Chiropractic Treatment of Foot Pain (Philip J Hehir DC)
Foot pain can wreak mechanical havoc on your joints and muscles.
Foot complaints are a common cause of pain and disability for many of the patients we see at our practice.
There are a variety of different sources of foot pain, luckily the vast majority are mechanical in origin and can be treated without drugs or surgery.
The foot is a very complex structure, to say the least.
The feet form the foundation of the body and if the feet are misbehaving, it is no real surprise that the knees, hips or low back (and sometimes the neck) can also begin to play up.
The foot is compromised of 26 individual bones.
With two feet that means you have 52 bones, which equates to about 25% of the overall number of bones in your whole body. That’s a lot of bones and joints!
Misalignment or reduced movement between any of these bones can be responsible for a lot of foot conditions.
As an example, if the calcaneus (the heel bone) lacks mobility, the Achilles tendon has to work harder. The extra effort induces a gradual strain into the Achilles tendon and calf. Over time, as the muscle gets over-worked it can eventually develop an Achilles tendonitis.
QUESTION: Would we call this a “muscle problem” or a “joint problem?” Correct answer: Both!
The patient has the right to more than one problem.
In a lot of foot complaints, it is not uncommon for several areas to be irritated. It’s only when a chiropractor inspects your foot pain in detail, symptoms can be elicited in areas you didn’t think were hurting.
Typical conditions we see in our practice are:
Plantar fasciitis (a commonly over diagnosed condition!)
Tarsal tunnel syndrome
Our ancestors may have run round barefoot in grassy terrains chasing mammoths, but modern humans wear shoes pretty much from the day they’re born.
We walk on flat surfaces, not bumpy ground. This in essence has changed the way our foot looks, and is the main theory as to why there is such a high incidence of ‘flat feet’ (also known as excessive pronation).
As with any complaint, it is necessary to determine the exact cause of the condition. It is therefore important to make an accurate diagnosis, so the chiropractor can perform specific treatment.
The chiropractor could then provide the patient with all the necessary information to prevent the problem from reoccurring. This can include, for example, exercises or custom-made orthotics (shoe inserts), which our Guildford Chiropractors make on site.
The treatment varies according to the individual patient and the condition.
If you would like to find out about treatment that does not involve surgery or drugs, contact clinic reception. If you would like a call back from one of our chiropractors, this can also be easily arranged.
Shoulder Pain Treatment (Philip J Hehir DC)
Looking for shoulder pain treatment in Guildford? Look no further.
In order of frequency, after the back and the neck, the shoulder is the most commonly treated joint by our chiropractors.
It is a very interesting joint – it allows you to move your arm in many different directions and subsequently perform many tasks from day to day. It is a ball and socket joint, which is wrapped up in a relatively loose bag (called the shoulder capsule) to permit a lot of mobility.
Shoulder movements are heavily influenced by the dynamics of your shoulder blade, collarbone, neck, mid back and ribs.
Alongside this, we have the ligaments, which hold the joint together with the muscles that move the joint with great power and accuracy.
The price we have to pay for such a sophisticated joint is that a dysfunction in any of its components can affect the way our shoulders work, which, over time can produce painful shoulder conditions.
This would include, simple sprains and strains, tendonitis, frozen shoulders and many other painful and disabling conditions.
If neglected, like almost all musculo-skeletal conditions, shoulder problems can, over time, deteriorate and lead to compensatory mechanisms elsewhere in the body.
This can in turn cause secondary painful conditions.
Hence why a lot of shoulder conditions seen by chiropractors are associated with neck pain and headaches.
The neck joints can be placed under undue stress because of the lack of movement in the shoulder joint. The neck muscles and joints are being recruited to try and perform the work the shoulder joint would usually do – a task this area is not designed to carry out. Conversely, it could be that the shoulder pain is due to the neck itself being dysfunctional.
Either way a shoulder condition needs to be assessed thoroughly to determine the exact cause of the problem.
Chiropractors and physiotherapists are highly competent in the non-surgical management of shoulder conditions.
Their aim is to determine the exact source of the problem, whether it comes from a weak muscle, a restricted neck vertebrae or a collarbone dysfunction.
A management plan consisting mainly of hands-on treatment, exercises and lifestyle advice, is then drafted out.
The fact is, the longer you put up with your shoulder pain, the more difficult it will be for your practitioner to sort out.
