Piriformis syndrome is a condition where the piriformis muscle (located in the hip) compresses and irritates the sciatic nerve. This results in pain, numbness and general discomfort in the buttocks, lower thighs, legs and lower back (this pain is often referred to as "sciatica"). The sciatic nerve starts in the spine and runs down the back of a person's leg.

The piriformis muscle helps with the lateral rotation of the thigh, and is instrumental for walking since it shifts the body weight to the other side of the foot that is being lifted, thereby keeping a person from falling over.

Causes Of Piriformis Syndrome

Piriformis syndrome can be caused by:

• Inactive gluteal muscles
• Prolonged external rotation of the hip, resulting in the shortening of the piriformis muscle (e.g. when a person sits with their hips flexed for extended periods of time)
• Overuse injury resulting from activities that are performed in the sitting position along with strenuous use of the legs (e.g. rowing, bicycling or sculling)
• Repetitive forward movements that lead to weak hip abductors, tight adductors and a resultant shortening and contraction of the piriformis muscle
• Overpronation of the feet, where a person initially makes contact with the ground on the lateral side of the heel while walking or running

When sciatica occurs and there is no clear spinal reason for the pain then piriformis syndrome is often considered as a possible diagnosis.

Symptoms And Diagnosis Of Piriformis Syndrome

Sciatic pain (sciatica) in the buttocks, thighs and lower legs is the predominant symptom of piriformis syndrome.

Diagnosis is clinical in nature, and relies upon the determined exclusion of other causes of sciatica. Physical examination consists of stretching the piriformis muscle in an attempt to provoke sciatic nerve compression. Types of maneuvers used are the Freiberg, Pace, and FAIR (flexion, adduction, internal rotation) exercises. Conditions that these exercises rule out (as the cause of sciatica) are herniated
nucleus propulsus (HNP), stenosis, facet arthropathy and lumbar muscle strains.

MRI, CT, ultrasound, EMG scans and magnetic resonance neurography (an imaging technique) can also be used to exclude conditions that result in sciatica.

Treatment Of Piriformis Syndrome

Our Richmond Hill Chiropractic, Physiotherapy and Massage Therapy center can help treat piriformis syndrome via:

• Proper stretching exercises and massage therapy that targets the piriformis muscle as well
  as the hamstrings and hip muscles
• Physical therapy, designed to strengthen the core muscles involved (e.g. abdomen, back, etc.)
  thereby reducing strain on the piriformis muscle
• Teaching you how to perform these exercises yourself
• Ice and heat therapy
• Ultrasound therapy
• Gait correction (teaching you proper walking and running techniques)
• Custom orthotics, used for both treatment and prevention

Piriformis syndrome is a debilitating condition that results in pain and discomfort, reducing a person's quality of life by limiting their physical activities.

Fortunately there are things that can be done to treat and prevent this condition.

Chiro-Med Rehab Centre has the necessary knowledge and expertise to start you on the road to recovery today. Try our services: we will have you back on your feet and feeling better, letting you get back to those activities that you love to do!

Metatarsalgia is a condition that affects the ball of your foot causing pain and inflammation. This condition is not considered serious but the pain can sideline an individual from their normal activities. Metatarsalgia is considered a common overuse injury that originates in the metatarsal region of the foot.

Causes Of Metatarsalgia

There are a few known causes of metatarsalgia. This “ball-of-foot” pain is experienced among those who have improper footwear, especially women. This is because women wear shoes that are not designed for comfort; high heels and shoes that narrow in the toe area inhibits a healthy walking process and leads to extreme discomfort in the forefront of the foot.

Also, those who participate in high impact activities without proper footwear and/or orthotics tend to suffer with metatarsalgia. In addition, as we grow older, the natural “padding” in our feet tends to thin out, making us more susceptible to pain in the ball-of-the-foot area.

Any person, regardless of age may experience metatarsalgia if they are physically active and participate in activities that involve running and or jumping.

