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Surgery for Neck and Arm Pain?

25 Jan

We in the healthcare management world are all biased. If a patient with neck and arm pain presents to chiropractic clinic, the doctor of chiropractic will usually recommend a non-surgical trial of care as long as “red flags” don’t exist (that is, “bad” things like bowel/bladder weakness, rapidly worsening symptoms, and a few others). Frequently, the patient asks, “…should I just have the surgery…am I just postponing the inevitable?” Here’s what we know…

In a 2015 study addressing this very question, the authors compared a non-surgical physical therapy approach using neck-specific general exercises, pain relief, coping strategies, and improving self-management strategies against surgical treatment (ACDF – anterior cervical decompression and fusion) with post-surgical physical therapy. Twelve months following the conclusion of treatment, they found 87% of the 31 patients in the surgical group reported a “better/much better” result compared with 62% of the 32 patients in the non-surgical group. However, at the two-year point, the satisfaction numbers were 81% (surgical) and 69% (non-surgical). The study’s “conclusion” states that a structured NON-SURGICAL treatment approach “…should be tried before surgery is chosen.”

More importantly, at the one year point, 62% of those treated WITHOUT surgery reported a “better/much better” result, which improved to 69% by year two while those receiving surgery DROPPED from 87% to 81% after two years. It would be interesting to see this split at three, four, and five-year time-points, as it is well known that degeneration occurs more rapidly above and below a fusion due to the increased biomechanical load. This can lead to the need for further treatment.

A very similar 2013 study followed 50 patients with herniated cervical disks and arm pain who received chiropractic treatment. After two weeks of care, 55.3% reported they were “better” or “much better.” After one month, 68.9% reported improvement and the percentage increased to 85.7% after three months.

The good news is that guidelines for treating neck pain that radiates into an arm recommend that patients undergo a course of “conservative” (non-surgical) care FIRST before progressing to surgical care. In fact, many guidelines DON’T even recommend MRI or EMG/NCV initially unless the result from the non-surgical care is not satisfactory, usually by the four-to-six week point into treatment.

These studies show that patients with neck and arm pain (most commonly caused by herniated disks) are frequently successfully managed WITHOUT SURGERY and hence, this approach should be tried FIRST and surgery be reserved ONLY to the non-responders.

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 or headaches, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR NECK PAIN!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Fibromyalgia “Diet” – Is There Such a Thing?

21 Jan

Folks suffering with fibromyalgia (FM) commonly complain that certain foods can make their symptoms worse. How common is this? One study reported 42% of FM patients found that certain foods worsened their symptoms!

Because FM affects each person differently, there is no ONE FM diet or, “…one size fits all” when it comes to eating “right” for FM. Patients with FM usually find out by trial and error which foods work vs. those that consistently don’t. However, remembering which foods do what can be a challenge so FIRST, make a three column FOOD LOG with the following headings: BETTER, NO CHANGE, WORSE. This will allow you to QUICKLY review the list as a memory refresher.

According to Dr. Ginevra Liptan, medical director of the Frida Center for Fibromyalgia (Portland, OR) and author of Figuring Out Fibromyalgia: Current Science and the Most Effective Treatments, there are some common trends she’s observed through treating FM patients. Here are some of her recommendations:

PAY ATTENTION TO HOW FOOD MAKES YOU FEEL: It is quite common to have “sensitivities” to certain foods, but this is highly variable from person to person. Examples of problematic foods/ingredients include: MSG (commonly used in Chinese food), other preservatives, eggs, gluten, and dairy. Dr. Liptan HIGHLY recommends the food journal approach! She also recommends including a note about the type of symptoms noticed with each “WORSE” food, as symptoms can vary significantly.

ELIMINATE CERTAIN FOODS: If you suspect a certain food may be problematic, try an elimination challenge diet. That means STOP eating that food for six to eight weeks and then ADD it back into your diet and see how you feel. Remember, FM sufferers frequently have irritable bowel syndrome, also known as IBS, and this approach can be REALLY HELPFUL! Food allergies may be part of the problem, and your doctor may refer you for a consult with an allergist and/or a dietician. They will also discuss the “anti-inflammatory diet” with you.

EAT HEALTHY: In general, your diet should emphasize fruits and vegetables and lean protein. Pre-prepare food so you have something “healthy” to reach for rather than a less healthy snack when you’re hungry and tired. Consider “pre-washed” and pre-cut up vegetables; try quinoa rather than pasta. Consume anti-fatigue foods and eat multiple small meals daily vs. one to two large meals. Protein snacks (like a hardboiled egg or oatmeal – GLUTEN FREE) help a lot! Eat breakfast and include protein. Also, GET ENOUGH SLEEP (at least seven to eight hours and be consistent)!

