The first question or concern about chiropractic for some people can be about the “cracking” or “popping” noise generated by a chiropractic adjustment. This feature seems to scare some people away from chiropractic care. We understand that some people are concerned about the safety of chiropractic adjustment and worry about what this noise is. Researchers have explained how this sound is produced.
Cavitation, or the audible “cracking” sound followed by a high-velocity, low-amplitude (HVLA) spinal manipulative therapy (SMT), is the result of forces acting on the joint, which increases the joint volume and decrease joint fluid partial pressure, creating a gas bubble as intra-articular gases are drawn out of solution.(1) A similar process that we might all have experience is when we pull a suction cup off the wall and it creates a “popping” sound. It is believed that SMT producing cavitation can relieve pain, relax hypertonic muscles, restore and increase segmental range of motion, and re-establish normal spinal function.(1)
Some underlying pathologies can contraindicate a HVLA manipulation. For example, osteoporosis is a disease that reduce bone density and it is a bone weakening condition.(2) In such cases, we modify our techniques to minimise the risk of potential complications.
At Little Sprouts Chiropractic, all of our chiropractors will take a full medical history and perform a thorough physical examination on your initial visit, therefore we have a better idea of your overall health to tailor a care plan for each individual to maximize your safety and results.
If you, or any of your friends have stepped back from chiropractic care because of the sound of cavitation please share this blog.
1. Conway P, Herzog W, Zhang Y, Hasler E, Ladly K. Forces required to cause cavitation during spinal manipulation of the thoracic spine. Clinical Biomechanics. 1993;8(4):210-4.
2. Rachner TD, Khosla S, Hofbauer LC. Osteoporosis: now and the future. The Lancet. 2011;377(9773):1276-87.
Click here to Neck pain is a leading cause of disability in adults, and in adults it is reported in up to as high as 20%. (1,2,3). Most cases of acute neck pain, will resolve within 3 months, although a substantial proportion of people will continue to experience low grade symptoms or frequent recurrences. (4) Do you or a loved one experience neck pain? This is an important article that could make the world of difference to you.
“A review in 2016 estimated that the annual cost of low back and neck pain was $87.6 billion in the US, ranking third behind diabetes and heart disease” (5)
There are several risk factors that predispose us to the development of neck pain, which include mental/emotional stress, sleep problems, sedentary lifestyle, history of neck pain, trauma, back pain, and poor general health. (6) Sports and work injuries have also been associated with neck pain. It has been found that office and computer workers, manual labourers, healthcare workers and occupational drivers are more likely than others to experience neck pain. (7,8) With acute neck pain, about half don’t resolve and patients continue to have low grade symptoms or recurrences, which means that it then becomes a chronic issue. (4) So it’s important to get on top of it and work out the cause.
In a recent research study they were looking at female veterans with neck pain who had chiropractic care. It was observed that female veterans with neck pain experienced a statistically and clinically significant improvement on their assessment scores over a short course of chiropractic management (9). So chiropractic may be a viable option for neck pain management.
If you want to find out if chiropractic may help manage neck pain for you or your loved ones, have a chat with one of our chiropractors to see how they can assist.
“With so many of our modern activities putting stress upon the neck, it is important to make sure that your neck is functioning well”
1.Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc 2015;90(2):284–99. doi: 10.1016/j.mayocp.2014.09.008.
2.Moradi-Lakeh M, Forouzanfar MH, Vollset SE, et al. Burden of musculoskeletal disorders in the Eastern Mediterranean Region, 1990–2013: Findings from the Global Burden of Disease Study 2013. Ann Rheum Dis 2017;76(8):1365–73. doi: 10.1136/annrheumdis-2016-210146.
3.Woodhouse A, Pape K, Romundstad PR, Vasseljen O. Health care contact following a new incident neck or low back pain episode in the general population; the HUNT study. BMC Health Serv Res 2016;16:81. doi: 10.1186/s12913-016-1326-5.
4.Cohen, S.P. and Hooten, W.M., 2017. Advances in the diagnosis and management of neck pain. Bmj, 358, p.j3221.
5.Dieleman JL, Baral R, Birger M, et al. US spending on personal health care and public health, 1996-2013. JAMA 2016;316:2627-46doi:10.1001/ jama.2016.16885.
