1. Spine, Shoulder and Knee Pain?
WAYNE GARD
CHIROPRACTOR ♦ ACUPUNCTURIST ♦ NATUROPATH
1 Secant St Liverpool (Near Westfields)

2. Who Am I and Why Should You Listen To Me?
Wayne Gard is a qualified Chiropractor, Naturopath, and Acupuncturist
He has been serving Liverpool residents for 23 years.
Served as a Sports Chiropractor at the 2009 World Masters Games.
Examiner and Tutor at Macquarie University
He is a keen amateur athlete, enjoys swimming, running and bike riding.

3. This seminar is a brief look at Natural Treatments for Pain Relief.
For those who want more detail a full copy of this presentation is available on my website.
This website also contains an offer to a great book called ‘The 7 Things Your Doctor Forgot To Tell You’

4. Spine,Knee,Shoulder Pain – The Real Causes?
            

5. What is Pain?
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
Pain motivates us to withdraw from potentially damaging situations, protect a damaged body part while it heals, and avoid those situations in the future.It is initiated by stimulation of nociceptors in the peripheral nervous system, or by damage to or malfunction of the peripheral or central nervous systems.
Most pain resolves promptly once the painful stimulus is removed and the body has healed, but sometimes pain persists despite removal of the stimulus and apparent healing of the body; and sometimes pain arises in the absence of any detectable stimulus, damage or pathology.
Pain is the most common reason for medical consultation in Australia

6. The Pain Game Chiropractors Naturopaths Acupuncturists
General Practitioners
Orthopaedic Surgeons
Neurosurgeons
Neurologists
Rheumatologists
Pain Physicians
Physiotherapists
Massage Therapists
Psychologists
Psychiatrists
Rehabilitation Physicians
Dentists
Etc etc Who do you see???
It can be VERY DIFFICULT to find someone to help you.
Most people go to their GP – however many GPs have a poor knowledge of anything except drugs and surgery!

7. Two Types of Tissues In Your Body 1
Two Types of Tissues In Your Body 1.The Neuromusculoskeletal System NMS = Nerves, Muscles, and Bones = The largest part of your body = 80% of your body 2.Organ Systems – circulation, digestive, hormonal etc = 20% of your body
Two Types of Pain
1. Nerve Pain – This is where the nerves of your body are pinched, pressured, or irritated
Two Types of Nerves - Motor and Sensory
Motor nerves control muscle movement – when irritated we get muscle imbalances – too tight = spasm, too loose = weakness
Sensory – controls sensation – tingling, numbness, burning
2. Tissue Pain – this is where these tissues become injured or wear out.
Two types of tissues - Soft and Hard Tissues
Soft tissues – muscles, ligaments, tendons, discs
Hard tissues – bones, joints, cartilages

8. Descriptions of Pain

9. Making a Diagnosis – Source and Cause?
Source of pain = what tissue is the pain located in?
Cause of pain = why is that tissue in pain?
No matter which health care practitioner you consult, and accurate Diagnosis of the Source and Cause of your pain is required.
Problem Is – you can’t measure pain – remember it is an ‘unpleasant sensory and emotional experience’
There is No Blood Test or X-ray that measures pain!
SO the fundamentals of a Diagnosis are:
- 1. Patient History – listening to when, where, why the pain began
- 2. Examination – physically examining the patient in order to locate the source of the pain
- 3. Imaging and Blood tests – these are most valuable only to VERIFY the Examination.
ALL 3 steps need to be used to arrive at a diagnosis.
It is a very common mistake to assume that a positive test is the source of the pain?
And of course it doesn’t explain the cause of the pain!
PROBLEM – Most GP’s are not well trained in Diagnosing Pain in the NMS system
they are much better at Organ Pain
-Most Specialists are only useful when there is major Tissue Breakdown = less than 5% of patients!!!
SO most of the time you need to look outside of the normal medical advise
This can be very challenging to some people who rely heavily on their GP for ALL their health care needs!

10. Back and Neck Pain

11. There are only 2 types of people – those who have back pain and those who are going to get back pain 
The spine is the most complex structure in your body!
Many brilliant people are researching the spine – but it still remains a mystery!
Over 90% of people will get spinal pain in their lives
Why???
There are many thoughts on this:
Genetics – about 60 to 80 % or spinal problems are passed down thru your genes
Posture – we live a very sedentary (non-moving) lifestyle. This places great strain on our body alignment. Your body likes to move!!!
We use our spine in EVERY activity that we do – it never rests – even when you are sleeping your Spine is active! It needs to monitor the ONLY constant FORCE in our bodies = GRAVITY!!!
The spine is connected to your organs and brain – SO any organ or brain problem causes spinal problems!
Evolution – many people believe that as we evolved from caveman into a more upright posture, that our spines have not yet evolved to cope with the physical demands?
Not getting your alignment checked throughout your life – imagine never brushing your teeth or going to the dentist – what shape would your teeth be in?
Stress – is a pro-inflammatory….
Poor diet – is pro-inflammatory

