Archive for November, 2012

Common Whiplash Myths – Second Part

Monday, November 19th, 2012

The previous month, we began discussing common myths about whiplash injuries, and this month, we will continue on that course. Remember, the amount of injury that occurs in an acceleration/deceleration injury is dependent on many factors, some of which include gender (females>males), body type (tall slender = worse), the amount of vehicular damage (less is sometimes worse as the energy of the strike was not absorbed by crushing metal), head position at the time of impact (rotation is worse than looking straight ahead), and more. Therefore, each case MUST be looked at on its own merits, not just analyzed based on a formula or accident reconstruction.

MYTH #5: THERE MUST BE DIRECT CONTACT WITH THE NECK FOR INJURY TO OCCUR.Injury to the neck most commonly occurs due to the rapid, uncontrolled whipping action of the head, forcing the neck to move well beyond its normal range of motion in a forwards/backwards direction (if it’s a front or rear-end collision) or, at an angle if the head is rotated or when the strike occurs at an angle. When this occurs, the strong ligaments that hold the bones together stretch and tear in a mild, moderate, or severe degree, depending on the amount of force. Once stretched, increased motion between the affected vertebra results as ligaments, when stretched, don’t repair back to their original length and, just like a severe ankle sprain, future problems can result. This excess motion between vertebra can result in an accelerated type of arthritis and is often seen within five years following a cervical sprain or whiplash injury.

MYTH #6:  SEAT BELTS PREVENT WHIPLASH INJURIES. It’s safe to say that wearing seat belts saves lives and, it’s the law! So, WEAR YOUR SEAT BELTS! They protect us from hitting the windshield or worse, being ejected from the vehicle. But, as far as preventing whiplash, in some cases (low speed impacts where most of the force is transferred to the car’s occupants), the opposite may actually be true. (This is not an excuse to not wear a seatbelt!) The reason seat belts can add to the injury mechanism is because when the chest or trunk is held tightly against the car seat, the head moves through a greater arc of motion than it would if the trunk were not pinned against the seat, forcing the chin further to the chest and/or the back of the head further back. The best way to minimize the whiplash injury is to have a well-designed seat belt system where the height of the chest harness can be adjusted to the height of the driver so that the chest restraint doesn’t come across the upper chest or neck. Move the side adjustment so the chest belt crosses between the breasts (this also reduces injury risk to the breasts) and attaches at or near the height of the shoulder (not too high). Another preventer of whiplash is positioning the head restraint high enough (above the ears typically) and close to the head (no more than ½ to 1 inch) so the head rest stops the backwards whipping action. Also, keep the seat back more vertical than reclined so the body doesn’t “ramp” up the seat back forcing the head over the top of the head restraint.

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

Fibromyalgia vs. Food

Monday, November 19th, 2012

Fibromyalgia (FM) is a derangement that affects everyone a little differently. Therefore, promoting a one diet approach for every FM patient doesn’t make a lot of sense. However, according to Ginevra Liptan, MD, medical director of the Frida Center for FM in Portland, OR, it is clear that what is included in a diet vs. what is eliminated makes a big difference for many FM patients. It has been reported that 42% of FM patients surveyed indicated their symptoms worsened after eating certain foods. Here are some recommendations about diet to consider:

  1. Pay attention to how food makes YOU feel. Many FM patients have sensitivities to particular foods, but this is highly variable from person to person. Sensitivity to MSG, certain preservatives, eggs, gluten, and dairy are quite common. Keep a daily food journal for at least 2 weeks and write down the foods eaten and any associated symptoms like headaches, indigestion (irritable bowel syndrome irritation – IBS), or fatigue.
  2. Try Eliminating Certain Foods. Many FM patients have irritable bowel symptoms, and using an elimination diet can help determine which foods to cut out. Try it out for no less than 6-8 weeks in order to get the best results. Then, add it back into your diet and pay attention to how it makes you feel. The most commonly eliminated foods are dairy and gluten and the most common improvement is in fatigue reduction and reduced IBS symptoms like bloating and constipation.
  3. If you think you might have food sensitivities or allergies, talk with us.Sometimes it is best to obtain an evaluation from an allergist for food allergy testing. Dietitians can also assist in assuring that you don’t eliminate essential nutrients when foods are eliminated from the diet.
  4. Make it easier to Eat Healthy. Everyone, including the FM sufferer, should try to eat fruits, vegetables, whole grains (if not gluten sensitive), and lean meats or protein. A well balanced diet will give you more energy, which in turn, can improve your overall health. When pain and exhaustion are present, choose healthy foods that do not require a lot of preparation such as buying pre-washed vegetables, or purchase pre-prepared foods like beet salad and quinoa.
  5. Use Food to Help Fight Fatigue. Consume foods in a way that increases energy levels and prevent fatigue. Anecdotally, FM patients have reported that eating small meals frequently vs. restricting themselves to 3 meals a day can keep blood sugar levels more even and prevent the “hypoglycemic lows.” A snack high in protein around 3pm can prevent mid-day fatigue.  Make sure your breakfast includes some protein and whole grains (again, assuming there is no gluten sensitivity). Focus on getting enough sleep and staying active during the day as these can also prevent fatigue during the day.
  6. Check on Your Supplements. Some supplements have significant side effects and can interact with medications. Talk to the prescribing doctor or pharmacist about this. For example, antidepressants and certain supplements can interact.
  7. Focus on Your Overall Well-Being. A multiple approach to managing FM symptoms works better than a single approach. Things like yoga, massage, and deep breathing exercises, as well as routine chiropractic treatments can improve the overall quality of life. Increasing the quality of life is the ultimate goal for managing the FM patient. Going to bed at a consistent time, not eating too late, and exercising regularly are key components.

