Glossary

A|B|C|D|E|F|G|H|I|J|K|L|M|N|O|P|Q|R|S|T|U|V|W|X|Y|Z


Previous - 1 - 2 - 3 - Next

This is when wear-and-tear arthritis degenerates the meeting point between the shoulder (scapula) and the collar bone (clavicle).

This is an AC joint sprain, taken to and beyond the joint’s limits.  Also called “separated shoulder.”

This is when the collar bone (clavicle) and the shoulder bone (scapula) are traumatized.  This condition can be very painful, long-lasting, and can disrupt the movement of the entire shoulder complex.

The Achilles tendon connects the powerful calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).  Tendonitis (inflammation of the tendon and/or the sheath around it) can vary from an annoyance, to severe.  In some cases the tendon may degenerate to the point of rupture, which is always addressed via surgical repair.

Treating Achilles tendonitis may include treatment to the tendon itself.  Certain specialized forms of soft tissue manipulation are especially helpful.  In athletes, correcting equipment problems (worn-out or improper footwear, for example) or surface issues (such as running on banked roads, or always running the same direction around a track) may be a part of management.  Addressing the entire biomechanical chain is also recommended in most cases.  This means that the foot and its bones, the ankle, the knee, the hip, the sacroiliac joints, the spine, and the area’s muscles and nerves must all be considered as contributors to the problem, and the solution.  Custom orthotics may be of value.  Dry needling and/or acupuncture may play a role.  As in all cases of inflammation, cryotherapy (cold therapy) and anti-inflammatory dietary measures may be of value during the acute or chronic phases of the condition.  Normalizing function of affected body parts may require manual manipulation of relevant joints (which affects the nerves that feed these joints, and related muscles and tendons).  A comprehensive program of stretching, strengthening, and balancing exercises is also advisable in most cases.

The art, science, and philosophy of treating disease and injury by stimulating specific energy modulating points on and beneath the skin. Methods of stimulation include, but are not limited to: needle insertion, electrical stimulation, light, heat and pressure (acupressure).  Acupuncture addresses a wide variety of health conditions which includes all systems and tissues of the body and focuses special attention to the relationship between the spine, nervous system and the meridian system.  Acupuncture is inclusive of all diagnostic and therapeutic principles and procedures that are consistent with Western, scientifically-validated methods.

According to the 2002 National Health Interview Survey, an estimated 8.2 million Americans have been to an acupuncturist, and an estimated 2.1 million U.S. adults used acupuncture in the previous year. Since the use of acupuncture has spread widely in the U.S. in the past 20 years, researchers are studying the benefits of acupuncture for many conditions, including low-back pain, headaches, and osteoarthritis of the knee.

Acupuncture may be useful as an independent treatment for some conditions, but it can also be used as a complement to other healthcare therapies.  [source: American Chiropractic Association]

The most common ankle sprain is a sudden over-stress to the anterior talo-fibular ligament on the lateral (outside) of the foot.  It is possible to hear a “pop” sound during an ankle sprain, even when no fracture occurs.  Bruising and pain may occur on the outside of the ankle, on top of or beneath the foot, or on the lateral (outside) aspect of the leg where the peroneal muscles reside.  In very severe cases, the peroneus brevis tendon can pull a piece of bone off the foot (avulsion fracture of the base of the 5th metatarsal).

As with all conditions, treatment requires a comprehensive history and examination, followed by development of a differential diagnosis and treatment plan.  First-line of treatment for an ankle sprain is PRICE:  Protect it (remove stress, tape, use a brace if practical and necessary), Rest it, Ice/cool it (see separate guidelines on ice/cooling as anti-inflammatory therapy), Compress it (wrapping & taping are popular methods), and Elevate it (to drain excess fluid).

