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Achy Neck and Shoulder Pain?

So are you ever in front of a computer?

Like most of us, you are probably sitting in front of a computer at least part of the day.  If not a computer, maybe a tablet or a phone (these are even worse since you probably aren’t in an ergonomically designed set  up for this).  If so, you probably have had some achy neck and shoulder pain in your time…

You know that achy bit of flesh between your neck and shoulders that you get people to rub?  That’s what most people mean when they come in to my clinic complaining of this so that is what a am going to talk about here.

Massage my neck please!

So that bit of muscle is made up of several muscles but the biggest one is called the Trapezius.  Usually, in my opinion, this isn’t the actual pain generator for this type of achy neck and shoulder pain.  I think in most people it’s another muscle called the levator scapula (but really who cares – it hurts so fix it …. right?)

If you have had this, I’m betting the first thing you did was rub it yourself, or get someone else to rub it for you. Right?

This makes sense because massage can help work out tired sore muscles and trigger points (aka knots).  These may have developed because of a period of overuse like sitting at the computer for a project for hours.

Been there right?

But it comes back…. so why?

 

Here is my perspective:

From my perspective as a chiropractor over use certainly plays a huge role, as does posture.  Staring at a computer or device for hours puts strain on our muscles AND joints.

At some point the muscles become overtired and can no longer protect the underlying joints.  The strain and stresses transfered to the joints begin an inflammatory cascade in the joint to add to that which is already going on in the muscle.

Inflammation bad.

It chemically irritates the joints and muscles further and then you get a decrease in range of motion of the joint and muscle as it is trying to protect itself further.  There is also inflammation in there.

Inflammation in the joint means there is more fluid in there.  This gets in the way of range of motion.  Think about surrounding your body in a thick snow suit and trying to bend your joints… same idea but inside the joint itself.

Ok so what can we do about it?

Again, my perspective as a chiropractor focuses on restoring normal range of motion to the joints.  When we do that the inflammatory response decreases and the pain dissipates…

We do that in my clinic in three ways

  1. Relax the muscle using muscle techniques
  2. Treat the fascia for adhesions (we will talk about that in a different blog)
  3. adjust the joint using various techniques

People respond to this type of treatment amazingly well – In fact in a poll in the USA recently conducted by Gallup 95% of past year users of chiropractic care said it is effective… that’s a pretty big number.  (97% of past year chiropractic patients said they were likely to see a chiropractor if they have neck or back pain – so I’m not sure what happened to the other two percent…)

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Neck Pain due to ‘Wry neck’

Neck pain is a pretty commonplace daily complaint in my office.  We see all kinds of neck pain from whiplash to herniated cervical discs. But today’s topic is for that special kind that makes it hard to turn your head to one side and look over your shoulder.  Some people call it wry neck or torticollis.  Others call it ‘wtf?!?! why can’t I turn my neck?

Causes of neck pain

  • accidents (car, sports injuries, falls)
  • arthritic changes
  • muscle spasm
  • subluxation
  • disc problems
  • nerve problems
  • and a bunch more fun things…

Treatment for many forms of neck pain

  • deep tissue muscle treatment
  • scar tissue treatment
  • chiropractic adjustments
  • specific exercises
  • postural retraining
  • cervical traction
  • kinesiotaping
  • inflammatory control

Today’s special kind of neck pain: Wry neck

Ok so what is wry neck/torticollis?

Ever wake up in the morning with pain in the neck and/or near the shoulder blade on one side?  Not able to turn your head to one side? Ya, that’s the one I’m talking about there.  It is often a problem actually in the upper back and rib cage which irritates one of the muscles that goes up from the shoulder blade to the neck and base of the skull.  Although the pain feels as though it originates in the neck, it really usually starts in the upper back. So, most of the time people get treatment for their neck alone and nothing helps…

We always treat both the upper back and the neck to resolve this problem and keep it gone.  Then we like to do postural re training so we can have a chance of keeping it gone for good. This type of thing is sometimes from sleeping awkwardly and it is important to change your pillow if it has happened frequently.  Especially if you notice that it seems to happen after sleeping.

