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Old 12-31-2009, 10:08 AM   #61
Neal Carlson
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Re: Ongoing back problems: a new hypothesis

Jeff,

It seems that at least that one time you lost the adjustment overnight. Do you know if you are active when you sleep - moving around a lot? Have you ever felt yourself start to lose the adjustment mid-day? Or does it seem to start in the morning?

I recommend you keep a log and write in it daily - perhaps every morning and evening. Describe what you did and how you feel with your back. You might notice patterns which you wouldn't otherwise.

Have you tried a neck brace at night? My doc has all patients wear a neck brace for an hour after the first two adjustments. Just a regular foam one, perhaps there are more supportive ones which would help more.

My doc also recommended a memory foam contoured herapeutic pillow. It supports the neck , and seems very comfy. I have a memory foam mattress, which I love, but haven't picked up the pillows yet.

Do you sleep on memory foam mattress or topper? An uncomfortable mattress may cause you to move more.

I'd think if strength is the cause - it is a case of unbalanced strength, and not from lack of strength. Can you visually or feel a difference in sizes of neck muscles? Perhaps stretching the stronger/tighter side regularly will allow it to relax? I wonder if you are being so careful that you aren't using your neck muscles enough right now... you said yourself that when you were active you kept the adjustment longer.

Do you ever sleep on a heating pad? I do occassionally, and it really helps with tense muscles. If your back/neck is tense which causes you to lose the adjustment - perhaps you should use one all the time. It also might be comforting and lead you to move less at night.

I'm not an expert, just guessing at things.
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Old 01-21-2010, 03:01 PM   #62
Jeff Evans
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Re: Ongoing back problems: a new hypothesis

Just providing an update from my side (I'm basically using this as a log now).

It turns out that I wasn't losing my adjustment. Rather, my atlas had come out in a different way than it started, unbeknownst to myself and the doctor until last week. On Jan. 11, when I went in, the doc said that something wasn't right and we needed new x-rays. I agreed and he took new "before" pictures. From this, it became apparent that my corrective need was different than was reflected on my original x-rays. In fact, the atlas needed to be adjusted from the opposite side than he had been coming from. The doc said this type of change was quite rare, but does explain why it seemed as though nothing was holding before. So, he performed the adjustment based on the new calculations and then took new "after" pictures, which showed C1 coming into alignment again.

I suspect this had happened when I first lost my adjustment (as described in this post - w/fs), because in those few seconds I had a distinct feeling of vertebra moving around in the general upper cervical area. However, the doc said even this was unlikely since it wasn't a major blow to the head. His theory is the bones shifted to their "natural" position they had been in before any of my previous chiropractic care (previous chiros definitely jerked my head around as part of their treatment). Regardless of how it happened, I want to emphasize the following point for posterity, in case anyone reading this in the future finds themselves in a similar situation: if you feel like the atlas correction isn't holding after repeated visits, despite the fact you are being careful with your head and neck, insist on getting new x-rays. It's possible that your needed correction has changed and you will just be wasting your time if you keep getting the original adjustment.

Since that appointment, it's been holding. I've had one follow up so far with the laser lights, and my hips/shoulders have been level in the mirror. I'm now back to the original sensations (described here - w/fs) where it feels like somebody is twisting my tailbone from behind. My guess is this is my hip muscles readjusting to the new pelvic position. As then, I feel much better (more comfortable, less cracking) when standing instead of sitting.

A few other observations over the past week or so:
  • The tactile difference I used to identify between touching my left and right scapula with opposite arms overhead appears to have vanished. It used to feel like there was a "gap" just to the right of my left scapula, which wasn't present to the left of my right scapula. This asymmetry was also identified by the orthopedist I saw last year, who diagnosed it as a deficiency in muscular mass on the left side. It felt a bit like the left scapula was winging, even though it wasn't nearly as extreme as some of the example cases illustrate. However, in my back there now appears to be no difference between the two sides, as far as I can feel.
  • The trigger points in my left scalenes, have pretty much disappeared on their own (without any self trigger point therapy). The formerly large trigger point in my left pectoral has decreased in size and "pain" dramatically, but is still present to some small degree. The large trigger point/lump/protrusion I used to feel on the left side of my neck around C2 has decreased to almost nothing.
  • Energy levels have been back to what I would call "great" again. Waking up refreshed at 5:00AM is a new experience for me.
  • Upper left back cracking (chief complaint) has been better but not significantly. It's much worse when sitting than standing, as mentioned above.

