Back pain & joint problems

Low Back Pain and Sciatica

Back pain affects health drastically and is a leading cause as to why people seek chiropractic care. Current evidence suggests that 60% - 70% of adults will have an episode of low back pain at some time during their life. However, back pain episodes can be helped by staying physically active with good exercise and with the help of conservative, physical and manual therapies.

Causes of Low Back Pain

Repeated daily activities such as bending, lifting and twisting may result in bad movement patterns, which could lead to a lower back pain episode. The reason for this will be a fatigue process in the muscles, ligaments and joints of the spine, pelvis and hip area. A major pain episode in your life can cause you to compensate your movements to initially avoid pain. Repetition of such compensation movements even after the injury has healed, can place excess pressure on structures.

Degeneration of the spine (osteoarthritis) and in particular of the intervertebral disc, typically happens due to excessive pressure on the lower back structures over a period of many years. 

Trauma from motor vehicle accidents, slips and falls and sports injuries may also be a cause of low back pain.

(Degenerative Joint Disease)

Osteoarthritis (OA) is also described as degenerative joint disease and occurs when the cartilage in the joints is worn down as a result of wear and tear, aging, injury or misuse. It can be due to increased forces on a functional joint or normal force on a dysfunctional joint over time. Osteoarthritis also includes loss of cartilage, overgrowth of bone and the formation of bony spurs. This causes the bones under the cartilage to rub together, resulting in pain, swelling and loss of motion of the joint. Osteoarthritis can occur in any joint but most often occurs in the spine, hips and knees.

 The typical symptoms of OA are:
• Joint pain
• Joint stiffness
• Instability of the joint/s
• Loss of function of the joint/s

Chiropractors cannot reverse osteoarthritis, but can help treat the symptoms with the aim to reintroduce movement to the areas that have become stiff over time. Joints that do not move and become stiff cause the soft tissues, such as muscles and ligaments around it, to tighten and lose flexibility as well. Performing manipulation or mobilization as a gentle, controlled movement, helps stimulate the fluid in the joints, allowing them to glide and move more easily, relaxing the soft tissues around it. Soft tissue techniques on the muscles may be performed and appropriate exercise advice given.

Spinal Stenosis

The backbone / spine runs from your neck to your lower back. The bones of your spine form a canal, which houses and protects the spinal cord and its exiting nerves. Spinal stenosis occurs when the open space of the spinal canal becomes narrowed, putting pressure on the spinal cord and the nerves that travel from the spine.

Spinal stenosis occurs most often in the lower back and the neck, and is mainly due to osteoarthritis / degenerative changes to the bones and joints due to ‘wear and tear’. Osteoarthritis may lead to overgrowth of bone, thickening of ligaments and herniation of disc material that result in spinal canal narrowing.

Symptoms of spinal stenosis include:

  • Numbness or tingling in a hand, arm, foot or leg; 

  • Weakness in a hand, arm, foot or leg; 

  • Problems with walking and balance; 

  • Neck or low back pain;

  • Spinal stenosis of the low back may cause pain or cramping in one or both legs when you stand for long periods of time or while walking. This is known as neurogenic claudication and usually eases when you bend forward or sit.

Bulging or Herniated Discs

The 'Slipped Disc'

Intervertebral discs in your back cannot actually "slip out" of place. It is better to classify them as bulging or herniated.

Spinal discs are made of outer fibrous rings (annulus fibrosus) attached to the vertebrae, with a softer gel sac inner core (nucleus pulposus). The annulus can tear from trauma or degeneration causing pain. Later on, this can allow the inner gel sac (nucleus pulposus) to push out. Direct mechanical pressure from the disc or inflammatory chemical irritation to the spinal nerve can occur. This is known as a pinched nerve or trapped nerve in your spine and is medically referred to as a radiculopathy.

Pinched nerve(s) from your lumbar spine can cause pain in your back and/or 'referred' nerve symptoms (pain, pins and needles, numbness or weakness) over an area that the nerve supplies. In the case of the lower back, irritated nerves cause sciatica, which is pain in the leg.

Neck Pain and Headaches

Your neck supports the weight and movement of your head and generally ‘works’ constantly as an adult's skull can weigh between 4 and 7 kgs and requires some stability. It also contains the vast majority of nerves that reach from your brain to the rest of your body.

Neck pain occurs for a number of reasons, including but not limited to:

  • Osteoarthritis (as indicated by stiffness and loss of proper joint movement)

  • A bulging / herniated disc (pinched nerve in the neck causing brachialgia or arm pain)

  • Whiplash injury (acceleration-deceleration neck injury)

  • Sports injury / sprain-strain syndrome

  • Prolonged poor posture

Neck pain may also be associated with and be a source of headaches.

Whiplash Injury

Whiplash injuries are also known as acceleration - deceleration injuries and need not be a result of a car accident. In fact, you do not have to hit your head or neck. Just a sudden movement, especially if it is repetitive, may cause a whiplash injury.

A slip, a fall or a collision on the sports field with an opponent can all cause a whiplash injury. In a road accident, all it takes is 8km/h or 5mph of velocity to cause whiplash symptoms. Even a 'minor' bumper bashing can cause a whiplash injury.

Rather than just a simple injury of a neck muscle strain or neck ligament sprain, research shows that during a motor vehicle accident involving a rear-end collision, the neck curves in an abnormal S-shape which alters normal neck movement. Normally the joints of your neck glide over each other, but a whiplash injury forces them together. This can injure the neck muscles, ligaments, intervertebral discs and spinal nerves. There are tiny nerve receptors, called proprioceptors, in the neck ligaments, muscles and in the spinal joint capsules surrounding the vertebral joints. These relay constant information to your brain about the position of the joints. The result is a loss of proper movement in the joints in your neck and stiffness in your muscles. This can lead to pain, although it may take days, weeks or even months to develop.

Whiplash symptoms include:

  • Neck pain due to muscle spasm

  • Headaches

  • Dizziness

  • Pain referred to the arms

  • Fatigue

  • Poor Concentration

  • TMJ Disorder

Beit Hanadiv Herzliya
71 Hanadiv St., 1st floor

Dr Roy Sery
Sports and Rehabilitation Chiropractor