Why You Should Seek Treatment for Whiplash ASAP!

22 Nov

Even though whiplash or whiplash associated disorders (WAD) is very common, it remains poorly understood. Recent studies report that up to 60% of people may still have pain six months after their injury. Why is that?

Investigations have shown there are changes in the muscle and muscle function in the neck and shoulder regions in chronic WAD patients. Symptoms often include balance problems as well as increased sensitivity to a variety of stimuli including pressure, light vibration, and temperature.

Interestingly, this hypersensitivity not only occurs in the injured area, but also in areas away from the neck such as the front of the lower leg or the shin bone. This can only be explained by some type of neurobiological processing of pain within the central nervous system, which includes the spinal cord and brain.

It’s not surprising that when pain continues for lengthy time frames, people with these symptoms may also experience psychological distress. The confusing thing is that not every WAD injury case has this “central sensitization” and when it’s present—its intensity is highly variable.

Current research into WAD is focused on the following: 1) developing better treatments in the early or acute whiplash injury stage with the goal to PREVENT development of these chronic symptoms; 2) determining what factors can PREDICT slower recovery following a WAD injury; 3) investigation into how the stress response associated with motor vehicle crashes influence pain, other symptoms and recovery, and how to best address and MANAGE the stress response; 4) research into the effect a WAD injury has on daily life function; and 5) developing improved assessment methods for healthcare providers so that EARLY treatments can be more targeted and effective.

A Swedish study is currently looking at the importance of reducing the acceleration of the occupant during an automobile collision by redesigning the body of the vehicle and its safety systems. In rear-end crashes, the main issue is to design a seat and head restraint that absorbs energy in a controlled way and gives support to the whole spine. In frontal crashes, the air bag, seat belt pretensioner, and load limiter must work together in a coordinated way to reduce the acceleration between the vertebrae of the spine and occupant.

What is known is that a “wait and watch” approach may NOT be appropriate in a lot of cases. It appears there is a relatively short window of time, the first three months, when treatment seems to be most effective. Doctors of chiropractic are trained to identify and treat these types of injuries, so PLEASE, don’t delay your initial visit—time is truly of the essence.  Don’t waste it!

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

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

How Does Neck Pain Cause Headaches?

15 Nov

Headaches can arise from many different causes. A partial list includes stress, lack of sleep, allergies, neck trauma (particularly sports injuries and car accidents), and more. In some cases, the cause may be unknown.

A unique common denominator of headaches has to do with cervical spine anatomy, in particular the upper part of the neck. There are seven cervical vertebrae, and the top three (C1-3) give rise to three nerves that travel into the head. These nerves also share a pain nucleus with the trigeminal nerve (cranial nerve V), which can route pain signals to the brain.

Depending on which nerve is most irritated, the location of the headache can vary. For example, C2—the greater occipital nerve—travels up the back of the head to the top. From there, it can communicate with another nerve (cranial nerve V or the trigeminal nerve), which can refer pain to the forehead and/or behind the eye.

When C1—the lesser occipital nerve—is irritated, pain travels to the back of the head, while irritation to C3—the greater auricular nerve—results in pain to an area just above the ear. When a nerve is pinched, the altered sensation can include pain, numbness, tingling, burning, itching, aching, or a combination of these sensations.

These are classified as cervicogenic headaches (CGH), and as the name implies, the origin of pain/altered sensation arises from the neck.

A 2013 study reviewing the literature on CGH found that manipulation and mobilization improved pain, disability, and function. The most effective approach included manipulation combined with neck-upper back strengthening exercises.

But what about migraine headaches? Migraines are vascular headaches, and some (but not all) are preceded by an aura or a pre-headache warning that may include blurry vision, tingling, strange olfactory sensations, etc. One study of 127 migraine sufferers reported fewer attacks and less medication required by those who received chiropractic care.

The good news is that spinal manipulation is very safe, and a trial is often very rewarding for many types of headaches.

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

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

What’s Wrong with My Shoulder?

10 Nov

Shoulder pain is a REALLY common problem that can arise from many causes. There are actually several joints that make up the shoulder, so shoulder injuries can be quite complex!

Probably the most common source of shoulder pain arises from the muscle tendons and the bursa—the fluid-filled sacs that lubricate, cushion, and protect the sliding tendons near their attachment to bone. The rotator cuff is made up from a group of four muscles and their connecting tendons. Typically, when the tendons tear, the bursa swells and “impingement” occurs. When this happens, it’s very painful to raise the arm up from the side.

The term “strain” applies to injuries of the muscles and tendons and are classified as mild, moderate, or severe (some refer to this as first, second, and third degree tears), depending on the amount of tissue that has torn. Overexertion, overuse, sports injuries, dislocation, fracture, frozen shoulder, joint instability, and pinched nerves can all give rise to shoulder pain.

