Tailbone Pain…Ouch! What Treatments are available for Coccydynia?

Tailbone Pain…Ouch!  What Treatments are available for Coccydynia?

Painful Tailbone!  OUCH!  What Treatment Options are Available for Coccydynia?

I have a patient who fell on her buttock while walking down the stairs.   Immediately, she felt a sharp and bruising pain in the buttock.   The next day she went to her family doctor who explained that her tailbone was inflamed – he called this condition coccydynia NOT tax pain (for those that have seen the H&R block commercials).  She asked me what treatment methods would help her coccydynia.  She explained that she wanted to not only decrease pain, but also fix the problem.

Before we discuss treatment options for coccydynia, let us discuss the anatomy/location of the tailbone.

Where is the Tailbone Located Anatomically?

The tailbone is located in the lower buttock.  Follow your spine all the way down and it is the final segment in the vertebral column.  Interestingly, the coccyx is a remnant tail!  The coccyx is usually formed of four rudimentary vertebrae (sometimes five or three).  It articulates above with the sacrum. Here is a picture of the coccyx attached to the sacrum above.

What is Coccydynia?

Coccydynia is associated with pain and tenderness at the tip of the tailbone – between the buttocks. The pain is often worsened by sitting on a hard surface.  Symptoms include:

  • Pain that is worse when sitting
  • Local pain in the tailbone area that is worse when touched or when any pressure is placed on it
  • Pain that is worse when moving from a sitting to standing position
  • Pain that is worse with constipation and feels better after a bowel movement

What causes Coccydynia?

Coccydynia can be caused by various factors.  For instance, coccydynia is often caused by an injury (fall on ice or on a hard surface), but it may occur seemingly spontaneously. Conditions which mimic coccydynia, include sciatica, infection, cysts, and fractured bones.  When the tailbone does break due to trauma such as a fall, it usually protrudes forward towards the front of the body – thus causing much discomfort.

How is Coccydynia Treated?

Patients with coccydynia are advised to use a well-padded  seat when sitting and avoid long periods of sitting.

Furthermore, the following treatment methods can help.  Rest, avoiding re-injury to the affected area, using an anti-inflammation cream and/or pain medications can help to relieve symptoms. Some patients with persistent coccydynia are treated with local cortisone injection. Rarely, when patients have unrelenting pain, a surgical resection of the coccyx can be performed to remove the irritated bony prominence.

Now let’s get back to my patient…

Amazingly, acupuncture helped my patient!  Four treatments of acupuncture and the pain was completely resolved.  The treatments were provided every other day and lasted approximately 30 minutes each.  The acupuncture needles were inserted around the sacrum on both sides.  Electrical stimulation was added to the surrounding area.  Furthermore, ice therapy also helps to reduce pain, swelling and inflammation in the area.  Laser therapy is also a treatment modality in which I have had success with.  Laser therapy has been known to assist in soft tissue healing.

All in all, coccydynia is poorly understand.  It is not too common, however, does occur.  Over the last few years, I have seen about eight to ten patients with this particular condition.  100% of these individuals fell on their buttock and immediately felt the buttock pain.  If you are unsure if you have this condition, make sure you go see your health practitioner.

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

Dr. Luciano Di Loreto, HBSc., DC

Chiropractor in Woodbridge, Ontario

www.fitforlifewellnessclinic.com

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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Mouse Hand and Wrist Pain…Yes, it exists! How to avoid mouse hand and wrist pain…

Mouse Hand and Wrist Pain…Yes, it exists! How to avoid mouse hand and wrist pain…

Okay…so what the heck is mouse hand?  Yes, I know it sounds ridiculous! Mouse Hand. My wife was mentioning that she heard this term ‘mouse hand’ from some colleagues.  These colleagues were complaining that their wrists and hands were hurting from typing reports all weekend.   They said that they had mouse hand. I did some background research on this topic and did not find much written on the slang term “mouse hand” solely.

What is MOUSE HAND in medical terms? 

Well, simply put, mouse hand is a repetitive strain injury to the wrist/hand area.  In the case of mouse hand, the wrist and hand becomes strained/sprained when using a mouse for lengthy periods of time.  They also complained of tightness, stiffness, decreased wrist range of motion as well as swelling at times.  I would imagine that individuals who are constantly using a computer with a mouse (bloggers, computer technicians, web designers, etc.), would experience this type of condition.     It is amazing that as our world changes and as it becomes more technologically advanced (2oth and 21st century changes), new musculoskeletal medical conditions come about.  As our job tasks change, so do our injuries and how these injuries may come about.   For instance, let us talk about the chauffeur fracture.  The name originates from early chauffeurs who sustained these injuries when the car back-fired while the chauffeur was hand-cranking to start the car. The back-fire forced the crank backward into the chauffeur’s palm and produced the characteristic styloid fracture (forearm fracture).  It is also known as a backfire fracture (for the same reason) or a Hutchinson fracture. Today, this fracture occurs, however not due to cranking cars.  Instead, it can occur if someone falls on an outstretched hand. Let us get back to Mouse Hand.

