How do I know if my low back pain is serious?

November 12, 2019



Believe it or not, this is not a common question.  Often, I find myself letting patients know the serious symptoms that may arise with a back injury so they are aware of what to look for.  I wonder sometimes if this scares people, but I know that in discussing this with patients they will be better prepared to recognize these symptoms and may not ignore the symptoms if and when they arise. 

One of the first signs or symptoms to look for is the presence of “saddle parathesia”.  This is numbness or tingling in the medial thighs, groin and/or around the anus.  Cauda equine syndrome, which causes saddle parathesia, occurs when there is damage to the nerves at the bottom of the spinal cord.  One example of injury to the cauda equine can come from a bad disc herniation and a piece of the disc breaks off. This  broken piece can float around the spinal canal making contact with several nerves which innervate the skin in this area.  The potential for this to become an even more serious problem is very high, particularly if the piece of the disc floats higher in the spinal canal.  For example, if this piece travels as high up as the brainstem there could be interference in several of the vital functions in the body including respiration and cardiovascular function.  

Another symptom that is considered an emergency would be change in  bowel or bladder control, either loss of control or incontinence.  This is a sign that there is damage that is affecting the neurological system.  Whether this is from swelling from a fractured vertebrae or a bad disc herniation, pressure on the nerves in the spinal canal can cause lack of control for either bowel or bladder movements. 

When disc injuries are progressing, one sign we continuously monitor is motor control or strength.  Are you dragging your feet when you walk?  Are you dropping objects with your hands?  Each nerve that exits the spine has a specific muscle designated to it so we can determine the level in the spine that is involved.  Some motor control issues that you can do on your own would be walking on your heels; making sure that your leg can hold your foot up the whole time not letting the foot drop.  You can also test toe walking by rising up onto your toes and taking a couple of steps.  The most common level for a disc herniation is L4/5 which would affect the L5 nerve root.  In this case, heel walking may show a deficit on one side or the other or both.  The most important thing to watch for with motor control is if it is progressively worsening. 

In the office, healthcare providers will be watching for the symptoms as mentioned above, but also they will check reflexes.  The reflexes that you are familiar with, hitting the reflex hammer over the patellar tendon for example, may change suddenly as injuries become worse.  The presence of some pathological reflexes (reflexes that are found that shouldn’t be present) may indicate upper motor neuron lesions which occur with damage to either the spinal cord or brain.  When these are present, it may not necessarily mean an emergency room visit, but likely a visit to your family doctor and/or a specialist like a neurologist for further assessment. 

Is there presence of shock like pain that shoots down your arms, legs or both with spinal movement?  When there is an injury to the spinal cord, all the nerves below the level of the injury will be affected, ie. if there is a fracture at the C4 vertebrae (in your neck) that causes swelling around the spinal cord, then everything below that level will be affected.  On examination, there will be numbness and tingling down both arms and legs that may get worse with cervical spine flexion.  With meningitis, an infection of the nervous system, movement of the neck will cause shock like pain that shoots down the spine and into the arms and legs.  Shooting pain needs to be assessed by a qualified healthcare provider. 

The last thing that needs to be considered is the patient’s medical history or recent changes in overall “well being”.  Is there a history of cancer?  Has there been any recent weight loss?   Is there on going treatment for another condition?  If there has been significant history of a pathology and now there is severe back pain, we need to confirm that the pathology is not the reason for the spine pain.  If there are any other symptoms happening as mentioned above, present to the nearest emergency department.  If not, your best option would be to try to see your family doctor or specialist that has been treating you for this other condition.   

Motor strength and reflexes should, at least, be assessed by your chiropractor or other health care provider during assessment and monitored throughout care. If testing results change for the worse, the injury is progressing and treatment may need to be changed or altered. 

If you are ever concerned and are not sure if you should go to the hospital, family doctor or chiropractor, please call us, 905-529-2911, to review your symptoms over the phone and we can guide you in determining your best route of care.  

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What causes low back pain?

November 12, 2019

There are several sources of low back pain. 

To understand the symptoms of low back pain, we must be aware of all the anatomical structures and how they contribute to the movement of the spine.  These sources can be grouped into our “mechanical” sources of low back pain (LBP). 
There are other sources of LBP that tend to be secondary to another condition that we will also briefly discuss.  We will refer to this second group as “non-mechanical” sources. 