SUPPLEMENTS: Consider a good general multi-vitamin, calcium and magnesium, omega-3 fatty acids, vitamin D3, and Co-Enzyme Q10. There are others, but this represents a great place to start. Remember to check any medication you may be taking with these/any suggestions before taking supplements!

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

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Morph an Addiction

19 Jan

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 both the quality and length of your life.

You know that tobacco addiction ages you—your blood vessels and your immune system become older so you suffer disabilities earlier –18 years of disability before death on average—and die 10 years earlier. But addiction isn’t limited to just tobacco. Addiction is everyone’s problem – and it’s time to get real about our nation’s most urgent health crisis. One in three American households bear the burden of life-changing addictions, so you likely know someone who’s faced the fear and frustration that surrounds this disease. The ripples touch the lives of 85 million people, harming friends, family, and co-workers.

Right now, more than 17 million Americans are dependent on alcohol; 1.9 million on prescription pain killers; 855,000 have a dependence on cocaine, and more than a half-million are addicted to heroin. When University of Southern California researchers looked at 11 types of addiction, they concluded that half of those addicted to nicotine, alcohol, or drugs are dependent on more than one substance. Still more were also addicted to sex, gambling, or overspending as well.

Drug-related deaths have increased three to five-fold since 2001 according to the National Institute on Drug Abuse (NIDA) as more and more children, teens, and adults get hooked on alcohol, prescription pain killers, heroin, and other chemicals. A life is lost every minute. Yet, 90 percent of those who need treatment cannot get it.

Beyond the War on Drugs

Addiction is a reversible brain disease — not a moral failing. It’s a result of dysfunction deep within brain circuits involved with reward, motivation, and memory. While criminals should be punished, we agree with Indiana Governor Mike Pence’s recent remarks that “we simply cannot arrest our way out of this problem. We also have to address the root causes of addiction and focus on treatment.” Indiana has seen a tenfold increase in the number of deaths from heroin overdoses from 2005 to 2013 — as well as a rise in child abuse and neglect related to substance abuse. Now, that state, like Ohio and like many medical centers, is among the many who are looking for a new direction. People struggling with addiction need access to research-based treatment, but it’s often is too expensive, too far away, or has a waiting list that’s too long. You cannot break an addiction without your brain being busy with something else… your brain needs a new addiction like walking, or talking to a buddy, or both.

The reason breaking addictions poses such a biological test is that repeated and addictive behavior actually changes your brain circuitry. When you learn a behavior, neurons communicate with one another, telling you,

“This is how you do the task,” whatever it might be. New connections are made to enable you to add numbers, solve problems, translate foreign languages, serve a tennis ball, learn guitar chords—anything.

Two things happen when you’re learning that skill or action. One, the connections between those neurons strengthen. Use those neurons, and they become tough so that the once-difficult skill becomes easy. It’s why learning piano may be difficult at first, but then you practice and practice until the neighbors are so sick of hearing “Chopsticks” that playing the song becomes second nature. Your neurons know what to do and do it quickly. It’s an example of biological efficiency: you need energy at first to learn the behavior, but not so much once you know it.

Two, while those connections between neurons are strengthening, the ones you aren’t using are being whittled away. It’s the whole “Use it or lose it” maxim. Let’s say that you learned Spanish in elementary school but haven’t used a lick of it since. If you try to remember it when you’re fifty-five, you may sputter a few words or phrases, but you won’t recall much at all. Those neurons said essentially, “This bozo knows nada about Spanish, so why are we wasting our time firing off ‘uno, dos, tres, cuatro’ to one another? Forget about it. We’re outta here.” And in the process, you lose those connections; you lose that ability.

So, how does this apply to addictions and habits? When you’re addicted to drinking or cigarettes or Lucky Charms, it works the same way. The repeated behavior rewires your brain to perform that action like you do when you learn to play Beethoven’s Fifth. I eat, therefore I smoke. I talk on the phone, therefore I smoke. I have sex, therefore I smoke. You have created the brain circuitry to reinforce those unhealthy habits because your brain wants the temporary high that comes from them, no matter the damage that follows.