I have found a couple of threads on the topic of mouse hand and noticed that some individuals have found ways to prevent and overcome these symptoms of mouse hand (pain, tightness, decreased range of motion and discomfort in the wrist/hand) by simply switching over to using an IPAD or device that does not require the use of a mouse or constant use of their wrist.  Others mentioned doing hand/wrist exercises or taking frequent breaks during long periods of computer/mouse usage.  These techniques both make a lot of sense to me. Mouse Hand is in medical terms a repetitive strain/sprain injury, overuse syndrome, or carpal dysfunction. What is this, you ask?  Well, our wrists consist of 8 carpal bones.  Sometimes these little 8 bones move out of position slightly, spraining the ligaments that attach one carpal to the other.  If this occurs, this causes pain, stiffness and decreased motion in the wrist – dysfunction.   Many patients present with these symptoms – they may not call it mouse hand but they realize that they have injured their wrist.

What happens to the soft tissues in the forearm?

In order to function properly, muscles (and other tissues of the body) require oxygen, which is carried by blood. When muscles are overused or overworked, which may be the result of over-training or performing repetitive motions, blood supply to muscles is reduced (tight muscles squeeze blood vessels thus decreasing flow). This places the muscle in what is called a hypoxic state. Simply stated, the oxygen supply required by the muscle to function is not being met due to decrease in available blood. This leads to the muscle not having the ability to form energy, remove metabolic wastes, etc. Your body, in an attempt to help itself then begins to replace muscle, a very oxygen-needy tissue, with scar tissue, which does not require oxygen to function. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis/tendonosis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.

I find that patients who present with these wrist symptoms (as long as there is no fracture) do well with wrist adjustments, mobilizations and soft tissue therapy to the forearm and wrist.  What do you mean by adjustments and mobilizations?  An adjustment and mobilization is essentially performed to move the carpals back into place or to get them properly moving again – to eliminate dysfunction.   Soft tissue therapy is great to relieve the tight muscles in the surrounding area.   Furthermore, wrist exercises work well to get those carpal bones moving again.  Squeezing a squishy ball or putting an elastic around your fingers and opening your hand works both the flexors/extensors of the forearm.

I hope you enjoyed this blog today.  Please provide feedback and comments.  Thank you.

 

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

 

Dr. Luciano Di Loreto, HBSc., DC

Chiropractor in Woodbridge, Ontario

www.fitforlifewellnessclinic.com

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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I Am Pregnant With Back Pain: What helps? Try Core Stability Execises!

I Am Pregnant With Back Pain: What helps? Try Core Stability Execises!

Recently, the Ontario Chiropractic Association launched an excellent pamphlet on pregnancy and back pain.  Within this blog, I would like to summarize the information provided and hopefully enlighten those interested on how to assist in alleviating back pain while pregnant.

According to studies, about 90 percent of pregnant women will experienced lower back and/or pelvic pain related to their pregnancy.  This is a huge number!  There are various reasons for this back/pelvic pain.  First off, weight gain during pregnancy places additional stress on the joints in the body and thus causes a cascade of functional changes to muscles and ligaments.  Furthermore, as the baby grows, muscles (such as the abdominal and obliques) become stretched and may not be as efficient in providing stability to the pelvis and spine.  In order to prevent and help reduce this acquired stress on the joints of the lower back and lower limb, it is important for expectant mothers to perform simple core strengthening exercised.  By performing these exercises, expectant mothers will also be reducing the pain experienced in their lower back and pelvis region.  Also, the expectant mother will be much more prepared for the physical tasks (lifting, carrying, pushing, etc.) that will occur once baby is born.  In the next paragraphs, I will discuss the recommended exercises for expectant mothers. Please ensure that before commencing any exercise program, you consult your health practitioner.

1) Abdominal Bracing

This exercise is very helpful.  By performing this exercise daily you will assist in keeping the muscles that hold the lower back (lumbar spine), fit and strong.  Start by laying on your back with your spine in a neutral position (neutral means not arching your back or changing the natural position of your back as it rests on the floor).  Next, concentrate on contracting your abdominal muscles without “sucking in” the muscles.  Tighten your abdominal muscles but DO NOT hollow the abdominal area.  You can perform this a couple of times per day.   Hold the position for 5-10 seconds and repeat 3-5 times for 1-3 sets.  Ultimately, this exercise will help to improve core stability  and protect the spine, thus decreasing painful spells.

2) Pelvic Tilt

This next exercise can be performed in various positions.  You can sit, stand, lay on your back or go on al fours….it is your choice.  Choose a comfortable position for you.  First, bring your pubic bone forward by tucking your buttocks in with a scooping motion.  Hold this for 2-3 seconds.  Rock the pelvis the opposite direction to arch the lower back and direct the buttocks out.  Try to maintain a continuous motion.  Repeat this exercise 3-10 times  for 3 sets.  Rest 30-60 seconds between sets.

3) Arm Extension

For the next exercise, you will be required to kneel down onto your hands and knees.  Keep your spine neutral, similar to exercise number one.  Keep your core contracted (tightened)….don’t forget to breath!  Now, extend one arm out in front as much as you can – point your fingers outwards.  Make your arm parallel to the floor, while keeping your body stable.  Hold for 2-3 seconds.  Return to the starting position and then switch sides.

