Portland Chiropractor Utilizing Chiropractic, Nutrition, Graston, Massage, Hypnotherapy and More
Portland, Oregon Chiropractic and Nutrition Clinic Info:
Address:
819 SE Morrison St. Suite 215 Portland, OR, 97214 (Click to Map)
Phone:
(503) 866-9739
Fax:
(503) 716-4575
Email:
i...@optfunction.com
Hours:
M/W/F By appointment only
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Portland Chiropractor, Chiropractor Portland, Portland Chiropractic, Chiropractic Portland, Chiropractor
Health Conditions
Click on the title of the health condition you are interested in from the list below.
- Bone Out of Place
- Carpal Tunnel Syndrome
- Chemical Radiculitis
- Degenerative Disc Disease (DDD)
- Disc Herniation
- Discogenic Pain
- Dysbiosis
- Edema AKA swelling
- Elbow Pain
- Foot/Ankle Pain
- Functional Movement Problems (Functional Dyskinesia)
- Functional Instability
- Headache
- Hallux Limitus/Rigidus
- Hip Pain
- Hypochlorhydria
- Inflammation
- Instability
- Joint Dysfunction
- Knee Pain
- Leg length differences
- Ligament Injuries
- Low back pain
- Mild Traumatic Brain Injury
- Myelopathy
- Myofascial Pain
- Osteoporosis
- Overpronation/Hyperpronation
- Radiculopathy
- Sacroiliac Joint Syndrome
- Sciatica
- Shoulder Pain
- “Slipped Disc”
- Spinal Curvature Disorders (Scoliosis/Kyphosis)
- Spinal stenosis
- Spondylolisthesis
- Tendonitis/Tendonosis
- Thoracic Outlet Syndrome (TOS)
- TMJ (Temporomandibular Joint) dysfunction or TMJD
- Wrist Pain
Bone Out of Place - A "Bone Out Of Place" sounds scary and possibly may even make sense to some patients. Doctors/therapists sometimes say that a patient has a bone that's out of place. While this can happen, it's very rare. Unless you had special imaging tests like a CT, MRI or in some cases a plain X-ray and told this by an orthopedic surgeon, qualified chiropractor, medical doctor or neurosurgeon, your bones are not out of place. Some Doctors/therapists use this terminology to describe joints in the spine that don't move in certain directions as much or as well as they should. Your bones all work in concert with each other as well as your nervous and muscular systems and other tissues like ligaments, tendons and fascia. You shouldn't be any more concerned about this than you would be about a stiff ankle or knee but your joints have a better chance of staying healthy if they move correctly. In fact, this is how they receive their nutrients and get rid of waste products.
Carpal Tunnel Syndrome - In this syndrome, one of the major nerves of the hand (Median Nerve) gets pinched at the wrist as it goes through a tight spot created by major ligaments of the wrist. Some studies suggest that approximately 15% of the general population (you and I) have symptoms that may resemble Carpal Tunnel syndrome. Symptoms may include weakness in the hand (usually dropping things), numbness or tingling in the thumb, and sometimes atrophy (muscle loss) in the “meaty” part of the thumb. Out of those 15%, one study showed that 5% actually had Carpal Tunnel syndrome but 23% had median nerve problems!
At Optimum Function, we will examine and diagnose your symptoms based on the most currently accepted orthopedic tests and procedures. If there is significant muscle loss or motor dysfunction/grip strength loss we will send you out for an EMG (electromyography: to investigate the health of your muscles) and/or a nerve conduction velocity study (to test the integrity of the median nerve). Treatment usually involves Graston Technique, Pin and Stretch techniques of the muscles, ligaments and nerves, gentle nerve mobilization, chiropractic manipulation of the joints in the wrist, elbow, and/or shoulder, cold therapy, active stretching and eccentric contraction/stretching of your wrist and hand. We will then asses the entire kinetic chain of the affected arm and prescribe appropriate, evidence-based exercises to strengthen your wrist, elbow and shoulder muscles. This allows your entire arm from the neck to the hand to work as a team. Surgery may help, but is usually only considered in the most severe cases.
References:
Davis PT, Hulbert JR, Kassak KM, Meyer JJ. Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trail. J Manipulative Physiol Ther. 1998 Jun;21(5):317-26.
