Treatment Modalities

Dry needling is a westernised treatment modality aimed at reducing muscle spasm, improving blood flow and reducing muscular pain and dysfunction. Dry needling should not be confused with acupuncture which is an eastern medicine technique aimed at stimulation of the meridians (energetic pathways) within the body.

The application of dry needling involves the insertion of a sterile, stainless steel, small-gauged needle into the muscle/tendon. Most often, you’ll hear your chiropractor refer to these as trigger points during the procedure. We aim to insert needles into trigger points which are found within your muscle belly. Trigger points are tight bands within a muscle which are suspended in a “non resting state”, known most commonly as a muscle spasm or “knot.”

The goal of dry needling is to decrease pain and increase joint and muscular range of motion. Dry needling is very specific as it increases blood flow locally which contributes to healing.

How does dry needling work?

When a muscle is overused/overworked, an energy crises occurs. When this happens, your muscle fibres receive less blood flow and hence, may have less of oxygen and nutrients. Without adequate oxygen and nutrients, your muscle struggles to return to its resting state. The tissue near the trigger point becomes acidic, stimulating nerve sensitivity, and thus more pain and decreased range of motion is experienced. (We often hear patients using terms such as feeling “locked up” or “stuck” which refers to a muscle spasm.)

When we insert the needle, we temporarily create a trauma response, which stimulates an influx of blood flow back into that muscle. In order to get blood back into the affected muscle, a small prick and injury channel needs to be created.  Thus, this trauma response is necessary for healing. This needle “prick” also stimulates your brain to release endorphins (which naturally decrease pain.) During the dry needling procedure you may feel a muscular contraction which is known as a local twitch response. This is a good sign as it indicates that the muscle is being stimulated. 

Once normal blood supply returns, oxygen and nutrient concentration increases and thus, the resting state of the muscle can then be achieved. Once this happens, there is a restoration of range of motion, decreased pain and improved joint function.

When is dry needling used as treatment?:

• Cervical , thoracic or lumbar facet syndromes
• TMJ syndrome (jaw)
• “Pulled muscle”
• Migraine and tension headaches
• Whiplash
• Spinal disc herniations as a supportive treatment
• Pelvic pain
• Carpal tunnel syndrome 
• Achilles tendinitis 

Please contact us should you be suffering from pain in the spine and /or extremities. Dry needling can be an effective treatment choice for your condition. Coupled with chiropractic joint manipulative therapy, pain and dysfunction may be greatly improved.

Chiropractic manipulative therapy involves applying a high velocity, low amplitude thrust to a joint. Chiropractors manipulate or adjust spinal and extremity joints. This means that we not only adjust the lower back or neck, but the ankle, hip, shoulder and elbow too, to name a few. 

Chiropractic manipulation has been shown to reduce pain significantly, increase joint range of motion and improve performance in sports. There is some misconception around chiropractic manipulation breaking bones/joints but this is not the case. When a joint is adjusted or manipulated, the facet joints in the spine move apart very slightly which changes the pressure within the joint complex, resulting in the “crack” one most often hears. Facet joints are found on either side of the vertebral bodies, which give us the ability to bend and move. 

In essence, the pressure gradient changes with the rapid motion and causes fluid to move and gas bubbles to collapse or coalesce. This is what creates the popping sound and is known as a cavitation. 

When would a patient require spinal/ extremity manipulation? 

• Lower back pain
• Headaches
• Neck pain
• Sacroiliac joint syndromes
• TMJ syndromes
• Cervicogenic dizziness
• Vertigo 
• Tennis elbow
• Osteoarthritis 

Lumbar flexion distraction is a form of treatment targeted at “stretching out” the structures of the spine. We use lumbar flexion distraction mostly for patients suffering from lower back and sacral spine pain. 

Also known as spinal decompression therapy, flexion distraction involves the use of a special chiropractic table which allows for stretching of the lumbar spine whilst the patient is in the flexed position. Your practitioner will put you in a position where you will be lying on your stomach and a controlled distraction force is applied against the lumbar spine and pelvis. 

This form of therapy aims at increasing blood flow, stretching the discs of the spine, reducing the pressure in the intervertebral disc and reducing  compression of nerves within the spine. Spinal ligaments, spinal joints known as facet joints and spinal musculature undergo therapeutic stretching during this procedure. 

Most often these are the types of conditions we use lumber flexion distraction for:

• Lumbar spine disc bulges – herniations
• Lumbar osteoarthritis
• Sacroiliac joint syndrome
• Acute back syndromes
• Chronic lower back pain
• Sacroiliitis
• Degenerative disc disease
• Facet joint syndrome
• Sciatica
• Postural dysfunction associated with acute lumbar muscle spasm

Like lumbar flexion distraction, cervical traction’s purpose is to achieve the same result in stretching out the spinal structures like discs, ligaments and spinal joints, in order to alleviate neck pain and tension. Cervical distraction involves gently pulling or stretching the neck to relieve pressure on the cervical spine and surrounding structures. 