An exercise that can help

Here are some stretches that can help- that said you really should seek treatment if you have pain.  Pain is the body’s warning signal that something isn’t quite right… so do something about it!

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Foot pain, Fallen Arches and Tight Muscles

So I put it out there on facebook and I did get a request for this article…  Its a pretty broad topic but suffice it to say that I do treat these things. Often.

Feet are amazing things really.  We walk on them all day and pretty much forget about them until they hurt.  There are a huge number of diagnoses related to feet some of the most common being plantar fasciitis, fallen metatarsal head (fallen arches), stress fractures, tarsal tunnel syndrome, turf toe, sesmoiditis and the list goes on and on and on…

From a simple sprain to chronic pain, there are a host of different solutions for different problems.

One of the things you hear associated with foot pain is often the prescription of custom made orthotics.  These little insoles can be amazing as therapy for the right foot condition. The drawback is that they are also expensive.  Although lots of people have plans to cover some or all of the cost, some people aren’t as lucky.  While they are a useful tool for things like fallen arches (fallen metatarsal heads) they aren’t the only solution.

When a patient comes to me with foot pain, fallen arches and tight calves I always prescribe strengthening exercises for the small muscles of the feet.  – these are easy to do exercises that will help support the natural arch and help a person retrain themselves to avoid the problem in future.  These include fun things like picking up marbles with your toes, and scrunching towels with the toes as well as learning to position the foot in the proper “short foot” position. (this one is much harder than the other two and really needs to be shown in person in a hands on fashion).

Also effective are muscle techniques such as ART for the muscles of the foot and scar tissue treatment if that is deemed to be a problem in the specific patient and adjustments of the small bones of the feet. If these bones are ‘stuck’ and not moving through their normal range of motion it causes inflammatory changes surrounding the joints and irritation and inflammation in those regions – this decreases the range of motion even further and increase the pain – all super easy to solve with a small corrective adjustment in the area.

The last thing I did want to mention was that if you have a fallen arch it tends to put a bunch of strain on the calf or back of the lower leg – the mechanics of the arch falling actually pulls on the gastrocs/soleus complex- those two giant muscles at the back of your leg attached to the Achilles tendon. This makes the muscle appear tight or reflexively be tight – stretching it will really do very little as the problem is in the foot to begin with  – correcting the arch with exercise, hands on treatment and an arch support (custom or otherwise) is the first course of action – this will likely improve the tightness in the back of the lower leg – if not then we can show some stretches to remedy this at that point but in general it corrects itself if we have done the rest of the therapy.

So, if you are suffering with foot pain please don’t wait any longer! Call us to find out how we can help you.

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I didn’t know I had ribs there!?!

So did you ever wake up in the morning and have trouble turning your neck one way and/or have pain right under your shoulder blade?

So that is what I like to call ‘rib pain’

Yes you have ribs there.

The rib cage is literally a cage that surrounds your heart and lungs.  The go from your clavicle or collar bone all the way to the top of your abdomen where you can feel them at the front of you.  They are in the front AND the back of you as pictured below.

Ok, so now that we have had a small anatomy lesson – why on earth does my rib hurt?

It doesn’t exactly.  Here is what happens: The ribs are supposed to swing up and down like a bucket handle gently with every breath. Up with breathing in and down with breathing out. For a number of reasons (lifting, sleeping funny, sitting, reaching driving, just merely existing…) one of your ribs can stop doing this and create irritation in the surrounding muscles, nerves, joints etc.

This tends to cause pain. It can be excruciating in the region of your shoulder blade and may make you want to lean against a door frame to put pressure on the area.  I have seen people with pain all the way down one arm or numbness and tingling in the arm, shoulder or flank, neck pain, headaches, jaw pain… all sorts of issues.

