1. Introduction

Mechanical low back pain is pain that comes from the spinal joints, muscles, ligaments, and supporting structures rather than from disease or major injury. It is the most common type of low back pain and often responds very well to chiropractic care. Unlike nerve compression syndromes (such as sciatica), mechanical back pain usually stays localized to the back and is triggered by movement, posture, or loading of the spine.

2. Relevant Anatomy

• Bones & Joints: Five lumbar vertebrae (L1–L5), sacrum, and facet joints.

• Discs: Provide cushioning but are not the primary source in mechanical pain.

• Muscles: Erector spinae, multifidus, quadratus lumborum, gluteals, and hip flexors.

• Nerves: Lumbar spinal nerves (L1–L5) supply sensation and motor control to trunk and legs.

• Blood supply: Lumbar arteries and veins nourish spinal structures and muscles.

3. Normal Biomechanics & Physiology

• Lumbar spine should maintain a lordotic curve to evenly distribute load.

• Facet joints guide bending, extension, and rotation.

• Core and glute muscles stabilize the pelvis and spine.

• Movement should be balanced between spine, hips, and pelvis.

4. Pathophysiology

Mechanical low back pain occurs when normal biomechanics are disrupted:

1. Joint Dysfunction / Subluxation

   • Misalignment or restricted motion irritates local tissues.

   • Facet joint irritation creates localized aching or sharp pain.

2. Muscle Imbalance & Spasm

   • Weak or inhibited core/glutes force lumbar muscles to overwork.

   • Tight hip flexors or hamstrings pull on pelvis and strain low back.

3. Ligament or Soft Tissue Stress

   • Overstretching or microtrauma from lifting, bending, twisting.

   • Poor posture and repetitive stress create chronic irritation.

5. Clinical Presentation

• Local low back ache or stiffness, worse with movement or prolonged sitting.

• Pain may be sharp during bending or twisting.

• Usually does not radiate below the knee (distinguishing from sciatica).

• Tenderness in paraspinal muscles or facet joints.

• Morning stiffness that improves with gentle movement.

6. Chiropractic Assessment

• Posture and gait analysis.

• Range of motion testing (flexion, extension, rotation).

• Palpation for restricted joints, muscle tightness, and tenderness.

• Orthopedic tests to rule out disc herniation or nerve compression.

• Functional evaluation of hip and pelvic mobility.

7. Chiropractic Management & Home Care

• Adjustments: Lumbar and pelvic adjustments restore alignment and mobility.

• Soft tissue therapy: For tight paraspinals, glutes, and hip flexors.

• Ice therapy: For acute flare-ups and inflammation.

• Exercise & rehab:

  • Core stabilization (bird-dogs, dead bugs, planks).

  • Glute activation (bridges, clamshells).

  • Hip mobility drills.

• Lifestyle advice: Ergonomic lifting, frequent breaks from sitting, supportive sleep surfaces.

8. Other Considerations

• Nutrition: Anti-inflammatory foods reduce systemic irritation.

• Hydration: Keeps joints and discs healthy.

• Stress: Increases muscle tension in the low back.

• When all else fails: Medications may temporarily mask pain, but they don’t correct underlying mechanics.

9. Rehabilitation & Exercise Progression

• Phase 1: Ice, gentle walking, avoid heavy lifting.

• Phase 2: Core strengthening, posture correction, mobility training.

• Phase 3: Functional retraining for lifting, sports, and daily tasks.

10. Prognosis & Prevention

• Most cases improve in 2–6 weeks with chiropractic care.

• Prevention: Maintain strong core and glutes, practice proper lifting, and keep good posture.

• Regular chiropractic adjustments help preserve spinal mobility.

11. FAQs

Q: Is mechanical low back pain dangerous?
A: No — it’s the most common and usually responds well to conservative care.

Q: Why does it keep coming back?
A: Recurrent episodes often mean underlying posture or muscle imbalances haven’t been corrected.

Q: Should I rest or move?
A: Gentle movement is best. Prolonged bed rest often makes it worse.

