Spinal Stenosis is a problem which builds up over many years. Most people who get spinal stenosis are over 50. In the first part of this article I will discuss the causes and in the second part I talk about symptoms

How Joints Wear: From Muscle Strain to Spinal Stenosis

The short-term episodes of spinal pain or lower back pain that we experience in our everyday life are caused either by strains or injuries to the ligaments and muscles. These may be a result of sports injuries, repetitive stress or sedentary lifestyle. 

People in the middle age are more likely to experience muscle aches and wear and tear of the intervertebral discs.  Aside from these, they also experience degenerative changes or spondylosis particularly in the cervical (neck) and lower lumbar (back) regions.

The discs in our backs naturally have high water content, but as we get older, the discs start to dry out and become weak, which can result in more severe spondylosis. This can cause loss of disc height. As the spine reduces in height the soft tissues and bones to harden and enlarge. These two factors reduce the space that spinal nerves pass through. Spinal stenosis is the narrowing of the space around the spinal nerves.  

Symptoms of Spinal Stenosis

Sciatica

Sciatica refers to a burning sensation that starts from the buttocks and radiates down the back of the leg. Too much pressure or damage to the sciatic nerve is the main cause of this. When the condition worsens, the symptoms will be felt on the sole of the foot.

Numbness and tingling of the buttocks or the legs

Another symptom of spinal stenosis is numbness and tingling of the buttocks and/or legs. When the pressure on the nerve becomes severe, numbness and tingling will be experienced along with the burning sensation; however, not all patients with spinal stenosis will experience both burning pain and sciatica at the same time.

Foot drop

Foot drop refers to weakness of the muscles that allow the ankles and toes to flex. This can occur when the pressure on the nerve reaches a critical level. Foot drop is when an individual has to drag the front of his/her foot and bend the knee in order to help lift the foot higher when walking. Some individuals feel that their foot slaps on the ground when ambulating.

Worsening symptoms with standing and walking

Pain caused by spinal stenosis may be worsened with standing and walking. Studies, however, show that patients experience less pain with sitting or leaning forward as this increases the spaces for the nerves to pass through. Some patients state that walking more than one block can exacerbate the pain and weakness. Walking while leaning on something or even riding a bicycle, however, does not worsen the pain.

With these symptoms, consulting a chiropractor is still the best option. Visit us at our chiropractic clinics in Chester or North Wales. We can help determine the cause of your pain and give appropriate treatment. Spinal stenosis is  not curable but a lot can be done to reduce the symptoms once the correct diagnosis is made.

To understand facet joint arthritis we need to know what the facet joints are! 24 spinal bones called vertebrae make up the spine. In between each vertebra, there are two sets of facet joints. These work as a hinge that connect the vertebrae together, and allow the lumbar spine to move easily as you bend backward and/or forward. The facet joint is also called zygapophysial joint or apophyseal joint.

Articular cartilage covers the outer part of the facet joints . This is a smooth material that  causes the ends of the bone to move smoothly against each other with minimal friction.

What Causes Facet Joint Arthritis?

The facet joints are supposed to fit together and smoothly glide against each other with no pressure. If pressure starts, the cartilage that covers the joint surfaces wears away.

Back injury that happened years ago can also cause the facet joints to become arthritic. Torn ligaments, fractures, as well as disc problems can cause irregular movements as well, which causes pressure and stress on the facet joint surfaces.

Facet joint arthritis does not develop immediately, Heavy, incautious twisting, rapid movements, and backward motions can increase the development of symptoms of facet joint arthritis.

What Are the Signs and Symptoms of Facet Joint Arthritis?

Pain from this condition is typically worse after sleeping or resting. Bending your trunk backward or sideways also causes pain on the side of the affected facet joint. Arthritic pain may start at the centre of the lower back and may radiate to one or both buttocks. It can also radiate to the thighs. It does not, however, go below the knee.

Diagnosing Facet Joint Arthritis

Obtaining a full detailed history and physical examination is important when diagnosing Facet Joint Arthritis. The process starts with the doctor asking about a patients symptoms and how the pain is affecting their day-to-day activities. The doctor will also ask a patient to point out which part of their body is in pain and whether or not the patient is  experiencing numbness and/or weakness in their legs. It is also important for the doctor to know what activities or positions worsen or relieve a patients symptoms.

The doctor will then perform a physical examination to find out which back movements or positions cause the symptoms.  This includes testing  the patients muscle strength, skin sensation and reflexes.

The doctor may also refer a patient for an x-ray examination to find out if the bone tissue in and around the facet joints are involved. X-ray images can show if bone spurs have occurred near the facet joints. The images can also show disc degeneration and vertebral collapse.

CT scan and facet joint injection (also known as facet joint block) are also helpful in diagnosing facet joint dysfunction.

