Coccydinia

Coccydinia

Coccydnia is a condition involving inflammation around the coccyx that causes pain at the very bottom of the spine. This condition is also referred to as tailbone pain, coccyx pain and coccygeal pain.

What is the Cause?

This condition is usually caused by trauma to the Coccyx such as a fall or childbirth. It is much more common in females than males largely due to it’s link to childbirth. This is also due to the fact that females more commonly have an anteriorly tilted pelvis making their coccyx stick out more. This means that females are much more likely to put pressure on their coccyx whilst sitting.

Coccydinia can develop after a partial dislocation of the Sacrococcygeal Synchondrosis, which is the connective tissue that connects the Sacrum and Coccyx. This causes trauma to the surrounding muscles and ligaments leading to the inflammation, which is responsible for much of the pain and discomfort experienced.

Signs & Symptoms

  • Persistent pain at the bottom of the spine
  • Pain when sitting
  • Pain going from sitting to standing

What Can We Do About It?

Clients that are suffering from Coccydnia are advised to avoid putting pressure on the Coccyx until the pain starts to subside. Using a donut pillow or gel cushion can be useful whilst sitting for long periods of time.

Other treatments such as deep tissue therapy and gentle mobilisation of the Coccyx have been shown to yield great results and can be performed by the therapist’s at Elite Spinal Physiotherapy.

The Standing Desk

The Standing Desk

The standing desk seems to the latest new craze to avoid work related back problems. But do you know how to get the most out of your standing desk?

Yes the standing desk is a great way to avoid the sustained flexion we experience when sitting, but standing in one position for long periods can also have negative effects on our posture and musculoskeletal system. The best option is to alternate between sitting and standing positions throughout the day. One study found that a ratio of 2:1 sitting versus standing is optimal for body posture and for best productivity results.

It is key to remember the correct set up for both a standing and a sitting desk. Whether it is sitting or standing the correct desk height and computer screen position is crucial.

As a guide, the desk should be positioned so the elbows are at approximately a 90 degree angle. It has been found that the screens optimal position is 20-10 inches from the face, with the top of the screen at eye level. So as you don’t tilt your head forwards or backwards, the screen itself should have a 10-20 degree tilt back

When either sitting or standing, regular breaks are required. The spine loves movement! Staying in any one position for long periods will cause the spine to become stiff and the surrounding muscles to either shorten or lengthen away from their optimal position. Some people will naturally change positions regularly. For those who don’t, an app on your smart phone or installing reminder software on your computer may be a better option.

So remember

  • Vary sitting and standing throughout the day
  • Correct desk set up is crucial
  • Regular breaks are necessary to decrease occurrence of poor posture and musculoskeletal abnormalities

Thoracic/Upper Back Pain

Thoracic/Upper Back Pain

Thoracic and upper back pain refers to any pain and/or dysfunction of the thoracic section of the spine. It can be anything from stiffness in the upper back to pain when taking a deep breath.

What is the Cause?

The thoracic part of the spine is structurally very different to the lumbar and cervical parts of the spine. It is designed to be very stable and strong providing protection for the vital organs. . The fact that the ribs also connect into the thoracic spine provides more rigidity. This predisposes the thoracic spine to stiffness. Therefore the most common cause of upper back pain is joint dysfunction.

Signs & Symptoms

  • Upper back pain while breathing
  • Muscle spasm
  • Stabbing pain
  • Pain radiating out to the ribs
  • Pain in the shoulders

What Can We Do About It?

Posture plays a huge part in decreasing pain in the upper back. The Physiotherapist’s at Elite Spinal will assess your posture and advise you in how to make the appropriate changes.

The therapist will also use manual therapy techniques to decrease the stiffness through out the thoracic spine and ensure it is appropriately aligned.

Spinal Stenosis

Spinal Stenosis

Narrowing of the spinal canal and/or foramen where nerve roots exit the spinal canal which results in choking of the spinal cord and/or nerve roots

Stenosis of the spine can involve:

  • Narrowing of the central spinal canal (space where the spinal cord lies). This is also called a Myelopathy.
  • Narrowing of foramen through which the nerve roots exit the spinal canal

Most commonly happens in the Cervical Spine (neck) and Lumbar Spine (lower back)

What is the Cause?

The most common cause of Spinal Stenosis is due to the wear and tear, which comes with the aging process. Specific causes include:

  • Lumbar disc herniation
  • Facet joint arthritis (also known as Spondylosis)as we age and our discs lose fluid and height. There is an increased pressure placed through our facet joints, which connect one vertebra to another. Facets can become thickened and extra bone can grow into the spinal canal
  • Spondylolisthesis
  • Ligamentum flavum thickening:With age and stress the ligament can thicken which narrows the spinal canal

Signs & Symptoms

Some people can present with no symptoms however you may experience pain, numbness, pins and needles muscle weakness or loss of control of bladder and bowel. If you have loss of bladder or bowel control you may have Cauda Equina Syndrome (If you experience this you should consult a medical professional immediately).

What Can We Do About It?

The therapist’s at Elite Spinal Physiotherapy will identify the cause of your spinal stenosis and help in reducing symptoms (pain, pins and needles, numbness, weakness). They will also be able to refer you to the appropriate specialist if required.

