How do I know if I have scoliosis?

July 14, 2010

What is scoliosis?

Scoliosis refers to a medical condition in which the spine curves sideways. On an X-ray film, the normal spine looks straight, but the scoliosis spine will look like a “C” or “S”.

Source: X-ray Famin
click for larger view

Source: Bistol Chiropractic
click for larger view

I suspect that I have scoliosis, how do I tell?

Besides looking at X-rays, one can look at his or her posture in order to look for possible signs of scoliosis.

Signs that may indicate scoliosis are:

Head not centered to the body Uneven shoulders (either one is in front of the other or one’s higher than the other)
Uneven shoulder blades: one is more prominent or higher
Uneven waist angle: the gap between arm to trunk is wider on one side
One hip is more prominent than the other or the hips are not leveled
The spine line is not straight

One can use the picture below for a quick self test of scoliosis:

Source: Whateverlife
click for larger view

You can also perform a Forward Bend test (also called “Adam’s test”) to detect for possible scoliosis.

Standing with the feet together, then bend forward as far as you can with your palms together, fingers pointing at between your toes.
Look at the back, one side of the back (either upper or lower back region) will be higher than the other side

Source: Medlineplus
click for larger view

Written by lf · Filed Under Featured, Lumbar, Spinal Conditions, Spinal Conditions, Thoracic | View Comments

Slipped disc – Do’s and don’ts

March 8, 2010

A slipped disc can be very painful and debilitating. However, in most cases, it should get better on its own, within six-eight weeks and there are certain things that you can do and avoid doing to aid and speed up your recovery.

What happens in a slipped disc?

Although people often mention about having a slipped disc, nothing in your spine has actually slipped out of place. Having a slipped disc means that one of the discs which sit between each of the bones in your spine has been damaged. When the disc is damaged, the soft gel-like inner pad of the disc squeezes out through a weak point in the torn outer layer, causing a bulge that often presses on nearby spinal nerves. This result in severe pain with symptoms that radiates down the leg/arm commonly referred to as sciatica. Slipped disc, also known as disc herniation, can occur in any disc in the spine but the two most common forms are lumbar disc and cervical disc herniation.

What can I do?

During the first 48 hours, a torn outer layer of the disc would result in the release of inflammatory chemical mediators which may directly cause severe pain, even in the absence of spinal nerve compression. This is the basis for the use of anti-inflammatory medication for pain associated with disc herniation. Thus, early treatment may include taking painkillers, anti-inflammatory medication and rest to give time for the body to reabsorb the herniated part of the disc. Before taking any medication, always see your doctor for a prescription.

Cold therapy should be applied immediately and after any activity that aggravates your symptoms as it helps to reduce pain and swelling. Use an ice pack or bag of frozen vegetables wrapped in a towel for no more than 10 minutes, every 2-3hrs. After 72hours or more Heat therapy, such as a wheat bag or warm soak can be used to promote muscle relaxation and pain relieve and may be used before performing stretching and strengthening exercises.

As the pain lessens, you will most likely to return to work and begin exercises to strengthen your back muscles and joints. Exercise is introduced to improve strength, flexibility and proper back mechanics as part of recovery. A physiotherapist will be able to give you an individually tailored exercise plan to help to strengthen any muscles that have become weak and also using techniques such as spinal manipulation to help improve the mobility of the spine. Physiotherapy would also help to correct one’s posture and use body mechanics to minimize stress and strain on any portion of your spine. This includes incorporating these exercises and posture principles into all your daily (e.g. sitting and lifting) and recreational activities.

What shall I avoid doing?

Don’t rest excessively and avoid activities. Studies have shown that it is important for one to remain active and keep up with your normal activities as much as possible.

However, it is paramount to discontinue with any activities that aggravate your symptoms such as bending over, heavy lifting and any quick twisting or jerking motions. Avoid standing or sitting (e.g. driving) for extended period of time as it would increase strain to your spine and aggravate disc pain. At home, keep away from overstuffed and low furniture, because it is difficult to stand back up after sitting in them. Don’t lie on stomach and prolonged bed rest especially during early stage post injury.

In the long run

Back pain from a slipped disc may return, whether or not you have had treatment and it is important to learn how to avoid damaging your back again.

The outcome for most people is that they will feel better within six-eight weeks; although for others it may take a while longer. With proper care through correct posture, core exercises and back ergonomics, it is possible for one to remain pain-free.

Written by Admin · Filed Under Lumbar, Spinal Conditions, Spinal Conditions | View Comments

Lower Back Lumbar Segmental Instability

March 4, 2010

Someone with a lower spine that frequently moves through a larger-than-normal range of movement is more susceptible to low back pain. This tendency of moving beyond its normal range is known as lumbar segmental instability.

click for larger view

The normal range of the movement is defined as the neutral zone. A person with lumbar instability tends to move beyond the normal range of movement into the extreme end ranges.