Treatment Options For Facet Joint Arthritis

There are a number of non-surgical treatment options for facet joint arthritis. While some of them can only offer short-term relief, there are also some that can give long-lasting help.

Knowing and maintaining the correct posture, changing your daily activities, and taking frequent short breaks can help relieve the symptoms. Hot or cold packs or hot showers can give short-term relief. Taking non-steroidal anti-inflammatory drugs (known as NSAIDs) can also help the symptoms.

For long-term effect, chiropractic adjustment is the best option. Spinal manipulation has proved to be very effective in treating patients who suffer from backache due to facet joint arthritis. Chiropractic treatments can also help reduce pain, inflammation, nerve sensitivity, and irritation. Facet Joint Dysfunction is one of the most commonly treated problems at our chiropractic clinics in Chester and North Wales We can treat it effectively by showing patients how proper posture can help to decrease pain. This in turn improves their mobility function and strength. We teach patients proper movements to protect their spine and prevent the problem from recurring. We use strengthening exercises and soft tissue massage to help minimise inflammation and pain.

Back pain often originates from the intervertebral discs. Your chiropractor may diagnose degenerative disc if you have back or neck pain. I am going to discuss how degenerative disc disease (DDD) develops, how chiropractors diagnose this condition and some treatment options.

How Degenerative Disc Disease Happens

The spine consists of twenty-four spinal bones called the vertebrae. In between each vertebrae, there is an intervertebral disc, which functions as a shock absorber. It protects the spine during forceful activities including lifting, running, and jumping.

An intervertebral disc has two parts: the nucleus and the annulus. The nucleus is the sponge-like material in the centre. The ligament rings that surround the nucleus to hold it in place is called the annulus.

Degenerative disc disease has multiple causes, including ageing. Certain types of vibration, activities, wear and tear, and even smoking can accelerate disc degeneration. Several studies have shown that genetics also plays a role in degenerative changes.

Degeneration starts when the nucleus loses its ability to absorb fluid. As a result, the nucleus dries out and becomes dehydrated, making it unable to absorb shock. Small tears then form in the annulus. When this happens, the disc starts to weaken and collapse. 

Description of Pain

The patient will first feel the symptoms of a deep ache in the centre of the low back. Heavy physical activities and staying in the same position for a long period of time can aggravate the pain but resting can help relieve it. Back stiffness may also be felt. At first, the symptoms may last only for a few days, but as the disease progresses, the symptoms could last longer. 

The pain caused by degenerative disc disease may come and go as the years pass. Each time the pain occurs, it may feel worse compared to the last. If not treated, the pain may radiate to the buttocks or thighs. It may also take longer to relieve. 

Diagnosing Degenerative Disc Disease

Your chiropractor will take a medical history and physical examination.  The patient is then asked to describe their symptoms and how the pain is affecting their daily activities. It is important to let the Chiropractor know what kinds of activities and positions exacerbate or relieve the issue.

The Chiropractor will then conduct a thorough physical examination. This includes assessing the posture and range of motion . This is to determine which spinal movements cause more pain. The chiropractor may do a neurological examination which involves checking skin sensation,muscle strength and reflexes.

If the symptoms are severe and the patient is unable to be treated the chiropractor may send the patient for x-rays. The x-ray will show if one of more discs have collapsed. IBone spurs (small outgrowth of bone), it will also show in the x-ray. However, more information may be required and this is where a MRI (magnetic resonance imaging) scan can highlight any problems in the spinal nerves.

Treating Degenerative Disc Disease with Chiropractic Manipulation

Chiropractic manipulation is an excellent option for treating degenerative disc disease. The main goal of chiropractic treatment is to relieve pain and improve mobility. When you are moving better, the pain will diminish. As well as improving mobility through treatment chiropractors will often prescribe an exercise programme to strengthen the back and core muscles to help release tight muscles. We aim to improve your mobility, reduce you a pain and teach you to look after your back at our chiropractic clinics in Chester and North Wales .

Sciatica is a result of injury, irritation, or pressure to the sciatic nerve. It causes discomfort, numbness, weakness, and/or tingling in one or both legs. Sciatica is not a medical condition but a symptom of a medical problem, so it is important to get a diagnosis of the underlying problem before starting on treatment. We offer diagnosis and treatment for sciatica at our chiropractic clinics in Chester and North Wales. This article is a brief discussion of the causes, symptoms, diagnosis, and treatment of sciatica.

Symptoms

The sciatic nerve is the nerve that runs from the lower spine down to the back of the legs. It is  responsible for controlling the muscles of the back of the knee and lower leg. It also supplies sensation to the back of thigh, part of the lower leg, as well as the sole of the foot. The symptoms of sciatica depend on its severity and people describe them as anything from a mild tingling sensation, through a a dull ache to a severe burning sensation.

