How Is Dizziness Related to My Neck Pain or Headaches?

26 Jul

Dizziness, neck pain, and headaches are very common symptoms that may or may not occur at the same time. Though this interrelationship exists, this month’s article will focus primarily on dizziness, particularly related to dizziness that occurs after standing.

First, it is important to point out that it is VERY common to be light headed or dizzy when standing up too fast, which is typically referred to as orthostatic hypotension (OH). OH is frequently referred to as a benign symptom, but new information may challenge this thought.

Let’s review what happens. When we are lying down, our heart does not have to work as hard as when we are upright; therefore, our blood pressure (BP) is usually lower while we lay in bed. When standing up, blood initially pools in the legs until an increase in blood pressure brings oxygen to the brain. This either resolves or prevents dizziness.

Orthostatic hypotension is defined as a blood pressure drop of >20 mm Hg systolic (the upper number—heart at FULL contraction), 10 mm Hg diastolic (lower number—heart at FULL rest), or both. This typically occurs within seconds to a few minutes after rising to a standing position.

There are two types of OH—delayed OH (DOH) where the onset of symptoms are not immediate but occur within three minutes of standing and “full” OH, which is more serious and occurs immediately upon rising. According to a 2016 study published in the prestigious journal Neurology, researchers reviewed the medical records of 165 people who had undergone autonomic nervous system testing for dizziness. The subjects averaged 59 years of age, and 48 were diagnosed with DOH, 42 with full OH, and 75 subjects didn’t have either condition.

During a ten-year follow-up, 54% of the DOH group progressed to OH, of which 31% developed a degenerative brain condition such as Parkinson’s disease or dementia. Those with initial DOH who also had diabetes were more likely to develop full OH vs. those without diabetes.

The early death rate in this 165 patient group was 29% for those with DOH, 64% with full OH, vs. 9% for those with neither diagnosed condition. The authors point out that those initially diagnosed with DOH who did NOT progress into full OH were given treatment that may have improved their blood pressure.

The authors state that a premature death might be avoided by having DOH and OH diagnosed and properly managed as early as possible. They point out that a prospective study is needed since this study only looked back at medical records of subjects who had nervous system testing performed at a specialized center, and therefore, these findings may not apply to the general population.

The value of this study is that this is the FIRST time a study described OH (or DOH) as a potentially serious condition with recommendations NOT to take OH/DOH lightly or view it as a benign condition. Since doctors see this a lot, a closer evaluation of the patient is in order.

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.

Fibromyalgia – “What Is the BEST Diet?”

25 Jul

Fibromyalgia (FM) and its cause remains a mystery, but most studies suggest that FM is NOT the result of a single event but rather a combination of many physical, chemical, and emotional stressors.

The question of the month regarding the BEST FM diet is intriguing since one might assume that the many causes should mean that there isn’t one dietary solution. But is that true? Could there be a “best diet” to help ease the symptoms from such a multi-faceted disorder?

Certainly, healthy eating is VERY important for ALL of us regardless of our current ailment(s). Obesity is rampant largely due to the fact that 60% of the calories consumed by the “typical” American center around eating highly inflaming food that include those rich in Sugar, Omega-6 oil, Flour, and Trans fats (“SOFT” foods, if you will!). Obesity has been cited as “an epidemic” largely due to kids and adults becoming too sedentary (watching TV, playing on electronic devices, etc.) and eating poorly.

Perhaps the BEST way to manage the pain associated with FM and to maintain a healthy BMI (Body Mass Index, or ratio between height and weight) is to substitute ANTI-INFLAMING foods for those that inflame (or SOFT foods).

You can simplify your diet by substituting OUT “fast foods” for fruits, vegetables, and lean meats. So there you have it. It’s that simple. The problem is making up your mind to change and then actually doing it. Once these two things take place, most everyone can easily “recalibrate” their caloric intake and easily adapt.

Not only have studies shown that chronic illnesses like heart disease, stroke, and diabetes significantly benefit by following this simple dietary shift, but so does pain arising from the musculoskeletal system! This is because the human body is made up largely of chemicals, and chemical shifts are constantly taking place when it moves. If you reach for an anti-inflammatory drug like ibuprofen or naproxen and it helps, it’s because you ARE inflamed and the drug reduces the pain associated with that inflammation. This is an indication that an anti-inflammatory diet WILL HELP as well (but without the negative side effects)!

The list of chronic conditions that result in muscle pain not only includes FM but also obesity, metabolic syndrome, and type II diabetes. Conditions like tension-type and migraine headaches, neck and back pain, disk herniation, and tendonopathies and MANY more ALL respond WELL to making this SIMPLE change in the diet. For more information on how to “DEFLAME,” visit http://www.deflame.com! It could be a potential “lifesaver!”

