Upper Cross Syndrome

I get tons of patients in my Woodbridge, Dale City VA Chiropractic office with neck and upper back pain.  The crazy thing is a lot of the time it is coming from their chest muscles being too tight.   Stretching the chest muscle can sometimes take the pressure off the upper back and allow those muscles to rest and decrease their waste production.  That usually cuts down on the numb spot or that burning spot in the upper back area.  Here is some great information from Kenneth Miller MS on upper cross syndrome.

If you’re like the millions of people who use electronic tools such as a cell phone, tablet, laptop or desk computer, you’ve probably spent hours upon hours looking at the screen with your head jutted forward. Other situations that might have you holding your head forward of your shoulders include reading books, significant time behind the steering wheel or watching TV. Whatever the cause, the migration of your head to this forward position can ultimately lead to overactive muscles and a complementing set of underactive muscles. This postural distortion pattern, known as upper crossed syndrome (UCS), can result in imbalances of muscle tone or timing, often leading to poor movement patterns, and in this tech heavy society, increased stress on the head, neck and shoulder joints.

Poor posture at any level may lead to muscle imbalances. This can have a trickle-down effect into the rest of the body, not just in the local areas of the neck and shoulders. An associated sequence of muscle imbalances in the hip region, referred to as lower crossed syndrome, can oftentimes be observed in conjunction with upper crossed syndrome. When looking for long-term success in relieving UCS, identifying and addressing postural issues that could exist elsewhere in the body will also be needed. This total-body approach will relieve tensions through the entire kinetic chain, while also enhancing desired results.

Crossed and Countercrossed

The “crossed” in upper crossed syndrome refers to the crossing pattern of the overactive muscles with the countercrossing of the underactive muscles. When viewed from the side, an X pattern can be drawn for these two sets of muscles. The overactive muscles form a diagonal pattern from the posterior neck with the upper trapezius and levators down and across to the anterior neck and shoulder with the sternocleidomastoid (SCM) and pectoralis major. The other side of the X now depicts the underactive muscles, with the deep cervical flexors down toward the mid/lower trapezius, rhomboids and serratus anterior. As we continually assume the seated, forward head postures driven by electronic devices or poor exercise selection and technique, this X pattern of muscle imbalances will increase.

Identify Imbalances

When working with clients or performing your own workout routine, attaining and maintaining ideal posture is paramount to a safe and effective program. In order to address postural or movement imbalances, the less-than-ideal posture has to be identified and a corrective exercise strategy developed. This corrective program can have two applications. First, it can serve as a stand-alone phase of training that will help the client achieve better postural control and endurance. Second, it can be applied as the movement preparation for a workout. In the first application, the client may be in a post-rehabilitation situation and need a program that incorporates flexibility with local and integrated strengthening. The second application will most likely be for the client looking to move better and improve coordination before applying speed and increased force during their workout session.

The first step to improving any postural distortion pattern is being able to identify the condition. Upper crossed syndrome can be observed from different vantage points with different motions. Some basic assessments that can be implemented to identify distortion patterns are gait observations, overhead squat, pushing and pulling motions, and static posture analysis. With any postural assessment—static, dynamic or transitional—UCS can be observed by watching head position relative to the shoulders, and the arms and shoulder blades relative to the ribs.

By using the landmarks of the ears, shoulders and the glenohumeral (GH) joint, a static posture assessment can identify UCS by observing if the ears are forward of the shoulder. You might even say that this person is slouching.

Observations for the shoulder blade and the upper arm can be seen from the front and side views with the overhead squat, pushing (pushup) and pulling (cable row) motions. The movements to note during an overhead squat assessment for possible signs of UCS include

  • Arms falling forward or to side during the descent
  • Head migrating forward
  • Elevating or elevated shoulder blades
  • Elbows flexed or challenged in keeping arms straight

Depending on the extent of the distortion, someone may exhibit one or more of the listed movement compensations. Combining the different assessments can also confirm findings. This helps in prioritizing the corrective strategies during program design.  Call Doroski Chiropractic to have this problem evaluated and to get some possible home exercises to help it go away.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Back pain stats

As a chiropractor in the Woodbridge, Dale City VA area I see patients for all sorts of reasons.  Of course one of the main reasons people seek out a chiropractor is for back/neck pain.  In fact, 31 million Americans experience low-back pain at any given time.1

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

One-half of all working Americans admit to having back pain symptoms each year.2

Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives.3

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.4


What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by DCs for the past century, spinal manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, spinal manipulation is receiving more widespread attention.

Spinal manipulation is a safe and effective spine pain treatment. It reduces pain (decreasing the need for medication in some cases), rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all available care for low back problems, the federal Agency for Health Care Policy and Research (now the Agency for Health Care Research and Quality) recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A well respected review of the evidence in the Annals of Internal Medicine pointed to chiropractic care as one of the major nonpharmacologic therapies considered effective for acute and chronic low back pain.7

More recently, research has shown that there is strong evidence that spinal manipulation for back pain is just as effective as a combination of medical care and exercise, and moderate evidence that it is just as effective as prescription NSAIDS combined with exercise.8

A patient information article published in the Journal of the American Medical Association in 2013 also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.9

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a doctor of chiropractic in your area. Search ACA’s database of members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

  1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.
  1. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.
  1. Ibid.
  2. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville, MD.
  3. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.
  1. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.
  2. Chou R, Hoyt Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians Clinical Practice Guideline. Ann of Internal Med 2 Oct. 2007;147(7):492-504.
  3. Bronfort G, Haas M, Evans R, et al. Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine. 2008;8(1)213-225.
  4. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

Back pain causes and treatment options

Back pain is something most people have to deal with at some point in their life.  At Doroski Chiropractic Neurology in Woodbridge VA we see all sorts of back complaints and injuries.  The most common thing I hear from patients is what is it or what did I do?  In quite a few instances you didn’t  do anything at that time.  It was all the stuff you did a month prior that created an environment where a sneeze caused the entire thing to fall apart.  That is where seeing a chiropractor on a regular basis helps, because you can keep making small corrections to your back to prevent the flare ups.