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

Carpal Tunnel – Natural Treatment Options

Monday, November 19th, 2012

Carpal Tunnel Syndrome (CTS) is a condition characterized by pain, numbness and/or tingling in the hand. This includes the palm and the 2nd, 3rd, and half of the 4th finger, usually sparing the thumb. Another indication of CTS is weakness in grip strength such as difficulty opening a jar to even holding a coffee cup. CTS can occur from many different causes, the most common being repetitive motion injuries such as assembly line or typing/computing work. Here is a PARTIAL list of potential causes of CTS: heredity (a small sized tunnel), aging (>50 years old), rheumatoid arthritis, pregnancy, hypothyroid, birth control pill use, trauma to the wrist (especially colles fractures), diabetes mellitus, acromegaly, the use of corticosteroids, tumors (benign or malignant), obesity (BMI>29 are 2.5 more likely), double crush (pinching of the nerve in more than 1 place such as the neck and the carpal tunnel), heterozygous mutations in a gene (associated with Charcot-Marie-Tooth), Parvovirus b19, and others. Again, repetitive trauma is still the most common cause. It becomes quite clear that a COMPLETE physical examination must be conducted, not just evaluation of the wrist! Once the cause(s) of CTS has been nailed down, then treatment options can be considered.

From a treatment perspective, we’ve previously discussed what chiropractors typically do for CTS (spinal and extremity joint manipulation, muscle/soft tissue mobilization, physical therapy modalities such as laser, the use of a wrist splint – especially at night, work task modifications, wrist/hand/arm/neck exercises, vitamin B6, and more). But, what about using other “alternative” or non-medical approaches, especially those that can be done with chiropractic treatment? Here is a list of four alternative or complementary treatment options:

  1. Anti-inflammatory Goals: Reducing systemic inflammation reduces overall pressure on the median nerve that travels through the limited space within the carpal tunnel at the wrist. An “anti-inflammatory diet” such a Mediterranean diet, gluten-free diet, paleo-diet (also referred to as the caveman diet) can also help. Herbs that can helps include arnica, bromelain, white willow bark, curcumen, ginger, turmeric, boswellia, and vitamins such as bioflavinoids, Vitamin B6 (and other B vitamins such as B1 and B12), vitamin C, and also omega 3 fatty acids.
  2. Acupuncture: Inserting very thin needles into specific acupuncture points both near the wrist and further away can unblock energy channels (called meridians), improve energy flow, release natural pain reducing chemicals (endorphins and enkephlins), promote circulation and balance the nervous system. For CTS, the acupuncture points are located on the wrist, arm, thumb, hand, neck, upper back and leg. The number of sessions varies, dependant on how long the CTS has been present, the person’s overall health, and the severity of CTS.
  3. Laser acupuncture: The use of a low level (or “cold” laser) or a class IV pulsed laser over the same acupuncture points as mentioned above can have very similar beneficial effects (without needles)! One particular study of 36 subjects with CTS for an average of 24 months included 14 patients who had 1-2 prior surgeries for CTS with poor post-surgical results. Even in that group, improvement was reported after 3 laser treatments per week for 4-5 weeks! In total, 33 of the 36 subjects reported 50-100% relief. These benefits were reportedly long-term as follow-up at 1-2 years later showed only 2 out of 23 subjects had pain that returned and subsequent laser treatment was again successful within several weeks.
  4. Acupressure: Acupuncture point stimulation with manual pressure. These points can be self-stimulated by the CTS sufferer multiple times a day via deep rubbing techniques.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

How Chiropractic Help Headaches?