What keeps the spine stable?

In order to understand what causes lumbar segmental instability, we first need to understand what keeps it stable in the first place. The human body holds the spine stable or steady through the help of three basic structures – the passive, active and neural structures.

Passive structures in the lumbar spine are the vertebrae, the discs, then joints and ligaments. These are structures that do not move.
Active structures are the global and local muscles. These contract or relax depending on the direction of the force required.
And finally the neural structures; nerves that control and direct the muscles. This control is also known as motor control.

A stable lumbar spine segment coordinates global and local muscles using the motor control system to supply compressive forces along the spinal passive structures for stability. This coordination helps maintain the spine's normal curvature at a segmental level as we move about.

Active Structures

click for larger view

The global muscles include:

Rectus abdominis,
External oblique
The thoracic part of lumbar illiocostalis (an erectae spinae muscle). ·

These three muscle groups are large torque producing muscles that provide general trunk stability and allow movement to occur.

The local muscles attach directly to the lumbar vertebrae. They are:

Lumbar multifidus,
Psoas major,
Quadratus lumborum,
Lumbar parts of lumbar illiocostalis and longissimus (more erectae spinae muscles),
Transverse abdominus,
The diaphragm and
Posterior fibres of internal oblique.
Interspinalis/ Intertransversii

click for larger view

These muscles control the segmental stability that is lacking in this condition.

The two lowest spinal segments, L4 and L5 vertebrae, are the most susceptible to segmental instability. This could be due to pathological/ degenerative changes to the passive structures that sometimes show up on x-rays. Instability can also occur if there is a loss of motor control and muscle strength/stamina within the neutral zone.

What does it feel like?

A person with lumbar segmental instability typically has a patient-history something along these lines.

Back pain may have started after a direct injury to the area, or it may have just developed gradually.
The pain tends to be recurrent and has more debilitating effects as time goes on.
That person will try to do as little as possible in an episode of pain. According to a survey (O’Sullivan 1997), people most commonly describe the pain sensation as · catching, · locking, · giving way or · feeling of instability.

Classically, the most painful postures are sitting or standing for long periods of time, or being in bent over postures.

The most painful movements are

bending forwards,
moving unexpectedly quickly,
standing up straight after being bent over, lifting or sneezing.

So basically….

The lumbar spine moves in an uncontrolled manner, causing pain. Because the big muscles and little muscles don’t work together properly and the body is unable to control each segment as the body moves.

How do I get rid of it!?

A physiotherapist will need to perform an assessment to find out what type of segmental instability is present (and the type of control that is lacking due to which structure – passive, active or neural). Based on the findings, an intervention will be planned.

In cases where the passive structures have degenerated, it is often possible to train the active and neural structures to compensate for the lower level of stability provided by the passive structures.

With this sort of condition, the exercises that are required are more ‘brain’ exercises than ‘muscle’ exercises. A new way of moving has to be re-learnt, and it requires a lot of concentration.

Written by Jessica Ellison · Filed Under Lumbar, Treatment Options | View Comments

Introduction to SpineCor Scoliosis Brace

July 31, 2009

This video introduces the SpineCor brace, a flexible dynamic brace for idiopathic scoliosis.

SpineCor^®’s unique dynamic action treatment approach offers improvement over traditional static braces. Research indicates that a significant dynamic action is required on the spine (vertebral growth plates) to alter the abnormal growth progressing the deformity in scoliosis patients.¹

Written by MCR · Filed Under Lumbar, Spinal Conditions, Thoracic | View Comments

Traction Therapy – No Help in Long Term

July 13, 2009

Traction Therapy

Many people may have heard stories about their friends having treatment for their spinal pains in hospitals or physiotherapy clinics where they were strapped into a contraption and having their back or neck stretched. This device is called a traction machine. To some the description may sound intimidating or even medieval, but in fact, traction is a very gentle form of treatment and is extremely effective when applied appropriately in specific conditions.

Written by Sylvia Ho · Filed Under Back, Cervical, Lumbar, Spinal Conditions, Spinal Conditions, Treatment Options | View Comments

Neuro-Muscular Control

February 15, 2009

Neuro-muscular control plays a big role in the management and prevention of chronic back and neck pains. It complements the rehabilitation therapy components that focuses on the joints, muscles and bones. With improved neuro-muscular control, the body is able to get the whole musculo-skeletal system working efficiently together.

Written by Sylvia Ho · Filed Under Lumbar, Treatment Options | View Comments

What is Sciatica?

December 12, 2008

WHAT IS SCIATICA?

click for larger view

The sciatic nerve is the largest and longest nerve in the body with a diameter of almost 2cm. It starts from the sacral plexus, a network of nerves in the pelvis region, branching out down into each of the legs.

