Archive by Author

Fibromyalgia and Foot Orthotics.

10 Feb

Fibromyalgia (FM) is a condition that (typically)  evolves slowly over time and often occurs for no apparent reason. The diagnosis is usually made by excluding other conditions leaving you with a diagnosis that in the absence of anything else, “….must be fibromyalgia.” Of course, the problem with that approach is that we all want to know, “…what caused this problem to start with?” In the end, we typically have to accept the fact that, “…it just did,” and move on to, “…now what are we going to do about it?”

A multi-disciplinary (involving several different types of doctors and approaches) treatment approach has been found to work well with Fibromyalgia patients. This approach may include medications from a primary care doctor who is aware and sensitive to this potentially disabling condition, massage therapy from a muscle relaxation point of view, clinical psychology when the stresses associated with FM become overwhelming and out of control, and chiropractic to quarterback joint mobility, diet management, exercise training, modality use, as well as offering foot orthotics. Coordinated care effort utilizing several disciplines is what is reported to be the most successful approach.

Because chiropractic embraces the concept of treating the whole person, this premise fits perfectly in the treatment plan for the FM patient since the entire body is considered, not just a specific area or system. In this approach, we assess posture, movement, alignment, and function and implement treatments to improve each of those areas.

During the postural assessment, because we are a 2-legged species, the feet must be carefully assessed for function and alignment. If you watch people walk, you will often see their ankles roll in with each step and for some, this can be quite dramatic where the ankle rolls in almost hitting the floor. What’s interesting is that most people don’t even know they are doing it! The truth is, most people with flat feet (technically called pes planus) and rolling-in ankles (or, ankle pronation) don’t have any foot pain or symptoms associated with the altered function. In fact, people with very high arches (pes cavus) usually have more foot pain than the flat footed person. If you look at shoes of those of us who pronate (which is about 80% of us), the wear pattern is usually quite excessive on the outer corner of the heel. Sound familiar? It is very common! So, why bother “fixing” ankle pronation if it doesn’t hurt? The answer is that biomechanical function is altered and it negatively affects the rest of the body quite significantly. Here’s what happens. When the ankle rolls in, the knee has to “knock” inwards, the hip has to impinge inwards, the pelvis on that side drops and the spine has to compensate for the pelvic drop and bend away from that side. Watch the shoulders and head sway back and forth as the pronated/flat footed person walks the next time you’re walking at the grocery store, mall, or airport.

So, how does the use of foot orthotics help the FM patient? It has been reported that it takes up to seven times more energy to walk when the ankles pronate excessively. Chronic fatigue is a frequent complaint in the FM patient, and the less energy expended from walking, the more energy will be left over for other daily tasks. Also, the biomechanical stresses on the ankle, knee, hip, and spine will be smaller from wearing foot orthotics, correcting the excessive side-to-side strain on the various joints. The journal Clinical Rheumatology recently reported a significant benefit when foot orthotics were used in the treatment of FM. The bottom line is that this is a VERY SIMPLE FIX and when so much of FM is so difficult to treat, this a no brainer!

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

 

Neck Pain and Our Pillow!

10 Feb

The relationship between neck pain and our pillow is more important than most of us realize! Though we all may have at one time or another slept on a variety of surfaces, and used any number of pillows (flat, medium, bulky) made of different materials (foam, feather, air, water, or memory foam), it’s usually not until neck pain and/or headaches start to become an issue that we start to think, “…how important is my pillow?” Thankfully, the question has been addressed in a randomized peer-reviewed study. So, what did they find out?

The goal of a pillow is to support the neck more so than the head. In a study headed by Dr. Liselott Persson, MD, of the department of neurosurgery at the University of Lund in Sweden, researchers tested whether specific neck pillows have any effect on neck pain, headache and sleep quality in people suffering with chronic (>3months), non-specific neck pain. They also researched whether there was an optimum or “best” type of pillow that was preferred by their 52 patient group. They used 4 different pillows, 1 “normal” pillow and 3 of which were specially designed, each having a different shape and consistency. Over a 4-10 week time frame, the pillows were randomly distributed to the neck pain group who then graded them according to comfort, the effects on neck pain, sleep quality and headache using a questionnaire, and also described the characteristics of an “ideal pillow.” Researchers and participants concluded the “ideal pillow” (for reducing neck pain and headaches and improving quality of sleep) includes a soft pillow with good support under the neck’s curve (lordosis).