Isam Atroshi, MD; Christina Gummesson, MS et. al. , Prevalence of Carpal Tunnel Syndrome in a General Population, JAMA. 1999;282:153-158
Jeanmarie Burke PhDa, , , Dale J. Buchberger DC, et. al. A Pilot Study Comparing Two Manual Therapy Interventions for Carpal Tunnel Syndrome. J Manipulative Physiol Ther. 2007 Jan; 30(1): 50-61
Chemical Radiculitis - The discs between the vertebrae are like gel filled sacs. When the outer covering of the sac gets a hole in it, the contents can leak out rather than pushing out (as in a herniated disc). When the gel leaks out over time, it can lead to an inflammatory condition known as a chemical radiculitis. If the inflammation isn't reduced by techniques like: movement that decreases symptoms, ice therapy and/or distraction/decompression, scarring around the nerve roots can develop.
Degenerative Disc Disease (DDD) - The vertebrae (bones) of the spinal column are separated from each other by cartilaginous cushions known as intervertebral discs. The discs: allow for the various movements that occur in our spine and provide structural support to the spine and act as shock absorbers. The discs are mostly water, allowing them to be very elastic and absorb stress but they also contain proteins and fibers. Age, repetitive strain, and (possibly) genetics cause disc wear and tear. Because there is little blood supply to the disc, it doesn’t repair itself if injured as well as our muscles do. A source of confusion is probably created by the term "disease", which is actually misleading. DDD is not really a disease at all, but rather a degenerative condition that at times can produce pain from a damaged disc.
DDD can produce pain as a worn disc becomes thin, narrowing the space between the vertebrae. There is even some evidence that nerves begin to grow deeper within the layers of the disc which means we may feel more pain after chronic disc injuries. As the disc loses its ability to absorb stress and provide support, other parts of the spine become overloaded, thus leading to irritation, inflammation, fatigue, muscle spasms, and back pain.
The amount of pain from degenerative disc disease can vary from a mild nagging back pain to severely debilitating. Most patients have some underlying chronic low back pain with intermittent episodes of severe pain. Usually, sitting worsens the pain more than standing. Bending, twisting, and lifting generally worsen the pain and lying down reduces it by relieving the strain on the disc space.
Here are a few risk factors:
Age
Activity
Smoking
Obesity
Vibration (eg, driving a car)
Sedentary lifestyle (meaning you don’t have a lot of activity in your life).
Disc Herniation - Disc herniation is a common cause of leg and back pain. A disc is composed of two parts: an outer rim of fibrous (tough) tissue surrounding an inner loose material. When there is a weakening in the outer rim, the inner material can push out, creating a bulge or even leak out of the disc space and enter the spinal canal where the disc material can compress nerve roots or the spinal cord.
Compression on the nerves can cause sciatica or shooting pain down one or both legs. Back pain can accompany the leg symptoms as well. Symptoms such as weakness or numbness in the involved legs may occur and should always be taken seriously.
The pain associated with disc herniation usually improves with lying down and worsens with prolonged sitting/standing or walking. Rarely, bowel or bladder problems and progressive neurological deficits (such as weakness or muscle wasting) may develop; this type of situation requires urgent care that usually consists of immediate surgery.
Non-urgent disc herniations respond very well to conservative care (like chiropractic and massage therapy). Studies have shown that non-surgical treatments like chiropractic care and massage therapy have helped with the pain, function and a few studies have shown that the herniation improved over time.
References:
Brouillette DL, Gurske DT. Chiropractic treatment of cervical radiculopathy caused by a herniated cervical disc. J Manipulative Physiol Ther. 1994 Feb;17(2):119-23. Links
Delauche-Cavallier MC, Budet C, Lumbar disc herniation. Computed tomography scan changes after conservative treatment of nerve root compression. et. al. Spine. 1992 Aug;17(8):927-33.
Discogenic Pain - Literally translates to pain that is “born of the disc” It's been known for years that the discs in between our vertebrae can become painful. This is very much related to Degenerative Disc Disease. The difference between the two may be strictly academic but one could consider discogenic pain to be acute (meaning, happening her and now) and DDD as chronic (meaning happening over and over again) Patient's who have this problem may notice a pop or snap at the time of their injury. After that, they can have fairly severe nagging pain that gets worse with staying too long in the same position. For more information, see Degenerative Disc Disease.
Dysbiosis - is a condition of microbial imbalance. Dysbiosis is most prominent in the digestive tract or on the skin, but can also occur on any exposed surface or mucous membrane such as the vagina, lungs, nose, sinuses, ears, nails, or eyes.
Under balanced circumstances, the bacteria located on the skin or in the gastrointestinal tract is beneficial to your overall health. These beneficial and appropriately sized bacterial colonies carry out a series of helpful and necessary functions. They also protect the body from the penetration of pathogenic microbes. These beneficial colonies also compete with each other keeping one another balanced so no specific colony dominates.