The diagnosis of what’s actually causing a patient’s shoulder pain is often determined by the history of how the injury occurred, or the “mechanism of injury.” This is followed up by measuring the range of motion and performing provocative tests to see which positions bother the shoulder the most. A doctor may use X-rays to assess for fracture/dislocation and an MRI to assess muscle tendon tears, labral tears (a rim of cartilage surrounding the glenoid fossa or cup of the ball & socket joint), and other soft tissue injuries.

People with jobs that require heavy lifting or repetitive pounding (carpenters and jack-hammer operators, for example), who play sports such as football and rugby, and those who smoke, have diabetes, and/or an overactive thyroid are at higher risk of injury. Because the shoulder joint is normally not very stable, MANY people tear their rotator cuff or injure their shoulder during their lifetime. One study found 17% of participants had full thickness rotator cuff tears (as opposed to partial tears). The researchers reported that age was an important determinant, as the incidence of full tears was only 6% in those less than 60 years old vs. 30% in those over 60! So obviously, this IS NOT an injury limited to the younger active person!

Outside of a medical emergency, patients should always try non-surgical treatment options first. Doctors of chiropractic offer the shoulder injury patient a non-surgical option that emphasizes exercise and self-management strategies in addition to manual manipulation, mobilization, and more. The most important message is BE PATIENT as these usually take time to manage, often up to a year.

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

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

You Can Get Rid of Your Pain

8 Nov

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.

This month, let’s talk about pain.  While no one therapy is 100 percent effective, there are effective ways to dial back and even prevent big pain. In fact, proven, non-drug therapies can slash your pain by 20 to 60 percent and let two-thirds of you with chronic pain slash pain-pill dosage too. Yes, the data are clear, chiropractic treatment is the least expensive and quickest way to return to normal function after back pain.

If you’ve got pain that won’t quit—headaches, nerve pain, digestive pain or aches in your joints—these eight tips can help you get the upper hand, brighten your mood, and improve your sleep:

#1: Quit smoking. A major cause of recurrent back pain (and all recurrent pain) is smoking and tobacco use! Tobacco users have a 300 percent greater rate of chronic lower back pain than nonsmokers. The cause of the back pain from tobacco is not known, but some research indicates that hydrocarbons from cigarette smoke increase inflammation and decrease blood flow. Researchers have also found that nicotine disrupts the flow of oxygen to the spine’s disks, and coupled with inflammation, can trigger disk degeneration (ouch!). Cigarette smoke (even secondhand smoke) also appears to kill off the cells that build bone, which affects bone density.  (So does smoking marijuana. One joint releases the inflammation from hydrocarbons of four cigarettes.)

So if you have chronic pain and you smoke, your best first step is to quit! (You’ll also reduce your risk for lung, esophageal, and many other cancers, COPD, stroke, and heart attack.) Need help?  Go to my.clevelandclinic.org and search for “smoking cessation.” Our email coaching program is 63 percent effective on the first try for at least seven months.

#2: Move gently. Exercise may be the last thing you want to do, but a gentle program like walking and yoga (ask your doc what’s best for you) can pay big dividends—like cutting your need for prescription pain pills and boosting the odds you’ll be back to work each by more than 50 percent.  Movement’s great for everything from that bum knee to headaches and pain associated with recovering from cardiac surgery.

#3: Watch your weight. Not only does an extra 10 pounds put 30 to 60 pounds of added force on your knees with every step, but added weight increases your odds for lower back pain, tension and migraine headaches, fibromyalgia, abdominal pain, and chronic widespread pain.  The good news? Losing weight takes that pressure off.

#4: De-stress daily. It’s not all in your head; tension makes pain feel worse. Progressive muscle relaxation by tightening, then releasing your muscles slowly from toes to head helps joint aches, headaches, rheumatoid arthritis pain, and inflammatory bowel disease. Massage and guided imagery also help you relax deeply and ease pain. There are at least eight more techniques you can try to see which works for you at ClevelandClinicWellness.com (look for StressFreeNow on the site).

#5: Meditate. Turning inward for a few minutes relaxes you—and helps you control your brain’s alpha rhythm, a brain wave that tunes out distractions like pain.  This also sharpens memory, which is good news because chronic pain can take a toll on your ability to remember names, dates, or where you left the car keys.  Try it: Close your eyes and breathe in and out at a natural pace, noticing how it feels. As thoughts, feelings, and physical sensations crop up, acknowledge them without judgment and return your attention to your breath, focusing on exhaling stress. After 10 minutes, start noticing your surroundings again, open your eyes, and go about your day refreshed!

#6: Make an appointment for more pain help. Therapies such as cognitive behavior therapy, acupuncture, and biofeedback, provided by trained practitioners, can also take the edge off pain. Ask your doctor for a referral.

#7: Use topical pain relievers. These halt pain signals before they reach your brain.