The sciatic nerve carries out two basic functions, namely motor (movement) functions and sensory (feeling) functions. When the nerve is compressed, the symptoms are called sciatica. Aside from sharp shooting pain, symptoms such as loss of reflexes, weakness and numbness are often present when both its motor and sensory functions are imparied.

WHAT CAUSES SCIATICA?

One common cause of sciatica is a herniated disc or "slipped disc". The herniated disc protrudes and places pressure on the nerve root which connects to the sciatic nerve.

As the longest nerve in the body, there are ample opportunities for the nerve to be compressed. They include:

Piriformis Syndrome is pain caused by the piriformis muscle that may be in inflamed, or irritated. This muscle is in your buttock and lies right on top of the sciatic nerve as it exits the spine and goes down your leg. When inflamed or irritated, this muscle swells and applies pressure on the nerve giving you the sciatica like symptoms.
Spinal Stenosis, which is the narrowing of the spinal canal can cause sciatica-like symptoms. The narrowing can be caused by disc problems as well as arthritis of the spine.

Sciatica-like symptoms may also be caused by other than compression on the sciatic nerve such as.

Sacroiliitis is an inflammation of your sacroiliac joint, where your hip meets the spine. Inflammation caused by trauma or arthritis can give you sciatica-like symptoms.
Lumbar Facet Joint Syndrome is pain that comes from the joints of your back causing not only back discomfort, but also it can give you sciatica-like symptoms. The facet joint, like any other joint of your body, such as the knee or elbow, can get inflamed and cause pain.
Iliolumbar Syndrome is simply inflammation or a tear of the Iliolumbar ligament. This ligament extends from the spine to the iliac crest, which is the back of your pelvis.

Your doctor or physiotherapists can perform one or more movement tests to determine the exact cause of your symptoms.

WHAT ARE THE SYMPTOMS?

One or more of the following sensations may occur as a result of sciatica:

Pain in the rear or leg that is worse when sitting.
Burning or tingling down the leg
Weakness, numbness or difficulty moving the leg or foot
A constant pain on one side of the rear
A shooting pain that makes it difficult to stand up

If severe pain symptoms occur along with bowel or bladder control problems, consider this as an emergency and is to be evaluated as soon as possible by a neurologist or orthopaedic specialist.

TREATMENT

As nerve pain is caused by a combination of pressure and inflammation on the nerve root, and treatment is centered on relieving both of these factors:

Manual treatments for sciatica including physiotherapy treatments such as mobilisation and manipulation to help relieve the pressure and inflammation with electrophysical agents.
Medical treatments for sciatica (such as NSAID’s, oral steroids, or epidural steroid injections) to help relieve the inflammation.
Surgery for sciatica (such as microdiscectomy or lumbar laminectomy) to help relieve both the pressure and inflammation may be warranted if the sciatic nerve pain is severe and has not been relieved with appropriate manual or medical treatments.

When sciatica has resolved, the patient should maintain optimum conditions for their spine. The fact that the spine has had a prolapse, and is not normal, does not preclude a relatively normal lifestyle. Specific exercises such as core stability exercises to maintain flexibility and strengthen the abdominal and spinal muscles are important.

Reprinted from www.CoreConcepts.com.sg

Written by MCR · Filed Under Lumbar, Spinal Conditions | View Comments

Medical Animation – Lumbar Radiculopathy (Sciatica)

August 3, 2008

<br />

Written by MCR · Filed Under Lumbar, Video | View Comments

Confused Over Core

July 12, 2008

If you suffer from back pain, you would have likely been told that exercises are good for you and specifically those that strengthen your core. Unfortunately, these days it is harder to get by a week without reading somewhere in the newspapers, health or fitness magazines, hearing in the gym about core strength, core conditioning and core stability or about some new fitness equipment.

It can all be rather confusing. So, if you are suffering from back pain, what sort of core exercises should you be doing?

What is core?

Before we start discussing which core exercises are relevant for back pain sufferers, what exactly do we mean by the ‘core’ muscles?

The core area relevant for low back pain is the trunk region below your ribs to your pelvis. On this point, both physiotherapists and fitness instructors generally agree.

Written by MCR · Filed Under Back Exercises, Lumbar, Spinal Conditions | View Comments

Lumbar Spinal Stenosis

June 21, 2008

Lumbar spine stenosis is a condition where the space in the lower spinal canal narrows. The spinal canal houses the spinal cord along the back. Narrowing of this space causes pain, numbness to weakness in the legs in more serious cases. In extreme cases, loss of bladder and bowel control. This condition typically affects adults over the age of 50. Read more

Written by Cindy Tan · Filed Under Lumbar, Spinal Conditions, Spinal Conditions, Treatment Options | View Comments