The goal of cervical distraction is to increase the space between the vertebrae, which can help reduce nerve pain, improve mobility, reduce pain and promote healing. This technique is typically performed using specialised equipment, such as a traction device, or can be done manually by a chiropractor.

Most often these are the types of conditions we use lumber flexion distraction for:

• Cervical disc bulges
• Cervical stenosis
• Cervical facet syndrome 
• Whiplash
• Cervical radiculopathy
• Headaches- tension, cervicogenic and migraines 
• Cervical osteoarthritis 
• Cervical spondylosis

Are you struggling to sit comfortably at your work desk or at-home office set up? This seems may be an issue for office workers and the alike. Having proper ergonomic setups can prevent a lot of neuro and musculoskeletal complaints that we see in our rooms, as chiropractors. 

Ergonomics refers to the relationship/interaction people have with their environment. In this specific case, ergonomic education will aim at improving a patient’s interaction with their environment in order to prevent/ assist and improve injuries due to sitting for such long periods of time.

As your chiropractor, we will ask you to give us a brief description of what your workplace set up looks like. We can identify any issues with the set up and tweak them if necessary, to prevent issues surrounding the upper part of the spine and the lower back,  which are most often affected. Some people may believe it is not such a serious issue – but if you think about it, one spends almost all of their time in the day at the office during periods where we are awake. And this gives all the more reason to have a correct and healthy set up. Already sitting for most of the day is not great for our health, but we have to make the most of it to prevent injuries. By preventing these injuries we can promote a healthy life cell so that patients are able to exercise in periods where they are not at work. 

Ergonomics is specifically important in the workplace nowadays due to the hours people sit/ stand and remain sedentary.

How can proper ergonomics help me?

• Reduce discomfort and pain
• Produce muscle spasm
• Better posture
• Increase productivity at the workplace
• Enhance well-being
• Improve focus and concentration
• Better work ethic
• Prevention of chronic health issues
• A reduction in healthcare costs
• Prevention of chronic disease

IFC therapy or interferential current therapy is a form of electrotherapy we use to stimulate muscles of our skeletal structure.

It involves the application of adhesive electrode pads to the affected muscle area. An electrical current of low frequency then intersects between these pads at either a two pole (two pads) or four pole (four pads) application. 

IFC stimulates our sensory nerves of the nervous system in order to help with:

• Pain relief
• Reduction of muscle spasm
• Increase blood flow to muscles
• Quicker recovery
• Reduction in oedema or swelling

Treatment: 

• Arthritis
• Oedema 
• Muscle spasm
• Tension headache
• Cervicogenic headaches
• Post surgical pain
• Neuropathic pain
• Sports injuries. 

Ultrasound therapy is a treatment modality that uses high-frequency sound waves to promote healing and alleviate pain in various medical conditions. It works by delivering mechanical vibrations to tissues, which can create thermal effects (increasing tissue temperature) or non-thermal effects (promoting cellular activity and enhancing tissue repair).

How does the body respond to mechanical vibrations during ultrasound therapy?

The body responds to mechanical vibrations during ultrasound therapy through several physiological mechanisms, which can lead to beneficial effects. Here are some key responses:

When ultrasound waves penetrate tissues, they generate heat due to the absorption of sound energy. This increase in temperature can enhance blood flow, relax muscles, and promote tissue healing by accelerating metabolic processes.

The mechanical vibrations also cause microscopic changes in the tissues. These include:

• Cell Membrane Permeability: Ultrasound may temporarily increase the permeability of cell membranes, facilitating the exchange of ions and nutrients, which can enhance cellular metabolism and repair.
• Cavitation: This involves the formation and collapse of tiny gas bubbles in the tissues, which can create micro-massage effects that stimulate cellular activity and improve circulation
• Increased Blood Flow: The thermal and mechanical effects can lead to vasodilation (widening of blood vessels), increasing local blood flow. This enhanced circulation helps deliver oxygen and nutrients to the tissues while removing waste products
• Pain modulation: The vibrations can stimulate sensory nerves, which may interfere with pain transmission pathways, leading to a reduction in the perception of pain.
• Tissue repair and Regeneration: By stimulating cellular processes, ultrasound therapy can promote the healing of tissues, helping with the repair of injuries and reducing scar tissue formation.

What conditions are treated with ultrasound therapy?

1. Muscle Strains and Sprains:Tendon Injuries:Joint Pain
2. Bursitis
3. Carpal Tunnel Syndrome:Post-Surgical Recovery:.
4. Scar Tissue Management:Plantar Fasciitis
5. Chronic Pain Conditions
6. Soft Tissue Injuries

Cross friction is a form of soft tissue therapy used on muscle, ligaments and tendons. Occasionally we also used cross friction along bony surfaces too.