#8: Get a second opinion about your pain meds. Using strong pain relievers long-term may be a smart choice if you’ve got cancer pain or are suffering from pain at the end of life.  After major surgery, taking them while well-supervised by a pain management specialist may be essential, too.  But remember meditating or yoga learned beforehand decreases need for pain meds even after cardiac surgery by 50%.

But for the rest of you, whether you’re stuck on pain meds or just started taking them, it’s the right time to see your chiropractic pain management specialist to learn about your options. Intercepting pain fast can stop it from becoming chronic. Finding new options can, at any time in your journey to control pain, put you back on the road to living the life you love.

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.

Can You Prevent Carpal Tunnel Syndrome?

3 Nov

Carpal tunnel syndrome (CTS) is the most common of the many “entrapment neuropathies”— nerve pinches in the arms or legs—likely because we use our hands and fingers repetitively for long time frames at work and during many of our hobbies. In addition, the wrist is a very complicated joint because it’s not a simple ball-and-socket or hinge, like the hip, elbow, or knee.

The wrist is made up of eight small “carpal” bones that are all shaped very differently and fit together a bit like a puzzle. These eight bones are lined up in two rows of four bones that form the “roof“ of the tunnel.

The shape of the tunnel changes with different activities, and the contents within the tunnel have to accommodate for this. Nine of the tendons that allow the hand to move the fingers also travel through the tunnel. Look at the palm-side of your wrist as you wiggle your fingers. See all the activity going on there? The median nerve travels through the tunnel as well, just under the “floor”, which is a very strong ligament that stretches from the pinky to the thumb-side of the tunnel.

Virtually ANY condition that increases the pressure inside the already tightly packed tunnel can create CTS symptoms like numbness, tingling, burning, etc. Over time, grip strength may weaken, causing one to accidentally drop objects.

To add to the causation list of CTS, conditions like obesity, pregnancy, diabetes, hypothyroid, rheumatoid arthritis (and other “arthropathies”), taking birth control pills (BCPs), and more can cause CTS without any increase in hand/wrist activities!

So HOW can we prevent CTS? First, consider your job and your “workstation.” There are ergonomic keyboard and mouse options that can help you maintain a “neutral” wrist posture. If you have to bend your wrist a lot to do your work tasks—like placing items in a package, assembly work, etc.—see if you can change the angle of the package or assembly set up that allows your wrist to be straight, NOT BENT! Also, sit/stand up straight, chin tucked back, and DON’T SLOUCH!

A “night splint” forces the wrist to stay straight and can REALLY help! Managing your weight and health (manage your diabetes, thyroid, and medications that increase swelling like BCPs) is VERY important! There are also natural anti-inflammatory vitamins and herbs like ginger, turmeric, and bioflavonoid you may want to consider—your doctor of chiropractic can help you with this!

Chiropractors can manage CTS very well and can frequently help patients avoid the need for a surgical release. The “KEY” is to not wait—get treated early on!

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

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

What’s the Best Mattress for Your Back?

1 Nov

Have you ever wondered “What type of mattress is best for my back?” Between the many types of mattresses available on the market—foam, coiled, water, as well as combinations of all these, not to forget further options between soft, medium, or firm—where do we begin? All of these variables make finding the right one truly difficult!

An orthopedic surgeon survey found that 95% of the surgeons polled believed that the mattress played a role in back pain management, and 76% recommended a firm mattress. But is this supported by research?

In an Oklahoma State University study, researchers provided 59 healthy people whose beds were at least five years old with new beds featuring a medium-firm, foam-encased spring mattress. ALL the study subjects said they had less back pain, less shoulder stiffness, improved sleep quality, and greater comfort after 28 nights on the new beds. However, when these researchers reviewed prior studies that compared foam vs. coil vs. water beds, the reviews were mixed, raising the question, “Would any new bed be better than an old one?”

Several studies have measured the difference between mattresses—including a chiropractor-led study that looked at two factors: spinal distortion and maximum pressure. The researchers concluded that the two goals of a mattress were to exhibit LOW maximum pressures and LITTLE spinal distortion.

Another study, this time from a team of South Korean researchers, found that participants gave the highest ratings when their spinal curve while lying down was similar to their standing spinal curve. This prompted a six-day/night follow-up study where researchers measured brain waves, eye movements, heart rhythm, chin movements, and body temperature overnight in a sleep laboratory. They found that sleep efficiency and deep sleep percentages were higher AND the participants woke up less often when the participant rated the mattress as “comfortable”.

A Spanish study found a connection between higher comfort scores how well the pressure of a user’s body distributed over the mattress.

Another study that included 313 adults with chronic low back pain divided participants into two groups that slept on either a medium-firm or a firm mattress for 90 days. The study found that those on the medium-firm mattress had the best outcomes for pain in bed, pain on rising, and disability.

So after ADDING up ALL these findings, it appears that doctors should recommend a mattress that does not distort the spine, distributes weight evenly, and is medium-firm in density.

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

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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