Therefore, the answer lies in the problem. We need to use that same circuitry to discover new habits that allow us to build new connections so that the destructive ones can be pruned. But here’s the thing: you can’t expect the cigarette or other addictive circuitry to whittle away by itself; you have to put something in its place. You have to find new circuitry boards to build so that your brain stops investing its energy in the connections that make you want to do the destructive behavior, like smoke. This is where the power of habit comes into play. As long as there are no adverse effects associated with that repeated habit, then you are going to rewire your brain away from the addiction and into a healthy habit.

That’s the ultimate goal of peer-to-peer and professional treatment: Creating new brain circuits that support healthy habits as you let the old, addictive circuitry wither. It can be a long, painful process, but it’s the path to freedom. We can only get there by working as a team. Don’t intervene alone; get help; remember you are showing love by helping the addicted person live longer, and with less disability. All of us have a role.

Thanks for reading. Feel free to send questions—to youdocs@gmail.com, and some of them we may know enough to answer (we’ll try to get answers for you if we do not know).

Young Dr Mike Roizen (aka, The Enforcer)

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 on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week). The YOU docs have tow newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz. These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens. And, the new book by Dr Mike Roizen: This is YOUR Do-Over

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.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

Carpal Tunnel Syndrome – Let’s Get the FACTS! (Part 1)

18 Jan

If tingling/numbness primarily affects your thumb, index, third, and ring fingers, it very well could be carpal tunnel syndrome, or CTS. Chances are you’ve probably had this condition for months or even longer but it’s been more of a nuisance than a “major problem” and therefore, you probably haven’t “bothered” having it checked out. Let’s take a look at some “facts” about CTS!

WHAT IS CTS? CTS is basically a pinched nerve (the median nerve) that occurs on the palm side of the wrist that innervates the three middle fingers and the thumb on the palm side. This nerve starts in the neck, runs through the shoulder to enter the arm, and travels down the palm side forearm through the carpal tunnel. The carpal tunnel is made up by eight small bones (called “carpal bones”) that form the roof and walls of the tunnel. The floor of the tunnel is a ligament called the transverse carpal ligament. The median nerve lies immediately on the floor, and deeper inside the tunnel are nine tendons that connect the muscles of our forearm to the fingers, which allow us to make a fist and grip. When swelling occurs inside the tunnel, the nerve is pinched against the floor (ligament) and symptoms occur.

SYMPTOMS OF CTS: Symptoms typically start gradually with tingling, numbness, burning, itching, or a “half-sleep” feeling in the palm of the hand, thumb, and middle three fingers. The fingers can feel swollen and weak, though “swelling” is usually NOT visible. CTS can occur in one or both hands, but it is usually worse in the dominant hand. Initially, you may only notice symptoms at night or in the morning. As CTS worsens, sleep interruptions, grip weakness, difficulty distinguishing hot from cold, increased pain, pain radiating up the arm, and more may occur.

CAUSES OF CTS: There are many causes of CTS that often occur in combination: 1) Heredity or genetics — being born with a smaller wrist than others; 2) Trauma — a fall on the arm/hand (sprain or fracture); 3) Overuse of the arms/hands (like repetitive line work, serving tables, or using a computer), 4) Hormonal causes — during menstruation, with pregnancy, during menopause, diabetes, hypothyroid, overactive pituitary gland; 5) Rheumatoid arthritis; 6) Fluid retention; 7) Cysts, tumors, or spurs inside the tunnel; 8) Vibrating tools, 9) Hobbies such as knitting, sewing, crocheting; 10) sports; or 11) an “Insidious” or unknown cause!

CTS RISK FACTORS: 1) Gender: Women are three times more likely to develop CTS, possibly because they generally have a smaller carpal tunnel than men, in addition to hormonal differences; 2) Diabetes or other metabolic disorders; 3) Adults, especially >50 years old; 4) Job demands.

CTS DIAGNOSIS: Your doctor of chiropractic will review your patient history and then evaluate the neck, shoulder, arm, and hand, as ALL can be involved in producing CTS-like symptoms. He/she may also order blood tests (to check for diabetes, thyroid levels, rheumatoid arthritis, etc.) and/or an EMG/NCV (electromyogram/nerve conduction studies) to test for nerve damage.

We will FINISH THIS interesting discussion next month covering: Treatment, prevention, and research.

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 Carpal Tunnel Syndrome, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Low Back Pain and Pregnancy

14 Jan

Did you know that 50-72% of women have low back pain (LBP) and/or pelvic pain during their pregnancy but only 32% do something about it? Let’s look closer!

