Facet Syndrome and lower back pain

Ever heard of a facet joint?

Ya probably not but you have a whole bunch of them all up and down your spine – four facet joints per vertebra really.  That’s tons considering in your lower back you have 5 lumbar (or lower back) vertebrae and a sacrum (more lower back stuff).

Suffice it to say that’s a lot of joints – why? more joints mean more mobility.  Your spine needs to be bendy to that you can move.  Simple as that.

excessive posterior loading of the lumbar spine leads to facet syndrome

(more about facet joints and facet syndrome and photo credit here: https://learnmuscles.com/blog/2017/09/27/17880/  )

The problem is that when one of these facet joints gets inflamed or irritated – it’s not such a party for the owner of the lower back.  These suckers are highly innervated (lots of nerves).  Lots of nerves means they can be big pain generators when they are pissed off.  Yes, pissed off facet joint is a diagnosis – we just use different language – but you get the point.

How to piss off your facet joints 101

Best way is to load your spine by carrying something then twist.

If you are really lucky, you will make one of the facets mad – sometimes people hear a pop, sometimes not.  Sometimes it happens right away and sometimes it is slower pain that develops over hours.

The pain from this can be sharp and excruciating – often feels like something is catching in the lower back and can be felt in a band like a belt around the lower back – sometimes on one side more than the other and often wrapping around to the front too.

How to fix a pissed off facet joint

A chiropractic adjustment is by far the most effective thing in my opinion.  It may take a few before you feel a difference because by the time people get to the chiro it has often been several days and allowed the inflammation to collect and do more damage.  The sooner you get some care the better.

Other things to do include ice, massage, and kinesiotape or other methods like TENS for pain control.

There is really no great exercise to fix this one – it is a joint level problem so moving the joints (aka a chiropractic adjustment) is really the best way to go.

Piriformis Syndrome – another pain in the butt

So, your but hurts?  We previously talked about how sciatica can cause a pain in the butt… but so can piriformis syndrome.

What is Piriformis Syndrome?

The Piriformis is a muscle in the rear end. In your butt. Wheusn it gets tight you can have pain in the tush.  How many more words can we find fro butt? This is fun…

Ok, Ok, so pain in the rump.  What else?  So because the sciatic nerve runs right under (and sometimes in some people it runs right through it).  Nerves don’t like being squished.  When you squish a nerve they do things like get all tingly or numb.  The sciatic nerve, if squished by the piriformis muscle can cause pain, tingling and/or numbness down the leg into the thigh, lower leg and/or foot.

What can you do about piriformis syndrome?

Several things can help with piriformis syndrome:




and of course chiropractic care.


What causes piriformis syndrome?

The piriformis muscle can become tight for any number of reasons and cause piriformis syndrome. Many things including prolonged sitting, injury, prolonged standing and repetitive strain can cause this problem.  It is really common in runners.


Easy stretches

One thing that you can do to help a tight piriformis muscle is the piriformis stretch.  See the YouTube video of me doing this one…  Remember to hold a stretch for 20-30 seconds at a minimum to have it make an impact and lengthen the muscle.




What’s Bringing on Your Back Pain?

Back pain Back ground

This is a guest blog by a collegue Dr. Celeste McLean in Virginia Beach.  I met her in an amazing facebook group for Women Chiropractors – if you are a female chiropractor and you aren’t in this group please check out https://www.facebook.com/groups/womenchiropractors1895/

Celeste kindly offered me anything on her blog to repost.  Dad is still in hospital and it has been sometimes a bit hard to juggle everything.  Life happens – ask for help.  You will be surprised! (though I’m not anymore…).  So the following are Dr. McLean’s words.  You can find more of her amazing blog here: https://www.virginiabeach.coastalchiro.net/blog


What’s Bringing on Your Back Pain?


Many people with sudden, acute back pain think, “But gosh, I didn’t even do anything!”

Struggling to find the source of your back pain? Schedule a visit with our practice.

Man feeling base of neck.

What many folks don’t know, or understand, is that it’s not always a case of what you did five minutes ago, or what you did yesterday, or even what you did last week that’s causing the current problem; it’s more a case of “the straw that broke the camel’s back,” no pun intended!

Discovering the Cause

Sometimes it’s chronic stress that wreaks havoc on your nervous system and finally causes your back to “go out” or a “pain in your neck” because of the strain of carrying the weight of all that stress on your back and neck.

Let’s use an everyday example to demonstrate. You go to the local eatery and put your purchase on your bank debit card. All of a sudden, bells and whistles go off because you didn’t have enough money in your account to cover that charge. It’s not this charge that “broke the bank,” it’s all the money you spent before this purchase and the fact that you didn’t properly manage your account in the first place that put you in this predicament. Now, you’re faced with fees, embarrassment and the inconvenience of having to deal with the situation.

It’s the same with your health–ignore it and it will find a way to let you know you’re overlooking something.

Beating Back Pain

The best way to stay on top of things so you don’t wind up “over spent” is to stay on schedule with your chiropractic adjustments, eat healthy foods, sleep at least eight hours each night, and learn how to manage your stress.