Symptoms Of Metatarsalgia

Those who have metatarsalgia usually experience a sharp, burning pain on the ball of the foot area (behind the toes). This pain usually worsens when the individual stands, walks or runs and also when the affected foot is flexed. Resting often can sometimes ease the pain. Some people who have metatarsalgia also experience toe numbness. Although these symptoms tend to manifest abruptly, it usually takes weeks for metatarsalgia to develop.

Prevention Of Metatarsalgia

Preventing metatarsalgia is easy so long as you are aware of the causes. Anyone who engages in running, jumping, or aerobic exercises must have proper footwear. Everyday proper footwear is essential in order to keep your feet in good shape. salgia if they are physically active and participate in activities that involve running and or jumping.

Metatarsalgia Treatment

First of all it is important to mention that getting a proper diagnosis is essential in order to treat metatarsalgia effectively. Only once properly diagnosed can a treatment plan be implemented.

Depending on the severity, metatarsalgia treatment can be as simple as applying ice packs to the affected area several times. Rest is another simple but effective way to treat metatarsalgia. Keeping stress off the balls of the feet is important in order to reduce inflammation and pain.

Athletes who need to still keep active are usually advised to temporarily switch to low impact exercises such as swimming. Even if some usual activities are maintained, no treatment will effectively work and the injury will inevitably worsen.

Causes Of Metatarsalgia

There are a few known causes of metatarsalgia. This “ball-of-foot” pain is experienced among those who have improper footwear, especially women. This is because women wear shoes that are not designed for comfort; high heels and shoes that narrow in the toe area inhibits a healthy walking process and leads to extreme discomfort in the forefront of the foot.

Also, those who participate in high impact activities without proper footwear and/or orthotics tend to suffer with metatarsalgia. In addition, as we grow older, the natural “padding” in our feet tends to thin out, making us more susceptible to pain in the ball-of-the-foot area.

Any person, regardless of age may experience metatarsalgia if they are physically active and participate in activities that involve running and or jumping.

Health professionals at Chiro-Med Rehab Centre in Richmond Hill find that many of their patients have a great recovery rate when they are prescribed custom orthotics to minimize pressure. Although there are over-the-counter shock-absorbing insoles, these are designed with a “one size fits all” template. There is no “one-size fits all” when it comes to proper foot support.

Orthotics from Chiro-Med Rehab Centre are medical inserts that comfortably fit into footwear, and are custom designed to support and improve the functioning of feet. Regardless of where you go, work, school, or recreation activities, orthotics should be worn at all times – even at home. Orthotic insoles work like prescription eye-glasses; they can only work when they are being worn. During the first couple of weeks while wearing custom orthotics, there may be a slight discomfort in the arches, feet, and legs. This is normal, and is actually an indication that your custom orthotics are working.

Only in the absolute most severe cases and when all other treatment avenues have been explored is surgery suggested. Surgery involves the realignment of the metatarsal bones.

Chiro-Med Rehab Centre in Richmond Hill has a convenient location and highly qualified health professionals to help you get back activities you once enjoyed – pain free!
Call 905-918-0419 for more information.

A pinched nerve can cause a lot of pain and yet most of us are unaware as to how this starts. Simply stated, a pinched nerve is a medical term for an impaired function of a nerve that is under a lot of pressure. Anyone who has experienced this knows that it can be quite painful and sometimes debilitating.

Pinched nerves develop when one or more nerves become constricted or compressed by muscle, a bone, tendon, or cartilage. How this comes about is often by poor posture, overdoing physical activity, obesity, or if there is a genetic predisposition. This condition happens to nerves that control muscle movements or to nerves that relay sensations to the brain.

What Exactly Are Nerves?

A nerve is a microscopic cell that has bundles of fibres running throughout the body transmitting impulses of sensation to the spinal cord or brain. Some of these are several feet in length. A nerve cell that is in the spinal cord or in the brain is known as a central nerve; and nerves that originate in the spine that extend to the arms or legs are called peripheral nerves. Peripheral nerves are 'packages' of millions of nerve fibres that leave the spinal cord and branch out to their target muscles to help make them move. These nerve fibres also extend to the skin to provide us with the ability to feel.

The Onset of a Pinched Nerve

Symptoms of a pinched nerve may begin with numbness, tingling, burning sensation or shooting pains down the buttocks, legs, or in the neck, shoulders, arms and fingers.

