Imagine walking with a leg length discrepancy of an inch or more—how would it affect walking, running, and getting around. Now imagine being a child. You walk with a limp. Maybe your spine is curved. Your back hurts, and you’re tired all the time. Other kids might tease you.
Leg length discrepancies, where one leg is noticeably shorter than the other, can happen in children and adults. It can be congenital or caused by illness or injury. In any case, it is at least annoying and can be associated with more severe conditions.
In Part 1 of the leg length discrepancy series, we’ll give you an overview of the condition. Later, in Part 2, we’ll talk about how it is treated.
What is Limb Length Discrepancy?
Limb length discrepancy is a condition in which either the two arms or the two legs are of noticeably different lengths. Many people have arms or legs of different lengths, but the difference is so small that they may not even know there’s a difference at all.
But for those who have a significant limb length discrepancy, there can be functional difficulties and mild to severe medical problems to overcome.
Arm Length Discrepancy
The bones of the arms have two growth plates—one at the shoulder and the other at the elbow. Bone growth occurs around these plates, which become solid bone when a child has reached skeletal maturity. However, sometimes one arm is prevented from growing normally, and it remains shorter than the other.
While it may cause fewer problems than a leg length discrepancy, an arm length discrepancy of two or more inches can become an interference. For example, it can be more difficult to securely hold bicycle handlebars or car steering wheels. In addition, playing a musical instrument may be more of a challenge.
Leg Length Discrepancy
A leg length discrepancy is more problematic. Among other things, leg length can affect one’s ability to walk and move about efficiently, as well as their spinal alignment. Therefore, a length discrepancy of more than one-half inch will need some kind of intervention, from adding lifts to shoes to complicated lengthening procedures.
What are the Two Types of Limb Length Discrepancy?
There are two ways to describe the types of limb length discrepancy—anatomical vs. functional and congenital vs. illness or injury-related.
Anatomical vs. Functional
An anatomical or structural discrepancy means that one leg is physically shorter than the other. A functional discrepancy is due to problems with soft tissues, joints, or ligaments.
Congenital vs. Illness or Injury
A child with a congenital leg length discrepancy develops the condition in the womb and is born with limbs of different lengths. The other type comes from the effects of bone diseases or bodily trauma.
Causes of Leg Length Discrepancy
Congenital (Idiopathic) Leg Length Discrepancy
It is unknown why some babies are born with leg length discrepancy, where one leg never fully developed. For some, the hip alignment is off, or the hip is dislocated. The condition usually becomes noticeable when the baby begins crawling and walking. Clubfoot, hip dysplasia, and other congenital conditions may contribute to the discrepancy.
Leg Length Discrepancy and Bone Defects, Diseases, and Tumors
Bone diseases affecting leg length include Ollier disease, cancer, neurofibromatosis, joint inflammation, and infections. Conditions such as cerebral palsy, paralysis, and spasticity are also contributors.
Any type of bone tumor or its treatment can affect bone growth on one side. For example, osteochondroma may damage growth plates, osteosarcoma affects growth plates and leg bones, and fibrous dysplasia weakens bones. Wilms’ tumor causes hypertrophy on one side, making one leg shorter. Enchondroma grows inside the bone marrow and affects growth.
Leg Length Discrepancy and Broken Leg Bone
Sometimes, a broken leg does not heal properly. A complicated break can lead to a leg length discrepancy. It may happen if:
The leg was broken in several places.
Connecting tissues was severely damaged.
It was an open fracture.
A growth plate was damaged.
Leg Length Discrepancy and Knee Osteoarthritis
Studies have linked leg length discrepancy to osteoarthritis of the hip or knee. One knee “ages” faster than the other when, many say, there is a difference of 20 millimeters or more. Others claim even 5 millimeters can make a significant difference.