When this balance is disturbed, by such things as repeated and inappropriate antibiotic exposure, hypochlorhydria, pancreatic insufficiency etc. , imbalances can start to colonize. This type of situation often instigates a vicious cycle. As more beneficial colonies are damaged, making the imbalance more pronounced, more overgrowth issues occur since the damaged colonies are less able to check the growth of the overgrowing ones. If this goes unchecked long enough, a pervasive and chronic imbalance between colonies will set in, which ultimately minimizes the beneficial nature of these colonies as a whole.
Microbial colonies also excrete many different types of waste byproducts. Using different waste removal mechanisms, under normal circumstances the body effectively manages these byproducts with little or no trouble. Unfortunately though, over-sized and inappropriately large colonies, due to their increased numbers, excrete increased amounts of these byproducts. As the amount of microbial byproducts increases, the higher waste byproducts levels can overburden the body's waste removal mechanisms.
It is the combination of these two negative outcomes that causes many of the negative health symptoms observed when dysbiosis is present. To find out if you have dysbiosis, a series of clinical questions are answered then usually a comprehensive stoll analysis is ordered. to find out more about my functional medicine program that is designed to detect such an imbalance, click here.
Click Here to fill out a questionnaire to see if you might have dysbiosis.
Edema AKA swelling– This is different than inflammation. Edema has many causes, many of which involve water excretion and/or retention. Inflammation is a process that usually is precipitated by injury or disease and is usually acute in nature. Edema can have very benign causes like a sudden change in altitude causing some people’s finger to swell for a bit to more harmful and potentially dangerous causes like congestive heart failure. At Optimum Function, we will determine the cause or get you the necessary tests to determine the cause and help to treat the swelling if there is not a serious medical condition behind it.
Elbow Pain – There are many reasons for a patient to experience elbow pain. Many people will jump to the conclusion that they have “tendonitis”. While this may be the case, it is often not. Over the past few years, experts have been doing away with the tendonitis diagnoses which have been over-utilized. This antiquated way of looking at tendon problems is giving way to the diagnosis of “tendinosis” (meaning a break down of the collagen that makes up and supports your tendons) or “tendonopathy” (literally means a problem with your tendon).
Other causes of elbow pain can be but are not limited to:
- Referred pain from trigger points in muscles elsewhere in the body
- Gout
- Inflammatory arthritis (like rheumatoid arthritis)
- Fractures
- Muscle strains
- Ligamentous sprains
- Functional instability of the shoulder
- Referred pain from a disc herniation in the neck
Click Here to read my blog about how just a single chiropractic adjustment can help decrease pain on the outside of your elbow (AKA tennis elbow)
Foot/Ankle Pain – Just like elbow pain, foot and ankle pain can have many causes, including but not limited to:
- Referred pain from trigger points in muscles elsewhere in the body
- Fractures
- Ankle sprains
- Neuromas (a non-cancerous growth of nervous tissue)
- Muscle strains
- Gout
- Degenerative and inflammatory arthritis
- Hyperpronation of the foot
- Functional instability of the hip
- Referred pain from a disc herniation in the low back
Functional Movement Problems AKA: Functional Dyskinesis - We all learn how to move and how to stabilize these movements. In fact, throughout your life there is a fine balance of mobility (or movement) and stability going on that determines things like:
- How fluid and efficient you move
- If there's any pain with movement
- How quickly and effiicient you can stabilize those areas that need it while also allowing mobility to occur
In fact, many injuries arise from an acute "tip of the scales" one way or the other. In general, problems and injuries will occur when there's too much or not enough mobility and/or stability. You may have heard the term "kinetic chain"; this illustrates how every joint, muscle, bone, tendon and ligament work together. When they work together in complete harmony, your movement is at its peak efficiency. When they are not, you have what I termed "Functional dyskinesia". Essentially, a functional movement problem.
We all learn how to move in patterns called "primitive movement patterns". These patterns can be utilized to screen for problems even in adults. There is some evidence that by doing very specific and easy exercises to improve these movement patterns, your risk for becoming injured is decreased. Furthermore, you will see a decrease in pain and discomfort during movements if these patterns are improved symmetrically. this will only be true if your pain and discomfort is cause by a problem with your joints, bones, muscles tendons and/or ligaments.
These movement patterns are:
- Squatting
- Stepping over things
- Touching your toes
- Lunging
- Rotational stability in a crawling position
- Push-up position with a stable spine/core
- Being able to bring your hand close together behind your back.