Monday, November 19th, 2012

Published on  under Headaches

 

Headaches are one of the most common reasons people seek chiropractic care. Many patients with headaches benefit significantly from adjustments made to the upper cervical region. So, the question is, how does adjusting the neck help headaches? To help answer this question, let’s look at a study that was recently published that examined this exact issue…

It’s been said that if one understands anatomy, determining WHERE the problem is located becomes easy. So, let’s take a look at the anatomy in the upper most part of the neck. In the study previously mentioned (http://www.ncbi.nlm.nih.gov/pubmed/21278628), the authors found an intimate relationship between the muscles that connect the upper 2 cervical vertebra (C1 and 2) together and their anatomical connection to the dura mater (the covering of the spinal cord). They identified this anatomical connection between the muscles that span between the back aspect of C1/2 and the dural connection as having a significant role in the development of headaches usually referred to as cervicogenic headaches.

There are several reasons why chiropractors adjust or manipulate the upper cervical vertebrae in patients with headaches. The obvious reason is simply because it helps to reduce the intensity, frequency and duration of headaches. The reason it works is this: If one or both of the upper 2 vertebrae (C1 and C2, also referred to as the atlas and axis, respectively) are either blocked or fixed and cannot properly move independently, then there is an abnormal change in the biomechanics in that region. Similarly, if one of the two vertebrae is rotated or shifted in reference to the other, a similar biomechanical “lesion” or problem occurs (often referred to as a “subluxation”). You can take all the ibuprofen, Aleve, Tylenol or other perhaps stronger, prescription medication for the headache, but it is not logical that the biomechanical problem at C1 and/or C2 is going to change by inducing a chemical change (i.e., taking a pill). All you’re doing is masking the symptoms for a while, at best.

Many people find that after a several chiropractic adjustments, their headaches are significantly improved. This is because restoring proper biomechanics to the C1/2 region reduces the abnormal forces on the vertebrae as well as any abnormal pull or traction of the posterior cervical muscles on the dural attachment. It has been reported that the function of this muscle/dura connection is to resist excessive movement of the dura towards the spinal cord when we look upwards and forwards. During neurosurgery, observation of mechanical stress on the dura was found to be associated in patients with headaches. In chronic headache sufferers, adjustments applied to this area results in significant improvement. There is no other treatment approach that matches the ability that adjustments or manipulation have in restoring the C1/2 biomechanical relationship thus, helping the headache sufferer. Another treatment option that has been shown to benefit the headache patient is injections to this same area. However, given the side effects of cortisone, botox, and other injectable chemicals, it’s clear that chiropractic should be utilized first. It’s the safest, most effective, and fastest way to restore function in the C1/2 area, thus relieving headaches.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

Low Back Pain and Sleep – Second Part

Monday, November 19th, 2012

Previous month, we discussed the relationship between sleep deprivation and low back pain (LBP) and found that LBP can cause sleep loss AND sleep loss can cause LBP. It’s a 2-way street! This month, we will look at ways to improve your sleep quality, which in return, will reduce your LBP. There are many ways we can improve our sleep quality. Here are some of them:

  1. Turn off the lights: Complete darkness (or as close to it as possible) is best. Even the tiniest bit of light in the room can disrupt your internal clock and your pineal gland’s production of melatonin and serotonin. Cover your windows with blackout shades or drapes.
  2. Stay cool! The bedroom’s temperature should be ≤70 degrees F (21 degrees C). At about four hours after you fall asleep, your body’s internal temperature drops to its lowest level. Scientists report a cooler bedroom mimics your body’s natural temperature drop.
  3. Move the alarm clock. Keeping it out of reach (at least 3 feet) forces you to get out of bed and get moving in the AM. Also, you won’t be inclined to stare at it during the night!
  4. Avoid loud alarm clocks. It is very stressful on your body to be suddenly jolted awake. If you are regularly getting enough sleep, an alarm may even be unnecessary.
  5. Reserve your bed for sleeping. Avoid watching TV or doing work in bed, you may find it harder to relax and drift off to sleep.
  6. Get to bed before 11pm. Your adrenal system does a majority of its recharging between the hours of 11 p.m. and 1 a.m. and adrenal “burn-out” results in fatigue and other problems.
  7. Be consistent about your bed time. Try to go to bed and wake up at the same times each day, including weekends. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning.
  8. Establish a bedtime routine. Consider meditation, deep breathing, using aromatherapy, or essential oils, or massage from your partner. Relax and reduce your tension from the day.
  9. Eat a high-protein snack several hours before bed to provide the L-tryptophan needed for your melatonin and serotonin production.

There are other “tricks” that ensure a good night’s rest that we will continue with next month as this is a VERY important subject and can literally add years to your life and life to your years.

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 presently and, in the future.