Taking Care Of Your Feet

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

The feet are an individual’s contact points with the ground, so how they support the rest of the body is critical.  Our feet have nearly 100 individual working parts, which all have to function together when we stand, walk, run and jump to provide proper stability and balance.

When a small problem develops in our feet, the subtle changes in the way we move can cause a chain reaction of adjustments in our posture and walking mechanics.  This can lead to symptoms such as: localized foot pain, arch and heel pain, along with ankle, knee, hip, and back pain.

Protecting your feet and choosing proper footwear can go a long way in preventing injury and pain.  Below are some helpful tips that can ensure your feet are protected and functioning to the best of their ability.

·     Choose footwear that is appropriate for your foot type.  For example, people with low arches, called pronators, will need a shoe that provides some degree of stability.  A shoe with good cushioning is important for people with high arches, called supinators.

·      Select a footwear store with knowledgeable staff who can provide advice on the shoe that best suits your activity, body structure and type of foot.  Shop in the afternoon or evening, as your feet tend to accumulate fluid and swell throughout the day.  What may have been comfortable earlier in the day could now feel tight later in the day.

·    Remember that not all shoes are created equally.  The same shoe sizes can have different fits depending on the manufacturer.  Be sure to try several sizes to find the most comfortable shoe.

·        Avoid buying shoes that you feel need a break-in period.  Shoes should be comfortable from the first time you put them on.

·      Don't cheap out on your shoes!  Better quality shoes may cost more but will pay off in terms of support and sturdiness.  A mid-priced shoe may offer the best value.

·      Do not hesitate to replace footwear after excessive wear as it may not be providing you with proper support and stability.

·   Consider custom orthotics to help support your feet.  Orthotics are mechanical aids that fit into your shoes as comfortably as an insole and work on your feet much like glasses work on your eyes – they decrease stress and strain on your body by bringing your feet into proper alignment.  This helps rebalance your feet and reduces pain and discomfort by enhancing your body’s natural movements.

·      Remember to exercise regularly and try to maintain a healthy weight.  Extra weight adds extra stress on your feet, knees, hips, and back.

In the event that you suffer a muscle or joint injury related to your feet that does not subside, you should contact a licensed health professional.  For more information, visit www.nhwc.ca.

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.

Common Back Pain Myths

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

80% of all Canadians will suffer from at least one significant episode of back pain in their lives.  Below are some of the common myths surrounding back pain and what modern science has to say about them.

Myth 1:  If you’ve injured a disc (i.e. herniation, rupture), you must have surgery.

Truth:  Surgery to relieve back pain should only be used as a last resort.  Even if specific testing reveals a damaged disc, recovery often results without surgery.  An injured disc in the back may become inflamed and put pressure on nerves and surrounding pain sensitive structures.  Non-surgical treatment aims at minimizing pain and discomfort from joint irritation and muscle spasm, and prescribing specific exercises to help with recovery.

Myth 2:  Most back pain is caused by injuries or heavy lifting.

Truth:  Injuries caused by heavy lifting do not account for all back pain.  In up to 85% of cases, individuals can’t recall a specific incident that brought on their back pain.  Back pain can result from a single exposure to a bending or twisting incident or it can be small cumulative loads placed on the spine over time.  Scientific research also links the following risk factors to back pain: smoking, being overweight, poor posture, poor physical fitness, and stressful life events.

Myth 3:  X-ray images, CT and MRI scans can always identify the cause of pain.

Truth:  Even the best imaging tests cannot identify a muscle spasm or ligament sprain that may be the cause of pain.  Imaging is usually reserved for special cases such as those suffering trauma in a fall or accident, surgical candidates, unresolved cases of severe chronic back pain, and suspicion of underlying tumor, infection or other serious disease.

Myth 4:  If your back hurts, you should take it easy until the pain goes away.  Bed rest is the mainstay of therapy.

Truth:  Clinical data indicates that individuals who remain active do better than those who try bed rest.  Remaining active means continuing with daily activities as tolerated and easing back into a regular routine.  Activities may have to be modified while recovery occurs, but movement is important for recovery provided it does not put the individual at risk for further injury.

Myth 5:  Diagnosing back pain is simple and straightforward.