If you’ve had a shoulder problem for a while, and it doesn’t appear to be getting any better, come and see us. We’ll be more than happy to help.
For further information on how chiropractors help with shoulders, or other sporting type injuries, read this article from the British Chiropractic Association.
Sciatica (Alain Michelotti, DC, PT)
So you think you may have sciatica?
Self-diagnosing is something we are all tempted to do.
Whether the symptoms we suffer from resemble the ones we had in the past, appear to be similar to those of a friend or a neighbour, or look very much like those described on medical website, it is easy to convince ourselves of a self-diagnosed ailment.
Do you remember “Three Men in a Boat” and Jerome’s study of the medical dictionary?
Making a diagnosis (labelling a condition) determines the management of the condition and has to be achieved by a process of elimination.
Roughly speaking, when in the presence of a patient suffering from low back pain, the practitioner has to decide if he is dealing with ordinary backache, nerve root pain or something more sinister.
To reach that decision, a careful history and examination are necessary. Sometimes even after that a doubt remains and complementary investigations are necessary.
Fortunately less than 1% of back pain is due to serious spinal disease.
Now, if we go back to self-diagnosing, it is true to say that we hardly ever see back pain sufferers entertaining the idea that their back pain can be associated with something sinister.
On the other hand, we regularly have patients consulting for what they think is a “sciatica”.
This is a word that has been in use from Greek times and is derived from “ischias” or pain around or coming from the buttock and thigh.
It then became “sciatica” and synonymous with pain in the leg and in the distribution of the sciatic nerve.
Sciatica can result from a disc prolapse (also commonly called a “slipped disc”), or the narrowing of the bony channels through which the sciatic nerve roots travel (called “spinal stenosis”).
One of the most common mistakes is to assume that all leg pain associated with back pain is “sciatica”.
The leg part of the pain is, most of the time, not caused by a “slipped disc”. It is due to the painful stimulation of the back muscles, of the little joints situated at the back of the spine, of the ligaments and of an array of other anatomical structures situated in the back.
Only when the leg pain is one-sided, extends to one foot, is constant, sharp, well-localized, and most of the time accompanied by numbness or pins and needles can it be labelled “sciatica”.
So, now that you’ve read this article, are you still convinced you suffer from sciatica?
The UK National Institute for Clinical Excellence (NICE) recommends spinal manipulation as performed by chiropractors for the treatment of low back pain and sciatica. For further information, visit NICE.
Are we sitting comfortably?
Sitting on the floor, in front of my wife and me, the other night, was our son, bolt upright with that perfect posture only young kids seem to manage, relaxed but not slumping.
I commented about this to my wife and we discussed how wonderful the young’s instinctive posture is; unsullied by years of poor school seating, lack of exercise and hours spent in front of TV or computer screen.
Any chiropractor will confirm that this upright posture is the best for the preservation and functioning of the spine, its associated muscles and the nervous system.
The body we are born with has all the bits and bobs to develop perfectly well on its own; it’s modern man with our modern ways that disrupt the normal developmental processes.
How can sitting at a desk all day, let alone an hour on the train, be good for you?
We are sleepwalking into an epidemic of spinal developmental problems.
In young children, the curves in the spine need activity to develop.
Running around and climbing trees is far better for your sensory system, cardiovascular system, nervous system, digestive system, lymphatic system, well just about every system you’ve got plus some sunlight to up your vitamin D levels, important for young and old bones alike (rickets is making a come back).
Playing on an X-Box or PS4 may give you some improved hand-eye coordination and strategy-making skills but you’ll get that outside when your friends are lobbing things at you or you’re climbing a tree.
Plus if you fall out of the tree you’ll get a sense of your own mortality, possibly a free trip to the Royal Surrey hospital and a clip round the ear which will improve your mum’s hand-eye coordination.
The ripple out benefits are endless.
We all need to be aware of poor posture. Slumping over a keyboard overloads the disc, which over time can cause a multitude of problems.
In offices get an agreement between yourself and your colleagues that if you see each other slumping you’ll shout “posture!”.
Have some fun and do yourselves some good in the process.
For exercises that could be useful to you, follow this link to Straighten Up UK, an incentive by the British Chiropractic Association to help us all improve our posture. https://chiropractic-uk.co.uk/straighten-up-uk/
“It can’t be tennis elbow, I don’t play tennis!”
