. As chiropractic care is multimodal, different methods can be employed for the management of sciatica including manipulation, exercise therapy and advice.
All joints in the body are placed under physical stress which can cause small amounts of damage. With increasing age or particularly high loads, the joint damage is not repaired as efficiently, the protective cartilage breaks down and becomes inflamed causing pain, swelling and reduced motion.
Factors increasing the likelihood of osteoarthritis include obesity, injury to a joint, age and also the type of joint. It is most commonly seen in the load-bearing joints of the body including the knees hips and spine. Unfortunately as osteoarthritis is due to ‘wear and tear’ damage to the joint, there is no cure so treatment is aimed at controlling symptoms and maintaining quality of life.
A multimodal approach to treatment is key in the management of osteoarthritis. Lifestyle advice, activity modification and exercise alongside manual therapy and manipulation is the recommended approach to help with the symptoms associated with osteoarthritis. Our Chiropractors will give you tailored advice, personalised exercise plans and shape treatment based on your needs, symptoms and goals.
PREGNANCY RELATED LOW BACK PAIN
The female body undergoes a number of hormonal and physical changes throughout the 9 months of term. Initially there is a surge in hormones leading to ligament laxity, then as the baby grows there is a shift in the centre of gravity and change in spinal curvature, which puts additional stress and loads on the spinal and pelvic joints.
The change in hormones can also affect joints in the legs, inflame tendons and fluid retention can put pressure on nerves. Some women can also suffer pain after delivery of their baby as a result of mechanical forces associated with labour, changes in hormones after birth and reduced core support due to overstretched muscles.
The Royal College of Obstetricians and Gynaecologists recommend a multi-modal care approach to pregnancy-related back and pelvic pain including chiropractic manipulative therapy, exercises and lifestyle modifications.
Literature shows that chiropractic care has a significant role in the management of musculoskeletal symptoms associated with pregnancy. The aim of treatment is to address postural alignment, maintain symmetrical body mechanics and ensure normal joint motion. This is achieved by a range of techniques, chosen based on the patient’s symptoms,including joint manipulation, mobilisations, massage, muscle strengthening and stretching and advice.