Functional Instability – The clinical definition of functional instability is still under debate. Most experts agree that the coordination of the muscles and support of passive structures (like the ligaments and intervertebral discs) are important to the stability of any joint complex (like the spine, shoulder or ankle). Over the past decade, more research has been performed to investigate the presence of functional instability. This means that your structure (skeleton) and passive tissues (like ligaments) are intact but the active component (muscles and tendons) of a certain joint complex’s stability aren’t working like they should. There are no commonly agreed upon criteria for a pure diagnosis but there are many telltale signs that we at Optimum Function are trained to identify. If you have a history of frequent, episodic back pain with minor or no trauma/provocation that comes about at random times, then you may have functional instability and should be thoroughly evaluated by a qualified chiropractor or other specialist.
Reference: “Local Complicators: Instability of the Lumbar Spine” by Ron Lefebvre DC at Western States Chiropractic College. 12/13/2005
Your big toe, AKA great toe or “Hallux”, is an incredibly important structure to proper lower extremity function. Not many people give their big toe much thought unless, it’s “too long”, “too hairy”, “ugly”, or, and more seriously, you have injured it. One of the injuries common to this area for athletes, is a condition known as hallux limitus.
Hallux limitus is described as a limitation in the range of motion of the big toe. These motions are plantar flexion or pointing your big toe toward the floor, and dorsiflexion, or pointing your big toes upwards. Hallux limitus can be extremely painful or can present itself with no pain whatsoever. Even if you have no pain, the condition is something to be concerned about, as stated, the big toe is extremely important to proper foot/ankle/knee/hip and even low back biomechanics. Hallux limitus, whether there is pain or not will create compensation in other areas of your body.
Click Here to read the full article
Headache - Post whiplash headaches or cervicogenic headaches (literally headaches from the neck) appear to have a few different causes. First, injuries to the neck can cause the head to move forward and this can irritate some nerves at the back of the head. These nerves, the greater occipital and the lesser occipital, can then cause headache. There are joints in the upper part of the neck (C2-C3) and in the jaw that can refer pain to the head. There are also areas in several muscles can develop trigger points which can refer pain to the head. The reason these trigger point develop is unclear but is likely due to some chronic, repetitive stress or maladapted muscles after a significant or minor injury.
Hip Pain – Like the elbow and foot/ankle, there may be many reasons for hip pain. Many people come into the office complaining of “hip” pain when they mean sacroiliac joint pain. Your hip is located at the side of your body right about where the pockets of your jeans end. Your hip is a very structurally sound joint, there are many strong muscles and structures that surround and support the hip. Even so, many things can cause hip pain. Here are some (not all) of the causes:
- Acetabular labral tear
- Fracture
- Degeneration
- Arthritis
- Blood Clots
- Ligamentous sprains
- Muscle strains
- Referred pain from trigger points in muscles elsewhere in the body
- Referred pain from a disc herniated in your low back
- Referred pain from a kidney stone
Hypochlorhydria - A poor output of hydrochloric acid by the stomach. Hypochlorhydria is fairly common; according to some experts, a low level of stomach acid occurs in up to about 50% of the general population, the highest incidence being found in older people.
Generally, most people think about about too much acid or hyperacidity as being the cause of their gastrointestinal problems. Millions of dollars are spent on antacids and acid blockers. Often, this helps temporarily but when hypochlorhydria exists, this kind of treatment can keep you from getting better.
Some people with hypochlorhydria may experience no gastrointestinal symptoms at all. Symptoms in these people do not show up for years and when they do, are often very severe.
Without acid, the body has a difficult time digesting food. The chief function of stomach acid is the initiation of protein digestion. Without it, proteins can be decomposed in the intestines by bacteria; producing foul-smelling compounds like hydrogen sulfide gas and cadaverine. The undigested proteins may even falsely alert your immune system causing you to become sensitive to certain foods (food allergies). Acid secretion is also of fundamental importance in the assimilation of many minerals, especially vitamin B12.
Another important function of hydrochloric acid is the stimulation of pancreatic enzymes and bile which is then released into the small intestine. Without enough pancreatic enzymes and bile, the digestion and absorption of carbohydrates, proteins, fats, and vitamins A and E, is severely compromised, inadvertently causing under nutrition even with an excellent diet.
Over time the stomach cells that secrete acid may be repaired through nutritional and/or supplemental intervention.
