by Stephen Mawhinney, Bsc Physiotherapy, Msc Sport and Exercise Medicine
Sciatic pain, commonly referred to as sciatica, is a condition characterized by pain that radiates along the path of the sciatic nerve. This nerve, the longest in the body, runs from the lower back through the hips and buttocks and down each leg. Sciatica typically affects only one side of the body and can range from mild to severe, often impacting daily activities and quality of life.
What Causes Sciatic Pain?
Several conditions can cause sciatica, including:
1. Herniated Disc: When a disc in the spine bulges or ruptures, it can compress the sciatic nerve.
2. Spinal Stenosis: Narrowing of the spinal canal can put pressure on the nerve.
3. Piriformis Syndrome: The piriformis muscle, located in the buttocks, can irritate the sciatic nerve if it spasms or tightens.
4. Spondylolisthesis: A condition where one vertebra slips over another, potentially pinching the nerve.
5. Injury or Trauma: Direct injury to the lower back or spine can lead to sciatic pain.
Symptoms of Sciatica
The hallmark symptom of sciatica is pain that radiates from the lower back to the buttock and down the leg. Other symptoms include:
· Numbness or tingling in the leg or foot
· Muscle weakness in the affected leg
· A burning or sharp pain that worsens with prolonged sitting or standing
· Difficulty moving the leg or foot
Diagnosis of Sciatica
Diagnosis typically involves a physical exam and medical history review. Doctors may perform tests to check muscle strength and reflexes. Imaging tests such as X-rays, MRI, or CT scans can help identify the underlying cause of the nerve compression.
Management and Treatment of Sciatic Pain
Managing sciatic pain involves a combination of self-care measures, medications, physical therapy, and, in severe cases, surgical intervention.
Self-Care Measures
1. Rest: Short periods of rest can help alleviate acute pain, but prolonged inactivity should be avoided.
2. Cold and Heat Therapy: Applying ice packs during the first few days can reduce inflammation, followed by heat packs to relax muscles.
3. Gentle Exercise: Activities like walking, swimming, or yoga can improve flexibility and strengthen muscles, supporting the spine and reducing pressure on the nerve.
Medications
Over-the-counter pain relievers such as ibuprofen or acetaminophen can help manage pain. In some cases, doctors may prescribe stronger medications, including:
· Anti-Inflammatory Drugs: To reduce inflammation and pain.
· Muscle Relaxants: To relieve muscle spasms.
· Antidepressants or Anticonvulsants: For chronic pain management.
Physical Therapy
A physiotherapist/chiropractor can design an exercise program tailored to the individual’s needs, focusing on:
· Strengthening Exercises: To support the spine and improve posture.
· Stretching Exercises: To enhance flexibility and reduce tension on the sciatic nerve.
· Manual Therapy: Techniques such as massage or spinal manipulation to alleviate pain.
Surgical Intervention
Surgery is considered when conservative treatments fail to relieve symptoms, or if there is significant nerve damage. Procedures may include:
· Microdiscectomy: Removal of a herniated disc portion that is pressing on the nerve.
· Laminectomy: Removal of part of the vertebra to widen the spinal canal and reduce nerve pressure.
Preventing Sciatic Pain
While not all causes of sciatica are preventable, certain lifestyle changes can reduce the risk:
1. Regular Exercise: Maintaining a strong core and flexible spine can prevent issues.
2. Proper Posture: Ensuring good posture while sitting, standing, and lifting can minimize stress on the spine.
3. Ergonomic Adjustments: Using supportive chairs and proper lifting techniques can prevent injury.
Conclusion
Sciatic pain can be debilitating, but with the right approach, it is manageable. Understanding the causes and symptoms is the first step towards effective treatment. Combining self-care, medication, physical therapy, and, if necessary, surgical intervention, can provide relief and improve quality of life. Preventive measures, such as regular exercise and proper posture, can also play a crucial role in minimizing the risk of sciatica. If you experience persistent sciatic pain, consulting a healthcare professional is essential for a tailored treatment plan.
by Andrea Kelly D.C Chiropractor
What is Osteoporosis?
Osteoporosis (literally translated as ‘porous bones’) is described by the World Health Organisation (WHO) as a progressive systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture.
Every year in the UK more than 500,000 broken bones are caused by osteoporosis and the most common locations of these fractures are the spine, hip and wrist. More than 1 in 3 women, and 1 in 5 men, will sustain one or more osteoporotic-related fractures in their lifetime.