Q: How do I know it’s not a disc problem?
A: Mechanical pain usually stays in the back and doesn’t cause leg numbness or weakness. Chiropractors can test and differentiate.

1. Introduction

Upper back pain is often overlooked, but it can be just as disruptive as low back or neck pain. The upper thoracic spine connects closely to the ribs, neck, and shoulder girdle, so dysfunction here can cause widespread discomfort. Chiropractors pay special attention to how costovertebral joints (where ribs meet the spine) and thoracic vertebrae influence not only local pain, but also neck function and even breathing.

2. Relevant Anatomy

• Bones & Joints: Twelve thoracic vertebrae (T1–T12), ribs, and costovertebral/costotransverse joints.

• Muscles: Rhomboids, trapezius, erector spinae, intercostals, serratus posterior, scalenes (which bridge into the neck).

• Nerves: Thoracic spinal nerves branch into intercostal nerves that wrap around the chest.

• Blood Supply: Intercostal arteries and veins, thoracic spinal branches.

3. Normal Biomechanics & Physiology

• The thoracic spine provides stability and anchors the rib cage.

• Costovertebral joints allow rib motion needed for breathing.

• Upper back muscles stabilize the shoulder blades and connect neck to thorax.

• Healthy function allows free breathing, balanced posture, and smooth neck and shoulder movement.

4. Pathophysiology

Upper back pain may arise from:

1. Costovertebral Subluxation/Misalignment

   • Misaligned rib–vertebra joint irritates nerves and restricts breathing motion.

   • Pain may radiate circumferentially around the chest wall, felt as a band-like tightness.

   • Local point tenderness that worsens with deep inspiration is common.

2. Muscular Dysfunction

   • Overuse or weakness in postural muscles (rhomboids, traps).

   • Tight intercostals and scalenes pulling unevenly.

   • Trigger points referring pain into the neck and shoulders.

3. Neck–Thoracic Connection

   • Upper back stiffness changes neck biomechanics.

   • Neck strain can, in turn, overload thoracic muscles and joints.

   • Dysfunction in one often fuels pain in the other.

5. Clinical Presentation

• Aching or sharp pain between the shoulder blades.

• Local tenderness at rib attachment sites.

• Band-like pain wrapping around the chest wall.

• Pain with deep breathing, coughing, or sneezing.

• Neck pain or headaches associated with thoracic stiffness.

• Postural fatigue with desk or computer work.

6. Chiropractic Assessment

• Posture analysis: forward head, rounded shoulders, thoracic kyphosis.

• Palpation for rib joint misalignment and paraspinal tenderness.

• Motion testing of thoracic and costovertebral joints.

• Breathing observation (rib expansion symmetry).

• Check cervical spine mobility and compensation patterns.

7. Chiropractic Management & Home Care

• Adjustments: Thoracic and rib mobilization to restore joint motion.

• Neck adjustments: When cervical dysfunction is driving thoracic stress.

• Soft tissue therapy: For rhomboids, trapezius, and intercostals.

• Ice therapy: Over tender costovertebral areas for inflammation.

• Exercise & rehab:

  • Thoracic extension drills (“wall angels,” foam roller extensions).

  • Scapular strengthening (rows, band pulls).

  • Breathing exercises for rib mobility.

• Lifestyle advice: Improve workstation ergonomics, break up screen time, support good posture.

8. Other Considerations

• Stress and emotional tension often build in thoracic musculature.

• Shallow breathing patterns can worsen rib–spine dysfunction.

• When all else fails: Medications or injections may be offered, but they don’t address alignment or biomechanics.

9. Rehabilitation & Exercise Progression

• Phase 1: Gentle thoracic mobility (cat-cow, foam rolling).

• Phase 2: Postural strengthening (rows, prone Y/T/Ws).

• Phase 3: Functional breathing with rib expansion, integrated core stability.

10. Prognosis & Prevention

• Most upper back pain improves in 4–6 weeks with conservative care.