Symptoms of poor stomach acid output:
- Stomach bloating
- Burping
- Upset stomach
- Burning
- Flatulence
- Diarrhea
- Nausea after taking supplements
- Rectal itching
- Weak, peeling, cracked fingernails
- Dilated capillaries in the cheeks and nose (in non- alcoholics)
- Post adolescent Acne
- Iron deficiency
- Other mineral deficiencies
- Chronic intestinal infections
- Undigested food in stool
Disorders associated with poor stomach acid output:
- Acne Rosacea
- Addison's disease or weak adrenals
- Asthma
- Celiac Disease
- Chronic autoimmune disorders
- Diabetes
- Eczema
- Food Allergies
- Gall bladder disease
- Gastric cancer
- Gastritis
- Graves disease
- Hepatitis
- Lupus
- Osteoporosis
- Pernicious Anemia
- Psoriasis
- Thyrotoxicosis
- Urticaria
- Vitiligo
- Colitis (Ulcerative)
- Hair loss
- Multiple Sclerosis (MS)
- Rheumatoid Arthritis
Inflammation – Inflammation is different than plain swelling or edema. Often, a symptom of an inflammatory process is swelling or edema but inflammation includes other processes. The goal of inflammation is to destroy any foreign material or things that are deemed “bad” for a certain area of the body (even if those things are supposed to be there), and bring in cells and chemicals to clean, disinfect and heal the area. Unfortunately, our bodies have the tendency to go overboard with this process. This leads to fibrosis and other tissue damage if not controlled. For this reason, it is important to ice after an injury and make an appointment to see us as soon as possible following an injury.
Instability -
The ligaments hold the bones and joints together. Ligaments also support joints when they are stretched beyond what the muscles and tendons can support. However, if one of those ligaments was torn or stretched, the joint it was protecting would move around too much. This could cause pain and swelling in the joint as well as popping and cracking. The joint would become unstable.
Common symptoms are as follows:
- popping, cracking, or grinding in joints with movement
- pain and often spasm that's gets much worse with activity
- Numbness or tingling into the hand(s) or feet that gets worse with activity or with the popping, cracking, or grinding
Flexion-extension X-Rays may be necessary to help diagnose this problem. A detailed physical exam where the physician tests the spine segment by segment is also essential.
Treatment usually proceeds as follows:
- Mobilize or adjust any stiff joitns around the area of concern that may be overloading the unstable segment
- Correct postural problems that may be making the instability worse
- Strengthen any weak, deep supporting muscles that may be allowing too much movement.
- Don't mobilize or manipulate the unstable segment (it will worsen)
- If all else fails, prolotherapy or surgical stabilization are last ditch options
Joint Dysfunction - Joint dysfunction is a term used to describe a joint whose movement is either restricted or not optimal. Joints have a better chance of staying healthy if they have optimum movement (both quantity and quality of movement). Joints receive their nutrients and get rid of waste products, largely, through movement.
Knee Pain - Knee pain after an injury can take many forms. For instance, a common knee injury after a motor vehicle collision is the knee cap hitting the dash. This can cause a gouging of the cartilage on the undersurface of the knee cap.
There are also assorted ligament tears to the major ligaments of the knee including:
- PCL-Posterior Cruciate Ligament (lower part of knee hits the dash)
- ACL-Anterior Cruciate Ligament (upper part of knee hits dash or knee takes a side impact)
- MCL/LCL-Medial Collateral Ligament or Lateral Collateral Ligament (knee takes a side impact)
- Meniscus Tear-torn cartilage (knee takes a side impact or is jammed suddenly)
Referred pain from the low back can also cause of knee pain. Contact us to schedule an appointment so we may diagnose, treat and help to restore function to your knee.
Leg Length Differences - Many practitioners have associated a difference in the length of the legs with low back pain. When a patient has a short leg, it's called a leg length inequality (LLI). The idea is that shorter leg indicates an asymmetrical pelvis, spine or sacroiliac joint which may cause unequal forces to be distributed to the low back and thus leads to pain. There are some well done medical studies on this question. None have found an association between a short leg and low back pain.
References:
"Does unequal leg length cause back pain? A case-control study. " Grundy PF; Roberts CJ; Lancet 1984 Aug 4;2(8397):256-8
"Leg length inequality. A prospective study of young men during their military service. "
Hellsing AL; Ups J Med Sci 1988;93(3):245-53
When these structures are injured, they usually heal. However, sometimes they can't heal and instability occurs. When this happens, deep supporting muscles get weak, nerves get irritated (causing more muscle weakness), and joints get inflamed and painful. Ligament injuries after whiplash are usually accompanied by lots of popping and cracking. While these symptoms are common after whiplash, this is usually caused by tight muscles and bad posture.