After acute management, treatment should begin promptly.  Nutritional therapy may be an important anti-inflammatory and healing consideration.  Certain specialized forms of soft tissue manipulation to the peroneus longus, peroneus brevis, and anterior talofibular ligament are especially helpful.  Addressing the entire biomechanical chain is also recommended in most cases.  Adjusting the foot (especially the cuboid bone) is often indicated;  but addressing the ENTIRE biomechanical chain means considering the foot and its bones, the ankle, the knee, the hip, the sacroiliac joints, the spine, and the associated muscles and nerves.  Custom orthotics may be of value;  though this is not necessarily a component of “ankle sprain” management, they may be a factor in returning the individual or athlete to full and high levels of function.  Dry needling and/or acupuncture may play a role.  Normalizing function of affected body parts may require manual manipulation of relevant joints (which affects the nerves that feed these joints, and related muscles and tendons).  A comprehensive program of stretching, strengthening, and balancing exercises is also advisable in most cases – though stretching a stretched ligament is specifically contraindicated.

The muscles in front of the shin serve to raise the toes (dorsiflexion) and turn the foot inwards.  They also control the motion of the foot and ankle, allowing control and impact adaptation during running or walking gait.  When overwhelmed (uphill running is one culprit), the muscles can become inflamed.  In more severe cases, normal walking or running becomes impossible.

Treatment requires a comprehensive history and examination, followed by development of a differential diagnosis and treatment plan.  In this area, muscular pain must be differentiated from stress fracture.  Also, muscle-based anterior shin pain must be differentiated from anterior compartment syndrome, a situation where the “compartment” containing these muscles, and related nerves and blood vessels, is too small to accommodate exercise-induced increases in pressure.

The feet (especially those that spend too much time in pronation, so-called “over-pronation”), the knees, the hips, the sacroiliac joints, and the lumbar spine may contribute to these strains—and thus, may be a part of addressing the problem.

Treatment will likely include soft tissue manipulation.  This may or may not be sufficient to avoid surgical correction in cases of anterior compartment syndrome.  Dry needling is one very effective tool that can be used to directly affect myofascial trigger points and optimize healing rates.  In athletes, correcting equipment problems (worn-out or improper footwear, for example) or surface issues (such as running on hills without adequate build-up) may be a part of management.  Acupuncture may play a role.  As in all cases of inflammation, cryotherapy (cold therapy) and anti-inflammatory dietary measures may be of value during the acute or chronic phases of the condition.  Normalizing function of affected body parts may require manual manipulation of relevant joints (which affects the nerves that feed these joints, and related muscles and tendons).  A comprehensive program of stretching, strengthening, and balancing exercises is also advisable in most cases.

Arth means “joint.” Itis means “inflammation.” “Arthritis” means inflammation of joints, i.e. inflammation where two bony surfaces meet. There are two main categories of arthritis: Systemic, which includes rheumatoid arthritis, gout, Lyme disease, and others; and “wear-and-tear” or osteoarthritis (AKA degenerative joint disease or DJD).  Systemic arthritis may be autoimmune, as in Rheumatoid;  in these cases, the body attacks its own joint linings as if they were invaders or foreign.  Osteoarthritis is the result of microtrauma (daily wear, such as standing for hours on end, that adds up over the years) or macrotrauma (such as falls, car accidents, and sports injuries).

Proper treatment for arthritis depends on the severity of the condition, as well as the type of arthritis.  Failing joints may be good candidates for replacement;  though recent product recalls offer a sobering caution (yes, companies have actually recalled their defective or sub-optimal joint hardware after it was implanted in patients).  Pain-killing medications and injections are merely stop-gap measures that delay the inevitable;  and some of these drugs may in fact accelerate joint destruction.  Modern science is working on regenerating joint cartilage, and injections of joint fluid substitutes may prolong joint function and decrease pain;  but conservative management is preferred when feasible.  Hydrate your joints with fluid, preferably by drinking water.  Keep joints strong, and avoid over or under –use.  Proper biomechanical function—the key area that doctors of chiropractic work with—is highly likely to preserve joint function.  Additionally, conservative care may include:  anti-inflammatory therapy for inflamed tissues; soft tissue manipulation (chiropractic soft tissue manipulation techniques and/or massage therapy); needling techniques (acupuncture—which is especially effective for osteoarthrosis of the knee); chiropractic spinal manipulation/adjusting to restore normal function to each affected joint, and to optimize nerve function to the affected joint(s); and therapeutic rehabilitative exercises to ingrain normal function and prolong its functional life.

