Tag: Chiropractor Sioux City

Does The Pop During A Chiropractic Adjustment Matter?

There are many different types of chiropractic adjustment styles. Examples include manual hands-on, flexion-distraction, drop tables, and instrument-assisted. While some adjustments produce an audible “pop” or “crack,” others do not.

Have you ever wondered about the significance of the “popping” sound that often accompanies chiropractic adjustments? Several research studies have explored the distinction between adjustments that produce a cracking sound and those that don’t. The findings reveal that the popping sound itself holds no bearing on the outcomes of the adjustment. Whether an adjustment produces a pop or not, there is no difference in terms of immediate, short-term, or long-term pain relief. Furthermore, improvements in disability and range of motion were found to be consistent across different types of adjustments. The table below summarizes the research studies.

Research Shows No Significant Difference Between Adjustments That Produce a Pop and Those That Don’t.

Different forms of adjusting did not lead to different outcomes in older low back pain patients. 1
No differences in pain or disability between groups were found for thrust manipulation versus non-thrust.2
There is no relationship between the number of audible pops during thoracic spine thrust manipulation and improvements in pain, disability, or range of motion. Additionally, a greater number of audible pops experienced was not associated with a dramatic improvement. 3
A perceived audible pop may not relate to improved outcomes for patients with low back pain at either an immediate or longer-term follow-up. 4
There is no relationship between an audible pop and improvement in range of motion, pain, or disability in individuals with low back pain. Additionally, the occurrence of a pop did not improve the odds of a dramatic improvement. 5
Currently there is little scientific evidence to support any therapeutic benefit derived from the audible pop and in fact, it appears the available evidence tends to refute many of the alleged beneficial effects. 6

It’s worth noting that the characteristic “popping” sound isn’t the result of joints snapping back into place. Rather, the sound originates from the rapid release of healthy gases within the joint during certain types of manual hands-on adjustments. However, there are chiropractic techniques designed to restore joint motion without generating a popping sound. Examples include flexion-distraction, drop tables, and instrument-assisted approaches. I have always used low-force adjustments because they are easy on me and the patient.

Exploring the Benefits of Low-Force Adjustments


1. Gentleness and Reduced Pain: One of the key advantages of low-force adjustments is their gentle nature, often resulting in less discomfort compared to more forceful techniques. The reduced intensity makes them a viable option for individuals who might be hesitant to undergo traditional manual adjustments.

2. Tolerated Well By All Ages: Some people can not tolerate the force used in manual adjustments. As we age the spine becomes arthritic which can make cracking style adjustments uncomfortable.

3. Precision and Consistency: Instruments used in low-force adjustments offer a consistent thrust and speed with each application. In contrast, chiropractors performing manual adjustments may experience fatigue throughout the day, affecting the precision of their adjustments. Low-force methods help maintain uniformity and accuracy.

4. Enhanced Patient Relaxation: Some individuals find it challenging to relax during the cracking style neck adjustments that involve twisting of their head. Low-force techniques, such as flexion-distraction, drop tables, and instruments, eliminate this concern. Most of these methods do not require neck twisting, promoting a more relaxed and comfortable experience for patients.

The world of chiropractic adjustments encompasses diverse styles, yet all aim to restore proper joint function and reduce pain and disability. The audible popping sound during adjustments is not an indicator of success, as studies show that both popping and non-popping adjustments yield similar outcomes. Low-force techniques, on the other hand, present a range of benefits including reduced pain, suitability for various patients, and enhanced precision.

