Migraine (Part 1)

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Migraines effect 12% of the population, I have seen it reported as high as 20%. Typically migraines tend to effect females more than males, it can be a regular occurrence or sporadic and infrequent. Typically it can be difficult to distinguish between a very severe headache and a migraine, however there are certain factors or symptoms that may help distinguish between the two. There are 4 phases when it comes to migraines.

Predome or Premonitory phase

Fatigue, light sensitivity, neck tension and stiffness, irritability, yawning, food cravings, difficulty sleeping, feeling unsettled to name a few. These can occur up to 72 hours prior to the actual migraine attack. It may seem strange that these symptoms are in fact related to migraines, the reason for this is because, migraines are a neurological condition happening at the level of the brain and specifically in area’s that control things like sleep, hunger, mood levels etc.

Aura Phase

Only about 30% of people who suffer from migraines will get an aura. Aura’s are reversible neurological symptom, although there are several different types of aura’s the most common is visual disturbances such as blurred or spotted vision. Other types aura’s include sensory, language and motor.

Attack Phase

This is the phase when people will get the headache, it tends to be one sided and felt at the base of the skull, side of the skull and eye and forehead. Its felt as a throbbing sensation and maybe accompanied by nausea/vomiting, sensitivity to light, smell and noise. This phase can last up to 4-72 hours.

Postdome Phase

This is usually felt as a headache, neck pain and stiffness, depression, fatigue after the attack phase has subsided.

Triggers

There are a variety of triggers, it is vital to be able to distinguish the trigger that are unique to you and the symptoms described in the predome phase. Triggers include emotional stress, hormones, not eating, sleep disturbances, neck pain, alcohol, bright lights, smoke, foods, exercise.

Although medications can be effective in dealing with migraines, there is the potential for migraine sufferers to get rebound headaches from overusing such medications and it becomes a viscous cycle of taking them to relieve a migraine while at the same time it is what is causing them. I will go in to greater details of medication induced migraines and other treatments in my next article.

kieranfMigraine (Part 1)
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Does Sitting Cause Low Back Pain?

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Does Sitting cause low back pain? This may seem like such a clear and obvious question, especially for those who tend to get their back pain specifically sitting for any length of time. However, recent research that looked at 41 studies on the matter found that sitting is not a factor and there is an absence of a relationship, with no association between prolonged or occupational sitting and lower back pain. I must admit I was quite surprised when I saw the results as I would have said, in fact I have said in the past with a fair degree of certainty that sitting is a major cause of back pain.

Although I did find some of the researchers comments quite interesting, he stated people who sit for long periods of time may get muscle tightness, which could be a factor in why someone feels pain, most pain is felt in the muscles especially the superficial muscles that support the spine. So sitting and pain are not directly related but may be influenced by other factors such as pre-existing muscle tightness. Most people I treat rarely have low back pain when just sitting, they may also also feel it on certain exercises, movements, first thing in the morning etc… Indicating sitting in of itself is not the cause but more likely the effect. In any case it should be reassuring that sitting does not damage your spine or discs and looking at you muscles and other factors could be more worth while.

Finally, it is worth mentioning people who get regular general physical activity have lower levels of back pain and other chronic health conditions such as heart disease, diabetes and some cancers so it is still important you keep active not only to help prevent low back pain but improve overall health.

https://www.deakin.edu.au/about-deakin/media-releases/articles/deakin-mega-study-shows-sitting-not-so-bad-for-back-pain

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Avoiding Ineffective Treatments

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Wack, Crack & Keep em Comin Back.

If you have been suffering from persistent or ongoing pain, no matter what treatment you get it is highly unlikely you will get effective relief from a 5-10 minute treatment, even worse still, if the professional is treating multiple people at once.  These are essentially “high volume business models” and rely on getting you in and out as quick as possible, return as often as possible and for as long as possible, or at least until your health fund runs out or you get the sense you are paying considerable money for short term relief. You will get the same cookie cutter treatment every time you go. Unfortunately, I have seen this with some of my chiropractic counterparts and they often use what I call this the “magic 6”. The same 6 adjustments which usually includes both sides of the low back, two in the mid back and both sides of the neck. Pretty much everyone gets the same treatment more or less.

