Headaches

What is a headache?

At some point in our lives we all experience the uncomfortable pain of a headache.  Although they are not entirely understood, there are a variety of causes that have been postulated such as diet triggers, joint restrictions, trauma, vascular issues, jaw problems, sinus problems, nerve irritation, etc.  In this blog we will focus on three of the most common types of headaches.

What are the different types of headaches?

Tension Type Headache- Thought to be the most common type of headache.  A tension type headache feels like a a pressing or tightening sensation around the entire skull .  It is considered to be mildly painful and the intensity does not change with physical activity.  It can be tender to the touch and generally lasts anywhere from 30 mins- 7 days. Often thought of as being stress headaches. These headaches can be treated with trigger point therapy and figuring out different ways to reduce stress such as yoga, exercise, meditation, etc.

Cervicogenic Headache– This type of headache is moderately painful in nature and is typically on one side of the head.  Symptoms can often be brought on by sustained awkward neck positions, certain neck movements, or external pressure on given neck and shoulder structures.  Everyone is different, so triggers can vary between people.  It commonly starts at the base of the skull and will wrap around the head to the persons eye.  Often times there is a lack of motion in the upper cervical vertebrae where the majority of cervical movement occurs.  There can also be weakness in the deep neck flexor muscles, which are on the front part of the neck.

Migraine- These headaches cause moderate to severe pain to the individual and are more commonly found on one side of the head. If the person is only suffering pain in a migraine patter, this is referred to as a migraine without an aura. A migraine with an aura can come with other symptoms along with pain following a migraine pattern. This includes aversions to light and sound, visual disturbances, such as, blind spots (scotomas), zigzag lines, shimmering spots, nausea, and even temporary decreases in vision. Although not entirely understood, theories as to why migraines occur include genetics, chemical imbalances, food triggers, and vascular issues.

How can chiropractic help?

Chiropractors are trained at recognizing and diagnosing a variety of headache types. The headache types listed here are just the more common headache types and headaches that shows evidence of chiropractic being beneficial for patients. Depending on the individual and their symptoms, a chiropractor will look at contributing factors such as, trigger points in muscles, dietary triggers, environmental factors, joint movement, and water intake. A chiropractor will be able to help identify, treat, and properly refer you to another medial professional if necessary.

Osteoarthritis

Recently we discussed a very general definition of “what is arthritis?” Today we will dive deeper into the most common type of arthritis people experience called Osteoarthritis. It is also known as Degenerative Arthritis. The most common joints affected by osteoarthritis are the spine, hips, knees, and feet.

What causes Osteoarthritis?

Osteoarthritis occurs when there is a breakdown of bone and supportive structures like cartilage. When this occurs, it causes irritation at the affected joint causing pain. This is more common in older adults due to the slow process of degeneration that comes with age.

Although it is more common in people who are 60 years and older, osteoarthritis can happen earlier in life due to genetics and previous injuries. For instance, a running back in football is more likely to get arthritis in the knees at an early age due to the wear and tear they put on their bodies compared to your average person.

How do I reduce my chance at getting osteoarthritis?

As we age it is important to make sure we are taking the adequate steps to ensure our bodies are healthy and we are doing what we can to reduce our chance of osteoarthritis. This includes maintaining a healthy weight, along with proper diet and exercise.

With obesity rates continuing to rise, it is important to address the stress it puts on the spine. With the increase in abdominal weight, it puts more strain on low back muscles and increases the lordotic curve in the spine. This increase in the lordotic curve in the lumbar spine can lead to degenerative changes and early arthritic changes in the low back.

Another way to help reduce your risk of early arthritic changes is to avoid injury. Although this is often a hard one to avoid, things such as being aware of your surroundings, proper warm up, and having a strong core can help decrease your chance of injury.

One very common injury many of us suffer from is due to repetitive movements. Being aware of your repetitive habits is very important. For instance, a worker who is constantly lifting needs to constantly lift with good form to avoid injury.

How Can Chiropractic Treatment Help Me?

Chiropractic care is a great option for preventative care and symptom relief.

There are many things chiropractors can do to ensure that your joints stay as healthy as possible throughout your life. This includes adjusting joints to provide proper movement of the area and slow down the process of degeneration due to wear and tear.