6.Croft PR, Lewis M, Papageorgiou AC, et al. Risk factors for neck pain: a longitudinal study in the general population. Pain 2001;93:317- 25doi:10.1016/S0304-3959(01)00334-7.
7. Hogg-Johnson S, van der Velde G, Carroll LJ, et al. Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The burden and determinants of neck pain in the general population: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. Spine 2008;33(suppl):S39-51doi:10.1097/ BRS.0b013e31816454c8.
8. Côté P, van der Velde G, Cassidy JD, et al. The burden and determinants of neck pain in workers: results of the bone and joint decade 2000-2010 task force on neck pain and its associated disorders. J Manipulative Physiol Ther 2009;32(Suppl):S70-86doi:10.1016/j.jmpt.2008.11.012.
9. Corcoran, K.L., Dunn, A.S., Green, B.N., Formolo, L.R. and Beehler, G.P., 2018. Changes in female veterans' neck pain following chiropractic care at a hospital for veterans. Complementary Therapies in Clinical Practice, 30, pp.91-95.
When people think of chiropractors, they tend to think about our work on the spine. But did you know that we work on ALL the joints of the body? Yep, that’s right, from your head all the way down to your toes.
We find that this whole-body approach is extremely important in helping you reach your full potential. And this is even more important with our little sprouts. Our clinical examination of children includes checking for dysfunctional movements of their arms and legs as well as their spine.
A recent study done in Melbourne on 202 cases of neonates and infants under the age of 12 months found 153 cases had extremity dysfunction, with 177 instances present (1). Over 70% of these were the shoulder, followed by the wrist (5%), knee (5%), and elbow (2.5%).
The majority of shoulder dysfunction was found on the right side. This has been suggested to be caused when the shoulder girdle (being the widest part) is passing through the pelvic outlet during the birthing process (2). Other causes have been listed as, in utero positioning of the baby, and post-natal.
So, what is the big deal then? Well, the problem comes down to something we have talked to you all recently about, proprioception; how well can the brain see/feel what your body is doing. A recent study has shown that peripheral joint dysfunction will alter the proprioceptive feed back to the brain in as little as 10 hours (3). This was reversed by correcting the joint dysfunction. This tells us that if we find joints in our arms or legs that are not moving properly, it can impact on our ability to use them properly. This is important when we think of our little ones when they are learning things that we may take for granted, such as; crawling, walking, or even feeding ourselves.
We often get asked this in our practice and while we tailor our management and treatment specifically to every patient including babies, toddlers, children, adolescents, adults, the elderly and pregnant mums of all gestational ages, studies have confirmed that chiropractic care is safe for both mum and babies during pregnancy,.
Many changes are occurring in pregnant mums as they are growing their baby and can include many physical changes, hormonal changes and emotional stressors. Aside from that, approximately 75% of pregnant mum’s report suffering from back or pelvic pain. One study on 115 pregnant women found that there was a 70% improvement in pain within 1 month of being under chiropractic care.
Chiropractic adjustments also help relax pelvic floor muscle at rest which may also help increase the likelihood of having a natural vaginal delivery. Another study conducted showed that new mums experienced on average a 25% reduction in labour time when under chiropractic care through pregnancy and this rose to 31% reduction in labour time for mothers who were under care and also given birth previously. However, these were small studies and require further investigation.
So if you are pregnant or know somebody who is that is experiencing back or pelvic pain, we would love to see if we can help in managing their pain and help them enjoy the magical experience of their pregnancy and birth.
 Stuber, K. J., Wynd, S., & Weis, C. A. (2012). Adverse events from spinal manipulation in the pregnant and postpartum periods: a critical review of the literature. Chiropractic & manual therapies, 20, 8. https://doi.org/10.1186/2045-709X-20-8
 Borggren C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70–74. https://doi.org/10.1016/j.jcme.2007.04.004
 Malmqvist, S., Kjaermann, I., Andersen, K., Økland, I., Brønnick, K., & Larsen, J. P. (2012). Prevalence of low back and pelvic pain during pregnancy in a Norwegian population. Journal of manipulative and physiological therapeutics, 35(4), 272-278.
