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Welcome to Ask Dr. Ray!

Patients, friends, and visitors have asked Dr. Ray many interesting questions. Here, he answers some of the best!

Do you have a question for Dr. Ray? Use our Contact form to submit it, and it may be featured right here!

Dr Ray I often have back pain that travels into my buttocks afer driving long distances or sitting too long. Can Chiropractic help?


Thank you for the question Michelle . It sound like you may have sacral pain also known at times as sacroiliitis. Pain at the base of the lower back or sacroiliac joint (Sacroilitis) is thought to be a possible cause of sciatica, occasionally resulting in back pain that radiates down the leg and below the knee. This type of pain is thought to affect tens of thousands yearly. 

Doctors and scientists have questioned what the best treatment option is for patients with sciatica and sacrum-related leg pain. In a recent study, researchers compared three treatment options: physical therapy, chiropractic manual therapy, and intra-articular injections of corticosteroids.

Researchers analyzed the effectiveness and relief afforded by each method after 6 weeks of selected treatments, and again after 12 weeks. The results for each patient was categorized as either a success or failure, based on relief or worsening of symptoms and average pain scores.                                                                         

The study’s findings revealed that manual ( chiropractic) therapy is the superior choice for treating leg pain associated with sciatica or Sacroilitis. The success rate for chiropractic manual therapy was 72% ,(ok, not perfect , but not too shabby either) compared to just 20% for physiotherapy and 50% for corticosteroid injections. Researchers also found that neither physical therapy nor injections resulted in significant pain relief, whereas manual therapy resulted in a significant improvement on pain scores.

Due to the success rate and pain reduction of manual therapy, the study authors concluded that chiropractic should be the first treatment of choice in patients with sciatica and or sacal related leg pain. They hoped that their findings would be confirmed by further research with a larger sample size.

Additional research has highlighted the efficacy of chiropractic for sciatica, even after surgery has failed.

Hope this helps 

Dear Doctor Ray When we hurt ourselves, should we use ice or heat treatment? What’s the difference between these 2 treatments?

For each treatment, how long should we applied and What are the precautions that we need to take note. Thanks, Kim

Dear Kim : We use ice for acute injuries or up to 48 hours after the injury.

With injury, the affected area will initially swell as a result of our body's reaction to start the repair process. Excessive swelling will cause additional pain.

Applying ice to the injured area will restrict blood flow to the region. This helps to control excessive swelling and also to reduce the pain.

Heat has the reverse effect; it will trigger an increase blood flow to the region thereby increasing the swelling.

We should apply ice for 20 minutes every 2 hourly if possible. This should be practiced in conjunction with elevation and compression of the area.

Application of ice directly to the skin may cause ice burns, therefore always make sure that there is a towel between the ice pack and the skin.

For about a month now I have had an occasional sharp pain at my right elbow . I don't remember hurting the elbow , but I have noticed that it is getting worse? Do I need to be worried?

- Sam, Alpharetta

Hello Sam; thank you for writing! I cant be certain what the problem is without getting a few answers, so work with me . Does the elbow hurt when you make a fist or when you attempt to open a jar or hold your toothbrush? If it does you likely have Tennis elbow.

Tennis elbow or lateral epicondylitis is an extremely common injury that originally got its name because it is a frequent tennis injury, appearing in a large proportion of tennis players. Nevertheless it commonly manifests in a vast proportion of people who do not play tennis at all. Some say that 90% of people with Tennis elbow dont play tennis. No single treatment has been shown to be totally effective, however a combination of the treatments below are known to resolve tennis elbow over time. Each individual will react differently to different treatments.

  • Apply ice or cold therapy to the elbow (15 mins up to six times a day). This will help reduce pain and inflammation if present.
  • Rest - an extremely important component in the healing of this injury.
  • Wear a wrist brace or support to protect the tendon whilst healing and strengthening, particularly when returning to playing / equivalent.
  • As with all soft tissue injuries a comprehensive rehabilitation program provided by your physical therapist or chiropractor should be carried out including hand and wrist stretches and strengthening exercises.

Hope your tennis elbow begins feeling better soon. If not, feel free to come and see us!

Hello Dr Ray. I have had low back pain for years now but have never been to a chiropractor. My family physician has implied that surgery may be an option for me in the future. This scares me. So my question is; Are there nonsurgical approaches to treating low back pain?"

- Rob  in Marietta

Thank you for the question Rob . My answer to this one is simple; most definitely YES. Various back care studies suggest that there is professional uncertainty about an ideal treatment approach for relieving chronic localized back pain. Commentary by many highly regarded experts in health care suggest that surgery is severely overused in the treatment of low back pain (LBP), and that there is evidence of excessive utilization of imaging (MRIs) in the diagnosis of LBP. In fact, surgery is only appropriate for a small proportion of patients with low back symptoms.

Most experts* agree that potential non-medical approaches to managing different forms of Low Back pain include :

  • Massage therapy;
  • Chiropractic care;
  • Aerobic conditioning;
  • Intensive strengthening exercise

*Deyo R. Weinstein J. Low back pain. The New England Journal of Medicine 2001; 344(5), pp. 363-369.

Thanks for the question, Rob! Anyone else have anything they'd like to Ask Dr. Ray?

Dr. Ray, I've never been to a Chiropractor before. The popping has me a little nervous. What makes that sound anyway?

- Jay, Woodstock

So glad you asked, Jay! Research has shown that small pockets of air or bubbles are found in the tissue fluid surrounding a joint capsule. When the joint tissues are stretched during a chiropractic adjustment, the pockets of air 'pop' creating a cracking sound. It might sound loud, or barely audible, but it is certainly not something to worry about.

Thanks Jay! Can't wait to hear what our visitors will ask next!

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