Health providers across the globe have become quite familiar with the body’s response to the new technology of the 21^st Century, and the last two years appear to have had a considerable impact on our joints and alignment in the hands, neck, shoulders, and upper backs including additional loading on the low back.

In conversations with our patients, we have noted a great deal of poor ergonomic desk setup that has occurred due to working at home requirements during the lockdowns, as well as greater demands of the companies/businesses on their employees, equating to more time in front of a computer, often with poor posture adaption.

Most students have spent more time in their rooms, particularly in the last two years. Laptop usage at school has also become commonplace. These days, most teenagers and University students lives revolve around staring at their laptops or their phones. This is not new information for everyone!

The Rise of Technology and Strain on the Body

The rise of technology accessibility and overuse, plus the consequence of lockdowns, have caused a great increase in complaints such as back pain, neck pain, headaches, shoulder pain and repetitive type strain injuries.

Tendinitis in the fingers, thumbs, wrists, elbows and all the way up the arm to the neck can result from tapping away on mobile phones. We are using our muscles and joints in ways that strain them. Wrists are flexed for long periods, holding too much weight, with fingers moving repeatedly across a very short range of motion. The head is often flexed forward changing the load onto joints and muscles. Over time, these actions can cause inflammation and pain. For example, studies have been done linking De Quervains tenosynovitis (tenosynovitis of the thumb) to mobile phone usage. The pinkie finger is often used to hold the weight of the phone also leading to problems.

Text Neck

From a clinical perspective, the greatest issue with mobile phone usage is headaches, neck pain and upper back pain, as the fulcrum of the head and neck tends to load up the joints and muscles in the upper back and lower neck causing strain here, as well as under the base of the skull from the muscle pull. Text neck or forward head carriage can load the neck muscles and cervical spine by a factor of 4 to 5! 10cm of forward head carriage (the ear forward of the tip of the shoulder) adds 4.5 kilograms on to the top of the shoulders. Ouch! Be aware of that word document or zoom call where you are leaning into your screen.

Very frequent phone usage can also affect the nerve at the elbow, the ulnar nerve. The symptomatic picture of this is numbness and weakness in the pinkie finger and ring fingers. However, loading the discs and nerves in the lower neck and upper back can also induce these symptoms. Anytime there is inflammation, there is also swelling. This can cause a squeeze on the nerves that run through them. Imagine standing on a hose.

Wear Tear and Pain

It is always important to remember that postural alterations could also exacerbate pre-existing nerve and joint issues. Our body, in a correct postural stance, free of any injury that has not caused a change in any of our normal curves of our spine, has a center of gravity that enables even weight distribution on the joints and a relative relaxation of muscle tissue and ligaments.  A simple analogy is a wheel alignment in a car. If you hit a curve badly, or are involved in a collision, the wheels and often the body of the car can be very altered. The tyres start to wear. The same applies to the spine. Imagine the implications of a building foundation that was not stable. Once areas of the spine or joints in the body take a greater load, then wear and tear will develop.

Sleep Issues

Blue light from our screens can also disrupt our circadian rhythms and therefore our sleep. Blue light affects the production of melatonin in our bodies reducing both the quality and quantity of sleep. Blue light glasses can help to block some of this light. Many companies will have different shapes and sizes to choose from as well as provide magnification if that is also required for reading.

Solutions

We’ve seen an ever increasing frequency of such issues at our Lane Cove chiro clinic. The good news is that much can be done to improve these issues with new technology. It is never too late to implement some change. Most of the lack of good joint movement and therefore the development of pain we see in practice is from poor loading patterns. The muscles are like cables and will adapt to what the structure is doing (think the Leaning Tower of Pisa). Simple chiropractic adjustments and adoption of healthy postural control can remedy many symptoms. There are also numerous devices on the market than can help restore normal spinal curves. Postural muscle strengthening is also key. Accelerated disc degeneration can result in any changes, so if you catch things early, they don’t tend to become chronic.

