Wednesday, March 6, 2013

7 Common Cause of Low Back Pain

Low back pain is one of the most common complaints at the doctor's office. It is estimated that over 80% of the population will experience at least one episode of severe LBP (low back pain) that will debilitate them for at least one week. That is significant! You are also more likely to experience periodic exacerbation of LBP following an injury to the lumbar spine. Chronic LBP tends to be episodic and generally comes on without warning.

This blog post is to identify the most common causes of low back pain.

1. Injury or Sprain/Strain of the lumbar spine: this is a common cause of LBP, especially in the workplace and following a motor vehicle accident. If treated within a short amount of time, this type of condition generally resolves in 8-12 weeks. However, other variables such as obesity, diabetes, pre-existing LBP, degenerative arthritis, deconditioning etc...may cause the lumbar sprain injury to take longer to resolve.

2. Degenerative Disc Disease, Osteoarthritis, Spinal Stenosis: I have lumped the degenerative arthritic conditions together, with spinal stenosis being the most severe and progressive condition of them all. Degeneration of the spine is caused by "wear and tear" and/or history of trauma. The "degenerative cascade" proposed by the famous orthopedist Dr. Kirkaldy-Willis starts with spinal dysfunction/fixation and/or injury of the spine. This leads to intervertebral disc cellular changes, tears, bulges, herniations and eventually leading to instability. The body then attempts to stabilize (the final phase) by stiffening up as the joints, discs and spine becomes arthritic with calcium deposits. End stage lumbar spondylosis is spinal fusion.

3. Disc herniation: there are several categories of intervertebral disc herniations. The most common is a circumferential bulge. Studies demonstrate that about 80% of the population have minor disc bulges and are generally asymptomatic. Another type of disc herniation is a protrusion. This is when the outer annular fibrocartilage weakens or tears and the inner "jelly-like" nucleus protrudes out from the spine. This will commonly compress or irritate a spinal nerve root. The other type of herniation is the disc extrusion. This is when the outer annulus fibers tear completely and the inner nucleus pulposus herniates out from the spine. This may compress a spinal nerve above or below the vertebra and usually requires surgery.

4. Facet syndrome: This is a very common cause of LBP and a condition that I treat frequently in my office. The facets, also called the posterior joints, are interlocking joints of the spine that are highly innervated with nerves and receptors and are covered by a joint capsule. This is why they are common pain producing structures of the spine. The facet joint capsules are often sprained during flexion and torsional movements. The facet joints frequently become "impinged" or "locked up" and is commonly referred to as facet imbrication or facet impingement. Chiropractic manipulation is effective for this type of problem.
5. Scoliosis: This is a condition in which right or left (lateral) curves of the spine are present and are generally more than 10 degrees. Any curve below 10 degrees is considered a minor "curvature" and is generally a functional curve. Adolescent idiopathic scoliosis is the most common type of scoliosis and starts between ages 10-16. Scoliosis management ranges from conservative chiropractic care, postural exercises, to bracing and in more severe cases surgery.

6. Sacroiliac Syndrome: This is another very common cause of low back pain. It is commonly mistaken as hip pain. The sacroiliac joints are found in the pelvis between the ilium and the sacrum at the bottom of the spine. Some people have small little dimples in the region of the SI joints. The SI joints are synovial joints and are connected by strong ligaments. The SI joints can also become sprained. Sacroiliac syndrome usually presents as localized joint and buttock pain, but can refer to the groin or posterior thigh. The gluteal muscles are almost always involved and are tender and/or weak. (specifically the gluteus medius and minimus)

 7. Postural syndromes: This is another common cause of low back pain and is almost always, to some extent, involved in all of the above conditions. Lower crossed syndrome is a common postural imbalance in the lower body which involves having tight low back muscles and hip flexors and weak glutes and abdominal (core) muscles. This will cause anterior (forward) pelvic tilting, causing dysfunction in the lower lumbar spine and sacroiliac joints. This is another condition that I see everyday in my office and it responds well to chiropractic manipulation and exercise/postural re-training.
For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter @BrantArtsChiro Facebook: Brant Arts Chiropractic.


Tuesday, December 11, 2012

Natural Sleep Aids

Statistics Canada found that 3.3 million Canadians (one in seven!) over the age of 15 have problems falling asleep or staying asleep. 8 hours of good quality, uninterrupted sleep is ideal.

