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Common Whiplash Myths – Part 2.

15 Jan

Last time, 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 dependant 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.

 

Common Whiplash Myths.

15 Jan

Whiplash is most commonly associated with the rapid, uncontrolled movement of the head as it whips back and forth during a motor vehicle collision. Though different types of injuries are associated with rear vs. front vs. side collisions, the net result is similar: the neck hurts! This month, we will look at several “myths” or untruths associated with the cause of whiplash or WAD, whiplash associated disorders.

MYTH #1: MEN ARE MORE VULNERABLE TO INJURY BECAUSE OF THEIR GREATER NECK MUSCLE MASS: FACT: This is exactly the opposite! Women are more vulnerable because they have LESS muscle mass, and hence, less tissue stopping the neck from going through a greater range of motion during the “crack the whip” process. Woman with long, slender necks are especially more vulnerable. They also take longer to recover and are more likely to suffer permanent residual problems long after their case settles.

MYTH #2: YOU CAN’T HAVE A CONCUSSION UNLESS YOU HIT YOUR HEAD: This seems logical as most concussions occur from direct head trauma. However, during the whiplash process the brain, which is suspended by ligament-like structures inside the skull, bathed in a liquid, can literally smash into the inside wall of the skull resulting in concussion just from the whipping action, without hitting anything. Permanent residuals such as memory problems, articulating thoughts, staying on task, and more can result. This is often called “post-concussive syndrome” or “mild traumatic brain injury.”

MYTH #3: NEGATIVE X-RAYS MEANS NO INJURY: Often, in the ER after a motor vehicle collision, x-rays are taken and read by the radiologist as “…essentially normal.” This can be confused as meaning, “…then there was no injury.” X-rays only show the bones in the neck and head region, not the muscles, tendons, ligaments or nerves. MRI (magnetic resonant imaging) shows more of these “soft tissues,” not just bone. But, due to the high costs of MRI, x-rays are performed first, and only later, if symptoms warrant it, is an MRI ordered. Soft tissue injury to the ligaments (the tissues that strongly hold bone to bone) can be assessed when we take flexion / extension (or bending forwards & backwards) x-rays, but many times these are not ordered in the ER.

MYTH #4: REST AND TIME ALONE WILL HEAL WHIPLASH: Though time for healing plays a role in recovery following all injuries, many patients find this approach fails and their pain persists. In fact, studies suggest that mobilization and manipulation performed as soon as possible after a whiplash injury yields significantly better outcomes than wearing a cervical collar and not moving the neck. Whiplash injuries, when not properly treated, often results in permanent loss of motion, pain, headache, and more. The days of rest and time only should be replaced by the sports medicine model of hot/cold packs, modalities such as interferential, pulsed magnetic stimulation, light or laser therapy, manipulation, massage, traction and guided exercise. Not, “…wait and watch.”

Tune in next month for addition myths about whiplash as there are MANY! Rest assured that prompt chiropractic care is the best approach for treatment of the whiplash injured patient.

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.

 

The Healing Secrets of Ethnic Cuisine.

15 Jan

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.

This month, I wanted to reemphasize something that tastes really good—ethnic foods. What do spicy Indian curry, zesty Italian pesto, refreshing Spanish gazpacho, and Mexican chocolate-rich mole sauce have in common? They’ll all get your taste buds dancing, and bring you more gold than Michael Phelps. Tasty ethnic cuisine all-stars like these deliver a heap of phytonutrients that make you younger by avoiding cancer, heart disease, high blood sugar, dementia, and more. Benefits like these are just another great reasons to visit your city’s summertime street fairs and make liberal and creative use of the herbs and spices hiding in your kitchen cabinet.

Don’t just eat ethnic sometimes — sprinkle more of this good stuff on the foods you munch every day.  How? Think outside the box, like Dr. Mike does (me). I dust steamed broccoli with cinnamon and spreads yellow mustard (a great source of the super-healthy spice turmeric) on everything from celery to grilled salmon, and whole-grain pasta!

Giving your spice rack a work-out is just as brilliant as eating fruit and veggies. Take oregano.  Prized in Italian and Greek cuisine, these tasty little leaves boast 30 times more polyphenols than potatoes, 12 times more than oranges, and 4 times more than blueberries. You’d never munch a bunch of oregano that’s as big as a potato, but even a pinch packs a wallop. A tablespoon of fresh oregano’s got as much antioxidant power as a medium-sized apple!

Here’s the lowdown on other herbs and spices that punch up the flavor of popular ethnic cuisine, along with ways you can use them to get healthier as you spice up whatever you’re cooking tonight.

Turmeric:  The compound curcumin, found in yellow mustard (not so much in brown mustard, as that has real mustard seed.. but there’s true value in its less expensive yellow imitation).  Turmeric and curry powder have anti-inflammatory, antiviral, antibacterial, and antifungal properties, and may offer protection from cancer, diabetes, arthritis and Alzheimer’s disease. It is a premiere flavor in Indian cuisine and you can use it on veggies, sautéed chicken, or salad dressing.