Pregnancy-related low back pain (PLBP) can be a highly debilitating syndrome that accounts for the most common cause of sick leave for pregnant women. In 2004, Americans spent $26.1 billion dollars in an effort to find relief from back pain during pregnancy. Statistics show one out of ten women will experience daily DISABLING LBP for at least two years following delivery.

Because of the limited number of treatment options available for the pregnant woman due to mother and fetus safety, and given the high propensity of potentially disabling PLBP that can significantly limit function and quality of life, chiropractic care seems to be a natural choice for this patient population! Obviously, pharmaceuticals and surgery are NOT appropriate options for the expectant mother, even during the post-partum breast-feeding time period. Chiropractic offers a non-invasive and safe approach to managing lumbopelvic pain that uses many different approaches.

In a 2009 research paper, 78 women participated in a study that investigated disability, pain intensity, and percent improvement after receiving chiropractic care to treat pregnancy-related PLBP. Here, 73% reported their improvement as either “excellent” or “good.” For disability and pain, 51% and 67% (respectively) experienced clinically significant improvement! Researchers followed up with them eleven months later and found 85.5% reported their improvement as either “excellent” or “good!” For disability and pain, 73% and 82% (respectively) experienced clinically significant improvement!

So, what’s causing LBP in pregnant women? Because of the biomechanical changes that occur in the low back and pelvis over a relatively short amount of time during pregnancy, especially in the second and third trimesters, common pain generators include (but are not limited to): the sacroiliac joint, facet joints, shock-absorbing disks, and the many connecting muscles (strains) and ligaments (sprains). During the later stages of pregnancy, the hormone Relaxin prepares the pelvis for delivery by widening the pelvic girdle, which can also be problematic.

Treatment options within chiropractic often include spinal manipulation, lumbopelvic exercises, patient education, posture correction, massage, an SI belt, soft tissue mobilization, and more. Exercises that target the transverse abdominus, multifidus, and pelvic floor muscles help to stabilize the lumbopelvic region. The American College of Obstetricians & Gynecologists recommends exercise at least three times a week during pregnancy, and studies report NO obstetric complications (pre-term labor, premature ruptured membranes, or changes to maternal or neonatal weight) with exercise.

So, the answer is clear! When PLBP strikes, seek chiropractic care to safely and effectively manage the pain and disability and so you can ENJOY YOUR PREGNANCY!!!

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 back pain, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888


Can Coconut Oil Help Fight Yeast Infections?

12 Jan

Do you suffer from Candida albicans (commonly called a yeast infection) and not know it? Many people do. Often times, one may be struggling with fatigue and other symptoms and not know candida is the culprit. For example, statistics show that 75% of all women will suffer with at least one yeast infection during their lifetime. Nearly half of these women will experience at least one more episode of infection. A small percentage (5-8%) will suffer from at least four recurrent infection per year.

What is candida albicans? Candidiasis is a fungal infection caused by yeasts that belong to the genus Candida. There are over twenty species of Candida yeasts that can cause infection in humans, the most common of which is Candida albicans. Candida yeasts normally live on the skin and mucous membranes without causing infection; however, overgrowth of these organisms can cause symptoms to develop that can vary depending on the area of the body that is infected.

Symptoms can include a sore throat, a white coating on the tongue, blisters or sores in the cheeks, a burning tongue, bad breath, food allergies, gas, abdominal pain, gastritis, rectal itching, sugar cravings, ulcers, bladder infections, burning urination, kidney infection, bronchitis, chronic cough, clogged sinuses, excess mucous, nasal itching, sinus infections, wheezing, sneezing, pneumonia, chronic congestion, diaper rash, eczema, red rashes, itchy patches on the skin, sores, and blurred vision. When Candida is present in the gut, it can generate toxins that can affect the brain causing apathy, confusion, dizziness, foggy thinking, poor concentration, poor coordination, and spaced-out feelings.

Candida infections can be persistent and difficult to treat, but new research indicates there may be a natural solution to this problem. A recent study led by researchers at Tufts University found that coconut oil effectively controlled the overgrowth of Candida albicans in mice. The research, published in the journal mSphere, suggests that it might be possible to use dietary approaches as an alternative to antifungal drugs in order to decrease the risk of infections caused by Candida albicans. In the study, mice who ate a coconut oil-rich diet experienced a 90% reduction the amount of Candida albicans in the gut when compared with mice in a control group. Dr. Alice H. Lichtenstein, director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University writes, “Food can be a powerful ally in reducing the risk of disease… This study marks a first step in understanding how life-threatening yeast infections in susceptible individuals might be reduced through the short-term and targeted use of a specific type of fat.”

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