Mechanical Sources of Low Bac...


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Delayed Onset Muscle Soreness (DOMS)

November 7, 2019


When we use the term DOMS or Delayed Onset Muscle Soreness, we are referring to the post workout pain that tends to peak around the 24 to 48 hour mark.  We want to discuss the potential treatment for DOMS and recommendations for the prevention of this pain.  After reading a great, lengthy article on this subject by Paul Ingraham (painscience.com) , I will summarize some his points. 

How delayed is this muscle pain?  The muscle soreness can come on almost immediately post exercise, but tends ...

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Cold cream review

October 7, 2019
What is your cold cream of choice  for use on sore and ache muscles?  We had a fun little experiment on one of our Monday afternoon meetings where we each tried out the cold creams that either we sell in the clinic, or various other products that companies have sent samples to us to try out.  Here are the contenders:
Biofreeze


Fisocream


Motion Medicine

Medistik solid 46%


Medistick spray 22%

 
After testing all five on each of our forearms, we rated each on smell, coldness, absorption rate, and leng...

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Proper Backpack fitting

August 13, 2019

As we prepare for the back to school season, let us remind you of how a backpack should be worn.  Remember the weight should be 15% of your body weight if you are older than 12.  Younger than 12, the backpack should only be 10% of your body weight.  If you have a scale at home, it is really easy to see how much your bag weighs.  Simply pack your backpack up for school with all the items you normally take with you and place it on the scale.  These rules also apply for all the other types of ba...


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Camping in Pain: Choosing Your Sleep System

July 9, 2019

Camping is a wonderful, age old summer tradition for outdoorsy Canadians. Something about natural landscapes and outdoor activities being good for your health. A road block for a lot of people can be pain. We know from the science that restriction of activities due to pain can lead to co-occuring mental health disorders like depression.

But it doesn't have to be that way.

It can be possible to adapt to pain while still doing what you love or even trying something new. When it comes to camping, ...


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Is your bike ready for summer? Summer Bike Tune Up.

June 6, 2019




The weather has been... well ok we won't talk too much about the weather as it has been raining a fair bit in the last while but I swear it can't rain all the time and when you catch those sunny days you will want your bike to be in ready-to-ride condition. A lot of people bring their trusty steeds up out of the basement between April and June to drop off at the local bike shop for tune ups but the truth is, a lot of the bikes only need a few small and simple adjustments that can be done at h...

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Range of Motion Training

May 9, 2019

 There is always a lot of talk about specific exercises for certain injuries or rehab protocols for different muscle groups.  One theory that has emerged in the last few years looks at the reason why many injuries happen, and that theory revolves around having an inaccurate range of motion. 

 The dancer above would not be able to move the way she does if she did not have full ankle planter flexion and toe flexion, knee flexion, hip flexion and extension, spinal extension, shoulder flexion, abd...

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Acute care for your Temporal Mandibular Joint Pain and Dysfunction

April 9, 2019
We have previously discussed Temporal Mandibular Joint (TMJ) Pain and Dysfunction in more detail (click here for previous article).  In this article, we want to review some acute care procedures you can do at home to help care for this problem.  

Finding Your TMJ

First, lets remind ourselves how to accurately feel where your TMJ is on our skull.  If you place your hands on the side of your face, just in front of your ear, your hand should be right over your TMJ (see diagram below).  To test if ...
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Tabata Workouts

March 2, 2019


Most people have one of two relationships with cardiovascular exercise... tolerate or hate. It's hard to refute the benefits of cardiovascular exercise for heart health. If you are in the hate category, Tabatas might be the right fit for you. Tabata exercises were created by Dr. Izumi Tabata, who researched new approaches to training the Japanese Olympic speed skating team. He created a 4 minute cardio workout that involves 20 seconds of work and 10 seconds of rest for 8 cycles. His research ...

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Spotlight on Women's Cardiac Health

February 26, 2019

March 8 is International Women’s Day and we decided to focus our newsletter on women’s heart health, an understudied, under-diagnosed and under-treated health concern for women. Though there have been incredible improvements in cardiovascular mortality rates in women, heart disease is still the leading cause of mortality in women. Regardless of age, women tend to die more frequently within 1 year of their first heart attack (at 26% vs men at 19%), and within 5 years, at 47% vs men at 36%,...