Fractures can cause substantial pain and severe disability, often leading to a reduced quality of life, and hip and vertebral fractures are associated with decreased life expectancy.
Here at North Down Chiro&Physio, patients present to us with a large variety of complaints, and our therapists will always consider the presence of osteoporosis, an osteoporotic fracture or major risk factors of osteoporosis (whether or not it is related to the presenting condition).
We aim to identify patients with significant risk factors prior to loss of bone density and to provide early preventative support and advice. We also strive to identify those at risk of osteoporotic fractures and support them to make the necessary lifestyle and practical changes to help limit this risk, as well as making appropriate referrals for further investigations and management.
Given that chiropractic involves hands-on treatment, understanding a patient’s bone health is of particular importance to us. Many of our patients have osteopenia and osteoporosis and we use modified techniques to treat these patients safely and effectively, based on each individual patient’s initial assessment.
The modifiable risk factors of osteoporosis include exercise, weight (BMI), smoking, alcohol intake, diet and supplements. Guidance to maintain good bone health is as follows:
Aim to do weight bearing exercise such as: walking; jogging; weight training; climbing stairs; tennis, trampolining and dancing. These are useful as they help to stimulate bone formation. Swimming and cycling are less useful as they are non-weight bearing.
Tai Chi and yoga are helpful for improving balance, co-ordination and posture, as are fall prevention classes which you can be referred to.
Under 65 year olds should aim to do 30 minutes of moderate intensity exercise 5 days per week (including muscle building exercises 2 days per week). Low force dynamic weight bearing exercise such as Tai Chi is associated with reduced decline in bone mineral density in over 65 year olds.
Try to maintain a healthy body mass index (BMI) of over 20 kg/m2, as low BMI is associated with an increased risk of osteoporosis.
Do not smoke and limit alcohol intake to less than 2 units a day.
Try to consume a healthy balanced diet which contains adequate intake of dietary calcium and vitamin D. Daily calcium intake should be between 700mg and 1200mg, preferably from the diet, but supplemented if necessary. The Royal Osteoporosis Society offer a ‘Calcium Calculator’ and food chooser, which can be helpful in maximising dietary calcium.
Consider Vitamin D supplementation (whole population), at least during the winter months. For postmenopausal women and men over 50 who are at risk of osteoporotic fracture, a daily vitamin D supplement of 20µg (800 IU) is advised since it aids calcium absorption.
Limit coffee intake to 4 cups per day, as observational studies have shown an increased fracture risk with high intakes of coffee.
Vitamin A may have a negative effect on bone density, therefore avoid Vitamin A supplements and limit liver intake (once per week max).
References:
Diagnosis and management of osteoporosis. Dr Barbara Noble
Royal College of Chiropractors. Chiropractic Quality Standard: Osteoporosis
TMJ dysfunction (Jaw ache)
In the past few months Chris Young our physiotherapist has seen an increasing number of patients with TMJ dysfunction or jaw pain. Some patients are unable to eat a proper diet due to restriction in opening the mouth, this can be incredibly debilitating and have a significant affect on our emotional health as well as our nutritional status.
Other associated problems with this condition include psychological impacts like anxiety and low mood. TMJ issues can also cause symptoms are varied as tinnitus, dizziness, headaches amongst many others this makes it a difficult condition to diagnose.
Chris uses a Bio-Psycho-Social approach to the management of TMJ issues, this means he combines his hands on physiotherapy techniques with advice on lifestyle factors and exercises. Often Chris will co- manage with local dentistry practices, this is incredibly important as dental conditions can have a large impact on TMJ. Chris’ hands on approach utilises Active Release Therapy (a in depth muscle treatment protocol), Dry needling or acupuncture, as well as manipulative techniques. This combination often can give quick and lasting results when combined with the lifestyle advice.
If you have TMJ issues or jaw pain please ring and make an appointment today.
Evidence supports the use of manual therapy. A systematic review of randomised controlled trials shows that the average amount of sessions required is 9.5. Within four sessions we were able to get great outcomes. Exercise therapy assists with a better longer term outcome and is provided to our patients to maintain the benefits of the manual therapy offered in our clinic.
J Clin Med. 2020 Nov; 9(11): 3404.
Published online 2020 Oct 23. doi: 10.3390/jcm9113404
Front Oral Health. 2023; 4: 1170966.