Truth:  The causes of back pain can be complex and difficult to diagnose.  There are many biological tissues that can generate pain in the back.  These may include muscles, ligaments, bones, nerves, and joints.  Quite often it is a combination of several or all of these structures that can manifest into back pain, and potentially radiating pain into the buttock or leg regions.  Sometimes stress and depression can also contribute to back pain.  A licensed health practitioner who deals with back pain is best trained to diagnose the source(s) of your problem and prescribe appropriate therapy when required.  For more information, visit www.nhwc.ca.

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.

How To Choose The Right Mattress

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

Choosing the right mattress can go a long way in determining the quality of your sleep.  Using a mattress that does not provide adequate support and comfort can also be a significant source of muscle and joint pain, especially in the shoulder, back, and hip regions.

The right mattress is usually defined as any mattress that helps a person sleep well, so that they wake up feeling rested and without pain and stiffness.  However, there is no single best mattress for everyone as there are a variety of factors that go into choosing the right mattress.

Below are some useful tips that can help you find the mattress that's right for you:

·       Consider how your mattress is made.  Mattress support is determined by the internal architecture of the mattress.  This can include innerspring coil mattresses (most common), memory foam, latex, and air mattresses.  Each offer different degrees of support and comfort.  Some manufacturers also include additional padding on top of the mattress for extra comfort, but this may not be necessary for all individuals.

·        Sleep experts recommend replacing your mattress on average every 8-10 years or sooner.  Look for visible sagging and/or material breakdown as a sign to replace your mattress.  Over time, mattresses collect dust mites and other germs that can exacerbate allergies and impact sleep.  In addition, our bodies change over time and an old mattress that had originally been comfortable may no longer be providing the comfort and support it once did.

·    Your physical health and your mattress.  Sleeping with painful conditions such as osteoarthritis, hip bursitis, and degenerative disc disease can be minimized by choosing the right mattress.  You can also incorporate additional sleep positioning tips to get the most comfort out of your mattress.

·      Try before you buy.  Lay on a variety of mattresses (i.e. firm, medium, pillow top) for at least 10-15 minutes in several simulated sleep positions to get a sense of how the mattress feels.

·    Shop at stores that specialize in mattresses.  These stores will offer a diverse range of choices and other important factors such as manufacturer and comfort warranties.

·  The right mattress achieves a balance between comfort and support.  A mattress that is too firm may cause pain in pressure points such as the hips.  A mattress that is too soft may not offer enough support and cause pain and stiffness.  Most people do well with a medium-firm mattress.  However, at the end of the day, a person's overall comfort level will determine which mattress is right for them.

If you experience muscle and joint pain that is causing difficulty with your sleep, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information, visit www.nhwc.ca.

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.

5 Ways To Avoid Backache While With Your Newborn

Ontario Chiropractic Association

You were up all night. The baby is crying. The telephone is ringing and the kettle is boiling. For most parents, this is a daily scenario. Parents are also continually faced with strenuous physical demands such as lifting, feeding, comforting and chasing after children.

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Consider the fact that parents may be lifting a 7-10 pound baby 50 times a day. By 12 months, your baby weighs approximately 17 pounds, and at 2 years, that child has become a 25-30 pound toddler. The repetitive lifting of your child may put you at risk for back problems.

What’s a parent to do? Well, here are some simple tips that can help parents avoid some common aches and pains.

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Lifting

• Stand with your feet at least a shoulder width apart.
• Keep your back in neutral position and bend your knees.
• Bring your baby as close to your chest as possible, and then lift using both arms.

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Carrying

• When carrying your little one, pivot with your feet instead of twisting your back.
• This will ensure that you’re turning with your hips, which will reduce your risk of back pain.
• Lower your child into the crib or onto the floor by bending at the knees, with a neutral back.

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Holding

• Hold your child in an upright position, directly against your chest.
• Carrying a child on one hip creates postural imbalances that can lead to low back pain over time.

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Feeding

• Always sit in a chair with back support and avoid leaning forward to reach your newborn’s mouth.
• Instead, use pillows or blankets to support and position your baby closer to you.

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Exercise

• Exercise can help increase muscle support for your aching back.
• While your baby is enjoying tummy time, join them on the floor and do some exercises to help strengthen your core.

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There is no time for back pain in parenthood. Talk to your chiropractor about specific exercises to stretch and strengthen your muscles so that you can stay on your toes and a step ahead of your toddler.

Understanding A "Pinched Nerve" In The Neck

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

About two-thirds of people will experience neck pain at some point in their lives.  Occasionally, neck pain can spread to involve other structures such as the upper back, shoulder, and arm regions.  Pain in these regions is often dismissed simply as muscle pain.  However, a “pinched nerve” originating from the neck can radiate pain to these nearby anatomical sites and be a significant source of discomfort.