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Welcome to the gun show!

February 11, 2019

You guessed it!  The guns we are referring to are the biceps.  In this article, we will discuss proper motion, common injuries, exercises and things not to do at the gym! 

The biceps brachii have two muscle bellies and attach the shoulder to the elbow.  For those that would like to know more specific anatomy, the short head, attaches to the coracoid process of the scapula and the long head attaches to the supra glenoid tubercle of the scapula.  Together, both muscle bellies come together to ...


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Gout: Recognizing, Risk Factors and Treatment

December 5, 2018

Gout is an inflammatory arthritis caused by excess uric acid in the bloodstream.  The symptoms of gout arise due to uric acid crystals that are deposited in the joints and the body’s response to them.  The pain is often so intense, anything touching the joint involved, including clothing or socks, causes extreme pain.  The most common joint affected is the big toe, with patients often commenting that even their bedsheet hurts the toe.  As this is a potentially destructive joint disease, it ...


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Fall 2018

October 16, 2018



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Does weather really affect our joints?

October 11, 2018


How many times have you heard the statements "My ankle hurts more when rain is coming"?  Or cold weather brings ache joints.  Often we have an influx of acute neck or low back pain during a "change in seasons" period.  Is there some validity to the theory that changes in weather can bring changes in joint pain sensitivity or even pathology to joints.  Let us take a look at some of the literature on this theory.  

If you search for "joint pain and weather" in Google, the first listed website th...
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Preparing for tryout season

September 4, 2018

Back to school is around the corner and that also means tryout time for school and out of school sports teams.  In my family, our baseball season is coming to an end, but within the first two weeks of school we have tryouts for next years baseball and basketball teams.  This can be a period of extreme stress for some, particularly if they are trying out for a new team with kids they don't know and coaches that may be very different from coaches they have had in the past.  Are their athletic s...


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Natural Bug Repellents

July 8, 2018


Last month I gathered together more information than any usual citizen should sift through and read about mosquitoes, ticks and bug spray. I wanted to better understand how these insects find us, and how well different repellents work and what the safety usage guidelines were for each of them. This is a condensed version of my findings because the whole thing worked out to be 5 pages! If you're interested to know all of it, let me know as it is the basis of my Natural Bug Repellent workshop! ...


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Patellar Tendonopathy

June 4, 2018

What it is

Patellar Tendinopathy, also known as patellar tendinosis, jumpers knee, or Landers knee is an overuse injury at the knee. There is no specific injury or trauma to cause it, but the repetitive motions over time result in the tendinopathy.


Suprapatellar vs Infrapatellar tendinopathy

Supra- or superior refers to   tendinopathy above the patella (knee bone). This area is also call the quadriceps tendon. This portion of the tendon connects the quadriceps muscle and the knee. Infra...


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Movement screening to prevent injury

June 4, 2018

Some of you may have experienced some new testing that I have done to assess how your body moves.  In the fall of 2017, I began studying a method to assess movement throughout the whole body.  The Selective Functional Movement Assessment, or SFMA, is a tool that takes a patient through a series of 10 movements.  These 10 movements are then classified as being normal functioning or dysfunctional.  This assessment tool is part of the Functional Movement System, which includes other screening te...


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Degenerative Disc Disease (DDD) vs Degenerative Joint Disease (DJD)

June 4, 2018

Have you been given one of these diagnoses DDD or DJD?  Depending on how specific your healthcare practitioner is, you may have heard these terms before as the source of your spine pain.  Degenerative disc disease or DDD can be the cause of many different symptoms resulting in localized pain or pain that radiates down the leg.   Degenerative joint disease or DJD is very different, but can have overlapping symptoms with DDD.  We will discuss both of these conditions a little more thoroughly so...


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Stretching: A guide to becoming the most flexible you

April 15, 2018

Static Stretching

Static stretching is the most common type of stretching we think of when we hear the word stretch.

This type of stretching increases muscle extensibility, in turn, increasing that joints' range of motion (ROM).

