Your  Core:  • Mechanical Low Back Pain     • Sciatica     • Sacroiliac Joint Syndrome      • Disc Herniation (slipped Disc)     • Neck and Upper Back Pain/Postural Syndrome      • Thoracic Outlet Syndrome 

Mechanical Low Back Pain
Low-back pain (LBP) is common in athletes and non-athletes. The odds of getting LBP during your lifetime are 60% to 90%. For Athletes, the lower back is a frequent site of injury in a variety of sports, including gymnastics, football, weight lifting, rowing, golf, dance, tennis, baseball, basketball, and cycling.

The spinal column is made up of 24 bony vertebrae with alternating discs. The vertebrae are made up of the cervical spine (neck), thoracic spine (mid-lower back) and the lumbar spine (low back). Five additional bones are fused together to form the sacrum and three more comprise the coccyx or tailbone. Together, they allow for an upright posture and mobility in several directions and planes. The discs are actually a gelatinous form of cartilage contained within a dense fibrous mesh that lubricate the joints between the vertebrae and act as shock absorbers for the spine.

The lower back is a particularly vulnerable area for discomfort since it supports the entire weight of the upper body. LBP can be caused by a variety of factors including poor posture, weak core stabilizers, stress, pregnancy, compression of nerve roots, bone or joint disease and many others. This can lead to joint or nerve irritation, muscle spasm, disc bulges and spinal degeneration.

Although patients often attribute the onset of their back pain to a specific injury, more often the injury is quite trivial, like bending over, twisting, or sneezing. This is because much of the time onset of low-back pain represents the cumulative trauma over month or even many years. Using the circulatory system as an analogy – If the blood vessels in the body have suffered the chronic insult of atherosclerosis (plaque build-up) over the years, an acute event of shovelling snow may precipitate a heart attack; in the same way, a lifetime of poor posture and poor lifting and bending habits may stress the spinal muscles, joints and discs to the point that even a minor stress precipitates an acute episode of low back pain.

If low back pain is usually due to cumulative trauma, does that mean it’s most often mechanical? Ninety-seven percent of back pain in the population seen by primary care physicians is mechanical in origin – there’s something wrong with the muscles, ligaments, or connective tissue. Even a herniated disk is a mechanical cause. Individuals who are most aerobically fit have the least back pain.

Treatment for low back pain depends on the cause and may include any or all of the following: Chiropractic, Physiotherapy, Targeted Soft Tissue Therapy, Acupuncture, and Functional Rehabilitation. Treatment is initially aimed at decreasing pain, reducing inflammation and muscle spasm, and restoring normal motion to the joints of the spine and pelvis. Subsequently, the goals of treatment are to correct any muscular imbalances that may be contributing to the altered biomechanics, improve core stability, restore appropriate balance to the back, core and pelvic muscles and focus on lifting and sitting posture. back to top

Sciatica
Sciatica is a term used to describe a symptom rather than a diagnosis. Sciatica simply refers to irritation of the sciatica nerve which runs from the back of the pelvis down the thighs, legs, and even into the feet. Irritation of this nerve may be caused by a number of sources including: compression from surrounding tight muscles, disc herniations, degeneration and misalignments of the spine. back to top

Sacroiliac Joint Syndrome
The sacroiliac joint (SI joint) is the joint between the sacrum (lower spine) and illium (pelvic bone). This joint moves every time we take a step. Sometimes this joint becomes stuck or locked causing low back pain. The surrounding muscles of the SI joint often go into spasm as a protective mechanism. Pain is experienced in the buttock and thigh regions. It is typically aggravated by sitting for long periods.

Various athletic activities, including walking, running, jumping, leaping, and squatting, can produce unwanted motion or stress in the SI joint and surrounding tissues. Soft-tissue failure, overload injuries, weak core stabilizing muscles, stress and direct traumas can all contribute to this condition. SI joint pain may also be a distant manifestation of an injury in other parts of the kinetic chain that are stressed during sports activities. back to top

Disc Herniation (slipped Disc)
The intervertebral discs are located throughout the entire length of the spine in between each of the vertebrae (bones of the spine). A disc Herniation occurs when the jelly-like substance from within the disc protrudes out the back and side of the spinal column. It is theorized that the protruded herniated disc material caused the release of irritating substances or initiated an autoimmune inflammatory reaction. This disc, the corresponding inflamed nerve root, or compression of the nerve root by the disc may be the source of pain. This can cause any of the following symptoms; low back pain, tingling, pain and weakness down the affected limb (usually below the knee). The pain is often of sudden onset from a bending and/or twisting manoeuvre but is the result of cumulative repetitive trauma. There is often a past history of several bouts of low back pain that have resolved.

The disc can become dysfunctional due to cumulative trauma (ie: repetitive combined movements of flexion of the back and rotation), the effects of aging, or degenerative disorders of the spine. Most people with back pain however, do not have pain from herniated discs. Current research using an MRI had shown that as many as one third to one half of healthy asymptomatic young men have signs of disc bulge or Herniation. back to top

Neck and Upper Back Pain/Postural Syndrome
Upper back pain may be caused by a number of things including joint irritation, poor posture or a mal-positioned rib. All types of conditions can refer pain to other areas. For example, rib pain can travel around to the front of the chest and is aggravated by deep breaths.

Pain will generally be located between the shoulder blades and anywhere from the base of the head and neck to the tip of the shoulders. People often describe this as constant arching in the middle of upper back region. The pain is usually relieved by activity and made worse by repetitive activity (sitting at a desk, driving, etc).

The imbalance between the front and back muscles of the neck and back are often accentuated by various work posture that emphasize a “hunched”, forward-head position. The large pectoral (chest) muscles become chronically “shortened” and tight in response to this sustained position. Meanwhile, the muscles in between the shoulder blades are weak and constantly strained from overuse having to support this hunched posture. This results in pain, loss of motion in the neck, upper back and shoulders, scar tissue formation and misalignments in the corresponding joints.

Treatment is aimed at minimizing pain, correcting the muscular imbalances and re-storing the normal motion to the neck, upper back and shoulder complex using Functional Rehabilitation, Targeted Soft Tissue Therapy, Physiotherapy Chiropractic and Acupuncture. Treatment and/or prevention of these aches and pains is accomplished by redesigning the work environment making it ergonomically efficient, taking frequent break throughout the day for stretching, varying your task to avoid repetition and mousing with your non-dominant hand at a computer. back to top

Thoracic Outlet Syndrome
The Thoracic Outlet is a tunnel whereby nerves and arteries from the neck run through to get to the arms and hands. Thoracic Outlet Syndrome (TOS) occurs when the nerves and/or arteries are compressed as they travel downward into the arm. Compression can occur at various sites from the neck down to the hands. This condition is characterized by having diffuse arm symptoms, including numbness and tingling. Often the symptoms will follow a path down the inside of the arm to the little ring fingers. This is often made worse by overhead activity.

Contributing factors to TOS include poor posture (forward head and rounded shoulders), muscular imbalances (tight chest, weak back), trauma, cervical ribs, carrying heavy loads and occupations or sports with overhead arm movements (ie: swimming, volleyball, tennis, baseball pitchers). Treatment is aimed at restoring normal mechanics to the neck and shoulder and establishing the correct balance between the postural stabilizing muscles. This is accomplished by breaking down scar tissue formation in the tight muscles with Targeted Soft Tissue Therapy and strengthening the weak postural stabilizing muscles with Functional Rehabilitation.  back to top