The “cervical spine” is the medical name given to the region of the neck.  Nerve roots originate from the cervical spine on each side.  These nerves send off various branches that travel to distinct regions in the upper back and arms to supply strength to muscles and provide sensation/feeling.  The term “pinched nerve” is often used to describe a mechanical and/or inflammatory irritation directly affecting any component of the nerve root(s) in the neck/cervical spine.

A “pinched nerve” in the neck can cause symptoms almost anywhere along the nerve pathway.  This may result in neck symptoms only, and/or symptoms that radiate into the chest, upper back, shoulder, arm, hand and finger regions.  The symptoms can vary widely and may include:  a cramping or achy feeling, tightness, burning or a sharp electric shock sensation, numbness, tingling, and arm muscle weakness.  The symptoms may start gradually and intensify over time.  Activities such as movement of the neck or shoulder, prolonged sitting or laying down, lifting, and even coughing or sneezing may aggravate the symptoms.

Below is a brief summary of three common causes of a "pinched nerve" in the neck:

1.     Spinal disc herniation/bulge – Spinal discs separate and cushion cervical vertebra.  Repetitive and cumulative loads or a heavy single load has the potential to cause a disc bulge or herniation, thereby causing a mechanical and/or inflammatory irritation of the nerve root(s).  This most commonly occurs in adults aged 20-50.

2.     Degeneration and Osteoarthritis – The normal aging process causes cervical disc degeneration and osteoarthritis of the cervical joints.  The consequence of these processes is that mechanical irritation from bony spurs on the vertebrae along with inflammation can cause irritation of the nerve root(s).  This most commonly occurs in adults over 50.

3.   Cervical spinal stenosis – This condition may cause “pinched nerve” symptoms due to narrowing of the spinal canal and/or nerve pathways, which puts pressure on the nerve root(s) or spinal cord.  This most commonly occurs in adults over 60.  It is usually secondary to degeneration and osteoarthritis.

Other causes of a “pinched nerve” in the neck include: direct irritation of nerve tissue by overlying muscles; direct trauma or injury to the nerve root(s); and mechanical changes in the neck associated with poor postural habits (i.e. head poking forward in the sitting position).  Some common causes of symptoms that act like a “pinched nerve” in the neck include muscular trigger points, ligament sprains and arthritic joints from the neck, upper back, and shoulder regions.

Treatment for a “pinched nerve” in the neck will often be different depending on the underlying cause of the symptoms.  Therefore, it is important to obtain an accurate diagnosis.  A proper medical history, along with physical examination consisting of range of motion, strength, neurological and orthopaedic testing, along with diagnostic imaging (if necessary) should be performed to aid in the diagnosis.  It is extremely important to rule out rare causes of “pinched nerve” symptoms such as spinal tumors, fractures and infections.  Disorders of the esophagus, trachea (windpipe), heart and thyroid can cause symptoms that overlap with those of a “pinched nerve” in the neck.  These potential causes require appropriate medical referral when applicable.

There are natural and conservative treatment options available for those suffering from a "pinched nerve" in the neck.  These may include: mechanical traction, spinal manipulation and mobilization, soft tissue techniques, acupuncture, ice/heat application, electrotherapy, activity modification, postural education, and rehabilitative exercise.  A qualified health professional can determine the cause of your symptoms and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

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.

Nutrients That Support Musculoskeletal Health

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

The musculoskeletal (MSK) system includes the muscles, tendons, joints, and bones of the body.  Many nutrients contribute to the healthy functioning and integrity of the MSK system.  Included below is a summary of 5 common nutrients that significantly contribute to MSK health.

 

1. WATER brings vital nutrients to muscle tissue to support movement and decrease the risk of cramps and strains.  Water also eliminates waste products and toxins from the body and helps to protect our joints by providing lubrication and cushioning.  The consequences of inadequate water intake/dehydration include:  muscle and joint pain, cramping, and fatigue.  A general rule of thumb to follow is to consume 0.5-1 litre of water daily for every 50 pounds of body weight.

2.    CALCIUM is best known for building strong bones.  It is also needed for muscular growth and contraction.  A deficiency in calcium status can lead to aching joints, muscle cramps, and osteoporosis.  Foods such as milk, yogurt, and cheese are good sources of calcium but may not be suitable for individuals sensitive to dairy products.  Other healthy foods high in calcium include pinto, navy, red and white kidney beans, sesame seeds, almonds, and dark leafy vegetables.

