Tag Archives: sciatica

Sciatica From Sitting Long Periods

sciatica treatment SFWe have been providing treatment for sciatica in San Francisco for over 23 years now. 

Most of the people we provide chiropractic services to in the SF Financial District spend the majority of their day sitting in front of a computer for long periods. This is very hard on the body…especially the low back.

Sciatica (pain that travels down the leg/s) occurs when there is pressure on the sciatic nerve or nerve roots. The sciatic nerve is the largest nerve in the body and is formed by branches of nerves that exit from in between the bones in your low back.  Pressure on these nerves, which are very sensitive to pressure, can cause pain, numbness, tingling, or weakness in the leg/s.

The primary cause of sciatica is a bulging or herniated disc in the lumbar spine (low back).  A herniated or bulging disc is a condition whereby the center (gelatinous) portion of the spinal disc pushes through the fibrous contain walls of the disc and irritates the spinal nerve roots or nerves.

A herniated disc can happen from a trauma such as a car accident, sports injury, or slip and fall. Or, more commonly, develop over time from abnormal wear and tear due to poor ergonomics or sleeping postures, stress, not enough rest, and life.

Obesity is a primary cause of back pain, sciatica and disc herniations  because it puts relentless stress of the joints of the spine, muscles, ligaments and tendons.

Sitting all day for years and years can take it’s toll too. Especially if you are overweight or do not live a healthy lifestyle.

There are things you can do to counteract the negative effects of sitting for long periods. Exercise is high on the list. Chiropractic adjustments are also. Frequent breaks can help, especially if you stretch and walk around in between sitting. Drinking lots of water and eating plenty of fruits and vegetables with have anti-inflammatory effects can help too.

We also recommend deep breathing techniques and Yoga as a way to counter the negative effects of mental stress and the physical effects of sitting.

Unfortunately, sitting for long periods has also been linked to heart attacks and strokes…even cancer.  The moral of the story is that we need to move around way more than was previously thought. Doing so will not only reduce the odds of developing sciatica…it will also be good for your heart and overall health and wellbeing.

To schedule an appointment with one of our San Francisco Chiropractors, please call 415-392-2225. Ask for an office tour. We have 2 clinics to serve you in downtown SF.  

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Managing Low Back Pain

We have been providing treatment for low back pain in San Francisco for over 22 years. 

Male Patient Visiting Doctor's Office With Back AcheOver 80% of the population will experience low back pain at some point in their lives. Many will develop chronic low back pain which is back pain that persists for over 90 days. Some will develop low back pain that goes away…but then it returns and becomes worse. Some get low back pain that goes away and never returns…and everything in between. Just about every case is unique and should be treated as such.

Sciatica, which is pain down the leg or legs due to pressure on the sciatic nerve can also result from the same underlying causes of low back pain. In fact, you can have sciatica and not have back pain at all…just the pain, numbness, or abnormal sensations in the leg. Most patients with low back pain just have low back pain with varying levels of severity.

The causes of low back pain are many. Things like obesity or weight gain can put too much stress on the low back and cause low back pain. If this persists it can result in thinning of the discs, disc degeneration, bulging and herniated spinal discs, and spinal stenosis. Since 2/3 of Americans are overweight or obese this is a primary cause.

Then there are injuries to the spine from sports, exercising, car accidents, poor posture and ergonomics, bad sleeping habits, slips and falls, traveling, and other activities of life.

Here are some of the more common conditions that cause Low Back Pain:  

  • Lumbar sprain or strain
  • Herniated or Bulging Disc
  • Spinal Stenosis
  • Facet Syndrome
  • Scoliosis
  • Degenerative Disc Disease
  • Vertebral Subluxation and Misalignment
  • Spondylolisthesis

The good news is the low back pain responds very favorable to chiropractic adjustments. This is good because often times the true cause is not known. That’s right…you can take 10 different doctors, physical therapists, chiropractors, medical, whatever, and get 10 different opinions. I sure would not want to be getting back surgery under these conditions. But chiropractic…sure, why not? Chiropractic is 100% natural and very very safe…and gentle too.

Heck…all you care about is getting rid of your low back pain right? Not many patients care about the name the doctor gives it…and why should you?