Sleep is directly correlated to better health. This is the time the body heals and rejuvenates. Poor sleep has been linked to heart disease, diabetes, obesity and depression.

Here are some tips to help you to fall asleep and stay asleep:

1. Avoid Caffeine- You should avoid caffeine about 4-6 hours before bedtime. Some people are affected by caffeine for up to 12 hours.

2. Avoid Bright Lights- before bedtime. Even the LED lights on your alarm clock and computer can stimulate the brain and cause you to stay up.

3. Reduce Stress- meditation, yoga, exercise, massage and chiropractic are therapies that can help to reduce stress and help you fall asleep.

4. Avoid activity or exercise close to bedtime

5. Have a light snack or warm drink before bedtime- warm milk contains tryptophan which converts to serotonin to put you to sleep. Warm decaffeinated tea such as chamomile tea is calming to help you to fall asleep.

6. Avoid alcohol- this will cause you to wake up throughout the night.

7. Routine is Key- try to fall asleep and wake up at the same time. Also have a bedtime routine such as having a warm bath, reading a book with a chamomile tea and preparing for sleep at the same time each and every day.

8. Natural Supplements- talk to your natural health care practitioner such as a naturopath or a chiropractor about natural supplements that can help with sleep.

For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic

Tuesday, November 6, 2012

A.R.T. - Active Release Techniques for soft tissue injuries and more

Some of you may have heard the term "A.R.T.", or the words Active Release Techniques. Today I would like to explain what ART treatment is, how it works, what kind of practitioners perform this very effective soft tissue technique and the many conditions this therapy can treat.
As stated above, A.R.T. stands for active release techniques. It is an advanced soft tissue technique that requires intensive training and certification. It is known to be the "gold standard in soft tissue treatment". Healthcare professionals that are able take this post-graduate training and certification in ART are Chiropractors, Registered Massage Therapists, Physiotherapists, Certified Athletic Therapists and Medical Doctors. This advanced training is not open to personal trainers, masseurs, and any other certifications that are not licensed to treat soft tissue problems. The practitoner must be competent in anatomy (not just basic anatomy), physiology and biomechanics. Here is a link to see a photo of an ART treatment being performed:

A.R.T. treats soft tissue conditions. Soft tissues include muscles, tendons, ligaments, fascia and nerves. It is a patented treatment that was founded and developed by a chiropractor Dr. P. Michael Leahy DC, CCSP.

Common conditions that respond very well to A.R.T. treatment include; back pain, headaches, sciatica, carpal tunnel syndrome, tennis elbow, shoulder or rotator cuff pain, knee pain, plantar fasciitis (heel pain), achilles tendonitis....just to name a few. The common denominator in all the above conditions is that they almost always involve overused muscles or repetitive motions. In the medical arena we call these conditions CTD (cumulative trauma disorders) or RSI (repetitive strain injuries).

Let's go into detail to explain what happens to overused muscles and soft tissues. When a particular muscle or tendon or any soft tissue is overused there are specific changes that will happen in the tissue.
    1.) you can have an acute injury such as a muscle tear, pull, strain or contusion.

    2.) you can have cumulative strain which accumulates small tears, called "micro-trauma"
    3.) or you can have lack of oxygen going to the muscle or tissue, called "hypoxia" creating "trigger points" or "knots" in muscle which can lead to fibrous tissue.

Most of the conditions I listed above will have one or more of the three soft tissue changes that happen to overused muscles.
Let me give you an example of how this can relate to a simple calf strain or leg pains. A female who wears high heels to work 5 days a week will overuse her calf muscles. Each and every step she takes in these heels will create excessive contraction of the gastroc-soleus (calf) muscles. Even when seated, the calf muscle will be over-worked because it is still in constant contraction while in the high heels. Over time this will create very tight, shortened calf muscles causing increased tension and friction in the muscle. The tension and friction causes micro-trauma (small tears) causing inflammation. The inflammation will then cause the body to actually lay down adhesions or scar tissue in an attempt to "fix" the injured and inflamed muscle. It is only at this point in the sequela of events that the patient will actually feel pain or any symptom. This is the classic example of a RSI (repetitive strain injury) and usually the patient will present with tight and achy and sometimes burning pain the affected muscles. The patient will say something like this..."doc my legs are killing me." "They are tender and sore all day long." "It just came on, I don't know what I did and I have never had this pain before..." As you can see, repetitive strain injuries develop over time from overuse. It creates a negative self-perpetuating cascade of events: overused muscle - becomes tight - increases tension - increases friction - causes inflammation and pain - causes scar tissue development - which causes more tightness, more tension, more friction, more inflammation and more scar tissue. You get the idea. This continually happens until the body breaks down and can no longer adapt, thus resulting in pain and symptoms. The tight muscles or scar tissue can even irritate, pinch or compress a nerve causing numbness and tingling and even sharp pains. A.R.T. is also used to reduce nerve entrapments.

