A new patient came into my office following a fall in which he landed on his outstretched arm.  He was unable to lift his arm without pain as a result.  Even more concerning was that he was having visible difficulty performing the movement at all.  I suspected he might have a little more than pain.

A good sports chiropractor should be able evaluate a shoulder or arm injury comprehensively.  This includes conditions that chiropractors don’t treat–like tears–so that they can refer the patient out to the appropriate health professional.  I suspected that the gentleman who came to see me might have a rotator cuff tear.  My suspicions came from his symptoms as well as my exam findings, most notably, his inability to lift his arm.

So what can a sports chiropractor do for a patient with a muscle tear?  The first thing I did was recommend an MRI so that we can see if in fact a tear was present.  An MRI is necessary since it shows soft tissue, like muscles, tendons, and ligaments.  An x-ray is good for visualizing bone and joint spaces and such; but to visualize a tear, an MRI is necessary.

In this case the patient was reluctant to get an MRI, as he claimed to be claustrophobic.  He also staed that cost was a concern, of which I am thoroughly sensitive to.  So he asked if there was anything else we could do.  He wanted to know if there was any way that the muscle might not be torn.

“Absolutely,” I said.  What we can do is treat it like a sprain for one week and reevaluate.  He’d need to immobilize the area, ice it several times a day to break the inflammation, refrain from exercise (he is a professional dancer and a artistic painter), and he’d need to see me within one week.  I let him know that the only way to know unequivocally if there is a tear would be to get an MRI; and if for any reason, he hasn’t healed to within a particular parameter that would be to my discretion, he’d need to get an MRI, no questions asked.  He agreed.

So now we wait.  Once the week is up and the patient returns, I will reevaluate him.  Active range of motion to the shoulder must return–that means he has to be able to lift his arm significantly more than he did when he first came in.  Does it have to be totally pain free?  No, but he does need to be able to do it on his own.  If there is a significant tear, he will not be able to do it.  If this is the case and the MRI shows a tear, then we have to evaluate the degree of tear.  Some tears need an orthopedic consult and possibly surgery.

Here’s the bottom line: If you have an injury to any part of the musculoslkeletal system, especially one where you are in intense pain and/or can’t move the body part, you need to see a doctor.  You can see an orthopedist, or you can see a sports chiropractor.  If you live in Los Angeles, Beverly Hills, or West Hollywood, then you can call my sports chiropractic office.  If you need an orthopedist–I have several that I send my patients to and will likely send you there if conservative care cannot help you.  Otherwise, you can find a sports chiropractor near you here; and I’m certain that every one of them will have an orthopedic office for you if necessary.

Nothing quite compares to the pain caused by a subluxated coccyx–nothing.  The coccyx is the very end point of the spine–it’s the rudimentary tail of human beings.  As the human mammal evolved, its tail shortened to the length of the tiny coccyx.  The coccyx, a spinal bone, has a joint between itself and the sacrum (the true tail bone); and as a result it can subluxate.

When the coccyx gets stuck–that is when there is a coccygeal subluxation–it is very difficult to sit down.  The pain is sharp and stabbing and hurts right where the sun don’t…ehem…where you sit.  Being at the very tip of the spine, the coccyx has the tendency to move forward, not backward like the other vertebrae, and this attribute makes it difficult to adjust.

For some coccygeal subluxations, a good chiropractor can just move with a push from back to front right at the sacro-coccygeal joint.  But for some coccyx subluxations, they need to be pulled front to back.  I know, I know–sound gruesome, right?  And unfortunately, it takes a very special chiropractor to do this.  I’m not one of these chiropractors, but i do know a great place to find a phenomenal chiropractor in your area–it’s called Planet Chiropractic, and it’s my number one source for chiropractic referrals.

If you have pain anywhere in your spine or back, and especially if you have pain in you coccygeal area, please find a chiropractor that can help you.  If you do not have a chiropractor, or if you need a specialized one, please visit Planet Chiropractic for a chiropractor near you.