Also known as: Herniated Disc

The cartilage pads between your back bones (vertebrae) are called discs, or intervertebral discs.  The center (nucleus pulposus) is under pressure;  and this pressure changes dramatically with stress and load.  If the outer ring (annulus fibrosus) is overwhelmed, the pressurized center can bulge through it.  If this bulge presses on a nerve, it may cause symptoms at the site of the spinal bulge, and/or where the nerve travels.  This may cause numbness, tingling, pain, or weakness down the arm or leg.  Disc herniation is especially common in the low back (lumbar spine), though it can occur anywhere in the spine.  The second most common site, after the low back, is the neck (cervical spine).  Discs are themselves very pain sensitive, and a bulging disc can cause considerable pain at the site of the herniation.


Proper diagnosis may include diagnostic imaging such as MRI, a clinical diagnosis based on a doctor’s examination, or both.  It is important to note that some degree of disc abnormality – including disc bulging – is present in up to 1/3 of the asymptomatic population, so MRI alone may not tell the full story of why you hurt, or do not.

Surgery (including various forms of discectomy and decompressive laminectomy) is not the first line of defense for bulging or herniated discs, as outcomes are poor.  The only clear exceptions are the cauda equine syndrome, where a disc herniation is damaging bowel and/or bladder function;  and progressive neurological deficit, where the condition is worsening over time and permanent loss of function is a risk.  Anti-inflammatory medications and injections do not improve function, though they may in some cases reduce inflammation and pain.  Though this sounds like a good thing, it is not--  you may be overriding protective signals, thus allowing your body to hurt itself considerably.

Since discs are often 65-92% water, hydrate well -- preferably by drinking water.  Core strength, balance, and control are also key (your doctor of chiropractic can tell you more, and guide you appropriately).  Stop smoking—smoking dries out the disc.  In addition, spinal manipulation (sometimes called spinal adjustments) are often very effective at restoring local joint (facet) motion and decreasing local nerve irritation;  and dysfunction of the facet joints may in fact be a correctible cause of failed discs.  Specialized chiropractic techniques like Cox Flexion-Distraction (see) are particularly gentle, safe, and effective ways of “pumping” nutrition to discs and allowing inflammatory waste products to drain from around the nerve roots.  Additionally, conservative care may include:  anti-inflammatory therapy for inflamed tissues; soft tissue manipulation (chiropractic soft tissue manipulation techniques and/or massage therapy directed at protective muscle spasms [note:  treating this symptom needs to be done wisely, as the protective mechanisms—though painful—also serve the function of limiting further injury); needling techniques (acupuncture and/or dry needling); chiropractic spinal manipulation/adjusting as noted to restore normal function to each affected joint, and to optimize nerve function to the affected joint(s); and therapeutic rehabilitative exercises to ingrain normal function and prolong its functional life.

Bursitis is a painful condition that affects the small fluid-filled sacs or pads — called bursae — that act as cushions vs. friction. Bursitis occurs when bursae become inflamed.

The most common locations for bursitis are in the shoulder, elbow, knee (patellar; iliotibial band friction), and hip. Bursitis often occurs near joints that perform frequent repetitive motion or have considerable friction (such as at the knee, with kneeling; or at the side of the knee with running or cycling).