Leg Length Discrepancy and Scoliosis
Scoliosis is both a potential cause and outcome of leg length discrepancy. Scoliosis patients often have uneven legs as a major symptom. The discrepancy can bring about scoliosis in some people when the body attempts to compensate for the difference.
Leg Length Discrepancy after Hip Replacement
It may be difficult to restore a patient’s equal leg length after hip replacement surgery. Arthritis, often the reason for hip replacement, can cause bone loss and leg shortening. Also, to ensure a stable new hip joint, stretching the surrounding soft tissues may be necessary, creating a slightly longer leg.
How is Limb Length Discrepancy Diagnosed?
Diagnosis begins with a medical history of family background and any injuries and illnesses. Next, the doctor observes the patient’s posture and movement. Tests may include X-rays, CT, and MRI. Radiography provides an image of the entire leg, and measurements involve a simple tape measure and manual palpitations. A doctor may place wooden blocks below the shorter leg to measure the extent of the difference.
We’re Looking Forward to Helping You at Our Chiropractic Offices in New Jersey!
At the Bergen Chiropractic and Sports Rehabilitation Center, our chiropractic team, led by Dr. Gregory Doerr, follows the highest and most professional medical standards to provide superior chiropractic help. After all, our mission is to provide unparalleled patient care and services in a comfortable healing atmosphere. Contact us to learn more about our chiropractic services! Our chiropractic offices in Cliffside Park, Hackensack, and Fairfield, New Jersey, are ready to welcome you. Also, feel free to access our blog page for more information on chiropractic treatments!
Cheryl felt dizzy and nauseous after experiencing a whiplash injury in a car accident. Mark’s whiplash injury happened during a football game—his lower back hurt! Patty’s whiplash injury gave her a severe concussion.
Whiplash is a painful condition that can cause a lot of damage to the neck, spine, and brain. It has multiple physical symptoms and includes unpleasant side effects. From ringing in the ears to back pain and neurological disorders, these side effects require additional healing.
What is Whiplash?
A whiplash injury is a sudden, violent impact to the body that throws the head backward and forward like a whip. The whipping motion excessively stretches the neck’s soft tissues, can force the cervical spine out of alignment, and damages bones and discs.
The most common causes of whiplash are rear-end car accidents, contact sports injuries, and physical abuse or assault (e.g., punching or shaking). The severe jerk forward may have adverse effects throughout the body with a multitude of symptoms.
What are the Main Whiplash Symptoms?
The most common symptoms of whiplash injuries include:
Pain, stiffness, and limited range of motion in the neck.
Pain in the back, shoulders, and arms.
Dizziness and tiredness.
What can make whiplash particularly dangerous is that you may not feel the symptoms right away. After a car accident, for example, you may feel fine and think you got lucky. But after a few days, the pain makes itself known, and you may have exacerbated the injury by moving around too much before the pain hits.
See Your Chiropractor
For this reason, it is vital to seek medical attention as soon as possible after a car accident or other incident, even if you think you feel fine. Since a neck injury is musculoskeletal, a chiropractor should be your first stop.
It is not unusual for a whiplash injury to be treated with pain medication (over-the-counter or prescription) and recommendations to rest for a few days. But a chiropractor will delve further into the nature of the injury and execute a treatment plan for treating symptoms and healing.
There may be more to your whiplash injury than just your neck pain, as whiplash can lead to other complications. All the more reason to seek a physical exam and treatment even if you initially feel okay.
What is the Difference between Whiplash and a Concussion?
A whiplash injury and a concussion have similar symptoms. While both involve injury to the neck, doctors may find it difficult to distinguish between the two without knowing how the injury came about. But there are differences, and the occurrence of whiplash may lead to a concussion.
A concussion involves injury to brain tissues, nerves, and blood vessels. Any force that violently shakes the brain will cause it to hit the inside of the skull. Even a mild traumatic brain injury can hinder the normal transmission of signals from the brain. For example, a concussion may be caused by a blow to the head or whiplash as the head is flung back and forth.