Tennis elbow is a painful condition affecting the outside of the elbow, and the muscles of the forearm. It is a fairly common condition, affecting up to 3% of the population, however, only about 5% of cases are linked to tennis. It is most common between the ages of 40 and 60, and usually affects the dominant arm.
Tennis elbow is a repetitive strain injury in which the extensor muscles of the forearm are overused. This leads to small tears developing in the tendon of one of the muscles, close to the bony lump (lateral epicondyle) on the outside of the elbow. These tears result in localised inflammation, and put extra stress on the rest of the arm, making it very painful to perform certain actions.
Although its name suggests that the condition is caused by playing tennis, many other work or recreational activities involving repetitive arm, elbow or wrist movements, can also cause repeated strain on the extensor tendons of the elbow. These include playing some musical instruments eg violin or guitar, excessive playing on games consoles, and prolonged periods of decorating, gardening, carpentry, DIY (especially using a screwdriver), or intensive housework.
The most common symptom of tennis elbow is pain and tenderness on the outside of the elbow, and in the extensor muscles of the forearm. There may also be some wrist pain, and elbow stiffness, making it difficult to fully straighten the arm. The elbow pain may increase until the elbow becomes too painful to touch.
The pain is usually worse on lifting the arm up, bending the elbow, rotating the forearm eg turning a door handle, opening a jar, or pouring water from a kettle. Grip may also be affected, making it painful to hold a cup or shake hands.
The symptoms may develop immediately after performing a specific activity, or gradually over a period of days or weeks, as a result of periods of unaccustomed intensive exercise or activity, such as lifting heavy boxes when moving house or playing a lot of sport on holiday. Alternatively in some people the condition develops for no apparent reason, and may not be linked to any particular event or injury.
Tennis elbow is usually a self-limiting condition and will often get better without treatment. However, more stubborn cases may require some sort of intervention.
Try to avoid or modify activities that aggravate the pain, especially lifting, gripping or twisting movements.
Apply an ice pack 2-3 times a day for 10 minutes to help calm any inflammation.
Wearing a tennis elbow support to compress just below the elbow reduces the strain on the tendon attachments on the lateral epicondyle and allows them to rest.
Chiropractors can help to speed up the recovery time by using massage, trigger point therapy and acupuncture to the affected muscles, mobilisation or manipulation of the elbow joints, or applying kinesio-tape to the affected muscles. We can also advise on stretching and strengthening exercises when it is appropriate to do them. In most cases this works very well.
If the tennis elbow doesn’t respond favourably to treatment, or if the pain is severe, your GP may suggest a steroid injection into the painful area, or botox injections into the affected muscles. If conservative options still fail to work, surgery may be advisable.
For more information on how Guildford Chiropractic Centre can help you and your family, please contact the clinic here https://www.guildfordchiropractic.co.uk/contact-us/
Can chiropractors help with carpal tunnel syndrome?
I have totally lost count of the number of times a patient has self-diagnosed themselves with carpal tunnel syndrome (CTS).
“My friend says I’ve got Carpal Tunnel!” is a remark often made by anyone who has some sort of ache and tingling in the hand or wrist. CTS is without doubt a common disorder, but not as common as some might think.
First of all, before addressing how chiropractors deal with CTS, let’s briefly discuss what it is. CTS is ‘simply’ a nerve compression disorder in the carpal tunnel of the wrist. The hand itself is provided with a series of blood vessels, nerves, muscles and tendons. The wrist is made up of rows of bones (called the carpal bones) which form a curved arch. This arch is reinforced by surrounding ligaments which form a narrow canal; this canal is called the carpal tunnel. A nerve, called the median nerve, passes through this arch alongside blood vessels and muscle tendons. Due to the crowded nature of the carpal tunnel, anything that reduces this space can irritate the structures inside it. If the median nerve is irritated, a true CTS is created.
Patients who complain of wrist or hand pain first need to be assessed properly. Chiropractors, are musculo-skeletal experts and will spend time to take a case history and carry out a physical examination to reach a diagnosis. Once a diagnosis has been made and should chiropractic treatment be appropriate for the patient, a treatment plan will be drawn up. If chiropractic treatment is not appropriate, the patient will be referred for further investigation.
