Thursday, 27 April 2017

Elbow Pain Treatment in Malaysia

There are different causes and various types of injury that can lead to elbow pain. A health care practitioner should first identify the major causes of pain so that the treatment can be targeted at reducing or correcting the anomalies. Chiropractic care and physiotherapy in Malaysia are proven to be able to reduce the symptoms of most elbow injuries with a musculoskeletal cause. However, there is no one single treatment has proven to be highly effective in treating a musculoskeletal condition of the elbow joint. A multi-modal treatment approach has been proven to be effective in resolution of the symptoms of most musculoskeletal based elbow injuries.


The treatment approach to address the musculoskeletal problems that leads elbow pain is similar to other treatments for soft tissue injuries. Initially the main goal of the treatment is to control the pain and promote the healing process. Restoration of flexibility and strength of the muscles and connective tissues can be achieved by active and passive stretching and strengthening exercises. Manual therapy, chiropractic adjustment and therapeutic modalities can be effective to treat associated factors such as increased neural tension and referred pain. Gradual return to sports activity can be achieved with functional strengthening exercises. Correction of the predisposing factors, especially poor techniques during sports activities, is very crucial in preventing re-occurrence of the same injury. 

Saturday, 22 April 2017

Chiropractic Care for Elbow Pain in Malaysia

There are two main types of injuries in patients with pain on the inner side of the elbow. One of the injuries involve repetitive stress to the tendinous insertion of the wrist flexors at the inner elbow. The tendons of pronator teres and the wrist flexors group are being irritated due to excessive activity of the wrist and hand. This condition is commonly known as the Golfer’s elbow, or flexor/pronator tendinopathy.

The other cause of inner elbow pain is due to excessive throwing activities. The throwing action can cause additional stress on the medial collateral ligament due to increased valgus stress on the elbow. The anterior part of the medial collateral ligament and the joint contour of the radiocapitellar joint are the major contributors to the stability of joint under valgus stress. Poor throwing techniques and repetitive throwing can lead to over-stretching of the medial collateral ligament. This can result in an instability of the joint due to increased laxity of the ligament.

Prolonged injury to the medial collateral ligament may lead to additional scar tissue deposition. This can result in fixed flexion deformity of the elbow joint. If this fixed flexion deformity continues, synovitis or loose body formation may develop in the elbow joint as the medial tip of the olecranon can impinge on the olecranon fossa. There may be an increase compressive force which can damage the radiocapitellar joint when additional valgus stress is exerted on the unstable elbow joint.
Chiropractic care in Malaysia can help with the elbow pain by correcting the misalignment of the elbow joint and muscle imbalances. We can also give you some advice on how to perform the exercises that you like without hurting yourself.







Monday, 17 April 2017

Neck Pain due to Slip Disc

Slip disc in the neck can cause neck pain, upper back pain, headache, and pain or paresthesia that radiates down the arm, forearm, hand and fingers. Physical exertion or trauma can lead to symptomatic cervical disc herniation. Slip disc in the spine does not happen overnight. Normally degenerative changes in the spine that change the structure of the spinal disc happened over a period of time before the disc herniates and become symptomatic. There are studies that showed weight lifting, especially lifting free weights, and bowling may increase the risk of disc herniation in the cervical and lumbar spine.

Patients who have done prior spinal surgery may be at risk of developing slip disc in the spine due to degenerative disc disease. Spinal segments adjacent to the surgical level are more prone to degenerative disc disease as there will be additional stress being placed on the segment above and below the affected level. People with increasing age are more likely to develop degenerative disc disease due to the natural history of aging and wear and tear over the years. Cigarette use and nicotine intake may correlate with radiological findings of degenerative disc disease as these may disrupt the bone metabolism of the spinal vertebrae.

Typically symptomatic slip disc in the neck that does not involve any trauma may recover within the first 4-6 months after the onset of symptoms with some form of treatment. However, the damaged disc may take up to 2 years for complete recovery due to the slow healing rate of the spinal disc. 

Wednesday, 12 April 2017

Chiropractic Care for Neck Pain


Slip disc in the neck can lead to diverse patterns of symptoms including neck pain, radicular pain into the upper limb, numbness, tingling or burning sensation of the upper limb, and progressive weakness in the upper limb. People who develop slip disc in the neck without a trauma usually reports that they wake up with sudden onset of symptoms. The health care practitioner should have a list of differential diagnosis in mind as the presenting symptoms may overlap with these diseases and syndromes. Space-occupying lesions and tumour should be considered in the correct population, especially those with genetic predisposition.


