If you have low back pain that keeps coming back, it could be that you have an unlevel pelvis; i.e. one side is higher than the other when standing.  This usually occurs from an impact trauma such as a hard fall or sports injury.

The pelvis is bowl-shaped structure comprised of two ischium bones and the sacrum.  The joint that connects it from the front is referred to as the pubis symphysis.  The legs attach to the pelvis via the hip joints.

When standing, the uneven pelvis causes the lumbar spine to bend in order to “right” itself.  A good analogy of this is what happens when you plant a tree sapling on a hill, perpendicular to the ground:  it will bend upwards as it grows so that it is perpendicular to gravity, not the hill slope.

This bending, or torque, will cause uneven weight distribution in the vertebral joints leading to lower back pain.  Back muscle spasms usually accompany the pain, as they try to stabilize the area.

Some patients with this condition respond well to orthotics prescription.  Orthotics are shoe inserts designed to correct gait problems.  They can be customized to correct fallen arches, for example; and foot pronation.  For uneven pelvis situations, one orthotic can be manufactured with a 3mm heel ramp or simply be constructed to be several millimeters thicker than the opposing one so that it corrects/levels  the pelvis when the patient stands on them inside his shoes.  This can ease the strain placed on the lumbar spine and effectively reduced chronic lower back pain.

Dan Perez, DC

Chiropractor San Francisco

Chiropractic is the world’s leading health discipline after allopathic medicine.  Chiropractic patients typically seek treatment for pain-related issues affecting the musculoskeletal system which have not resolved with time, nor responded well with medications.   The main reason for chiropractic’s success is that it seeks to correct the mechanical cause of the condition, rather than to simply alleviate the symptoms (pain) using anti inflammatories or other nerve-influencing drugs.

A chiropractor San Francisco can help you identify what’s causing your pain, and determine if it is something that can respond to chiropractic treatment.  Unless your symptoms are due to more serious underlying conditions like cancer, stroke, or neuropathic disease, the chances of success are very good.

Chiropractors will examine the alignment and function of the joints associated with the pain.  They trace the origin of the nerve down to its terminal point and determine if there are any mechanical obstructions, and if those obstructions can be reduced/removed using manual means (spinal adjustments, stretches, exercises).  If this is the case, the patient is put on a treatment plan typically involving multiple visits over several weeks, depending on the nature of the problem.  The patient is re-evaluated, and if the symptoms are gone and function returns, is given exercises and other home care instructions until it is totally resolved.

So, if you are experiencing pain, numbness, tingling, reduced range of motion in your spine or extremity joint; or poor posture and reduced strength, contact a chiropractor, San Francisco.

Dan Perez, DC

chiropractor san francisco

Most rainy day car accidents occur when one car is stopped, and another car behind it collides due to reduced vision and/ or loss of road traction.   Usually the driver behind sees the collision about to happen and is slowing down (slamming on the brakes).  However, because of the large mass of the vehicle, even at 10 mph there is enough kinetic energy to injure the occupants in the car in front.  The injuries are usually limited to soft tissue injuries due to the low impact; however, these types of injuries can still be very debilitating, causing headaches, neck pain and stiffness, even dizziness and fatigue.  Some people even get jaw  (TMJ) pain, as the mandible moves quite freely and injure joint structures during the collision.  The symptoms following a car accident can be very persistent and not respond well to aspirin and NSAIDs like Tylenol, which prompts the victim to call a chiropractor to see if chiropractic treatment for whiplash can help.

The force of the striking car transmits into the car in front; accelerating it from zero MPH to the striking car’s speed (let’s say 20 mph) within one second.  This creates a lot of g-forces.  Most of the damage comes to the neck and upper back, because of design.  The torso (thoracic spine) is relatively stable, supported by the ribcage and made stationary by the car seat.  However, most people drive without their head against the car seat headrest; about 4-6 inches in front of it.  This is enough space for the head to violently arch back, straining the neck at the time of impact, building up potential energy like a spring.  So when the struck car rests a second later, this potential energy unloads and propels the head ( a 12 lb weight on the neck) forward at roughly the same speed, further injuring soft tissues in the neck and back.

In some cases the victim  may experience a mild concussion, fractured vertebrae, and even spinal nerve or spinal cord damage.  That is why it is important to get checked after experiencing whiplash from a car accident.  Not only can their be soft tissue and nerve damage, the individual vertebrae could be knocked out of relative position to one another, causing problems with flexibility in the future.

Chiropractic care for whiplash will typically include an X-ray series of the cervical spine to rule out contraindications like fracture and ligament rupture.  Once the patient is cleared, treatment can consist of physiotherapies to reduce pain (ice, heat, laser, muscle stim), manual therapies (lymphatic massage, passive stretches, manual traction), and as the acute phase ends, spinal adjustment to various parts of the neck, thorax, and lumbar spine.