Simply resting the area may provide some relief; though, like pain-relieving medications and injections, failure to address underlying biomechanical faults sets you up for re-injury. Proper management may initially include PRICE (Protect, rest, ice/cool, compress, elevate the affected part if feasible) and natural reduction of inflammation (dietary modifications, cryotherapy [see]). Other conservative interventions may include soft tissue manipulation (chiropractic soft tissue manipulation techniques and/or massage therapy); needling techniques (acupuncture; dry needling for acute or persistent trigger points); supportive devices such as custom orthotics (knee and hip bursitis can result from foot dysfunction); chiropractic manipulation/adjusting to restore normal function to the kinetic chain (example: hip “bursitis” may be the result of sacroiliac joint dysfunction, and may possibly not be a true bursitis at all); and therapeutic rehabilitative exercises to ingrain normal function and decrease likelihood of recurrence.

The calf muscles consist of superficial and deep muscles that help us push off when walking, running, jumping, or standing on tippy-toes.  The deeper muscles attach beneath the foot and help stabilize, absorb impact shock, and control subtle but important motions of the foot and ankle.  The more superficial muscles are very powerful, and they attach to the heel bone (calcaneus) via the Achilles tendon.  These superficial calf muscles are the gastrocnemius (which plays a role in knee flexion, as well as in ankle push-off), and the soleus.  When overwhelmed due to acute (sprinting) or chronic (misuse/overuse) stress, the muscles can rip or tear (grade 2 or 3 strain), or can microtear (grade 1 strain).  This can be very painful.

Treatment requires a comprehensive history and examination, followed by development of a differential diagnosis and treatment plan.  Calf strain must be differentiated from more sinister entities, as clots from the legs can travel to the lung with disastrous consequences.  The feet (especially those that spend too much time in pronation, so-called “over-pronation”), the knees, the hips, the sacroiliac joints, and the lumbar spine may contribute to calf strains—and thus, may be a part of addressing the problem.

Treatment will likely include soft tissue manipulation.  Dry needling is one very effective tool that can be used to directly affect myofascial trigger points and optimize healing rates.  In athletes, correcting equipment problems (worn-out or improper footwear, for example) or surface issues (such as running on banked roads, or always running the same direction around a track) may be a part of management.  Acupuncture may play a role.  As in all cases of inflammation, cryotherapy (cold therapy) and anti-inflammatory dietary measures may be of value during the acute or chronic phases of the condition.  Normalizing function of affected body parts may require manual manipulation of relevant joints (which affects the nerves that feed these joints, and related muscles and tendons).  A comprehensive program of stretching, strengthening, and balancing exercises is also advisable in most cases.

True carpal tunnel syndrome is a progressively painful hand and arm condition caused by a pinched nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems, patterns of hand use (including your workstation setup)-- even pregnancy.

Bound by bones and ligaments, the carpal tunnel is a narrow passageway — about as big around as your thumb — located on the palm side of your wrist. This tunnel protects a main nerve (median nerve) to your hand and nine tendons that bend your fingers. Compression of the nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome. True carpal tunnel syndrome never affects the pinkie.

Fortunately, for most people who develop carpal tunnel syndrome, proper treatment usually can relieve the pain and numbness and restore normal use of their wrists and hands. SEE ALSO THORACIC OUTLET SYNDROME.

Treating the condition—as with all conditions, illnesses, and diseases—requires proper diagnosis. T.O.S. must be differentiated from Carpal Tunnel Syndrome (see). By determining which tissues are irritating the nerves or nerve trunk, the doctor of chiropractic can address them appropriately (adjusting, soft tissue manipulation, acupuncture, dry needling). Braces may or may not help the condition.

 
Also see: Thoracic-Outlet Syndrome (T.O.S.)

A health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health.  Chiropractic care is used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.  [source: American Chiropractic Association]

One of your main enemies may be your chair. Sitting -- especially in front of your computer or driving long distances -- is a tremendous stress to your spinal discs. Discs require motion for proper nutrition, so consider taking frequent breaks. Be sure your feet are comfortably placed, and adjust your seat if possible so that your neck isn’t tipped too far forward or back for long periods of time. Also, be sure your computer monitor is located directly in front of you. Here’s a simple way to locate a good position for your monitor: Sit comfortably in your chair, and close your eyes. Adjust your body until you feel comfortable. Open your eyes, and you should be looking at your monitor. If you have to look up, down, or to the side, then your monitor isn’t where it should be. Relocate it.  And remember:  Doctors of chiropractic are fully and expertly trained in the human body and ergonomics (the relationship of the human body to our work and play environment).  Take advantage of their expertise and live, better.