• Prevention includes maintaining posture, regular chiropractic care, strengthening scapular stabilizers, and practicing deep breathing.

11. FAQs

Q: Why does my chest hurt with upper back pain?
A: Rib–spine joints can irritate intercostal nerves, causing wraparound pain across the chest wall.

Q: Can upper back problems cause neck pain?
A: Yes — the two regions are mechanically linked. Stiff thoracic joints force the neck to overwork, and vice versa.

Q: Should I stretch or rest?
A: Gentle mobility and posture exercises are better than complete rest.

Q: Can chiropractic fix rib pain?
A: Yes — specific adjustments restore costovertebral motion, reducing both point tenderness and breathing-related pain.

1. Introduction

Neck pain affects a large percentage of people at some point in their lives. It may come on suddenly after an accident, or gradually from posture, stress, or wear and tear. Chiropractors look at the spine, nerves, muscles, and posture together to find and correct the source of the problem, rather than just masking the pain.

2. Relevant Anatomy

• Bones & Joints: Seven cervical vertebrae (C1–C7) allow movement and protect the spinal cord.

• Muscles: Suboccipital muscles, trapezius, sternocleidomastoid, scalene group, deep neck flexors.

• Nerves: Cervical spinal nerves (C1–C8) control sensation and movement in the neck, shoulders, and arms.

• Blood Supply: Carotid and vertebral arteries supply blood to the brain and upper spinal tissues.

3. Normal Biomechanics & Physiology

• The neck should have a natural C-shaped curve (lordosis) that distributes weight and protects discs.

• Joints allow rotation, side-bending, flexion, and extension.

• Muscles stabilize the head, balance posture, and support smooth movement.

• Nerves pass freely between vertebrae without compression.

4. Pathophysiology

Neck pain can arise from multiple overlapping issues:

1. Biomechanical Dysfunction

   • Poor posture (forward head, rounded shoulders).

   • Misaligned vertebrae stressing joints and discs.

   • Reduced curve of the cervical spine.

2. Nerve Irritation

   • Pinched or inflamed nerves causing radiating pain, tingling, or weakness into arms/hands.

   • Often from disc bulge, bone spurs, or narrowed joint spaces.

3. Myofascial Pain

   • Tight, overworked muscles (upper traps, suboccipitals).

   • Trigger points that refer pain into the head, shoulders, or arms.

5. Clinical Presentation

• Stiffness or soreness in the neck and shoulders.

• Pain worsened by sitting at a desk or using screens.

• Headaches starting at the base of the skull.

• Tingling, numbness, or weakness in the arms (if nerve irritation is present).

• Limited range of motion, especially with turning.

6. Chiropractic Assessment

• Posture exam (forward head carriage, uneven shoulders).

• Range of motion and orthopedic tests (Spurling’s, distraction).

• Palpation for joint restriction and muscle spasm.

• Neurological screen for nerve involvement.

7. Chiropractic Management & Home Care

• Adjustments: Gentle, specific adjustments to restore motion and alignment.

• Soft tissue therapy: Release tight suboccipitals, scalenes, trapezius.

• Ice therapy: For acute pain and inflammation (15–20 minutes).

• Exercise & rehab:

  • Chin tucks and deep neck flexor training.

  • Shoulder blade strengthening.

  • Ergonomic posture correction.

• Lifestyle advice: Proper desk setup, regular movement breaks, hydration.

8. Other Considerations

• Stress management reduces tension headaches and muscle guarding.

• Nutrition: Omega-3s and anti-inflammatory foods support recovery.

• When all else fails: Medical management may include painkillers, muscle relaxers, or injections — but these don’t correct underlying dysfunction.

9. Rehabilitation & Exercise Progression

• Phase 1: Gentle stretching and chin tucks.

• Phase 2: Scapular retraction, postural strengthening.

• Phase 3: Functional retraining for sports/work demands.

10. Prognosis & Prevention

• Most neck pain improves in 4–8 weeks with conservative care.

