https://www.sciencedirect.com/science/article/abs/pii/S0003999313010605
I recall hearing this statistic at a conference a few months ago. It sobered me but did not surprise me. 1/4th of all motor vehicle accidents, even “minor” ones, is an awful lot of people walking around with some persistent mild head injury symptoms 12 months later. Chiropractic, nutrition, and some brain exercises, especially visual, is what it often takes to clear them up.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2517983/#:~:text=Overall%2C%2022.0%25%20(95%25,did%20not%20use%20a%20statin.
This blog came on the heels of several patients reporting a common problem in the same week: Intense persistent pain in their legs and quads from taking statin medications. The problem is well known, but often underreported by patients and not always recognized by the prescribing physician. Differential diagnosis of neuro-musculoskeletal pain can be challenging in the population most often taking statins. But in the context of our chiropractic practices, we always need to take statin side effect as a possible reason for persistent pain, especially in the lower extremity. This can mimic or compound pain from other areas (hip and knee arthritis, bursitis, lumbar nerve pinching) and limit how much a patient can recover.
The solution can be just as complex as isolating the problem. Patients needs to inform themselves on risk benefit ratios of any medications and non pharmacological approaches to improving abnormal lipid profile.
I had a couple of back to back cases of the same “mysterious” problem, always a sign for me that I will be writing a new blog.
In both instances the patient had pretty localized pain on the outside of the knee, and it both instances, the pain had been elusive to treat and diagnose. Imaging was normal for damage to the cartilage and meniscus on the outside of the knee, it was being treated as an iliotibial band problem and not responding.
The fibula is a long thin bone that attaches to the tibia just below the main join on the outside of the knee. The attachment on the upper part of the tibia is a small cartilage joint with very tight ligaments and very little movement. The attachment to the lower part of the leg at the ankle has a lot more movement. The lower part of the fibula makes up the lateral ankle bony prominence known as the lateral malleolus.
The upper fibular head can be misaligned like any other joint, but the problem almost always starts at the ankle, with an ankle inversion ( “rolling “ ) sprain, that creates a sudden upwards and lateral/anterior force to the upper joint. This would also explain why patients with fibular head dysfunction are always so dumbfounded about the origin of the pain as they do not recall any trauma to the knee, until someone asks them about a specific recent ankle sprain. The good news is that the pain usually responds really well to a few adjustments with no residual long term problems
I often get patients presenting to an appointment with a stack of medical records and imaging, stating that their problem is caused by spinal stenosis. It becomes very apparent to me that while those patients can correctly articulate the word stenosis, most are at a complete loss to describe really what it is, much less what it means clinically.
The word stenosis basically means “narrowing”. In the context of the spine, the term stenosis is used to describe the narrowing of a bony passage for important neurological structures. Lateral stenosis describes the narrowing of the passageway of the spinal nerves during their exit from the spinal cord into a limb, and central canal stenosis describes the narrowing of the conduit for the spinal cord behind the vertebra, prior to the point where it sends it to the spinal nerves.
Stenosis is often a degenerative anatomical constant, meaning it is an unchanging narrow space from narrowing of the spinal disc and other overgrowth of other spinal structures. Patients with stenosis however can have significant fluctuation of pain while the stenosis is constant. The explanation is that other, intermittent and modifiable factors will make it better or worse: spine/pelvis/leg alignment, posture shifting, and muscular core deconditioning. This explains why many patients with diagnosed stenosis on an MRI can still report quite a bit of relief from chiropractic care.
This photo does a pretty good job at illustrating a complex physics problem: your 10 lb head becomes much heavier with every degree of static neck flexion. The additional load will be distributed to the lower neck, upper midback, and shoulder ridge.
This is a common problem for modern humans as our technology has become smaller and more portable. This is even worse for patients who already have an existing postural tendency to anterior neck shifting (as is common with forward cervical sprains). Time will tell but the data is already looking worrisome for our youngsters who are failing to develop the appropriate neck curve because of how much time they spend looking down at their cell phones and tablets.
When using a smartphone, prop up the hand holding the phone over your crossed leg, and armrest, or anything that will hold the phone closer to eye level. Same applies to using a tablet. For laptops , set up the whole unit on a stand at eye level and use a blue tooth or USB connected keyboard that you can place at elbow level.
A video is worth a thousand words and this brief recording we did recently helps pregnant moms and all interested in the connection between chiropractic, the bony pelvis and the baby’s descent through the birth canal, get a better visual representation of that path.
https://www.youtube.com/watch?v=l5VUjIAloeY
I recall running into one of the first editions of this book during my last year of chiropractic training ( 29 years ago…) The resource library of the school satellite clinic had that among the many great patient resources that could be checked out, along with books on stretching and the first anti-inflammatory diet. Among us intern students, it was certainly a more popular read than some of the useful, dry material of the other books, and the fodder for much chuckle and smart talk. Most of us were still in our 20s, still a wee bit green in our real world clinical experience, and certainly able to athletically engage in our amorous pursuits ourselves - in other words, very ill equipped to field questions much less give useful answers to the patients who were not.
I recall frantically looking for “the Book” after my second month in practice in Cannon Falls. A lovely 80 year old gentleman limped his way into the office that week with a very nasty, hot sacroiliac sprain. Which, he candidly described, went out on him while he was “ being conjugal” (sic) with his wife of 57 years. His problem responded to care quickly, but just as quickly came the question of what he shouldn’t do and how he should not do it in order to avoid a reinjury, as his lady was apparently quite eager to pick up where they left off. In spite of my liberal European upbringing, I felt a bit under-resourced to properly advise him on the subject.
Sexual activity is no different than doing your job, your sports, cleaning your house, and doing your favorite hobby: if you have a significant spinal injury, or a more chronic degenerative issue, you have to know how to make some modifications to make it happen safely and comfortably, so that you continue to do what is important in your life rather than give up on it all together. This is not an uncommon subject that we have to broach in the office, and beyond the basics, I have found this book to be still very relevant and informative.
https://www.amazon.com/Sex-Back-Pain-Restoring-Comfortable/dp/1879864029/ref=sr_1_3?crid=3DXFL4XVDFNCJ&keywords=book+sex+and+back+pain&qid=1645760200&sprefix=book+sex+and+back+pain%2Caps%2C126&sr=8-3
Much like in the winter we tend to have a number of fall injuries associated with slips on the ice, in the spring we see an increase number of individuals with gardening or spring cleaning related discomforts. Check out the image below for some QUICK TIPS to reduce injury risk this spring during cleaning and gardening!