4) Leg Extension

Remaining on the floor on all fours, extend one leg behind you as much as you can.  Stretch your toes out.  Keep stable!  Hold for 2-3 seconds.  Return to starting position and switch sides.  Repeat this move 3-10 times and work up to 3 sets.  Furthermore, you should rest 30-60 second in between sets.

Maintain Good Posture During Pregnancy!

In order to maintain good posture during pregnancy, try to avoid slouching and rolling your shoulder forward.  Keep your shoulders “down and back” and your chin slightly tucked.

After the Baby Arrives

When carrying your child, hold them upright, close to your chest.  Sit in a chair with back support when feeding your baby and try to avoid leaning forward to reach your child’s mouth.  This avoids straining your back.  Safely lift your child – have your feet shoulder width apart, keeping your back completely straight and bend your knees.  Lift with both arms and your thigh muscles.

These are all excellent tips that expectant mothers should know.  There are excellent resources to explore. Thank you for reading this post.

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

Dr. Luciano Di Loreto, HBSc., DC

Woodbridge Chiropractor

www.fitforlifewellnessclinic.com

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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Part 2 of 2: Is it Carpal Tunnel or Is it Something Else? Median Nerve Entrapment Sites

Part 2 of 2: Is it Carpal Tunnel or Is it Something Else? Median Nerve Entrapment Sites

In part 1 of 2 of Is it Carpal Tunnel or Is it Something Else?, you were introduced to the common signs and symptoms of carpal tunnel syndrome.  In part 2 of this blog, you will learn about other compression sites and conditions influencing the median nerve, which may resemble the signs an symptoms of carpal tunnel syndrome. Why is this important, you ask? First off, if you think you may have carpal tunnel syndrome, you want to be 100% certain.  Second, you don’t want to receive treatment to an area of the forearm that may not be the area or reason for your health problem.

Of course, let’s get started with Forearm Anatomy!

Brachial Plexus 1

Brachial Plexus 1

Nerves of the forearm and hand originate in the neck area off the spinal cord.  The spinal cord (the main cord coming from the brain) breaks down into many smaller branches (roots, trunks, divisions, and cords) of nerves that travel from the neck, through the shoulder, via the arm and down to the wrist and fingers.  Nerves bring the ability to move and feel to our bodies.  Specifically, the MEDIAN NERVE nerve is one of the nerves that provides movement and sensation to the forearm and hand.As you learned in the first blog, nerves can become compressed or squeezed by soft tissue such as muscles and ligaments.  Moreover, compression of a nerve occurs due to various reasons such as sport injuries, repetitive strain/sprain, a tumor (very uncommon), etc.   The nerve involved in carpal tunnel syndrome is the median nerve at the wrist.  As you recall, when this nerve is squeezed around the wrist, a patient may experience frequent burning, tingling, and/or numbness in the palm of the hand and the fingers. Some sufferers say their fingers feel swollen and weak, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night. The person may wake up feeling the need to shake out the hand or wrist. Continued carpal tunnel may result in decreased grip strength and muscles wasting at the base of the thumb. Furthermore, some people are unable to tell between hot and cold by touch.

In part 1, we gave the analogy that a traffic jam on a road resembles a compressed nerve.  When a road is blocked with many cars, cars move slower than normal.  A nerve that is squeezed or compressed transmits signals of movement and sensation slower to the hand.  Now, to make things a little more complex, think of a busy highway….throughout the highway you have many areas in which traffic is slower than others.  Let’s call these bottleneck areas. Throughout a stretch of road, there maybe multiple areas of blockages or bottlenecks.  A nerve can also be blocked in various areas in the arm.  Thus, it is important to examine the entire nerve pathway to be sure that no other areas are affected.

Ok, let’s get to the point….

Carpal tunnel syndrome symptoms appears similar to other compression syndromes/sites of the MEDIAN nerve.  There are four regions where this blockage can occur below the shoulder.

1) Supracondylar process of the humerus and struther’s ligament (what a mouth full!):

The median nerve maybe compressed as it passes under a bony spur (normal variant) in the arm.  This would cause weak hand grip, a hard time turning the forearm to a position in which the palm is facing down and it would also create tingling into the 1st to 4th fingers (never the 5th finger). The presence of having a difficult time turning the forearm into a position in which the palm is facing down is what differentiates this compression problem area from carpal tunnel syndrome.

2) The Lacertus Fibrosus:

The median nerve travels in front of the elbow (palm up side).  The lacertus fibrosus is another area of compression and it is located just before the elbow. One must suspect that the lacertus fibrosis is the problem when pain is experienced in the forearm with resisted elbow flexion.

3) Pronator teres

The pronator teres is located just after the elbow on the palm up side of the forearm.  This area of compression is VERY COMMON and confused many times with carpal tunnel syndrome.  The nerve gets compression as it travels between the two pieces of PRONATOR TERES (Top and Bottom) muscles.  When the muscle is tight and squeezes the median nerve, patients will complain of pain following resisted bending of the the long finger.  Furthermore, the pronator teres muscles will be very tight and tender to touch and may produce symptoms down the forearm when touched.  Usually, patients that do a lot of work with their hands and arms (plumbers, electricians and receptionists) experience this type of compression condition. Increased activity makes this condition worse.  Furthermore, just like the compression areas above, a pronator teres compression will cause tingling to the 1st to 4th finger (palm side).  Pronator teres compression is commonly confused with carpal tunnel syndrome!

