Low Back Pain and Balance.

31 Dec

Statistically, most people (estimated to be about 90%) will seek care for Low Back Pain (LBP) at some point in their lifetime.

Balance is a skill that is learned as we develop. Initially, as infants, we have not developed the “neuromotor pathways” or, sequence of signals between the brain and our toes, feet, ankles, knees, hips, and so on. The constant flow of sensory information received and processed by the brain prompts motor messages to be sent back to our limbs and allows us to move in a progressively more coordinated manner as we develop. This natural progression of developing motor control starts with crude, rather uncontrolled movement of the fingers, hands, arms, legs, and feet, and soon, we learn to hold up our head, scoot, roll over, crawl, stand, and eventually walk (usually during the first 12 months of life). The learning process of recognizing sounds, voice quality and inflections, and words occurs simultaneously. This bombardment of sensory information to the brain leads to the ability to gradually perform highly integrated functions including walking, running, jumping, and dancing. As part of that learning process, falling frequently occurs. We all recall the challenges of learning how to ride a bike, swim, do a somersault, climb a tree, swing, dance, do gymnastics, ski, and on and on. As time passes and we enter middle age, we become more sedentary. As a result, we start losing our “proprioceptive edge” and become less steady, leading to more frequent balance loss and falls. Eventually, we have to hold on to hand railings or the wall in order to keep our balance and falling occurs more frequently. Couple this gradual loss of balance with bone demineralization (osteoporosis) and the risk of a fracture, such as a hip or vertebra, increases as well.

So the question arises, what can we do to slow down this process and maybe even reverse it? The answer is, A LOT!!! Just like muscles shrink and atrophy if they are not used, so does our ability to maintain our balance. We have to keep challenging our balance in order to keep those neuromotor pathways open. That need doesn’t stop after childhood, and in fact, becomes more important as we age. Last month, we talked about the “normal” length of time people can stand on one foot with the eyes open verses closed. If you tried the test, do you remember the steadiness difference? This “test” can be used at various time intervals, such as once a month, as you add balance challenging exercises to your daily routine. Frequently, people will find that within the first 2-4 weeks, they will feel more “sure” or secure on their feet, and even may not feel the need for a cane, or they’ll reach out less often for a hand rail. Start with simple exercises like standing with your feet together and hold that position for progressively longer times (eyes open and closed). We will continue this discussion next month with more balance stimulating exercises.

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.

 

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Are You Getting Enough Sleep?

30 Dec

“A well-spent day brings happy sleep.”  ~ Leonardo da Vinci

For many, there is no bigger pain in the entire world than the sound of their alarm clock rousing them from a beautiful, deep slumber.

Do you get up or hit the snooze button?  Are you lazy if you slept eight hours and don’t get up? Well, perhaps not.  New research shows that your desire for more sleep may not come from laziness at all.  It may be genetic. More on that in a moment, but first, how much sleep do you really need?

The amount of sleep your body needs is the amount that results in you feeling fully rested and alert. According to a report by ABC News, if you find yourself sleeping in on weekends, then your body may be catching up on lost sleep time. On one hand, some researchers recommend trying to sleep more during the week to balance out your sleep schedule so you sleep the same number of hours on weekends. A short 25-minute nap in the afternoon can help make up for a sleep deficit during the week. On the other hand, Dr. W. Christopher Winter, medical director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Virginia, thinks there’s no harm in sleeping in on Saturday and Sunday morning to make up lost time. But, that may not be such a good idea for some people. We’ll cover that later too…

How Many Hours of Sleep Do You Need?

The Centers for Disease Control and Prevention (CDC) recommends adults sleep 7-9 hours per night, teenagers sleep 8.5-9.5 hours per night, and children (ages 5-10 years old) sleep 10-11 hours per night. A review of 16 long-term studies published in the journal Sleep found that both short sleepers (under 7 hours) and long sleepers (over 9 hours) lived shorter lives than those who slept 7-9 hours per night. This may be the basis for the CDC’s 7-9 hour recommendation.

Inadequate sleep can negatively affect your heart, lungs, kidneys, appetite, metabolism, immune system, reaction time, mood, and brain function. People who don’t get enough sleep are more likely to develop type 2 diabetes (and all the health problems associated with that disease) because inadequate sleep affects insulin sensitivity.

A study of 24,000 Japanese women found those who slept less than six hours a night were more likely to develop breast cancer while a study by Case Western Reserve University in Cleveland found men who slept less than six hours a night were at a higher risk for potentially cancerous colorectal polyps.