I'll update again when/if anything changes.
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Old 01-25-2010, 11:09 AM   #63
Neal Carlson
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Re: Ongoing back problems: a new hypothesis

Wonderful news Jeff, very glad to hear it. And I'm happy to help keep this thread going as a log for others to use.

An update on me:
Last Thursday I was doing my regular starting strength type routine: squats, presses & chin-ups. I've been slowly, slowly putting up new PRs, although I'm quick to reset weights or skip squats/deads if I have a hint of back tightness. And I only squat heavy on my press workout days, when I bench I only squat light. Anyway, I was finishing my last set of chin ups and must have pulled or strained a muscle in my neck. It felt painful. It doesn't hurt to move it really, and my range of motion wasn't reduced much. Massaging it seems to help, as does heat.

I saw the chiropractor this weekend and he agreed I did something to the muscle, but I don't recall exactly what words he used. He said I lost my adjustment a little bit, and that might have been the cause. So he reminded me to pay attention and keep my neck and head and back in straight alignment whenever I do chin ups. I'm quite certain I didn't last Thursday, I was tired after a long day and tough workout, and just wanted to finish and get out of the gym. Lesson learned.

I still feel pain in my neck, and a bit on my shoulder as well. But it has gotten quite a bit better in 3 days.
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Old 02-16-2010, 03:44 PM   #64
Neal Carlson
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Re: Ongoing back problems: a new hypothesis

I've got good and bad news and wanted to bump this thread to the top.

The good news first, because it is short and more relevant to this thread:

Due to pain I went to an orthopedist today. He took Xrays. He said there is no severe problem with my spine or disks no indication of hernia, rupture, or anything. Everything is ok, other than the pain. His Xrays also gave zero indication of scoliosis. Zero. It was a partial Xray only of the lower back, but I could swear that all past Xrays (full or partial spine) I've seen of myself showed curvature. I'm quite simply... amazed.

The bad news is my back has been giving me pain again for about 2-3 weeks now. Almost since my last post about neck pain. What was unusual, and scary for me is even when I stopped exercising and did regular stretches and tried to pay attention to posture, the pain still came and went for the two weeks. And yesterday, pop I was picking up my dog and had extreme pain and basically could only lay down the rest of the day. Today I feel quite a bit better, not too much pain and able to move.

I don't think this episode had much to do with NUCCA adjustments. In those 2/3 weeks, I missed an adjustment due to weather, but had 2 others as usual. I had an adjustment Friday night, and my severe pain was 2 days later.

I have three theories about this episode.

1- I bought a $10 memory foam contoured pillow at Walmart and have been using it as one is supposed to with the large hump under the neck. I think the pillow might be too hard or too high or both, and caused problems. I'm not going to use the pillow again. Perhaps this theory is wrong though since I didn't use the pillow at all the night before the severe pain.

2- by abs are weak. Throughout my SS exercises, I haven't done much direct ab work. Occasional leg raises, very occasional crunches. I think my abs are at best not stronger since when I started SS, and at worst they've gotten weaker. My back has definitely gotten stronger so I have an imbalance. I feel silly for not having recognized or thought about this earlier and done regular ab exercises.

3- it is related to my neck pain. My back pain seemed to come on just after my neck pain went away. Perhaps I overcompensated in some way.

But none of those theories explain why the pain was recurring for 2/3 weeks and remained even when I did extra stretching and paid close attention to posture.
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Old 03-01-2010, 04:24 PM   #65
Kulsoom Ahmed
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Re: Ongoing back problems: a new hypothesis

Neal and Jeff,

I am sorry to hear about your pain. I am not completely 100% but I thought to go ahead and give some updates.. maybe it will help or not.

