Other Ailments

Below are some of the reasons people might seek chiropractic care. Not all chiropractors treat all these conditions and in some cases there may be causes for these conditions which are beyond the scope of the chiropractor. The best way to determine what is wrong and whether it can be treated by the chiropractor is through a thorough history and examination.

Acid Reflux (Heartburn)

Heartburn, often mistaken for cardiac pain, requires proper diagnosis. Acid reflux can be aggravated by irritation of the mid to upper thoracic spine, which seems to cause a softening of the lower esophageal sphincter. This results in acid from the stomach being allowed direct contact with the unprotected walls of the esophagus. Adjustments, as well as dietary modifications and modifications to activities of daily living, can be made to ameliorate symptoms.

Some heartburn pain is caused by hiatal hernia, which is a condition where the lower esophagus and upper stomach slide up through a hole in the diaphragm causing the upper portion of the stomach to become strangled and narrowed in the diaphragmatic opening. This results in direct trauma to the stomach musculature and also results in the pooling of acid near the top of the stomach which results in heartburn.

Abdominal Pain

Abdominal pain is one of those symptoms that is not frequently considered a chiropractic malady. The reason for this is quite simple; it mostly is not. However, there are incidences when a chiropractor is the right choice to manage abdominal pain.

1. Some abdominal pain is caused by strained, spasmed, or scarred musculature in the abdominal wall or diaphragm.
2. Perceived abdominal pain can also be transmitted from the back (referred pain) via intercostal and other nerves emanating from the spine.
3. Some patients experience abdominal discomfort, "queasiness", due to irritation in their mid-spine region.
4. Abdominal pain can be a result of food allergies or sensitivities.

Arthritis

There are dozens of types of arthritis and even more subtypes. All arthritis has 3 commonalities: they produce some level of inflammation in the joints (some more than others), they result in some form of deterioration in the joints, and they result in some aberrant motion in the joint.

Knowledge of how arthritis is affecting these three elements guides the chiropractor in the proper application of treatments. Some arthritis or their sequelae are contraindications to manipulation to some localities; however, adjustments properly performed can be enormously helpful to the arthritic patient in pain control, enhanced movement, and slowed progression.

Asthma

Asthma is a disease with many different causes and triggers and presents a spectrum of severities. Some asthma patients respond well to chiropractic adjustments. Adjustments to the lower cervical and thoracic spine produce a neurologic effect which assists in the opening of bronchial airways and a mechanical effect which frees up the costal-vertebral joints allowing enhanced chest expansion and increased total lung capacity.

Bell's Palsy

Bell's Palsy can be a scary disorder because of its similarity to a stroke. Differentiating the two can typically be discerned by looking for forehead sparing in the stroke patient and effects beyond the innervation of the facial nerve in the stroke patient.

Research shows that aggressive treatment of Bell's Palsy with conservative interventions can shorten the duration and reduce the lasting effects versus treatment with pharmaceuticals alone. Bell's Palsy is thought to be caused by irritation and swelling of the facial nerve as it exits a bony hole through the skull on its way from the brainstem to the muscles of the face.

Conservative management focuses on sensory feedback loops through the trigeminal nerve (scraping the affected area), and facial nerve and external stimulation of musculature through the application of TENS. Adjustments to the cervical spine seem to assist and the prescription of exercises for the afflicted muscles is crucial.

Bursitis

A bursa is a thin fluid-filled sac that can be found between two tissues which might otherwise be subject to friction. The bursa reduces the incidence and impact of friction. Sometimes the bursa becomes irritated and inflamed causing the sac to fill with excess inflammatory fluids making the area painful to touch and move.

Treatment focuses on reducing inflammation through the use of physiotherapeutic, adjustments, supplemental products, exercises, and correction of the problem that may have allowed the bursa to swell originally.

Buttock Pain

Buttock pain can be caused by muscular strain or injury to the large muscles of the area. It can also be referred from a low back injury. Some sciatica pain refers to the area. Piriformis syndrome causes lower buttock pain.

Car Accident Injuries

Chiropractors are fully licensed to treat musculoskeletal car accident injuries through the no-fault system.

Carpal Tunnel Syndrome

Carpal tunnel syndrome is caused by a narrowing of the space/tunnel in the wrist where nerves and blood vessels pass. Because this tunnel is full, any inflammation will have a crushing and chemotactic (direct chemical irritation) effect on the median nerve which travels through. In most incidences, the patient will experience pain, numbness, and/or tingling in the 1st through the 3rd digits though the lateral portion of the 4th digit can also be involved.