Can Whiplash Cause Migraines?
Sometimes, with whiplash symptoms come headaches. And for some people, those headaches become migraines. A migraine headache is extremely painful, often with a throbbing sensation, upset stomach, and an overly sensitive reaction to light and sound. It can last for a few hours or days.
Most post-whiplash headaches (about 80%) originate from an injury to facet joints in the neck. Others may be caused by injuries to a disc in the neck.
Can Whiplash Cause Tinnitus?
A whiplash injury can lead to symptoms such as ringing, buzzing, or hissing sound in the ears— i.e., tinnitus—that follow the rhythm of the heartbeat or breathing. It happens most frequently in men and both men and women over 40. Chiropractic manipulations are beneficial for treating tinnitus caused by whiplash.
Can Whiplash Cause Nausea?
Whiplash can cause severe headaches and dizziness, and it may block circulation affecting the inner ear. This may make some people feel nauseous and even cause vomiting. About 25 to 50% of people with whiplash experience nausea.
Can Whiplash Cause a Traumatic Brain Injury?
Whiplash victims may have symptoms indicating a brain injury, including dizziness, headache, cognitive problems, visual impairment, and sleep disturbances. Studies have shown blood flow changes and decreased density in the brain’s gray matter in whiplash patients.
Can Whiplash Cause Acute Peripheral Vestibular Deficits?
The vestibular system regulates your balance, i.e., the work of your inner ear and brain. A whiplash injury may disrupt this system, causing balance difficulties and dizziness. A peripheral vestibular disorder prevents your system from producing normal sensory information about the movement and position of your head.
Can Whiplash Cause Lower Back Pain?
When you experience whiplash, most of the force is concentrated in your neck. But your whole body experiences the violent jolt, including your lower back. Pain in the muscles and muscle spasms are common whiplash symptoms.
Can Whiplash Cause Cervical Vertigo?
Cervical vertigo is a feeling of dizziness and spinning due to an injury to the neck. Moving your neck and head intensifies these sensations. As a result, you may have a hard time keeping your balance or concentrating. This dizziness is a common symptom of whiplash.
Can Whiplash Damage Your Nervous System?
Because of the damage it can cause to the neck, cervical spine, and brain, a whiplash may bring about several neurological symptoms. Whiplash injuries such as herniated discs can exert pressure on nerve roots and lead to chronic issues. In some cases, whiplash can also lead to problems with memory, focus, sleep, and sudden mood changes.
What is the Average Whiplash Healing Time?
For many people, whiplash symptoms last a few weeks with treatment. However, whiplash means more than neck pain for some patients, so it may take longer to heal, given the other symptoms that may accompany the whiplash. Without proper care, some people end up with chronic pain and serious complications.
We’re Looking Forward to Helping You at Our Chiropractic Offices in NJ!
At Bergen Chiropractic and Sports Rehabilitation Center, we use adjustments and soft tissue treatments to alleviate immediate pain and symptoms of whiplash and prevent further injury and chronic complications. Contact us for an appointment. We will develop a treatment plan to put you on the road to healing! Also, we invite you to visit our blog page for more information on chiropractic treatments!
Headaches! They are unpleasant things that slow you down. Most can be handled with over-the-counter medication and some rest. But a migraine headache comes with significant pain and can last for hours, even days. It needs more than ibuprofen and a nap.
In the United States, migraine headaches affect more than 39 million people, from children to adults. In addition, about 144 million around the world experience them.
There is no cure for migraines, but some treatments are effective at holding them in check, including medication. One type of treatment that has become more prominent in recent years is chiropractic adjustments. Migraine symptoms may affect the neck and spine, so they fall into the chiropractors’ area of expertise.
What is a Migraine Headache?
The long-lasting pain from migraine headaches can be severe. It may come with a throbbing sensation, an upset stomach, and oversensitivity to sound and light. Symptoms such as mood changes, neck stiffness, or fluid retention can appear days before the migraine attack. The attack itself may last for 4 to 72 hours. Patients may experience an aura—visual illusions, pins and needles, or difficulty speaking. Fatigue generally follows the attack.
