Headache Danger Signals

25 Feb

There are four main arteries that bring blood to the brain: two in the front of the neck called the carotid arteries and two in the back of the neck called the vertebral arteries. The carotid arteries supply the front and middle portions of the brain with blood while the vertebral arteries join together to form the basilar artery that supplies blood to the back portion of the brain and the brain stem.

A stroke occurs when the blood supply to the brain is interrupted and oxygen can’t get to the brain tissue, which causes damage. Each area of the brain is programmed to run different bodily functions, so symptoms associated with stroke can be mild to severe depending on the amount of area involved. Stroke victims commonly have problems with speech, behavior, thought processing, motor skills, and memory.

There are basically two ways a stroke can occur: 1) Blockage in one of the many arteries (called Ischemic stroke, which is associated with about 83% of cases), or 2) A tear, leak, or rupture in a blood vessel (called hemorrhagic stroke, which is associated with about 17% of cases). Again, symptoms are directly related to where the blockage or bleed occurs and the area deprived of oxygen. Mini-strokes (called TIAs or Trans-Ischemic Attacks) can precede a larger stroke and last a few minutes to several hours. These are caused by a temporary disruption in blood flow and SHOULD NOT BE IGNORED, as these are important warning signs of a potential larger impending stroke!

Studies have shown that the symptoms associated with stroke are similar to those that drive people to either their family doctor and/or chiropractor—most notably, neck pain and headache.

So, what is the difference between the symptoms of a “normal” neck pain/headache vs. one associated with stroke? In some cases, not much! However, a stroke-related headache is often SUDDEN, SEVERE, and UNUSUAL for that person. The tension-type “normal” headache may be part of the patient’s long-term history, not severe or unusual, and NOT typically accompanied by other symptoms such as dizziness.

A 2008 study found that the incidence rate of stroke occurring in the clinics of an MD vs. a DC were IDENTICAL. In other words, it’s not the treatment performed by either type of doctor that caused the stroke but rather the stroke had already occurred and the symptoms drove the person to see either their MD and/or DC. In recent case reports, two different patients presented to their chiropractors with these headache/neck pain symptoms. In both cases, their doctor properly identified they were at risk for a subsequent stroke and referred them to the appropriate healthcare professionals BEFORE any treatment was administered.

Classic stroke symptoms include: 1) Sudden weakness or numbness in the face, arm, or leg, usually on one side of the body; 2) Difficulty in speaking or understanding language; 3) Altered vision (poor acuity or blurriness); 4) Sudden severe headache; 5) Unexplained balance loss or dizziness. If any these occur, call 911! Time IS of the essence for minimizing brain damage!

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, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE!

FOR A FREE NO-OBLIGATION CONSULTATION CALL717-697-1888

Whiplash – What Exercises Should I Do? (Part 2)

23 Feb

Last month, we looked at the VERY important deep neck flexor muscles. As promised, this month, we will cover exercises to work the deep neck extensors.

Since the 1990s, the deep neck flexors have been getting most of the attention as being the “missing link” in rehab of the neck after whiplash. As important as the deep neck flexors are, the deep neck extensors cannot be ignored. In fact, BOTH the deep neck flexors and extensors have to work in concert to control segmental movement! A 2013 study reported the deep neck extensors can become quite de-conditioned and weak in patients with neck pain. Recent studies confirm that neck pain patients typically display reduced activation AND a less defined activation pattern in the deep neck extensors, and the amount of weakness and poor activation is proportional to the amount of pain present (i.e., the higher the pain level, the worse the activity response).

PROCEDURE 3 (Prone Neck Extensors): Lying on your stomach, arms at your sides, palms facing outwards, tuck in the chin without looking down. Lift you head and chest off the floor and hold the position for ten seconds or as long as can be tolerated. Remember, stay within “reasonable boundaries of pain” (that only YOU can define) and gradually add repetitions over time.

PROCEDURE 4 (Neck Extensor Isometrics): Sitting or standing, tuck in your chin without looking down. Extend the head back slightly and place one hand behind the head. Slowly push the head back into your fingers at about 10% of maximum force and gradually use a greater amount of force over time. Once you feel you have good motor control and are tolerating the exercise well, vary the amount of resistance from 10% to 90%, gradually increasing then decreasing the resistance SLOWLY (crescendo and decrescendo the resistance)!

PROCEDURE 5 (Neck Extensor Isotonics): Same as above but this time the head moves while applying a steady light (10-25% of max.) resistance from full extension into full flexion. Repeat this for three to five slow repetitions through the full range. Keep your chin tucked while moving the head into your hand. The object is to SMOOTHLY move your head into and out of flexion/extension SLOWLY through as much of the range as possible (remember you define the pain boundaries)!

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 Whiplash, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH!

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

Can Chiropractic Help My Headaches?

22 Feb

Everyone, well at least almost everyone, has had headaches from time to time, and we all know how miserable they can make us feel. In fact, at some point in time, 9 out of 10 Americans suffer from headaches that range between mild and dull to throbbing, intense, and debilitating, sometimes to the point of requiring bed rest in a dark, quiet room.