Here is an excerpt from an article entitled The Mysteries of Low Back Pain on the great website Chiro-Trust.org

Do you realize how complicated the low back region is when it comes to investigating the cause of low back pain (LBP)? There can be findings on an x-ray, MRI, or CT scan such as degenerative disk disease, arthritis, even bulging and/or herniated disks that have NOTHING to do with why the back hurts. Similarly, there are often other abnormal findings present in many of us who have NO low back pain whatsoever! Because of this seemingly paradoxical situation, we as clinicians must be careful not to over-diagnose based on the presence of these “abnormal findings” AND on the same hand, be careful not to under-diagnose them as well.

Looking further into this interesting paradox, one study reported findings that support this point. Investigators examined 67 asymptomatic individuals who had NO prior history of low back pain and evaluated them using magnetic resonant imaging (MRI). They found 21 of the 67 (31%) had an identifiable disk and/or spinal canal abnormality (which is where the spinal cord and nerves run). Seven years later, this same group of non-suffering individuals were once again contacted to see if they had developed any back problems within that time frame. The goal of the study was to determine if one could “predict” who might develop low back pain based on certain abnormal imaging findings in non-suffering subjects. A questionnaire was sent to each of these individuals, of which 50 completed and returned the questionnaire. A repeat MRI scan was performed on 31 of these subjects, and two neurologists and one orthopedic spine surgeon interpreted the MRI studies using a blinded approach (without having knowledge about the subject’s symptoms or lack thereof). Each level was assessed for abnormalities including disk bulging/herniation and degeneration. Those who had initial abnormal findings were defined as “progressed” (worsened) if an increased severity of the original finding was evident or if additional or new spinal levels had become involved over the seven-year time span.

Of the 50 who returned the questionnaire, 29 (58%) had NO low back pain. Full story here

Bottom Line: It’s easy to get all caught-up in a bunch of unnecessary diagnostic testing and doctors visits. My recommendation is to make the first visit to the chiropractor…it will most likely also be your last.

To find out if you are a candidate for low back pain treatment in San Francisco please call 415-392-2225. 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Sciatica Relief in San Francisco

sciatica relief in SFWe have been providing treatment for Sciatica in San Francisco for over 22 years now.

The majority of the time, sciatica (leg pain) is the result of Pinched Nerves in the low back (lumbar spine). Pinched nerves or nerve roots are mostly caused by herniated or bulging discs.

Pinched lumbar nerves can also be asymptomatic. That’s right, you can have a herniated disc in the lumbar spine and have no symptoms. In fact, unless there is a trauma, herniated discs usually develop over time and the symptoms such as sciatica happen after the problem has been there for a while.

When a chiropractic patient presents with new symptoms of sciatica they have a tendency to think the problem is new…and it is in a way…but the cause has usually been there a while if the cause is a bulging or herniated disc, which it usually is.

That’s the bad news. The good news is that herniated and bulging discs in the low back, and the low back pain and sciatica they cause, respond favorably to gentle chiropractic care.

In the event that sciatica does not respond to chiropractic care we have nonsurgical spinal decompression with the DRX9000 as a “next step”.

Spinal decompression systems are designed and built to treat lumbar disc herniations, bulging discs, spinal stenosis, facet syndrome, and degenerative disc disease. The DRX9000 is safe, gentle and effective. It’s also painless. Sure, some get sore in the beginning, but that’s how it is with most treatments that are physical in nature.

So there you go. If you are suffering with low back pain or sciatica or both, you may have a herniated disc in the low back.

Your best bet is to find a doctor that treats herniated discs on a regular basis and does so nonsurgically. We are the clinic with the most experience treating herniated discs in SF. We also have a team of medical doctors, physical therapists, athletic trainers, and nutrition experts.

To find out if you are a candidate for Sciatica Relief in San Francisco please call 415-392-2225.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Sciatica Treatment in San Francisco

spinal decompression SF

Spinal Decompression Therapy SF

We have been providing treatment for Sciatica in San Francisco for over 22 years now.

Recently, Executive Express Chiropractic (EEC) as acquired by Chiro-Medical Group, Inc. Chiro-Medical Group (CMG) is a team of medical doctors, chiropractors, physical therapists, athletic trainers and staff that are highly trained in the area of sports medicine and chronic pain syndromes.