The pain may radiate from the lower back down to the back of the thigh and the back of the leg. Some patients’ symptoms are severe enough to cause immobility. The symptoms often occur on one side and some patients feel a sharp pain in a part of the hip or the leg and numbness in other parts. The problem may also affect the calf or the sole and cause weakness to the affected leg.

Sciatic pain can be worse at night. The symptoms may be aggravated by certain activities such as sitting or standing; sneezing, coughing and/or laughing. Bending backwards may exacerbate the problem, especially if spinal stenosis has caused the sciatica. Bending forwards may aggravate it if it is caused by a disc herniation.

Treatment

Because sciatica is a symptom of another medical problem, it is important to know the cause. Piriformis syndrome, disc prolapse, lumbar facet irritation, spinal stenosis, spinal tumour and prostate cancer can all cause sciatica. Most cases of sciatica are not anything serious, but it is important to rule out underlying pathology.

In the short term you can achieve pain relief by applying heat or ice to the painful area or taking over-the-counter pain relievers. It is important to keep moving and we do not recommend bed rest. Your GP may offer you stronger pain relief. If the pain does not subside then you should seek a consultation with a chiropractor. 

For a diagnosis, short term pain relief and a full rehabilitation programme to get to the root of the problem we recommend that you seek chiropractic help at one of our clinics in Chester or  North Wales.  

Discs are small, rubber-like, soft pads found in between the vertebrae that form the spinal column. These discs help keep the flexibility of the spine and serve as the spine’s shock absorbers. They can “burst” due to their softness and flexibility. When this happens to a disc it is called a prolapsed disc. The discs in the lower back (lumbar spine) and the neck (cervical spine) are made up of an inner jelly-like material called the nucleus. The nucleus is encircled by a thick cartilage called the annulus.

Causes of a Prolapsed Disc

A prolapsed disc is often described as a “slipped disc” a “herniated disc” or a “ruptured disc”. Spinal injury may cause a disc prolapse, but the most common cause is wear and tear, or disc degeneration. Disc degeneration starts as small cracks in the annulus or outer rings of the disc. Later, the gel-like nucleus pushes through the annulus, and puts pressure on the nerves, causing weakness, pain, and numbness in the legs.

Other Risk Factors

Discs have a high water content while we are young but as we grow older, the water content lessens, affecting their flexibility. This causes them to shrink while bringing the vertebrae closer together. Smoking, sudden careless lifting, pressure, and repetitive strenuous activities may contribute to disc prolapse. Obesity is another risk factor as the excess body weight adds strain to the spine.

Signs and Symptoms of Disc Prolapse

Neck

When the nerves in the neck are compressed people often experience shooting pain in the neck and the trapezius muscles. This can radiate down the arm and may also cause headaches. Other symptoms include weakness and/or tingling in the arms and burning sensations.

Lower Back

The most common symptom of a slipped disc in the lower back is sciatica. This is often experienced pain, tingling, numbness, and/or weakness tin the back of the legs. Any stress on the spinal nerves can cause sciatica.

It does not automatically mean that you have a ruptured disc just because your have back pain or sciatica. It is always better to see a chiropractor, especially if an injury or fall has caused your symptoms. Patients often seek help for a prolapsed disc at our chiropractic clinics in Chester and North Wales. There are chiropractic adjustments designed specifically for prolapsed discs.

If you experience bowel or bladder incontinence with severe neck or low back pain, you should seek urgent medical help.

Part 2: Diagnosis and Treatment

To confirm the diagnosis of a disc herniation, chiropractors start by asking for your full medical history. It is important to tell him or her if you are having pain in the neck, back, arm or leg. You should also tell your chiropractor if you have had a recent injury.

Your chiropractor will perform a physical examination to find out which nerve roots have been affected and to determine the severity of the prolapse. He/she will test your reflexes, muscle strength, and sensation as well as checking for any signs of muscle wasting. Your chiropractor will also check your posture and palpate your spinal joints for areas of restriction.

We may order an x-ray as it can show evidence of changes in the spine and discs. We may also order other imaging studies such as magnetic resonance imaging (MRI), computed tomography (CT) scan, and/or electromyography if the symptoms persist.

How Do you Treat a Prolapsed Disc?

Your chiropractor will decide how to treat you based on your lifestyle and symptoms. Chiropractic is a safe, non-surgical option. If we do not improve your symptoms we may consider referring your for surgical treatment.

Surgical Options

Surgery may be an option if you are experiencing a significant loss of function and pain. There are two main surgical options depending on the position and size of the disc prolapse; laminectomy and microdiscectomy, also called spinal decompression therapy.

Non-surgical Options

The following are some of the non-surgical treatment options that can help improve slipped disc symptoms. In most cases, non-surgical treatment is the first option, which is effective in not less than 90{b67a0f01f7b147b7e978da5adbadca47e09d0d78364efaa0732b6ae8d4f320dc} of patients.

• Muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDS), or analgesics can help to relieve the symptoms. For severe cases drugs such as amitriptyline are recommended.

• You should apply cold compresses several times a day, for no longer than 20 minutes at a time. After the spasms have settled we recommend that you use heat.

• Chiropractic treatment. Chiropractors perform low-force chiropractic adjustments especially designed for herniated discs. They also use a form of non-surgical spinal decompression therapy or traction.  Chiropractic treatment is one of the most effective and safest treatments for herniated discs.

If you want to fins out more about treatment options at our chiropractic clinics please call our clinic in Chester or North Wales.

Spondylosis is a degenerative condition of the spine. It is also known as spinal osteoarthritis. There are two common types of spondylosis: Cervical, which affects the neck, and lumbar, which affects the lower back.

Causes

According to experts, spondylosis is mainly caused by aging. When a person gets older, they tend to exert their bones and cartilages more with every movement, and this causes wear and tear. When this happens, the cushioning in the spinal discs decreases and the bones develop spurs. This results in pain.

Risk Factors

There are a lot of factors that could put someone at risk for this degenerative disease and these include the following:

• Diet
• History of injury
• History of spinal surgery
• Mental health problems
• Smoking
• Sedentary work

Symptoms

Pain in the affected part is one of the most common symptoms of both cervical and lumbar spondylosis. However, the symptom could extend to other areas of the body. It tends to be more severe at the beginning and the end of the day. Other symptoms include numbness, tenderness in the area, tingling, and feelings of weakness.

Spondylosis symptoms develop over time. In some cases, however, symptoms occur all of a sudden. It is recommended to have this condition treated as early as possible because if these symptoms remain untreated, it could result in certain complications such as chronic pain and muscle function loss.

Treatment

While some patients prefer to treat spondylosis with conventional medicine, others prefer chiropractic treatment as this option does not need medications or surgery. Chiropractic treatment restores spinal joint mobility which helps reduce pain as well as improving your overall health.

Chiropractic treatment has a range of methods including spinal adjustment, heat or cold therapy, lifestyle modification, and ultrasound. Most people, as they get older, suffer from spondylosis and this is one of the main conditions we treat at our chiropractic clinics in Chester and North Wales.

Spondylolisthesis is a back condition that occurs in both children and adults. In this article we will discuss the different types of Spondylolisthesis together with its causes and symptoms. We then offer the recommended exercises and treatment options available.

What is Spondylolisthesis?

Spondylolisthesis is a medical term for slipped vertebra. This occurs when one vertebral body slips forward over the bone below it. It often affects the lower vertebral bodies. Spondylolisthesis causes back pain, numbness, and/or weakness in one or both legs.

What Are The Symptoms of Spondylolisthesis?

One of the most common symptoms of Spondylolisthesis is an achy-type sensation, however, there are two additional types of pain associated with this condition.

1. Sciatic – Sciatic pain involves tingling, numbness and weakness that starts from the lower back and radiates to the buttocks, down to the back of the thigh and calf. 
2. Claudication – Claudication generally means limping and difficulty in walking.  The numbness and weakness in the legs is related to prolonged activity such as walking and standing. The symptoms are normally felt in the back, buttocks, thighs, or calves.

The Five Types of Spondylolisthesis

1. Isthmic

Usually caused by a fatigue fracture and people who play sports that involve repetitive stress to the lumbar vertebrae are most at risk.

2. Congenital or Dysplastic

This is caused by inadequate bone formation in the spine. Misalignment of the spine puts the vertebrae at risk of slippage. This occurs during a childhood growth spurt in about 14{b67a0f01f7b147b7e978da5adbadca47e09d0d78364efaa0732b6ae8d4f320dc} to 21{b67a0f01f7b147b7e978da5adbadca47e09d0d78364efaa0732b6ae8d4f320dc} cases.

3. Degenerative

This type is most commonly seen in older patients  and is caused by erosion. This results in breakage to the pars interarticularis. Longstanding instability as a result of disc and facet joint degeneration is usually the cause.

4. Traumatic

This is a fracture in the neutral arch as a result of direct injury or trauma.

5. Pathologic

This is the least common form which is brought on by destructive lesion to the pars interarticularis due to severe osteoporosis, carcinoma, or metastasis.

Exercise Recommendations

Doing some knee-to-chest stretch exercises of the tight iliopsoas muscles and hamstrings may help relieve the symptoms temporarily. Core strengthening exercises can also be particularly helpful.  However, it is not recommended to attempt any new exercises or stretches as some of these can cause or exacerbate symptoms.

Chiropractic Treatment

Treatment of Spondylolisthesis depends on the signs and symptoms a patient has. At the Back Doctor Chiropractic Clinic in Chester, we have helped patients with this problem.

If conservative treatment does not relieve the symptoms, the condition has most likely become sever and surgical consultation may be required.