What are the Main Causes of Migraine Headaches?
The medical world is uncertain of the exact cause of migraine headaches. However, the problem may originate from an overactive nervous system sending signals that cause swelling in the blood vessels lining the brain, leading to inflammation and pain.
This inherited neurological disorder can be activated by a number of triggers, such as changes in hormones, bright lights, certain foods or smells, the weather, or stress. It’s different for everyone.
Other triggers include caffeine, tobacco, loud noises, certain medications, physical activity, and changes in sleep patterns. Women have migraines three times as often as men, and most of the people affected by migraine headaches are between 10 and 40 years of age.
What is the Traditional Treatment for Migraine Headaches?
Treatment focuses on the migraine attack itself and works to prevent headaches in the future. It usually consists of pain relievers and other prescription medication or devices designed to stop the pain. Preventative measures may involve medication, medical procedures, devices, changes in lifestyle, and avoidance of known triggers.
Recent technology has produced several devices that help ease migraine pain and other symptoms without medication. For example, one device is applied to the forehead and electrically stimulates a nerve that causes migraines. A second device, controlled by a smartphone app, sends electrical pulses to the arm. However, these devices can be expensive, and not all are covered by insurance.
There are medications available to treat migraines in progress, help prevent them, and prevent any symptom from worsening. Oftentimes, doctors prescribe muscle relaxants, nonsteroidal anti-inflammatory drugs, and other medications to keep any migraine symptom in check. Unfortunately, they often pose the risk of significant adverse effects, such as drowsiness or rebound headaches, and don’t address the problem in its entirety.
Since no one wants to deal with the adverse effects of migraine medication, many turn to chiropractic care for drug-free help.
Can a Chiropractor Treat Migraine Headaches?
Approximately 75% of people with migraine headaches complain about neck pain and stiffness, muscle tension, and jaw issues. This falls squarely into the realm of the chiropractor. Not only does the chiropractor treat the symptoms, but they also address the underlying issues causing the pain.
One recent study suggested that as many as 53% of chiropractors were treating migraine headache patients.
While there is not yet much research into the effectiveness of chiropractic care for migraine headaches, early results show that it may be as effective as preventative medication. Other patients with chiropractic treatment reported more days without pain, decreased medication intake, and less anxiety.
Thus far, studies suggest that chiropractic care may help reduce the frequency, strength, and duration of migraine headaches,
Collaboration between Medical Doctors and Chiropractors
With research beginning to show the efficacy of chiropractic care, more medical practitioners are interacting with chiropractic experts and integrating their services for enhanced overall patient care. It also helps that patients often ask for chiropractic care to avoid the adverse effects of medication.
Spinal Manipulation Therapy for Migraine Headaches
Chiropractors treat migraine headaches with spinal manipulation and adjustments to relieve headache pain and reduce stress. Soft tissue therapy includes massaging the muscles and joints and myofascial release massage, which targets muscle-supporting membranes. Chiropractors may also advise patients on posture and lifestyle and dietary changes.
Trigger Point Therapy for Headache Pain
Some patients find relief in the stimulation of pressure points. Applying pressure to specific areas of the body can help reduce the many symptoms associated with migraine headaches. More research is needed to support effectiveness, but practical application is pointing in that direction.
Types of Headaches Treatable with Chiropractic Treatment
Chiropractic treatment affects other types of headaches as well. Here are two examples.
Almost everyone experiences tension headaches from time to time. They may come from daily stress, repetitive actions, or poor posture. The headache pain travels from your neck to the base of your skull to your head.
Chiropractic treatment, such as spinal manipulation, can strengthen the muscles and relieve the pain resulting from tension headaches.