Another study found lack of sleep might cause relationship problems. This research from the University of California at Berkeley (UCB) found that couples fight more and are less healthy after a bad night’s sleep.  “For the first time, to our knowledge, we can see the process of how the nature, degree, and resolution of conflict are negatively impacted by poor sleep,” said Dr. Serena Chen, a Professor of Psychology at UCB.

One thing to keep in mind is that if you sleep less than seven hours a night but you feel rested and alert when you wake up, that may be fine too. In fact, researchers at the University of California at San Francisco discovered individuals with a mutation to the DEC2 gene can function well on five or six hours a night, with no apparent adverse effects.

Oversleeping May Be Just As

Bad As Not Getting Enough Sleep!

Interestingly enough, sleeping over nine hours a night can lead to many of the same problems as sleeping too little. Long sleepers are at risk for obesity, type 2 diabetes, back pain, depression, and heart disease. If you tend to wake up before your alarm clock and you feel rested, get up and start your day. Forcing yourself to sleep in may do you more harm than good.

If it’s true that some people may genetically need less sleep, then the opposite is likely true as well: some of us may be genetically predisposed to needing more sleep than the “average” person. So, if you need more than nine hours of sleep to feel rested and alert, that may be okay.

Irregular Sleep Patterns May Be A Problem Too!

People with irregular work schedules (that, in turn, lead to irregular sleep patterns) may also experience health problems. One study recently found that females working shift patterns are associated with an increase risk of menstrual disruption and subfertility. The study collected data on 119,345 women from 1969 – 2013 and found that those working shifts (alternating shifts, evenings and nights) had a 33% higher rate of menstrual disruption than those working regular hours, and an 80% increased rate of subfertility.

In a nutshell, you must get the proper amount of sleep to be healthy. One of the biggest things we can take from this study is that the proper amount of sleep is individual.  It is not “8 hours.”  We are all different, and you must figure out what the proper amount of sleep is for you.

We all know people who can sleep five hours and wake up with a full charge. Five hours might be optimal for them, and that is awesome.  However, you might need eight, nine, or even more.

If you’re the type who has trouble getting restful sleep, here are some tips:

Regular exercise is often advised to improve sleep. Some experts recommend you try exercising earlier in the day, others think the evening before bed is a better idea. See what works best for you. Stress and anxiety can affect sleep and exercise has been shown to help relieve stress and anxiety, even if you don’t really want to work out.

Eating before bed may trigger acid reflux or an upset stomach that can hinder sleep. However, consuming a relaxing food or beverage (like a warm glass of milk) may help you fall asleep.

Avoid caffeine, alcohol, and smoking before bed as they can disrupt sleep patterns.

Take a hot bath, shower, or sauna before bed. This will raise your body temperature and cooling off facilitates sleep. The temperature drop from getting out of the bath signals to your body that “it’s time for bed.” On the same note, keep the room cool. Lower temperatures help with sleep.

Get out of bed. If you are having trouble falling asleep, get up and do something else. Don’t linger in bed and fret about not being able to fall asleep because it could develop into an even bigger sleeping problem.

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.

Consider a “sound machine.” Listen to the sound of white noise or nature sounds, such as the ocean or forest, to drown out upsetting background noise and soothe you to sleep.

Try to sleep a consistent number of hours each night. While it may be okay to catch up on sleep during the weekends, if you can’t sleep Sunday night because you slept in on Sunday morning, that can be a problem.

Increase your melatonin. If you can’t increase levels naturally with exposure to bright sunlight in the daytime and absolute complete darkness at night, consider supplementation.

Last but not least, health conditions like back pain or neck pain can interfere with a good night’s sleep so make sure to get adjusted regularly to help keep your body functioning optimally so you can sleep restfully.

Don’t forget, if you ever have any questions or concerns about your health, talk to us. Contact us with your questions. We’re here to help and don’t enjoy anything more than participating in providing you natural pain relief.

Whiplash Facts.

30 Dec

“Whiplash” is considered a non-medical term that encompasses a range of injuries. These injuries typically affect the neck and are caused by a sudden movement of the neck associated with extension or forceful backward bending. The medical term “cervical acceleration-deceleration” (CAD) is considered to be a more accurate description of what happens during a car accident, and the term “whiplash associated disorders” (WAD) describes the injury’s residual signs and symptoms.