The common reflex is to reach for that bottle of pills and pray the headache subsides so you don’t have to call in sick and lose another day of productivity when you have so much to do. Unfortunately, between the side effects of many medications designed to help headaches and the pain associated with the headache, this approach is frequently NOT the answer. So what is?

The good news is that many studies have identified spinal manipulation therapy (SMT), the main type of care utilized by chiropractors, as being very effective for popular types of headaches—in particular tension-type headaches that arise in the neck. An important 2001 study reported that SMT provided almost immediate relief for headaches that arose in the neck with SIGNIFICANTLY fewer side effects and longer-lasting results compared with commonly prescribed medications.

Another interesting study that found similar results included tracking the prevalence/frequency of headaches after treatment stopped. The authors of the study reported the patients receiving SMT had continued to experience sustained benefits throughout the following weeks, and even months, in contrast to those in a medication treatment group where headaches came back almost immediately after they discontinued treatment.

The most commonly prescribed medication for tension-type headaches are non-steroidal anti-inflammatory drugs (NSAIDs). Common over-the-counter options include ibuprofen (Advil, Nuprin, etc.) and Aleve (Naproxen). For those who can’t take NSAIDs because of blood thinning and/or stomach-liver-kidney problems, doctors commonly prescribe acetaminophen (Tylenol), but it can be hard on the liver and kidneys, especially when taken over time.

So, what can you expect from a visit to a chiropractor for your headaches? The typical approach begins with a thorough history and examination with an emphasis of evaluating the neck and its associated function. Your doctor of chiropractic may also perform tests designed to reduce pain and some that provoke a pain response to identify the “pain generator” or cause!

Because each patient is unique, the type of care provided will be individually determined based on the findings, the patient’s age, comfort, and preference of both the provider and patient.

So, the next time you find yourself reaching for pills because of headaches, remember that there are better options! Give chiropractic a try. You’ll be GLAD you did!!!

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 HEADACHES!

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


Fibromyalgia and Sleep — Is There a Connection?

18 Feb

Is there a connection between fibromyalgia (FM) and sleep disturbance? Let’s take a look!

FM is a condition that causes widespread pain and stiffness in muscles and joints. Patients with FM often experience chronic daytime fatigue and some type of sleep problems like getting to sleep, staying asleep, and/or feeling restored in the morning upon waking. The National Institutes of Health estimates between 80-90% of those diagnosed with FM are middle-aged women, although it can affect men and happen at any age. As little as 10-20 years ago, it was hard to find a doctor who “believed” in FM, and it was common for the patient to be told that their pain “was all in their head.” FM has now been studied to the point that we know it is a real condition, and it affects between 2-6% of the general population around the world.

It is well established that sleep disturbance frequently occurs after surgery, which usually normalizes as time passes. One study used a group of healthy women who were deprived of sleep (particularly slow wave sleep) for three days to see if there was a link between sleep disturbance and pain. Results confirmed that the women experienced a decrease in pain tolerance and increased levels of discomfort and fatigue after three days—the same symptoms found among FM sufferers!

Fibromyalgia may have NO known cause, or it can be triggered by other conditions such as repetitive stress injuries, car crash injuries, and other forms of trauma. FM also appears to run in families though it’s still NOT clear if this is a true genetic link or caused by shared environmental factors. Some feel FM is a rheumatoid condition, and though FM is NOT a true form of arthritis, it has been found that people with arthritis are more likely to have FM.

FM sufferers frequently suffer from conditions such as irritable bowel syndrome, chronic fatigue syndrome, migraine headaches, arthritis, lupus, and major depressive disorders. Approximately 20% of FM patients have depression and/or anxiety disorders, and a link between chronic pain and depression exists and seems to play a role in people’s perception of pain.

Because conditions such as sleep apnea can result in symptoms similar to FM, it’s recommended that patients suspected of FM keep a sleep/sleepiness diary in order to rule out sleep apnea as a cause for their condition.

There are many “tips” for improving sleep quality, which we will dive into next month, as these may prove VERY HELPFUL in the management of FM!

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

The Three Most Important Medical Stories of 2015 to Help YOU Stay Young…

16 Feb

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.

Here are our choices for the three most important medical stories of 2015 in regards to helping you stay young…

  1. Try A Periodic Fast. In a new study from the University of Southern California, researchers tested a super-short periodic fast diet strategy that offers the potential benefits of both continual calorie reduction and fasting—without giving up much when it comes to food. Mice ate low-calorie diets for five days twice a month for several months. Humans ate a low-calorie, healthy diet for just five days a month for three months. The results? Mice on the eating plan had less cancer, lost more heart-threatening abdominal fat, developed stronger immunity, and displayed sharper thinking skills than those who chowed down as usual. They also lived longer. Levels of insulin-like growth factor (IGF-1)—a compound that can fuel the growth of cancer cells—decreased. Your fellow humans saw improvements in markers linked to a lower risk for cancer, diabetes, and heart disease.