 Peterson, C. K., Mühlemann, D., & Humphreys, B. K. (2014). Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropractic & manual therapies, 22(1), 15.
 Borggren, C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70-74.
We get a lot of people visiting our practice due to Neck Pain.
Neck pain is commonly debilitating and often you struggle to do the things you love. Sleeping comfortably, getting out of bed or simply moving around is annoying at best. Neck pain can make you feel cranky and often you will snap at those you love. Correcting your neck pain helps you and often those around you (or at least we are often told).
It is hard to know what to do, there seems to be many options….You deserve to live life uninterrupted, feeling great and thinking clearly!
Neck pain is very common and has many different causes. Direct causes of mechanical neck pain are rarely identifiable. Most neck issues are functional problems as a result of imbalances in neck support structures. Over time this tends to result in degenerative change that then leads to greater problems with the anatomy itself which can be irreversible depending on presentation.
For neck pain, a thorough diagnosis is important to lay the foundation for appropriate treatment and rehabilitation. Neck pain treatment reduces the likelihood of recurrent flare-ups and helps prevent the development of chronic (longer term) issues.
There are lots of reasons why you might have neck pain, there are also many different symptoms with neck pain. Here at Little Sprouts Chiropractic (yes we see big sprouts too), we will help identify why you have the pain, then we will develop a game plan specific to you, to help you manage your recovery. We use natural and gentle means to help manage your recovery. Amongst other tests we look at muscle weakness patterns and dermatome or numbness patterns in the arms and hands to help diagnose the problem (1,2).
One easy test you can do at home to determine if you have early signs of neck trouble (remember get to the cause before it becomes a big issue) is a simple range of motion test. Data from a scientific study suggests that there are early range changes associated with the development of neck pain (3). If you go through the following ranges: flexion, extension, side band and rotation; and there are ranges that hurt or are restricted, it would be worth getting screened.
Another test we use is Spurlings test (4). The Spurling test is a medical maneuver used to assess nerve root pain (also known as radicular pain). WARNING DO NOT do this at home (there are some reasons why you should not do this test - we won’t be discussing here) a trained professional must use this test. The examiner turns the patient's head to the affected side while extending and applying downward pressure to the top of the patient's head. A positive Spurling's sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome (skin supply) on the same side. It is a type of cervical compression test.
Patients with a positive Spurling's sign can present with a variety of symptoms, including pain, numbness and weakness. In addition to the clinical history, the neurological examination may show signs suggesting a cervical radiculopathy. This can indicate a disc issue, other symptoms of this are usually numbness into the hands and pain although you may not be experiencing these issues.
We are passionate about what being well means, and love seeing you and your family reach maximum potential and experiencing all that life can offer. If you have a neck issue of any sort make sure you get in early and get it properly diagnosed and checked out.
We get a lot of people visiting our practice with Shoulder Pain. For many people with shoulder pain it is hard to know what to do, there seems to be many options….
Read on to check out one simple test to see if you have a problem that we may be able to help manage. Recent studies show that management should focus on prevention and early intervention in shoulder complaints (1).
When you have Shoulder pain you feel irritated and frustrated, it is hard to move and pick things up, let alone exercise. It becomes hard to think clearly and to truly enjoy life when your activities are limited.. Yoga, golf, simply picking up a shopping bag or hugging your child becomes difficult!! Recent research has demonstrated the most problematic areas are placing objects on a high shelf, washing one's back and carrying heavy objects (1).
The shoulder is the most flexible joint in your body, and given the number of everyday activities it's involved in—from brushing your hair to reaching up into the cupboard—it's easy to see why shoulder pain is something you'd want to get to the bottom of right away. Without free movement, often you struggle to do the things you love.
Your shoulder joints move every time you move your arms. These bones are held together by muscles, tendons, and ligaments. The shoulder joint has the greatest range of motion of any joint in the body. Because of this mobility, the shoulder is more likely to be injured or cause problems. The acromioclavicular (AC) joint, which lies over the top of the shoulder, is also easily injured.