A spinal decompression and core strengthening exercise program will be developed to help prevent any re-occurrence of symptoms and appropriate manual therapy will be used.

In most cases the spinal stenosis cannot be reversed however the progression of the stenosis can be greatly reduced, so you can enjoy a pain free, active life for as long as possible.

Myelopathy

Myelopathy

Myelopathy refers to compression of the spinal cord causing neurological deficit. Inflammation of the spinal cord is called Myelitis.

What is the Cause?

A Myelopathy is compression of the spinal cord caused by Spinal Stenosis. Specific causes of Spinal Stenosis include:

  • Lumbar disc herniation
  • Facet Joint Arthritis (also known as Spondylosis)
  • As we age and our discs lose fluid and height. There is an increased pressure placed through our facet joints which connect one vertebra to another – facets can become thickened and extra bone can grow into the spinal canal
  • Spondylolisthesis
  • Ligamentum Flavum thickening: With age and stress the ligament can thicken which narrows the spinal canal
  • Tumors

Signs & Symptoms

Signs and symptoms vary depending on which part of the spinal cord is affected and the extent of the compression.  Some general signs and symptoms are:

  • Pain in upper or lower limbs
  • Weakness
  • Numbness
  • Pins and needles
  • Jerky movements
  • Lack of coordination
  • Bowel or bladder abnormalities
  • Sexual dysfunction

What Can We Do About It?

The therapist’s at Elite Spinal Physiotherapy will identify the cause of your Myelopathy and help in reducing symptoms (pain, pins and needles, numbness, weakness). They will also be able to refer you to the appropriate specialist if required.

A spinal decompression and core strengthening exercise program will be developed to help prevent any re-occurrence of symptoms and appropriate manual therapy will be used.

In most cases the Myelopathy cannot be reversed however the progression of the compression or irritation of the spinal cord can be greatly reduced.

Ankylosing Spondylitis

Ankylosing Spondylitis

Ankylosing Spondylitis is a disease that causes inflammation of the spinal vertebrae and other joints. It affects up to 2% of Australians. It is a member of the rheumatic diseases and is associated with the presence of a genetic marker HLA-B27.

Chronic inflammation of the spinal joints causes the joints to produce extra bone formation, which leads to disruption of spinal alignment and may eventually lead to a bony fusion between the vertebrae.

What is the Cause?

There is no known cause to Ankylosing Spondylitis however the presence of a genetic marker HLA-B27 appears to significantly increase the risk of developing this condition.

Signs & Symptoms

  • Back pain
  • Spinal stiffness, especially in the morning
  • Stiffness in hips

What Can We Do About It?

The therapist’s at Elite Spinal Physiotherapy will identify whether your back pain is inflammatory or not and refer you to the appropriate specialist if required.

A spinal decompression and core strengthening exercise program will be developed to help prevent any re-occurrence of symptoms and appropriate manual therapy will be used.

Facet Joint Syndrome

Facet Joint Syndrome

Facet Joint Syndrome refers to a range of disorders involving the facet joints. It is also know as facet joint disease or a facet joint sprain.

Facet Joint Syndrome is one of the most common back disorders that cause lower back pain, thoracic pain and neck pain.

Understanding Facet Joint Syndrome comes with understanding the biomechanical role of the facet joints. The Facet Joints are the joints between the vertebrae of the spine. They are responsible for guiding and limiting the movement of the spine. They play a large part in communicating to the brain regarding the position and condition of the spine. They are therefore full of nerves, giving them the potential to produce large amounts of pain.

Facet Joint Syndrome is essentially mal-alignment or locking of the facet joints which can cause mild to severe back pain.

What is the Cause?

Stiffness (hypomobility) of the spine which is caused by:

  • Prolonged sitting
  • Lack of physical activity
  • Lack of stretching
  • Muscle spasm
  • Arthritis in the facet joints
  • Joint capsule damage caused by:
  • An uncontrolled movement
  • Trauma to the spine

Signs and Symptoms:

  • Back pain
  • A stabbing or sharp feeling near the spine
  • Decreased mobility of the spine
  • Pain, weakness or numbness in the limbs

What Can We Do About It?

Physiotherapy is very helpful when you are suffering from facet joint syndrome. The therapist will perform thorough, hands on assessment to determine which of the facet joints is causing the pain. They will then proceed to perform a range of manual therapy techniques to unlock the facet joint and restore it to full function. The therapist’s at Elite Spinal Physiotherapy do not use rigorous manipulating techniques but instead gentle mobilisation techniques that yield great results.

Once your spine has returned to its normal alignment the therapist will teach you a range of stretching and strengthening exercises to prevent the issue from reoccurring.

Sacroiliac Joint Dysfunction

Sacroiliac Joint Dysfunction

Sacroiliac Joint Dysfunction is a term given to the abnormal movement of the sacroiliac joints. It involves either hyper mobility (decreased movement) or hypo mobility (increased movement) of the joints. It can also involve inflammation of the joints, which is referred to as sacrolitis.

What is the Cause?