Currently I have not had to be adjusted 5 weeks, that is I have held my correction for this long. In this duration I was checked twice and not corrected. Previously I had an issue with getting on vertical, I tended to be twisted more to one side. My NUCCA recommended massage therapy to help get rid of muscle adhesions. I have done this a few times. I think I am better but not yet completely. I still feel or sense tightness sometimes.

Additionally I did get a CHEK assessment near the end of December. I was given pre-stretches to do before a WOD, and corrective exercises to do after a WOD. These are to address imbalances. I think that this has been helping. I do this everyday, it is tedious but I am trying to be patient as I want to recover and I know it will not happen that fast.

I also try to use a lacross ball and PVC pipe at least once a day on tender spots. I also asked the massage therapist what she recommended I do based on her assessment. I am noticing that I have less tender spots and do not need to spend as much time. I think it is also good for maintenance.

Neal, from your post I wonder if you have some similar issues. The pillow is possible.. I have been using a pretty flat pillow with a neck roll inside it. I find that memory foam is too thick for my neck.

Of my ab imbalance, I was told to avoid situps. I have been doing a corrective exercise where I lay on my back with my knees up. Then I press my lower back into the ground. It is similar to what you are taught when learning the hollow position for a handstand. This has helped strengthen my core and back.

So I think I am getting there.. I would recommend a CHEK assessment. I can't afford more visits but the CHEK practitioner I went to was nice enough to give me all the movements in one visit and work mostly on my own but still email him with questions.

Additionally I have been still crossfitting.. I mainly avoid ab mat situps only.. and I still try to pay attention that nothing is causing any tightness or issue. I recently competed in sectionals and I had no pain or issue.

Last edited by Kulsoom Ahmed : 03-01-2010 at 04:25 PM. Reason: more info
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Old 03-09-2010, 08:51 AM   #66
Kulsoom Ahmed
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Re: Ongoing back problems: a new hypothesis

Today I did have to get adjusted. I was on vertical but had a twist. After the adjustment I was back to normal.

Not sure why I lost it, or that I even did lose it. I did not notice any increase of symptoms. I would say I felt the same or better.

At this point, I will just continue doing what I do and hope for the best. I am not sure what else, and I dont think I can purchase more visits to the NUCCA after these visits finish. So if I am not over it by then, I will have to wait or try something else.
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Old 03-18-2010, 09:34 AM   #67
Jeff Evans
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Re: Ongoing back problems: a new hypothesis

Thanks for the updates, all.

Kulsoom, I'm curious... is your doc doing new x-rays every time? If not, then how did he identify a vertical twist if you didn't have any outward symptoms?

Neal, I had the opposite problem as you a year or so again - abs were relatively too strong compared to my back. I plan to address that first when I get back to a regular workout schedule. Sorry to hear about your pain; hope it improves. I have noticed that pillow selection and sleeping in general can make a huge difference either way; I've been trying to train myself to sleep on my back. This (w/fs) is the pillow I'm currently using; it seems pretty good for holding the head in a fixed position due to its shape.

For myself, I had to get re-adjusted once more since my last post, about two weeks after the new x-rays. Not sure what knocked that prior one out. But, since that correction, it's been holding great.

A couple of weeks ago, I had a shoulder tilt that made me think I'd lost it for sure, but when I went for the checkup, hips were still even and leg lengths were still good. I think there are some major muscular things going on in my back which changes my limb position day-by-day.

So the last adjustment has been holding for over a month now and I'm starting to see primary symptom improvements at last. Cracking and dorsal tension/pain is noticeably decreased on a regular basis (not just one day here or there). Sitting is still worse but is more manageable now. Walking/standing up for extended periods still feels great so I try to do that as much as possible. I feel some occasional pain just to the left of my sacral spine, which I'm assuming has to do with all the muscles in that area adjusting to the new hip position.