A cervicogenic headache originates in the neck. It can be caused by a sudden neck movement or by the neck remaining in one position for too long. Symptoms include pain on one side, pain when you cough or sneeze, and a stiff neck. Chiropractic treatment for cervicogenic headaches involves spinal manipulation, massage, and physical therapy.
Our goal is to reduce the severity and frequency of migraine headaches. We invite you to contact us for an appointment today to create an effective treatment plan for you. We will work with your physician to develop the best solution for your specific condition. Also, we invite you to visit our blog page for more information on chiropractic treatments.
You do not need to live with frequent migraine headaches. We are here to help!
Contrary to popular belief, a healthy spine is not perfectly straight. Instead, it is designed to have three small curves. Two of these curves are in the neck and lower back, a region known as normal lordosis, while the other curve in the upper back bows slightly outward, a region known as normal kyphosis. These curves help the spine absorb shock, support the head, and keep the body stable.
But sometimes, the natural kyphosis and lordosis regions can become extreme, creating excessive spinal curves and hampering the spine’s ability to function properly. The three main spinal curvatures are scoliosis, kyphosis, and lordosis. When the spine bends due to poor posture, injury, or birth deformities, it can cause pain, a swayback appearance, and additional health issues. If symptoms of kyphosis, lordosis, and scoliosis get increasingly more pronounced or painful, it may be time to seek medical attention and formulate a treatment plan. Here are some ways to recognize the symptoms of kyphosis and lordosis.
What is Kyphosis?
While scoliosis is a sideways curve of the spine, kyphosis refers to the spinal deformity that occurs when the backbones of the upper back round forward. A normal spine should appear straight from behind, but a spine under the effect of kyphosis will curve forward. This gives the appearance of a “humpback” or rounded hump near the base of the neck.
According to Johns Hopkins Medicine, kyphosis is determined via x-ray by measuring the curvature of the spine. A healthy spine should bend from 20 to 45 degrees, while anything with a curvature of 50 degrees or more is diagnosed as kyphosis and recommended for medical treatment.
Found most often in females, kyphosis can vary from barely noticeable to severe. Patients suffering from extreme kyphosis curvature experience back pain or stiffness and a rounded spine. However, patients often suffer from mild forms of kyphosis that are only noticeably visible as a small hump or rounded upper back. Other symptoms include a forward-positioned head, rounded shoulders, fatigue, breathing difficulties, and muscle spasms.
There are three primary kyphosis types:
Kyphosis can be age-related due to weakened spinal bones that may compress or crack. Compression fractures caused by broken vertebrae, osteoporosis, or specific cancer treatments also weaken the spine resulting in excessive curvature. In addition, a kyphotic curve can be diagnosed in infants and teenagers due to birth malformations or the wedging of the spinal bones over time through poor posture.
While postural kyphosis treatment includes posture improvement exercises, those with Scheuermann’s kyphosis are often treated with back bracing, physical therapy, and pain medications. Physical therapy can help strengthen the back and abdominal muscles to better support the spine.
Congenital kyphosis occurs when a child is born with a deformed, outward spinal curve. There must be an abnormal shape of one or more vertebrae to diagnose congenital kyphosis. Similar to scoliosis, the curvature may become more apparent as a child grows. Treatment may require surgery to keep the curve from worsening.
Postural kyphosis, also known as postural roundback, refers to a spine kyphosis of over 50 degrees with normal-shaped vertebrae in the thoracic region. This is the most common type of kyphosis, especially among teenagers. When you slouch or have poor posture, it stretches the ligaments and muscles which hold the vertebrae out of their natural position, resulting in a rounded spine.
Scheuermann’s kyphosis, named after the Danish radiologist who first identified it, occurs when the vertebrae have a different shape. Rather than a rectangular shape, the vertebrae take on a wedge shape that curves the bones forward. This type of kyphosis occurs most often in male teens. It can be painful and hinder the body’s flexibility.
What is Lordosis?