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

The Most Important Principles for Staying Young: YOU Can Win The Jackpot!

21 Jul

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, we want to discuss My Feeling About the DHA-Omega-3 Jackpot. (By the way, check out my new book, This is YOUR Do-Over: The Seven Secrets to Losing Weight, Living Longer, And Getting A Second Chance at the Life You Want (shameless plug—you can order it here) .  You can send us questions anytime to youdocs@gmail.com, just put the phrase “Question for Dr Mike Roizen to answer” in the subject line, and I’ll try to get to it.)

In October 2015, a group of eleven women working together at the Canada Post won a nine million dollar lotto jackpot.  And when your author learned that 900 mg of DHA a day can make one’s memory six years younger and maybe even protect you from sugar binges, all of us won a jackpot without even buying a ticket. If you read my articles even occasionally, you probably know my feeling about sugar being a trigger for brain dysfunction.

Sugar for the slightly and very diseased brain is like cocaine—short-term increases in sugar levels in blood and in the brain improve brain function (more sugar in damaged cells temporarily improves function—as sugar or insulin through the upper plate in the nose do for Alzheimer’s patients, and even substances that decrease the blood brain barrier like saturated fats help this temporarily). But chronically (even over a two-week period in humans) slightly raised sugar levels—even if you don’t have diabetes or prediabetes—will decrease your memory. That excess blood glucose you get from a sugar donut (made worse by the saturated fat in it)—you can substitute any sugar laden food here—damages brain cells.

In one study, people had their sugar levels tested and were asked to memorize 15 words, then repeat them a half-hour later. Those with higher levels of blood sugar (chronically elevated) remembered, on average, two fewer words. Higher blood sugar is linked to a smaller hippocampus, which means poorer ability to form and store new memories. The same thing (or at least its rat equivalent) occurs when rodents were fed the equivalent of a liter of sugared soda a day.

The rats that got the sugar in their diet took twice as long to run mazes and learned them much slower. But there is some good news here (don’t skip ahead). These decreases in learning new memories were associated with a large number of changes in gene function as sugar changed the “C” function (cytosol) of the DNA making it less visible to protein manufacturing.

No matter if that is the cause, the decrease in ability to learn and store memories and the gene changes were prevented if the rats were given the equivalent of 900mg of DHA-omega-3 a day (conflict of interest note: I did chair the scientific advisory board of a company that made DHA-Omega-3 from algae; I no longer do so. Algae are where the fish get DHA-Omega-3 from, as like us, fish generally do not make it themselves).

Now we do not know if these gene effects are why sugar is bad, or DHA-Omega-3 fat is beneficial for memory because of its gene effects (that specific part of fish oil that reversed the effect). But we have known for several years from randomized studies in individuals who were 55 to 75 years of age and had started to lose their memory that 900mg of DHA a day made their memory forming and brain speed about six years younger. Additionally, a recent study also showed that consuming a little fish each week can lower one’s risk for developing Alzheimer’s disease. So, take 900 mg of DHA-Omega-3 a day from either supplements or by consuming 18 ounces of salmon or ocean trout a week (the only fish with predictable amounts of DHA in the USA) to protect your brain and keep it young.

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.

Is Surgery Necessary for Carpal Tunnel Syndrome?

19 Jul

Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy—that is, it’s the most common place to trap a nerve in the extremities (arms or legs). CTS affects 6-11% of adults in the general population, and it occurs in women more often than men. The cause is often difficult to determine but the most common reasons can include trauma, repetitive maneuvers, certain diseases, pregnancy, being over the age of 50, and obesity.

So, is surgery the only answer? The short answer is NO! In fact, in a recent randomized clinical trial published in the Journal of Pain, researchers observed similar improvements in function when they compared the outcomes of patients who underwent surgery vs. those who received manual therapies (such as those performed several times a day at chiropractic clinics around the world) at both six months and one year later. The improvements included increased strength, function, and decreased hypersensitivity in both the surgical and non-surgical groups. Interestingly, the manual therapy group did BETTER at the one and three month assessments when compared with the surgical group (again, with no difference at six and twelve months)!

The median nerve, the culprit behind CTS, starts in the neck and travels down through the shoulder, elbow, forearm, and finally through the carpal tunnel, which is made up of eight small carpal bones that form the arch of the bridge. Entrapment of the median nerve occurs when the normally tight quarters within the carpal tunnel combine with the inflamed nine sheathed muscle tendons that push the nerve into the floor of the tunnel (a ligament), which results in CTS! The goal of therapy—both surgical and manual therapy—is to reduce the pressure within the tunnel and free up the compression of the median nerve.