It involves the use of the practitioners hands, elbows and fingers on the affected area like the tendon of the Achilles. We also use specialised tools called fascial instruments or blades in order to create pressure across on area. Cross friction involves applying a deep perpendicular pressure on a tendon, ligaments or scar in order to break down scar tissue, increase blood flow and speed up healing and tissue remodelling. The application of cross friction is perpendicular to the area of concern as to prevent blistering and move the skin and tissue as one. 

Let’s say you strain your Achilles tendon- as in some of the fibres of the tendon tear – your body would then attempt to repair the area by depositing down scar tissue during the healing phase. Having scar tissue in a tendon is not great as it reduces the tendons flexibility and elasticity. Scar tissue is less than ideal because although it is mostly made up of  collagen, the bundles are arranged in such a was that  a thicker, less flexible structure is created, which as you can imagine, predisposes us to future injury. If your Achilles tendon cannot stretch and contract to its optimum form/percentage, you are then more prone to injuries to the calf, the Achilles itself, the foot and the knee.

 Thus cross friction is a great form of treatment as it breaks down this thick collagen layer,  and allows a more  “stretchy” scar tissue, prevents adhesions which restricts mobility, increases blood flow and then, less chances of injury in future. 

When do we use cross friction on patients:

• Tendon tears
• Ligaments sprains
• Achilles tendinitis
• Biceps tendinitis
• Plantar fasciitis 
• Rotator cuff sprains 
• Finger injuries

K- tape or kinesiology taping is a therapeutic tool used by chiropractors for all patients – even for babies. It involves the application of a elastic tape to the patient’s skin. Kinesiology type is used as a modality for pain, scar tissue, inflammation, oedema and more. 

Kinesiology tape is made from a blend of cotton and elastic fibres, hypoallergenic dyes and is latex free. The tape is applied to the skin with a 10 to 15% stretch, which is known as paper off tension. The tape can be worn for several days but we like to recommend anything from 1-4 days. 

How does kinesiology tape work?

The stretch created from the application of k-tape can create a mechanical stimulus and activate pathways of your central nervous system. The density in your skin is changed which will then affect the layers of the skin known as the dermis and epidermis. This mechanical stimulus is converted into electrical impulses called mechanotransduction and may produce cell movement and thus, may be able to stimulate our receptors in the skin that are involved in our pain pathways. The resultant affect is pain relief. 

The pain gate theory is what we refer to in this example. Tape can give off signals of light touch and pressure on the skin, so if the tape is applied over a painful area, the theory states that some of the pain signals going to the brain are modified due to the stimulation of that light touch stimulus. 

When do we tape patients?

• Muscle strains
• Pain in the neck
• Rotator cuff injuries of the the shoulder
• Hamstring strains
• Swelling in the ankle after a sprain
• Hip bursitis
• Lower back pain

Ischaemic compression involves compressing an area of muscle using one’s fingers in a pincer like grip, for a sustained period of time. This is often practiced by chiropractors, physiotherapists and other manual therapists.

The pressure temporarily restricts blood flow to the muscle which helps reduce pain and muscle tension.

Once the pressure is released, blood flow returns to the muscle which aids in healing and reduces muscular discomfort. Most often ischaemic compression is not used alone but accompanies other techniques such as sports massage, cross friction. IC supports the overall goal of improving the blood flow in the muscle in order to flush out inflammatory cells.

Occasionally therapists will involve movement to the ischaemic compression. How they do this is ask the patient to move the muscle into a contraction and relaxation. This is very beneficial as it can increase range of motion and elongate very tight and sore muscles.

At our practice we send our patients rehab programs after their appointments. Mostly stretching techniques are issued first after a first  appointment and then strengthening exercises, once a patient has a decrease in pain and improvement in function

It’s important for patients to stretch regularly in between their chiropractic appointments to maintain some flexibility and improve their recovery in between sessions

The benefits of stretching:

• Increased range of motion
• Decrease in incidence of injury
• Improved sports performance
• Healthier joint promotion
• Improvement in posture
• Pain relief
• Better blood circulation

The benefits of strengthening:

• Improved bone density
• Increase in muscle mass
• Improvement in our metabolic rate
• Injury prevention
• Decrease in chronic pain
• Improved balance and coordination
• Chronic disease management. 

Active release

This refers to a hands on technique that involves active movement of the patient’s limb or joint by the patient. In this technique there is a muscle contraction. We use this technique along with combining a tension to a muscle (as in, the doctor grabs the muscle between the fingers/hands or via the elbow) whilst the patient is moving.  What this can do is, help break up muscle adhesions, improve range of motion and improve pain. 

Passive release 

This techniques refers to a hands on approach where we as the the doctor move a patient’s joint through a range of motion. In other words, there is no muscle contraction involved. We do this to manipulate the musculature and improve stretch, range of motion and tension within the muscle. 

Benefits:

• Less pain
• Increased flexibility
• Return to sports
• Increased circulation