4) Anterior Interosseus Nerve (Branch of Median Nerve) 

Brachial Plexus

Brachial Plexus

The Anterior Interosseus Nerve can become compressed in the forearm (palm side up). It is important to note that compression of the median nerve has two presentations.

1) The pronator syndrome in which patients have pain and paresthesias mimicking carpal tunnel syndrome (above),

and

2) the anterior interosseous nerve syndrome in which patients have muscle weakness in there hand (thumb side).

If the Anterior Interosseus Nerve is involved, the patient will not be able to make the ‘OK’ sign with his/her thumb and index finger.  Also, with the forearm flexed, the patient would have difficulty/weakness turning the palm from facing their torso to away from them.

How to you treat a median nerve compression?

Soft tissue therapy, electrotherapy and stretching often helps to relax tight muscle and decompress the tension placed on the nerve.  In my practice, I apply a combination of chiropractic treatment modalities.  I also have found acupuncture to provide pain relief as well periodically decrease the tingling sensations experienced.  Acupuncture also helps by relaxing the tight muscles in the forearm, which is beenficial since it may reduce compression of the nerve.

Conclusion:

Yes, I know, it is overwhelming and sometimes confusing to understand the course of a nerve.  The point I am trying to get across is that the body is tricky and you must not jump to conclusions.  If you or someone you know is experiencing tingling or has a decreased ability to move their forearm or hand, it is not automatically a case of carpal tunnel syndrome.  You must screen whatever nerve is corresponding to the area of interest very carefully.  If you have any questions, please feel free to comment and/or message me.

MEDICAL DISCLAIMER: The following information is my personal notes about this subject matter. It is intended for informational purposes only. Consult a health practitioner to help you diagnose and treat injuries of any kind.

Thank you for reading this post.

Dr. Luciano Di Loreto, HBSc., DC

www.fitforlifewellnessclinic.com

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

 

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Why is My Knee Locking? The Torn Mensicus Injury

Why is My Knee Locking? The Torn Mensicus Injury

The Locked Knee Syndrome

Knee Anatomy

Knee Anatomy

Over the last few years, I have worked on a variety of patients with knee problems. Contrary to the general perception, not all knee problems and conditions occur in the adult or elder population.  In fact, some conditions occur more frequently in children and teenagers.  Some of these younger patients present with laxity or a loose knee, while others present with locking in the knee.  Regardless of age or type of knee concern, a thorough history and physical examination is extremely important to conduct if we are to rule in and rule out conditions.  Today, I will dive into the intricacies of the typical locked knee patient.  I will answer the following questions. What makes up a knee joint? What is a knee lock? What causes a knee to lock? What treatment options are available for a locked knee?

Anatomy of the Knee Joint

Let us learn about the anatomy of the knee joint. Our knee joint is made up of a variety of bones. You have the femur, tibia, and patella (kneecap).  These bones together are involved in creating the knee joint and/or involved in knee function (mainly bending). In between the femur and tibia (see picture) there are two menisci. You have one meniscus located on the inside (medial meniscus) and one meniscus on the outside (lateral meniscus) of your knees.   The menisci are made of tough cartilage that fits nicely between the bones.  Surrounding the knee joint, you have layers of muscle. There are two groups of muscles at the knee.  The four quadriceps muscles, on the front of the thigh work to straighten the knee from a bent position. The hamstring muscles, which run along the back of the thigh from the hip to just below the knee, help to bend the knee. You also have a number of ligaments that stabilize the knee joint. You have four ligaments that connect the femur to the tibia.  The medical collateral ligament (MCL), lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruiciate ligament (PCL).

Let us talk more about the Menisci

The menisci are important because they distribute weight across the knee joint. If you lack menisci or a meniscus, weight would be unevenly distributed across the joint, leading to uneven force distribution and early arthritis of the knee joint.  Another important function of the meniscus is to keep the knee joint stable.  The menisci are crucial to the health of your knees!

Life as a Meniscus

The menisci are nourished by small blood vessels along the outer surfaces.  They do not receive any nourishment in the inner areas.  As a result, this becomes a problem when an injury occurs within the inner areas.  Without a proper blood supply, essential nutrients cannot reach the inner injured menisci for healing to occur.  Thus, the menisci do not heal properly in the inside areas.

What does this mean?

Knee Anatomy

Knee Anatomy

The menisci can be easily injured by the force of rotating the knee while bearing weight.  A partial or total tear of the meniscus may occur when a person quickly twists or rotates the upper leg while the foot stays still.  If the tear is tiny, the meniscus stays connected to the front and back of the knee; if the tear is large, the meniscus may be left hanging by a thread of cartilage.  The seriousness of the tear depends on its location and extent.  A patient with a menisci injury will most commonly experience knee pain, swelling, tenderness, popping or clicking and/or limited motion or locking of the knee.

Finally! Why does the knee lock?