Core Strengthening Exercise #4 – Proper Crunches

Doing Crunches the right way

We love core strengthening right? So I bet you think you know how to do a crunch right? Are you sure? Hmmm. Maybe not…. to do crunches properly and make sure you are really strengthening your core as much as you need to read on…

Instructions for proper core strengthening with crunches…

step by step instructions are easy and almost exactly what you have always done with one or two new twists…

These extra bits make all of the difference in activating the proper muscles including a muscle called the transversus abdominus which really helps to activate the whole core (anteriorly and posteriorly).

Here are the steps:

  1. Lay on your back with your knees bent
  2. place one hand on your belly
  3. place the other hand behind your neck with your thumb and fingers spanning your neck to the upper back
  4. brace (this is exercise #1 – told you that you would need it again)
  5. put your tongue on the roof of your mouth (yes you read that right)
  6. crunch and lift your shoulders slightly off the floor without moving your neck into flexion.

Ok so why with the tongue thing?  It makes it so you can’t engage your neck muscles and you have to use your core.  This is the way you were always supposed to do crunches. Who knew right?


for a step by step how to please see my YouTube video below!



Questions, Comments and Queries

And as always, if you have any questions or need more help with something please don’t hesitate to call our office.  If you aren’t sure this one is for you please also ask us.  If you have an injury this may not be appropriate for you  — yet.  I always give this exercise to my lower back pain patients but it usually requires some treatment first before we can get to this point. If you have pain, please seek treatment first – Pain is your body’s way of letting you know something is wrong… go get it looked at and fixed! Let us help…



Lower back pain and the dreaded herniated disc

So you slipped/popped/herniated a disc.  Nope nothing sipped or popped really. But this sucker hurts.  Like a lot.

Let’s back up a minute. What the hell is a herniated disc and why does it cause so much back pain?

Ok here is a bit of a small anatomy lesson.  The spine is made up of bony vertebrae and in between them sits a disc that is made of connective tissue with a gel filled middle.  Picture a jelly donut with the donut part actually made up of concentric rings layered like an onion.  Are you with me so far?  Ok, so then really close to these discs are nerves on either side of the spine at each disc level (kind of).  Now that you have that picture in your head I can explain what happens to the discs sometimes when we injure them.

Sometimes with repetitive movement, lots of flexion, sitting, moving, lifting, standing (and just life in general – because these things are cumulative) the jelly in the disc starts to make its way through the concentric rings causing the outer layers of the jelly donut to bulge outwards.  If this bulging is anywhere near the nerve the nerve gets ANGRY. Nerves do not like pressure. Nerves. Do. Not. Like. Pressure.  In fact it only takes 8 mm of pressure to cause the nerve to have altered function and possibly cause pain, numbness or a whole host of other symptoms.  8 mm of pressure is the amount of pressure you feel on the back of your hand if you place a dime on it. So not much pressure on the nerve and you get back pain. This is just mechanical pressure but the nerve can also be irritated by chemical mediators released in the area such as inflammation… ok lets not get too complicated.

Where were we?  Ok, we have a bulging jelly donut and this is causing pain in the nerve.  This could translate into back pain, back pain with leg pain or even numbness and tingling in the leg.  This can get even worse if the jelly makes its way all the way out of the  donut rings and we call this a herniated disc.

Right so what do we do?

Firstly most herniated discs do not like flexion of the lower back or increased intra abdominal pressure.  That means sitting, bending and often coughing and sneezing too.  These things will cause increased symptoms and should be avoided if possible.  Because of the common course of herniation bending forward at the waist actually forces the jelly in the donut backwards causing the bulge or herniation to get worse.

For this reason those with a herniated disc may respond really well to the McKenzie protocol which I prescribe to patients in my clinic.  I am going to upload a video with a simple exercise below but you have to promise me that if you suspect you have a herniated disc to please go check with your health care professional to make sure that this is the thing for you to do. If you do try it on your own and symptoms worsen – STOP.

Ok now that that is out of the way  – the easiest (but not always the correct) McKenzie exercise to show you are simple back bends or extensions.  All I want you to do is stand up and put your hands on your lower back. Then bend backwards keeping your neck in neutral and arching only your back then stand up again.  I want you to do that 5-6 times in a row – all of this should take less than 15-20 seconds.  That is it. If you are doing this right and you do have a herniated disc the pain or numbness in the leg should feel better a little bit better.  If it feels worse please discontinue the exercise!!!

****Important note – if you have bowel or bladder changes such as a loss of control you need to seek emergency care – as in go to the Emergency Room.  Do not pass go, do not collect $200. Ok?


Right, so if this exercise does make the leg pain or numbness less but increases the lower back pain that is actually ok and expected… If it does some of all of these things you can do this up to once an hour.

You still need treatment and fast so please contact me or another health care provider so that we can help you  – hope this helps!!!