Back pain is very common and is treatable but it does require some regular maintenance once you have had your second or third injury.  Your back is made up of small joints held together by muscles and ligaments.  Once you sprain (stretch) the ligaments they become loose and even after they heal they are not as tight as before.  A good analogy I use with patients is a twisted ankle.  The first time you twist your ankle you did something.  You stepped in a hole, jumped and landed on it wrong…. Something!  The next time you did it you did something just not as traumatic.  Maybe you step off the curb funny.  The third time you are tying your shoe.  By the fourth time you woke up and your ankle hurts and you limp on it for a week trying to figure out what happened.  Your back is the same way but with many more moving parts that can cause the same stress and same pain.  That is why maintenance after your second or third time is necessary to prevent flare-ups.  Here are the ACA statistics about back pain.

 

Back Pain Facts & Statistics

Although chiropractors care for more than just back pain, many patients visit chiropractors looking for relief from this pervasive condition.  In fact, 31 million Americans experience low-back pain at any given time.1

A few interesting facts about back pain:

Low back pain is the single leading cause of disability worldwide, according to the Global Burden of Disease 2010.

One-half of all working Americans admit to having back pain symptoms each year.2

Back pain is one of the most common reasons for missed work.  In fact, back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections.

Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer.

Americans spend at least $50 billion each year on back pain—and that’s just for the more easily identified costs.3

Experts estimate that as many as 80% of the population will experience a back problem at some time in our lives.4

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture disks, and irritate joints, all of which can lead to back pain. While sports injuries or accidents can cause back pain, sometimes the simplest of movements—for example, picking up a pencil from the floor— can have painful results. In addition, arthritis, poor posture, obesity, and psychological stress can cause or complicate back pain. Back pain can also directly result from disease of the internal organs, such as kidney stones, kidney infections, blood clots, or bone loss.

Manipulation as a Treatment for Back Problems

Used primarily by Doctors of Chiropractic (DCs) for the last century, manipulation has been largely ignored by most others in the health care community until recently. Now, with today’s growing emphasis on treatment and cost effectiveness, manipulation is receiving more widespread attention.

Chiropractic spinal manipulation is a safe and effective spine pain treatment. It reduces pain, decreases medication, rapidly advances physical therapy, and requires very few passive forms of treatment, such as bed rest.5

In fact, after an extensive study of all currently available care for low back problems, the Agency for Health Care Policy and Research—a federal government research organization—recommended that low back pain sufferers choose the most conservative care first. And it recommended spinal manipulation as the only safe and effective, drugless form of initial professional treatment for acute low back problems in adults.6

A patient information article published recently in the Journal of the American Medical Association also suggested chiropractic care as an option for people suffering from low back pain–and noted that surgery is usually not needed and should only be tried if other therapies fail.7

The American Chiropractic Association (ACA) urges you to make an informed choice about your back care. To learn more about how the services of doctors of chiropractic may help you, review the results of recent research studies and contact a Doctor of Chiropractic in your area. Search our online database of ACA members to find a doctor of chiropractic near you.

Tips to Prevent Back Pain

Maintain a healthy diet and weight.

Remain active—under the supervision of your doctor of chiropractic.

Avoid prolonged inactivity or bed rest.

Warm up or stretch before exercising or other physical activities, such as gardening.

Maintain proper posture.

Wear comfortable, low-heeled shoes.

Sleep on a mattress of medium firmness to minimize any curve in your spine.

Lift with your knees, keep the object close to your body, and do not twist when lifting.

Quit smoking. Smoking impairs blood flow, resulting in oxygen and nutrient deprivation to spinal tissues.

Work with your doctor of chiropractic to ensure that your computer workstation is ergonomically correct.

References:

1. Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2. Vallfors B. Acute, Subacute and Chronic Low Back Pain: Clinical Symptoms, Absenteeism and Working Environment. Scan J Rehab Med Suppl 1985; 11: 1-98.

3. This total represents only the more readily identifiable costs for medical care, workers compensation payments and time lost from work. It does not include costs associated with lost personal income due to acquired physical limitation resulting from a back problem and lost employer productivity due to employee medical absence. In Project Briefs: Back Pain Patient Outcomes Assessment Team (BOAT). In MEDTEP Update, Vol. 1 Issue 1, Agency for Health Care Policy and Research, Rockville,

 

4. In Vallfors B, previously cited.

5. Time to recognize value of chiropractic care? Science and patient satisfaction surveys cite usefulness of spinal manipulation. Orthopedics Today 2003 Feb; 23(2):14-15.

6. Bigos S, Bowyer O, Braen G, et al. Acute Low Back Problems in Adults. Clinical Practice Guideline No.14. AHCPR Publication No. 95-0642. Rockville, MD: Agency for Health Care Policy and Research, Public Health Service, U.S. Department of Health and Human Services, December, 1994.

7. Goodman D, Burke A, Livingston E. Low Back Pain. JAMA. 2013; 309(16):1738.

 

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Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link