What this means to you is we now have the ability to combine nonsurgical spinal decompression at Executive Express Chiropractic with physical medicine at CMG, which is only a short walk away. Patients are reporting outstanding results so far.

Sciatica, which mean “pain in the leg” is caused primarily by pinched nerves in the low back due to herniated and bulging discs. These conditions tend to be progressive in nature and can become severe and debilitating.

Fortunately, sciatica responds favorably to conservative chiropractic care and exercises most of the time. It just depends on the nature and severity of your condition. In the event chiropractic fails to deliver favorable outcomes with chiropractic we will consider spinal decompression with the DRX9000 as a next step.

Spinal decompression machines are designed and built to treat neurovascular compression syndromes such as herniated discs, bulging discs, disc degeneration, and facet syndromes, naturally.

The treatment program is around 6-10 weeks depending on the severity of the problem and necessary rehab involved. If you have health insurance they will most likely cover some of the ancillary charges such as exercises, x-rays, medical consultations, blood work, physical therapy and home care supplies.

If you have been diagnosed with a herniated or bulging lumbar disc and are experiencing low back pain or sciatica then we would be glad to meet with you to discuss treatment options.

To find out if you are a candidate for low back pain and sciatica treatment in San Francisco please call 415-392-2225 and schedule a consultation with one of our back pain doctors. 

Chances are…you will be glad you did :-)

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Low Back Pain From a Herniated Disc?

herniated disc treatment san francisco

Low Back Pain

We have been providing natural treatment for low back pain and sciatica in the San Francisco Financial District for over 22 years now. 

A common cause of low back pain and sciatica is a herniated or bulging lumbar disc. This condition is often referred to as a “Pinched Nerve” because the herniated or bulging disc traps the nerve as it exits the spine. Nerves are very sensitive to any kind of pressure. Even the weight of a pencil erasure on the sciatic nerve can alter the nerve signal by 60% and cause severe pain.

When a patient presents to a chiropractor with low back pain or sciatica we will check for a pinched nerve. If it is determined you have a pinched nerve from a herniated disc we will prescribe a course of treatment that may include chiropractic adjustments, exercises, massage or nonsurgical spinal decompression.

This combination of treatment is highly effective when it comes to reducing the symptoms associated with herniated or bulging discs and can often times help prevent back surgery.

If you feel you may have a herniated herniated disc in your low back it is probably a good idea to visit a chiropractor first. They may want to take x-rays or send you for an MRI in order to quantify the problem. Sometimes we need to do this first and sometimes we don’t.

To find out if you are a candidate for herniated disc treatment in San Francisco please call 415-392-2225. Mention this blog post for a complimentary consultation.  

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Low Back Surgery or Chiropractic? Study Results

Low Back Pain Treatment in SF

Low Back Pain Treatment in SF

We have been providing treatment for low back pain in San Francisco for over 20 years.

Low back pain (LBP) is the second most common cause of disability in the United States (US) and a very common reason for lost days at work with an estimated 149 million days of work lost per year. The total cost associated with this is astronomical at between $100-200 billion/yr, of which 2/3rds are due to decreased wages and productivity. More than 80% of the population will have an episode of LBP at some point in their lifetime. The good news is that 95% recover within two to three months of onset. However, some never recover which leads to chronic LBP (LBP > 3 months), and 20-44% will have a recurrence of LBP within one year with lifetime recurrences of up to 85%! What this means is that most of us have, have had, or will have LBP, and we’ll get it again! So the question is, what are we going to do about it?

 

            Surgery has traditionally been considered a “last resort” with less invasive approaches recommended first. Chiropractic adjustments and management strategies have traditionally faired very well when compared to other non-surgical methods like physical therapy, acupuncture, and massage therapy. But, is there evidence that by receiving chiropractic treatment, low back surgery can be avoided? Let’s take a look!

 

            A recent study was designed to determine whether or not we could predict those who would require low back surgery within three years of a job-related back injury. This is a very important study as back injuries are the most common occupational injury in the US, and few studies have investigated what, if any, early predictors of future spine surgery after work-related injury exist. The study reviewed cases of 1,885 Washington state workers, of which 174 or 9.2% had low back surgery within three years. The initial predictors of surgery included high disability scores on questionnaires, greater injury severity, and seeing a surgeon as the first provider after the injury. Reduced odds of having surgery included: 1) <35 years old; 2) Females; 3) Hispanics; and 4) those who FIRST saw a chiropractor. Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor! WOW!!! This study supports the FACT that IF a low back injured worker first sees a chiropractor vs. a surgeon, the likelihood of needing surgery in the three years after the injury would be DRAMATICALLY reduced! In fact, the strongest predictor of whether an injured worker would undergo surgery was found to be related to who they saw first after the injury: a surgeon or a chiropractor.