 

WAD or CAD is most commonly associated with motor vehicle collisions (MVCs), when a vehicle is struck from behind. Other less common causes include: dancing (especially “headbanging”), falls from stools or ladders, bicycle injuries, horse related injuries, and many others. In the UK in 2007, 430,000 people made an insurance claim for WAD, accounting for 14% of every driver’s premium. In the US, over 1 million WAD injuries occur annually due to car accidents alone with an estimated 3.8 cases per 1000 people per year. An estimated 6.2% of the US population has “late whiplash syndrome” or long-term problems associated with WAD.

Prior to the advent of the automobile, WAD was referred to as “railroad spine” (as it resulted from a train crash), first documented in 1919. WAD also occurred frequently in pilots landing on aircraft carriers due to the rapid deceleration that occurred as the planes landed and suddenly braked. When one thinks of “whiplash,” the visual of a high speed crash comes to mind. However, WAD can occur at speeds less than 15 mph due to less crash energy absorption by crushing metal. Since there is less car damage at lower speeds, that energy is transferred to the contents (the people) inside the car.

The neck consists of 7 vertebrae, the 6 disks, the 8 pairs of nerves, and the muscles, ligaments and other “soft-tissues.” There are 4 phases of injury (initial, retraction, extension and rebound), which all occur within 300 msec. Whereas, it takes about 800msec to voluntarily contract a muscle. Therefore, you can’t really “prepare” or fully brace for the impact. Most injuries occur at C5 and C6 in the lower part of the neck between 150 and 300 msec. of the cycle. Factors that influence injury include: the seat back angle, the seat back rebound, the headrest position, the direction the head is positioned at impact (worse if rotated), the occupants gender (females are at greater risk due to a more thin, less muscular neck), the size of each vehicle involved, and more. All these factors make it extremely challenging to accurately reconstruct a MVC on paper.

The most common symptoms associated with WAD include neck and upper back pain and headache, referred pain into the mid-back or down an arm and sometimes legs. The onset of symptoms can be immediate or delayed for days. Risk factors that worsen the prognosis of a case include: the presence of radiating pain from the neck to the arm and hand that follows a specific nerve, failure to respond to initial treatment, a delay in getting treated, and being placed in a cervical collar (especially if not allowing to be mobilized and exercised — i.e. chiropractic care). The key to the success of WAD treatment is to get treated immediately, don’t restrict yourself to a cervical collar, unless you have an unstable fracture, and do your exercises!

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.

 

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Cervical Traction – The Many Options and How To Use It!

30 Dec

The type of traction that this discussion will address will be limited to the kind that can be purchased and then used in the home, usually multiple times a day, giving it a clear advantage over in-office traction treatments which can only be applied a few times a week during office visits. In some cases however, it may be appropriate to use the in-office type for a few sessions to determine dosage and/or tolerance prior to administering a home unit, but this varies from case to case, and each type of traction unit is different. In the neck or cervical spine, there are many varieties including: sitting over-the-door types, cervical collar types, as well as supine (lying on the back) types. Each variety has its pros and cons and prices vary considerably from $10 to $600.

CONDITIONS: Probably the most common condition treated with cervical traction is “cervical radiculopathy,” or a pinched nerve. When a nerve root in the neck is pinched, pain, numbness, tingling, and/or muscle weakness occurs in the area the particular nerve innervates. For example, if a patient presents with pain and numbness radiating down the arm to the thumb and index finger and/or have weakness in bending their elbow and extending their wrist, then we know that the C6 nerve is pinched. When pulling or stretching the neck relieves the arm pain, traction is usually helpful. If pain worsens, the person is probably not ready for traction yet.

PROTOCOL (DOSAGE): The key to a successful outcome using cervical traction is finding the right dosage. If you start with too much weight, it may leave you feeling sore, or worse, making you reluctant to try it a second time. Therefore, rather than relying on using a certain percentage of body weight, it’s safest to start with less weight and then gradually increase it, such as 5# (# = pounds or .45 kg) for 15-20 minutes. If that dose feels fine, try 7#/15-20 min., then 9#, 11#, 13#, etc., until you find it just isn’t quite as comfortable at the last weight. You have now found your current threshold and should drop down to the last most comfortable weight and use that for a few days and then MAYBE try increasing it again. Studies show a maximum stretch is usually achieved within 15-20 minutes, so extending the time longer may be less productive. Facing the over-the-door unit may be better tolerated than facing away. Try it both ways and you decide which feels best. The next most important issue is frequency.

