Healthy Back Blog

June 2010 Archives

  Chiropractors focus on injuries of the neck, back and the pains associated with these injuries. Every Chiropractor will offer slight variations on which treatments they choose for you. I will discuss several of the most common approaches here today.
 On your first visit the Chiropractor will discuss the specifics of your injury, your health history, surgical history and medication use. This will allow the Chiropractor to determine if your condition is treatable and also rule out contraindications.
 Once it is determined that you are a good candidate for Chiropractic care a variety of modalities are often used which vary from ultrasound, electrical muscle stimulation, ice and or heating pack use. These modalities often are used to decrease inflammation or reduce muscle spasm at the site of injury. Myofascial trigger point therapy is often used to assist in relief of muscular pain and tightness associated with your injury. The most common therapy used is spinal manipulation, often called an adjustment. This focuses on loosening tightened joints and restoring normal motion of the joints in the back or neck. Exercise and stretching routines should be given to all patients to help them fully restore normal motion and strength once pain levels become more tolerable.

 Bryan M. Steele, DC

 In this day and age we have a variety of different tests/scans available to help make an accurate diagnosis. Often patients do not understand why they are having the test and what exactly the ordering healthcare professional is looking for. Below is a list of commonly used tests concerned with diagnosis of spinal pain, muscle pain, or nerve pain.
1. X-ray (radiograph) - Commonly used when fracture, dislocation or other bony pathology is in question. Soft tissues such as muscles, nerves, or discs of the spine are very poorly visualized, if at all.
2. MRI (magnetic resonance imaging) - Commonly used to diagnosis disc herniations, muscle/tendon tears, ligament damage, tumor as well as a host of other pathology. It should be noted that MRI uses very large and powerful magnets, hence the name, to obtain the images. There is no radiation dose with MRI unlike X-ray or CT scan.
3. CT scan (computerized tomography) - Commonly used to quickly diagnosis internal injuries to the abdomen, chest or brain. Often used with injected contrast material. A CT scan involves taking a series of x-rays through the affected area, much like slices of bread in a loaf. CT scans are general considered less discerning between different tissue types. For this reason they are used less often for musculo-skeletal diagnosis outside of a hospital setting.
4. EMG (electromyography) - EMG is primarily used to diagnosis nerve or muscular pathology. An EMG measures the nerve pathways in the body and is able to assess the health of your muscles and nerves that control them. EMG is commonly used to assess which structures are damaged in carpal tunnel type syndromes or with pinched nerves in the neck or back.
5. Bone Scan - A bone scan is commonly used to diagnosis bone diseases that may not be visible on x-ray. Bone scan is frequently used in to track potential spread of cancer. A bone scan may also be used for more benign conditions such as osteoporosis or suspected bone infection.

 As always more in-depth information can be found using your favorite search engine. Education is your best tool, read up!

The best exercises for core strength

 As promised last week, I will discuss exactly which exercises are best to strengthen and help prevent occurrences of lower back pain. It should first be noted that all exercise whether it be walking or far more aggressive power lifting put stress on the joints and muscles of the lower back. Injury occurs when more stress is put on those structures than they can withstand. The key to strong back and core is putting the right kinds of stress in the right amounts to stimulate muscular growth while minimizing chance of injury.
 Back to our Canadian friend Stuart McGill, PhD. Dr. McGill studied several exercises for the lower back. He measured two things; the amount of muscle activation and the amount of sheer stress and compressive force these exercises imparted on the lower back. The best exercises were chosen based on higher levels of muscle activation while putting lower amounts of sheer and compressive force on the spine. The result was an exercise program that would strengthen the correct muscles while decreasing the chance of injury during the exercise.
 The three exercises are as follows. The abdominal crunch, isometric Side Bridge and Bird Dog exercises. Visual instruction of these exercises can be found through your favorite search engine. Seems pretty simple, right? Certainly there are exercises that are more advanced and require more muscle activation but because of the complex nature and controlled movement required they often become injurious to the amateur rather than therapeutic. As with any exercise program, there are contraindications involved. It is recommended that you consult your health care professional before starting these or any exercise.

 Bryan M. Steele, DC


 Other than the obvious that a strong muscle can handle more stress before failing, there are several reasons to strengthen the muscles of your lower back and abdomen. I'll keep this straight forward.
 A study was published in Spine in 2007; Spine is a peer reviewed journal that publishes research regarding various ailments of the spine. The study tested 19 participants with chronic lower back pain and 19 "healthy" participants. They made each participant carry out of number of lifting and reaching activities at specific heights and loads. Yeah I know, pretty boring so far. Here is the take home point. The 19 subjects with chronic lower back pain had less muscular control over their lower backs during these tasks.
 Less muscular control leads to more aberrant motion which often leads to the initial lower back injury, or as hypothesized in this study, increases likelihood of continued or prolonged back pain. We'll discuss exactly which exercises you should and should not be doing future.

Bryan M. Steele, DC

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Bryan M. Steele D.C.

Bryan Steele is a Hudson Falls native and Ithaca College graduate with a B.S in Exercise Science. He also graduated with a doctorate degree for Chiropractic from New York Chiropractic College graduate. He has a special interest in research pertaining to neck and lower back pain rehabilitation. Bryan is currently in private practice at O'Leary Chiropractic in Queensbury NY.