Wednesday, September 26, 2018

Low Back Or Leg Pain Aggravated By Back Extension

By Dr. R. Greg Lusk, DC

Spine flexion, or bending forward of the spine, has been the main movement or function discussed in the articles I've written to date, and rightly so as it is the dominant activity that produces and perpetuates low back pain. However, it's counterpart, spine extension, which often plays a relieving role for most cases of low back pain, can be a source of aggravation in others. Specifically, in a low back with prominent osteoarthritis (OA), which is the general term for degenerative disc and/or joint disease, the structural changes can result in disc space narrowing between our vertebrae, the development of bone spurs, and/or the thickening (i.e. hypertrophy) of the bony sides of the joints (facets) or other soft tissues (e.g. ligamentum flavum). Collectively, these changes can narrow the hole(s) between the vertebrae (foramen) where our spinal nerves exit and even compress the nerve(s) as it passes through the opening. Back extension exaggerates this narrowing (i.e. stenosis) further and can lead to low back and leg pain, numbness, weakness, and a reduced ability to stand or walk. Medically, this is referred to as neurogenic claudication or degenerative lumbar spinal stenosis (DLSS).

Now, since low back OA is incredibly common, particularly with increasing age, it is important to realize that this doesn't mean that back extension is bad for everyone with OA. Remember that disc bulges are in fact part of low back OA and can irritate nerves that travel down the legs, but that they often respond well to back extension exercises while being aggravated by spine flexion. This highlights the need for case by case management with investigation of the patient's symptoms and then confirmation via assessment. With respect to a patient with DLSS, it is often reported that low back or leg symptoms are aggravated with either standing or walking, but alleviated with sitting or bending forward. It may even be noted that walking while pushing a shopping cart or riding a bike, which flex the lumbar spine and open up the spaces where the nerves exit the spine, are comfortable. Assessment of ranges of motion and nerve tension in the legs are components of an examination that could then be done to increase confidence in the diagnosis of DLSS.

For patients with severe symptoms, surgery may be an option where bone and ligaments around the stenosis are removed to decompress the nerve. However, for those with mild to moderate symptoms related to DLSS there have been encouraging results published when participants completed a 6 week spine mobility boot camp. The multimodal program included manual therapies to improve mobility in the low back and hips, numerous daily exercises that promote spine flexion, and education with respect to body repositioning for symptom relief. Self-rated disability, leg pain intensity, and improved walking tolerance were improved upon completion of the program and persisted for 3.5 years. Exercises examples include lying on your back and pulling either one or both knees to your chest, pulling one knee to the chest and then leaning it across the body toward the opposite hip, seated toe touching, and riding of a stationary bike. Walking with a posterior pelvic tilt, where you rotate your pelvis to tuck your tailbone and/or raise the area where a belt buckle would rest, which opens up the lumbar joints, is an example of body repositioning during activity. Timing your baseline walking duration prior to symptom onset, and then re-checking after performing these sorts of things for a number of weeks would allow you to monitor your progress and assess the value of your effort.

This article is for general information purposes only and is not to be taken as professional medical advice.

Monday, September 24, 2018


The New Hamburg Wellness Centre has been nominated as a top 10 finalist in this year's Record Reader Awards in the following 3 categories:

1.      Favourite Chiropractic Clinic

2.      Favourite Massage Therapy Clinic

3.      Favourite Alternative Medicine Clinic

We are asking for your support to help us get to a winning position.

All you need to do is:

    1. Login in with your email and password if you have voted in previous years


    1. Select "Register a new account" if you have not voted in the past

  • Select Health, Wellness & Beauty and select each of the above 3 categories and vote for New Hamburg Wellness Centre.

For those with multiple e-mail addresses, you can register with each address and vote again!

Voting will take place from Saturday September 22nd until Saturday September 29th at midnight.

Please share this with your contacts.

We appreciate your support!

Thank-you in advance.

Friday, September 14, 2018

Understanding Medical Acupuncture Treatment

By Dr. John A. Papa, DC, FCCPOR(C)

Acupuncture is a 2000-year-old Chinese treatment in which needles are inserted into specific points on the body.  The World Health Organization (WHO) lists approximately four-dozen different conditions that can legitimately be treated by acupuncture.   Acupuncture treatments can be particularly helpful for pain complaints such as:  muscular strains, joint sprains, arthritic pain, neck and low back pain, rotator cuff tendonitis, tennis elbow, hip, knee and leg pain, sciatica, bursitis, migraine and tension headaches.