• Prevention relies on posture correction, strengthening, regular chiropractic care, and stress management.

11. FAQs

Q: Can neck pain cause headaches?
A: Yes — suboccipital tension and misalignment often trigger cervicogenic headaches.

Q: Should I use heat or ice?
A: Ice is better for acute pain. Heat can help later for stiffness.

Q: Is cracking my own neck safe?
A: No — self-manipulation is not precise and can strain joints or ligaments. Chiropractic adjustments are specific and controlled.

Q: Will it go away on its own?
A: Sometimes, but untreated misalignments can become chronic. Chiropractic care speeds healing and prevents recurrence.

1. Introduction

Headaches are one of the most common health complaints, but not all headaches are the same. Some are mild and occasional, while others are intense and disabling. Chiropractors understand that many headaches are linked to the spine, posture, and muscle tension, and can often be managed without medication.

2. Differentiating Headache Types

• Tension Headaches: Dull, pressure-like pain, often starting in the neck or back of the head and wrapping forward.

• Migraines: Usually more severe, one-sided, and may be preceded by a prodrome (warning phase) such as irritability, food cravings, or vision changes (aura). Migraines often come with nausea, vomiting, light sensitivity, and sound sensitivity.

• Nutritional or Toxic Headaches: Can result from dehydration, caffeine withdrawal, alcohol, food sensitivities, or exposure to chemicals.

3. Relevant Anatomy

• Bones & Joints: Upper cervical spine (C0–C2), where the skull meets the neck.

• Muscles: Suboccipital muscles (small muscles at the base of the skull that control head movement).

• Nerves: Greater occipital nerve, trigeminal nerve, and cervical spinal nerves (C1–C3).

• Blood flow: Vertebral arteries and carotid arteries supply the brain and meninges.

• Meninges: The protective layers covering the brain and spinal cord can become irritated with misalignment and dural tension.

4. Normal Biomechanics & Physiology

• The head should sit balanced on top of the spine.

• Suboccipital muscles stabilize and guide small head movements.

• Nerves and blood vessels flow freely without compression.

• Proper hydration and nutrition support brain and nerve function.

5. Pathophysiology

Headaches develop when one or more of these systems are disturbed:

• Dural stretch: Misalignment in the upper cervical spine can create tension in the dura mater (meningeal layer), leading to pain signals.

• Suboccipital tension: Tight muscles at the base of the skull compress nerves and restrict blood flow.

• Dehydration: Low fluid levels reduce blood volume and irritate pain-sensitive tissues.

• Toxic/nutritional triggers: Caffeine, alcohol, MSG, processed foods, and environmental toxins can irritate the nervous system.

• Migraine mechanisms: Nerve hyperexcitability, blood vessel changes, and neurotransmitter imbalances.

6. Clinical Presentation

• Tension HA: Pressure or tight band around head, worse with stress or long sitting.

• Migraine: Throbbing, one-sided, with nausea/vomiting, light/sound sensitivity.

• Cervicogenic HA: Starts in neck/occiput, worsens with neck movement, often from posture/misalignment.

• Nutritional/toxic HA: Follows certain foods, alcohol, dehydration, or chemical exposure.

7. Chiropractic Assessment

• Posture exam (forward head, rounded shoulders).

• Palpation of cervical and suboccipital muscles.

• Range of motion tests of cervical spine.

• Neurological screening for migraine signs.

• History of dietary triggers, stress, hydration.

8. Chiropractic Management & Home Care

• Adjustments: Upper cervical and thoracic adjustments reduce misalignment and dural tension.

• Soft tissue therapy: Release of suboccipital muscles and cervical tension.

• Ice therapy: For acute headache pain and inflammation (especially migraines).

• Hydration: Encourage adequate water intake daily.

• Lifestyle advice: Improve posture, stress management, identify food/environmental triggers.

9. Other Considerations

• Nutrition: Avoid trigger foods (alcohol, MSG, artificial sweeteners). Add magnesium-rich foods (leafy greens, nuts).