How can you tell the difference?When the popping and cracking feels good or relives pressure, it's almost always due to tight muscles and bad posture. However, when the popping causes more pain, numbness, or other symptoms; it may be due to instability and should be evaluated immediately.
Low back pain - Low back pain can come in a variety of forms. Pain in the lumbar (waist) area of the back can be described as sharp, sudden, dull, or constant. The spine is made up of vertebrae (bones), cartilaginous cushions known as discs, and nerve roots; any of these components can be the source of pain. The pain can result from a sudden injury or from gradual wear with age and repetitive strain.
If you're suffering from low back pain you're not alone. More than 80% of North Americans will at some time in their life suffer from the disabling confines of low back pain.
According to experts, low back pain is the number one disability culprit in workers' compensation claims and accounts for more than $50 billion annually in the US through medical care and lost production. In addition, the latest research shows most lower back problems which cause low back pain do not fully resolve without extensive treatment and proper rehabilitation, contrary to previous beliefs.
The chiropractic doctor is unique in the health care field in that much of the training in chiropractic colleges is specifically aimed at identifying and successfully treating and managing low back conditions. General medical practitioners generally lack adequate training in this area and have not learned the skills necessary to most effectively identify and treat most back conditions.
Mild Traumatic Brain Injury - Many people experience problems thinking, concentrating, and remembering after physical trauma. The most common causes are pain and insomnia. Pain can effect the way our brains process information. Getting the pain under control is essential.
Good, restorative sleep is another problem after physical trauma. The lack of sleep usually leads to problems thinking, concentrating, and remembering. Talk to your doctor about different methods to increase sleep. Another problem that can effect thinking that's sometimes seen after physical trauma is depression. While we do not treat depression at Optimum Function, we will work with you to find you a professional who does.
Finally, it's possible to get a bruise on the brain due to physical trauma. This is most commonly associated with getting hit on the head or knocked out, but it can also happen without those things. Like any bruise, 99% of these heal without any problem. However, in a very small number of people, problems persist. If you feel that all of the things above have been checked and you still have difficulty with thinking, concentrating, and remembering, make sure you tell us or another doctor. He or she may wish to refer you for a neuropsychological evaluation.
Myelopathy –a term that means compression of the spinal cord. This can be caused by bone spurs, a larger herniated disc, or a small spinal canal (the hole through which the spinal cord passes). If it occurs in the neck, it can cause all four extremity numbness, tingling, and sometimes weakness. If the problem occurs in the low back, it can cause significant lower extremity numbness, tingling, and sometimes weakness. Myelopathy is almost always a surgical problem. It should be noted that a small spinal canal that has never caused symptoms can become symptomatic when the patient is exposed to spinal trauma. Bowel or bladder problems are always a surgical emergency. Symptoms of myelopathy include neck pain, problems with balance, numbness in the hands and fingertips, and difficulty with fine movements like buttoning a shirt. Patients can also display exaggerated reflexes. Conditions which can result in myelopathy are multiple sclerosis, amyotrophic lateral sclerosis, and spinal cord disorder. However, cervical spondylotic myelopathy (meaning a myelopathy that is caused by bony spurs in the neck) is the most common cause of spinal cord dysfunction in the elderly.
Myofascial Pain - is one of the most common diagnoses given to chiropractic patients. In essence, it means muscle pain. In the first 3 months after an injury or even a minor incident, most of the symptoms are generated by injury to the muscles. However, as patients get more chronic (still have pain after 3 months), the muscle pain becomes a symptom of other problems like loss of spinal curves, postural abnormalities, and ligament damage. While it's true that muscles hurt when pressed and can have trigger points, most of the time the muscle problems are being caused by a deeper, more significant injury. If you still have pain and problems after 3 months, you should seek a specific diagnosis. For instance, your upper trapezius muscles might hurt causing pain across your neck to the shoulders, they may even have trigger points that cause headaches, but why is this still the case after enough time has passed for the muscles to heal themselves? If you still have a diagnosis of myofascial pain after 3 months, you and your doctor need to re-think your diagnosis and treatment.
Osteoporosis - Osteoporosis is defined and diagnosed by a decrease in bone mineral density. Osteoporosis results in decreased mechanical strength and increased likelihood of structural failure. Osteoporosis is the most common skeletal disease associated with aging.