Now that you understand how RSI (repetitive strain injuries) happen, it is very easy to understand how A.R.T. works to fix the problem, not mask it. Conventional allopathic medicine would try to treat this by giving anti-inflammatory (NSAID) medications. This may help to reduce some inflammation and pain, but it just masks the problem. The cause of the problem is not the inflammation, it is the tight, fibrotic (scar tissue) muscle. This is where A.R.T. comes in. The treatment will break down the fibrous adhesions (scar tissue); reduce the tension and tightness in the muscle so it can heal properly. Immediately following an ART session, the patient will feel looser and the pain and tension should be reduced. Exercise rehabilitation, postural correction and improving the ergonomics at the workplace are also implemented to get superior results.
For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic

Tuesday, October 23, 2012

Over-Training : How to measure and prevent.

How does over training happen?

Over training is the result of “inappropriate recovery methods that do not keep in pace with the demands of training.” Patients and athletes need to know that adequate rest is important to make gains and avoid over training.

Why does over training happen?

• Energy stores become depleted, therefore performance decreases.

• Inappropriate rest and recovery leads to injuries and no strength or mass gains.

• Poor nutrition; cannot heal tissues and replenish energy stores or electrolytes.

• Poor workout planning. Need adequate time following high intensity workouts.

Symptoms of over training

• Morning pH readings; basic urine readings means body is acidic, therefore prone to illness. (Ebbets, 2006)

• Personality, attitude and motivational changes. (Ebbets,2006)

• Elevated morning heart rate; greater than 10%. (Ebbets,p.32,2006)

• Fatigue, apathy, listlessness, loss of will power. (Ebbets,p.32,2006)

Stage control test

• Easy tests that can be performed to see if the athlete is over training. (Ebbets,p.32,2006)

• Examples include: vertical jump heights, standing long jump.

• Get baseline measures, and re-test at a later date for decrease in performance.

Physiological indicators for signs of over training

• Decreased strength, speed, coordination and endurance.

• Muscle soreness, injury, and slower recovery rates

• Increased sweating, excessive thirst, nausea, loss of appetite

Immunological indicators for signs of over training

• Increased susceptibility to illness, colds, allergies, infections, swollen lymph glands.

• Decreased lymphocyte counts, increased eosinophil counts

The 10 Day Rule (Ebbets, p.83,2006)

• Latency periods for organs and systems in the body to recover following exercise.

• Examples: heart rate 20-60mins, muscular system 24-48hrs, CNS 7x the muscular system

• Average recovery of the muscle system =36hrs. 36hrs X 7 =252hrs approximately 10 DAYS

• 10 Days of rest are needed following “personal bests” e.g.: 5k run, bench, squat, deadlift.

Proper nutrition to avoid over training

• Adequate protein for building and repair. 1.2g per kilogram of body weight.

• Complex carbohydrates for metabolic energy cycles and replenishing glycogen stores.

• Plenty of water to achieve optimal hydration and functioning of systems.

• Multivitamin and antioxidants for increased demands and stress on the body.

Other remedies for over training

• Change or revise training programs and goals

• Rest or active rest (low level exercise) will speed up recovery.

• Reduce psychological stress: meditation, deep breathing, tai chi, yoga.

For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic


Ebbets, R., (2006) Principles of Training Theory. The study and application of elite sport science. P.4-84.

Tuesday, October 16, 2012

Can Orthotics help foot, knee or back pain?