Severe pain and/or locking may occur if a fragment of the meniscus catches between the femur and tibia within then knee joint. Pain may go away while the locking may continue to persist due to the fragment of torn meniscus floating around the knee joint.

Ok, my knee locks, now what?

When presenting with a suspected meniscus injury such as a meniscus tear, which may cause a locking of the knee joint, it is important to conduct x-rays and/or MRI to verify the extent of the injury. Remember, x-rays are conducted to visualize bone, while MRI’s are conducted to visualize soft tissue structures such as the meniscus. Visualizing a torn meniscus on MRI does not mean a specific treatment is required.  Treatment depends on several factors.

Treatment Possibilities for a Meniscus Tear

Treatment of a meniscus tear or locked knee depends on several factors including: type of tear, response to conservative treatment and the activity level of the patient.  Many menisci tears are treated non-surgically via pain control modalities (electrotherapy, ultrasound, laser therapy), soft tissue therapy, acupuncture and rehabilitation. In practice, interferential current and acupuncture helps to reduce pain. Furthermore, laser therapy and ultrasound therapy can assist in healing of some areas of the meniscus and the surrounding soft tissues.  Soft tissue therapy can help with loosening tight quadriceps and hamstring muscles.  Last, but not least, it is important to commence a rehabilitation and exercise program to strengthen muscles.  These treatment methods are effective; however, everyone is unique and will respond differently to these conservative treatments.

If conservative non-surgical treatment fails to alleviate pain and a patient continues to experience mechanical knee symptoms such as locking, inability to straighten and clicking/popping noises – he/she may consider surgical options.

When surgery is necessary, a surgeon may discuss the following options to help improve mechanical symptoms.  Either remove the torn meniscus (a partial meniscectomy) or perform a meniscus repair to place the edges of the meniscus together with sutures or tacks.  Both are performed using a scope within the joint (arthroscopy).  It is important to discuss these options with your family doctor and/or surgical specialist.

Conclusion:

Knee locking is not a diagnosis; it is a symptom of a meniscus injury.  Not everyone who experiences a meniscus tear will experience the locking of their knee joint.  The type of meniscus tear and position of the tear will decide whether locking, clicking, popping or an inability to straighten the leg occurs (mechanical knee symptoms). I hope you found this blog both informative and educational.

Dr. Luciano Di Loreto, HBSc., D.C.

Chiropractor & Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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Headache Referring Behind My Eye!

Headache Referring Behind My Eye!

Headache Referring Behind My Eye!

Have you ever experienced a headache that refers from the back of the neck to your eye? The sensation that I experience is often quite sharp and localized to one side of my head (usually the right side). These type of headaches are quite commonly experienced by many individuals in the population. Perhaps, increased stress, working at the computer for long hours or long commutes maybe responsible for these headaches…

There are a variety of headaches out there – migraine, cluster and tension-type to name a few. The headache that I am referring above is known in the medical literature as a “cervicogenic headache”.

What is a Cervicogenic Headache?

A cervicogenic headache is caused by an abnormality of the structures in the neck. What structures you ask? Basically, the muscles, nerve, bone, fascia and other soft tissues located in the neck area. A cervicogenic headache is sometimes debilitating and is a condition that accounts for 15% to 20% of all headaches. The criteria for diagnosing a cervicogenic headache is as follows:

A. Pain is referred from a source in the neck and perceived in one or more regions of the head and/or face, fulfilling criteria C and D

B. Clinical, laboratory and/or imaging evidence of a disorder within the cervical spine or soft tissues of the neck known to cause headache

C. Clinical signs that implicate a source of pain in the neck.

  • 1. Reduced range of motion
  • 2. Mechanical exacerbation of pain
  • 3. Focal neck tenderness
  • 4. Trigger points that refer to the head

D. When myofascial tender spots are the only cause, the headache should be diagnoses as tension-type headache and not cervicogenic.

What is the cause of a Cervicogenic Headache?

An issue to the neck muscles and other surrounding tissues/structures (bones and joints) are responsible for this type of headache. Whether it be a strain or strain, trauma or fall, our soft tissues and joints can become involved and negatively influenced. Sometimes the C0-C1 joint (first neck joint between the spine and head) or those neck joints below become tight/locked or restricted for whatever the reason. Furthermore, sometimes the muscles in the areas also become tight and tender. A question that is difficult to answer is what causes what – Is it the joint tightness that causes the muscle pain/tightness OR is it that tight muscles that cause the joint pain and thus the cervicogenic headache? This is like the classical chicken and egg scenario. What came first the chicken or the egg? My guess is that the headache can be caused by either structure (joint or muscle/soft tissue) and that both structures influence one another. When the joint is tight, the muscle become tight and when the muscle is tight, the joint does not move as well.

What Evidence Based Treatment Options are Available for Cervicogenic Headache Suffers?

I find that a chiropractic adjustment helps to alleviate my neck and cervicogenic headache symptoms quite quickly. I get cervicogenic headaches periodically – once a month. When I feel that my neck is tight and stiff and a headache is coming on, I have a colleague of mine adjustment my neck and upper back area. Sometimes the relief is instant!

