Spinal Care

It's not just about the pain

The greatest miracle on Earth is the human body. It is stronger and wiser than you may realize, and improving its ability to self heal is within your control.

Dr Fabrizio Mancini

Human nature means that we tend to only try and fix something when it is broken, rather than being preventative and looking after it so that it does not break. We tend to only seek care once we experience pain in our bodies while the dysfunction leading to that pain event has most probably been present for far longer.

A Little Anatomy

Cervical spine showing verves.The complex structure and design of our nervous systems is so that all parts of our bodies can communicate with each other by receiving and sending information through electrical or chemical means. For the most part, the central nervous system which is comprised of the brain and the spinal cord that runs the length of the spine, receives and sends information to organs, muscles, etc via the peripheral nervous system, which is made up of the autonomic and somatic nervous systems.

The peripheral nervous system exits the spine via the intervertebral foramina which are the small openings, on each side of the spine, between the vertebrae. The nerves at these points of exit from the spine are called the spinal nerve roots, which then split into the different major and minor nerves, travelling on to their target organs or tissues.

The spine or vertebral column is made up of 33 vertebrae over five different regions with 7 vertebrae in the cervical or neck region; 12 vetrtebrae in the thoracic or chest region; 5 vertebrae in the lumbar or low back region; 5 fused vertebrae in the sacrum and 4 fused vertebrae in the coccyx.

The vertebral column has natural curves in it which remain very important to its function and movement. In the cervical spine there is a convex to the front curve called a cervical lordosis; the thoracic spine has a concave to the front curve called a thoracic kyphosis; the lumbar spine has a convex to the front curve called a lumbar lordosis; while the sacrum and coccyx have the sacrococcygeal curve.

Whole body spine from behind.

These curves develop as we grow, the cervical lordosis develops as we learn to hold our necks upright and sit, the lumbar lordosis develops when we begin to walk and remain vital to our body's ability to have strength, flexibility and absorb shock. These curves also ensure that we remain upright with our centre of gravity maintained in a position so that the structures of our musculoskeletal system can all integrate properly to do thier tasks.

When Things Go Wrong

Pain may be one of the primary driving factors for seeking treatment, however the level of dysfunction often has far more profound effects on injury management and rehabilitation.

There are a multitude of factors that can bring about changes to our spines and how they move, bad seated posture, lack of exercise, incorrect exercise, carrying too much weight and ageing are a few, but ultimately dysfunction of the musculoskeletal system becomes a reality and more often than not, in the absence of an injury, no pain is experienced during the initial stages.

A graphical representation of the relationship between injuries, dysfunction and pain.

Symptoms vs Function

Normal behaviour tends to show that we only seek help with an injury once we experience some significant symptoms, usually pain, which are in turn preventing us from doing some of the things that we love. These symptoms usually only present after a significant period of dysfunction where changes to the normal biomechaincs of the affected area place undue stress and strain on the musculoskeletal structures requiring them to operate outside of their normal parameters.

Our bodies, through compensatory mechanics, try to adjust to the altered movement patterns as best they can so that we may continue to move and function as close to normal as possible. An example of this would be turning the whole upper body to look over a shoulder because of a lack of movement in the neck due to muscle stiffness or joint restriction. These new movement patterns, through repetition, become dominant movement patterns which in some cases contribute to the underlying injury and in most cases prolong the treatment and recovery from the injury.

By addressing functional problems in our movment and maintaining good movment patterns not only can we limit inhibitory symptoms such as pain, weakness and stiffness but we can also help to expedite treatment and recovery times a significant number of injuries.

Treatment Implications

It is true that most mild musculoskeletal injuries are self limiting, meaning that with a bit of rest the injury will improve on its own without any other intervention. This is most noticeable when there is suitable underlying stability and strength and the injuries are of an acute(short duration) nature. Chronic(long duration) injuries or an accumulation of injuries which have not been suitable addressed show very different characteristics. As dysfunction starts to increase, we notice two different things start to occur with regards to injuries. One: The rate of injury improvement when left untreated starts to decrease; Two: With increased instability and weakness, untreated injuries typically deteriorate with time.

These factors are important when assessing a suitable treatment option for any musculoskeletal injury and correlating that to the desired outcomes of being symptom free or symptom free and functionally sound, as the level of underlying dysfunction will more often than not determine the length of care required. The holistic approach of Chiropractic means that we try to provide care that not only resolves the symptoms, but also improves the biomechanics of the affected area thereby decreasing the dysfunction and hopefully preventing the injury from deteriorating once again.

Wellness is not only pain dependent.

Being "well" involves addressing functional, biomechanical and behavioural factors to limit the recurrence of injury.