Education is one of the greatest ways chiropractors can help patients. By providing useful information on proper biomechanics, diet, icing, and exercise, we can ensure that you are taking the necessary steps to ensure you are as healthy as possible. Depending on the state you live in and the modalities the chiropractors use they may recommend ultrasound, low level laser therapy, electrotherapy, or cryotherapy.

Arthritis

What is Arthritis?

Arthritis is a condition almost everyone has heard of, but what actually is arthritis?  As it turns out there are more than 100 of different types of arthritis and related conditions.  It is often thought of as being an “old person disease,” but in fact people of all ages, sexes, and races can get arthritis.  Many factors such as diet, infection, age, gender, prior injury, and family history can contribute to a person being predisposed to getting arthritis.  This is condition in which an individual joint or multiple joints can experience pain, swelling, stiffness, and decreased range of motion.  The most common types of arthritis are osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

Arthritis can cause permanent joint changes and is the leading cause of disability in America.  Certain changes may be visible, such as knobby finger joints or swelling, but frequently the extent of the joint damage can only be seen on x-ray.  Some types of arthritis can also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

How is it diagnosed?

Your doctor will take into consideration your past health history, family history, and symptoms.  From there they may take x-rays or do blood work to help diagnose and distinguish what type of arthritis you have. Blood tests will be able to detect whether arthritis markers such as rheumatoid factor or anti-ccp are present.

How is it treated?

There are many ways to help reduce symptoms such as ice, heat, medication, dietary restrictions, exercise, chiropractic care, massage, physical therapy, and surgery.  The type of arthritis and severity of the person’s condition will determine what the most effective treatment strategy will be.  Every person responds differently to treatment so monitoring of the results is very important to long-term symptom management.

How common is it?

Arthritis affects around 54 million people in America today.  The most common type of arthritis is osteoarthritis which an estimated 31 million people have.  These number is expected to continue to increase too.  By the year 2040, the number of people with arthritis is expected to climb to 78 million people.

With arthritis impacting 26 percent of women and 18 percent of men, more needs to be done to help reduce these numbers. We need to work to increase awareness, do more research, and improve treatment methods.

Walk to cure arthritis

The Walk to Cure Arthritis is an upcoming event in the Puget Sound happening on May 5th.  It is being put on by the Arthritis Foundation and is located at the Renton Memorial Stadium.  Here is a link to the site where you can sign up to donate or register to walk at the event to help fight against arthritis.

Walk to Cure Arthritis May 5 Renton Memorial Stadium

 

 

 

 

 

Tennis Elbow

What is Tennis Elbow?

Tennis elbow (also known as lateral epicondylitis or lateral epicondylosis) is an injury that occurs on the outer part of the elbow.  It is called tennis elbow because tennis players are more predisposed to experiencing this pain due to the forces they place on their elbow, although it can happen to anyone. Damage occurs to the tissues located on the outer aspect of the elbow where the wrist extensor muscles originate.  Nerve irritation can arise if there is any inflammation in the area, which can make movements such as extending the wrist, deviating the wrist, grasping objects, or turning the hand to be very painful.

What causes Tennis Elbow?

LONDON – JULY 04: Novak Djokovic of Serbia plays a backhand during the Men’s Singles third round match against Nicolas Kiefer of Germany during day nine of the Wimbledon Lawn Tennis Championships at the All England Lawn Tennis and Croquet Club on July 4, 2007 in London, England. (Photo by Ryan Pierse/Getty Images)

 

LONDON – JULY 04: Novak Djokovic of Serbia plays a backhand during the Men’s Singles third round match against Nicolas Kiefer of Germany during day nine of the Wimbledon Lawn Tennis Championships at the All England Lawn Tennis and Croquet Club on July 4, 2007 in London, England. (Photo by Ryan Pierse/Getty Images)

Tennis elbow is an overuse condition, which is why anyone can get it.  Those prone to tennis elbow (other than tennis players) are professions in which there is a lot of wrist movement such as painters, butchers, cooks, carpenters, and so on.  By holding a weighted object like a tennis racquet, it is going to cause more stress at the elbow due to the torque force that is building as the person pulls the racquet back and then swings.  The most common ways for tennis players to suffer from this injury is with their backhand swing and/or serving.  Experience also plays a role in the liklihood of these injuries.  Novice players are more likely to feel the pain in their elbow resulting from poor backhand swing form.