According to some of the latest research on cervicogenic headaches, the following treatments are effective. Spinal manipulation therapy two times per week for 3 weeks. Joint mobilization 8-12 treatments over 6 weeks. Deep neck flexors exercises twice daily for 6 weeks. It is important to note that there is no consistently additive benefit of combing deep neck flexor exercises and joint mobilization for cervicogenic headache. Sourced from “Clinical Practice Guideline for the Management of Headache Disorders in Adults – Jan 2012?

After each treatment, it is important to reassess the condition.

I hope you have found this blog educational.  Remember, it is always important to rule out serious conditions which may also be a source to a headache.  These conditions should be ruled out first before any treatment is commenced.  Always consult your health practitioner prior to commencing any treatment.  Thank you for reading my blog Headache Referring Behing My Eye.

Dr. Luciano Di Loreto, HBSc., D.C.

Chiropractor & Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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Can Back Pain Refer to My Testicle?

Can Back Pain Refer to My Testicle?

The answer is YES!  This blog will help you to understand how this occurs.

The type of back pain that I am referring to is muscular in nature.  In your lower back (lumbar) you have a muscle called Quadratus Lumborum (QL). The QL muscle is responsible for four actions:

  • Lateral bending of vertebral column
  • Extension of lumbar vertebral column
  • Fixes the 12th rib during forced expiration
  • Elevates ilium (hip bones)

The QL attaches from the 12th rib and spine to the pelvis.  You have two QL muscles, one on each side.  The QL is a common source of lower back pain. If you twist, turn, bend or lift improperly you can trigger spasm, strain and injury to the QL muscle.  Often times those presenting with QL Syndrome display the following symptoms:

  • “Locked up” spine
  • Acute back pain and spasm
  • Pain is often one-sided
  • Pain may radiate towards the gluteal region (buttock)

Clinical Features

  • Pain upon palpation at the top attachment of the quadratus lumborum (3 cm off the vertebrae in the lumbar spine)
  • Elevated pelvis on the side of pain
  • Lumbar region may be slightly flexed laterally to the side of pain (antalgic position)
  • Acute injury often accompanied by lifting and twisting movements

Males and females may experience referral of pain to their groin region due to an injury to QL.  You have nerves that branch off the spinal cord at the level of the lumbar spine in close proximity to QL.  You have the Ilioinguinal (L1),  which supplies cutaneous distribution to the scrotum (labia for females) AND the Iliohypogastric (T12-L1), which supplies cutaneous innervation to the lower abdominal and groin region.  It is important to note that you also have other nerves that branch off the spinal cord lower down. When the QL muscle gets taught, spastic and/or injured, it can affect the nerves that pass near it.  If the nerves are inluenced, they can refer to their area of their innervation.  Thus, sometimes a muscle strain in the back can create symptoms (such as a sharp shooting pain) in the testicle or labia.

Various treatments can be used to heal a QL strain.  First off, a combination of ICE and HEAT will assist in decreasing pain and relaxing the muscle.  Moreover, electrotherapy, laser therapy, soft tissue therapy and chiropractic adjustments will help as well.   Usually four to six treatments of passive treatment helps to decrease the pain and relax the QL muscle.  It is recommended that following passive treatments, you  focus on some active care (exercises and rehabilitation) to ensure the QL muscle is functioning properly.

Dr. Luciano Di Loreto, HBSc., D.C.

Chiropractor & Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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The Locked Ankle Patient

The Locked Ankle Patient

Case: 60 Year Old Female with Ankle Stiffness

A patient recently came to see me four days following her ten day beach vacation.  She explained that she did 5 kilometres of walking along the beach daily.  On the ninth day of her trip, she found it very difficult to walk, due to a restriction/locking in her ankles.  She wore flip flops, sandals and sometimes went barefoot on her walks. As much as she tried, she could not bend her ankle/foot up or down.  She explained that she was worried that she broke something in her ankle and thus the cause of her limited motion.  During the airplane ride back, she noticed some swelling in both the ankles and immediately became concerned.  When she returned home, she went to see her family doctor right away about the health concern.  Her family doctor did some blood work and requested x-rays of the ankle and foot. Everything came back normal.  The doctor suggested she go to a Chiropractor or Massage Therapist.

When she showed me her ankle, it appeared to be slightly swollen and was fairly tight/restricted.  Her ankle range of motion was limited 50%.  Although she could walk, she found it difficult to do so not due to pain, but to limitation in ankle movement.  She had no problems bearing weight on her ankles.  After a history and physical examination, we had ruled out infection, fracture, tumor, compartment syndrome and other serious health conditions/concerns.

Locked Ankle

Locked Ankle

After doing some research, this seemed like a sprain of a ligament in both her ankles.  However, what type of ankle sprain grade did this fall under AND what could cause such a sprain?

According to the Medscape Ankle Sprain Grading:

Grade 1 injuries involve a stretch of the ligament with microscopic tearing but not macroscopic tearing. Generally, little swelling is present, with little or no functional loss and no joint instability. The patient is able to fully or partially bear weight.

Grade 2 injuries stretch the ligament with partial tearing, moderate-to-severe swelling, ecchymosis (bruising), moderate functional loss, and mild-to-moderate joint instability. Patients usually have difficulty bearing weight.

