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.

Sciatica

Sciatica

Sciatica describes the symptoms of pain (mostly) and sometimes tingling and numbness that runs from the Lumbar Spine into the buttock and down the back of the leg and sometimes foot.

What is the Cause?

The majority of sciatic symptoms come from back disorders between L4-S1 that put pressure on or cause irritation to a lumbar nerve root.

The symptoms can arise from an underlying Herniated Disc or Spinal Stenosis (which can compress the nerve root), or a degenerative disc or facet joint, which will release inflammatory proteins and irritate the nerve.

Signs & Symptoms

There can be any combination of the following:

  • Buttock, leg and/or foot symptoms
  • Burning, sharp, searing pain as opposed to achy or throbbing
  • Tingling / pins and needles
  • Weakness of leg or foot
  • Symptoms are usually only in one leg
  • Symptoms that are intermittent (can get better or worse, rather than staying constant)
  • Can be aggravated by sitting, walking, standing, twisting or bending

What Can We Do About It?

Physiotherapy will aim to identify the cause of your sciatic pain and treat with a combination of hand on therapy and specific sciatica relieving exercises

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

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.

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.

Clinical Pilates: The best exercise for back pain

Here at Elite Spinal Physiotherapy and Pilates we combine both Clinical Pilates and Exercise Rehabilitation methods into the same session depending on your needs. All of our practitioners have degrees in both Exercise Physiology as well as Physiotherapy.

How we are different?

  • Physiotherapist led sessions
  • Small groups of maximum 4 per session
  • Health fund rebates available
  • Fully equipped, state of the art studio

Benefits of Clinical Pilates:

  • Reduced neck and lower back pain
  • Increased postural awareness and correction
  • Improved core strength and spinal stability
  • Reduced risk of injury from work and sport
  • Increased bone density
  • Whole body toning
  • Enhance performance in other physical activities

Headache Physiotherapy: How your neck causes your headache

Headaches and migraines can be very debilitating and affect approximately 50% of the population.

There can be a range of causes responsible for headaches. Some of the latest research has shown that dysfunction in the top three vertebrae of the spine is a major contributor to headaches and migraines. This is the case is because it has been shown that the brainstem has become sensitised. This means that normal stimuli that is transmitted through the brain stem is interpreted in a different way to normal by the brain.

The areas that transmit stimuli through the brain stem are:

  • Neck
  • Eyes
  • Ears
  • Nose and Sinuses
  • Forehead
  • Sinuses
  • Scalp

This is why if one of your triggers is associated with one of the areas mentioned above, dysfunction in the neck may be a causative factor.

Treatment of the cervical spine consisting of gentle mobilisation helps to reduce the dysfunction of the cervical spine, therefore decreasing the sensitisation of the brainstem. This leads to a decrease in headaches and migraines.

Getting to the ‘Core’ of the problem

Having a strong core is very important in both prevention and rehabilitation of back pain, hip pain and knee pain.

What are your core muscles?

Deep stabilising muscles that support your spine. These include:

  • Pelvic Floor
  • Transverse Abdominus
  • Multifidus

The most common muscle that people refer to when talking about the core is the Transverse Abdominus. This is the deepest layer of the abdominal muscle wall and are hidden under the six-pack muscles called the Rectus Abdominus and Internal and External obliques.

The Transverse abdominus attaches to the thoracolumbar fascia and lower 6 ribs, so when tensioned, creates a support for your back, similar to a corset tied tight and gives you the shapely waist most desire.

Pilates is arguably the best way to learn to engage your core.