Tag Archives: pain relief

What Is Iliotibial Band Syndrome?

10 Nov

Up to one-in-five adults experience knee pain each year, and many seek chiropractic care to find relief from both pain and disability. While knee pain can have many causes, when discomfort is concentrated on the outside of the knee in active adults, iliotibial band syndrome (ITBS) is an important condition to consider.

The iliotibial band is a tough, fibrous band of fascia that runs from the iliac crest at the top of the pelvis down to the outer surface of the tibia just below the knee. It serves as a dynamic stabilizer of both the knee and the hip during walking and running, and research has shown that it also stores and releases elastic energy during these activities, much like a spring.

Pain from ITBS rarely begins with a single traumatic event. Instead, it typically develops after a gradual increase in running loads, such as taking on longer distances or increasing speed. The condition is estimated to account for up to 14% of all running-related injuries, but there is still debate about the exact mechanism of injury. The traditional explanation is that the band becomes irritated as it rubs back and forth over the bony prominence of the lateral femoral epicondyle as the knee bends and straightens. More recent studies, however, suggest that the band is firmly anchored to the femur and that repetitive knee motion instead compresses the soft tissues beneath it, leading to pain. A third view emphasizes the role of weak hip muscles, which reduce pelvic control and place greater strain on the ITB, creating a sprain-like overload.

Because there is no blood test or imaging procedure that can definitively diagnose iliotibial band syndrome, clinicians rely on a combination of history and physical examination while ruling out other potential causes of lateral knee pain such as meniscus injury, synovial plica syndrome, or bone stress fracture. Iliotibial band syndrome is most strongly suggested when tenderness is present directly over the lateral femoral epicondyle, when pain worsens with prolonged running, downhill activity, or stair descent, and when there is no evidence of catching, locking, or clear trauma that would indicate another problem. Findings on clinical tests such as Noble’s compression test, Ober’s test, or Renne’s test can further support the diagnosis.

Treatment of ITBS usually requires a multimodal approach. Patients often need to modify their activity levels to reduce strain on the ITB, while also addressing underlying inflammation. Rehabilitation exercises to strengthen the hip and core muscles and improve posture can restore balance, while manual therapies may be used to improve the movement of joints and soft tissues. In some cases, orthotics or footwear changes are recommended to correct ankle or foot mechanics that place additional stress on the knee. As with most musculoskeletal conditions, the earlier care is initiated, the better the outcomes. With prompt attention, patients can usually expect a satisfactory recovery that allows them to return to their usual recreational and occupational activities without lingering limitations.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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Monthly update on Lower Back Pain

14 Jul

Chiropractic Treatment for Lumbar Spinal Stenosis

            Lumbar spinal stenosis is a condition caused by the narrowing of spaces within the lower spine, which can compress either the spinal cord or nerve roots. This pressure can lead to pain, numbness, or weakness—either locally or radiating down the legs—especially during activities that involve spinal extension (e.g., bending backward or prolonged standing) or compressive loading. While stenosis may result from trauma, congenital anomalies, or systemic diseases, approximately 80% of lumbar spinal stenosis cases are degenerative in origin. Common degenerative contributors include intervertebral disk bulging or herniation, facet joint hypertrophy (arthritis), ligamentum flavum thickening, spondylolisthesis (vertebral slippage), and osteophyte (bone spur) formation. How might chiropractic care help a lumbar spinal stenosis patient both avoid surgical intervention and return to their normal activities to as high a degree as possible?

In the medical model, initial treatment may include physical therapy and/or medications. If those fail to provide relief, a common next step is epidural steroid injections (ESIs), which aim to reduce nerve inflammation and provide temporary symptom relief. A 2025 systematic review of 90 randomized controlled trials found that ESIs can offer short-term improvement in pain and disability but do not result in long-term symptom resolution. If a patient experiences minimal relief after one to two injections, if relief lasts less than one month, or if neurological symptoms progress, further injections are generally not recommended. Clinical guidelines typically limit ESIs to a maximum of three per year, and suggest limiting repeated use to no more than two to three consecutive years due to risks such as bone loss, adrenal suppression, and soft tissue damage.