Most causes of CTS are easy to define – poor hand positioning or repetitive strain injuries (e.g. from typing), but other causes are possible. Fluid retention (as a result of pregnancy) can be a cause of CTS as can certain types of arthritis. A commonly overlooked area for CTS is that sometimes the source actually stems from the neck!
Whatever the cause, our chiropractors are well trained to deal with it. CTS is one of the most common conditions to be treated by surgery nowadays. Yet, in many cases an operation can be delayed or even avoided through a course of ‘hands-on’ chiropractic treatment.
Our chiropractors provide a very high standard of treatment using a variety of techniques, including chiropractic adjustments, acupuncture and soft tissue therapy to improve CTS, thus preventing the need to go ‘under the knife’.
For further information on Chiropractic treatment visit: https://chiropractic-uk.co.uk/chiropractic-care/
Osteoarthritis (OA) is a very common joint disease. It is characterized by stiffness, pain and sometimes swelling around the affected joint. It is also referred to as “wear and tear” or degenerative joint disease.
Like most non life-threatening conditions it is mainly treated by “tea and sympathy”. If it becomes too painful and disabling your GP will be very likely to give you pain killers (eg: Paracetamol, Co-codamol) and anti-inflammatory drugs (eg: Ibuprofen, Diclofenac, Celecoxib). To alleviate pain and improve function physiotherapists and chiropractors use physical therapy.
But how does one become osteoarthritic? Well, if you are not a vegetarian and pay a visit to your family butcher you may have noticed that, where the bones meet to form a joint, bone extremities are white, shiny and very smooth. This represents the cartilage, which provides a rubbery, lubricated cushion. Cartilage allows the two bones to glide easily with one another during joint movement.
In individuals with OA, the cartilage gradually wears away with the result that, over time, the two bones start “rubbing” against each other. This in turn will gradually cause pain, stiffness and sometimes swelling around the joint. OA commonly affects the fingers, knees, hips and spine. Although OA has a higher incidence in an older population, it still can affect younger people by trauma or overuse of a joint (e.g in athletes).
In order to establish whether a patient is suffering from OA a thorough medical history and an in depth physical examination needs to be performed. Plain X-rays films, to confirm the diagnosis and to assess the extent of OA, may also be required.
Once the chiropractor has ruled out other possibilities for the pain and the disability and a diagnosis of osteoarthritis has been confirmed a treatment plan can be drawn. In addition to a programme of pure joint and muscle rehabilitation patient suffering from OA may be advised to modify their lifestyle, as exercise and diet are important factors in the treatment of OA.
Unfortunately, most sufferers consult only once they have lost a substantial amount of joint mobility and muscle power. Chiropractors and physiotherapists are experts in the diagnosis and treatment of musculoskeletal conditions such as osteoarthritis. If you think you suffer from joint “wear and tear” why not consult one?
Additional information can be found:
Pain is usually the reason why most patients consult a chiropractor.
The practitioner’s task is to try to determine the source of the pain so that it may be addressed effectively. Once any serious underlying pathology such as bone damage, tumours and infection has been ruled out, we are left with pain of a mechanical origin. It is then important to consider the onset of the pain, which everybody likes to be able to associate with a particular cause.
When the onset of the pain is sudden, as often happens after lifting or bending awkwardly, twisting suddenly or making a jarring movement, it is reassuring for the patient to be able to attribute the cause to a specific event. “I did something foolish”, “I know I should not have done that” are the types of comments we hear regularly.
“The pain came from nowhere”,
“It came out the blue”,
“I was fine when I went to bed and the following morning it was so painful that I could not get my head off the pillow”
However, although the onset can still appear to be sudden, there may be no particular event, which can be identified as a possible trigger. In these cases the patient often feels let down by his/her body. “The pain came from nowhere”, “it came out the blue”, “I was fine when I went to bed and the following morning it was so painful that I could not get my head off the pillow” are the comments we hear.
This impression that the pain has appeared “from nowhere” occurs because the process has been developing well before we become aware of it. In addition to this gradual build-up of a problem, the culmination comes when some minor, trivial activity (eg lying in bed) acts as a trigger. The British describe it as ‘the last straw that breaks the camel’s back’ and the French, ‘the last drop that makes the vase overflow’ and this is exactly what occurs.