  • 1. A randomized controlled trial comparing 2 types of spinal manipulation and minimal conservative medical care for adults 55 years and older with subacute or chronic low back pain. J Manipulative Physiol Ther. 2009 Jun;32(5):330-43. doi: 10.1016/j.jmpt.2009.04.012.
  • 2. No Differences in Outcomes in People with Low Back Pain Who Met the Clinical Prediction Rule for Lumbar Spine Manipulation When a Pragmatic Non-thrust Manipulation Was Used as the Comparator. Physiother Can. 2014 Fall;66(4):359-66. doi: 10.3138/ptc.2013-49.
  • 3. The audible pop from thoracic spine thrust manipulation and its relation to short-term outcomes in patients with neck pain. J Man Manip Ther. 2007;15(3):143-54.
  • 4. The audible pop from high-velocity thrust manipulation and outcome in individuals with low back pain. J Manipulative Physiol Ther. 2006 Jan;29(1):40-5
  • 5. The audible pop is not necessary for successful spinal high-velocity thrust manipulation in individuals with low back pain. Arch Phys Med Rehabil. 2003 Jul;84(7):1057-60.
  • 6. THE THERAPEUTIC BENEFIT OF THE AUDIBLE RELEASE ASSOCIATED WITH SPINAL MANIPULATIVE THERAPY. A Critical Review of the Literature. Australas Chiropr Osteopathy.1998 Jul; 7(2): 80–85.
  • 7. Chiroup

Lower Back Pain During Pregnancy

Low back pain is common during pregnancy. Researchers estimate that between 45-80% of pregnant women will experience low back pain at some stage of their pregnancy.1-8 The pain may be mild for some and not require treatment. For others, the low back pain can be so severe that it interferes with daily activities and work. Although pain is usually experienced sometime between the fifth and seventh month of pregnancy, it can begin as soon as eight to twelve weeks after becoming pregnant.9

Pregnancy-related back pain is usually due to a combination of functional stressors such as weight gain, postural changes, altered walking patterns, and hormone changes that cause ligamentous laxity. As the baby develops, a woman’s center of gravity changes. The abdomen and pelvis shift forward to accommodate for the growth of the baby. This causes the lumbar curve in the lower back to increase which puts increased strain on the joints of the low back and pelvis. This can also cause alterations to balance and walking patterns.10 These postural changes may lead to increased pain, muscle tightness, tenderness, and discomfort.9

Some women can experience low back and pelvic region pain the year after birth, and even up to three years after labor and delivery.11-12 Pregnancy-related low back and pelvic pain, as well as post-partum spinal disorders, are not only common, but they can impede recovery, nursing, and caregiving.5

Symptoms of pregnancy-related low back pain are usually located in the lower back, pelvis, or hips, but may radiate into the buttocks or back of the thigh. Symptoms are often aggravated by activity, including standing, sitting, coughing, sneezing, and straining during a bowel movement. Symptoms often increase throughout the day. Many women also have pain at night that disturbs sleep.

Pregnancy can be a challenging time to deal with pain as most women do not want to take pain medications for fear of harm to the baby. Pregnancy is a time when safe non-drug options are needed.

Chiropractic is a safe and effective non-drug option for the treatment of pregnancy-related low back pain. The goal of chiropractic care is to restore normal joint motion and reduce muscle tension. Spinal manipulation (adjustments) is an important component in the management of pregnancy-related low back pain. Almost 75% of women undergoing chiropractic manipulation report significant pain reduction and clinically significant improvements in disability.14-15 Postpartum low back pain also responds to spinal manipulation- approximately 10 times greater than watchful waiting.16 Treatment can improve functional activities such as standing, walking, sitting, and sleep.

Low force chiropractic adjustments work well for pregnant women. Hormone changes during pregnancy create a looseness in the ligaments so very little force is needed to adjust the pelvis and lower back. Tables with drop away abdominal pieces accommodate the growing abdomen so pregnant women can still lie down on the treatment tables.

Chiropractic table with the abdominal piece lowered. This allows pregnant patients to lie face down comfortably.

Other common treatments for pregnancy-related low back pain include exercise, education, acupuncture, and pelvic belts. Maintaining optimal function and reducing pain levels are goals that should be discussed with a doctor of chiropractic as well as an OBGYN when it comes to pregnancy-related pain.9 A detailed history and clinical examination are essential for determining what biomechanical source is causing a pregnant woman’s low back or pelvic pain.13

Low back pain and pelvic pain do not have to be an inevitable part of pregnancy. If you are one of the 45-80% of pregnant women experiencing pain during your pregnancy, there are options for treatment available to help make your pregnancy more comfortable.

Sean Flynn, DC
Sioux City, IA Chiropractor

1.Wu WH, Meijer OG, Uegaki K, Mens JM, Van Dieen JH, Wuisman PI, Östgaard HC. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal. 2004 Nov 1;13(7):575-89.