Our esteemed colleague Claire Byrne is now fully qualified in both Yoga and Pilates. Claire has been providing one to one yoga sessions at North Down Chiro and Physio and has already helped rehabilitate many of our patients back to full activity levels.
Claire has recently undertaken an extensive course of training to expand her knowledge base and is now able to pull on both existing yoga theory as well as newly developed pilates knowledge.
Each body is unique and each persons story is individual, Claire is therefore able to both listen, understand and plan an appropriate approach to help guide you from pain to recovery or from stiff to flexible.
Claire is now trained in
Yoga Pilates Pre and Post Natal Seniors Injury rehab
Claire is available for one to ones Monday and Thursday
This blog post is taken from a guest lecture given by Stephen Mahwinny on 14th may 2024 to the hairdressing students at SERC college Bangor.
Hairdressing is an art that requires skill, creativity, and an eye for detail. However, behind the scenes of the is seemingly glamorous profession lies a significant physical toll on those who practice it. At the clinic, we encounter many hairdressers suffering from a variety of musculoskeletal issues. This blog aims to highlight the common sources of pain in hairdressing and provide actionable advice to help our patients manage and prevent these injuries
Physical demands of hairdressing.
Hairdressers often endure long hours on their feet, repetitive hand movements, and awkward postures, all of which can lead to chronic pain and injury. Key physical demands include:
1. Prolonged standing: Standing for extended periods can lead to lower back, leg and foot pain.
2. Repetitive movements: The continuous use of scissors, hairdryers, and other tools can cause repetitive strain injuries in the hands, wrists, and shoulders.
3. Awkward postures: Leaning over clients and holding arms in elevated positions can contribute to neck, shoulder, and upper back pain.
Common Injuries in Hairdressers
1. Carpal Tunnel Syndrome: Resulting from repetitive hand movements and prolonged gripping of tools
2. Tendonitis: Inflammation of the tendons in the wrists, elbows, and shoulders due to overuse.
3. Lower Back Pain: Caused by prolonged standing and improper bending techniques.
4. Neck and Shoulder Pain: Due to holding arms up for extended periods and the weight of hair styling tools.
5. Foot Problems: Including plantar fasciitis and varicose veins from long hours of standing.
Physiotherapy interventions
In the clinic, we play a crucial role in helping hairdressers manage pain and prevent injuries. Here are some key strategies.
1. Ergonomic Assessment: Conduct an ergonomic assessment of the patients workstation. Recommend adjustments such as raising the height of chairs.
2. Posture Correction: Educate patient on maintaining proper posture whilst working. Encourage them to keep their spine aligned and avoid leaning of hunching over clients.
3. Strengthening Exercises: Develop a tailored exercise program that focuses on strengthening the core, shoulders and back. Stronger muscles can better support the demands of the job.
4. Stretching Routine: Introduce a daily stretching routine to alleviate muscle tension and improve flexibility. Focus on stretches for wrists, shoulders, back and legs.
5. Manual Therapy: Utilise manual therapy techniques to relieve muscle tension and pain. Techniques such as myofascial release, deep tissue massage, and joint mobilisation can be beneficial.
6. Education on Proper Techniques: Teach patients about the importance of using proper techniques while cutting and styling hair.
7. Regular Breaks: Advise patients to take regular breaks throughout the day to rest and stretch. Short, frequent breaks can help prevent muscle fatigue.
8. Supportive Footwear: Recommend supportive, cushioned footwear and orthotics to reduce foot and lower back pain. Footwear with good arch and support and shock absorption can make a significant difference.
Conclusion
Conclusion
Hairdressers face physical challenges that can lead to chronic pain and injuries. At the clinic, we can make a substantial impact by providing targeted interventions, ergonomic advice, and ongoing support. By addressing the specific needs of hairdressers we help them continue their craft with reduced pain and improved quality of life. Ensuring they can thrive in their careers without compromising their health.
Hey guys, unfortunately due to the amount of new patient bookings cancelling within 24 hours we will now require a 50% deposit upon booking a new patient appointment.
If you cancel or try to reschedule within 24 hours of your appointment you will unfortunately lose your deposit, and will not be able to rebook until it is paid in full.
It is unfortunate that these measures are having to be put in place, but due to how busy we are it is causing disruption to therapists diaries and meaning those of our current patients are unable to book.
