by Dr. Chad Koterba | Nov 7, 2023 | Back Pain, Leg Pain
When you think about lower back pain (LBP), you might envision someone hunched over, clutching their lower back. We have all experienced back pain at some point, and we can probably recall how it limited our movements during the acute phase of our last back pain episode. However, when lower back pain comes with different symptoms, like tingling or shooting pain down one leg, it can be both perplexing and concerning. Let’s take a closer look at the anatomy of the low back to better understand where these symptoms come from.
In the front of the spine, closer to the inside of your body, you’ll find the large vertebral bodies and shock-absorbing disks that support about 80% of your weight. Toward the back of each vertebra, there are the spinous and transverse processes that connect to the muscles and ligaments in your back. Between the vertebral body and these processes are tiny bony pieces called the pedicles. The length of these pedicles partially determines the size of the openings through which the nerves exit the spine.
When the pedicles are short (often due to genetic factors), the exiting nerves can get compressed due to the narrowed openings. This is known as foraminal spinal stenosis. This compression usually occurs later in life, especially when osteoarthritis and degenerative disk disease further crowd these “foramen” where the nerves exit the spine.
Similarly, short pedicles can also narrow the “central canal” through which the spinal cord travels up and down the spine from the brain. Later in life, the combined effects of the narrow canal, along with disk bulging, osteoarthritic spurs, and ligament thickening or calcification, can result in “central spinal stenosis.” Symptoms related to spinal stenosis (whether foraminal or central) often involve difficulty walking, with a gradual increase in tingling, a heavy or crampy feeling, and sometimes aches or soreness in one or both legs. The tingling in the legs linked to spinal stenosis is referred to as “neurogenic claudication,” and it must be distinguished from “vascular claudication,” which feels similar but is caused by inadequate blood flow to the legs, rather than nerve issues.
In younger individuals, tingling in the legs can be caused by a bulging or herniated lumbar disk, or it may be referred pain from a joint, usually a facet or sacroiliac joint. The main difference in symptoms between nerve-related and joint-related leg tingling is that nerve pinching from a problematic disk is located in a specific area of the leg, such as the inside or outside of the foot.
In other words, the tingling can be traced fairly specifically in the leg. Tingling from a joint is often described as a deep, “inside the leg,” generalized achy-tingling that can affect the entire leg or foot or may stop at the knee, but it’s more challenging to pinpoint as it’s less specific in its location.
If these symptoms sound familiar, get in touch with us and we’ll help create the right treatment plan for you.
by Dr. Chad Koterba | Sep 5, 2023 | Back Pain, Exercise
It’s quite common for people dealing with low back pain to find themselves cutting back on their activities in an attempt to escape the discomfort. Unfortunately, this often leads to a gradual weakening of the core muscles—the ones that provide support to your midsection—because they aren’t being used regularly. This weakened core can actually increase the risk of further injuries.
So, the key to improving your low back pain situation effectively is to start by practicing core-strengthening exercises and maintaining gradually and as tolerable!
Think about doing one to three sets of ten repetitions each for simplicity, and always remember to release each exercise slowly—avoid abruptly returning from the end position of the exercise.
Abdominal Muscles
When we talk about the abdominal muscles, they can be broken down into four groups: the rectus abdominis (these connect your rib cage to your pelvic area, with fibers running straight up and down), the internal obliques (their fibers run down and inward, overlapping on the sides), the external obliques (fibers run down and out), and lastly, the transverse abdominis (with fibers running horizontally, attaching to the lower back’s fascia).
If we consider three levels of exercise difficulty, an easier approach (Level 1) to a sit-up could involve a “crunch” or simply lifting your head and shoulders off the floor. Stepping up the challenge (Level 2), you could bend your knees and hips at 90-degree angles while doing a sit-up. For a more demanding exercise (Level 3), try a double straight leg raise during the sit-up. The rectus abdominis benefits from straight up-and-down movement, while the obliques are worked through trunk twists. You can engage your core muscles, or perform an “abdominal brace,” in any position or activity during the day—it’s like bracing yourself for a stomach punch.
Lower Back
To bolster the muscles of your lower back extensors, there are several effective core-strengthening exercises to consider, including the “bird-dog” (starting on all fours) by extending the opposite arm and leg separately (Level 1), progressing to simultaneous movement and alternating sides (Level 2). At Level 3, you could extend hold times, trace a square with your hand and foot, or increase repetitions.
Another exercise to strengthen your lower back is the “Superman.” Lie on your stomach and start by lifting one arm and then the opposite leg separately (Level 1); then lift opposite limbs at the same time (Level 2); and finally, raise both arms and legs simultaneously (Level 3). Placing a cushion under your pelvis/abdomen can add comfort.