The goal for whiplash patients is to reduce pain, reduce swelling, restore proper kinematics of the vertebrae, and strengthen/ rehabilitate supportive muscles and ligaments.

If you’ve been injured in a low-speed car accident and are in the San Francisco area, you can call our office for a consultation at (415) 627-9077

Dan Perez, DC

Here’s the link to my page, under San Francisco chiropractors:

Sacroiliac Joint - Left Side

Just completed a chiropractic treatment plan for a patient who came in complaining of low back pain.  Upon close examination, the problem wasn’t really in her lower back (spine), it was her right sacroiliac joint.

The sacroiliac joint is where each pelvic bone attaches to your sacrum.  The sacrum is a triangular shaped bone below the spine; at the end is the coccyx, commonly referred to the tail bone.  The pelvic bowl is made up of the sacrum and the two pelvic bones, or ischiums.

The sacroiliac joint is a tough, rigid, fibrous joint.  Movement there is very minimal.  However, in women, the sacroiliac joint can move during pregnancy.  It slides to allow expansion of the pelvis during delivery.  Sometimes it doesn’t return to its normal position after giving birth, and gives the mother pain in that area for a long time.

A hard fall on the buttocks can injure the sacroiliac joint and cause it to move out of place.  I’ve had skateboarders, surfers, rock climbers, and other patients who do things that put them at risk of falling on their seat complain of sacroliiac joint pain.

When I make the diagnosis, I have the patient come in for several treatments of chiropractic spinal manipulation and physiotherapy.  I use a drop table to gently nudge the sacroiliac joint back into alignment.  Then, I use manual techniques to put it through its range of motion until realignment sets in.  Hotpacks, phototherapy, and InterX stim are also used to speed up healing.

If you are experiencing very low,  “low back pain,”  it may not be your back, but your sacroiliac joint.  Check your local chiropractor.

Dan Perez, DC

Chiropractor San Francisco

(415) 627-9077

After 15 years seeing patients in my downtown San Francisco office I’ve been able to compare and contrast these types of cases.  What is the common denominator?  Does it affect males or females mostly?  What does the pain respond to?

To this day, the diagnosis of such types of presentations remain elusive.  These patients typically have ran the gamut of health care providers.  They’ve seen their primary care MD, orthopedic specialists; sometimes neurologists; had physical therapy, massage, chiropractic, acupuncture; over the counter anti-inflammatories like Ibuprofen; and prescription muscle relaxants.  Yet in most cases, the pain doesn’t completely go away.  What can it be?

Well, the most important thing to know is that despite the similarities, the origin of the pain differs from case to case.  Based on my clinical experience, here are the things that can cause “non-specific” muscle pain:

1.  Old injuries resurfacing.  I have a patient who used to snowboard.  He took a hard fall on his back over ten years ago.  It went away for a long time.  Now older, he is experiencing pain in the same area after standing too long.  You see, as we age, our connective tissue (ligaments, tendons, muscle) gradually lose their strength and allow an old joint injury to “come back to life” in the form of abnormal joint movement.

2.  Fibromyalgia.  This is a syndrome that many health professionals originally rejected, but now accept as a legitimate health condition.  The reason for the controversy is there are currently no diagnostic tests available to confirm fibromyalgia– it  is diagnosed based on how the patient describes her pain (widespread, constant, no apparent cause).  A person suffering from fibromyalgia will report extremely sensitive areas all over her body, like over the sternum, the side of her hips and legs, arms, etc.   Some studies attribute it to a virus; others suggest it is a metabolic disorder.  It is usually accompanied by another condition called chronic fatigue syndrome.

3.  Prescription Drug Side Effects.  Many types of prescription drugs cause muscle pain as a side effect.  You see, your muscles rely on a steady flow of electrolytes (calcium, sodium, potassium) in order to contract and relax properly.  Some drugs alter this electrolytic flow and cause muscle pain.  If you are on some type of prescription drug, try Googling (your drug name)(side effects) and see what comes up, or ask your doctor.

4.  RSD- Reflex Sympathetic Dystrophy.  Similar to the old injury resurfacing, but more serious.  RSD is basically neurogenic pain.  It is believed to be an over-reaction of the sympathetic nervous system following an injury– the nerve pain fails to “shut off”, and the RSD patient is plagued with pain long after the injury is healed.  For example, you can fracture your wrist, have the  bones heal, but be plagued with RSD pain.  It’s not clear why some people develop it, and others don’t.

5.  Psychosomatic.    This word, loosely translated means “mind affecting body”.  It is widely believed that psychological factors can play a role in the body’s pain levels.  The saying “it’s all in your head” originated from the diagnosis of psychosomatic disorders.