           

If this isn’t enough evidence, another recent study (University of British Columbia) looked at the safety of spine surgery and reported that (taken from a group of 942 LBP surgical patients): 1) 87% had at least one documented complication; 2) 39% of the 87% had to stay longer in the hospital as a result; 3) 10.5% had a complication during the surgery; 4) 73.5% had a post-surgical complication (which included: 8% delirium, 7% pneumonia, 5% nerve pain, 4.5% had difficulty swallowing, 3% nerve deterioration, 13.5% wound complication); 5) 14 people died as a surgical complication. Another study showed lower annual healthcare costs for those receiving chiropractic vs. those who did not. The “take-home” message is clear: TRY CHIROPRACTIC FIRST!!!

 

            We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family both presently and in the future.

To schedule an appointment for low back pain treatment in downtown San Francisco please call 415-392-2225. Mention this blog post for a complimentary consultation.

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Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Low Back Pain From Sitting All Day?

low back pain treatment in SF

Low Back Pain From Sitting?

If you spend the majority of your day sitting in front of a computer like most of our downtown San Francisco Chiropractic patients, you are prone to low back pain.

There are things you can do to reduce the odds of low back pain such as stretching and and setting up your workstation properly. We teach all of our patients some simple at your desk spinal exercises that can be done throughout the day at work to help pass off spinal tension that builds in the muscles from sitting. We recommend you try these. You will notice an immediate benefit.

The downside of sitting all day is that the back pain can lead to bulging and herniated lumbar discs, disc and spinal degeneration, and poor posture that may become irreversible.

We actually recommend standing over sitting if possible, which means you would need to have a raised work service. Standing all day and sitting in between is better for your back and heart (believe it or not) than sitting all day and standing in between.

Regular visits to the chiropractor is also a good idea as chiropractic adjustments can help to counter the stresses on the spine from sitting and modern day living.

To find out more about the detrimental effects of sitting all day check out this article from the Mayo Clinic entitled How Much Is Sitting Too Much?

And follow us here on our San Francisco Chiropractor Blog and we will keep you up to date on the latest back pain and health & wellness news.

To schedule an appointment for Low Back Pain Treatment in SF call 415-392-2225

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Herniated Disc Back Pain Relief

spinal decompression SF

Spinal Decompression Therapy SF

We have been providing natural herniated disc back pain relief for over 20 years now in downtown San Francisco.

We use a combination of chiropractic adjustments, massage, deep tissue laser, custom exercises, and spinal decompression therapy to achieve favorable outcomes in most cases.

When a disc herniates and pinches a nerve it can cause low back pain, sciatica or leg pain, numbness and tingling in the legs and feet, and leg and foot weakness. Patients typically present with one or more of the above symptoms that are new or have been going on for a while.

In order to confirm a disc herniation an MRI is necessary of the lumbar spine. We will only order one if either the symptoms are severe or do not respond to conservative chiropractic, laser, exercise and massage.

If we order an MRI and disc bulge or herniation is confirmed, we will most likely recommend nonsurgical spinal decompression with the DRX9000. The DRX9000 is designed and built to treat lumbar disc herniations non-surgically. Success rates are high.

Sometimes the combination of chiropractic and spinal decompression achieves the best results. All cases are different and are handled as such.

Most of the patients that seek herniated disc treatment from us do so to prevent back surgery and for the most part that is what happens. Sure, there are exceptions and sometimes surgery cannot be avoided. But this is the exception and not the rule.

To find out more about herniated disc and back pain relief in San Francisco at Executive Express Chiropractic please contact us at 415-392-2225 and ask for a complimentary consultation.

By Eben Davis

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Sciatica Treatment with Spinal Decompression

Spinal decompression in san franciscoWe have been providing relief for sciatica symptoms in downtown San Francisco since 1992.