What You Can Do:

• Microbreaks – Take regular breaks to unload. Recommended 30 seconds every hour. Neck retraction, arms by your side, turning your thumbs out and holding your shoulders back for a 30 second hold can prevent repetitive strain on joints, ligaments and muscles. Also find time in the day where you think about how you are holding your body and fix it. Hopefully, with enough practice, it will become subconscious.
• Invest in a large foam roller – Lie on it vertically, head resting, knees bent, feet flat on the floor, dropping the arms back, opening the chest. This is also brilliant to calm the nervous system and can be helpful before bed to rest the mind.
• Learn to strengthen your shoulder blade stabilisers – Ideally starting with a theraband. It is important to keep these muscles switched on when working on a computer. This can prevent many shoulder injuries, including rotator cuff.
• Mobilise – Broomstick rotations, wall angels, knee to chest pull ups, hip rolls, neck rotations.
• Improve the home office setup – Standing workstations relieve the pressure on the low back tremendously. It is very important to have your eyes looking straight ahead so improving screen height is essential and this includes laptops. Improve the keyboard so your elbows remain at 90degrees and are not extended out (this causes rounding of the shoulders) and adopt the use of a better mouse or wrist support.
• Voice to text option for mobile phones and hold the phone up! – Use phone grips.
• Tone Up with Pilates or Gym or do some Yoga – Without the concrete pillars in a building, what’s going to hold it up?
• Regular Chiropractic adjustments – Free joint movement, balancing the body’s biomechanics, unloading discs and nerves will also relax the muscles, keeping yourself tuned. Here, unlike dental work or your car mechanic, we can’t replace the parts, so get tuned up!

If you suspect you may be experiencing sciatica symptoms, you’re probably not wrong. That’s because the sensations and pain – ranging from mild to severe, sporadic or constant, acute or dull – are highly unique. In this analysis, we’re going to take a closer look at the most striking sciatica pain symptoms to watch out for – and what you can do next to get back to the life you love!

What does sciatica feel like?

• Shooting, searing or dull pain deep in the buttock?
• Similar pain radiating down the back of your leg?
• Numbness, tingling, burning, electric-like sensation along the sciatic nerve?

Many people refer to the feeling as electricity-like, which is no surprise given that it’s got everything to do with the sciatic nerve. The trouble usually starts in the lower back due to the pinching, touching or irritation of any of a series of nerve roots that can radiate their messages down the sciatic nerve, through your buttocks, your legs and even all the way to your toes. And if you’re feeling it predominantly on just one side of your body, such as pain shooting down a leg, it’s almost certain sciatica pain.

What causes sciatica symptoms?

As mentioned above, sciatica pain originates in the series of nerves in the lower back – most commonly with a lower back injury such as a herniated or bulging spinal disc. These rubbery discs are filled with gel-like fluid that makes our spine so effortlessly flexible, but other potential causes are spinal stenosis (narrowing of the spine), bone spurs, and other conditions such as facet joint osteoarthritis, lumbar degenerative disc disease and spondylolisthesis.

What are the other sciatica symptoms?

In addition to our description of the sciatica pain symptoms outlined above, we believe just about all cases of those suffering from this problem can be covered by the following 8 basic categories of symptoms:

1. Lower back pain

Those experiencing sciatica usually report that the trouble began with lower back pain, which is no surprise given that 9 in 10 cases are caused by a herniated spinal disc. The good news is that many such disc problems resolve.

2. Shooting pain

People often describe sciatica pain as ‘shooting’ and triggered by moving, lifting, standing, sitting or twisting in certain ways. It’s referred to as ‘shooting’ because it can ‘shoot’ from the lower back all the way to the toes.

3. Rear leg pain

Another widely reported symptom is pain in the back of the thigh, which again is caused by affected lumbar nerves. The sensation is often sharp and worse when you move, but it can also be duller and more sporadic.

4. Hip pain

Sciatic nerve problems can sometimes cause inflammation around the affected area, resulting in discomfort or pain in the hip. In many cases, gentle exercises can greatly help relieve the symptoms over time.

5. Pins & needles

This symptom can resemble the feeling of a ‘dead leg’ and resulting pins & needles, and it will usually recede with a period of rest.