Manual therapies focus on joint mobilization and manipulation to reduce joint fixations, muscle release techniques in the forearm and hand, stretching techniques, and at-home exercises that emphasize a similar stretch, the night brace, and management of any underlying contributing factor. These “underlying factors” might include diabetes, hypothyroid, taking birth control pills, weight management, and inflammatory arthritis.

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.

I’m Told I Have “Facet Syndrome” – What Is It?

18 Jul

As stated in previous articles, low back pain (LBP) can arise from many different structures. Lumbar facet syndrome is one that involves the facet joint and includes both acute (new) and chronic (old) varieties. The facet joint is synonymous with the zygapophyseal joint, so if you hear that word, don’t let it throw you off! Approximately 45% of patients with chronic low back pain suffer from “facet syndrome” (FS) in which the facets are the low back pain generator.

There are many conditions that give rise to FS. Some of these include the straining of the surrounding joint capsule (the capsule holds the joint securely together), joint hypomobility (reduced motion in the joint), a synovial cyst (similar to a ganglion on the back of the wrist but its located inside the joint), and degeneration (also called osteoarthritis—the wearing out type of arthritis).

Because facet syndrome can accompany other conditions, a doctor of chiropractic must evaluate each patient individually and manage each person appropriately. In “pure” facet syndrome, pain rarely ever passes the level of the knee and does not cause neurological loss (weakness, loss of reflex, etc.). It can create numbness but usually NOT beyond the knee. Pain is usually not worsened by hip movements such as straight leg raise or hip rotation.

The facet joint’s “job” (at least in part) is to limit or guard twisting movements in the upper lumbar/low back region, and the lower lumbar facets are shaped to limit motion when bending forwards and backwards. Facet joints are unique because they are innervated by specific nerves that can be blocked by injecting an anesthetic agent to determine if the facet (and its innervating nerve) is the main source of pain. The surrounding capsule around the facet joint contains mechanoreceptors (cells that detect movement) and nociceptors (cells that detect pain) that fire when the facet joint is compressed/jammed or over-stretched. These nociceptors can become “hypersensitized” (very irritable) when they remain inflamed over time.

In many patients, injury to a facet joint is the result of many microtraumas over a period of time and not one single isolated event. For example, repeatedly bending backwards, twisting, and leaning to one side can stretch the joint capsule and fatigue it until some capsular tissues finally “give” and it inflames which generates pain.

These joints commonly become arthritic with age, which is one reason people over 50-60 years old commonly present with FS. Osteoarthritis results in a narrowing of the joint space and causes a more permanently “jammed” joint. This is one reason many elderly people walk partially bent over—as bending forwards opens the facet joints and “feels good!”

The good news is that chiropractic manipulation is a highly effective treatment for facet syndrome, and most patients feel much better within the first or second week of care (often within three to five visits).

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.

The Important Benefits of Drinking Enough Water!

18 Jul

With the availability of beverages like coffee, tea, soda, and juice, it’s easy to miss out on one of the most important liquids that should fill our cup—water.

So how much water should a person drink to stay healthy? One study conducted by the Mayo Clinic found that properly hydrated women consume about 2.7 liters (91 fluid ounces) of total water a day. That being said, factors like physical activity, hot or humid weather, high altitude, or having an illness can play a part in how much fluid a person should take in.

Drinking enough water has important health benefits. Here are just a few:

  • Weight Control – Not only does switching out a high-sugar, caloric beverage for water help reduce excess energy consumption, but it may also aid in determining whether or not the body is signaling for food or hydration. One study found that obese individuals who drank more water had increased energy expenditure and weight change when blood carbohydrate and insulin concentrations were not elevated.
  • Protects Against Cardiovascular Disease – A recent study found a connection between dehydration and negative endothelial function with impaired cardiovascular health in humans. The study out of the European Journal of Nutrition claims that, “Mild dehydration can impair vascular function nearly as much as smoking a cigarette.”
  • Stabilizes the Brain – Research into adolescent dehydration discovered that inadequate consumption of water can cause headaches, irritability, poorer physical performance, and reduced cognitive function. It is unlikely that these ailments are restricted to the adolescent age demographic.
  • The Harvard School of Public Health claims “Drinking enough water is essential for physiological processes such as circulation, metabolism, temperature regulation, and waste removal.”

So, how do you know if you’re drinking enough water? Here are some things to look out for that may indicate dehydration: decreased urine output, dry skin, headaches, constipation, dizziness, dry mouth, or fatigue.

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