The term "Medical Acupuncture" refers to acupuncture performed by a licensed health care professional who has training in the health sciences.  Practitioners of Medical Acupuncture derive the concepts of disease, dysfunction, and healing from the western biomedical understanding of pathology, anatomy, physiology and biochemistry.  Under this model, the act of inserting an acupuncture needle into the body is believed to result in the following:

·      Pain Control - Pain-blocking substances are released locally and by the central nervous system to suppress the transmission of pain.
·   Inflammation Control - Natural anti-inflammatory chemicals are released locally, and inflammation control centers are stimulated in other parts of the body.
·   Blood and Lymphatic Flow - Enhancement of blood and lymphatic flow locally and throughout the body allows for the delivery of fresh oxygen and the removal of injury debris from the injury site.

The needles used for acupuncture are much smaller than a standard hypodermic needle.  These needles are solid, not hollow, and have a finely tapered point as opposed to a bevelled cutting-edge point.  The sensations felt during needle insertion range from feeling nothing at all, to mild tingling, to slight numbness/achiness, to small electrical pulsations distant to the site of insertion.  All these sensations typically subside once the needles are removed.  It is common practice nowadays for practitioners to use sterile disposable needles that are discarded following treatment.

As with any health intervention, there is always a potential for side effects and adverse reactions.  The good news is that acupuncture performed by an experienced and knowledgeable practitioner is relatively safe and infrequently yields minor side effects.  These may include but are not limited to: a slight discoloration at the acupuncture site that is temporary and not dangerous; minor bleeding; nausea; short-term fatigue or drowsiness; or a short-term increase in pain before relief sets in.  An experienced and knowledgeable practitioner aims to avoid treatment of certain points during pregnancy, over wounded or infectious areas, to individuals who are hemophiliacs, and to individuals who have needle phobia.

Medical Acupuncture treatments can be safely and successfully employed to help promote healing and recovery from pain complaints including muscle and joint injuries.  Acupuncture treatments are also often utilized in conjunction with other rehabilitative strategies such as exercise prescription, manual adjusting and mobilization techniques, and soft tissue therapy.  For more information visit

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, September 10, 2018

Fitness Tips For Recreational Athletes

By Dr. John A. Papa, DC, FCCPOR(C)

Physical activity is an important part of a healthy lifestyle.  Being active can help you maintain a healthy weight, reduce blood pressure, build strong bones, relieve stress, and maintain flexibility and good posture.  Included below are some tips to help you protect your body and prevent injury so that you can get the most from your favourite activity this summer season.

1.    Warm-up and cool-down both before and after your game.  Include gentle stretching and range of motion exercises, as well as a brisk walk or gentle jog to loosen the muscles and joints.

2. Improve your performance by including flexibility and strengthening exercises as part of your training and practice routine. Muscles act as important shock absorbers and help prevent strains and sprains of vulnerable regions such as the back and neck, along with the shoulder, elbow, wrist, hip, knee, and ankle joints.

3.    Nourish your body by staying hydrated.  Drink plenty of fluids before, during and after physical activity - even in colder weather.  Remember that once you are thirsty, you are already starting to dehydrate.  Dehydration affects your energy level and your physical functioning.

4.    Prepare for the elements.  Avoid sunburn which is a result of overexposure to the sun’s UV radiation and can contribute to certain skin cancers, and a premature aging and wrinkling of the skin.  To protect from sun exposure, apply sunscreen and wear a wide-brim hat and light-colored clothing that covers your exposed skin.  Your eyes should also be protected with UV blocking sunglasses.  Outdoor activities and sports should be limited to the early morning or late afternoon when UV rays are not as strong.  Be cautious on cloudy days, as your skin is still susceptible to burn under these conditions.

5.  Learn the proper technique.  Learn the right technique for your sport from the beginning.  Using the wrong sport-specific technique can create incorrect muscle memory and can make it difficult to break bad habits.  Poor technique can also cause injury to your joints and muscles.

6.    Use the right equipment.  Make sure your equipment is the right fit, height and capacity for you to avoid a sport-related injury.  Recreational athletes should have their equipment professionally fitted and checked before starting out.

7.    Avoid over-training.  Too much.  Too fast.  Too soon.  Over-training is one of the most common causes of recreational athletic injuries.  Take your time and work up to it slowly before pushing yourself too hard.  Remember – rest is as important as training.  Take a training break and give your body a chance to recover.

In the event that you suffer a muscle or joint injury that does not subside, you should contact a licensed health professional.  For more information, visit  The author credits the Canadian Chiropractic Association (CCA) in the preparation of this educational information for use by its members and the public.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Wednesday, September 5, 2018

Now Offering Nursing Foot Care!