Exercise video listed below (underlined: “McKenzie Exercise” please click it and it will take you to the video)

McKenzie Exercise video click here

Safe lifting techniques

So this week I was at a retail store where they were gearing up to do inventory.  They asked me to come in to review safe lifting techniques – which by the way is a great idea.  Although many people have been taught this along the way it is always good to review.  And I find that the more people you get information from the more you remember and you tend to learn a different little tip from each source.

So I thought it may be a good idea to review.  Just this week I have had a patient move homes, another continue to pack and go through things to move homes, patients travelling, and patients who work in retail or warehouses who lift regularly.  Also there are the rest of us who continually lift and carry throughout our days: small children, bags and boxes for work, groceries, hockey bags you name it and we lift it. (does the question ‘hey doc why does my back hurt?’ seem a bit more clear cut now?  Ya life is full of busy and we are hard on our bodies… this stuff is cumulative and one day when you bend over the bathroom sink to brush your teeth you can’t stand back up.  Toothbrush too heavy? Nope. Just all of that catching up with you and the bending in the morning was the straw (or toothbrush) that broke the camel’s back so to speak).  Ok so lets do our best to protect the camels shall we?  (the camel is you in case you were confused).

Lifting tips and rules to live by:

Before you lift anything brace your stomach muscles (see Brace2 video link below)


Bend at the knees not at the back

Keep the load as close to your body as possible

take breaks

share heavy or awkward loads with a partner

Do not twist while lifting

Here is a helpful poster I found on line:

Also for smaller items try the golfer’s lift – see video link below !

Golfers lift

I am superhuman – crap I hurt my back…

And so, I got the above picture from a patient via text this week with the following words attached: “I didn’t want to make two trips and now my lower back hurts… have anything this week at your home (office)?”

Yep, we’ve all done it. Sometimes we get away with it unscathed with no problems but most of the time we tweak something in to hurting… that picture above is 9 grocery bags from the car to condo by the way.

So, lesson one – make two trips

lesson 2- text me for an appointment because there is no way you will actually make two trips

This is a good one because she did. I did see her and her problem is minor and relatively easy to treat at this stage… leave it  a week or two or three and if it is unresolved the longer it has been around the longer it takes to get rid of as a general rule.  Even if it seems to go away you really shouldn’t ignore what your body is telling you hurts – these aches and pains that come and disappear unfortunately accumulate over time and build until one day you do something innocent seeming, like bending over at the sink to spit out your toothpaste, and you can’t get back up.  (Seriously I have heard this story I don’t know how many times over the years and when they told us that at school I thought they were joking).

Patients always ask me – Doc how did I get this? what can I avoid so this doesn’t happen again I mean I was only bending over the sink?!?!

Well the bending over the sink didn’t do all of it – it was the straw that broke the camels back (pun intended).  Life happens. We all do stuff we shouldn’t do like not make two trips, sit too long in front of the TV or computer, stand too long at work, lift things that are too heavy, engage in weekend warrior antics, play one sided sports like golf or hockey, carry kids in one arm primarily … I could go on forever and I haven’t even mentioned slips and falls and minor injuries.  Scar tissue and injury accumulate over the years.  Chiropractic care can make sure that you aren’t headed for that last straw by making sure that the minor things that are there already are taken care of before that happens.   Love living life to the fullest myself and I don’t have time for setbacks…. Chiropractic wellness care is just for that. And if you do hurt yourself, don’t wait, make the call and get it fixed sooner than later.

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.”


Sciatica – it can be a pain in the butt (also in the thigh, leg, groin…)

Sciatica can be an amazingly painful condition.  The symptoms can include back pain with pain into the butt, thigh, calf, sometimes the foot and even the groin.  There can even be pain into the genital area.   Amazingly sometimes there is no back pain at all but just a combination of pain in the other regions mentioned (leg, butt, thigh, groin etc…).

I have had patients come in to see me embarrassed about their symptoms (especially with the groin or genital pain) and confused because their family doctor really had no suggestions or solutions.

Here is the cool thing:  We can help you fix it.

If its chronic and has been around a long time, or if it is relatively new and only been there a week or two there are a ton of things we can do.

Often sciatica results from inflammation in and around the sciatic nerve.  This big nerve travels down your leg and provides motor power and sensation to the whole leg.  This is why the pain can be is such varied locations.  Prolonged standing often really aggravates this pain.  Sometimes it is difficult to find a position that is at all comfortable.  Sleep can even be interrupted.

When I treat this condition I always do deep tissue treatment to the sacroiliac joints and piriformis muscle.  This joint and muscle are the closest things to the sciatic nerve and the piriformis muscle actually lays right on top of the sciatic nerve and can compress it if it is too tight.  So muscle treatment, treatment of the joints to relieve the inflammation in the area and restore motion to the joint are key in solving this problem.  Prescription of exercise is also key to stretch tight muscles and strengthen the core to ensure this condition doesn’t come back.

I too have suffered with sciatica and know what a pain in the butt it can be.  It doesn’t need to be suffered with – there is something that we can do about it.