12. Types of Spinal Pain
Facet Joints
Discs
Nerves
Muscles
Ligaments and tendons
Arthritis

13. Prevention of Spinal Pain
The best Treatment of ALL Neuromusculoskeletal problems is Prevention – waiting for pain is waiting too long!
When should you start? First Injury for most of us = Birth
However for most of us this doesn’t happen. Largely because we haven’t been educated to have spinal checkups from birth, for example like dental checkups

15. What else can you do?
Proper Posture – especially when sitting for long periods – at a desk, driving
Good workplace ergonomics
Good back support when driving – rolled towel lumbar support, head rest at correct height and lean – very important in case of whiplash!
Take regular breaks from poor posture – 5 minutes every hour
Don’t smoke – increase disc degeneration 40%
Reduce stomach obesity – places strain on spine
If you have a car accident – even at low speeds – get a chiropractic checkup
Do some regular spinal exercises
Check for stress posture – at set of lights when driving – deliberately lower shoulders, unclench jaw, slide butt back in seat, move spine a little, stretch neck muscles
Stop if it hurts!

18. Knee Pain

19. Knee Pain is the most common source of pain outside of the spine.
Affects 5% or people – children and adults, rising to 25% in people over 50yoa
Knee surgery –arthroscopy and replacement - is the most common joint procedure performed. However 40% of people still have pain AFTER their knee surgery!
The knee is very easily injured due to:
the long levers of the legs transfer greater strain to the knees
The knees are commonly misaligned via their connection to the pelvis
Sedentary lifestyle – too much sitting!
Lack of exercise – runners knee is a fallacy!
Two types of knee injury – Trauma and Overuse
Trauma – from sport, slips and falls
Note – trauma also causes misalignment – which often remains after the painful tissue heals! Therefore creating future problems eg OA
Overuse – from poor alignment = Genetic Cause!
The most Common Overuse Injury = Unbalanced Weight Bearing = different weight carried on each leg!
Unfortunately most people don’t even know they have Unbalanced Weight Bearing – until they get pain! Need to get checked earlier – ideally from First Steps – 2 yoa, but definitely by 20yoa!

20. Types of Knee Pain
Cartilage
Ligament – ACL and MCL 80%
Muscles
Tendons
Arthritis

21. Preventing Knee Pain
Exercise regularly – especially bike riding
Posture - Don’t sit cross legged!
Stretch your hips and knees daily
Take 1500mg Glucosamine and 1200mg Chondroitin Daily
Get into Fish Oil Supplements – They have an anti inflammatory effect on joints, not to mention all the other wonderful benefits.
Maintain a healthy weight – for every 1kg of weight it places extra 4kg of strain on knees
Stop if it hurts!

23. Shoulder Pain

24. Shoulder pain is the next most common painful joint after the spine and knee
The shoulder is different to the knee in that it is a highly flexible joint. In fact is is only held together by the Soft Tissues – therefore it is very vulnerable to being injured.
It is also an area where surgery is best avoided, as the results are often poor!
A common current treatment is cortisone injection – however recent research has suggested that this may lead to weakening of the shoulder long term and therefore more problems.
What is the most common cause of shoulder pain?
Poor Shoulder Rhythm is a “sticking” of the shoulder blade to the rib cage beneath. This can be caused by many everyday activities. These activities include traumatic events (e.g. fall on an outstretched arm, “yanking” of the arm), repetitive motions (e.g. throwing a ball, weightlifting, swimming) and chronic, improper postures (e.g. operating a computer, driving).
When the shoulder blade is no longer participating in the team effort to move the arm, increased strain is placed on the other joints and muscles forcing them to become overworked, inflamed and painful
Restoring the shoulder rhythm requires a combined approach that addresses both the joint mechanics AND the muscles that support joint function. This includes the spine – especially the neck.

25. Preventing Shoulder Pain
Strengthen your shoulders – pushups, pressups, pressdowns
Maintain muscle bulk in upper body – especially women – due to weight of breasts, and reluctance to do shoulder exercise for fear of getting ‘too muscular’
Stretch shoulders – 3 movements
Avoid Stress Posture
Don’t forget to stretch your neck and upper back

28. What About Pain Killing Medication?

30. Many people use drugs for pain relief – both over the counter and prescription
74% of the population report having pain on a regular basis
52% of people use pain medications
SO it is HUGE BUSINESS for the pharmaceutical companies
PROBLEM IS? Drugs are only treating the Symptoms, not the Cause
ALSO – growing evidence that whilst the symptom is being treated that the underlying problem is getting worse!
ANSWER – use both the drug for short term relief and Natural Therapies (chiropractic, nutritional and herbal remedies, and exercise) to treat the cause.