If the patient pursues chiropractic care, the aim of treatment would be to reduce neural compression by improving lumbar spine mobility and joint spacing. For lumbar spinal stenosis, current guidelines discourage high-velocity, low-amplitude (HVLA) spinal manipulation. Instead, they support gentler techniques such as flexion-distraction, mobilization, and instrument-assisted soft tissue therapies. Chiropractic care may also include targeted exercise, posture training, and neuromuscular re-education to support spinal health and nerve mobility.

Just as critical as in-office treatment is the home management component. Patients are encouraged to perform flexion-based and low-impact exercises—such as stationary biking, inclined treadmill walking, wall sits, and knee-to-chest stretches—which can reduce pressure on lumbar nerves. Core stabilization improves spine support, while posture training and ergonomic adjustments (e.g., lumbar support, avoiding prolonged standing, sleeping with knees elevated) help maintain relief. Lifestyle modifications such as weight loss, an anti-inflammatory diet (rich in omega-3s, vegetables, and whole foods), hydration, and use of ice, heat, or TENS units for pain control can further support long-term improvement.

The good news: with consistent effort, as many as 70% of patients with lumbar spinal stenosis can improve or maintain stable symptoms without ever needing surgery. Only about 30% of patients progress to requiring surgical intervention—typically when pain is disabling, function is severely limited, or neurologic decline occurs.

Watching your back,

Dr. Binder

Pain Relief Chiropractic

painreliefcare.net

(717) 697-1888

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Glute Weakness & Low Back Pain

30 Jan

Glute Weakness and Low Back Pain

While we traditionally view low back pain as the result of a problem localized to the low back itself, several studies have found that issues in adjacent parts of the body can play a role in the development of low back pain.  For example, chronically tight hamstrings can affect pelvic tilt, which in turn can alter the posture of the lumbar spine, potentially leading to low back pain. Another potential contributor to low back pain that’s often overlooked is glute muscle weakness.

In September 2024, the New York Times ran an article focused on a condition called gluteal amnesia, though it’s more colloquial name is dead butt syndrome. Gluteal amnesia is the result of prolonged inactivity of the three glute muscles (maximus, medius, and minimus). Prolonged inactivity can occur from things such as sitting at a desk or in a car for more than two to three hours at a time without getting up to move around and stretch. The gluteals help stabilize the hip, lift the leg, and rotate the thigh. This muscle group also serves an important role in the kinetic chain, and when not working properly, the risk for problems like hamstring tears, sciatica, shin splints, and knee arthritis increases.

Gluteal amnesia is NOT like the temporary numbness/tingling noticed when we sleep on an arm and it “falls asleep” or goes numb and recovers quickly when we change positions. Some people may feel a dull ache or pain after a long walk or after a jog or hike. Because muscle strength and activation are affected, the body may recruit nearby muscles to help perform regular movements, which can lead to pain in the lower back, for example.

            Though it’s best to be examined by a qualified healthcare provider, like a doctor of chiropractic, you can perform the following test to check if you may have dead butt syndrome: stand on one leg letting the other leg dangle (standing sideways on a step holding onto a railing works well) press into your buttocks region on the dangling leg, it should feel soft (not firing); do the same on the other side; now stand on both feet and squeeze your “cheeks” hard; you should feel the muscle contract or get firm; if it takes a few squeezes before you feel it get firm, then you may have gluteal amnesia.

            The key to overcoming this condition is to restore normal activation to the gluteal muscles. You can start by setting an alarm on your phone to stand up every 30-50 minutes and gently tap on your glut/butt cheeks with your fingertips. This reminds the brain that these muscles need to fire. Better yet, march in place, do some hip circles and squats and consciously tighten your gluts with each rep. Other exercises for this include clamshells, hip thrusts, side planks, split squats, and single-leg glut bridges. Just remember to consciously engage the glutes.

            If the condition persists, schedule an appointment with your doctor of chiropractic so they can determine if there are additional problems present that can be addressed with treatments provided in the office, such as manipulative or mobilization therapy, with the goal of helping restore normal function.

Pain Relief Chiropractic

4909 Louise Drive, Suite 102

Mechanicsburg, PA 17055

Painreliefcare.net

717-697-1888

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Neck Pain Treatment Options.