Sometimes the sensations (or pain) you feel are is nowhere near the point of pressure. A pinched nerve in the lower back may originate in the calf. If there is constant pressure then the pain may increase. The person afflicted with this may experience a loss of movement, reflexes, and atrophy in the muscles. Once the pressure is relieved then the pain diminishes.

Many people tend to associate pinched nerves with the neck yet it is most common in the lower area of the back. A trained health professional can follow the pain to determine the origin.

Pinched nerves in the lower back can inhibit a person from participating in sports and even from walking, standing, twisting or lifting something.

If there is a pinched nerve in the neck then the pain will shoot down the arm. Pinched nerves in the neck are generally the result of repeatedly bending the neck but sometimes they can happen due to an impact. When there is a pinched nerve in the neck sometimes the pain can be so horrific that it limits neck motion. Sometimes this is brief and other times it can last quite some time. In severe situations a person can lose their reflex and muscle atrophy sets it.

Some people describe a pinched nerve in the neck as though it is ‘shooting lightning’.

Pinched Nerve Treatments

If you rarely experience a pinched nerve then this is something you need not worry about. However, if this occurs on a somewhat frequent basis then it’s advisable to seek treatment.

There are non-steroidal anti-inflammatory drugs available on the market such as ibuprofen or aspirin but these are designed to mask the pain, not treat the source of the problem.  Some doctors may even say that surgery is required and if this happens to you be sure to get a second and a third opinion. Surgery is not only invasive it involves being right near the spinal cord. Many patients who have taken this route discover that surgery may only relieve pain for a period of time and it re-occurs if the overall structure of the spine is not corrected.

The chiropractic treatment methods do not cover up the pain or the symptoms; it treats damaged areas so that there is complete healing. Often this may include a scan of your spine and central nervous system using the most up-to-date technology available. This helps to target the exact location of the pinched nerve(s). No two individuals are alike so an individualized treatment plan is required in order to receive maximum results.

Often there will be proper chiropractic adjustments required to help relieve the pressure. Since daily activities are sometimes the cause of pinched nerves to begin with the treatment will include ‘the whole picture’. This means putting a plan in place to avoid the activities that cause the problem as well as looking at your diet. Good quality food is the fuel your body needs to help recover and regain good health.

If you have suffered with pinched nerves and want to explore a holistic approach to treatment that works then Chiro-Med Rehab Clinic can help you. Their staff is fully qualified professionals who have the know-how and the experience to help you.

Chiro-Med Rehab Centre has a walk-in clinic conveniently located at 10144 Yonge Street, just north of Major MacKenzie Drive in the heart of Richmond Hill. Call 905-918-0419 for more information or to book a consultation.

Orthotics are shoe inserts that fit inside shoes and other footwear and are designed to support the feet as well as recreational activity such as walking, running, jogging, and much more. Custom orthotics are personalized to fit a specific person, and should always be worn once someone starts using them. They provide constant support to a foot's heel, muscles, arch, tendons and ligaments. Walking can be very enjoyable when the proper support is there.

It is common to experience mild discomfort for the first couple of weeks when starting to wear orthotics. Rest assured that this is normal, and this is caused due to the body readjusting to a new and healthier gait (walking pattern). In fact, mild discomfort is a positive indicator that your orthotics are doing their job!

Who Can Use Custom Orthotics?

Anyone from children to the elderly can wear custom orthotics. The use of orthotics is not age dependent and can benefit people of all ages. Custom orthotics help alleviate foot pain, joint pain, arthritis and various injuries. They are also used in a corrective capacity (orthopedic correction), correcting uneven leg lengths.

Some people worry that custom orthotics may reduce their muscle tone. This is not the case. Custom orthotics will actually help position your foot properly so you will be using the right muscles at the right time. This in turn will help to minimize fatigue and will allow your muscles to be used more efficiently.

How Custom Orthotics Are Made

The first step in making custom orthotics is to analyze a person's gait and feet. A person's gait is analyzed using the Footmax Metascan system. The Footmax System is a cutting-edge patient assessment tool, whereby patient data is recorded and then analyzed by proprietary diagnostic software called Metascan. This diagnostic software then generates a detailed gait report.