So what can you do about it? Well unfortunately not too much… it may go away on its own (but don’t count on it – I have seen people with this pain that has persisted 6 or more years before they came to see me). You can try lying on a stress ball or getting someone to massage it.  Generally though it will likely come back or only give you temporary relief until you get a chiropractic adjustment.

So there you have it. It is fixable.  I tend to do lots of muscle work surrounding the area and then do some adjustments, apply essential oils and sometimes kinesiotape.  We also give strengthening exercises and talk about desk ergonomics if needed to help make sure the problem doesn’t come back.

If you have this, or someone you know does, please come in and have it checked out or give us a call and we can chat about it.  It is something I have seen a lot in practice and had great success with – I tend to get this myself so I can really empathize with the irritation of this condition.

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Have a more comfortable and healthy Pregnancy with Chiropractic

I am a chiropractor and a mom.  I have been through a pregnancy and a really rough delivery.  I know the pain that can happen during pregnancy – I had some pretty severe back pain during my pregnancy and at times had difficulty getting out of bed.  With some self care, a specific stabilizing belt that I wore for a couple of months, and some care from chiropractic friends, I managed to make it through it all while continuing to practice right up until I had the baby.

It can be rough. But it doesn’t have to be – there is help out there.  I love helping pre- and post-natal women and have been doing it since I started practicing almost 17 years ago.  I have to say I developed a much MUCH better appreciation for what pregnant women go through regarding pain after my own.  I really feel we are best at providing treatment when we can really empathize with the problem.

Over the years I have seen it all from sciatica to round ligament pain to swollen and sore legs and feet, carpal tunnel syndrome (from swelling due to pregnancy), headaches and neck pain and way more.  More than once I have been called in for an emergency house call for someone who couldn’t get out of bed because of back pain during pregnancy and after the birth of the baby.  I am always honoured to be able to help.

While writing this blog I found some information directly from the Canadian Chiropractic Association – so I though why try to re-write something so well written? The following was taken directly from the Canadian Chiropractic Association Website –

“At least 50% of pregnant women will experience back pain, with many suffering from severe discomfort that impacts their activities of daily living. Pregnancy-related back pain can be multi-factorial and rarely only has one cause. Back pain, wrist pain and leg cramps are the most common complaints reported.

The average healthy weight gain is approximately 30 lbs, most of which is around the abdomen adding a significant frontal load. The added weight puts stress on the back, hips, knees and feet/ankles. Additional weight can lead to altered posture and biomechanics as we change the way we sleep, stand, and move during pregnancy. As the baby grows and the uterus expands, the abdominal muscles also stretch and lose their ability to support as they did. The change in posture, shifting forward, may cause pain and discomfort specifically in the lower back.

During the third trimester, levels of the hormone “relaxin” increase and contribute to the loosening of joints in order for the pelvis to accommodate for enlarged uterus, the baby and later birth. However, the loosening of joints can decrease joint stability and further alter posture. Other structures including musculature may be taxed, resulting in a predisposition to pain and injury. This may result in back pain.

Women report pain and discomfort including:

  • Neck pain
  • Low back pain
  • Mid-back pain
  • Pelvic pain and pressure
  • Aching legs and buttocks
  • Peripheral swelling
  • Sciatica or shooting pain down the leg/foot
  • Fatigue and low energy
  • Night-time muscle spasms
  • Carpal tunnel syndrome
  • De Quervain tenosynovitis
  • Sleep disturbances

Studies have shown that manual therapy, including chiropractic, can help decrease pain in pregnancy and labour. Chiropractors can provide safe, effective and drug-free conservative care to relieve pain and improve function during pregnancy and after birth.

 

Reduce back and pelvic pain: Conservative care including spinal manipulation and mobilization of joints and soft tissue therapy can help reduce pain and improve function.

Relieve fatigued, aching muscles: Chiropractic treatment plans can include soft tissue therapy and various modalities including TENS, IFC, and acupuncture among others. Chiropractors can also recommend exercises to help rehabilitate postural changes.