Overpronation/Hyperpronation - The motion "pronation" is usually a motion that happens at the wrist and elbow. Many experts have adopted this term when describing motion at the foot/ankle. People who overpronate are thought to rolled their ankle/foot in during some portion of their gait (the process to take one step, then another and so on). Not only does this effect the efficiency of their running/walking, it takes its toll on the rest of the body. This syndrome can have negative effects on the body that range from mild to severe. Overpronation may be the underlying cause for you back pain, hip pain, knee pain, or foot pain. At Optimum Function, we thoroughly examine your structure to determine if an orthotic is necessary and help the rest of your neuromusculoskeletal system adapt on a functional level to bring your gait back to optimal function.
Radiculopathy - Radiculopathy refers to any disease of the nerve root. Radiculitis indicates actual inflammation around the nerve root; the associated pain is sometimes called radicular pain. Thus radicular pain may radiate directly from mechanical abnormalities or indirectly from herniated discs, fractures, or tumors.
Sacroiliac Joint Syndrome - The sacroiliac joint (SI Joint) can be injured. The strong ligaments that hold the joint together can become stretched, much the same way the ligaments in the knee can be stretched. This can cause some extra movement in the joint (small amounts of extra "give" in unusual directions). This can lead to inflammation and swelling inside the joint and or to overload of the ligaments.
Common Symptoms:
- Pain in the back of the hip, usually on one side, but can be on both sides.
- Numbness, tingling, or burning into the front of the thigh, side of the thigh, or down the back of the leg.
- Pain in the groin.
- Problems sitting in one place for too long.
Manipulation or mobilization into the directions that are stiff has been a mainstay of treatment. Other types of treatment include strengthening the hip girdle muscles, lumbar stabilization exercises, SI belts, Graston technique, and Kinesiotape.
Sciatica - The sciatic nerve exits the spinal column between the lowest lumbar vertebral body (L5) and first level of the sacrum (S1). It supplies sensation to the posterior thigh and buttock, knee flexors, and foot muscles. When this nerve is compressed, inflamed, or irritated anywhere along its length, pain may result. The term sciatica refers to pain radiating down the course of the sciatic nerve into the posterior thigh, leg, and little toe, mostly due to nerve root irritation or compression in the spinal column.
Shoulder Pain - The shoulder is a complex and very mobile joint. In general, the more mobile a joint is, the less stable it is as well. There are many muscles that help stabilize the shoulder. The specific location of your shoulder pain can tell your doctor a lot but a thorough examination is necessary to rule out some of the more severe shoulder diagnoses before conservative care can commence.
There are many causes of shoulder pain. Here are some (not all).
- Referred pain from the neck
- Referred pain from a nerve root
- Referred pain from trigger points
- Referred pain from organs (like the liver or gall bladder)
- Torn labrum
- Tendonosis/tendonitis
- Rotator cuff muscle strain
- Ligament sprain
- Entrapment of one of the nerves that supply the shoulder
“Slipped Disc” - Intervertebral discs are actually heavily anchored to their respective vertebrae and thus do not “slip”, they do, however, herniated. See Disc Herniation.
Spinal Curvature Disorders (Scoliosis/Kyphosis) - Curvature of the spine takes two forms. Scoliosis is a lateral (toward the sides) curvature in the normally straight vertical line of the spine; it may occur in the thoracic or lumbar segment of the spine, and it may or may not include rotation or deformity of the vertebrae. Kyphosis is a curving of the spine that causes a bowing of the back - usually the upper back.
The treatment of scoliosis is determined by the extent of the deformity and the stage of bone growth (how near the growth centers are to closure). Many scoliotic curves require no treatment (less than 30 degrees) but should be followed in 6-month intervals. More serious cases may require observation, exercise, a back brace, or surgery. The treatment is most successful when it is started early.
The treatment of kyphosis depends on the cause of the disorder. For kyphosis caused by poor posture, treatment may consist of exercises, a firm mattress for sleeping, and a back brace to straighten the curve until growth is complete. Bed rest is recommended for severe pain. Gradual weaning from the brace begins after maximum correction of the curve by the back brace has occurred. Surgery may be indicated if neurological symptoms occur. Traction may be used for pain relief.
Spinal stenosis - Spinal stenosis refers to narrowing of the spinal canal which causes pressure on the spinal nerves or cord. This condition is mostly seen in patients over the age of 50. Although the cause of spinal stenosis is not clear, two types have been described.
The congenital form of spinal stenosis is seen in individuals who are born with a narrow spinal canal. In these individuals, minimal changes in the structure of the spine can cause severe spinal stenosis.