2.Pierce HM. Pregnancy-related low back and pelvic girdle pain: listening to Australian women (Doctoral dissertation).

3. Diakow P.R.P., Gadsby T.A., Gadsby J.B., Gleddie J.G., Leprich D.J., Scales A.M. Back pain during pregnancy and labor. J Manipulative Physiol Ther. 1991;14(2):116–118.

4. Berg GÖ, Hammar M, Möller-Nielsen JE, Lindén UL, Thorblad J. Low back pain during pregnancy. Obstetrics and gynecology. 1988 Jan;71(1):71-5.

5. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine. 2005 Apr 15;30(8):983-91.6.

6. Weis CA, Barrett J, Tavares P, Draper C, Ngo K, Leung J, Huynh T, Landsman V. Prevalence of low Back pain, pelvic girdle pain, and combination pain in a pregnant Ontario population. Journal of Obstetrics and Gynaecology Canada. 2018 Aug 1;40(8):1038-43.7.

7. Saxena AK, Chilkoti GT, Singh A, Yadav G. Pregnancy-induced low back pain in Indian women: Prevalence, risk factors, and correlation with serum calcium levels. Anesthesia, essays and researches. 2019 Apr;13(2):395.

8. Weis CA, Barrett J, Tavares P, Draper C, Ngo K, Leung J, Huynh T, Landsman V. Prevalence of low Back pain, pelvic girdle pain, and combination pain in a pregnant Ontario population. Journal of Obstetrics and Gynaecology Canada. 2018 Aug 1;40(8):1038-43.

9. Montgomery, S.P. “Management of back pain during pregnancy.” (2009). Retrieved March 2020 from: https://www.spine-health.com/conditions/pregnancy-and-back-pain/management-back-pain-pregnancy

10. Verstraete, V.H., Vanderstraeten, G., and Parewijck, W. (2013). Pelvic Girdle Pain during or after pregnancy: a review of recent evidence and a clinical care path proposal. Facts Views Vis Obgyn. 2013; 5(1): 33–43.

11. Yoo, H., Shin, D., and Song, M. (2015). Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women. J Phys Ther Sci. 2015 Jan; 27(1): 279–284.

12. Maiers, M., et al. (2018). Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap. 2018; 26: 26.

13. Katonis, P., et al. (2011). Pregnancy-related low back pain. Hippokratia. Jul-Sep; 15(3): 205–210.

14. Shaw G. When to adjust: chiropractic and pregnancy. J Am Chiropr Assoc. 2003;40(11):8-16.

15. Murphy DR, Hurwitz EL, McGovern EE. Outcome of pregnancy-related lumbopelvic pain treated according to a diagnosis-based decision rule: a prospective observational cohort study. Journal of Manipulative and Physiological Therapeutics. 2009 Oct 1;32(8):616-24.

16. Schwerla F, Rother K, Rother D, Ruetz M, Resch KL. Osteopathic manipulative therapy in women with postpartum low back pain and disability: a pragmatic randomized controlled trial. J Am Osteopath Assoc. 2015 Jul 1;115(7):416-25.

17. Chiroup

18. Chiropractic Success Academy

Text Neck

Text neck is not an actual medical diagnosis. It is a term coined to describe the symptoms associated with the overuse of technology such as cell phones. The typical text neck position is when you have your head forward and bent down while you are looking down at your phone. It can become a problem when you hold this position for hours at a time.

Looking down at your phone for hours at a time can dramatically increase the stress on your neck, upper back, and shoulders. The average head weighs about 12 pounds. Flexing the head forward to use a smartphone directly affects the spine. Tilting the head forward to 15 degrees places about 27 pounds of force on the neck. This increases to 40 pounds at 30 degrees, 49 pounds at 45 degrees, and 60 pounds at 60 degrees. Text neck can occur with the use of a desktop or laptop computer as well. If the monitor is not at the proper height it can cause you to hunch forward when using the computer. Damage caused by untreated text neck can be similar to occupational overuse syndrome or repetitive stress/strain injury.1

Text-neck

Typical symptoms associated with text neck include:

-Neck pain
-Headaches
-Upper back pain
-Shoulder pain
-Numbness/tingling in arms or hands
-Muscle aches and tension

Using proper posture while using your electronic device will go a long way towards reducing text neck pain. When using a phone or tablet bring the screen up to eye level rather than bending your neck down to look at the device. For more information on the proper setup for laptops and desktops see this previous blog post: http://flynndc.com/blog/index.php/2020/03/15/avoid-computer-pain-when-working-at-home/

Remember to take frequent breaks. The body was designed to move frequently. Even if you use proper posture you can still get pain if you hold one position for too long, so get up and move around.

Chiropractic adjustments can free up common text neck joint restrictions that can occur in the neck, upper back, and shoulders.

Stretching can help with muscle tension. The following stretches may help relieve text neck pain. These are for educational purposes only and can not replace the diagnosis from a licensed healthcare provider. Stop immediately if they cause an increase in symptoms.

Trapezius

Levator Scapulae 

Shoulder Rolls

Chest Stretch

Sean Flynn, DC
Sioux City, IA Chiropractor

1. https://www.physio-pedia.com/Text_Neck#cite_note-:0-1

2. Infographic from Chiroup

Low Back Pain Myths And Facts

Low back pain (LBP) is the leading cause of disability worldwide. It is important to remember low back pain can be a normal experience in life. About 80% of Americans will have low back pain at some point in their lives.

“Unhelpful beliefs about LBP are associated with greater levels of pain, disability, missed work, medication use and healthcare seeking. Unhelpful beliefs are common in people with and without LBP, and can be reinforced by the media, industry groups and well-meaning clinicians.1” How many of these myths do you believe? How many of the facts do you believe? Belief in the facts will help you recover and function better. Sometimes it is hard to give up the belief in the myths. I admit there was a time I used to believe myths 6,7, and 8.

Low-Back-Pain-Myths-And-Facts

The Facts

Low back pain is almost always due to non-threatening causes. Low back pain is rarely an emergency. It is an emergency when there is a loss of bowel or bladder control, worsening weakness or numbness in legs, inner thigh, groin, or buttocks, sudden or gradually paralysis/difficulty walking, or occurring with a fever. 

Most episodes of LBP tend to improve and it does not get worse as we age.

Think your LBP is caused by tissue damage? Think again. Believing “you will have to live with it” because your back is damaged and avoiding activity because you don’t want to make it worse, actually causes more pain than tissue damage.

People tend to place too much importance on x-rays and MRIs. They can show you what the spine looks like. They cannot determine the prognosis of your current episode of back pain or tell you the likelihood of future episodes of low back pain. They have not been shown to improve LBP treatment outcomes. They are a tool that works best when combined with a proper exam and history. It is well known that people without any history of LBP will have degenerative, bulging, or herniated discs on MRI.

Pain with movement is not a warning sign that you need to stop. This is one of the most common and harmful myths that I see. It’s very common in people with chronic pain. They fear exercise will make the pain worse, so they avoid all exercise, which unfortunately leads to more pain in the long run. Avoiding exercise leads to deconditioning, weakness, and stiffness. Movement and exercise are key components in helping low back pain.

People are always looking to improve their posture to prevent pain. They should be focused more on consistently changing their position. Any position held for too long can cause pain, even positions with perfect posture. The body was designed to move, not sit or stand in the same position for hours at a time.

People with a strong core can have back pain. While it is good if you have strong core muscles. It is also helpful to relax them when they aren’t needed.

Bending, lifting, and carrying can be safe when you start off slow and gradually increase weight and time as you adapt. Injuries occur when we do too much too fast after doing too little for too long.

Pain flare-ups are not fun, but they are normal. They are not sign of tissue damage. They can occur when doing a new activity that you aren’t used to or when doing a repetitive activity when your body is fatigued.

Effective care for back pain includes such things as engaging in physical activity and exercise, social activities, healthy sleep habits, healthy body weight, and remaining in employment.  

If you suffer from low back pain, stay positive, stay active, and seek safe and affordable non-drug options including chiropractic. Chiropractic care is a safe and effective way to treat back pain.