Some may use whatever time is left over to treat the muscles, in my experience 5 or 10 minutes is not even close to enough time to adequately release them. I’ve been a myotherpist and sports therapist for well over a decade, muscles can be extremely difficult to treat especially in chronic situations and the reason why most treatments only provide short term results.

X-rays

X rays are all but useless when it in comes to diagnosing back pain, they are expensive and expose you to unnecessary radiation and potentially makes your pain levels worse. Things that show up such joint and disc degeneration are rarely the underlying cause of pain and are a result of normal ‘wear and tear’. Similarly, things like mis-aligned pelvis’s, decreased neck curvatures, leg length differences, scoliosis etc… are rarely the issue. Research has continuously shown you can get a large group of people with no history of back pain and the vast majority will often show things listed above and showing someone who is in pain their “broken” spine will often lead to worse outcomes.

I have seen x rays used as a scare tactic countless times over the years, with unsuspecting pain suffers committing to excessive treatment based on x ray findings and it is nothing short of a scam.

If you have back pain and a history of cancer, trauma or other more serious symptoms indicting an underlying pathology then x rays may be required this is roughly less than 1% of all back pain suffers.

Excessive Treatment

Most people I treat only need 2- 4 weekly treatments and as needed after that, this is because I use a holistic treatment that isn’t rushed and I educate you on how to become an active participant in your own recovery.  You shouldn’t need multiple treatments a week or regular ongoing “maintenance”. More than likely the reason you need regular and ongoing treatment has more to do with the fact the person treating you is ineffective rather than the seriousness of your back pain.

Catastrophizing Pain

Generally, people who are in pain whether it is acute or chronic have an emotional response, which is understandable. But it is vital you understand that the amount of pain you are experiencing pain does not represent the amount of ‘damage’ to your back or spine. In fact with most back pain there is actually no tissue damage and telling someone who is dealing with pain they have a slipped disc, bone out of place or even a weak core (I’ll further into this in another article) actually has nothing to do with their pain but potentially increases the fear and emotional response to it, which often ramps up the body and nervous systems response and can become a viscous cycle.

I have often found that professionals will tend to do all these things together. They will x ray the patient, tell them their pelvis is out of alignment, they have arthritis etc… this then heightens the fear response and they become very dependent some cookie cutter treatment requiring multiple treatments a week and ongoing for months on end.

kieranfAvoiding Ineffective Treatments
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Chronic Back Pain?

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Below I have linked a short video by Professor O’Sullivan, a back pain researcher, which I highly recommend watching. It contains some extremely useful information that I’m sure will increase your knowledge and provide you with a new view of your back pain. The presentation was intended for professionals and clinicians; as such, it contains a certain amount of technical language. However, I think you will easily be able to follow the main points.

The idea of weak core or that bones are out of place and need to be put back into alignment, spinal degeneration/arthritis (wear and tear) as causes of the low back is a very common and persuasive myth. Besides the fact these do not cause back pain, if you inform a person who has chronic back pain of this, it can increase their anxiety and fears. This can make the symptoms worse, increase feelings of vulnerability, and motivate people to invest unjustified faith in overly expensive treatment. Next time you go to a physiotherapist or chiropractor, remember this article, and I’m sure the things mentioned above will probably be repeated.

Of course, the overwhelming majority of back pain does stem from physical causes (see case study below); however, stress and anxiety can make matters worse. Unfortunately for the chronic back pain suffer, there is little understanding of the ways in which the muscles create chronic back pain, and there are no physiotherapy or chiropractic courses teaching students how to diagnose and treat the muscles to alleviate back pain. They generally rely on chiropractic adjustments, strengthening and stretching, which is another reason why so many therapies achieve such unsatisfactory results. Speaking from personal experience, when I trained as a chiropractor, virtually no time was spent on the muscular system in regards to how it sets up back pain and how to best approach the muscles.