• Sleep hygiene: Poor sleep is a major headache trigger.

• Stress: Breathing exercises, stretching, relaxation.

• When all else fails: Medications, injections, or advanced neurological consults may be considered, but are usually not first-line.

10. Rehabilitation & Exercise Progression

• Phase 1: Postural stretches (chin tucks, chest openers).

• Phase 2: Suboccipital release with tennis ball, gentle mobility drills.

• Phase 3: Strengthening deep neck flexors and upper back muscles for posture correction.

11. Prognosis & Prevention

Most patients see improvement in 4–6 weeks with regular chiropractic care, posture correction, and hydration. Long-term prevention comes from stress management, ergonomic changes, and avoiding dietary triggers.

12. FAQs

Q: What’s the difference between a migraine and a headache?
A: Migraines are usually more severe, often with nausea, vomiting, and light/sound sensitivity. Tension headaches are dull and pressure-like.

Q: Can chiropractic help migraines?
A: Yes — many migraine patients improve with cervical adjustments, muscle release, and lifestyle changes.

Q: Should I use heat or ice?
A: Use ice during a headache or migraine to calm inflammation. Heat can sometimes worsen vascular headaches.

Q: Do I need an MRI or CT scan?
A: Most headaches don’t need imaging, but red flags like sudden severe pain or neurological changes may require medical referral.

1. Introduction

A “pinched nerve” in the neck happens when one of the nerves leaving the spine is irritated or compressed. Pinched nerves can happen anywhere in the spine, but are most common in the neck or lower back. For this portion we will assume the neck is responsible. This can cause pain in the neck itself, but more often it radiates into the shoulder, arm, or hand. Chiropractors focus on the root causes, such as spinal misalignment, disc bulges, or tight muscles, and restore proper motion to relieve nerve irritation naturally.

2. Relevant Anatomy

• Bones & Joints: Seven cervical vertebrae (C1–C7) form the neck, with openings (foramina) where nerves exit.

• Discs: Cushion between vertebrae; can bulge and irritate nerves.

• Nerves: Cervical nerve roots (C1–C8) supply sensation and strength to the neck, shoulders, arms, and hands.

• Muscles: Scalene group, trapezius, levator scapulae, and deep cervical flexors.

• Blood Supply: Vertebral and carotid arteries nourish spinal cord and neck tissues.

3. Normal Biomechanics & Physiology

• The cervical spine should have a lordotic curve that distributes weight evenly.

• Discs and joints allow smooth motion without narrowing the nerve exits.

• Muscles balance head posture and protect joints.

• Nerves send signals freely to the arms and shoulders.

4. Pathophysiology

A pinched nerve may result from:

1. Disc Bulge or Herniation – Disc material presses on a nerve root.

2. Joint Misalignment – Vertebrae shift, narrowing the nerve opening.

3. Arthritic Changes – Bone spurs or thickened joints reduce nerve space.

4. Muscle Entrapment (Myofascial) – Tight scalenes or levator scapulae compress nearby nerves.

5. Clinical Presentation

• Sharp, shooting, or burning pain into the shoulder, arm, or hand.

• Tingling or numbness in specific fingers (depending on which nerve is affected).

• Weakness when gripping, lifting, or turning the head.

• Neck stiffness, especially with rotation or looking up.

6. Chiropractic Assessment

• Posture exam (forward head, rounded shoulders).

• Orthopedic tests: Spurling’s test (nerve compression), distraction test (relief of pressure).

• Neurological testing: Reflexes, sensation, and muscle strength.

• Palpation for muscle spasm and joint fixation.

• Imaging (X-ray, MRI) if severe or progressive symptoms.

7. Chiropractic Management & Home Care

• Adjustments: Gentle spinal adjustments to restore motion and relieve nerve pressure.

• Flexion-distraction: For disc-related nerve compression.

• Soft tissue therapy: Release tight muscles like scalenes and trapezius.

• Ice therapy: To reduce inflammation around the nerve root.