Following a short jog, a few jumping jacks or even a heating pack to increase muscle temperature, complete the recommended stretches holding the stretch for 10-30 seconds feeling a light tingle or slight discomfort. Consider a scale from one to ten, one being barely a...


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Travelling with Acute Pain

March 7, 2018
Pain alone, is enough to have to worry about and deal with.  Now add in the travel component and this could make for some very aggravated pain episodes, not to mention the irritated travel companions.  The following is a list of things to consider and some tips for dealing with your pain while on the go.
  1. Explain your injuries to your travel companions.  Nothing is more awkward then letting your frustration make the best of you while with your travel companions that know nothing of your current...

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Travel Tummy Tammer: An Aromatic Remedy

March 7, 2018

I've done enough trips away from home to have learned my belly just doesn't like it. Whether it's the stress and worry about sleeping away from home, eating unfamiliar foods or drinking unfamiliar water, I have learned the value of having a travel kit for my gut.

Without getting into all the ugly details, colic and bowel upset are awful, especially when you are supposed to be away having fun. Emergency trips to walmart to buy tea, metamucil, or jumping off the bus to gnaw on a raw lump of gi...


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Orthotics

February 8, 2018

For some people, orthotics are the only device that provides any relief from pain.  For others, congenital deformities in the foot or toes prevent them from having a normal gait.  Whether you are experiencing pain or just looking for cushioning, orthotics can be very helpful for many.  

At MMD Chiropractic Health Centre, Dr. D'Andrea uses a foam mold to cast a patient for orthotics.  Orthotics are made by a local Chiropodist, Robert Nekrasas, and come in a wide variety of choices.  If you requ...


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Laser Therapy

February 8, 2018

The laser we use at MMD Chiropractic Health Centre is the Theralase therapeutic laser.  Theralase therapeutic laser treatments provide patients with a safe, effective and painless therapy that uses the body's own natural healing systems to relieve pain, increase joint mobility, increase tissue integrity and promote cell regeneration.

Theralase lasers work by supplying energy to the body in the form of billions of photons of light. The body absorbs this laser light on a cellular level and trans...


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Recognizing Clinical Depression in Youth

January 31, 2018

The teenage years are often a busy and trying time for both kids and their parents.  Teens are learning to deal with more adult situations as their bodies continue to take on an adult size and their brains are developing to their full potential (anatomically and chemically).  Their parents are dealing with their babies now making different choices and often choices that they don’t necessarily agree with.  But no matter what the events are that occurring, as parents, we need to recognize whe...


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Assessing Posture

January 31, 2018


What Causes Poor Posture

Poor posture can result from a combination of 5 reasons:

  1. Central nervous system disorders,

  2. Peripheral nervous system disorders,

  3. Eye problems,

  4. Ear problems,

  5. Musculoskeletal system problems.

In terms of Chiropractic, chiropractors focus more on the musculoskeletal system and its relation to the nervous system. Many musculoskeletal problems can affect posture, but in terms of the effects of posture, the most common problem is decondit...


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Aromatherapy Part 2

October 1, 2017

By Jennifer Fleming, RMT
In the last article we discussed a little bit about what aromatherapy is, what essential oils are and some of the ways they have been used and why people are turning to them today.  This article I want to focus on some basic need to knows about acquiring essential oils.
Currently there are many of resources and a lot of conflicting information about what the best sources of essential oils are.  The aromatherapy community is in agreement about one thing though; we want o...


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Introduction to Aromatherapy

September 11, 2017

By Jennifer Fleming, RMT

It's no secret today, thousands of people are trying out new (and old) ways to self manage their health and wellbeing.  As a health care provider, I think this is great.  One of the things I try to encourage my patients to do is take their health into their own hands when they can.  Of course, I recommend they have some qualified guidance in doing so, after all it is their health and I bear responsibility for it.

What is Aromatherapy?

Aromatherapy is the use of plant der...


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The Chiropractic Adjustment

June 27, 2017

By Dr. Marnie Mabee D’Andrea

“What is that popping sound”?  In my last article, I discussed the examination that happens on the first chiropractic visit.  After an examination or assessment is completed, the chiropractor will give you a treatment.  One form of treatment is an adjustment.  An adjustment is used to correct a restricted joint, or rather, to apply motion to the joint to make the joint move better.  An adjustment can be given through several different techniques.  The one t...


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