14 Dec

Neck pain is a very common problem. In fact, 2/3rds of the population will have neck pain at some point in life. It can arise from stress, lack of sleep, prolonged postures (such as reading or driving), sports injuries, whiplash injuries, arthritis, referred pain from upper back problems, or even from sinusitis! Rarely, it can be caused from dangerous problems including referred pain during a heart attack, carotid or vertebral artery injuries, or head or neck cancer, but these, as previously stated, are very uncommon. However, since you don’t know why your neck hurts, it’s very important to have your neck pain properly evaluated so the cause can be properly treated and not just covered up from the use of pain killers!

Barring the dangerous causes of neck pain listed above, treatment methods vary depending on whom you elect to consult. Classically, if you see your primary care physician, pharmaceutical care is usually the approach. Medications can be directed at reducing pain (Tylenol, or one of many prescription “pain killers”), at reducing inflammation and pain (Aspirin, Ibuprofen, Aleve, etc.), to reduce muscle spasms (like muscle relaxers) or, medications may be directed to reduce depression, anxiety, or the like. When a sinus infection affects the 2 deep sinuses (ethmoid and sphenoid sinuses which are located deep in the head), the referred pain is directed to the back of the head and neck. Here, an antibiotic may be needed and/or something specifically directed at allergies when present. In general, in cases that do not respond to usual chiropractic care, co-management with the primary care physician is a good option.

However, the good news is that chiropractic care usually works well, and the need for medication can be avoided since the side effects of medication can sometimes be worse than the benefits. Recently, The Bone and Joint Decade Task Force on Neck Pain published arguably the best review of research published between 2000 and 2010 regarding neck pain treatment approaches. They concluded that spinal manipulation and mobilization are highly effective for many causes of neck pain, especially when arising from the muscles and joints – the most common cause. Therefore it would seem logical to consult with a Chiropractor FIRST since manipulation and mobilization are so effective and safe. When we add neck exercises, the results are even better, according to some studies. As chiropractors, we will often use different modalities including electric stimulation, ultrasound, hot and/or cold (which are usually given as a good home-applied remedy), and others. In particular, low level laser therapy (LLLT) has been shown, “…to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain” [Lancet, 2009; 374(9705)]. LLLT is a commonly used modality by chiropractors and when combined with spinal manipulation, the results can be even faster! We will also evaluate your posture, body mechanics, and consider “ergonomic” or work station problems and offer recommendations for improving your work environment. We also frequently utilize anti-inflammatory nutrients including vitamins, minerals, herbs, and more to avoid the negative side effects to the stomach, liver, and kidney negative that can result from using non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, or Aleve. Make chiropractic your FIRST choice when neck pain strikes, NOT last resort!

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Fibromyalgia – Do We Know The Cause?

14 Dec

Fibromyalgia (FM) is a condition that is characterized by widespread pain, fatigue and an increased pain response. Symptoms can include tingling of the skin, muscle spasms, weakness in the arms and legs, nerve pain, muscle twitching, bowel disturbances, chronic sleep disturbances, and more. So, what can cause such a widespread, whole body condition? Though the “cause” of FM is unknown, several hypotheses have emerged. Here is what we know:

The brains of FM patients: Structural and functional differences have been identified in the brains of FM vs. healthy individuals. What is unclear is whether these identifiable brain changes cause the FM symptoms or are the result of an unknown cause. Some experts have reported that the abnormal brain findings may be the result of childhood stress, or prolonged, severe stress at any time in life. An area commonly affected is called the hippocampus, which plays a crucial role in maintaining cognitive functions, sleep regulation, and pain perception.

Lower pain threshold: Due to an increased reactivity of pain-sensitive nerve cells in the spinal cord and brain (called “central sensitization), FM patients feel pain sooner and worse than non-FM subjects.

Genetic predisposition: It has been reported that FM is often found in multiple family members. This genetic propensity also includes other conditions that often co-exist in FM patients such as chronic fatigue syndrome, irritable bowel syndrome (IBS), and depression.

Stress & lifestyle: Stress by itself may be an important cause of FM. It is not uncommon to develop FM after suffering from post-traumatic stress disorder. An association between physical and sexual abuse both in childhood and adulthood has also been identified. Poor lifestyle issues including smoking, obesity, and lack of physical activity increase the risk of developing FM.