6. Leg weakness

Sometimes, the symptoms can progress to the point at which leg weakness makes even walking difficult. However, continuing to move during these flare-ups can help, although surgery for nerve damage may be necessary. Often, your health specialist will help to diagnose sciatica and its causes by asking you to lay down and raise your straightened leg, and if this is particularly difficult or results in pain below the knees, that’s a red flag for sciatica and its causes.

7. Backside pain

Sciatica can be a real pain in the backside – literally! We’re talking about the gluteal muscles, which can also feel weak or numb depending on the extent of the affected nerve.

8. Urge to go to toilet

While most common only in more extreme cases, the frequent urge to either urinate or empty the bowels can be associated with sciatica – and can be extremely painful as well. In these cases, the pressure on the sciatic nerve is so great that permanent bladder and bowel damage can result, making urgent medical attention a must.

Your chiropractor can help with sciatica

Did you know your local North Shore chiropractor can help resolve your sciatica symptoms? They do this through a combination of:

• Spinal adjustment techniques like chiropractic instrument adjusting
• Hot & cold therapy
• Chiropractic exercises
• Initiating more healthy habits

Drop the LRCC team a message today!

At Longueville Road Chiropractic Centre, we understand how difficult sciatic pain can make your life. Our team can help with acute diagnosis and personalised Sydney chiropractic care so you can get back to doing all the things you love. If you’re ready to tackle your sciatica pain symptoms, get in touch with the team at LRCC today.

The Benefits of the Chiropractic Adjustment – A Neurological Perspective

Function and therefore dysfunction of the spine play a crucial role in neuro(nerve) muscular control. Many people think that chiropractic is just about the bones of the skeleton. Our whole principle is actually based on the nervous system and how spinal and skeleton joint dysfunction affects neuromuscular control.  Our 5-year University degree covers many subjects with extensive study into anatomy, neuroanatomy and neurophysiology amongst other such subjects as orthopedics, radiology and many more.

Central Segmental Control (CSMC) is a fancy word for vertebral column dysfunction. CSMC alters neuromuscular function. This research paper shows how spinal adjustments (directed at CSMC) and spinal manipulation (directed at segments that may not have clinical indicators of CSMC) affects neuromuscular function, also providing a biologically plausible explanation of how the neural motor control can dysfunction, leading to self-perpetuating central motor control problems, and how these adjustments can improve this.

There are many studies showing that physical injury, inflammation, pain, acute or chronic physiological and psychological stress alter the vertebral columns central motor control causing CSMC. The development of pain leading to chronic pain can therefore become an issue. This is of course why we recommend a regular visit to your chiropractic care clinic. You service your car; you clean and service your teeth. Spinal segments and your central nervous system however cannot be replaced like car parts and teeth. Altered loading patterns from CSMC can fast track wear and tear.

Vitamin D and Pain

Chronic pain is the leading cause of disability and disease globally. It can be due to tissue injury, an underlying health condition or have an unknown cause. In 2016, almost 20% of Australians aged 45 and over reported chronic pain with 20% showing little benefit from currently available analgesics. Emerging research is showing that improving Vitamin D status does have analgesic effects.

Another 20%- it has been reported that 20% of adults in sunny Australia over the age of 25 are deficient in vitamin D (2011-2013 Australian Health Survey). It can actually be a genetic conversion issue instead of not getting enough sun. Winter and the southern states can also be an issue of course.

The potential mechanism of action is that vitamin D receptor sites are found in numerous cell types of the body including those involved in pain signalling – skin, neurons, spinal cord and the brain. Vitamin D appears to mediate gene expression for pain genes and the proteins associated with pain signalling. Pain reduction always involves modifying the inflammatory response. It is proposed that vitamin D can assist here as well as influence pain sensitivity and provide analgesic effects after injury.

PEA Supplementation for Pain

Palmitoylethanolamide (PEA) is found in our plasma membranes with increasing concentrations in response to tissue damage, inflammation, and pain fibre stimulation.

It was a supplementation initially used for the prevention of the flu and common cold and treatment for rheumatic fever. Today PEA is used to counteract deficiency associated with diet, lifestyle, stress, ageing and chronic inflammation. Sources of PEA are found in beans and peas, tomatoes, coffee, apples, potatoes, lentils, lecithin, human milk, black-eyed peas, egg yolks, peanuts and soybeans.