How Pollard Chiropractic can help?

Kinseo Tape to Help Tennis Elbow

Since this injury is an overuse injury, resting is a key to success in treatment.  Giving time for the tissues to heal and using ice to reduce any sort of inflammation will go a long way in the healing process.  What Pollard chiropractic can do to help reduce the pain and decrease recovery time is using Graston Technique on the extensor muscle tendons.  Since tendons do not get the same blood supply like muscles do, this helps to bring fresh blood to the area to help heal the tendons.  Kinseo Tape is also a great way to help provide some support to the area, decompress skin that may be putting pressure on irritated nerves, and help reduce pain in the area.  We can also provide supplementary nutrition recommendations, adjust the elbow joint if needed, and use the cryotherapy machine to reduce any sort of inflammation in the area as well.

Shoulder Impingement

 

What is Shoulder impingement?

 

Shoulder impingement is a very common shoulder issue.  It occurs when the area between the acromion of the scapula and the head of the humerus bone (known as the subacromial space) pinches down on one of three structures.  Either the supraspinatus tendon, the long head of the biceps tendon, or the subacromial bursa.  The person will not experience pain until they reach mid range of their shoulder movement and then the pain will subside near the top of the movement.

Why does shoulder impingement occur?

1.Shoulder impingement can occur for a variety of reasons.  One reason may just be due to the structure of their scapula’s acromion.  As you can see in the picture, people with type 2 or type 3 shaped acromion are more likely to suffer from impingement syndrome.  This is due to the acromion hooking in, which reduces the amount of space for tendons and bursa to move through.

2. Another possibility is due to bony spurs growing off of the acromion.  This is more likely to occur in older individuals and these bony outgrowths will put pressure on the structures as the person moves their arm up.

3.The last cause I will discuss occurs due to shoulder instability/hyper mobility.  When there is no stability in the shoulder it can cause excessive movement of the humeral head within joint.  Increased shoulder mobility is something I have personally dealt with in both shoulders and have experienced impingement like symptoms over the years.  Focusing on stretching out the pec muscles, doing rotator cuff muscle exercises, as well as back exercises has made a huge impact for me in stabilizing my shoulders and scapula.  I notice that if I have not been working on these things consistently that my pain comes back.

How can Pollard Chiropractic help?
If you are suffering from impingement like symptoms we will look to find the root of the cause.  There are only three examples here, but there are more possibilities as to why you may be suffering from shoulder impingement.  We can help with proper guidance on behavior modification, proper icing/heating, exercises to be doing as well as which ones to avoid, adjusting, Kineso taping, and Graston technique.

 

Disc Herniation

This weeks discussion will be all about disc herniations, but in order to discuss what a disc herniation actually is, we must first look at the anatomy of the disc.

In between each vertebra in our spine we have discs to help cushion the spine from the compressive forces that we put on it.  This includes walking, jumping, running, etc.  The discs have two separate parts to it.  The first one is referred to as the anulus fibrosus and is the outer layer of the disc.  It is made of strong connective tissue that has a pattern similar to a basket weave pattern design to help it deal with the various movement forces such as twisting and bending.  An interesting fact about the annulus fibrosus is that only the outer 1/3 of the disc actually receives pain innervation.  This means that damage can be happening to the inner portion of the disc without the person even realizing it.

 

The other part of the disc is referred to as the nucleus pulposus and unlike the basket weave pattern of the annulus fibrosus, the nucleus pulposus is gelatinous in nature and absorbs more of the compressive forces.  This part of the disc is composed mostly of water and during the day, as more stress is placed on the disc, this water is pushed out.  When we sleep the discs will the absorb water back into the discs.  This is one of the reasons why someone may feel stiff in the mornings is that the discs are just full of fluid.

Now we can get into what exactly is a disc herniation/bulge.  Essentially a disc bulge is just a precursor to a disc herniation.  As damage occurs to the disc, the nucleus pulposus will start putting pressure on this weakened part of the disc and begin to bulge outward.  A great analogy to describe a disc herniation is to think of the disc as being a jelly filled doughnut.  We can pretend the dough is the annulus fibrosis (the outer part of the disc) and the jelly is the nucleus pulposus (the inner gelatinous part).  If we were to use our hand and push down on the doughnut, it would cause the jelly to squeeze outward, taking the path of least resistance.  In this case the path of least resistance would the damaged outer disc (the dough).