There are many styles of contoured cervical or neck pillows that vary considerably. This study supports the use of a specially designed style over a normal pillow. So what are some of the things to look for? First, consider your neck’s length and girth.  When you look in a mirror, do you have a neck that is short vs. long or, narrow vs. wide? This will direct you to a pillow that has a larger “hump” for your neck to be cradled in if it’s a long neck and, the height of the hump – taller for the slender neck or, shorter for the wide neck. Some pillows have 2 options of “hump” sizes (located on the long edges of the pillow) – one short and flat and the other side taller and wider. Others recommend lying in the middle of the pillow if you’re a back sleeper vs. lying on the edge of pillow when sleeping on your sides. A measurement taken from the neck to the point of the shoulder determines if the pillow should be a small, medium, or large. Water filled and/or air filled pillows can be varied by the amount of water or air added. The bottom line of which is “best” is based on comfort and support. Regardless of which you choose, it can take several days to get used to the new pillow, so we recommend using the pillow for at least 1 week. By then, you’ll know if you chose the right style.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck 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.

 

Whiplash and Side Collisions.

10 Feb

Whiplash is most commonly studied when it is a result of a rear collision where the occupant of the vehicle is injured  from a flexion (forwards) and extension (backwards) whip-like mechanism of injury, but what happens when a T-bone type of impact occurs?

The answer to this question is quite similar to many of the factors associated with any collision: the size of the bullet vs. target vehicle, the speed at which the collision occurs, the deployment or lack thereof of the airbag(s), the position of the neck at the time of impact, the “build” of the patient (skinny/tall vs. muscular), the road conditions, the “springiness” and angle of the seat back, and so forth. Unique to side impacts is the location of the strike to the target vehicle (front, middle, rear) and perhaps more importantly, the lack of space between the occupant and the point of the strike as there is a relatively shallow “crumple zone” between the occupant and the side of the vehicle.

Probably one of the best examples of how side impacts from different angles can be appreciated is to think about what happens to a person when they ride the “Bumper Cars” at the local fair. Though many fairs have now banned that “ride,” you may recall participating or watching those kids who were “having fun.” When a bumper car is struck in a classic “T-Bone” manner in the front end, the target car is spun around and the occupant hangs on for dear life. Similarly, a side strike from to the rear of the bumper car spins the back end around. When the occupant is aware of the impending crash, they grip the wheel, tuck their head by shrugging their shoulders and make their body rigid and typically, do not get “whipped around” as much as those that don’t anticipate the impact. Because the bumper cars don’t dent or crush (that is, there is no plastic deformity where damage occurs, only elastic deformity where there is no damage or, no energy absorption by crushing of the car), ALL of the crash energy is transferred to the occupant or the contents. If a person has a purse lying on the floor of the bumper car, it can go flying out and spill all over. Similarly, the person who is unaware of the impending collision will “go flying,” giving great satisfaction to the driver of the bullet bumper car.

When considering factors such as plastic vs. elastic deformity, side air bags, and the shallow crumple zone on the sides of motor vehicles, some manufactures stand out in their ability to protect the occupants in side impact collisions. Generally, those vehicles with a stiff side and roof structure have been found to be the best in protecting the occupant from injury by maintaining the survival space and dissipating the energy, or force, of the impact away from the occupant. Manufactures that stand out include Volvo, Mercedes, and Subaru. They have had the best design for decades and remain at the forefront for occupant protection in side impact collisions. The combination of energy absorbing side structure design and the side airbag has proven to be one of the most important factors in improving the crashworthiness in side impact collisions. Side air bags became popular in the 1990s. In 2012, more than 95% of all passenger cars sold in the US are equipped with side impact airbags as standard equipment.

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.

 

Low Back and Obesity Part 2.

10 Feb

Losing weight can dramatically reduce low back pain (LBP). Like last month, we will look at easy ways to lose weight without the need for fancy, hard to follow diets. As the saying goes, this is a “no-brainer.”

Alcohol hints. When consuming alcohol, follow the first beverage with a glass of water. This will reduce calories and often reduces unhealthy snack intake such as chips or nuts.

Go “green” as in tea! Studies show green tea can “rev up” calorie burning.

Try Yoga! According to the Journal of the American Dietetic Association, women who do Yoga tend to weigh less. Plus, yoga is  calming and promotes self-awareness!

Eat at home. According to Consumer Reports, eating at home at least 5 days a week was a top habit of “successful losers.” Emphasize foods like fruits and vegetables!

Chew strong mint gum! Studies have shown a strong flavored sugarless gum can curb your risk for a snack attack. Chewing gum is a great substitute for “mindless eating” when socializing, watching TV, studying, or working on that computer project.