The palm is spared in the majority of the population. Treatment consists of electric stimulation across the tunnel, inflammation reduction regimens, the stretching of the tunnel, cervical and upper thoracic adjustments, and exercises.

Chest Pain

Because chest pains can be caused by cardiac structures, a thorough and frequently cooperative evaluation with medical professionals is carried out. If the condition is non-cardiac and non-organic then an evaluation of other causes can proceed. These other causes include hiatal hernia, acid reflux, thoracic spinal irritation, and strained musculature or trigger points in the pectoral or sternal muscles.

Disc Bulges

Disc bulges occur both naturally as part of the aging process and following trauma. A disc has a gelatinous center (nucleus pulposus) surrounded by a concentric arrangement of ligaments (annular ligaments).

To describe a disc bulge, think of the disc as a shock-absorbing balloon between the bones (vertebrae) of the spine. As degeneration occurs with age, there is some loss of height in the disc because of a redistribution of the volume of the gelatinous center of the disc.

This causes the horizontal margins of the disc to bulge out like a balloon being squeezed by two hands pushing together. The redistribution of the disc material causes a slackening of the outer ligaments reducing their effectiveness at limiting translatory movement between vertebrae and resulting in a fixating response by the body.

This fixating response manifests early on as muscle tightness and ultimately leads to bone spurs and osteoarthritis. Sometimes the disc bulge causes direct pressure on nerves or the spinal cord resulting in local back pain and occasionally sciatica.

A second type of disc bulge is caused by repetitive strain to the disc complex usually a result of repetitive lifting and twisting. This results in multiple micro-tears to the concentric annular ligaments which allows the horizontal plane of the disc, which is unencumbered by bony limits, to lose its tensile strength.

As the nucleus pulposus radiates and redistributes central pressures to the surrounding annular ligaments, those ligaments begin to fray allowing an overall expansion of the annular circumference; a bulging.

Depending on the extent of the process at the time of intervention, different treatments can be employed. Stable disc bulges are good candidates for low rotational manipulation because the adjustment induces a controlled movement which enhances disc imbibition and limits the encroaching limitations of arthritis.

They are also good candidates for axial traction because the traction induces imbibition and movement but also causes a negative pressure in the central disc and thus can result in the reformation/restoration of the disc as a whole.

Sequelae of the disc bulge (muscle spasm, pain, weakness, paresthesias) can be managed through adjustments, physiotherapeutic interventions such as electric muscle stimulation, heat, and ultrasound, massage, and rehabilitator exercises.

Surgery is an option in severe cases. The accepted criteria for surgical intervention are discussed under the disc herniation heading.

Disc Disorders

See disc bulge, disc herniation, extruded disc, or sequestered disc.

Disc Herniations

The entirety of the explanation offered above in disc bulges applies to disc herniations, but the outcome differs, and the appropriate interventions vary. Disc herniations may begin in much the same way as disc bulges but as they progress, they exploit an area of enhanced weakness in the annular ligaments.

The disc herniation eventually bubbles out away from the rest of the disc. This can happen insidiously or it can happen suddenly following a trauma. There are two common areas for this to happen:

1. To the left and right of the anterior longitudinal ligament. This is rarely discussed because the chances or severity of problems resulting from herniation in this direction are minimal. After all, the area is not confined and the neurologic structures in the area are not so easily compressed.
2. To the left and right of the posterior longitudinal ligament. A herniation in this area can compress the spinal cord or more frequently the left or the right nerve root as it exits the neural foramen, a bony and unforgiving space, whose simultaneous occupation by a disc herniation results in compression of the nerve root and pain (often referred into the leg).

Adequate assessment of disc herniations is essential to ensure appropriate treatment. Mild to moderate disc herniations which are still contained can be treated with traction and non-rotary manipulation and sequelae can be treated as defined under disc bulges.

Large disc herniations which put direct pressure on the spinal cord, cauda equina, or nerve roots have little hope of resolving using traction and are contraindicated to manipulation. The accepted criteria for surgical referral and intervention are paresis, paralysis, increasing neurologic deficit, and intractable pain which results in significant dysfunction or alteration of the patient's lifestyle.

Paralysis is a no-brainer. Paresis is often missed. A rapid onset of footdrop is a form of paresis as well as an increasing neurologic deficit and requires immediate referral (It is accepted that from the moment of onset of footdrop, the patient has a brief window of opportunity for muscular restoration that begins to close at 24 hours depending on numerous variables).

A local area of numbness or paresthesia does not necessarily warrant a surgical referral but an increasing distribution or increasing loss of neurologically modulated modalities is. Further diminution of reflexes from a post-trauma baseline represents an increasing neurologic deficit.