• Exercise & rehab:

  • Chin tucks to strengthen deep neck flexors.

  • Shoulder blade squeezes to open nerve spaces.

  • Nerve glide exercises (“nerve flossing”) for the arm.

• Lifestyle advice: Ergonomic desk setup, avoid cradling phone between ear and shoulder, proper pillow support.

8. Other Considerations

• Nutrition: Anti-inflammatory foods support nerve recovery.

• Hydration: Keeps discs and joints healthy.

• Stress: Can worsen muscle tension and nerve irritation.

• When all else fails: Injections or surgery may be needed for severe, unrelenting cases.

9. Rehabilitation & Exercise Progression

• Phase 1: Pain relief, posture correction, ice.

• Phase 2: Controlled mobility and strengthening.

• Phase 3: Functional training for work, sports, and daily activities.

10. Prognosis & Prevention

• Many cases resolve within 6–12 weeks with conservative chiropractic care.

• Prevention includes good posture, regular exercise, ergonomic awareness, and chiropractic checkups.

11. FAQs

Q: How do I know if I have a pinched nerve or just a muscle knot?
A: Pinched nerves often cause numbness, tingling, or weakness along with pain. Muscle knots cause more localized ache without nerve symptoms.

Q: Will a pinched nerve heal on its own?
A: Some mild cases do, but chiropractic speeds recovery and prevents recurrence.

Q: Should I rest or stay active?
A: Gentle movement and stretching are better than total rest. Avoid aggravating positions.

Q: Can chiropractic help without surgery?
A: Yes — many cases respond well to adjustments, decompression, and targeted rehab.

1. Introduction

The sacroiliac (SI) joints connect the spine to the pelvis and play a key role in stabilizing the body during walking, lifting, and bending. Dysfunction here can cause localized low back and buttock pain, sometimes radiating into the thigh. It is often confused with disc or sciatic pain.

2. Relevant Anatomy

• Bones: Sacrum + ilium.

• Ligaments: Strong sacroiliac ligaments stabilize the joint.

• Muscles: Gluteals, piriformis, hamstrings, erector spinae.

• Nerve supply: Sacral plexus (L4–S3).

• Blood supply: Iliolumbar and gluteal arteries.

3. Normal Biomechanics & Physiology

• SI joints allow small gliding and tilting motions (~2–4 mm).

• Provide shock absorption between spine and legs.

• Work with lumbar spine and hips for smooth gait and posture.

4. Pathophysiology

• Hypomobility: Fixation/misalignment creates joint stress.

• Hypermobility: Excess motion overstretches ligaments (common in pregnancy).

• Asymmetry: Uneven pelvic mechanics alter gait, causing pain and muscle imbalance.

5. Clinical Presentation

• Aching or sharp pain near the dimple area of low back.

• Pain may radiate into buttock or thigh, but not below the knee.

• Worse with standing from sitting, climbing stairs, or prolonged walking.

• Point tenderness over SI joint.

6. Chiropractic Assessment

• Palpation for SI motion restriction.

• Motion tests (e.g., Gillet’s test).

• Leg length evaluation for pelvic imbalance.

• Gait analysis.

• Rule out disc or hip pathology.

7. Chiropractic Management & Home Care

• Adjustments: SI joint manipulation to restore symmetry.

• Soft tissue therapy: Piriformis, hamstrings, glutes.

• Ice therapy: For acute irritation.

• Exercise:

  • Core stabilization.

  • Glute strengthening (bridges, clamshells).

  • Hip mobility drills.

8. Other Considerations

• Pregnancy and ligament laxity increase SI stress.

• Sedentary lifestyle weakens stabilizers.

• When all else fails: Injections or fusion, but rare with proper conservative care.

9. Rehabilitation & Exercise Progression

• Phase 1: Pain control, gentle mobility.

• Phase 2: Strengthening glutes and core.

• Phase 3: Functional retraining (walking, lifting).

10. Prognosis & Prevention

• Most cases improve in 2–6 weeks.