Sciatica is a symptom not a cause. Sciatica occurs when the sciatic nerve or nerve roots, which originate in the lumbar spine and travel down the leg become irritated and inflamed. When this happens it typically causes pain that travels down one or both legs, usually one. There can be associated numbness, tingling or weakness. Sometimes there is back pain and sometimes there isn’t.

The most common cause of sciatica is a herniated or bulging disc in the low back. Although, the pain associated can be severe and debilitating, it’s also the type of problem that can be brought under control within a few weeks. Chiropractic adjustments, physical therapy, and exercise can help with sciatica symptoms. But in reality, they are just treating the symptoms and not the cause.

About 9 years ago we began to incorporate nonsurgical spinal decompression with the DRX9000 into our herniated and bulging disc treatment protocols. We were the first to offer these services in San Francisco. Since then we have performed more than 20,000 decompression sessions to thousands of disc patients, and the results have been outstanding.

Spinal Decompression machines are designed and built to treat lumbar disc herniations, bulges, facet syndrome, degenerative disc disease, and spinal stenosis…all sciatica causes, naturally.

Disc decompression therapy with the DRX elongates the spine, enlarges the disc space, re-hydrates the injured spinal disc and re-positions the herniated disc fragments away from the nerve roots and spinal cord and back to the center of the disc. Does it do this every time? NO…just most of the time. No treatment is 100% effective. However, spinal decompression IS 100% natural. No drugs, No surgery. Either it works or it doesn’t (rare). In the rare event the DRX fails to deliver results, you are still whole and can pursue other treatment options. The DRX is very very safe…and effective.

To find out if you are a candidate for sciatica treatment in San Francisco please call 415-392-2225 and ask for a complimentary consultation.

 By: Dr. Eben Davis

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Herniated Disc Symptoms and Treatment


Herniated disc san franciscoWe have been offering natural solutions for cervical and lumbar disc herniations in San Francisco for over 20 years now.

The spinal disc is a fibrous elastic cushion that sits between the bones of the spine. The spinal disc has two primary functions, to give the spine flexibility and to hold the bone above and the bone below together acting as a "ligament". Ligaments hold bones together. 

The spinal disc when healthy also helps creates a nice opening between the bones for the spinal nerves to exit, which travel, split, and eventually connect to all body parts controlling their functions.

With age, the spinal discs become less elastic and more rigid which predisposes them to injury and rupture (disc herniation). A trauma at any age can cause a disc herniation but for the most part they develop slowly over time.

Depending on the lifestyle choices you make, including your physical  activity level, diet, stress, body-weight, habits (smoking and drinking), work environment, sports injuries, car accidents, etc., you may be more prone to disc herniations than others.

A little known fact is that many of us have disc herniations and don't even know it and never will. That's right…we will live and die with them and they never bothered us.

Not all disc herniations cause symptoms. And, those that do cause symptoms such as neck pain, arm and hand pain, low back pain and sciatica do not usually require surgery. In fact, chiropractic care can more often than not help people with a herniated disc in the neck or back return to more normal lives.

For those people that have disc bulges (a less severe form of a herniation) or disc herniations that have symptoms that do not respond to conventional chiropractic care or physical therapy there is always nonsurgical spinal decompression with the DRX9000. The DRX9000 is a computerized machine specifically designed and built to treat disc herniations without surgery. We have one at our San Francisco Chiropractic and Spinal Decompression Clinic.

We also incorporate deep tissue laser therapy into the mix with difficult to treat disc patients to help control the pain and inflammation in the beginning. Disc decompression therapy takes 20-24 one hour sessions and is not covered by insurance. Success rates are very high.

So, there you go. Sure, a herniated disc can seem like a nightmare. It can also seem like there are no other options but cortisone injections or back or neck surgery. But that simply is not true because gentle chiropractic and spinal decompression will help the majority of all cases. if chiropractic or decompression fail to deliver you are still whole and can try other treatment options including surgery.

But just know…If you have back or neck surgery and there is any type of fusion involved you will be permanently excluded from ever being able to try spinal decompression. Try it first if you qualify…it's the smart thing to do!

To schedule an appointment to see if you qualify for herniated disc treatment in San Francisco please call 415-392-2225. Mention this blog post for a complimentary consultation and spinal decompression tour.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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