Once this is done our professionals analyze the data and determine the type of custom orthotics needed by the patient.

Symptoms And Treatment

Custom orthotics can help out with the following conditions and symptoms:

• Achilles Tendonitis (tendonitis of the Achilles tendon)
• Ankle Pain
• Bunions (often mistaken as enlarged bones around the big toe)
• Fallen Arches
• Flat feet (collapse of a foot's arch)
• Hammer Toes (deformity of a toe's joint, causing it to be bent)
• Headaches
• Hip pain
• Knee pain
• Low Back Pain
• Medial Tibial Stress Syndrome (also known as shin splints)
• Metatarsalgia (a painful foot condition that affects the foot's forefoot region)
• Neck Pain
• Painful Feet
• Pes Cavus (a foot with a high arch, the opposite of "flat foot")
• Plantar Fasciitis (a painful inflammation of the connective tissue on a foot's sole)

Where To Get Custom Orthotics

Custom orthotics that are specifically made to your particular situation are available from Chiro-Med Rehab Centre. Chiro-Med Rehab Centre has the experience and expertise needed to effectively assess and treat conditions that can be alleviated with the use of custom orthotics. Take the first step and call us today to book your appointment for custom orthotics.

Carpal tunnel syndrome refers to compression of the median nerve at the wrist, resulting in weakness, pain and possibly numbness of the hand and wrist. The median nerve controls sensation in the palm of the hand (thumb and fingers, excluding the pinky or little finger).

Treatment of carpal tunnel syndrome (CTS) is very important, since long-term carpal tunnel syndrome can lead to permanent nerve damage, constant numbness and atrophy of muscles related to the carpal tunnel.

Causes Of Carpal Tunnel Syndrome

Often times the specific cause of carpal tunnel syndrome (CTS) is undetermined. However, it is known that CTS is associated with the following:

• An abnormally small carpal tunnel
• Repetitive, work related stress
• A wrist injury that results in swelling (e.g. wrist sprain or fracture)
• An overactive pituitary gland
• Arthritis (rheumatoid)
• Fluid retention during pregnancy
• Menopause
• Cysts/tumors that form in the tunnel

Symptoms Of Carpal Tunnel Syndrome

Symptoms of CTS usually start gradually, and become more severe as the problem worsens.

The following symptoms are listed from initial to later stages:

• Tingling, itching and even a burning sensation in the thumb and fingers
• Numbness in the palm of the hand
• A feeling of tightness or swelling
• Pain in the hand or wrist
• Loss of strength when gripping some object
• Inability to distinguish between cold and hot objects
• As the condition worsens atrophy of the thenar muscles may occur

Please note that it is common for these symptoms to first occur at night only, since many people sleep with their wrists in a flexed position. As the condition progresses some or all of the symptoms will occur throughout the day as well.

Treatment Of Carpal Tunnel Syndrome

There are two types of treatments for CTS: surgical and non-surgical. It is very important to diagnose CTS as early as possible in order to avoid surgical treatment.

Non-surgical treatment consists of:

• Resting and immobilizing the affected hand via splints or braces
• Avoiding activity that stresses the hand and wrist
• Physiotherapy
• Massage therapy
• Non-steroidal, anti-inflammatory drugs to ease pain and swelling
• Injection of corticosteroids into the wrist (can also be taken orally) to relieve pressure on the
  median nerve

Surgery is often recommended if symptoms have been present for 6 months.

There are two types of surgery used to treat carpal tunnel syndrome:

1. Traditional "open release" surgery, which involves an incision in the wrist followed by severing
   of the carpal ligament (this increases the size of the carpal tunnel)
2. Endoscopic surgery, which involves inserting a tiny camera into the wrist/palm and results in a
   faster recovery time, less post-operative discomfort and a smaller degree of scarring.

It is very important to catch carpal tunnel syndrome early on. Unfortunately CTS can be difficult to diagnose, and symptoms can also be caused by things other than carpal tunnel syndrome.