So, how can chiropractic help non-specific pain?  I would first determine which category the pain falls under.  If I think  it is a #5, I refer out to a professional in the mental health field.   A #4 would probably be referred to a pain management specialist for consultation and possible co-treatment (pain management specialists use drugs, injections,  and special surgical  implants to reduce pain).  I would still attempt to treat categories 1-4.

Chiropractic adjustments to various parts of the spine and extremities can do a number of beneficial things; such as increase the range of motion of a joint; break up adhesions (scar fibers that restrict movement), fire off nerves that help with posture, and improve circulation.

I employ phototherapy (therapeutic light) to the areas, which helps stimulate ATP production (cell energy units)  in the muscle cells.  This stimulates protein synthesis and cellular waste removal.   InterX Muscle stim can help block the pain, and also stimulate fibroblasts– the cells that repair damaged tissue.

Active Release Therapy is great for category #1 cases.  It’s a special, active form of massage that involves moving your limbs in a certain pattern as the therapist works on you.   And then there’s nutritional supplements.  I use supplements based on fibrinolytic constituents like bromelain and papain enzyme.  These are substances that can  safely dissolve scar tissue/ debris, and are known to help reduce non-specific muscle pain.  Although you can find them in your basic vitamin store, I use a proprietary, extra-strength blend, made only for health care providers.

So if you are suffering from muscle pain and you aren’t sure what is causing it, this information hopefully can provide you with some answers.

Dan Perez, DC

San Francisco Chiropractors

Choosing the right chiropractor is not easy.  There are so many variables to consider, such as technique used, years of experience, treatment philosophy (pain treatment?  wellness care?  holistic?) and of course, personalities.  This website is designed to make the chiropractic experience transparent.   It addresses chiropractic techniques, the language/terminology that chiropractors use; chiropractic approaches/philosophies on treatments, tools and equipment that chiropractors use, and even billing practices.  The purpose of the website is to enrich and educate patients so that they can make smart decisions on choosing the right chiropractor.

Check out the new San Francisco Chiropractors website, and pass it on to friends/ acquaintances who you know can use a good chiroprator.

It is this confusion that motivated me to put up a website that can serve as a resource hub for those in the San Francisco area who are looking for a chiropractor.  I have attempted to anticipate and answer any question a first-time chiropractic patient might have.  The website is http://www.san-francisco-chiropractors.com.  I quickly put it up to get things going.  I will add to the site each month.   I plan to add a free “Ask the chiropractor” form as an added public service.

Check it out!

Dr. Dan

San Francisco chiropractor

A joint, whether the spinal joints of the neck or back, or the shoulder joint, knee joint, or hip joint, consists of two bones connected by ligaments and muscles. When a muscles is injured/strained, it becomes less elastic (stretchable), and may develop painful trigger points. This affects the muscle’s ability to contract properly.

In ART, the therapist identifies the problem muscles, and has the patient repeatedly move the joint in the plane of muscle contraction while “stripping” it with point pressure using the thumbs and fingers. As a result, scar tissue adhesions are broken up and the muscle fibers are elongated. The therapy also causes oxygenated blood to the area, further improving healing.

Check out ART being done on the upper extremities and neck by visiting this link.

Sessions are usually 15-35 minutes long. It is an area-focused massage procedure. In most cases, you will notice a noticeable increase in range of motion in the joint immediately following the therapy.

San Francisco Chiropractic offers Active Release Technique Mondays-Fridays at our downtown office. This therapy is particularly effective for sports injuries, but is also good for people who have overuse-related muscle pain such as tendonitis, carpal tunnel, and chronic neck and shoulder pain.

For more information, call us at (415) 627-9077

Dr. Dan

San Francisco Chiropractor

I am working on a web directory of San Francisco Chiropractors that will include helpful information on chiropractic care so that the prospective chiropractic patient can familiarize herself with the methodologies used by chiropractors before she makes a decision on which one to choose.

Choosing a doctor of any kind should not  be taken lightly.  Patients should do their due diligence.  Getting a referral from a friend or relative can save a lot of time; but even so, one must do her own research and find out what kind of doctor she is going to  be working with.

Chiropractic, thanks to its diverse nature can be difficult to understand.  There are over 50 chiropractic techniques practiced within the profession, and myriads of therapeutic modalities.  On top ot that, your treatment recommendations will typically vary greatly depending on the philosophical approach of the chiropractor.

With the new website I am in the process of putting together, I intend to help prospective patients locate a good chiropractor; one who will fit the individual’s needs.  Social sites like Yelp.com are nice, but many of the testimonials are solicited by the businesses and are therefore slanted in the positive.  It’s  best to research chiropractic thoroughly, familiarize yourself with the techniques and treatment approach used by chiropractors, and the terminology used in the chiropractic profession.  That way, you can ask intelligent questions and better evaluate each chiropractor.  Plus, going through this process will enable you to observe the chiropractor’s  bedside manners.

Dr. Dan

San Francisco chiropractor