• Prevention: Strong glutes/core, regular chiropractic care, proper lifting technique.

11. FAQs

Q: Why does SI pain feel like sciatica?
A: SI irritation can radiate into the buttock/thigh, mimicking nerve pain, but doesn’t usually go below the knee.

1. Introduction

Sciatica is pain, tingling, or numbness that travels down the back of the leg. It happens when the sciatic nerve is irritated, compressed, or inflamed. Not all “sciatica” is the same: sometimes the problem comes from the nerve itself, sometimes from spinal alignment, and sometimes from tight or irritated muscles. Understanding the difference helps guide care.

2. Relevant Anatomy

• Nerve: The sciatic nerve is the largest in the body, formed by spinal nerves L4–S3.

• Pathway: Runs from the lower spine, through the pelvis and buttock, down the back of the thigh, and branches into the calf and foot.

• Muscles: Piriformis, hamstrings, and gluteals lie near the sciatic nerve.

• Blood supply: Inferior gluteal artery and femoral artery branches.

3. Normal Biomechanics & Physiology

• Healthy discs and joints keep the spinal nerves free of pressure.

• The pelvis provides a balanced foundation for the spine.

• The sciatic nerve normally glides smoothly as the hip and spine move.

• Muscles of the hip and pelvis stabilize and protect the nerve.

4. Pathophysiology

Sciatica can arise from three main categories of dysfunction:

1. Nerve Compression/Irritation

   • Disc bulge or herniation pressing on nerve root.

   • Spinal misalignment narrowing nerve space.

   • Bone spurs or arthritic changes.

2. Biomechanical Dysfunction

   • Pelvic or sacroiliac misalignment altering load on the lumbar spine.

   • Poor posture or weak core muscles leading to instability.

   • Abnormal gait increasing stress on the lumbar segments.

3. Local Myofascial Pain (Mimics Sciatica)

   • Tight piriformis muscle squeezing the sciatic nerve (piriformis syndrome).

   • Gluteal trigger points referring pain down the leg.

   • Hamstring tension irritating nerve glide.

5. Clinical Presentation

• Classic nerve pain: Sharp, shooting, or burning pain down the back of one leg. Often worse with sitting, coughing, or bending forward.

• Biomechanical dysfunction: Low back stiffness, pain that worsens with movement, posture changes, or long standing.

• Myofascial pain: Deep ache or pulling sensation in buttock/thigh, may not go past the knee, often tender spots in muscles.

6. Chiropractic Assessment

• Posture and gait analysis.

• Orthopedic tests (straight leg raise, slump test).

• Palpation for trigger points in piriformis, glutes, hamstrings.

• Spinal alignment and motion testing in lumbar/pelvic joints.

• Neurological screening for numbness, weakness, or reflex changes.

7. Chiropractic Management & Home Care

• Adjustments: Restore motion to lumbar spine and pelvis, relieve nerve compression.

• Soft tissue therapy: Release piriformis, hamstrings, and glutes to reduce myofascial entrapment.

• Ice therapy: 15–20 minutes several times daily for acute pain and inflammation.

• Exercise & rehab:

  • Core stability training.

  • Gentle nerve glides (sciatic flossing).

  • Hip and hamstring stretches.

• Lifestyle advice: Avoid long sitting, keep hydration up, use lumbar support.

8. Other Considerations

• Nutrition: Anti-inflammatory diet (omega-3s, leafy greens, lower processed foods).

• Weight management to reduce spinal load.

• Stress reduction for muscle relaxation.

• When all else fails: Steroid injections or surgery may be considered, but most cases resolve with conservative care.

9. Rehabilitation & Exercise Progression

• Phase 1: Walking, McKenzie extension exercises, gentle piriformis stretches.

• Phase 2: Core strengthening (planks, bird-dogs), glute activation.

• Phase 3: Functional retraining for work/sport (lifting mechanics, balance).

10. Prognosis & Prevention

• Nerve pain often takes longer (6–12 weeks), while myofascial cases may improve faster.