Lordosis refers to the abnormal inward curvature of the spine, generally affecting the lumbar spine or lower back. Typically, a healthy spine curves a little at the cerebral, thoracic, and lumbar regions. A person suffering from lumbar lordosis may appear to sway back with an exaggerated posture and stuck out buttocks due to an excessive curvature of the lumbar region. Lordosis can also occur in the neck, resulting in a “swayback” neck.
Both lordosis and kyphosis disrupt the structure and alignment of the spine and force the muscles and tendons to overwork in order to provide the necessary support. Lumbar lordosis and other spinal curvatures such as scoliosis can be painful, sometimes affecting ease of movement. While extreme lordosis can cause severe pain in the lower back, its initial symptoms are trunk weakness, short hamstrings, or weak thighs. Lordosis in the neck can be accompanied by symptoms such as neck pain, spasms, and limited mobility. Other lordosis symptoms include numbness, tingling, weakness, or bladder incontinence.
There are five lordosis types:
Post-surgical laminectomy hyperlordosis;
Lordosis secondary to hip flexion contracture.
Lordotic curve treatment is determined by the cause and severity of the patient’s condition. Some treatment options may include pain medications, physical therapy, weight loss, bracing, or surgery. Physical therapy helps build muscle strength, improves flexibility, and increases the range of motion in the spine and lower back.
Traumatic lordosis results from injuries that cause the connecting parts of the spine to break or fracture. Over long periods, the injury may slide the vertebrae forward, pinching the spinal nerves and causing pain, numbness, or weakness.
Excessive weight or weak back and abdominal muscles can cause this type of lordosis. The lumbar spine is dependent on these muscles for support. Thus, patients with weak muscles are more prone to developing postural lordosis.
Post-surgical Laminectomy Hyperlordosis
While post-surgical laminectomy hyperlordosis occurs in both adults and children, it is more common in children. A laminectomy, or removal of part of the vertebrae to reduce spinal cord or nerve root compression in the spine, makes the spine unstable or curved. Surgery to remove spinal cord tumors in children commonly results in lordosis.
Similar to some types of scoliosis, neuromuscular lordosis is due to conditions such as muscular dystrophy or cerebral palsy. For example, some patients with cerebral palsy undergo a minimally invasive surgery called selective dorsal rhizotomy. This surgery reduces leg spasticity but may also lead to lordosis.
Lordosis Secondary to Hip Flexion Contracture
As the hips are integral to the proper function of the spine, a weakening or contracting of the hip muscles, tendons, or ligaments rotates the pelvis forward and displaces the spine. In response to the rotation, the patient will lean forward or form a hyperlordotic spine, which can result in lordosis secondary to hip flexion contracture.
Kyphosis and Lordosis: What are the Differences between the Two?
Kyphosis and lordosis are two different types of spinal curvatures. Severe kyphosis forces the spine to curve forward, rounding the upper back. On the other hand, excessive lordosis results in an abnormal inward curvature of the spine or a swayback.
Both kyphosis and lordosis can be painful and may need medical treatment. These abnormal curvatures cause discomfort and can lead to increased health problems. Yet, they all affect the spine differently by curving it in different directions. In addition, they have different causes ranging from sports injuries to congenital disabilities. Physical therapy, posture correction, and bracing are some of the available treatment options for these varying spinal conditions.
Can You Have Both Kyphosis and Lordosis?
To get diagnosed and treated for either a kyphotic or lordotic curve, you should explore a physical exam or imaging options. The type of treatment used for kyphosis and lordosis symptoms is dependent on the cause and severity of the spinal curve. In severe cases, an individual can suffer from both kyphosis and lordosis. For example, those with scoliosis, a sideways curvature of the spine that begins before puberty, often have both kyphosis and lordosis. Suffering from all three types of spinal deformities can severely impact spinal functions and complicate treatment options.
We’re Looking Forward to Helping You at Our Chiropractic Offices in NJ!