The two photographs below show one of my patients who recently visited me with chronic back pain. The first photo (sorry that it’s rather blurry) was taken prior to the second treatment, and the second photo was taken post-third treatment. It is clear that the pain was being caused by physical problems, and after just three treatments, the pelvis and spine were more level, with the legs positioned correctly beneath the pelvis. While further treatment is necessary, this individual suffered from chronic back pain for more than a decade, which seriously distorted his posture, For this particular individual he had little life stress events, which had no bearing on his pain levels and if this were my focus he would of achieved the same minimal results he got from another chiropractor who supposedly “put his hip back in”  or physiotherapist strengthening his core.

posture low back painchronic low back pain - Sydney chiropractic

 

Most people need a holistic treatment that looks at the physical body as whole as well as potential life/stress events, without creating fear and vulnerability for a complete treatment, which can be difficult to find as there are very few ‘experts’ that have training in either one, yet alone both!

kieranfChronic Back Pain?
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Rounded Shoulders? DON’T DO THIS!!!

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Kieran Finnegan– Your Chiropractor Sydney CBD.

 

Over the years I have treated many people who have been given some bad advice in regards to posture and more specifically how to sit and/or stand to help correct rounded shoulders, although the therapist/professional may of been well intentioned, however; inevitably it made things worse.

People with rounded shoulders are often told to forcibly pull their shoulders blades back and down. This is actually a un-natural posture and it uses your postural muscles in a way they were simply not designed to do, i.e, in a constant and sustained contraction. What happens when the shoulder blades are pulled back and down is the upper trapezius is placed under a lengthened contraction, or more accurately referred to as an eccentric contraction, while simultaneously the lower trapeszius muscles are under a constant shortened contraction. Both of which are not useful but it is the eccentric contraction that tends to cause the most pain and tension.

If you can imagine the upper trapezius as an elastic band (red arrow) that runs from the of neck to the top of the shoulders. As the shoulders are being forcibly being pulled down the upper trapeszius is under constant tension as either ends of the muscle are being pulled away from each other. Similarly, if you were to pull the ends of an elastic band away from each other you will notice the tension actually increases dramatically. It then becomes a viscous cycle, as the longer and more frequent someone does this the more tension and pain is created and they more they will forcibly contract their muscles in an attempt to relieve the tension and pain.

A much better postural cue would be to stand tall, relaxed with a lengthened neck as if their is a helium balloon attached to the crown of your head and creating a very light traction and the shoulders rolled back slightly. This way the muscles are being used correctly, the spine is in better alignment and rather than causing tension and pain it will hopefully relieve some.

On a side note, when it comes to posture and sitting its not necessary ‘bad’ posture that is the problem, its the not moving and static postures. Get up and move around every 30-60 minutes, change from sitting to standing several times through out the day where possible, even changing from a regular desk chair to an exercise ball may also beneficial as well as going for a walk before, during or after work. In regards to treatment, you need to see someone who actually has training in treating the muscles, in my experience, chiropractors and physio therapists who actually have this are far and few between as its not covered in these course or programs and in my experience are often the ones who give bad advice like above.

 

 

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Self Treatment Guide for Low Back Pain

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If you suffer from ongoing or chronic low back pain, I’m sure many of you reading this will attest to the fact its very difficult finding a professional who can quickly and effectively solve your back pain, with the exercises and stretches often prescribed only achieving short term results. These techniques and tips I have in this article are a great way to treat your own back pain or supplement any treatment you may be getting for better results. I frequently recommend that they embark on a program of self-care or management by which they can treat and release there own muscles using self myofascial release (SMR) techniques. I often use the analogy of brushing your teeth, as you eat and drink throughout the day you need to brush your teeth to prevent damage and decay. Similarly, sitting or standing for long periods throughout the day, high-stress levels, previous injuries, poor posture, heavy or intense training and exercise will cause tension the build up and regular self-treatment is needed to prevent pain.

kieranfSelf Treatment Guide for Low Back Pain
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How Many Treatments Will I Need?

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As a Sydney & Waterloo chiropractor I often get asked how many treatments will be required to help with there back pain, a rough guideline I use to help determine this, is for every month you have been suffering from back pain it may take the same number of treatments to start to see considerable improvements. I.e one month may only require 1-2 treatments, 6 months, 6-7 treatments etc…

Over the years I have treated many people who sought help from other professionals; who even after 10 or more treatments with no ongoing results still continued getting treatment. Using the above guideline’s and the information below will help hopefully avoid.this happening to you.