Grade 3 injuries involve complete rupture of the ligament, with immediate and severe swelling, ecchymosis, an inability to bear weight, and moderate-to-severe instability of the joint. Typically, patients cannot bear weight without experiencing severe pain.

-Source for Ankle Sprain Grading – Medscape

After careful consideration of each sprain grade, none fit her profile and condition well.  If any, the grade 2 ankle sprain came the closest.  The patient did not sustain an injury, did not have any bruising and was able to bear weight on her ankles.  She did have moderate functional loss of the ankle joint (ankle mortise – see picture above) and slight swelling.

Is this a classical ankle sprain or is this something different?

The patient explained that this condition happened to some of her relatives back in Europe.  She went on to describe that sometimes when her relatives walked along the beach for a long time (with or without shoes), they experienced three to four days of restriction and what she called “impacted ankles”.  I never heard of this term used in this fashion before.  After further review of the literature, the only information I came across in regards to impacted ankles was associated with ankle fractures, which we ruled out.

When I felt the ankle joint, I noticed that it was not moving well.  The ankle mortise joint (joint between the tibia and talus), felt locked on both sides.  Furthermore, the other bones below the ankle (tarsal bones and metatarsal bones) before felt locked, tight, and restricted.

Treatment

I proceeded with some electrotherapy, therapeutic ultrasound, soft tissue therapy and an ankle adjustment.  As soon as I finished, she felt relief and felt that both her ankles were much looser.  I retested her ankle range of motion and noticed a 25% improvement.  The patient came back the next day and received the same treatment.  After the third treatment session, the patient explained that she was 100% better and had retained full function in her ankles.

Conclusion

It appears that this health condition experienced by my patient is different from the classical graded ankle sprain.  It seems that the patient did in fact “impact” or lock her ankles somehow.  Perhaps, this was due to a increase in walking or from walking on the harder sand near the shoreline.  Perhaps, it was due to improper or no footwear at all.  The direct cause, in her scenario, remains unknown.

I look forward to any comments in regards to this health concern.

Dr. Luciano Di Loreto, HBSc., D.C.

Chiropractor and Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

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What is Sacroiliac Joint Dysfunction? Relationship between SI, Hip & Back Pain

What is Sacroiliac Joint Dysfunction? Relationship between SI, Hip & Back Pain

Over the last few years, I have treated various individuals (male and female, young and old), for a condition that is often under and/or misdiagnosed.  Patients usually come to my office as a last resort – after trying various treatments that have not provided them with any longer term  success. These patients usually complain of locking or discomfort in their hip joint and point to an area above their buttock.  Sometimes, they complain of lower back pain or thigh pain.  After a history and physical examination, I notice that it is neither the hip or back that is the source of pain/discomfort.  In other words, the pain/discomfort/locking maybe a consequence of a bad back or hip, but not the source of the pain.  The type of condition that I diagnose is known as Sacroiliac Joint Dysfunction (SI Joint Dysfunction). Try saying that name five times fast. 

What is the Sacroiliac Joint?

The sacrum is the triangular bone located at the bottom of the spinal column.  Above the sacrum, you find articulation with the last lumbar vertebrae (L5) and below is the joint made with the coccyx (tailbone).  At either sides of the sacrum you have two ilium or ala.  The sacroiliac joint is the joint that is formed between the sacrum and ala.  The ilium is the bone that also forms part of the area of the hip joint (where the thigh bone, known as the femur, articulates with the ala).  The hip joint is the joint that allows us to move our thighs freely in many directions – upwards, outwards and backwards.

What is the function of the Sacroiliac Joint?

The function of the SI joints is to allow torsional or twisting movements as well as to provide shock absorption from the forces coming above and/or below the joint.  Our thighs and legs act like long levers and without the sacroiliac joints and other joints within the area, the pelvis would be at greater risk of fracture or injury.

What is Sacroiliac Joint Dysfunction?  What does dysfunction mean?

Sacroiliac Joint Dysfunction refers to the SI joint not working properly.  Sometimes the joint can be either too tight (hypomobile) or too loose (hypermobile).  Said another way, the joints can either be locked/restricted (hypo) or loose/abnormally moveable (hypermobile).  When you have a hypo or hyper SI joint, you influence the ligaments, muscles and other surrounding soft tissues in the area (gluteal muscles, piriformis muscles, etc).  As a result of the dysfunction, you change the biomechanics of the joints above and below the area – the back and the hip joints.  The question is – Is it an injury or dysfunction to the back or hips that causes the SI joint dysfunction OR is it the SI Joint dysfunction that causes the hip and/or back pain?  This is the chicken and egg scenario that we commonly get faced with as health practitioners.  I think it can go either way.

What Conservative Treatments are available for SI Joint Dysfunction?

Chiropractic adjustments work very well for SI Joint Dysfunction.  Furthermore, I find that electrotherapy, soft tissue therapy, laser therapy and taping techniques, in combination, also help.   Of course, it is important to address the other joints in the region to ensure that they are functioning properly.  Strengthening exercises are also prescribed for the lower back, core, gluts and legs.

What is a Chiropractic Adjustment?