What is Nursing Foot Care:

     A foot care nurse is a Registered Nurse or a Registered Practical Nurse, who has taken in addition to their formal training as a nurse, specialized training in foot care.  They usually collaborate with a team of health care professionals to help keep a person mobile and pain-free.
    Advanced Foot Care Nurses can provide treatment to high risk clients including those with arthritis, autoimmune disorders and diabetes.
     Foot Care Nurses are primary health care providers and there is no medical referral necessary to access these services.
    The College of Nurses of Ontario governs the profession and is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.
      Foot Care Nurses in general deal with the nails and skin of the foot.
      Nursing foot care is considered a “dry treatment”, which means, there is no soaking of the feet as per the College of Nurses guidelines due to infection control purposes.  The Foot Care Nurse uses an approved cleanser and nail/callus softener to achieve the same affect as soaking the feet in a basin.
    Each individual will have a specific care plan tailored to their foot care needs but it is most common for clients to have scheduled foot care treatments every 4-8 weeks.

If you have Extended Health Care (EHC) insurance you may be eligible for all or part of your treatment to be reimbursed. Your employer, human resource representative, or union will be able to provide information as to the details of your coverage for Nursing Foot Care under your EHC plan. Your receipts may also be applied as a tax deduction where applicable.

Common Conditions That Can Be Successfully Treated With Regular Foot Care Treatments:

     Reducing thick, hard, and fungal nails
     Reduction of calluses
     Removal of corns
     Treatment of ingrown toenails
     Reducing serious complications that often arise in diabetic clients
     Health teaching to promote healthy feet

About Jessica Hecktus:

·         Registered Practical Nurse - RPN
·         Advanced Foot Care Nurse - AFCN

Jessica is a Registered Practical Nurse and is a member in good standing with the College of Nurses of Ontario (CNO), and the Registered Practical Nurses Association of Ontario (RPNAO). She graduated from Conestoga College in 2008 and is certified in Basic and Advanced Foot Care.

With her extensive years of nursing experience, Jessica has seen many cases of neglected feet. These cases are often due to problems with accessibility, poor vision, circulation problems or diabetes. Fortunately, most foot problems are avoidable with the proper preventative care and maintenance. Jessica believes that the option to have regular foot care treatments offers the potential for improved mobility, reduced pain, and a higher quality of life.  Her main focus is to provide the highest quality of foot care as the first line of defense against foot issues that can ultimately affect someone’s overall health and wellness. 

Jessica is currently available Mondays and Wednesdays.
No referral required.
Call 519-662-4441 to schedule your appointment today.

Monday, September 3, 2018

Ice Therapy For Muscle And Joint Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

Ice therapy is an effective self-care treatment strategy for muscle and joint injuries.  It is commonly used for acute injuries (within the first 72 hours), but can also be very helpful in managing flare-ups of chronic problems, and as a preventative measure following activities or exercise.

Ice therapy reduces the amount of swelling and inflammation at the injury site and also acts as an anesthetic to provide pain relief.  Icing as soon as possible after an injury will help with speeding up recovery time, and minimize the chances of secondary problems such as muscle spasm and joint irritation.

Below are some helpful  tips that should be followed when using ice therapy:

·       Crushed ice and ice cubes are ideal sources of ice because they easily mold around an injury site and can stay cold for long periods of time.  Commercial ice/gel packs and frozen vegetable bags are good secondary choices when crushed ice or cubes are not available.
·   Use compression when applying ice to an injury site.  Compression is most easily achieved with an elastic tensor bandage to add support and slow swelling.  The principles of elevating and resting the injured site should also be followed during initial injury management.
·       Ideal ice application time is 10 to 20 minutes.  There should also be a period of 10 to 20 minutes or more where there is no ice application before icing is done again so that skin temperature can return to normal.  This cycle can be repeated as often as necessary within the first 24 to 72 hours after injury or activity.

Below are some precautions that should be followed with ice therapy:

·       Ice should never be applied directly over the skin for a prolonged period of time as this can damage skin tissue.  A wet towel can safely be used as a barrier between the ice and skin and acts as an excellent conductor of cold.
·       Ice should never be applied on blisters, open cuts or sores.
·         Ice should not be applied before exercise or activity as this impairs your body’s ability to detect proper joint and muscle function, making one more susceptible to further injury.
·        Ice therapy should not exceed the treatment time recommended as prolonged exposure can reverse the positive effects of ice and can lead to possible frostbite.
·    Special care must be taken when icing the elbow, wrist, knee, or foot as superficial nerves in these areas can become irritated or damaged with prolonged icing.
·     People hypersensitive or allergic to cold and those who have a circulation problem should avoid ice.

If you have a muscle and joint injury that is not resolving, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit  From all of us at the New Hamburg Wellness Centre, have a safe and enjoyable summer!

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.