There are many different types of Shoulder Issues and most are diagnosed by history and presenting factors. There are lots of reasons why you might have shoulder pain, there are also many different symptoms with shoulder pain. Here at Little Sprouts Chiropractic we will help identify why you have the pain, then we will develop a game plan specific to you, to help you manage your recovery. We isolate the major muscles and do very specific strength testing on these muscles to ascertain where the problem is. We also do stability tests and range of motion testing to work out if the shoulder problem is stemming from somewhere else (eg the neck). We then go about balancing the joints that support the shoulder and the shoulder joint itself.
We use natural and gentle means to help manage your recovery.
Here is a simple tests you can do with someone else to see if we might be able to help manage your shoulder.
It is called speeds test. Speeds test is traditionally used to detect an injury to the long head of the biceps (1). We also use a modified form of this test to determine if there is scapular (shoulder blade) instability. Simple stand with your arm outstretched in front of your body with your palm up. Have someone push gently down on the arm just above the wrist. If the arm can hold against the pressure the test is a pass. If the arm cannot hold against resistance (or there is pain) there is a good chance you have either a biceps issue or scapular instability. This can indicate irritation or injury to the suprascapular nerve. A mechanism of suprascapular nerve injury is traction (2), this happens when there is scapular instability. Mechanical stretching of the nerve will weaken certain muscles (we check for these) and this can cause shoulder issues and pain. If this is the case we can help out with you management. There are lots of other causes of issues and we will screen for these.
Motion sickness can happen when you are on a roller coaster ride, on a boat, or sitting in the backseat of a car. Common symptoms can range from mild to serious, and can include dizziness, generally feeling unwell and tired, excessive production of saliva, headache, nausea, vomiting, burping and sweating (1). Most people nerve ask why, but rather take the magic pill.
Motion sickness occurs when there is a mismatch between the three key system within the body. “Balance is comprised of an integration of three main senses: visual senses, inner ear senses and proprioception or information from the joints. In terms of where in the body the proprioceptive system is most important, or where we can have the most influence, the cervical spine and particularly the top two joints in the neck have an exponential amount of leverage. That influences this. Straight away, chiropractors can have a great impact just on that.” said Dr Rinaudo(2).
Dr Carlo Rinaudo’s (PhD candidate on the topic of vestibular rehabilitation) work is focused on balance and dizziness conditions. He said evidence is now showing us that the connection between the vestibular system and the spine is huge(2).
On top of a Chiropractor’s work on the upper cervical spine, feedback from all joints on the body are being sent and processed by your brain. When there is an error in the joint position there is an error in the feedback. We have research showing spinal adjustment have great impact on balance improvement and falls prevention in older population(3).
With limited research we have to date, we cannot claim chiropractic can cure motion sickness. However, chiropractic may help improve your overall body balance.
A quick challenge is to stand on one leg for 10 seconds, like how a flamingo would, with eyes closed. If you are struggling with the challenge, maybe it’s time to have a chat with us and see how we may be able to help.
1. Goverment VS. Motion Sickness 2020 [Available from: https://www.betterhealth.vic.gov.au/health/HealthyLiving/motion-sickness.
2. Foundation ASRF. Motion Sickness: More Than Nausea And Vomiting 2016 [updated 29 March 2016. Available from: https://spinalresearch.com.au/motion-sickness-nausea-vomiting/.
3. Holt KR, Haavik H, Elley CR. The effects of manual therapy on balance and falls: a systematic review. Journal of manipulative and physiological therapeutics. 2012;35(3):227-34.
Opioid use in Australia and internationally has been increasing rapidly over the last 2 decades (1). Risks associated with the use of prescription opioid analgesics are well known. (2). Recent guidelines have recommended non-pharmacological treatment as the first line of approach to treating back pain, with consideration of opioids only as the last treatment option or if other options present substantial risk to the patient (2). Do you or a loved one use any form of opioids? This is an important article that could make the world of difference to you.
“A retrospective claims study of 165,569 adults diagnosed with low back pain found that utilisation of services delivered by DCs was associated with reduced use of opioids” (3)
Drug overdose deaths in 2017 increased by almost 10% compared to 2016, with opioids accounting for almost 48,000 cases (4), Among US adults prescribed opioids, 59% reported having back pain (5). So it is a prevalent issue, and it’s important that we consider non-pharmacological treatments to address spinal pain.