The presence of mild to moderate back pain in and of itself does not represent a surgical interventive trigger. Anyone whose surgeon states that mild to moderate pain is reason enough to undergo surgery should seek a second, objective opinion because this level of pain often returns post-surgically.

It is neurologic deficits which are most responsive to surgery. However, there are unique instances where these guidelines become flexible. If an MRI demonstrates a disc herniation or sequestration which currently is causing only minimal problems for the patient but which will clearly, undoubtedly become a problem shortly then surgery may be indicated.

Also, the patient's age, occupation, lifestyle, and physical fitness may affect the decision. A young professional football player with a disc herniation that gives him only mild pain but prevents him from continuing to play football might be recommended for surgery despite a lack of increasing neurologic deficits because of a high reward-to-risk ratio, whereas a similarly aged white collar worker might not opt for surgery because of a low reward to risk ratio.

As with all surgeries, the patient's health history (age, risk of cardiac event, infection risk, etc.) may modify if and when surgery is attempted. The rule that I pass on to patients when they are unsure as to whether or not they should have surgery is this: Surgery is a risk, a gamble. "When in your mind, based upon the collective information provided to you by your healthcare team, the potential benefits of the surgery outweigh the potential risks that are an appropriate time to have surgery."

For example, the risk of death during a particular surgery might be 0.5%, but one person might give that a 25% level of importance whereas another might give it an 80% level of importance.

Dizziness

While dizziness is a somewhat vague term, it is often lumped in with vertigo. See Vertigo for more information.

Ear Infections

Ear infections are common in children because at birth the Eustachian tubes are angled down from the mouth towards the middle ear. This allows bacteria from the mouth to drain toward the middle ear.

As we age and grow the angle of that tube reverses so that the middle ear drains back towards the mouth. Adjustments to the cervical spine in children prone to ear infections have been shown to reduce the overall incidence and intensity of ear infections.

Extruded Disc

Extruded discs are very severe disc herniations which are not encapsulated. On MRI, they appear to have unrestrained margins as opposed to the smooth bubble-like margins of a typical herniation. Extruded discs are usually cause for a surgical referral and consultation.

Failed Back Surgery Syndrome

Formerly called failed laminectomy syndrome, back surgery traditionally has poor long-term outcomes and often requires repeat procedures or ongoing post-surgical care.

This is due to the inherent dangers of surgery and post-procedure sequelae including scar tissue formation, destabilization of the spine, and enhanced deterioration of joints.

Many failed back surgery syndrome cases are not recorded by surgeons when discussing success rates, as they tend to manifest beyond the surgeon's last follow-up with the patient.

Fibromyalgia

Fibromyalgia is a constellation of symptoms with many instigating causes. Primary symptoms include diffuse ubiquitous pain, fatigue, bouts of sleeplessness, and psychological sequelae.

Treatment of fibromyalgia patients in a chiropractic office must be an evolving process as each individual tends to respond favourably or unfavourably to various treatment modalities.

Massage tends to be a tried and true intervention and seems to work via a feedback loop to the brain.

Frozen Shoulder

Frozen shoulder or adhesive capsulitis must be treated with an aggressive stretching and exercise program facilitated by shoulder mobilization and adjustments to the thoracic and cervical spine.

The frozen shoulder patient will always have motion maladies and trigger points in the interscapular and subscapular regions as the shoulder blade succumbs to motion abnormalities.

Golfer's Elbow (Medial Epicondylitis)

Medial epicondylitis is a form of tendonitis that occurs in the medial elbow. Treatment focuses on physiotherapeutic, massage, and extremity adjustments when indicated.

Headaches

95% or more of all headaches are tension headaches, triggered by tightness in suboccipital and occipital muscles or muscles in the neck. Treatment for these types of headaches is often effective, with massage, trigger point therapy, adjustments, and a unique simultaneous application of heat and cold usually reducing headaches in several visits.

Heart Disease, Cancer, and other Diseases

Chiropractors can provide pain management options, nutritional advice, exercise, and rehabilitative prescriptions as part of a healthcare team, although they cannot treat these diseases directly.

Hip Pain

Hip pain in younger people is usually muscular and can be remedied through physiotherapeutic interventions, massage, and rehab exercises. Adjustments are important for restoring normal gait mechanics.

Hip pain in the elderly must be thoroughly investigated to rule out fractures. Arthritis is a common cause, and physiotherapeutic interventions, supplements, and exercise recommendations can be effective.

Infantile Colic

Colic in infants can have various causes. After evaluation by a pediatrician, gentle adjustments and massage can effectively reduce colicky outbursts.