Your Chiropractor Sydney CBD & Waterloo Chiropractor has listed some factors that he has found  influence how responsive a person may be to treatment, your Sydney & Waterloo chiropractic clinic’s specialise’s in helping people suffering from back pain & injury.

Duration of complaint: it should be obvious the longer you have had the problem, more often than not it will require more treatment. For the average person the guideline above will apply, when I say “average” I am referring to people who may of only had the problems for 3-6 months, get a reasonable amount of exercise, average diet and stress levels.

Age:

As a person gets older and especially when they don’t get regular treatment on there muscles they can become very stiff and tense, mainly due to lacking good blood supply to the tissues over time and generally require more time & effort to bring about suppleness to the tissue’s as opposed to someone who may be in there late teens/early twenties.

Exercise:

When it comes to exercise it is really is important to exercise to your appropriate level of fitness  and general health. Just like getting very little or no exercise can be a factor in back pain, doing too much high intense workouts such as pump class, spin class etc.. can be counter productive, especially if your muscles aren’t in the best condition or you suffer from pain or injury to begin with.

Also having poor technique or mobility can exacerbate or lead to an injury. I find swimming a great form of exercise as it low impact, full body resistance that also has a cardio element. If you prefer gym based training or higher intensity training having a exercise physiologist or personal trainer guide you through the appropriate exercises may be necessary.

Diet:

This is something that very rarely gets talked about and definitely not something I was taught at university while studying chiropractic. It wasn’t until I started learning myotherapy (SLM) I was introduced to this fact. Personally I find it  can be hard to determine if someone has a bad diet based on the feel of there muscles as there a so many different factors, but I can generally feel if someone has a good diet, although the might have muscle imbalances & tightness they also have a supple feel to them & have a bit of ‘give’ and generally don’t require as much time and effort to correct. Diets high in fresh fruit & vegetable, nuts, grains, legumes, fish & low in processed foods such as processed sugars/fats, red meat etc… are generally helpful in making your body more responsive to treatment.

Stress:

Its not uncommon for people suffering from back pain, especially chronic back pain to also suffer from stress, anxiety & depression and if this is the case seeing the appropriate health professional may also be required. Also ‘day-to-day’ stress is another major factor especially when it come’s to upper back, neck and shoulders, it important to realise this and take the appropriate steps in managing it.

Your Sydney & Waterloo chiropractic clinic’s I take a wholistic approach when trying to help some with there back pain in order to get them feeling at there best in the least amount of time possible. Contact your Sydney & Waterloo chiropractor today for more information.

Related Searches: Wateloo Chiroparctic, Waterloo Chiropractor, Waterloo Massage, Chiropractor Sydney CBD.

 

kieranfHow Many Treatments Will I Need?
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Self Treatment For Neck Pain & Headaches

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Your Sydney CBD & Waterloo chiropractor enjoys working with those suffering chronic & acute neck pain, even when other therapies have failed. Neck pain is the fourthleading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences (1).

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Which Exercise Is best for Back Pain? To Get Back Pain Relief

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As a Sydney CBD & Waterloo chiropractor, I often get asked what is the best form of exercise for back pain & sciatica. The good news is, generally speaking they all work as equally well as each other. One study looked at two types of specific low back stability exercise’s versus general exercise prescribed by a physical therapist and found one was not superior over the other when reducing low back pain & were all equally effective.(Unsgaard-Tøndel 2010) 

kieranfWhich Exercise Is best for Back Pain? To Get Back Pain Relief
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Heat or Cold Therapy for Back Pain?

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Over the years as a chiropractor, myotherapist (SLM) & massage therapist I have noticed some confusion when it comes to using ice or heat on an acute injury or pain. A lot of pain sufferers are unfortunately incorrectly guided by other professionals in this matter, which I think is partly due to a lack of understanding when it comes to treating the myofascial system (myo= muscle) (fascial= connective tissue) & what treatment works, what doesn’t & why. I have written this article to help you make a better, more informed decision, not only with ice/heat but acute back pain in general.

kieranfHeat or Cold Therapy for Back Pain?
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