In a recent research article, health insurance claims were analysed, it was found that among patients with spinal pain disorders, for those who received chiropractic care, the risk of filling a prescription for an opioid analgesic over a 6 year period was reduced by half compared to those who didn’t receive chiropractic care (2). It was also found that those who saw a chiropractor within 30 days of being diagnosed with spinal pain, the reduction in risk was much greater compared to those who visited the chiropractor after the acute phase (2). So depending on the cause, chiropractic care should be considered to reduce the risk of requiring an opioid prescription. Though it’s common knowledge, it is better to get to the issue sooner rather than later for better outcomes.
So if you want to find out if chiropractic care may help manage spinal pain for you or your loved ones, have a chat with one of our chiropractors to see how they can assist.
“Health outcomes are more likely to be better when issues are addressed earlier!”
1.Lalic, S., Ilomäki, J., Bell, J.S., Korhonen, M.J. and Gisev, N., 2019. Prevalence and incidence of prescription opioid analgesic use in Australia. British journal of clinical pharmacology, 85(1), pp.202-215.
2. Whedon, J.M., Toler, A.W., Kazal, L.A., Bezdjian, S., Goehl, J.M. and Greenstein, J., 2020. Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain. Pain Medicine.
3. Rhee Y, Taitel MS, Walker DR, Lau DT. Narcotic drug use among patients with lower back pain in employer health plans: A retrospective analysis of risk factors and health care services. Clin Ther 2007;29(Suppl):2603–12.
4. US Department of Health and Human Services. Facing Addiction in America: The Surgeon General’s Spotlight on Opioids. Washington, DC: Office of the Surgeon General, US Department of Health and Human Services; 2018.
5. Hudson TJ, Edlund MJ, Steffick DE, Tripathi SP, Sullivan MD. Epidemiology of regular prescribed opioid use: Results from a national, population-based survey. J Pain Symptom Manage 2008;36(3):280–8.
Over the last couple of months, we have been talking about the impact of Covid-19, the stress, the isolation, etc. Today, I want to talk about the impact of working and studying at home can have. This is mostly driven by where and how we are using our devices. In bed, on the couch, at the kitchen table. We are not using a proper set up with ergonomics in mind!
We have previously talked about how to set up your work station with proper ergonomics, so check out our previous blogs and videos.
What I want to talk about today, is how these poor choices in posture can impact on your wellbeing. For example, it has been said for a long time that a slumped posture is a diagnostic feature of depression. (2) One recent study looked at what happens when we straighten out our posture. They found an increase in arousal, a positive affect and lower levels of anxiety. (2) Another study found that improving our posture has the potential to assist our sleep, pain threshold, and blood pressure! (1)
So, if you have noticed that you are feeling a bit flat, not sleeping as well, and just generally struggling to get through your work, have a look at how you have set up your work space. Make sure that it allows you to have good posture, and make sure that you take regular breaks from sitting and your screens.
With the current pandemic restrictions, everyone is being advised to do their best to slow the spread and self-isolate. But self-isolation can actually carry lot of health risks in itself that you should know about…
Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter of a century (1). Furthermore, loneliness has been associated with changes in the HPA axis and the sympathetic nervous system, promoting a pro-inflammatory response and defensive mechanism with our genes that ultimately increases the risk of chronic illnesses such as cardiovascular, neurodegenerative and neoplastic diseases, while simultaneously undermining resistance to viral infections (1).
Evidence also indicates that loneliness heightens sensitivity to social threats, but it can also impair executive functioning, sleep, and mental and physical well‐being (2). So if you’re noticing changes to any of these systems within your body, you may be really experiencing the heat of cabin fever.
While slowing the spread is so important during the current pandemic, here are some tips to help alleviate the stress of social isolating:
Cacioppo, J. T., Cacioppo, S., Capitanio, J. P., & Cole, S. W. (2015). The neuroendocrinology of social isolation. Annual review of psychology, 66, 733-767.
 Cacioppo, J. T., & Cacioppo, S. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and personality psychology compass, 8(2), 58-72.
The Drs and Staff of Little Sprouts Chiropractic