How often to repeat the traction sessions depends on: 1. The condition’s severity and your response; 2. Your time availability. If there is a severe nerve pinch with muscle twitching, weakness and dense numbness/tingling, then the traction be repeated MANY times a day, gradually increasing the weight to find the optimum amount. We’ve had people repeat the traction 10x/day! With the option of wearing a cervical collar traction unit, you can actually travel and/or do certain activities during traction. We’ve had people travel to and from work while performing traction! Since each case is unique, we’ll discuss that individually. The bottom line, IT WORKS GREAT with proper chiropractic management and in many cases, surgery CAN be avoided!

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.

 

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Fibromyalgia and “SHINE.”

30 Dec

Fibromyalgia (FM) management can be as difficult as making a definitive diagnosis.  FM is characterized by generalized body aches and feeling exhausted, and yet, in spite of the exhaustion, the inability to sleep is a “classic” FM complaint. Some have referred to FM as “blowing a fuse” or as an “energy crisis,” as more energy is expended than what’s being made. FM sufferers, as well as the caregivers, know how physically and mentally difficult it is to manage this controversial condition. Many management strategies that have been published; SHINE is one approach. SHINE stands for Sleep, Hormones, Infections, Nutritional supplements, and Exercise. By focusing treatment strategies on these 5 areas, significant benefits can be achieved.

SLEEP: Some feel this is the most important problem to manage in order to gain control of FM. If we cannot reach “deep sleep,” (which is the sleep stage that is usually reached after about the 4th hour into sleep) then the body cannot fully rest. When discussing sleep problems with the FM patient, it is common to hear them say, “…I wake up every 1-2 hours and can’t get back to sleep for at least 15-30 minutes.” This results in NEVER getting to the deep sleep stage and eventually, because the body hasn’t fully relaxed often for years, everything starts hurting. This is the hallmark of FM. Some “tips” to help us get to sleep and stay sleeping include: keeping the bedroom cool (such as 65°), taking a hot bath before sleep to relax your tight muscles, spraying the pillow with lavender oil (helps promote sleep), taking 75-150mg of magnesium, avoiding caffeine (especially later in the day), the use of Valarian Root (a muscle relaxing herb) and/or melatonin (an amino acid that promotes sleep) can also help. The goal is to try to get 8-9 hours of sleep a night. Establish a routine in the evenings and go to bed at the same time or close to it.

HORMONES: These chemicals are produced by our endocrine glands (pituitary, thyroid, parathyroid, adrenals, ovaries/testes, and part of our pancreas. They are in balance with each other, and somehow, in FM they often fall out of balance. Have your health care provider perform tests (usually blood and/or urine) to determine your hormone levels and get them balanced!

INFECTION: The lack of sleep lowers our immune function, and infections can occur more readily. In addition to treatments, there are nutritionally based approaches to improve immune function, and if recurrent illnesses are part of your FM profile PLEASE consult with us regarding ways to boost your immune system!

NUTRITIONAL SUPPLEMENTS: This topic is related to the last as there are MANY supplement recommendations that have been found to boost immune function, increase energy, enhance sleep quality, and more. This is an area of FM management that is largely overlooked by traditional medical management approaches. Remember, a “team” of providers offers the FM sufferer the best way to manage this challenging to treat condition. Look for health care providers who are willing to work together as a team on your behalf.

EXERCISE: This is a MUST! For example, in a 2010 Oregon Health & Sciences University study, women with FM who practiced yoga for 8 weeks had a 24% pain reduction, 30% fatigue reduction, and 42% depression reduction.

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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New Research Shows How Sugary Drinks Are Probably Harming Children As Young As 2 To 5 Years Old…

24 Dec

“What we do for ourselves dies with us. What we do for others and the world remains and is immortal.”  ~ Albert Pine

Earlier this year, New York City Mayor Michael Bloomberg proposed a ban that would stop restaurants, delis, movie theaters, food carts, and stadiums from selling certain sugary drinks in containers larger than 16 ounces as a way to help combat obesity in the city. As you can imagine, there was enormous public and political backlash.

Eventually, an appeals court ruled against the proposed ban just before it could go into effect, citing that it was an overreach of executive power. While it may not be Mayor Bloomberg’s place to tell you or your children not to drink sugary drinks, research has tightly linked sugar-sweet beverage consumption to weight gain among older children.  But what about younger children?

