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Statins – What You Need to Know!

26 Feb

Patients frequently obtain chiropractic services for aches and pains associated with their muscles and joints. In fact, some of the most common diagnoses chiropractors make are “sprains and strains” of the neck, back, and extremities. So, how does this fit in with the use of statin medications?

Statins are a group of medications frequently prescribed to lower cholesterol, particularly LDLs (low density lipoproteins) – the “bad” cholesterol. Not long after FDA approval was granted in 1987, patients taking the new statin medications began complaining of muscle pain, sometimes so severe that the pain remained permanent after they stopped taking the medication. A recent study offers NEW EVIDENCE that statins are linked to “skeletal adverse events,” NOT just muscle aches and pains. Researchers found that statin users are up to two times more likely to receive a diagnosis of musculoskeletal disease (including degenerative joint disease or osteoarthritis) than non-statin users. This is of great concern especially in reference to the recent recommendation that statins should be prescribed to PREVENT cardiovascular disease in young healthy patients! This recommendation has the potential to significantly increase the number of people taking statin medications even though studies show NO significant benefits when statins are prescribed to members of a healthy population! With this anticipated increase in statin use, a 20-25% increase in patients presenting with musculoskeletal side effects such as muscle pain and/or bone/joint pain is likely. Since these complaints frequently drive patients to chiropractic physicians, it is VERY IMPORTANT that both patients and doctors are aware of these relatively common side effects.

Common symptoms/conditions associated with taking statins can vary considerably, making the association between the two difficult to determine in some cases. These include (but are not limited to) myopathy (muscle pain, weakness, cramps), liver damage, autoimmune muscle disease (rhabdomyolysis), tendinous diseases (like tennis elbow, shoulder, or knee tendonitis), cataracts, kidney failure, cognitive impairment, impotence, and diabetes mellitus. Here are some interesting facts about cardiovascular disease (CVD): 1) CVD is one of the most misdiagnosed and mistreated conditions in medicine; 2) Eating cholesterol and saturated fat does NOT increase the risk of heart disease; 3) It’s NOT the amount of total cholesterol or LDL in the blood that drives heart disease risk but rather, the number of LDL particles (LDL-P); 4) It is a myth that statin drugs save lives in healthy people without heart disease and in this group, the side effects associated with statins are far more potentially dangerous and quality-of-life altering.

There is evidence that statins benefit those with pre-existing heart disease to some extent. In a 2010 large meta-analyses regarding statin use in those with pre-existing heart disease who took statins for five years, Dr. David Newman noted the following: 1) 1.2% (1 in 83) had their life span extended (were saved from a fatal heart attack); 2) 2.6% (1 in 39) were helped by preventing a repeated heart attack; 3) 0.8% (1 in 125) were helped by preventing a stroke; but, 4) 96% saw NO benefit at all; 5) 0.6% (1 in 167) likely developed diabetes because of statin use; 6) 10% (1 in 10) experienced muscle damage related to their statin use. As noted in points one through three, there are some benefits, but at what risk? The study also reported that in men or women over age 80, regardless of their cardiovascular health, statins did not extend their life span. The objective of discussing this subject is to inform the reader that you have choices, and it’s wise to discuss both the benefits and risks with your primary care physician prior to taking a statin.

We realize you have a choice in whom 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 requires care, we would be honored to render our services.

Lose Weight with Potatoes?

24 Feb

Potatoes (and other carbohydrates) have gotten a bad rap in recent years. Now, newly published research claims they can help you lose weight. Well, sort of. According to researchers at McGill University, a potato extract may help limit weight gain from a diet that is already high in fat and refined carbohydrates. The study was done on mice that were fed an obesity-inducing diet for ten weeks. Some of the mice were also fed a potato extract. The mice fed the potato extract gained less weight.

Here are a few things that are important… The extract comes from 30 potatoes. Obviously, attempting to eat 30 potatoes a day would not achieve the same results (due to the large amount of calories) and is not advisable. That’s why an extract was used. But there is a bigger issue: This potato extract was tested on mice eating diets high in fat and refined carbohydrates. A much better solution would be to stop eating that sort of low-quality diet. The answer is not to eat poorly and hope that a supplement or drug will solve your problems. The answer is to eat right in the first place. The study said the mice taking the extract with the poor diet gained LESS weight. This means they still gained weight. There are no good shortcuts to losing weight and staying healthy. Making the decision to eat right and exercise for the rest of your life is the only real solution.