A young man–about 29–walked into my office this week with acute mid-back pain.  The pain was localzed to his left shoulder blade, just beneath it, and just next to the spine.  He was feeling it more diffusely though, and it felt as if it was his entire left mid and low back that was “on fire”.

I ask all incoming new patients what their goals are regarding their care at my office.  Essentially, I want to know what they are looking for.  This young man with mid-back pain wanted to know why he was having pain–what was the cause and what could he do to fix it.  Fair enough; it was apparent to me that the young man had two major problems going on: he had poor posture and he was very tight muscularly.  The first–postural problems–are directly related to the second.

So that at least answered his question as to what was the cause of pain, but why?  Well, his particular postural problem was an over-hunching upper and mid-back.  His shoulder are so rolled forward as to make him appear in a perpetual slouch.  This happens as a result of tight pectorals or chest muscles.  The concommitant weakness is in the back, at the lower trapezius muscles.  The trapezius is a large diamond-shaped muscle of the back.  Although it is one muscle, we classify it into three regions based on the actions of each part.  The upper traps shrug the shoulders, the middle traps pull the shoulders back, and the lower traps are what we call scapular stabilizers–that is, they hold the shoulder blades down during overhead arm movements.

When the lower trapezius muscles get weak they lead to shrugging shoulders.  And if the pecs are also tight…hunched forward look.  What makes this scenario even worse is that both the pec tightness and lower trap weakness can create stress on the spinal bones of the mid-back, which can lock-up or subluxate.

So the answer for this young man and anybody else in this same situation is the following: Chiropractic adjustment to correct subluxations, myofascial release (massage) to relax the tight muscles along the spine, stretch the tight pectorals and upper traps, and exercises to strengthen the weakened lower traps.  Simple.

I have been treating a young man in my office for sciatica.  He came into my office limping–unable to step down onto his right leg.  Walking hurt, sitting hurt, and moving from one side to another while lying down sent pain shocks down into his leg making it spasm.  The only relieving position for the poor guy was lying flat on his back and being still.

Nothing can stop you dead in your tracks faster than sciatica.  Sciatica is an infalmmation of the sciatic nerve–the large, thick nerve running down the back of the leg.  The sciatic nerve innervates (controls) the legs from the buttocks to the thighs to the calf and foot.  When it gets inflamed, it causes an excruciating pain down the leg and makes any type of movement unbearable.  Basically, people suffering from sciatica need to sit or lie down.  The unfortunate thing is that even sitting can be unbearable with sciatica.

Sciatic pain is often described as “hot burning water being poured down the back of my leg.”  It is sharp and electrical in nature.  Sciatica originates either at the lumbar spine through a herniated disk pushing up against the nerve root, or at the buttock where the piriformis muscle sits right on top of the nerve.

I’ve been treating my sciatic patient with chiropractic adjustments, ice, myofascial release and light stretching.  he’s getting better slowly but surely.  In one week, we’ve got him able to step down on his right leg and bear some weight.  He can sit for short periods and he’s been able to sleep a little bit.  We’ll keep working on him, and hopefully, he’ll be back on track within the next few weeks.

One of the most common conditions that people come into chiropractic offices with is dizziness.  Dizziness can have any number of causes including mechanical and vestibular ones among others.

Mechanical causes of dizziness include subluxation of the neck’s spinal joints, occipital (skull) subluxation, and spasms and/or hypertonicity (tightness) of the neck and upper back muscles.  These situations are best addressed by a chiropractor.

Vestibular causes of dizziness include inflammation of the nerves that innervate the inner ear, recent infection and sinus congestion, and otoliths, or quite literally, ear stones.  Another common cause of vestibular dizziness is benign paroxysmal positional vertigo (BPPV), which is thought to be due to the accumulation of debris in the inner ear.  These types of dizziness require additional care like habituation exercises and maneuvers to “move” the debris out of the sensitive parts of the ear.

A chiropractor will asses the situation, determine the cause and treat accordingly.  If you are having symptoms of dizziness or lightheadedness, with or without nausea, contact your local chiropractor.  If you live in Los Angeles, Beverly Hills or West Hollywood and you need a chiropractic office in which to be evaluated, contact my office.