Mechanisms of action include anti-inflammatory, antimicrobial, neuroprotective, analgesic, and immunomodulatory.  It appears to support exercise recovery and may reduce exercise withdrawal due to pain and inflammation causes. PEA has other reported benefits including post-traumatic stress disorder, anxiety, and depression

Studies have shown that arthritic and rheumatic joints have lower PEA levels in the joint fluid and PEA did not increase in chronic widespread pain subjects suggesting a potential for PEA supplementation.  It does however appear to increase in acute situations naturally.

All of these studies support the idea of trying to reduce the occurrence of chronic pain altogether. Good diet, the appropriate exercise for you, including core strengthening and correct neuromuscular control, are fundamental. Health is defined as physical, emotional, and chemical wellbeing and is fundamental for a pain-free life. Correct postural control, clean food, fresh air, sunshine, exercise love and joy are the elixirs of life. Ask for support if needed. It’s been a rough couple of years so please, invest in your health.

A frequent complaint in runners is shin pain or shin splints, with the most common condition known as Medial Tibial Stress Syndrome (MTSS) making up 16% of all running injuries. It certainly isn’t comfortable, with pain on the inside of leg, often bilateral, and tender on the touch covering an area greater than 5cm.

Plyometric type activities like running and jumping are usually the aggravating factors. Pain can sometimes appear initially at a workout, disappear as warming up and return on post-exercise. It is a condition that can increase in severity with pain remaining during exercise and continuing for days.

It is often thought that one of the main causes is due to the soleus muscle pulling on the tibial bone, causing periosteal (the membrane that covers the outer surface of the bone) irritation as well as underlying bone irritation from increase loading.

Other Causes of Pain and Locations

There are numerous causes of lower leg pain and it is important to differentiate between them. A very focal pain could potentially be a stress fracture. Stress fractures often tend to be worse with activity and won’t warm up like the early stages of MTSS.

Pain directly at the front of the leg (anterior) could be anterior compartment syndrome or a tibial stress fracture.

Posterior calf pain or pain at the back of the calf area, a condition called Deep Posterior Compartment Syndrome is to be considered. This often presents as more cramping /burning type pain and is likely to send pain and/or pins and needles into the foot.

MTSS is quite localised, so if there is any altered sensations or pain in the foot area, then it could be posterior compartment syndrome, nerve issues more proximal, for example from the lumbar (low back) spine, distal neuropathies for example diabetes, or vascular involvement in the leg. A simple ruling out for functional foot problem is also important as there are many bones in the feet. Flat feet or very high arches can cause a mechanical issue within the movement patterns of the foot during any gait activity and can also lead to pain and/or discomfort in the feet, not always bilaterally.

Just to add to diagnostic confusion, in a study in 2017, 32% of those with MTSS had co-existing pathologies (e.g. anterior tibial stress reaction or muscle pain, calf pain).

Management

Multifactorial causes must be acknowledged for all running injuries including structural, genetic, running mechanics, training loads and tissue qualities including strength and mobility.

Modifying the training load so as not to exceed 4-5/10 regarding pain markers is required. Above this pain score, then cross-training type exercises should be considered.

The biggest strain on the tibial bone is muscle contraction which is greater in running uphill so best avoided in MTSS. Step rate (cadence) increase as well as step width increase are wise to employ as well as trying to reduce impact loading. Visualise running on hot coals (running quietly) instead of stomping like an elephant!

Calf muscle strength is a very important consideration as studies have found that those with MTSS had weaker calves following a single leg raise to fatigue test.

Corrective Procedures

Calf strengthening procedures are best with single leg weighted calf raises adding weights incrementally to keep repetitions under 12. Calf strengthening is important for MTSS to assist in greater absorption of impactful forces as well as strengthening to improve tibial bone strength.

Plyometric exercises (jumping, hopping, skipping) are another great way to improve calf and tibial bone strength. It is important that the strength of the of other leg muscles and hips and pelvis be assessed for any weaknesses and corrected.