Help prepare for childbirth: A chiropractor can recommend safe, effective exercises and stretches to help prepare your body for the baby’s delivery.

Ensure a faster recovery: As part of a comprehensive plan of management, chiropractic treatment can help manage quicker recovery and address post-natal biomechanical complaints and rehabilitation.”

 

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Shoulder Pain – What the Rotator Cuff?

I recently had someone ask me if I treat shoulders.  The treatment that chiropractors are best known for is back pain and neck pain.  This is great but for me really falls short of describing what I do every day.  One of the things I love most about my job is the variety of problems I see daily and my ability to problem solve for them and help patients get the care and treatment they need to heal.

I had a patient recently who came to me after having care for a shoulder injury for three months somewhere else.  He told me that he was no better at all and still had trouble sleeping despite the care he received.  We did an examination and I diagnosed him with a rotator cuff problem – specifically a possible small tear in the supraspinatus muscle (one of four muscles the rotator cuff).  He had been given exercise, ultrasound and some massage already but hadn’t seen improvement.

What I do differently is examine the whole spine as well as the shoulder and add treatment that also involves much more hands on therapy and support for the spine – the shoulder doesn’t float around in space it is attached to the skeleton by muscles – muscles that get tight, angry and irritate all of the joints surrounding them.  Irritated joints tend to cause inflammation.  More inflammation causes more tightness in the muscles – a vicious cycle that we need to break.

Pain from rotator cuff problems can refer down the arm, into the hand, into the upper back and neck and can even cause headaches.  This can cause decreased range of motion of the shoulder and weakness in the arm.  I love treating shoulders because the results can be super dramatic.

Within 2 weeks of seeing the patient I was talking about he told me he felt 80% better and his range of motion was amazing and almost 100% better.  He told me he could sleep again at night and started bringing me lunch because he loved to cook and was able to do that again.

Please don’t live with shoulder pain – it usually gets worse and sometimes turns into a frozen shoulder which is often much harder to treat and takes much longer to heal.  I would love to help you.

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Why I am a chiropractor

So I thought this topic would be appropriate at the start-ish of my new blog… Let’s take a journey together…. way way back in time – to where my son Leo thinks Dinosaurs roamed the Earth…. Yes, that’s right, all the way back to 1993.

I was in first year university at the University of Waterloo.  The good daughter of a pharmacist who had worked since she was 12 or 13 in a Shoppers Drug Mart  knew she wanted to be in healthcare somewhere but wasn’t sure where.

Fast forward to mid terms, or maybe it was first term finals – I really don’t know it was so so long ago (Dinosaurs you know).  Anyways, I digress, I had been studying like crazy, as usual, and had tremendous neck pain and headaches.  So much so that I would take about 100 Advil a month.

I look back on that now and think it is crazy but the fact is that there are so many people out there taking this much over the counter or even prescription medication for pain due to headaches or mechanical neck pain.

One of my friends suggested I see a chiropractor – I had never been and had no idea what to expect.  I did end up going with a friend of mine and after about 3 visits I was amazed that I no longer had headaches.  I mean at all. I knew this is what I wanted to do with my life.

Now, I do get the odd headache and I continue to see friends who are chiropractors but they are few and far between and rarely need any medication.

It was so simple and easy and, really it still is.  If this sounds like you – 100 Advil a month is not a great idea, any MD or other health practitioner will tell you so for sure. I can help you and would be honoured.  It’s not magic, its physical medicine using soft tissue techniques like massage and deep tissue, stretching and exercises as well as adjustments if they are warranted – You may be surprised that often headaches respond best to upper back adjustment so if you fall into the category of people who are nervous about neck adjustments I promise I can still help you.

By the way, in my office my rule is that we only provide treatment that is safe, effective and that you are 100% comfortable with.  It’s your body so you are in charge.  If you are not comfortable with something the dialogue is always open and I will find a way to help you that you are comfortable with that is still effective.

I would be honoured to help you.