Sean Flynn, DC
Sioux City, IA Chiropractor

  1. https://bjsm.bmj.com/content/early/2019/12/31/bjsports-2019-101611.abstract#article-bottom
  2. Chiroup

Avoid Computer Pain When Working At Home.

Thanks to improved remote working technology and 24/7 connectivity, employee demand for flexibility, and cost-savings opportunities, 60 percent of companies offer to telecommute, working remotely from home on an occasional or regular basis, according to the latest benefits survey from the Society for Human Resource Management. American employees are taking advantage.

Two decades ago, only 20 percent of companies offered it. A 2016 report from the Bureau of Labor Statistics showed that more employees are working from home than ever before.

In a Gallup poll released earlier this year, 43 percent of Americans said they spent at least some time working remotely. Combine this with the increase of entrepreneurs and people that run an online business out of their home; it seems this trend will only continue to grow.

Working from the comforts of your home is not always best for your joints and muscles. While some who work from home have a separate home office with a desk, desktop computer, and comfortable chair, many do not. A more typical setup up is the person slouched over a laptop on their couch or at the kitchen table. Some people even use their laptop while lying in bed. Improper laptop use can lead to various musculoskeletal issues.

The most important tip when working from home is to have a designated workstation with a comfortable office chair. While this would preferably be a height adjustable desk, not everyone has space or budget to have a freestanding desk in their home. If that is the case, then set up your workstation on a stable flat surface such as a kitchen/dining table or a countertop.

Your chair should be adjustable so you can get the proper body positioning and height when sitting, especially if you’re using a surface that is not height adjustable.

If you have a desktop computer at home, the top of the monitor screen should be at eye level.  It should be placed at least 20 inches from your eyes or about arms length away.  If you have armrests on you chair it will help decrease neck and upper back strain.  You arms should be close to your body and elbows bent at a 90 degree angle.  Your wrist should be in line with your forearms when typing and the mouse should be close by the keyboard.  If you have to reach for the keyboard or mouse it increases strain. 

Fewer people have desktop computers outside of their office as laptop computers have become more popular for their portability. Unfortunately, certain ergonomic features are compromised for the sake of portability. Keyboard spacing, screen size and positioning, and mouse touch pads are all poorly designed when it comes to laptop computers. Furthermore, it is nearly impossible to have good posture when using a keyboard fixed to the laptop.

Computer vector created by freepik – www.freepik.com

With laptops the keyboard and monitor are attached to each other, so you can not have the keyboard at the proper height for your arms and have the screen at the proper height for your eyes at the same time.

If you have to look down at the screen all day it can lead to neck, upper back, and shoulder pain and produce a rounded hunched posture. Remember, the screen should be at a level that your eyes are in line with the top portion of the monitor while maintaining proper posture. As laptops tend towards smaller and smaller devices, the keyboard gets smaller and is not ideal for typing, and can place strain on the hands, wrists, and forearms.

If you put the laptop in a position where the screen is at a proper height it then forces you to reach for the keyboard to type. This again causes the rounded sitting posture and puts excessive stress on the shoulders, upper body and neck.

Despite the poor ergonomics inherent to laptops, there are certain steps you can take to improve your ergonomics when using a laptop.

  • You can get an inexpensive full sized wireless keyboard and mouse for your laptop.
  • Place a stand underneath the laptop so that the screen is at the optimal height that aligns with your eyes.
  • There are affordable stand up desk converters that you can place on top of your desk or table to make it into a standing desk. This is perfect for laptop users as you can easily go from seated to standing. 
  • Take a break every hour. Get up and move around.

Creating a better ergonomic home environment is easy if you follow the steps we have outlined above. Doing so will help improve productivity and the quality of your work, but will also help prevent stress and injury.

Sean Flynn, DC
Sioux City, IA Chiropractor

Resources

Sciatica

Sciatica is pain down the back of the leg that follows the path of the sciatic nerve, the largest nerve in the body.  The pain can occur with or without lower back pain and may travel from the buttock, down the back of the thigh and calf, and into the foot.  