Side Muscles
To target the side muscles of the core, or lateral trunk stabilizers, try a side bridge or plank (lying on your side, propped up on your elbow and feet, hips lifted off the floor). Level 1 might involve a six-second hold from your knees, Level 2 a six-second hold from your feet, and Level 3 could be a twelve-second hold between your elbow/forearm and feet. You can modify this with slow repetitions of lowering your pelvis to the floor and back up. Don’t be afraid to mix things up!
There’s a multitude of other Core-Strengthening Exercises out there, but these should give you a good starting point!
Remember, always stay within your “reasonable pain boundaries” that you set, release each exercise slowly, and most importantly, enjoy the process!
Better yet, start these before you even start to have low back pain to help prevent it from happening.
by Dr. Chad Koterba | Aug 22, 2023 | Back Pain, Chiropractic
Oh, the woes of persistent pain! If you’re nodding your head in agreement, you’re not alone. Millions around the world grapple with this nagging condition that just won’t quit. Today, we will uncover the triggers behind chronic lower back pain.
Together, we’ll delve into the intricate design of the lower back and unravel the mysteries that shroud this discomfort. So, grab a seat (a comfy one!) and let’s dive in.
The Marvels of Your Back
The lower back—a remarkable structure designed to bear the weight of the world and protect your spinal cord. Picture five lumbar vertebrae, intervertebral discs as shock-absorbing heroes, and facet joints that bring flexibility to the party. And let’s not forget the sacrum, the lumbar spine’s loyal companion, joined at the hip—literally—at the sacroiliac joint (SIJ). It’s an intricate team working hard for your support and mobility.
The Culprits
Back pain can have various triggers. From herniated discs and spinal stenosis to osteoarthritis and SIJ dysfunction, the causes can range widely. Pinched nerves in the lumbar region might induce pain that radiates to the legs or cause numbness or tingling. Poor posture, spinal misalignment, and muscle strains can also instigate lower back pain.
How to Diagnose
To pinpoint the exact reason for your pain a chiropractor will conduct a comprehensive examination. Based on your symptoms and signs, they will perform tests assessing your back’s nerve and joint functionality. For instance, if a patient describes leg pain, the chiropractor will examine reflexes, sensation, and muscle strength to see if a herniated disc is pressing a nerve. Any identified nerve damage will be addressed to remove the pressure and restore leg sensation and strength.
Chiropractic Interventions
Chiropractic care is a proven, non-invasive method. Depending on the identified cause, a chiropractic doctor can use spinal adjustments, manual therapies, and rehabilitative exercises to realign the spine, restore function, and reduce pain. Chiropractic interventions can also enhance your posture and prevent future episodes.
Don’t allow back pain to dominate your life. Contact us today or schedule an appointment to uncover the root cause of your pain and discover effective strategies for lasting relief.
by Dr. Chad Koterba | Jul 25, 2023 | Back Pain, Nerve Pain
When someone mentions low back pain our minds often conjure up images of a person hunched over, clutching their achy back. We’ve all experienced lower back pain at some point, and we can relate to the struggles and limitations it brings during those acute episodes. But what happens when back pain comes with unexpected symptoms like tingling or shooting pain down the leg? It can be confusing and worrisome. Let’s take a lighthearted journey into the anatomy of the low back to unravel the origins of these mysterious symptoms.
Unveiling the Backstage of the Spine
Picture the front of the spine, where the heavy-duty vertebral bodies and shock-absorbing disks diligently carry 80% of our weight. Now, venture to the back, where the spinous and transverse processes connect to the muscles and ligaments. Ah, and there they are—the tiny boney pieces known as pedicles. These pedicles determine the size of the holes through which the nerves make their grand exit from the spine.
The Case of the Narrowed Nerve Exits
Sometimes, due to genetic factors, these pedicles can be short, leading to compressed nerves. Enter foraminal spinal stenosis, where the nerves find themselves in a pinch due to the narrowed openings. This usually occurs as we age and osteoarthritis and degenerative disk disease join the party, crowding these nerve exits called “foramen.” But wait, there’s more! Short pedicles can also narrow the “central canal” where the spinal cord takes its journey up and down the spine. As time goes by, a combination of factors like disk bulging, osteoarthritic spurs, and ligament thickening can create a spectacle known as “central spinal stenosis.” Cue the symptoms!
Symptom Adventures: Tingling Legs and Beyond
Now, let’s talk symptoms. With spinal stenosis (whether foraminal or central), you might experience difficulty walking as tingling sensations gradually increase. Those legs might feel heavy, crampy, achy, or sore—one or both legs can join the sensation party. We call this tingling in the legs “neurogenic claudication,” which we must differentiate from “vascular claudication” caused by poor blood flow. The plot thickens!