Dopamine dysfunction: Dopamine is a chemical needed for neurotransmission and plays a role in pain perception. It is also connected to the development of restless leg syndrome (RLS), which is a frequent complaint of FM patients. Medications found effective for RLS such as pramipexole (also used for the treatment of Parkinson’s disease) can be helpful for some FM patients.

Abnormal serotonin metabolism: Another neurotransmitter, serotonin, regulates sleep patterns, mood, concentration, and pain and can be involved in causing FM. Decreases in other neurotransmitters (especially norepinephrine), when combined with serotonin depletion, can especially cause FM (more so in women than men). Hence, medications like duloxetine (Cympalta) originally used to treat depression and painful diabetic neuropathy, have been found to help FM patients, especially women.

Deficient growth hormone (GH) secretion: Abnormal levels of GH have been found in FM patients, but studies report mixed results when treating FM with GH.

Psychological factors: Strong evidence supports the association of FM and depression. Similarities include neuroendocrine abnormalities, psychological characteristics, physical symptoms and similar treatment benefits using the same approach (medication, counciling, etc.).

Physical Trauma: Trauma can increase the risk of FM. One report found a direct association with neck trauma and increased risk of developing FM.

Small bowel bacterial overgrowth: This can contribute to FM and may explain the association with IBS. The autoimmune response to the presence of bacteria resulting in FM symptoms has been hypothesized in these cases.

CONCLUSION: As previously stated, it is clear that a “team” of providers is needed to effectively treat FM. We’d be honored to be part of your team!

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

 

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Headaches and Chiropractic Care.

14 Dec

Did you know that 9 out of 10 Americans suffer from headaches? There are many different types of headaches with a multitude of symptoms including achy, throbbing, nausea, vomiting, dizziness, numbness, blinding, noise, light and/or odor sensitivity, and more. The causes of headaches can include genetics (familial traits like migraine headaches), stress or tension (probably one of the most common), environmental (allergies, seasonal, bright sunlight, loud noises, certain foods), behavioral (insomnia, excessive exercise, blood sugar problems, depression), and many more.

Environmental factors can “trigger” the onset of a headache. About 95% of headache sufferers have “primary headaches” such as tension, migraine, or cluster headaches. The other 5% may be caused by other physical conditions or problems and the headache serves as a “warning sign” that something else is wrong. The “key” in the 5% of potentially dangerous types of headaches is to pay attention to when there is a rapid onset (“…it came out of nowhere fast!”), if they are very intense, and are “different” from other headaches previously suffered. When nervous system symptoms occur that are unusual for that person, such as lapses in memory, the person is not responding, rapid onset of dizziness, balance disturbance,  and/or a “blinding sharp pain,” these should trigger a warning sign that something specific and potentially dangerous may be causing the headache.

For the main 95% of headaches sufferers, neck tension is a common complaint with the headache. Research supports that spinal manipulative therapy (SMT), the primary form of care utilized by chiropractors, is an effective option for tension headaches. A 2001 Duke University study reported that SMT resulted in almost immediate improvement for those headaches originating in the neck, had fewer side effects, AND longer-lasting relief of tension-type headaches compared to those receiving commonly prescribed medication. Another study found that SMT was effective, not only for relieving the headache, but had a sustained benefit AFTER it was discontinued after a 4-week treatment period. This was NOT seen in a similar tension-type headache group receiving prescribed medication treatment only.

Here is how to help yourself:

Improve your posture: Most of us are “chin pokers” and “slouchers.” The weight of the head pulls on the neck and upper back muscles and when held in that fixed position while driving, typing, watching TV, the static muscle tension can create a headache.

Take “mini-breaks” every 30-45 minutes from static fixed positions and perform some exercises. A good stretch is to reach over to the opposite side of the head and gently pull to stretch the sides of the neck. Repetitively, poke and tuck your chin in & out to stretch different muscle fibers. Then, add flexion, extension and/or rotation to the same movements for about 10 sec./side. Try it now!

Avoid clenching your teeth and shrugging your shoulders. We do these things without being conscious that we’re even doing it. Those static loads play havoc with our neck muscles.

Drink plenty of water – at least 8 oz., 8x/day (more when exercising or pregnant). If you want to be more accurate, take your current weight and divide by 2. (Eg., 130# person = 65oz./day; 190# = 95oz./day).

If you have chronic headaches, COME SEE US! This is what we do, and it helps A LOT!

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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