An adjustment is a highly skilled and precise movement usually applied by hand to a joint of the body. Adjustment loosens the joint to restore proper movement and optimize function.

When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about.

Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor. Your chiropractor is well-trained to determine if your problem will respond to chiropractic care or if you require referral to another health care provider.

-Ontario Chiropractic Association

I hope you have enjoyed this blog post.  Please feel free to write any comments or to contact me if you have any questions.

Dr. Luciano Di Loreto

Chiropractor & Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

More

What is Sacroiliac Joint Dysfunction? Relationship between SI, Hip & Back Pain

What is Sacroiliac Joint Dysfunction? Relationship between SI, Hip & Back Pain

Over the last few years, I have treated various individuals (male and female, young and old), for a condition that is often under and/or misdiagnosed.  Patients usually come to my office as a last resort – after trying various treatments that have not provided them with any longer term  success. These patients usually complain of locking or discomfort in their hip joint and point to an area above their buttock.  Sometimes, they complain of lower back pain or thigh pain.  After a history and physical examination, I notice that it is neither the hip or back that is the source of pain/discomfort.  In other words, the pain/discomfort/locking maybe a consequence of a bad back or hip, but not the source of the pain.  The type of condition that I diagnose is known as Sacroiliac Joint Dysfunction (SI Joint Dysfunction). Try saying that name five times fast. 

What is the Sacroiliac Joint?

The sacrum is the triangular bone located at the bottom of the spinal column.  Above the sacrum, you find articulation with the last lumbar vertebrae (L5) and below is the joint made with the coccyx (tailbone).  At either sides of the sacrum you have two ilium or ala.  The sacroiliac joint is the joint that is formed between the sacrum and ala.  The ilium is the bone that also forms part of the area of the hip joint (where the thigh bone, known as the femur, articulates with the ala).  The hip joint is the joint that allows us to move our thighs freely in many directions – upwards, outwards and backwards.

What is the function of the Sacroiliac Joint?

The function of the SI joints is to allow torsional or twisting movements as well as to provide shock absorption from the forces coming above and/or below the joint.  Our thighs and legs act like long levers and without the sacroiliac joints and other joints within the area, the pelvis would be at greater risk of fracture or injury.

What is Sacroiliac Joint Dysfunction?  What does dysfunction mean?

Sacroiliac Joint Dysfunction refers to the SI joint not working properly.  Sometimes the joint can be either too tight (hypomobile) or too loose (hypermobile).  Said another way, the joints can either be locked/restricted (hypo) or loose/abnormally moveable (hypermobile).  When you have a hypo or hyper SI joint, you influence the ligaments, muscles and other surrounding soft tissues in the area (gluteal muscles, piriformis muscles, etc).  As a result of the dysfunction, you change the biomechanics of the joints above and below the area – the back and the hip joints.  The question is – Is it an injury or dysfunction to the back or hips that causes the SI joint dysfunction OR is it the SI Joint dysfunction that causes the hip and/or back pain?  This is the chicken and egg scenario that we commonly get faced with as health practitioners.  I think it can go either way.

What Conservative Treatments are available for SI Joint Dysfunction?

Chiropractic adjustments work very well for SI Joint Dysfunction.  Furthermore, I find that electrotherapy, soft tissue therapy, laser therapy and taping techniques, in combination, also help.   Of course, it is important to address the other joints in the region to ensure that they are functioning properly.  Strengthening exercises are also prescribed for the lower back, core, gluts and legs.

What is a Chiropractic Adjustment?

An adjustment is a highly skilled and precise movement usually applied by hand to a joint of the body. Adjustment loosens the joint to restore proper movement and optimize function.

When a joint is adjusted, a gas bubble escapes causing the popping noise you may have heard about.

Chiropractic adjustment techniques have been researched extensively. Complications are rare and side-effects, such as temporary soreness, are usually minor. Your chiropractor is well-trained to determine if your problem will respond to chiropractic care or if you require referral to another health care provider.

-Ontario Chiropractic Association

I hope you have enjoyed this blog post.  Please feel free to write any comments or to contact me if you have any questions.

Dr. Luciano Di Loreto

Chiropractor & Acupuncture Provider

Fit for Life Wellness & Rehabilitation Centre

—–

Dr. Luciano Di Loreto graduated from the Canadian Memorial Chiropractic College (2010) as a Doctor of Chiropractic and obtained a certificate in Medical Acupuncture at McMaster University (2010). At his practice located in Vaughan, Ontario, Canada, Dr. Luciano Di Loreto combines evidence-based chiropractic care with a multidisciplinary and collaborative approach to health care. He is an approachable, passionate, and diligent practitioner with a focus on delivering exceptional acute, preventative, rehabilitative and supportive care for a variety conditions relating to the muscle, nerve, and bone. During his spare time, Dr. Luciano Di Loreto takes pleasure in spending time with his family and friends. He enjoys fishing and playing sports.

Fit for Life Wellness & Rehabilitation Centre is a health clinic located in Vaughan, Ontario, just north of Major Mackenzie on Weston Road (Located in the Vellore Medical Centre & Walk In Clinic). If you have questions for Dr. Luciano Di Loreto, please comment and we will get right back to you promptly with information on your conditions/concerns.

More