Thank you
💥SHOULD I CRACK MY OWN BACK?💥 Listen to my thoughts on cracking your own back/neck, is it dangerous? Does it help? Should I get my spouse to walk on my spine
CERVICO-GENIC HEADACHES
In todays blog we are going to talk about 1) what is a cervicogenic headache 2) where do they come from 3) what do they feel like 4) what are the treatment options.
WHAT IS A CERVICOGENIC HEADACHE?
A cervicogenic headache is a headache that arises from the neck, this quite ambiguous statement has made it hard to pin down in the research and thus cervicogenic headaches have had a hard time until more recently. The top suspects for these headaches are the top three vertebra in the neck, however the muscles, ligaments have also been implicated. These top three vertebrae converge on an area in the brain called the Trigeminocervical nucleus, this area also has input from the trigeminal nerve, and thus sensitisation can occur from corresponding areas.
WHERE DO THEY COME FROM?
Cervicogenic headaches seem to have no definite onset, however can arise from a number of different situations that put stress on the structures in the neck, such as whiplash, sports injury, certain postures. In my opinion the trauma in the neck produces dysafferentation of the proprioceptors around the facet joint, leading to poor sensimotor control inappropriate muscular contraction and neurological sensitisation, this hypothesis supports the authors positive experience in treating the issue with spinal manipulative therapy.
WHAT DO THEY FEEL LIKE? DO I HAVE ONE?
We often try to start piecing together the diagnostic clues for a cervicogenic headache in the case history, we are looking for a few idiosyncratic signs such as:
Pain is usually at the base of the skull, over the head and above the eye, and usually one sided
Pain is made worse by neck movements
There is often tenderness on the top three vertebrae
Headache is usually “Episodic” and chronic.
Usually non throbbing
Very occasionally can have sensitivity to light/sound, dizziness or nausea.
TREATMENT FOR CERVICOGENIC HEADACHES
Treatment for cervicogenic headaches is often multi-model, which means we use a number of different approaches in conjunction. We often use spinal manipulative therapy, mobilisations, soft tissue work, acupuncture and stretching as our first approach. This “hands on” care aims to reduce down symptoms and speed up the reported outcome measures. These hands on therapies have been found to be effective in the research.
We also employ therapeutic exercise, such as craniocervicoflexion exercises, shoulder strengthening amount other approaches. This is done to correct the weakness in the deep neck flexors that is often found, and seems to particularly help long term with symptoms.
For more information please see the great blog post here
✅ We are open for patients who are in pain, or who will be in pain if they do not attend for an appointment (please call us if you are unsure if you fall into this category)
✅ We are asking all patients: Arrive no more than 5 minutes early, wear a mask (or buy one at clinic) sanatise hands, confirm you social distancing throughout, do not attend with COVID symptoms.
✅ What we are doing : PPE for therapists, patient appointment spacing, full updated cleaning routines, telephone risk assessment and triage for each patient prior to appointments.
As Chiropractors we fall under the NI Governments “essential” workers under the Corona Virus Restrictions 2020 (section 2 schedule 3) so we never were asked to close by either the government or our regulating body (GCC). We did however take the decision close to protect you the patients and our staff.
Please if your unsure of any information:
1) Call our dedicated reception team on 02891859990 2) Message the page 3) Email info@www.northdownchiro.co.uk
Kind regards Team at NDCC
From the months of October to December we will be running a 30% reduction on prices for our one to one pilates therapy. Fiona McRoberts is a highly qualified Body Control Pilates Therapist with years of experience managing back pain and neck pain. The ability of having Fiona spend an hour for one on one classes is especially relevant for those of our patients (and others) who suffer with back pain were classes may not be appropriate
In a class situation there is often 6-20 people present, all doing the same (or thereabouts exercises) this is fantastic if you are pain free and confident in your back, but what if you are just coming back from a episode of severe pain? or maybe you have chronic pain? We think this is where one to one Pilates comes to the forefront. Fiona will help guide you through a progressive rehabilitation program to get you from back pain back into a class situation. Fiona will also work alongside your chiropractor to prescribe the correct exercises for your condition, this is another huge benefit of having onsite Pilates!
A course of 10 sessions was £380 and is now £266 A course of 5 sessions was £200 and is now £140 A single session was £45 and is now £31.50
Please either speak to your chiropractor or give the clinic a call on 02891859990 for further information