Whiplash and PTSD

23 Feb

Whiplash injuries commonly result from motor vehicle collisions (MVC) and are caused by a sudden jolt that initiates a startle response that has been found to tighten the muscles deep inside the neck, which has been reported to increase the risk of injury to the joints and structures of the cervical spine. The amount of physical injury to the person is highly variable depending on many factors that include, but are not limited to, the size of the involved vehicles, speed at impact, amount of energy absorbed by crushing metal (especially the lack thereof), a slender female neck vs. shorter muscular male neck, the stiffness and angle of the seat back, the direction of the impact, head position (rotation is worse vs. straight), headrest position, and more. A cervical sprain/strain is commonly diagnosed in MVCs and these tend to resolve with chiropractic care, often without complications. However, this is not always the case. What factors are involved that result in one case improving and/or resolving but not another, especially when everything seems identical (or at least similar)? What does post-traumatic stress disorder (PTSD) have to do with MVCs? Is this a factor triggering a prolonged recover? Is PTSD commonly associated with whiplash injuries?

In a group of 112 PTSD whiplash patients, researchers examined the role of pain as well as pain-related psychological variables. Participants completed various questionnaires at three different time points after admission into a standardized multidisciplinary rehabilitation program. The findings revealed consistency with other studies showing injury severity indicators including high pain levels, reduced function / disability, and more severe scores on pain-related psychological variables in those suffering from PTSD following a whiplash injury. However, contrary to expectations, pain severity did NOT contribute to the persistence of PTSD. Rather, the most significant variables were self-reported disability, catastrophizing, and perceived injustice. These results suggest that early intervention that focuses on pain management and disability following whiplash might reduce the severity of PTSD but not the persistence of it. Rather, interventions that focus on resolving perceptions of injustice appear to be most important for helping patients recover from PTSD.

Similarly, another study looked at the factors that result in the best treatment outcome for patients involved in motor vehicle collisions (MVCs) with the subsequent onset of PTSD. Here, researchers carried out a review of prior studies to identify the risk factors associated with a prolonged recovery and a treatment strategy proposed to resolve the PTSD. They reported that at least 25% of study participants who sustained a physical injury developed PTSD and that the prevalence is most likely even higher in those who developed chronic whiplash.

Looking at what factors of PTSD are the most accurate predictors of duration and severity of PTSD, another study investigated the relationship between PTSD symptoms of avoidance, re-experience, and hyperarousal and their role in interfering with the resolution, the severity and duration of neck complaints following MVCs. Questionnaires were sent to 240 MVC injured patients that had initiated compensation claims with a Dutch insurance company and were evaluated three times – initially, at six months, and again at twelve months. They found that the hyperarousal symptoms of PTSD initially had predictive validity for persistence and severity of post-whiplash syndrome at six and twelve months. They concluded that the hyperarousal symptoms of PTSD had the greatest detrimental effect on the severity and recovery of PTSD and focusing treatment at that was most important.

We realize you have a choice in whom 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 requires care for Whiplash, we would be honored to render our services.

Neck Function and Balance

19 Feb

In the nervous system, there are three primary areas that regulate our balance: the cerebellum (located in the back of the brain), the dorsal columns (located in the back of the spinal cord), and the inner ear (the “vestibular” part of our cranial nerve VIII). There are also small, microscopic “proprioceptors” or mechanical receptors located in our joint capsules, muscles, and tendons that relay information to the brain and work hard to keep us upright when we walk, run, and play!

Conditions that can result in balance problems include, but are not limited to, BPPV (Benign Paroxysmal Positional Vertigo), spinal stenosis (narrowing of the spinal canal where our spinal cord is located), dorsal column disease, cerebellar lesions, and/or circulation loss into the back of the brain. Other conditions associated with light headedness include low or high blood pressure, hydration, medications, postural or orthostatic hypotension, diabetes, endocrine disorders, hyperventilation, heart conditions, and vasovagal syncope. However, issues with BPPV/inner ear are the most common reported cause of dizziness. Emergency actions should be exercised when dizziness is associated with chest pain, shortness of breath, or palpitations. If eating helps resolve the dizziness, blood testing for hypoglycemia is appropriate. If confusion, memory lapses, changes in speech, facial droop, weakness on one side of the body, or acute headache occur, these could be signs of a stroke or a brain bleed or tumor and should be quickly evaluated. If ANY of these signs or symptoms is present, we will refer you to the appropriate specialty for further evaluation.

