Conditions We Treat
Back Pain
Several problems can cause back pain. In most cases, a disc drives much of the mechanical low back pain. Along with the disc, you can have nerve entrapment, which brings radicular pain. It can also come from dysfunction of the joints, where the capsules and facets flare up from mechanical disruption. We start with a thorough evaluation to identify which tissues are involved. If a disc is the problem, we consider non-surgical spinal decompression along with chiropractic adjustments and rehabilitation exercises. For general mechanical low back pain, we recommend chiropractic, exercises for core stability, and often shockwave therapy.
Neck Pain
Neck pain can be similar to low back pain. More often than not, there is a mechanical imbalance, and you get the same pain generators. It could be a pinched nerve. It could be coming from the disc. Soft tissue inflammation around the joint capsules can also be a cause. Patients often have neck pain with headaches, sinus fullness, or aching radiating into the shoulder, down the arm, and to the fingertips, with tingling and numbness. When someone has a neck problem, they typically have a mid-back problem. We treat it with adjustments, postural rehabilitation, muscle stem, and shock wave. With disc involvement, we can decompress the cervical spine. Dr. Francesca may add cupping or instrument-assisted soft tissue mobilization.
Sciatica
When a patient has sciatica, it can show up in a couple of ways. Some have pain running down the back of the leg and into the foot, without much low back pain. Others have both. In most cases, the sciatic nerve gets compressed in the lower back. The sciatic nerve is the largest nerve in your body. Usually, the pain comes from the nerve being pinched as it exits the spine. A disc herniation or bulge can also add to it, which makes the case more advanced. Our core treatment is chiropractic adjustments, supported by ice, muscle stem, or shock wave to bring down pain and inflammation. As soon as we can, we start an exercise program to rehabilitate the back.
Herniated Disc
With a herniated disc, you will usually see a radiating pattern. It can travel into the buttocks and down to the foot. The further it radiates, the more likely it is to get worse. As it progresses down the leg, you may start having numbness and some muscle atrophy, which points to a higher-grade herniation. Diagnosis comes from orthopedic testing, and an MRI confirms it. An X-ray will not show the herniation, but it reveals whether the disc space is thinning. Our main treatment is non-surgical spinal decompression, with appropriate chiropractic adjustments and shock wave therapy to bring blood flow and lower the pain. We add active care to encourage that disc to reabsorb.
Headaches and Migraines
Headaches and migraines are a Pandora’s box. A lot of it comes from biomechanical imbalances in the joints, muscles, and nervous system. A bigger piece we are diving into now is gut health. Because of the blood-brain barrier, certain triggers from the gut biome cross into the head. On the biomechanical side, we look at misalignment in the upper cervical spine and at upper cross syndrome. That is where the muscles up to the base of the skull and the pecs overwork, while the lats, lower traps, and deep neck flexors stay weak. It creates a rounded shoulder, head-forward posture. We treat with adjustments, physiotherapy, and posture correction. If patients still are not getting results, we look at food sensitivity testing to find gut triggers.
Scoliosis
There is functional and structural scoliosis. Some start at a young age, and some happen later from genetics or environment, such as a person’s profession. A patient might come in at 70 with moderate to severe scoliosis and tell me they hung wallpaper or did overhead painting for most of their life. Because of that structural change in the spine, it can show up as altered muscle tone, shooting pains, one side weaker than the other, trigger points, or adhesions. Treatment depends on the degree and the age. In younger patients caught soon enough, bracing can be a step, along with physical therapy and chiropractic care. As chiropractors, we cannot correct a scoliosis, but we can help maintain a person’s current state.
Knee Pain
Knee pain can be caused by many problems. Sometimes a biomechanical imbalance causes it, and sometimes it is tendinopathy or a previous chronic injury. For most knee pain, we go the corrective care route. For a more extensive case, that runs about 18 visits of chiropractic adjustments, corrective therapy, and most likely shock wave, because the knee does not naturally receive much blood flow. With a chronic injury, inflammation and edema can build up. We also look from the feet up, doing a foot scan to check whether custom orthotics are needed, plus an X-ray of the low back. We take the whole lower kinetic chain into account, not the knee alone. For an older patient, we may add supplementation such as hyaluronic acid.
Auto Accident and Whiplash
Whiplash can occur from any backward trauma that causes hyperextension of the cervical spine. It can happen when getting hit from the rear, even at around five to ten miles per hour. That hyper extension from the shoulders to the neck causes trauma to the posterior muscles and deeper to the spine itself. Those muscles and ligaments are injured, and it may not feel bad at first. For some, it does not show for a month or more, and those injuries can linger for years down the road. As chiropractors, we correct the restrictions in the spine and address the soft tissue injuries, because if they are not treated, they keep growing. If they are ignored, you start seeing structural change and faster degeneration.
Work Injury
A person’s job can play a big part in the condition they come in with. Years of overhead work, such as painting or hanging wallpaper, can show up as changes in the spine over time. Sitting at a desk or working online all day, along with being on the phone, pulls the head forward and rounds the shoulders. Left alone, that posture gets more pronounced and can speed up the wear on the joints and discs. During the evaluation, we go through the history in detail and ask what may be affecting your daily activities and whether anything at work is contributing. From there, we treat with chiropractic care and rehabilitation exercises to change the mechanics, since correcting the posture is what holds the results.
Carpal Tunnel Syndrome
We often see carpal tunnel tied together with neck problems. When someone has a neck problem, the symptoms can travel down the arm, into the shoulder, and out to the fingertips, with tingling and numbness. So part of the exam is figuring out what kind of patient is in front of you, which tissues are involved, and how far the problem has progressed. When the neck is driving it, we treat the neck the way we would for any neck problem, with adjustments, muscle stem, and shock wave, plus cupping or instrument-assisted soft tissue mobilization for the tight muscles in the upper back. If a neck problem like this is left alone, it tends to get worse, and over time, you can lose sensation in the hands.
Shoulder Pain
Shoulder pain often shows up along with neck problems. When someone has a neck problem, they can get pain radiating into the shoulder. We look at what tissues are involved and how far the problem has progressed. A lot of overactive muscles build up in the trap area, so Dr Francesca will do some cupping there or instrument-assisted soft tissue mobilization to break that up. We also use shock waves for chronic shoulder injuries, previous tears, and rotator cuff injuries. It helps bring blood flow to a tendon or ligament, which does not naturally receive much on its own. For really tight traps, we use shock waves to loosen them up. In athletes, I see quite a few shoulder and upper back complaints.
Arm & Leg Pain
Arm and leg pain often trace back to a compressed nerve in the spine. With the neck, patients may have pain down the arm, into the shoulder, or to the fingertips, with tingling and numbness. That usually comes from a mechanical imbalance, a pinched nerve, or a disc. When it is discogenic, it is more advanced and can bring radiculopathy or muscle atrophy. With the lower back, an entrapped nerve can send searing pain down the back of the leg and into the foot, sometimes with numbness and loss of muscle function. Disc herniation or bulges can add to it. We diagnose through history and orthopedic testing, then treat with adjustments, muscle stem, and shock wave. If a disc is involved, we can do decompression.