As the disc begins to bulge outwards, pain signals are sent to the brain.  Depending on how bad the disc bulge is and the location of it, the disc may put pressure on a spinal nerve and cause referred pain into the arms or legs.  Interestingly it is not uncommon for people to get MRI’s of their spine and learn they have a disc bulge/herniation and are completely asymptomatic.

How Pollard chiropractic can help

Chiropractic care is great, conservative treatment that works by applying forces to the spine in order to get the nucleus pulposus to move more towards the center and take pressure off of the nerve.  We also provide instructions on how to reduce any inflammation in the area and behavior modifications to ensure symptoms are not exacerbated.

Contact us at: (253) 638-2424

 

Ligament Sprains

Two weeks ago I discussed the basics of muscle strains.  If you missed that blog, feel free to check it out, as I will be building upon that knowledge. (muscle strain blog) This week I would like to talk about two terms that I hear people use interchangeably and help to clarify the difference.  These two terms are “strain” and “sprain”.  As mentioned previously, a muscle strain occurs when a muscle exceeds it’s maximum ability to withstand a given load or has been stretched beyond its natural capability.  This causes tears within the muscle and our body clues us in by sending pain signals.  So, what exactly is a sprain then?

What is a sprain?

Unlike a strain, which involves muscles, a sprain occurs when enough force has been produced to overcome the strength of the ligament.  Joints are designed to only move so far to avoid damage to important structures.  Ligaments are there to ensure that we do not go past our designed physiological barrier.  They are made up of strong, dense, connective tissue which helps to stabilize the joint by connecting bone to bone and they are everywhere!

 

How does a sprain occur?

Sprains are most commonly the result of trauma to a given area.  Although sprains to any ligament is possible, there are some that occur more than others.  (In the future, all of these will be discussed in more detail.):

Whiplash- Although technology keeps improving to make cars safer, whiplash is still a very common injury occurring in a motor vehicle accident.  Depending on the persons position and where the impact is will determine what structures are more vulnerable.  This picture helps to demonstrate what occurs in a rear end collision.  It shows why the interspinous ligament and joint capsule are vulnerable.  The force exceeds the ligaments capacity and tearing of the ligament results in a sprain.

AC sprain- The term “AC sprain” is in reference to the acromioclavicular ligament.  It describes exactly where the ligament is located, between the acromion of the scapula (or shoulder blade) and the clavicle (or collar bone).  This injury most commonly occurs through two mechanisms: 1. A fall on an outstretched hand, also known as a FOOSH injury.  The force transmits from the hand all the way to the shoulder and results in an AC sprain.  2. Falling directly onto the shoulder.

 

Inversion sprain- Often times you will hear people say “I rolled my ankle” and point to the outside of their ankle.  With enough force, this leads to a sprain of three possible ligaments, the anterior talofibular (ATFL), calcaneofibular (CFL) and posterior talofibular ligaments (PTFL). When a person lands on their foot wrong, they are unstable and this causes their foot to cave inward, which leads to the sprain.

 

Medical illustration of the consequences of ligament rupture of the ankle

ACL sprain- ACL stands for “anterior cruciate ligament”, it connects the femur to the tibia and is one of the major knee stabilizing ligaments.  An ACL sprain happens frequently in a variety of sports.  The mechanism of injury occurs when the athlete plants their foot and changes direction.  When this happens their is a quick deceleration and the femur bone continues to move forward and when the athlete twists, it causes rotational forces on the ACL.  This puts it in a vulnerable position and explains why these injuries often occur without any contact to the athlete.

How can Pollard Chiropractic help?

In the early phases of healing, we focus on reducing any sort of inflammation or swelling that may occur.  Patient’s learn proper ways to ice, we use kinesiology tape (or K-tape), light adjusting, and cryotherapy.  As the patient begins to exit the acute phase of injury, we incorporate proper rehab exercises, Graston technique, and build upon the methods already mentioned.  If you or anyone you know is suffering from a sprained ligament, come visit Pollard Chiropractic.