Younger Troublemakers: Disks and Joints
In our younger years, tingling legs can also be attributed to a mischievous bulging or herniated lumbar disk. It can even be a case of referred pain from a joint—usually a facet or sacroiliac joint. The key difference between nerve and joint tingling lies in the symptoms. Nerve pinching from a misbehaving disk manifests in a specific area of the leg, like the inside or outside of the foot. Meanwhile, joint-related tingling feels like a deep, generalized achy-tingling that can affect the whole leg or foot. It’s a bit trickier to pinpoint, but it’s all part of the adventure!
Chiropractic to the Rescue!
Amidst this exciting journey into the mysteries of low back pain, there’s good news. Chiropractic care offers a non-invasive, effective solution—a non-surgical, non-drug approach that aligns with lower back pain guidelines.
Have you been dealing with lower back pain, disk issues, or mischievous joints? Schedule a free consultation with me today and let’s work together on the solution that is best for you.
by Dr. Chad Koterba | May 2, 2023 | Back Pain
Have you been feeling like you’re carrying the weight of the world on your lower back? Does your back hurt so bad that you dread getting out of bed every morning? You’re not alone. Millions of people worldwide suffer from low back pain (LBP), and it can be downright debilitating.
Last month we discussed if getting an MRI was right for your lower back pain. But now let’s explore how chiropractic care can help you find relief and get back to living your best life.
First, let’s start by taking a closer look at the anatomy of the lower back. Your lower back is made up of five lumbar vertebrae that hold up the weight of your upper body and protect your spinal cord. It’s like the foundation of a house, and when it’s not working correctly, everything else can crumble. Between each vertebrae, you have these little cushiony disks that absorb pressure from your daily movements, and facet joints that allow for flexibility in movements like bending forward, backward, and sideways. The sacrum, which is at the base of the spine, is connected to the pelvis by the sacroiliac joint (SIJ).
So, what can go wrong in this complex system of bones and joints? A lot, actually. Lower back pain can be caused by herniated disks, spinal stenosis (narrowing), osteoarthritis, and SIJ dysfunction. Pinched nerves in the lower back can also cause weakness, radiating pain down the legs, numbness, or tingling sensations. Additionally, spinal misalignments, poor posture, and muscle strains can trigger low back pain. It’s like a game of Jenga – if one piece is off, the whole thing can come tumbling down. It is a system that all needs to work properly together, or dysfunction occurs.
If you’re suffering from lower back pain, a Chiropractor can help you find relief by conducting a thorough exam to identify the root cause of what is causing your pain. Once the problem is identified, the use of spinal adjustments, manual therapies, rehabilitative exercises, and addressing lifestyle changes will help to restore proper alignment and function of your spine and alleviate your pain. Many patients have decreased pain immediately after their care!
The best part? Chiropractic care is safe, non-invasive, and effective. You don’t have to resort to painkillers or surgery to find relief. And not only will it help alleviate your current pain, but it can also improve your posture and prevent future episodes of back pain. It’s like hitting the reset button on your lower back.
So, if you’re tired of living with lower back pain, don’t wait any longer. Book a Free Consultation today and let’s help you feel better quickly.
by Dr. Chad Koterba | Apr 4, 2023 | Back Pain
Hey there, fellow back pain sufferer!
It’s no secret that lower back pain can be, well, a real pain. And during these winter months there’s a good chance you’re less active than normal. And you’re not alone. Lower back pain is one of the top reasons people visit their doctor.
But have you ever considered getting an MRI scan of your back to help identify the problem and fix it? It’s a pretty common belief, but is it really the best idea?
Here’s my thoughts – There is a time and a place in care where an MRI might be needed. While an MRI can show detailed images of your spine and any abnormalities like disk degeneration, bulges, herniation, joint arthritis, and more, it can be tricky to determine which findings are actually causing your pain. It is only one piece of the puzzle to figuring out what is causing the problem.
Upon doing some research I saw a recent study that found patients who had an MRI earlier in their care for lower back pain had worse outcomes, more surgeries, and higher costs compared to those who didn’t have an MRI. Not good!
And get this: research shows that up to 64% of people have some type of disk problem without ever experiencing back pain. So even if an MRI shows a disk problem, it might not actually be the root cause of your lower back pain.
Don’t get me wrong, an MRI can be helpful if a surgical treatment decision depends on the findings or if you have weakness, numbness, or non-resolving lower back pain despite 4-6 weeks of non-surgical care. But generally, it’s unnecessary for most cases of lower back pain. In fact, it could even end up confusing you and your doctor.
So, before you go scheduling an MRI, make sure to talk to a healthcare professional (or trusted Chiropractor!) who can help determine the best course of action for your specific needs.