Further imaging of the cervical spine is needed to rule out other serious causes of cervical radiculopathy. People with unusual presentation or those who do not respond well to initial conservative treatment will need imaging of the cervical spine for further investigation. Spondylosis is the most common differential diagnosis; however, spondylosis can sometimes co-exist with slip disc injury. There are a few differential diagnoses with similar presenting symptoms such as peripheral compressive neuropathy, spinal trauma, spondylolisthesis, root avulsion, radiation injury, infiltrative, infectious, para-infections, and metabolic conditions, muscular pathology, brachial plexus pathology, rotator cuff disease, arthritis, or complex regional pain syndromes.  The list should not be limited to the above-mentioned differential diagnosis as each patient should be evaluated to find the most suitable working diagnosis that explains the patient’s symptoms. 

Friday, 7 April 2017

Neck Pain and Slip disc in Malaysia


Chronic neck and back pain is becoming an epidemic in Malaysia and is affecting a lot of people at different stages of their life. One of the reasons for the development of chronic neck and back pain is the sedentary lifestyle that we are adopting due to the advances of technologies. Occupations or habits that require repeated heavy lifting, prolonged sitting, prolonged desk work or activities that involve repeated axial loading can cause damage to the spinal disc in the neck and back. People with a genetic predisposition to early degeneration of the spinal disc or inflammatory disease are at a higher risk of developing slip disc in the neck and back.

The C6/C7 disc is the most commonly affected spinal segment in the cervical spine. Slip disc at this level will cause irritation and compression of the C7 nerve root. Common symptoms of slip disc at this level include neck pain, posterior arm pain, triceps weakness, wrist drop, and numbness, tingling or burning sensation of the middle finger. Slip disc at C5/C6 and C7/T1 levels are the second most commonly affected spinal segments in the neck.


Slip disc injuries at different levels that are symptomatic can cause pain and sensory changes in a specific pattern according to the dermatomal distribution and weakness in specific muscles. The symptoms in each slip disc cases may be different but normally involve neck pain, radicular pain, paresthesias, and progressive weakness. 

Sunday, 2 April 2017

Slip Disc (Slipped Disc) in the Neck

The cervical spine in the neck consists of 7 bony vertebrae, from C1 to C7. The cervical spinal cord is protected by these bony vertebrae as it travels down from the brain. The cervical spinal cord is considered as the most important part of the spinal cord when compared with the thoracic, lumbar and sacral levels. The cervical spinal segments of the spinal cord contribute to the major musculature of respiration and are involved in the autonomic nervous system of our body. Therefore, an injury to the cervical spinal cord can lead to major dysfunction of the body system and sometimes this can be fatal. Herniated nucleus pulposus, or slip disc (slipped disc), and degenerativedisc disease are the two most common disorders affecting the spinal disc in the cervical spine.


There are a few causes that can lead to slip disc injury or nucleus pulposus herniation in the cervical spine. A trauma or accident can cause spinal disc injury with a sudden onset. However, most of the slip disc injuries in the neck are caused by prolonged irritation from chemical and mechanical degenerative changes in the cervical spine. Occupation based injuries are one of the main contributors to slip disc in the neck, especially prolonged desk work with poor work place ergonomics. Slip disc in the neck can cause not only neck pain but also pain and/or numbness and tingling sensation in the upper back, arm, forearm, hand and fingers.

Tuesday, 28 March 2017

Frozen Shoulder Treatment in Malaysia

Frozen shoulder normally presents as a sudden onset of shoulder pain followed by marked stiffness in the shoulder and significant limited range of motion in the affected shoulder. Both passive and active range of motion of the shoulder is significantly reduced. The condition rarely attacks the same shoulder unless the shoulder joint is repeatedly injured due to physical activities, trauma or disease processes. The proposed aetiology for the development of frozen shoulder, also known as adhesive capsulitis, is the contracture of the glenohumeral capsule. The involvement of the coracohumeral ligament that lies adjacent to the glenohumeral capsule and rotator cuffs is noted in most of the arthroscopic and histologic studies. This condition is usually self-limiting; however, the signs and symptoms may last from 6 months up to 2 years without treatment. It has been reported that there may be up to 41% of patients have mild to moderate residual symptoms 7 years after the initial onset and less than 10% of patients present with continuous severe symptoms with pain and functional loss. 


The most effective treatment for frozen shoulder in Malaysia involves non-surgical interventions that address the symptoms at different stages. Health care practitioners should be able to recognise the different presentations of frozen shoulder and should understand that this condition is a continuum rather than having well-defined stages. Physiotherapy that includes different modalities and manual therapy can help to alleviate the symptoms and improve the mobility of the shoulder joint. Chiropractic care can provide some relief to the symptoms and mobilise the shoulder and the adjacent joints. Home exercise plays a major role in restoring the range of motion of the shoulder joint.