Degenerative Disc Disease is a long term meaning "spinal arthritis" due to drying out of the spinal discs.  Between your back bones lies a cushion called an intervertebral disc or "disc" for short.  This cartilage is mostly water-- up to 92% water in a very young, healthy person.  As we age, these discs dry out ("desiccate"), which means less shock absorption between your spinal bones, and less space for the delicate nerve roots that exit the spine via portholes called "foramina" ("intervertebral foramina" or IVF''s).  This can result in stiffness (especially with inactivity, or excessive sitting, or exercise), or nerve symptoms (sciatica, numbness, pain, or weakness wherever the nerve travels).  That pain in your foot, or the weakness in your grip may be related to your spine, and DDD.  Surgical options include replacing the disc with an artificial device;  or cutting away bone (foraminotomy, laminectomy) in order to free up space for the affected nerve(s).  Conservative, non-invasive methods include the use of therapeutic exercises and teaching adaptive postural strategies, nutritional support (especially emphasizing proper hydration), acupuncture to modify pain perception and improve the ability to engage in normal motion patterns, and spinal manipulation.  Spinal manipulation may include classic, hands-on adjusting of vertebrae, thus normalizing stresses applied to the disc;  or techniques like Cox Flexion-Distraction to gently "pump" nutrition to the discs and free up the IVF.


Also see: Osteoarthritis

Though the hip rarely dislocates, the shoulder (glenohumeral joint) fairly commonly does so.  This occurs exclusively through trauma.  Repeat dislocations can cause instability and glenoid labrum tears (see).  The more times you’ve dislocated a shoulder, the more likely it is to re-occur.

Dry Needling is “a physiologic therapeutic technique and procedure. Its purpose is to neutralize soft tissue, [release myofascial trigger points], and to restore and improve muscle and fascial function. This treatment mechanically disrupts physiologically locked tissue. It consists of insertion of a monofilament, sterile, thin-gauge needle, a needle that also happens to be used by acupuncturists.” He adds, “The soft-tissue entities in the periphery are influenced by and influence the central and peripheral nervous systems."

Comparison to acupuncture:  “The dry needling procedure works with myofascial trigger points and tender points. It is based on Western concepts of anatomy, physiology, neurology, and biomechanics. The only common element is the choice of tool.”

Source:  American Chiropractic Association (JACA).  Quotes by Dr. David Fishkin.

Frozen Shoulder (glenohumeral adhesive capsulitis)

Frozen shoulder is a disorder in which the shoulder capsule, the connective tissue surrounding the main (glenohumeral) joint of the shoulder, becomes inflamed, contracted (shortened), and stiff. This limits normal motion and causes chronic pain and loss of function.

Adhesive capsulitis is a painful and disabling condition that often causes great frustration for patients and caregivers due to slow recovery. Movement of the shoulder is severely restricted. Pain is usually constant, worse at night, and when the weather is colder; and along with the restricted movement can make even small tasks impossible. Certain movements or bumps can cause sudden onset of tremendous pain and cramping that can last several minutes.

Patients often ignore the condition until pain sets in, or when basic life functions become difficult or impossible (putting on or taking off a bra; leisure activities; basic bathing and toileting functions). The condition is usually preceded by some form of injury/trauma or disuse. A stroke is one known way this condition may develop.

Proper treatment often includes natural reduction of inflammation (dietary modifications, cryotherapy [see]); manipulation of the cervical spine (the nerves of which control the shoulder joint and related muscles); manipulation of the thoracic spine, which medical literature suggests (when in combination with treating the shoulder directly) is more effective than physical therapy to the shoulder alone; manipulation of the shoulder complex (glenohumeral joint, scapulothoracic joint, etc.); acupuncture; dry needling; specific therapeutic exercises; and soft tissue manipulation-- especially to the tissues that form the rotator cuff.