Orthotics for Foot Pain, Knee Pain and Back Pain


            Orthotics are prescribed and recommended by chiropractors, podiatrists and other health care professionals, and are custom-made for the patient's postural problems. Custom orthotic inserts provide functional support and cushioning.
Custom-made orthotics are designed to allow your feet to maintain their structural and functional balance. Your feet are the foundation of your body, to support your body when you stand, walk, or run; they assist you in locomotion; and they absorb forces or shock as you move to protect your spine, pelvis, and muscles.
Your feet are at optimal functioning when all the bones and arches are in their ideal stable positions. Foot problems such as weakness, instability, flat feet, or high arches will often contribute to postural problems in the rest of the body, which may lead to spinal misalignment. Custom-made orthotics will help to keep the feet in a stable and desirable position. On the photo to the left, you can see what over-pronation (rolling in) of the subtalar joint can do to the ankle, knee, hip, pelvis, spine and even the shoulders and neck. It is estimated that over 80% of the population have pronation problems which can lead to plantar fasciitis, heel spurs, bunions, knee pain and OA, sciatic impingement and scolisis of the spine.

How can orthotics correct over-pronation and pes planus (flat feet)?
When the foot is over-pronated (flat footed), the femur and the tibia stay in internal rotation.  (see pic above with left foot) This causes other parts of your body to compensate, changing the muscular structure and biomechanics of the gait cycle.
Orthotics will support the medial arch and keep the subtalar joint in a neutral position. In other words, when the foot is casted to correct the pronation, the joint is put in the correct position to compensate for the excessive "rolling in" of the ankle. The above picture illustrates how the custom orthotic aligns the foot and ankle in the correct postion.
Custom-made orthotics should be prescribed and casted by a licensed health care professional. Chiropractors, Chiropodists, and Podiatrists are experts in foot and gait mechanics and the effects of these problems on other areas of the body.

For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic

Tuesday, October 2, 2012

Prostate Cancer Risk Factors

Prostate Cancer Risk Factors

  The BRCA gene, may also be found in men.  Men who carry this mutation, may increase their risk of prostate cancer, and breast cancer. (  The incidence of prostate cancer increases drastically with increasing age.  It is very rare to see prostate cancer before age 50.  With regard to family history, it is estimated that 15 percent of men with prostate cancer have a brother or father (first-relative) that had prostate cancer as well.  Risk of prostate cancer is higher among blacks and lowest among Japanese (whites in the middle).  A number of studies have also reported higher levels of DHT and testosterone among blacks, and lowest among Japanese.  These hormone levels are essential to normal prostatic development.  The risks for developing prostate cancer directly parallel the race and androgen levels.  Your risk may also increase with high fat diets, especially animal/saturated fats.  There have been many studies that illustrate this correlation.  Possible explanations; dietary fat increases serum androgen levels, and fatty acids (linoleic acid, omega 6) may initiate prostate cell growth, while omega 3 fatty acids inhibit cell growth. ( National Cancer Institute.

Related blogs: See my post about about the anti-cancer diet and breast cancer risk factors.

For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic


Breast Cancer Risk Factors

Breast Cancer Risk Factors

 Risk is a person’s chance of getting a disease over a specific time period.  A person’s risk is usually estimated by looking at a specific age group, race etc..

For example, by looking at 100,000 women, ages 20-29 for one year, approximately 4 would develop breast cancer. That is to say, 1 per 25,000 women.  However, the lifetime risk of breast cancer for an American women born in 1990 is about 1 in 8, if she lives to be 85 (  Risk factors can range from lifestyle choice to genetics to environmental factors, such as radiation.  It is known that early menarche (before age 12) have a higher risk of developing breast cancer.  Factors that decrease risk are called protective factors.  Women who have given birth before age 30 have a lower risk.  Therefore, giving birth is a protective factor against breast cancer.  It is also reported that women who take postmenopausal hormones have a 25 percent increase in risk.

            Several inherited mutations of genes have been linked to breast cancer, such as BRCA1, BRCA2, p53, and ATM.  These mutations would increase the risk of developing breast cancer, but they are in fact very rare in the population.  Thus, they only account for 10-15 percent of all types of breast cancer diagnosed in the U.S. (  BRCA1 and BRCA2 mutations are well recognized, although it is estimated that only 250,000 women in the U.S. carry this mutation.  If one does carry the BRCA1 mutation, they have a 60-80 % chance of developing breast cancer. (BRCA2, a slightly lower risk)  Since these mutations are quite rare among the general population, it is likely a combination of factors that contributes to the development of breast cancer.

( The Susan G. Komen Breast Cancer Foundation)
Related blogs: See my post about about the anti-cancer diet.

For more information Dr. Brent Moyer can be contacted at Brant Arts Chiropractic 905-637-6100. Twitter: @brantartschiro Facebook: Brant Arts Chiropractic