New research published in Pediatrics, the official journal of the American Academy of Pediatrics, studied 9,600 children from birth to age five.  The researchers found correlations between sugary drink consumption by children as young as two years old and weight gain in later years. The drinks examined in the study were sodas, sports drinks, and any other sugar-added beverages or juice drinks that were not 100 percent juice.

Because of the study’s size and length of follow-up, many experts believe the information to be very valuable.

According to Dr. Dyan Hes, Medical Director of Gramercy Pediatrics in Manhattan, who has been lobbying for public policies like soda taxes that would make these drinks less attractive to families, “It’s a fantastic study because we need more evidence… We know that sugar-sweetened beverages are the greatest contributor to increased obesity in young children because they’re cheap. It shows that by giving your children sugar-sweetened beverages by age two, you’ve already set up habits that are very hard to break.”

Here’s what is really important about this study: The study did not find that two year olds who drank at least one sugar-sweetened drink to be any heavier than other two year olds.  But, drinking just one sugary drink per day did set those toddlers up for weight gain in the near future.  In fact, the children who drank at least one sugary drink per day were already heavier by the age of five.

According to Scientific America: In fact, they were 1.43 times more likely to be obese than preschoolers who consumed sugary drinks less than daily, even after accounting for other factors that could influence weight gain.  Mark DeBoer, Assistant Professor of Pediatrics at the University of Virginia, says the findings support the hypothesis that regular consumption of sugar-sweetened beverages has a cumulative effect over time. “We were struck by this data that even at a very young age, the sugar-sweetened beverages contribute to weight gain… and we wanted to put this information out for pediatricians and for families to help them make healthier choices for their children.”

Why Do Sugary Drinks Cause

So Much Weight Gain?

The answer to that question is most likely two-fold.  First, is simple caloric intake.

Sugary drinks are full of “empty calories.”  In other words, they contain very little (if any) nutritional value but are high in calories.  These calories, because they are liquid, do not make you feel full. So someone drinking all these empty calories will still need to eat solid food to feel full, increasing the total amount of calories consumed in a day. The second reason is how your body chemically reacts to sugar.  These types of drinks are usually loaded with fructose. Fructose can be harmful to your body by setting up the conditions for not only obesity, but also diabetes.

This “junk sugar” unstabilizes blood sugar levels and makes your pancreas work overtime.  Your pancreas is the organ responsible for secreting the hormone insulin so the sugar in your blood stream can be absorbed by cells.  After years of sugar consumption, the pancreas may “wear out” and an individual could become a type 2 diabetic.

Many type 2 diabetics start taking insulin injections when the better solution for many may to manage their blood sugar levels may simply be proper diet and exercise.  However, the best solution is to prevent the condition altogether by limiting consumption of bad sugar, such as sugary drinks (along with a proper diet and regular, moderate exercise).

Here Is Something Disturbing…

A UCLA study published in the Journal of Physiology is the first to show how a steady diet high in fructose can damage your memory and learning.

Researchers investigated the effects of high-fructose syrup. It’s similar to high-fructose corn syrup, a cheap sweetener six times sweeter than cane sugar which is used in most soft drinks, processed foods, condiments, and even many baby foods.

They fed rats a fructose solution instead of clean drinking water for six weeks. Then, they tested their ability to remember the way out of a maze.

The results were quite shocking.  The rats fed fructose syrup struggled to negotiate the maze, demonstrating significant impairment in their cognitive abilities.  They were slower and their brains showed a decline in synaptic activity.  Their brain cells had trouble signaling each other, disrupting the rats’ ability to think clearly and recall the route they’d learned six weeks earlier.

Additionally, the fructose-fed rats showed signs of resistance to insulin, a hormone that controls your blood sugar and synaptic function in your brain.

Researchers concluded that a high-fructose diet negatively affects the way the brain functions. According to Dr. Fernando Gomez-Pinilla, a Professor of Neurosurgery at the David Geffen School of Medicine at UCLA and a Professor of Integrative Biology and Physiology in the UCLA College of Letters and Science, “Our findings illustrate that what you eat affects how you think… Eating a high-fructose diet over the long-term alters your brain’s ability to learn and remember information.”

Don’t forget, if you ever have any questions or concerns about your health, talk to us. Contact us with your questions. We’re here to help and don’t enjoy anything more than participating in providing you natural pain relief.

 

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