What happens is that long before we’re aware of the severe pain, most of us suffer from all sorts of periods of mild discomfort and stiffness caused by general ‘wear and tear’. All this takes a gradual toll on our joints and their supportive structures. Add to that a lifestyle of poor posture at work, long hours of driving, slouching on the sofa in front of the television and you have the perfect recipe for an acute episode of neck, mid back or low back pain one day.
But, you will say, what steps could I take to avoid reaching the acute stage? Our advice would be to monitor your health and keep your body working as smoothly as possible. Think about your car, do you keep it regularly serviced, or do you wait until you break down in the pouring rain in the middle of nowhere before you call a mechanic?
The analogy may be obvious, but don’t you think your body is just as important as your car? If so, a visit to the chiropractor may save you a lot of trouble and pain further down the road.
For further information, please visit http://www.webmd.com/pain-management/guide/chiropractic-pain-relief#1
Treatment for Temporomandibular Joint Pain (Philip J Hehir DC)
Some of you may be surprised to learn that our clinic sees more than just back or neck pain.
A frequent condition we see is jaw pain – medically referred to as temporomandibular joint dysfunction (TMD).
TMD is a common condition characterised by pain, and sometimes clicking, on opening of the jaw, usually on one side. Headaches, toothaches, limited range of movement of the jaw can also occur.
I want you now to swallow.
What happens during this process?
We approximate our teeth and, in so doing, mobilise our jaw.
When you realise that this process takes place approximately 2,400 times per day, it is not difficult to imagine that the temporomandibular joint is the most highly used joint in the body. As it is involved in swallowing, talking, biting and chewing, it is no wonder that a troublesome jaw can be a painful and frustrating problem.
The jaw joint is made up of the mandible (the real jaw bone) and the outer side of the skull, called the temporal bone.
If you place your fingers just 1cm in front of your ear, they will be on the temporomandibular joint. Then slowly open and close your mouth as far as you can. Ideally you should feel a symmetrical movement that is taking place under your fingers and the movement should be pain-free. However, if you suffer from TMD, when you open and close your mouth you may notice that one jaw joint moves before the other one; that it clicks; or that it is sore or even painful.
Apart from trauma to the joint itself, bruxism (or grinding of one’s teeth) seems to be the biggest causative factor in the development of TMD.
The jaw itself is controlled by powerful muscles. Bruxism causes over or under-activation of certain muscle groups and restriction of the jaw joint itself, which over time results in pain and headaches.
In order to secure the best outcome, your chiropractor will use specific muscle and joint mobilisation techniques with a view to restoring better mechanical function. This, in turn, will reduce pain. Exercises and advice will then be given to prevent recurrence of the problem.
If you think you are suffering from TMD, you do not have to learn to live with it. Something can be done about it!
Our Guildford Chiropractors see patients who have suffered with this debilitating condition for years and, with hindsight, regret they had not received treatment sooner.
For further information please visit To Your Health.
Strictly Come Back Pain (Andy Hewitt DC)
It’s capable of hauling you around for years on end with no more than an occasional grumble after slumping too long in front of “Strictly.”
Being the custodian of your spinal cord is a heady job.
Would you want to protect the nervous system as it leaves the brain to connect with the rest of the body?
It’s no mean feat when you consider the spine is made up of 22 articulating vertebrae with spinal nerves exiting out of holes on the side at each level. These connect your brain with all parts of your body although judging from “Strictly” this isn’t always the case.
So a wobbly pile of bony articulating blocks somehow manages to do its job for years upon end with barely a grumble. It begs the question how on earth do we ever get beyond the first year of life without complete spinal meltdown?
The aircraft makers Boeing and Airbus would be chuffed to bits if they managed the same incredible levels of reliability as the spine. They have scheduled servicing and parts that get replaced after a certain number of hours regardless (sometimes sooner if it’ a Boeing).
So next time you’re out on the dance floor strutting a paso doble or cobbling together a slightly shoddy rumba, think of your spine.
Think about what a fabulous job it does and how we so often take our wonderful bodies for granted.
If your back has been niggling more than normal, pop it into see us at Guildford Chiropractic Centre for a service (no replacements possible).
Get a tune up and get those problems resolved before they escalate. So that next time you go out on to the dance floor to “bust some moves” as my kids call it, your body is better prepared.
Throw on some sequins, get out there dance like a hairy biker and, at the very least you’ll be having fun and that’s got to be good for you.
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