This condition is caused by anything that causes the ligaments surrounding the sacro iliac joint to become either too loose (hyper mobile) or too tight (hypo mobile). Some conditions that can cause this are:

  • Pregnancy
  • Osteoarthritis
  • Damage to the ligaments
  • Issues with the near by joints

Signs and Symptoms:

  • Back Pain
  • Buttock Pain
  • Radiating pain
  • Increased pain when standing on one leg

What Can We Do About It?

The first thing that needs to be done when suffering sacroiliac joint dysfunction is for the physiotherapist to do a thorough assessment to determine what is causing the dysfunction of the sacroiliac joint. Once the cause is determined the Physiotherapist at Elite Spinal Physiotherapy can perform the appropriate treatment. This will generally involve improving spinal alignment, soft tissue therapy and a tailored exercise program.

Degenerative Disc Disease

Degenerative Disc Disease

Degenerative disc disease refers to the process of degeneration of an intervertebral disc. Your intervertebral discs are the fluid filled sacks, which lie in between each vertebrae and act as the shock absorbers for your spine. They are made up of two parts: Inner nucleus pulposes and outer annulus fibrosis.The annulus fibrosis is made up of dense fibrocartilage rings and encases the nucleus. The outer ring of the annulus is innervated, meaning there is a nerve supply and can be painful when damaged. The nucleus is the inner part of the disc, which is jelly like in consistence. It changes shape as it adapts to the different loads placed on the disc. A healthy disc is fluid filled. Breakdown of a disc begins when it becomes dehydrated or loses part of its fluid content. This can initiate a cascade of events, which leads to eventual breakdown, and degeneration of the spinal complex.

Disc degeneration can lead to: 

Disc degeneration is a normal part of the ageing process. It is important to note that you can have disc breakdown with the absence of pain. The good news is there is lots you can do yourself to rehydrate your discs and slow the degenerative process down. 

What is the Cause?

Disc degeneration is a normal part of the ageing process however there are certain things that can accelerate the degenerative process.

Risk factors include:

  • Sedentary lifestyle
  • Overweight
  • Poor core stability
  • Repetitive heavy manual labor 

Signs and Symptoms

  • Persistent pain at the bottom of the spine
  • Pain when sitting
  • Pain going from sitting to standing 

What Can We Do About It?

Your physiotherapist will first identify the abnormalities in movement of your spine and will then determine the cause of this.

Core stability training will form a large part of your rehabilitation and prevention of further episodes of back pain.

Movement is the key to rehydrating discs and encouraging repair. Your physiotherapist will provide you with an individualised exercise program to help enable the healing process.

Natural Anti-inflammatories

Natural Anti-inflammatories

In an acute episode of back or neck pain drug based anti-inflammatories may be necessary however they have a few side effects so  avoiding them where possible is a good idea. This is where natural anti-inflammatories can be very useful.

Curcumin

Curcumin has a long history in Ayuvedic medicine as a treatment for inflammatory conditions. Curcumin is the orange pigment in turmeric and is a potent antioxidant that offers numerous health benefits including cardiovascular function, joint health and painting the bodies normal inflammatory response.

Curcumin is generally poorly absorbed into the blood stream so taking a type of curcumin called Meriva curcumin helps increase the bioavailability of the product. Bioavailability refers to the degree at which the product is absorbed.  Some studies have suggested that meriva curcumin demonstrated 29 times greater bioavailability than normal curcumin.

When looking for the product that will help you the most you need to consider the bioavailability and the dosage. By looking for a product that contains meriva curcumin you are ensuring you have the best chance of absorbing it. With regards to dosage we recommend taking 1000mg when in s flare up and 125-250mg when not in a flare up, therefore keeping this in mind make sure you find a product that has a high dosage per capsule so you don’t have to take too many. The product we use here at Elite Spinal is Thorne Meriva-SR which contains 125mg per capsule.

Fish Oil

Fish oil has been shown to possess many health benefits. One of these is its ability to decrease inflammation through out the body. It acts in a way that resolves inflammation after it has done its job. Research shows that as we age we produce less inflammation resolving agents so taking fish oil you are increasing the amount of inflammation resolving agents in your system.

The active ingredients that are in fish oil are EPA and DHA. When looking for the right product for you you need to read the label and look at the level of EPA and DHA in the product. Many products will say the total amount of fish oil in each capsule for example 1000mg on the front of the container however it is important to read the back of the label to find the EPA and DHA level. You would want a product that contains at least 250mg of EPA and 230mg of DHA.

Another thing to consider when choosing your fish oil is the cleanliness of the product. Many companies obtain their fishoil from larger fish, therefore there is a risk that it may contain mercury. It is important to look at the purification method that is used to ensure there are not high levels of mercury in the product. The product we use here at Elite Spinal is Usana’s Biomega, it contains 290mg of EPA and 235mg of DHA. It is purified using a double distillation process leaving it essentially free of harmful contaminants.

With regards to dosage we recommend taking 1000mg  EPA and 920mg DHA when in s flare up and 250mg  EPA and 230mg DHA when not in a flare up, therefore keeping this in mind make sure you find a product that has a high dosage per capsule so you don’t have to take too many.