Chiro-Med Rehab Centre located in Richmond Hill has the necessary expertise and knowledge to help you recover from carpal tunnel syndrome. As professionals we can recommend the type of treatment needed and effectively implement that treatment, getting you on the road to recovery as quick as possible!

Glucosamine sulfate and Methyl Sulfonyl Methane (MSM) are perhaps the most widely used natural
supplements when seeking relief from joint pain. Together, these supplements have been extensively studied for almost thirty years and the results indicate that both these supplements offer a natural solution.

What Are Glucosamine Sulfate And Msm?

Glucosamine sulfate is a naturally occurring chemical found in the fluid that is around our joints.
Glucosamine is also found in other places in nature, for example, the glucosamine sulfate that is often put into dietary supplements is often harvested from shellfish. Although this is a natural substance, it can also be made safely in a lab.

MSM is a white powder that is a naturally-occurring nutrient found in many foods such as cabbage,
broccoli and other cruciferous vegetables. During food preparation, we lose most of it because it is
water soluble therefore it evaporates with the steam or gets tossed out with the water. Over processing our food supply has drastically reduced the amount of MSM that we consume. As a dietary supplement, MSM is synthesized.

What Separate Functions Does Glucosamine Sulfate And Msm Perform?

Glucosamine sulfate is commonly used for arthritis and more specifically, osteoarthritis. Over the years, people have tried glucosamine sulfate for a variety of other health ailments such as glaucoma and even for weight loss. Glucosamine sulfate has not been adequately studied for these uses and as of yet, there is no proof that glucosamine sulfate is beneficial for these conditions. Glucosamine also has the potential to rebuild cartilage lost in a joint due to injury or osteoarthritis.

MSM provides sulfur, which is a vital building block of joints, cartilage, skin, hair and nails, and methyl groups, which support the many vital biochemical processes in the body and this includes our energy production.

Glucosamine Sulfate And Msm Benefits

Together, glucosamine sulfate and MSM have been proven to provide relief from painful joints and

connective tissue. These ingredients have synergy so that together, they maintain the structural
integrity of connective tissue and joints while supporting the healing process.

Glucosamine sulfate protects connective tissue and cartilage to optimize joint function while MSM's
powerful therapeutic agent lessens inflammation, reduces muscle spasms, inhibits pain impulses, softens scar tissue and increases blood supply.

The addition of MSM to glucosamine sulfate is a proven and effective combination in supporting joint health as a whole.

Osteoarthritis

Cartilage absorbs impact and allows for smooth, pain-free motion when joint tissues are healthy.
Osteoarthritis has become a common condition where these soft joint tissues become inflamed, harden or they simply wear away – the results are pain and the loss of mobility. This debilitating disease can affect anyone at any time, although it tends to become more common as we age.

Many of the pain killers and anti-inflammatory drugs used to suppress arthritis symptoms can cause serious side effects that many people do not like. Those wishing to reduce or avoid these potentially dangerous drugs are increasingly turning to natural alternatives that are proven to be safe that lessen symptoms as well as promote long-term healing.

Remember, it's important not to self-diagnose. Let the healthcare professionals at Chiro-Med Rehab Centre in Richmond Hill provide you with all the care you need to ensure safe and proper healing.

When used under the guidance of a healthcare professional, glucosamine sulfate and MSM are perhaps the most effective natural supplements available today that provides relief from joint pain.

Studies have proven that regular massages are highly beneficial to our overall health and for treating specific ailments as well. What many people are not aware of is that hot stone massage therapy can be just as beneficial and has a long history of doing so.

Brief History

• Hot stone massage may have originated in India 5,000 years ago from the ancient healing tradition of Ayurveda. Smooth river bed stones were warmed or cooled for use in healing and massage.
• The Japanese used warm stones to help their abdomens improve digestion. This apparently dates back about 4,000 years ago.
• More than 2,000 years ago, ancient Chinese used heated stones to improve the function of internal organs.
• Native Americans used hot stones during rituals and in sweat lodges and many are still using them today.
• For hundreds of years, Hawaiians have used hot stones for massage and healing for many years. Heated lava stones were used on the body to help increase blood circulation.
• Ancient Greek and Roman cultures used many forms of massage for healing and for simple relaxation including hot stones.