Cinnamon: A compound in this tasty spice called hydroxychalcone makes receptors on cells work better, so your body absorbs blood sugar more easily. Getting ½ to 1 teaspoon a day, sprinkled on food, could lower blood sugar 10 points.It’s a favorite in German baked goods and Greek main dishes like hearty moussaka. Cinnamon is also delicious on oatmeal, in hot cocoa, and sprinkled on fresh fruit, like apples and bananas.

Ginger: This popular flavor in Thai cuisine may also cut your odds for inflammatory diseases like arthritis, as well as cancer and migraine headaches. You can also eat some if you’re prone to motion sickness or are nauseous, too. Try grated fresh ginger in salad dressings and shake powdered ginger into whole-grain muffins.

Garlic: Munching a clove a day could help lower your cholesterol by as much as 9%. Garlic contains tons of tangy compounds that may help protect against cancers of the breast, stomach, colon, esophagus, and pancreas — and soothe high blood pressure a bit, too. Garlic’s a favorite from Scandinavia to Spain and China. Use it to spice up veggies, fish, and your next pan of brown rice. It seems to make everything taste better (you could even try it on fruit and all veggies).

Rosemary: A top seasoning in Mediterranean cooking (the French roast it with almonds, the Italians add it to herb mixes), rosemary’s antioxidant capabilities make it a must for 21st-century grill masters. Adding this herb to meat, fish, and veggie marinades before grilling reduces cancer-causing compounds, called heterocyclic amines, by up to 80%.

So, use spices to keep your body and brain younger and watch the Dr Oz show for more spicy tips.

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.

 

 

 

Carpal Tunnel Syndrome – Natural Treatment Options.

15 Jan

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:

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.

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.

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.

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.

 

Low Back Pain and Sleep -(Cont).

15 Jan

Last 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:

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.

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.

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!

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.

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.

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.

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.

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.

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.

 

Fibromyalgia, Sleep and Restless Leg Syndrome.

13 Jan

Fibromyalgia (FM) and sleep dysfunction seem to go hand in hand. In fact, most people who have FM complain of problems associated with sleeping. Sleep problems can include difficulty falling asleep with or without waking up one to multiple times a night. Also, the inability to reach “deep sleep” results in waking up un-restored. People with fibromyalgia frequently state, “… I feel exhausted when I wake up; I have no energy.” They often feel more tired in the morning, and many go back to sleep during the day to ease their fatigue. Another common FM complaint is having great difficulty concentrating during the day, often referred to as, “…fibro fog.” Other sleep disorders such as sleep apnea and restless leg syndrome are also often associated with FM.

Restless legs syndrome (RLS) is a neurologic disorder that is characterized by an overwhelming urge to move the legs at rest, thus interfering with sleep. Restless legs syndrome is more common among those who have fibromyalgia. Patients with RLS describe this as an unpleasant sensation in their legs and sometimes their arms or other parts of the body accompanied by the irresistible urge to move the legs in attempt to relieve the sensation. The terms, “itchy” or “pins and needles” or “creepy crawly” are frequently used when describing the sensations and can range from mild to intolerable. Symptoms are typically worse at rest, especially when lying or sitting and frequently results in sleep deprivation and stress. The intensity of the symptoms can vary, frequently worse in the nighttime, better in the morning. RLS may affect up to 10% of the population in the United States, especially women, and can affect both young and old, even young children. The severe cases usually affect the middle-aged or older and account for about 2-3% of the 10% incident rate. The diagnosis is often delayed, sometimes for 10-20 years. Although the cause is not clearly described, genetics seems to play a role given about 50% of those affected have a family member with the condition.

Other conditions often associated with RLS include iron deficiency, Parkinson’s disease, kidney failure, iron deficiency, diabetes and peripheral neuropathy. Treatment applied to these conditions often indirectly helps RLS resulting in sleep quality improvement. Medications such as anti-nausea drugs, antipsychotic drugs, some anti-depressants, and cold/allergy medications that contain antihistamines can worsen symptoms. Pregnancy can also trigger RLS, especially in the last trimester. It commonly takes about 3-4 weeks for the symptoms to quiet down after delivery. Other factors that affect RLS include alcohol intake and sleep deprivation itself. Improving sleep and/or eliminating alcohol can be quite effective treatment strategies. There are no medical tests that confirm the diagnosis of RLS, but blood tests can at least rule out other conditions, and when all the tests are negative, the diagnosis is made based on a patient’s symptoms, family history, medication use, the presence of an interrupted sleep pattern with daytime fatigue, and knowledge about the condition.

Treatment utilizing chiropractic management has been reported to be effective in managing RLS associated symptoms including the use of spinal manipulation, muscle release techniques, exercise training, and at times, physical therapy modalities. Nutritional approaches that emphasize muscle relaxation have also been reportedly helpful.

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

 

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