ITB (Iliotibial Band) Syndrome

See thigh pain.

Knee Pain

Significant tears to knee ligaments and menisci should be handled by orthopedists. Other causes, like patellar tracking issues due to injury or muscular imbalance, are usually treated with exercise prescription.

Subluxation of the fibular head is easily managed with an extremity adjustment, and mild ligament problems are treated through physiotherapeutic modalities and exercise prescriptions.

Low Back Pain

Low back pain has numerous causes, categorized into muscular, ligamentous, joint, disc, and neurological issues. Treatment approaches vary based on the cause and can include adjustments, physiotherapeutic modalities, massage, and exercise prescription.

Numbness or Tingling

Chiropractic treatment can relieve numbness or tingling caused by nerve pressure and chemical irritation through a combination of physiotherapeutic modalities, massage, and adjustments. Some cases are due to trigger point referrals.

Nutritional Disorders

Chiropractors provide nutritional prescriptions for clinical nutritional problems and optimal health, tailoring recommendations based on individual needs, disorders, medications, age, gender, etc.

Occipital Neuralgia

Occipital Neuralgia, a headache type, is characterized by pain in the back and/or top of the skull. It can be alleviated with careful soft tissue massage and spinal adjustments.

Osteoporosis

Osteoporosis treatment includes nutritional, supplemental, and exercise recommendations.

Paralysis

Paraplegics and quadriplegics often receive chiropractic adjustments above and below their spinal cord injury sites. Adjustments above the involvement level optimize mobility and reduce irritation.

Adjustments below the injury site are gentle and aimed at removing facet and intervertebral irritations. Massage, lymphatic drainage techniques, and facilitated limb motion are also commonly performed.

Paresthesias

See numbness and tingling.

Pinched Nerve

Pinched nerves can occur from misaligned vertebrae joints, creating pressure affecting the nerves. Adjustments relieve these pressures. Some nerves become impinged as they pass through soft tissue defects, ligaments, or bones. Once diagnosed, these can be released through soft tissue and/or joint manipulation.

Piriformis Syndrome

Piriformis Syndrome starts as lower buttock pain. The piriformis muscle extends from the lower pelvis to the hip. It can become chronically tight, causing persistent buttock pain.

In some cases, sciatic nerve irritation can result from the contracted piriformis muscle, causing sciatica. Treatment involves physiotherapeutic, deep massage, adjustments to the lumbar and sacroiliac areas, and stretching exercises.

Plantar Fasciitis

Plantar fasciitis can be treated with corrective insoles, orthotics, footwear changes, stretching, massaging the foot arch, and adjustments to the foot bones. Gait modifications and changes to daily activities can impact the condition. Adjustments to modify the kinetic chain can also help.

Pregnancy-Related Back Pain

Pregnancy changes weight distribution, causing pain in the lumbar and thoracic paraspinal muscles, sacroiliac joints, and facet joints. Chiropractic adjustments and massage can manage these discomforts.

Increased elastin hormone in later pregnancy can lead to joint abnormalities, and chiropractors can direct exercise and stretching regimens.

Radiculopathy

Radiculopathy is nerve impingement where a nerve root exits the spinal cord. Adjustments, along with other treatments and exercise prescriptions, can help relieve radicular symptoms.

Referred Pain

Referred pain originates from trauma or irritation in muscles or organs not at the pain site. Skillful diagnosis is key to locating the source. Trigger points and organ-related referred pain can be recognized and treated.

Rib Pain

Rib pain can result from fractures due to trauma, sneezing, or coughing. Intercostal muscles often strain, and rib heads may become hypermobile and irritated at their articulation with the spine.

Rotator Cuff Injuries

Early physiotherapeutic interventions for rotator cuff injuries minimize inflammation and scar tissue formation. Adjustments and exercise prescriptions optimize motion and strengthen muscular coordination.

Sacroiliac Syndrome

Sacroiliac syndrome involves aberrant movement of the sacroiliac joint, resulting in pain radiating to the buttock or posterior thigh. Heat, massage, and adjustments provide relief.

Sciatica

Sciatica, caused by disc issues, arthritis, stenosis, or soft tissue entrapment, is a form of nerve impingement. Electric stimulation, ultrasound, adjustments, and trigger point therapy minimize nerve pain and irritation.

Scoliosis

Scoliosis, lateral spine curvature, can cause deformity and compression. Early detection and intervention are vital. Exercises, bracing, mobilization, and manipulation are used.

Sequestered Disc

Sequestered discs should be referred for surgical consultation due to the risk of emergency distress. Adjustments near the sequestration are contraindicated.