Shrink your dishes! By choosing a 10” vs. 12” plate, the amount eaten automatically reduces by 100-200 calories a day (according to Cornell University research)!

The “80-20 rule.”  Eating until you are 80% full vs. 100% can be accomplished 2 ways: 1. Stop eating at the 80% full point or, 2. Dish out 20% less food.

Eating out options: A. Split an entrée with a friend; B. Order an appetizer as a meal; C. Use a small plate; D. Have them pack ½ the meal into a “doggie bag” BEFORE serving it and order a salad or extra veggies to substitute for the other half.

Reach for Red Sauce: Choose marinara over Alfredo sauce as it has fewer calories and much less fat than cream-based sauces. A serving = the size of a tennis ball.

Go meatless more often. Consider bean burgers, lentil soup, veggies and fruit and when you have to have meat, make it a lean variety, remove the fat, and cook in olive oil.

Burn 100 calories by doing one of the following: A. Walk a mile, or about 20 minutes; B. Pull weeds or plant flowers for 20 minutes; C. Mow the lawn (walking) for 20 minutes; D. Clean the house for 30 minutes; E. Jog for 10 minutes.

CELEBRATE! Once you’ve successfully kicked the habit of soda, ice cream or other “calorie-poor” foods, be PROUD of your accomplishment! You’ve also improved your quality of life, longevity, and reduced your chances of developing diabetes, heart disease and other health issues. PLUS, you’ll feel better!

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.

 

Carpal Tunnel Syndrome – A Yoga Class!

3 Feb

Carpal Tunnel Syndrome (CTS) is a very common problem that affects many people. In fact, the US Bureau of Labor Statistics reports about 28,000 CTS cases per year and because so many sufferers jump to a surgical option, it’s become THE LEADING CAUSE of lost workdays in the United States. Women are 71% more likely more likely to develop CTS than men!

In a review of over 31,000 cases, women spent an average of 30 days off work because of CTS. Jobs most commonly affected include: production workers in food processing and clothing manufacturing, typists who work at keyboards for hours on end, and construction workers who use tools that vibrate, such as jackhammers or tools that have poorly designed handles. The Journal of the American Medical Association recently estimated that almost 3 percent of adults in the United States may suffer from Carpal Tunnel Syndrome at some point in their lives.

Now that we’ve learned how susceptible we are to CTS, what are some things you can do to decrease your chances of acquiring Carpal Tunnel Syndrome? For starters, keep your weight reasonable (Body Mass Index between 19 and 25), take “mini-breaks” during the repetitive work day, and receive chiropractic treatments aimed at releasing the tight muscles in the neck, shoulders, upper arms, forearms, hand and adjusting the associated joints.

You can also stretch! There are many different types of stretches that should be considered. Feel free to watch the entire 37-minute YouTube video at the link below that addresses many exercises that may help:

http://tinyurl.com/CTSYOGA

(CTSYOGA is ALL CAPS)

As you perform these various stretches, take deep breaths, “feel” the different fibers of muscles stretch and keep the intensity, “…within reasonable pain boundaries.” That is, a “good hurt” is what you’re striving for here, no sharp pain is allowed!

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.

 

3 Steps To More Active & Healthier Kids.

3 Feb

The Most Important Principles For Staying Young: 

3 Steps To More Active & Healthier Kids

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

Our basic premise is that your body is amazing:  You get a do over: it doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course in what to do so it becomes easy for you, and for you to teach others. We want you to know how much control you have over your quality and length of life.

Believe it or not, in the United States only 6% of middle and high schools provide daily physical education (PE) for everyone, and 20% of elementary schools have abolished PE altogether.

We want everyone to realize physical education reduces stress and calms kids, making them happier and more attentive in the classroom. Physically fit kids are more likely to skip risky behaviors. PE is also the best way to battle obesity (30% of all teens) and type 2 diabetes (21% more kids have type 2 now than in 2001), which threaten children’s heart health even while they’re young.

Now, the summer is a great time to start a year-round plan for getting your kids active. You’ll establish habits for life-long good health.

Step One: Get yourself off the sofa and away from the computer! Active parents have kids who are 5 to 6 times more physical than children of couch-potatoes.

Step Two: Plan all-season family activities: Walk for 45 minutes after dinner; take kids to a swim club twice a week; go on weekend hikes; garden or do tasks around the yard!

Step Three: Make it a community effort. Call teachers, neighbors, and the parents of your kids’ friends. Even if your kids go to a private school, the health of your community may depend on it.  Plan activities together, and lobby that school board to get PE back into your school!

Thanks for reading,

Young Dr Mike

NOTE: You should NOT take this as medical advice. 

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.