I'm planning to start lifting again soon, assuming this keeps holding for a few more weeks (I'm being extra paranoid given the relative difficulty of my case thus far). Will provide another update here in a while, or if something changes.

As far as NUCCA goes, count me among the Kool-Aid drinkers . I'm looking forward to seeing the results of the larger-scale follow up to the controversial high blood pressure study (w/fs) published, which probably won't be for another couple of years since it just started. I'm also trying to pressure my doc to document all his equipment, techniques, etc. since I'm not sure how much longer he's going to be able to practice, and it would be an outrage if his knowledge was lost.
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Old 03-18-2010, 01:34 PM   #68
Mike Mallory
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Re: Ongoing back problems: a new hypothesis

Jeff, you can have a pelvic twist, or any number of other small, but nonsymptomatic places that rotation shows up.

All that stuff about keeping the head stable, and losing the correction in sleep, is basically nonsense. If you're having those kinds of problems holding, then there are overlooked issues. It's not a matter of keeping the head more stable, its a matter of looking to more biologically important structures that may be affecting the atlas.

Keep in mind, Upper cervical just frees the space in the body to go to work on the muscles and joints. If you don't do any specific exercise/mobilization work to correct musclature and tissue, then you have to take the long route; a million upper cervical adjustments until it 'just happens' to hold.

If you actively hold back the range of motion in your neck, you'll just make things worse in the long run.......Those structures need a certain amount of stress to stay healthy, and should operate in a full range of motion.

Dorsal tension/pain needs accompanying rehab.....NUCCA is just not enough for those kinds of things because it won't change the saggital plane posture.
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Old 03-18-2010, 06:53 PM   #69
Anthony Ricci
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Re: Ongoing back problems: a new hypothesis

Mike-well stated. Joints are meant to be moved.You will not subluxate unless your motion patterns are abnormal or you introduce interference to the nervous system.
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Old 03-21-2010, 08:34 AM   #70
Jeff Evans
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Re: Ongoing back problems: a new hypothesis

Quote:
Originally Posted by Mike Mallory View Post
Jeff, you can have a pelvic twist, or any number of other small, but nonsymptomatic places that rotation shows up.

All that stuff about keeping the head stable, and losing the correction in sleep, is basically nonsense. If you're having those kinds of problems holding, then there are overlooked issues. It's not a matter of keeping the head more stable, its a matter of looking to more biologically important structures that may be affecting the atlas.

Keep in mind, Upper cervical just frees the space in the body to go to work on the muscles and joints. If you don't do any specific exercise/mobilization work to correct musclature and tissue, then you have to take the long route; a million upper cervical adjustments until it 'just happens' to hold.

If you actively hold back the range of motion in your neck, you'll just make things worse in the long run.......Those structures need a certain amount of stress to stay healthy, and should operate in a full range of motion.

Dorsal tension/pain needs accompanying rehab.....NUCCA is just not enough for those kinds of things because it won't change the saggital plane posture.
Mike, all good points. Just to clarify a few things... the doc never said anything about keeping my head stable, not moving my neck around, etc. Those are just things I (erroneously) did when I kept losing corrections. All he ever said was to not hit my head on things, and to not sleep on my stomach (which is valid even if for other reasons). Of course, as of recently I started to realize how silly it is to restrict motion of the neck and I don't worry about that anymore. All I do is make sure I don't whack my head against something when bending over or getting in/out of the car, etc.

Regarding the rehab question, I'm sure it is helpful. But I can't quite reconcile what you're saying with what I see at the office. I visit the most frequently, by far, of any of the current patients (I can tell by looking over the sign in sheet). Most people are coming in 1-2 times per year to get checked. A lot of them are older, and there's no way they are doing any kind of physical rehab on the side. How are they able to hold their adjustments without any kind of outside work, while I kept losing them for such a long time period?

I also don't quite understand the statement "it won't change the saggital plane posture". Having pelvic and shoulder unevenness corrected clearly affects the plane (w/fs). Maybe I have misunderstood something.
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