3.   VITAMIN D is essential for helping bones absorb calcium, keeping them strong, and preventing osteoporosis.  Signs of Vitamin D deficiency may include painful muscle spasms, leg cramps, numbness in the extremities, bony malformations, and arthritic pain.  Vitamin D is naturally found in food sources such as cod liver oil, salmon, mackerel, tuna fish, sardines, and egg yolks.  Sensible and safe sun exposure is also an important natural source of Vitamin D.

4.  VITAMIN C plays a vital role in collagen production and tissue repair.  Collagen is the building foundation for many body tissues and is found in all MSK structures.  There is an abundance of Vitamin C in strawberries, citrus fruits, and vegetables including, red peppers, broccoli, spinach, brussel sprouts and cauliflower.

5.    GLUCOSAMINE SULPHATE is a normal element of cartilage matrix and joint fluid and provides the body with the building blocks necessary to repair joint damage.  As we age, our bodies slow down the production of glucosamine sulphate.  Published research suggests that glucosamine sulphate is beneficial for arthritic patients, particularly for those individuals with mild to moderate osteoarthritis of the knees.  Some glucosamine sulphate supplements also contain anti-inflammatory herbs that can be combined with other nutrients such as Omega-3 fatty acids to help with arthritic pain.

Sensible eating should include nutritional balance with the correct proportion of quality carbohydrates, proteins, healthy fats, and adequate water intake.  Although nutritional supplements can help support MSK health, many nutrients appear to be most effective when consumed in their natural state within whole foods.  For additional information on diet, nutrition, and how you can improve your MSK health, visit www.nhwc.ca.

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.

Plantar Fasciitis: A Common Source Of Heel Pain

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

Plantar fasciitis is caused by injury to the plantar fascia, which is the tendon-like soft-tissue along the bottom of the foot that connects your heel bone to your toes.  This condition is a common source of heel pain that can be quite disabling.

Plantar fasciitis usually develops gradually, but it can also come on suddenly.  Sharp, knife-like pain on the inside-bottom part of the heel is often characteristic.  Pain and discomfort can also extend into the arch of the foot.  Heel pain tends to be worse with the first few walking steps in the morning, and after extended periods of sitting or inactivity.  If plantar fasciitis becomes severe or chronic, heel and/or arch pain will be present with all weight-bearing activities, and may result in secondary areas of discomfort in the foot, knee, hip or back due to compensatory movements.

Under normal circumstances, your plantar fascia acts like a shock-absorbing rubber band, supporting the arch of your foot.  Excessive tension and repetitive stretching can create small tears in this soft-tissue fascia, causing it to become irritated or inflamed.  This may occur with activities that require running, jumping or prolonged walking and standing.  Improper footwear can make the plantar fascia more susceptible to stretch and strain during these activities.

Faulty foot mechanics may also contribute to the development of plantar fasciitis.  Individuals with flat feet or those who excessively pronate (role feet inward) will experience added strain on their plantar fascia.  Old lower extremity injuries such as ankle sprains and fractures can increase susceptibility due to altered lower limb movements.  Being overweight is also a risk factor.  Carrying extra pounds can break down the protective fatty tissue under the heel bone, causing heel pain and putting additional mechanical load on the plantar fascia.

Self-care strategies for reducing the pain of plantar fasciitis include: ice application; rolling a tennis ball or soup can from your heel and along the arch of your foot; and gentle stretching of the achilles tendon, calf muscles, and plantar fascia.  Gel or “donut pads” placed under the affected heel(s) in shoes may also provide relief.

Plantar fasciitis that does not respond to self-care strategies may require professional treatment.  This can include electrotherapeutic or laser modalities to assist in healing, manual and soft tissue therapy to supporting structures, therapeutic taping of the heel, and specific rehabilitative  exercises for the muscles and joints of the lower leg and foot.  A custom made orthotic may also be helpful by minimizing pronation, cushioning the heel, and supporting the arch.

It is important to establish an accurate diagnosis of plantar fasciitis.   Other causes of heel pain may include stress fractures, heel fat pad syndrome, achilles tendonitis/bursitis, arthritis, gout, or nerve irritation.  If you are having difficulty with heel pain, 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 www.nhwc.ca.

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.