Joint Disorders - Spine
Be ready to provide your medical history, which will be essential for preparing a course of treatment for you. Medical records, such as diagnostic test results, or imaging results, such as X-rays and MRIs, also will provide important information about your condition.
Certain things in your health history are particularly vital to a chiropractor. This information could provide important clues that will allow your chiropractor to properly diagnose your problem. Such clues include whether you have or have had:
Bone disorders, such as osteoporosis
Circulatory problems (poor circulation could be a sign that you have a subluxation, for example)
Dizziness or blurred vision
Heart conditions such as hypertension or high blood pressure
Infections, especially those affecting your spine
Injuries, such as bone fractures, muscle sprains, or disc injuries
Joint disorders such as arthritis
Be prepared to answer such questions as:
Did the onset of your pain immediately follow an injury?
Is there anything you do that improves or worsens the pain?
When and how did your pain start?
Where is the pain centered?
The physical exam
Here's what to expect:
The first order of business is checking your vital signs, reflexes, and blood pressure.
Sometimes measurements will be taken to determine arm and leg length. Next, you will be asked to do a series of simple and easy activities or exercises. These exercises will provide information about your motor skills, balance, and gait, among others. These tests also help determine your range of motion, muscle tone and strength, and integrity of your nervous system. Any abnormalities could provide clues about a condition. You may be asked to:
Bend forward, sideways, or backwards - Misaligned spinal vertebrae can sometimes be detected during this exercise.
Flex and extend your leg - This is a test for signs of sprain and helps determine the integrity of your joints (also called the "Yeoman's Test").
Grip something such as a rubber ball - Your grip strength is vital for showing signs of muscular or nerve damage.
Lie down and raise one leg - This is often referred to as the "Thomas Test," in which the chiropractor gently pushes on your raised leg to check for hip joint mobility.
Stand and raise one leg - This test can sometimes show whether you have sciatica, a nerve disorder in your lower back. Another test may involve pushing on your raised leg to determine whether you have pain, inflammation, or imbalance in the joints between your spinal vertebrae. (This is also called the "Psoas Muscle Test.")
Stand or sit - Posture can sometimes show whether you have misalignments in your spine.
Walk a straight line - This test measures your gait, and helps to determine if you have a normal walking pattern.
Walk in Place - Abnormalities in the way your pelvis and spine coordinate can be seen during this test.
Next, a short physical exam by the chiropractor will involve palpation, or use of the hands, to explore the alignment of your spine and other structures, as well as provide information on any stimuli that may cause pain. Depending on your condition, a series of diagnostic tests may follow. These tests may include MRIs, CT scans, X-rays, blood work, and other laboratory tests.
The chiropractor may also consult with you about making important lifestyle changes, such as exercise, nutrition, and smoking cessation to improve your chances of healing faster or preventing further injury.
The bony structures that allow your back and neck to easily move in different directions are called "facet joints." Facet joints provide about one-fifth of your lower back and neck's twisting stability. Facet joints are located in pairs at each vertebral level (except for the top vertebra) down your spinal cord.
The surfaces of facet joints are coated with slippery cartilage, allowing them to glide freely as you move. Each joint is encased in a capsule that generates lubricant for the joint while it moves.
When joints are injured in a traumatic event, or degenerate over time because of the aging process or disease, a wide variety of problemsand painoften result.
Facet joint syndrome develops when the cartilage in joints wears thin. Your body begins producing material (called bone spurs) to shore up the cartilage. This material can calcify, or harden, causing stiffness in the joint. In some cases, facet joint syndrome can contribute to joint inflammation, muscle spasms, and later osteoarthritis. Advanced cases of facet joint problems are sometimes referred to as degenerative spondylolisthesis, a condition in which joints slip forward.
Facet joint disorders in the lower back can cause stiffness, and make it difficult to stand straight or get out of a chair. Facet joint disorders in the cervical (neck) region can cause headaches and difficulty rotating the head.
A common joint disorder involves the sacroiliac joint, which links the bottom of the spine with the pelvic bone. This joint endures a lot of pressure and absorbs the shocks from the upper body. Although it is a very strong and mostly stationary joint, the sacroiliac joint can become damaged or impaired. Sacroiliac joint dysfunction can mimic many of the symptoms of a herniated lumbar disc. People with sacroiliac joint dysfunction typically complain of pain on one side of their lower back or buttocks. The pain can sometimes shoot down one or leg or both, sometimes extending all the way down to the foot.