The more common acquired form of stenosis is caused by progressive changes in different spinal elements (such as the discs, joints, ligaments, etc. ) As people age, all these different elements sag or bulge and form arthritis that narrows the spinal canal.
Patients with spinal stenosis complain mainly of leg pain which worsens with walking. Back pain is also commonly seen with this problem. The leg pain is often improved with sitting or bending over. Rarely, bowel or bladder symptoms or progressive weakness can occur; these symptoms are very severe and necessitate immediate surgery.
Spondylolisthesis - Spondylolisthesis is a condition in which a vertebra is displaced forward of the one below it in the spine. This problem can cause both back pain and leg symptoms.
There are different causes of spondylolisthesis. The congenital form (being born with abnormalities which contribute to the displacement) is a rare cause. Other causes include trauma (sudden falls, accidents, etc. ), degenerative changes in the spine (like arthritis), or destruction by tumors.
Spondylolisthesis is characterized by the percentage of displacement of one vertebra over another. Displacement of over 50% is considered high grade.
The treatment of spondylolisthesis is usually non-surgical. Chiropractic adjusting, soft-tissue work to keep the rest of the spine mobile and rehabilitation to strengthen the back and abdominal muscles are the primary modes of treatment. Surgical treatment may become necessary if conservative management fails. Surgery is especially effective for patients with associated leg, bowel or bladder symptoms.
Tendonitis/Tendonosis - The primary fiber in a tendon is collagen. Over time, with poor nutrition and with minor or major trauma, collagen can start to break down. When this happens, the muscles that the tendon connects to bone and the joints that the tendon is associated with may start to malfunction. We used to think this had a lot to do with inflammation of the tendon, this caused many doctors to diagnose tendon problems as "tendonitis". We are now learning that this process may have more to do with the break down of collagen and less to do with inflammation.
Treatments for this condition include, but are not limited to:
- Adjusting
- Mobilization
- Graston Technique
- Vibration assisted cross-fiber friction
- Ice therapy
- Kinesiotape
Thoracic Outlet Syndrome (TOS) - The thoracic outlet is an area in the shoulder where the nerves and vessels travel. Since these nerves go into the hand, when irritated, they can cause numbness and tingling as well as swelling and weakness. Some of the muscles in this area go from the neck to the ribs. These muscles are commonly tight after a an injury due and may contribute to the loss of curvature in the neck. When tight, these muscles tend to close in the walls of the thoracic outlet and compress the nerves and/or vessels. When these muscles are tight, the first rib and second rib are pulled up, further closing down this space and making it even tighter for the nerves and vessels. Finally, postural dysfunction like a forward head posture or forward shoulders may also cause dysfunction in the thoracic outlet.
TMJ (Temporomandibular Joint) dysfunction or TMJD (Temporomandibular Joint Dysfunction) - The jaw joint or TMJ is a common area of injury. The most common symptoms include popping or cracking in the joint, pain in the jaw with chewing, and headaches.
Most people have simple sprains of the ligaments in the joint after an accident or other form of injury. Many people have complications to the joint because of problems with posture. For example, a forward head posture after whiplash is common because of straightening of the neck. When this happens, the muscles of the jaw that were designed for chewing, start trying to hold the head up!As you might imagine, this hurts!
Another common syndrome related to TMJ is weakness in the deep neck flexor muscles. These muscles help stabilize the neck on a segment by segment basis and are frequently injured with even minor physical trauma. When they're weak, the muscles around the base of your skull and front of your neck to overwork and pull on the TMJ.
Some patients may have injuries to the disc inside the joint. When this occurs, it usually means the problem will be harder to resolve.
Treatment can include: chiropractic soft-tissue and TMJ mobilization, Graston technique, ice therapy, a splint made by a dentist, rehabilitation focused on the jaw and upper part of the neck, acupuncture, trigger point therapy, and posture exercises. It is rare that TMJD patients require surgery.
Wrist Pain - There are many bones and therefore joints in the wrist. There are also many muscles and other connective tissue structures like ligaments in the wrist. Carpal tunnel syndrome is a commonly diagnosed problem in the wrist but that diagnosis may be to hastily determined. Other cause of wrist pain are:
- Referred pain from the nerve roots
- Referred pain from trigger points
- Referred pain from muscles
- Referred pain from other joints
- Tendonosis/tendonitis
- Joint dysfunction
- Muscle strains
- Ligament strains
- Fractures
- Bone disease
- Arthirits
Yours in Health,
Tim Irving DC, MS, LMT, CKTP, Nutritionist
Optimum Function
819 SE Morrison St.
Suite 215
Portland, OR
97214
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