Also see: Frozen Shoulder

This occurs when the fibrocartilage “cup” holding the arm bone (humerus) into the scapula tears.  Most commonly, this is associated with trauma such as a dislocation.  Includes SLAP Lesions & Bankart Lesion.

Golfer's elbow is pain and inflammation on the inner (medial) aspect of the elbow, where the tendons of the forearm muscles attach to the bony bump on the inside of your elbow (medial epicondyle). The pain may spread into your forearm, and even your wrist.

Interestingly, tennis elbow (SEE) may be more common in golfers than golfer's elbow.

Any activity or sport that requires repeated use of wrists or strong grips may cause golfer's elbow.

Simply resting the area may provide some relief; though, like pain-relieving medications and injections, failure to address lifestyle and/or ergonomic faults (poor workstation setup, poor or suboptimal golf form, bad habits) sets you up for re-injury. Proper management may initially include PRICE (Protect, rest, ice/cool, compress, elevate the affected part as feasible) and natural reduction of inflammation (dietary modifications, cryotherapy [see]). Other conservative interventions may include soft tissue manipulation (chiropractic soft tissue manipulation techniques and/or massage therapy); needling techniques (acupuncture; dry needling for acute or persistent trigger points); chiropractic manipulation/adjusting to restore normal function to the kinetic chain (adjusting the elbow or cervical spine, for example); and therapeutic rehabilitative exercises to ingrain normal function and decrease likelihood of recurrence.

The hamstrings are the muscles at the back of the thigh.  They are the biceps femoris (yes, there’s a “biceps” in the thigh), the semitendinosus, and the semimembranosus.  When overwhelmed due to acute (sprinting) or chronic (misuse/overuse) stress, the muscles can rip or tear (grade 2 or 3 strain), or can microtear (grade 1 strain).  This can be very painful.

Treatment requires a comprehensive history and examination, followed by development of a differential diagnosis and treatment plan.  Hamstring strain is more complicated than it might at first seem, and can be caused by faulty movement patterns and neurological mis-firings.  The feet, the knees, the hips, the sacroiliac joints, and the lumbar spine may contribute to hamstring strains—and thus, be a part of addressing the problem.

Treatment will likely include soft tissue manipulation.  Dry needling is one very effective tool that can be used to directly affect myofascial trigger points and optimize healing rates.  In athletes, correcting equipment problems (worn-out or improper footwear, for example) or surface issues (such as running on banked roads, or always running the same direction around a track) may be a part of management.  Acupuncture may play a role.  As in all cases of inflammation, cryotherapy (cold therapy) and anti-inflammatory dietary measures may be of value during the acute or chronic phases of the condition.  Normalizing function of affected body parts may require manual manipulation of relevant joints (which affects the nerves that feed these joints, and related muscles and tendons).  A comprehensive program of stretching, strengthening, and balancing exercises is also advisable in most cases.

Cervical spine (neck) based headache - Some headaches originate in the neck;  in fact, up to half of all headaches may relate to the cervical spine and suboccipital (base of the skull) region, rather than originating in the head itself.  By manipulating the tissues and bones of the neck, doctors of chiropractic can decrease irritation to tissues that can cause these headaches… especially irritated nerves.  Needling techniques (acupuncture, dry needling) address local nerve function, blood flow, and muscle tension/tone -- all factors in cervicogenic headaches.

These headaches are characterized by recurrent, severe, unilateral [one-sided] orbitotemporal [around the eye and temples] pain associated with ipsilateral photophobia [one-sided aversion to bright light], lacrimation [crying/weepy eye], and nasal congestion.  One theory is that they are caused by a hypersensitivity to histamine;  but long-term drug (pharmacological) therapy may be a losing battle.  These headaches may respond well to acupuncture, which lacks the side effects of many common medications.

Previous - 1 - 2 - 3 - Next