Symptoms can be mild to severe and may include aching, burning, sharp, shooting, or dull pain, numbness or tingling.  With increasing compression, people may have a loss of sensation or muscle strength.  You may notice an increase of pain while coughing, sneezing, straining, and sitting. Symptoms can occur suddenly or gradually over time.

Sciatica is caused by irritation or compression of the sciatic nerve. Common causes include herniated or bulging discs, degenerative discs, stenosis, piriformis syndrome, or spondylolisthesis.

Sciatica can be extremely painful and worrisome, but it is also treatable. Very few cases will require surgery. It can respond well to conservative treatments like chiropractic. In this office, I use a special adjustment, Cox Flexion Distraction, that lowers disc pressure and creates space for the irritated nerves. It has been shown to be more effective than an exercise program for relieving leg pain.1

An at home exercise that can help is nerve flossing. Irritated nerves are more sensitive to pressure and are wider than normal nerves due to swelling. This sciatic nerve flossing technique can help decrease pain and improve the mobility of the sciatic nerve. Flossing may release adhesions along the path of the nerve.

Do the flossing on the painful side. Do 10 repetitions or about 30 seconds. Start with your chin tucked to your chest and knee flexed. Then look up to the ceiling as you extend your leg. Then return to the starting position. The movements are the same for the side lying position. You may feel a stretch but you should not feel an increase in pain. Stop immediately if this causes an increase in your symptoms. If your sciatic nerve is very irritated, you may have to wait for the irritation to lessen before attempting this move.

Call the office if you need help and you are tired of letting sciatica stop you from doing the things you want to do.

Sean Flynn, DC
Sioux City, IA Chiropractor

  1. https://www.ncbi.nlm.nih.gov/pubmed/16341712

Lumbar Stenosis

Lumbar Spinal Stenosis Sioux City Chiropractor

Lumbar stenosis is the narrowing of the spinal canal in your lower back.  The narrowing can put pressure on the spinal cord and nerves.  It most commonly occurs in those over the age of 50.  It can be caused by wear and tear, injuries, and age-related changes such as degenerative discs, ligamentous thickening, or spinal arthritis. 

Symptoms can include chronic lower back pain that may radiate into the buttocks or legs.  Numbness, burning, fatigue, weakness, and heaviness may occur in the legs.  Symptoms are aggravated by standing and walking. 

Sitting or bending forward when standing decreases the pain.  Many will find leaning forward on a shopping cart decreases the pain and allows them to walk longer in stores. Those with stenosis may find sleeping on their sides in the fetal position is more comfortable than sleeping on their back. 

Surgery has not been shown to be significantly better than non-surgical treatments, so it is best to try conservative methods such as chiropractic first. Chiropractic treatment goals include restoring mobility, improving function, and decompressing nerves.  Forceful adjustments may increases symptoms for those with stenosis so it is important to use gentle adjustments.  Flexion-distraction is a low force adjustment that has been proven to increase the area in the spinal canal during adjustments, which takes the pressure off the nerves.  

A study comparing the effectiveness of nonsurgical treatment methods in patients with lumbar spinal stenosis looked at 3 nonsurgical interventions. Medical care consisted of medications and/or epidural injections provided by a physiatrist. Group exercise classes were supervised by fitness instructors in senior community centers. Manual therapy/individualized exercise consisted of spinal mobilization, stretches, and strength training provided by chiropractors and physical therapists. The care provided by the chiropractors and physical therapists resulted in greater short-term improvement in symptoms and physical function and walking capacity than medical care or group exercise.1

In addition to in-office care it is also important to do at-home exercises. Water aerobics and exercise bikes are tolerable for those with stenosis. The following stretches can help provide relief for lumbar stenosis. It is best to consult your doctor before beginning any exercise routine. Stop immediately if the stretch causes an increase in your symptoms.

Knee To Chest Stretch Sioux City Chiropractor
Seated Lumbar Flexion Sioux City Chiropractor
Sciatic Nerve Floss. Seated and Side Lying.
Cat Camel Stretch

This article is for education purposes and is not intended to replace diagnosis or treatment by a healthcare provider.

Sean Flynn, DC
Sioux City, IA Chiropractor

  1. https://www.ncbi.nlm.nih.gov/pubmed/30646197