Manual therapy could be useful such as Chiropractic Adjustments to the foot bones, tibia, fibula, femur and pelvis bones to address any biomechanical joint dysfunctions and massage and trigger point therapy or dry needling to overly contracted muscles.

Assessing and correcting dysfunctions in the whole kinetic chain is important to remove any contributing factors.

In some cases, foot orthotics might be required, also a change in footwear could be the answer. A compression sleeve or sock can benefit some people.

The duration of MTSS can be quite long with some studies suggesting it can take up to 3 months to run at a moderate intensity with minimal pain, however, it is our experience that if detected early with the application of early treatment protocols, this time can be shortened.

For a free biomechanical foot scan, please contact our Sydney chiropractic clinic for an appointment. It can be the first step to correction!

It’s a question we get a lot: ‘Are chiropractors doctors?’ If you’ve been treated by a chiro before, you may well have called them doctor – and they may well have called themselves doctor, too. So what’s the deal? Are chiropractors called doctors or not? We take a deep dive to find the answer:

Do you call a chiropractor a doctor?

Almost exactly ten years ago, the Chiropractic Board of Australia tweaked the system so that practitioners in NSW do indeed go by the title ‘Dr’. But at the very same time, a debate was raging in the professional medical community over whether chiropractors – and other ‘doctors’ like podiatrists – can legitimately use the ‘Dr’ title after all.

So is a chiropractor a Dr … really?

First, it’s important to recognise that ‘doctor’ is a broad term that is not just reserved for your GP. Indeed, chiropractors in Australia rightfully get their right to the ‘Dr’ title via their professional body – just like other health care professionals including medical doctors who also use that title.

The important thing for all health professionals is that they do not mislead their patients or the public. They do this by not engaging in any protectionist debate about who the ‘real’ doctors are, but simply by being fully transparent about what their specific role and qualifications are.

That’s why you may see a title advertised as something like “Dr Jane Doe (Chiropractor)”.

The ‘Dr’ title also comes with some crucial responsibilities, as chiropractors – like medical doctors and surgeons – are subject to certain rigorous and standard testing procedures, licensing, and ongoing monitoring by peer-reviewed boards.

For chiropractors, their professional registration body is the Australian Health Practitioner Regulation Agency (AHPRA) – the very same body that handles registration for other well-known health professionals like GPs, dentists and more.

What qualifications does a chiropractor have?

Chiropractors work hard for their title over the course of at least five years of education at university (Bachelor’s degree plus Master’s degree). But their deep knowledge of your bones, muscles, joints, and the health conditions related to musculoskeletal problems, is much more than just theoretical. By the time of their graduation, your ‘Dr Chiro’ will already have treated hundreds and hundreds of patients – under the guidance of already-registered chiropractors – to accumulate the hands-on skills required.

In that way, the road to becoming a chiropractor is very similar to becoming any other doctor, giving them arguably as deep a knowledge of most aspects of human medicine including:

• Anatomy
• Physiology
• Cell biology
• Pathophysiology
• Neuroanatomy
• Chemistry/biochemistry
• Immunology
• Physical examination/diagnostic skills
• Physical therapies/rehabilitation.

And where a generic medical doctor is trained in diagnosing and treating various bodily disorders and diseases, they’re less qualified, skilled and experienced in the sorts of specialised ‘hands on’ and manual therapies mastered by a chiropractic doctor. The chiro therefore will typically have a much deeper understanding of the musculoskeletal system, including how to treat lower back pain, headaches or neck pain, sporting injuries and much more. They are distinct from medical doctors in terms of prescribing medication or carrying out surgical procedures.

LRCC’s ‘doctors’ can’t wait to see you!

So while a chiropractor is not a GP, the same is true in reverse – but they are both ‘Dr’. And the Sydney chiropractors at Longueville Road Chiropractic Centre (LRCC) are widely regarded as some of the most reliable and effective in safely treating many spine-related conditions for a drug and surgery-free way to improve your life.

Need an appointment? You can fill out the forms online, so please feel free – our ‘doctors’ can’t wait to see you!