What is a Hot Stone Massage?

Placing smooth, warmed up stones in order to achieve results needs to be done by a qualified therapist. Anyone can place hot stones on the body where there may be an ache, but in order to target specific ailments and to properly increase circulation having a trained professional is important.

Massage oils are used in the process in addition to smooth stones. Basalt stones are commonly used as well as various river stones. These stones are safe to use, sterilised and properly heated so that no discomfort will be experienced by the patient. The stones are heated in a sterile heating unit that either provides a temperature reading or has an adjustable thermostat control.  The massage therapist always holds the stones first before touching them to your body, which ensures that the temperature will not be too hot.

Stones are strategically placed at various points on the body and as the warmth penetrates the skin the client will experience a massage and effleurage. Stones are sometimes used to massage and glide over targeted areas to assist with healing.

The therapist might also leave heated stones in specific points along the sides of the spine, in the palms of the hands, on the stomach, or even between toes; this assists in improving the flow of energy throughout the body.  Heat warms and relaxes muscles allowing the therapist to apply deeper pressure, if required. Many people find the warmth of the hot stones to be quite comforting and deeply relaxing.

This form of therapy is often used for the same conditions as a regular massage:

• Anxiety
• Back pain
• Depression
• Insomnia
• Osteoarthritis

Hot Stone Massages Are Not For Everyone

While hot stone massage is generally considered safe when performed by a trained and licensed massage therapist, it's not right for everyone. This is not recommended for those who have had recent surgery, or have certain medical conditions, or have wounded areas (including inflamed areas). Pregnant women and children should avoid hot stone massages as well.

Palliative Care and Hot Stone Massages

According to an article published in the Journal of Oncology, massage therapy is a popular adjunct to cancer palliation. There was a study conducted with favourable results. It was discovered that those in palliative care who received a hot stone massage saw a decrease in some very common symptoms they commonly experience.

Most individuals who were studied reported a decrease in:

• Pain
• Fatigue
• Nausea
• Depression
• Anxiety

However, there was no difference in lack of appetite.

If you feel you need a hot stone massage or are wondering if it is right for you then Chiro-Med can help.

For more information about hot stone massage or how chiropractic and physiotherapy can help you, please give Chiro-Med a call. Established in 2007 by Dr. Behfar Sanjari, Chiro-Med Rehab Centre has been committed to providing quality health care services to the Greater Toronto Area for a decade. We have clinics located in Richmond Hill and Newmarket; call 905-918-0419 or 905-235-2620 for more information.

Link to the study done on palliative care patients:

http://ascopubs.org/doi/abs/10.1200/jco.2015.33.29_suppl.179

You may have specific ailments that you are concerned about, or perhaps you are simply concerned about overall wellness. No matter what your reason for visiting a Richmond Hill chiropractor, acupuncturist or massage therapist, there is a treatment that will leave you feeling relieved and refreshed, and possibly years younger. Part of achieving optimal health involves taking responsibility for your body’s specific needs and taking steps to correct any imbalances that may occur. When stress, injury or overexertion causes pain and illness, why suffer needlessly? You can visit a Richmond Hill professional therapist to relieve your pain and stress as well as help detoxify the body to combat serious illnesses.

A Richmond Hill chiropractor can correct spinal alignment to relieve the back pain that often results from poor posture or repeating the same type of motions over and over again. Many jobs require us to stand, sit or repeat the same actions continuously for eight hours or more. Our bodies are not designed for such abuse and eventually pain will develop. Regular visits to your chiropractor can relieve such pain and can also help for a myriad of other health issues including digestive problems, headaches and neurological disorders.

A Richmond Hill acupuncture specialist can target any area of the body to provide relief from pain and disease. Acupuncture has proven to be effective for weight loss and helping people to quit smoking. It can improve digestive function and brain function, improving moods and helping the body to detoxify itself.

Richmond Hill massage therapy can provide relief from pain and tension in every part of your body. It improves blood circulation and helps to eliminate toxins from the body and will leave you with extra energy and a feeling of well-being. Visit Richmond Hill for natural therapies today!