31. Pain medications side effects account for a large number of people being admitted to hospital
Common side effects and adverse reactions:
nausea
vomiting
drowsiness
dry mouth
miosis (contraction of the pupil)
orthostatic hypotension (blood pressure lowers upon sudden standing)
urinary retention
constipation and/or faecal impaction
Less common side effects and adverse reactions:
confusion
hallucinations
delirium
hives
itch
hypothermia
bradycardia (slow heart rate)
tachycardia (rapid heart rate)
raised intracranial pressure-brain swelling
ureteric (kidney) or biliary (liver) spasm
muscle rigidity
flushing
Most severe side effects and adverse reactions:
respiratory depression
fatal overdose
Stroke
Heart attack
PANADOL is the leading cause of children poisoning in Australia

32. What are the Main Medications Used
Analgesics – Pain killers
Narcotic – morphine, codeine
- are addictive, cause constipation
Non-narcotic – paracetamol
cause liver and kidney disease
Panadol one of the leading causes of child poisoning and death
Anti-inflammatories – Nurofen, Voltaren, Mobic, Celebrex
short term – few days ok
Longer – are Killers – cause stomach ulcers, gastric bleeding, strokes, heart attacks
Muscle relaxants – Valium
- are addictive
Anti-depressants
reduce pain response, dull the brain
Are addictive
Anti-Convulsants
Epilim – used for epilepsy
Nerve sedatives
- Neurontin, Lyrica

33. Nutrtional and Herbal Pain Medications
Glucosamine
Fish Oil
Magnesium
Iron
Green Lipped Mussels
Turmeric
Devils Claw
Licorice
St Johns Wort
Withania
Plus Others……………….

34. The Solution?

35. Your Spine Controls Your Body

36. Did you know that your Brain and Spine control every other part of the body?
Nerve signals – Brain > Spine > Organs > Spine > Brain.
It’s a never ending, constant process
SO if your spine is misaligned then your body can’t work properly!
This includes controlling your Pain levels
Your Spine is easily misaligned from birth trauma, falls, injuries, bumps, poor posture, incorrect sporting technique, car accidents etc.
60% of spinal disorders are genetic – inherited from your family!
Most spinal problems do not cause pain - waiting for pain is waiting too long!!!
We only feel 10% of our misalignments.

37. It is a great idea to have your spine checked by a chiropractor.
Chiropractors use X-rays, computer scanning, and physical examination to find nerve pressure
Modern Chiropractic Care is safe, gentle and effective
Chiropractic is suitable for all ages, from babies to elderly, including pregnant women
The bad old days of chiropractic involved twisting and cracking the spine into alignment.
However modern chiropractic is gentle and pain free.

38. Posture Check

39. Computer Spinal Scan

40. Spinal X-Ray Analysis

41. 1. Health is a Sliding Scale
Optimal Health
Declining Health
Disease
Strength
Flexibility
Fitness
Positive Mental Attitude
Posture
Immunity
Digestion
Sleep
Pain Free
Good Skin and Hair
Fertility
Energetic
Ease of breathing
NORMAL METABOLISM
All tests normal
Loss of Strength
Loss of Flexibility
Loss of Fitness
Negative Mental Attitude
Poor Posture
Lowered Immunity
Decreased Digestion
Sleep Problems
Frequent pain
Skin & hair problems
Fertility problems
Fatigue
Poor breathing
SLOWING METABOLISM
Chiropractic/Naturopathic tests positive.
Medical tests normal
Arthritis
Bulging Spinal Discs
Pinched Nerves
Depression & Anxiety
Cancer, Colds & Flu’s
Reflux. Ulcers, constipation
Insomnia
Pain
Heart Disease
Eczema, Psoriasis
Infertility
Asthma
SLOW METABOLISM
Chiropractic/Naturopathic/ Medical tests all positive

42. So What Do I Do Next?
Understand that Pain is the end result of a process that has taken time…
Decide to get it Fixed
Decide to put in the Time/Effort/Money to get it fixed
Understand that Healing takes time – it is realistic for tissues to take 6-12 months to heal

43. To make it easy for you I am offering a Free Initial Consultation and Assessment.
Simply fill in the handout and we will contact you for an appointment time.
If you wish to speak with me about a specific health concern or your suitability for treatment, please visit my website or phone me on