Shin Splints

Shin splints, caused by inflammation at muscle attachment sites, are treated with massage, physiotherapeutic modalities, orthotics, footwear changes, and bracing/taping.

Shoulder Pain

Shoulder problems, often inflammatory, include tendonitis, bursitis, strains, and sprains. Chiropractic care or collaboration with an orthopedist can manage these issues.

Sinus Problems

Sinus problems are sometimes confused with referred headache pain. Treatment involves acupressure, heat, adjustments to open sinuses, saline sprays, and heat at home.

Sleep Disruption

Chiropractic care aims to reduce discomfort affecting sleep and advise on activities and nutrition for restful sleep.

Spondylolisthesis

Spondylolisthesis causes vertebral body slippage and central stenosis. Exercise, posture modifications, pain management, stability assessment, and treatment of secondary issues help manage it.

Sports Injuries

Chiropractors help prevent and manage injuries for athletes, maximizing health potential and performance.

Stenosis

Stenosis, the narrowing of spine structures, can be lateral or central. Adjustments, traction, exercises, and massage help manage stenosis symptoms.

Stiffness

Stiffness from muscles, ligaments, capsules, or joints can be treated with physiotherapeutic modalities, massage, stretching, exercise, or adjustments.

Tendonitis

Tendonitis, inflammation of tendons due to repetitive irritation or trauma, is treated with physiotherapeutic modalities, ice/heat, massage, and adjustments.

Tennis Elbow (Lateral Epicondylitis)

Lateral epicondylitis is treated with physiotherapeutic modalities, massage, and adjustments for repetitive hand or arm activities.

TFL Syndrome

See thigh pain.

Thigh Pain

Different types of thigh pain, including anterior, lateral, medial, and posterior, have various causes. Physiotherapeutic modalities, massage, and chiropractic adjustments can treat these conditions.

Torticollis

Torticollis, acquired from trauma, causes unilateral neck spasms and rotation. Hot packs, electric muscle stimulation, massage, and adjustments provide relief.

TMJ Disorder

Temporomandibular Joint Disease causes jaw popping and pain. Skilled chiropractic interventions involve massage, trigger point therapy, ultrasound, bracing, exercises, and adjustments.

Upper Back Pain

Upper back pain from muscular strain or spinal irritation can be managed with chiropractic adjustments, massage, and pain assessment. Proper differentiation from referred pain is crucial.

Vertebral Subluxations

The term "subluxation" can be misunderstood and misused. Instead, joints are often referred to as hypomobile or irritated. A subluxation can mean a bone is abnormally relocated within a joint.

In chiropractic, vertebral subluxations are disturbances in spine articulation causing pain, reduced range of motion, muscle spasms, trigger points, and nerve irritation. Adjustments to hypermobile joints restore normal motion while strengthening and balancing exercises stabilize hypomobile ones. Subclinical subluxations may lack conscious symptoms but affect optimal function, leading to maintenance chiropractic care.

Vertigo

Vertigo, a spinning sensation, often comes with lightheadedness, poor balance, nausea, and more. Proprioception, our sense of body position, is complex, involving inner ear fluid, visual recognition, cervical spine receptors, and brain integration. Contradictory information from these structures can lead to vertigo. Chiropractors can identify and treat vertigo causes using adjustments, trigger point therapy, and Epley's Maneuvers.

Weight Loss

Obesity's impact on health is significant. Professional guidance or established systems can help those aiming to lose weight.

Whiplash

Whiplash, caused by rapid acceleration and deceleration, damages soft tissues and joints. Multi-modal treatment includes ice for inflammation, low-intensity adjustments, electric muscle stimulation, massage, ultrasound, strengthening, and range of motion exercises.

Work-Related Injuries

Chiropractors are licensed to treat work-related injuries through the worker's compensation system.

Stroke Risk and Chiropractic Adjustments

The risk of stroke following a neck adjustment is not increased compared to a medical doctor's visit. The chiropractic adjustment does not cause a stroke. Concerns about the vertebral artery's path through the cervical spine causing shearing forces are false.

Strokes may occur post-adjustment, but the adjustment itself doesn't affect stroke likelihood. Chiropractic adjustments can hasten stroke onset of symptoms (headaches, neck pain) and lead to chiropractic visits. Research shows the stroke risk remains the same whether the person visits a chiropractor or a primary care doctor. Most vertebral artery strokes result from arterial dissection, where the inner wall separates, causing various effects.

Pain often leads patients to chiropractors, but strokes may occur whether the person seeks chiropractic care or not. Stagnated blood may lead to clot formation and stroke.