• Regular chiropractic care, core training, and posture awareness prevent recurrence.

• Staying active, hydrated, and strong keeps the sciatic nerve healthy.

11. FAQs

Q: How do I know if it’s true sciatica or just a muscle problem?
A: True sciatica usually runs below the knee and may cause numbness or weakness. Muscle-related pain often stops higher in the leg and feels more like an ache.

Q: Should I rest or move?
A: Gentle movement (walking, stretching) is better than bed rest. Too much sitting worsens sciatica.

Q: Can chiropractic fix sciatica?
A: Yes — adjustments and soft tissue care address both spinal misalignment and muscle tension, which are common causes of sciatica.

Q: When should I worry?
A: If you lose bowel/bladder control or develop severe weakness, seek emergency medical care.

1. Introduction

Carpal Tunnel Syndrome (CTS) is when the median nerve is compressed as it passes through the wrist tunnel. It causes numbness, tingling, and weakness in the hand. However, many patients are misdiagnosed, because nerve irritation at the neck, shoulder, or elbow can mimic CTS. Chiropractic addresses the whole nerve pathway, relieving “double crush” points and restoring proper wrist mechanics.

2. Relevant Anatomy

• Nerve: Median nerve (roots from C5–T1).

• Tunnel: Formed by carpal bones and transverse carpal ligament.

• Muscles affected: Thumb opposition, grip strength.

• Blood supply: Radial and ulnar arteries.

3. Normal Biomechanics & Physiology

• Median nerve glides freely at the wrist during hand motion.

• Proper neck/shoulder alignment reduces upstream nerve tension.

• Balanced flexor/extensor muscles protect the tunnel.

4. Pathophysiology

• Local compression: Swelling of tendons or ligament tightness.

• Double crush: Nerve irritation in cervical spine or shoulder combined with mild wrist narrowing.

• Myofascial: Tight forearm flexors limiting nerve glide.

5. Clinical Presentation

• Numbness, tingling, or burning in thumb, index, middle, and half of ring finger.

• Hand weakness, dropping objects.

• Night pain/awakening with “pins and needles.”

• Worse with typing, driving, or holding phone.

6. Chiropractic Assessment

• Cervical and shoulder exam for upstream nerve involvement.

• Wrist palpation for tunnel tenderness.

• Orthopedic tests: Phalen’s, Tinel’s at wrist.

• Neurological exam for sensation/strength.

7. Chiropractic Management & Home Care

• Adjustments: Cervical, shoulder, elbow, and wrist.

• Soft tissue therapy: Forearm flexors, pronator teres.

• Ice therapy: For acute wrist pain.

• Exercise & rehab:

  • Median nerve glides.

  • Forearm stretches and strengthening.

  • Posture correction.

• Lifestyle advice: Ergonomic tools, wrist-neutral sleeping, frequent breaks from repetitive work.

8. Other Considerations

• Nutrition: B vitamins for nerve repair.

• Stress: Tension worsens nerve compression.

• When all else fails: Carpal tunnel release surgery, though many cases don’t need it.

9. Rehabilitation & Exercise Progression

• Phase 1: Ice, rest from repetitive tasks, gentle nerve glides.

• Phase 2: Strengthen grip and forearm muscles.

• Phase 3: Ergonomic retraining and gradual return to load.

10. Prognosis & Prevention

• With chiropractic care, many improve in 4–8 weeks.

• Prevention: Proper ergonomics, regular stretching, maintaining cervical and shoulder alignment.

11. FAQs

Q: Why do my hands tingle at night?
A: Wrist flexion during sleep compresses the median nerve.

Q: Can CTS be mistaken for neck problems?
A: Yes — cervical misalignments can mimic CTS. Chiropractic distinguishes between them.

Q: Do I need surgery?
A: Most cases improve conservatively. Surgery is last resort.

Q: How does chiropractic help?
A: By adjusting spine, shoulder, elbow, and wrist, chiropractic clears nerve irritation along the entire pathway.