The upper cervical spine has also been found to affect balance, and it’s a primary area of treatment that we as chiropractors focus on when patients complain about balance dysfunction. Unique to this upper cervical region is the fact that the nucleus of cranial nerve V (the trigeminal nerve) extends down the spinal canal to the C2 level and adjustments in this region can have significant benefits for several other conditions, including trigeminal nerve problems as well as BPPV (inner ear dysfunction such as dizziness) where small crystals dislodge from the ampulla of the semicircular canal and interfere with the flow of fluid inside the canal with resulting dizziness. Adjustments and the BPPV exercises (Epley’s and / or Brandt-Daroff) significantly benefit this cause of dizziness. You can depend on our evaluation to determine if chiropractic is the right choice in managing your balance disturbance!

We realize you have a choice in whom 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 requires care for neck pain, we would be honored to render our services.

Are You Drinking Enough Water?

17 Feb

Throughout each day, your body loses water through your urine, exhalation, and sweat glands – even when you’re not purposely working up a sweat. As a result, you have to drink water to constantly replenish this fluid. No, coffee and soft drinks do not count toward this requirement. Both coffee and soda are high in caffeine, which act as a diuretic that will dehydrate you. Worse yet, sodas, fruit juices, and other sweetened beverages are loaded with sugars that could negatively impact your health. So, the key is to drink pure water. Once your body has lost 1-2% of its total water content, it will signal its needs by making you feel thirsty.

Besides listening to your thirst, a good rule of thumb is to look at the color of your urine. In most cases, you want to drink enough water to turn your urine a light-colored yellow (if it’s clear, you may be drinking too much water). Also, Riboflavin (vitamin B2, which is also found in most multi-vitamins) will turn your urine a bright, almost fluorescent yellow. So, if you’re taking supplements containing B2, it may be more difficult to judge hydration by the color of your urine. Frequency of urination can also be used to judge your water intake. If your urine is scant or if you haven’t urinated in several hours, that too may indicate you need to drink more water.

Commonly Asked Questions about Fibromyalgia

16 Feb

WHAT IS FIBROMYALGIA? FM is a relatively common chronic disorder where widespread pain, diffuse tenderness, and potentially a host of other symptoms may be present. The word “fibromyalgia” is derived from the Latin term “fibro” (fibrous tissue) and the Greek term “myo” for muscle and “algia” for pain. Even though FM is often described as an arthritis-type of condition, it does NOT cause inflammation of the joints, muscles, or other tissues as is observed with some types of arthritis. However, FM does “look” like arthritis in that FM can cause significant pain that can interfere with a person’s tolerance to daily activities, including work.

WHO GETS FM? It has been reported that FM affects five million Americans ages 18 and older. For unknown reasons, between 80-90% of those affected are women, but men and children can also develop FM. Most people are diagnosed during their middle years. Several studies have reported that women with a positive family history of FM are more likely to develop FM, but it remains unclear if this is from a shared environment vs. a true heredity issue, or both. Currently, researchers are looking at variations in certain genes that cause some people to be more sensitive to stimuli, which may lead to pain syndromes like FM. People with rheumatic diseases (such as rheumatoid arthritis, lupus, or ankylosing spondylitis – a special type of spinal arthritis) may be more likely to have FM as well.

WHAT CAUSES FM? Even though no one REALLY knows why some people develop FM and others do not, we have learned that FM is linked to the central nervous system. There are two types of FM: Primary (no known cause) and Secondary (occurs with a known underlying condition). Secondary FM has been associated with a physical/emotional stress or traumatic event such as a motor vehicle accident, and some develop FM after sustaining a repetitive motion injury or after an illness. In primary FM, it seems to develop spontaneously with no known cause or associated condition.

HOW IS FM TREATED? Treatment is challenging as not all doctors are familiar with FM and may not even “believe” it’s real (they may think it’s depression or all in the patient’s head). It is therefore BEST to find a “TEAM” of healthcare providers knowledgeable about FM and willing to work with you. This team may include primary care doctors, chiropractors, physical therapists, clinical psychologists, and perhaps rheumatologists, among others. Massage therapists, acupuncturists, and nutritional therapists can also be part of the multi-dimensional treatment approach. However, the MOST important team member is YOU because keeping track of sleep hours, exercise amounts, diet, and knowing when to rest are critical for a good treatment outcome. You can guide us in finding care that works, what doesn’t, and at what “dose” feels best for you. Focusing on “control” rather than “cure” is important so you do not get too discouraged during the treatment process.

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

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