This new “fast-mimicking diet” that combines a five-day low-cal plan followed by regular eating (an essential important component of the diet) seems to be an effective way to flip on healthy switches throughout your body—and you never miss a meal. In lab studies, the researchers observed the low-cal portion of the plan prompts the death of aging cells throughout the body, and that may increase cells’ resistance to stress. Then, eating normal-size meals again prompts an increase in the number of stem cells—the cells that help repair and rebuild tissue throughout the body.

  1. Test Your Grip Strength with Dr. Roizen’s Nutty Rice Bucket Challenge to Find Out How Long and Well You’ll Live. Don’t ignore your hands. Building grip strength in midlife protects you from inability to do activities of daily life, like dressing, and mobility problems later on and keeps you active longer. Several small studies over the last few decades indicate that your grip strength predicts your risk of disability and even death. This year, a large 17 country 142,000 person study found that your grip strength really does predict if you will live long and prosper. It is not obvious why your grip strength is such a good predictor of disability and death, but it is even a better predictor than your overall muscle mass, your blood pressure, your LDL cholesterol levels, etc. Go to NuttyRiceBucket.org to find a fun (and even entertaining) method using this rice bucket that can help predict if your biological age is older or younger than your calendar age. It’s also a method used by pole vaulters, rock climbers, and even defensive linemen in the NFL to strengthen their grip. Remember, no cheating, but beating 15 seconds will mean you may be much younger than you think.
  1. EAT DMB (Not dumb, but eating this may really make you smarter, and keep you younger much longer). A heart-threatening substance produced by bacteria inside your gut to chow down on foods like red meat and pork called TMAO can be a menace to your body by stimulating it to plug arteries with more and more plaque (and it might also help cancers thrive, and kill brain cells, too). Now we know how to stop it. Brand new studies from the Cleveland Clinic (where Dr. Mike is Chief Wellness Officer) have uncovered a “Superman” compound that thwarts TMAO. And you can start using it today—deliciously—to lower your risk for heart attack, stroke, even kidney problems and wrinkles. This protector is called DMB, but it’s far from dumb.

Found in some extra-virgin olive oils and red wines, DMB stops bacteria in your digestive system from turning choline, l-carnitine, and lecithin from food into the compound that becomes TMAO. In lab studies, DMB stopped gut bugs from making this “pre TMAO.” That means the liver couldn’t convert it into TMAO. With less TMAO in the bloodstream, atherosclerosis—the build-up of fatty, gunky plaque in artery walls—slowed down and even went into reverse. Wow! Meanwhile, back in the digestive system, there was a decrease in TMA-producing gut bugs. Double whammy! It doesn’t take many of these unfriendly bugs to cause problems in your arteries, so the fewer the better.

TMAO seems to matter as much or more than cholesterol in regards to heart and brain health. A study measured TMAO in more than 4,000 men and women, and those with the highest levels were 2 ½ times more likely to have a heart attack or stroke over the next three years than those with the lowest levels. Interestingly, the risk was high regardless of whether their levels of “bad” LDL cholesterol were high or low. Where did this TMAO come from? In related studies, people who ate two hard-boiled eggs or an 8-ounce sirloin steak saw blood levels of TMAO soar. TMAO traps cholesterol inside gunky, foamy cells that burrow into artery walls. Normally, some of this cholesterol is sucked out and whisked away by friendly HDL cholesterol. But dastardly TMAO shuts down that clean-up operation, inviting more and more cholesterol to pile in.

You don’t have to become a vegan to reduce TMAO levels, but it helps. It appears TMAO levels won’t increase if you eat less than four ounces of red meat, eight ounces of lean pork, or two egg yolks per week (not all of ‘em, but any combo of them). Fish is a better entrée, but limit servings of tilapia, cod, and Chilean sea bass—the samples of these tested contained more TMAO than other seafood.

Go for “EV” olive oil: There’s DMB in some cold-pressed, extra-virgin olive oils—such as types produced in Spain, in some parts of Turkey and Greece, and California. You need 2-4 tablespoons a day; at 120 calories per tablespoon that could add up so be sure to use it instead of other fats and make other calorie adjustments as needed. Store olive oil away from light in a tightly-capped brown bottle to preserve DMB. Grape seed oil, balsamic vinegar, and red wine may also be good sources.

Now combine the grip strength strengthening of the Nutty Rice Bucket with the periodic reduced calorie diet, and eating DMB, and you just may be 50 years younger than your calendar age at age 95. Not Bad. Now you see why I think these are the three best medical breakthroughs for staying young in 2015….

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 2)

15 Feb

Healthcare providers tend to agree that in non-emergency situations, patients with conditions like Carpal Tunnel Syndrome (CTS) should try non-surgical treatments before consulting with a surgeon. The “PRICE” concept, that is Protect, Rest, Ice, Compress, & Elevate can be applied to most injuries, including CTS, especially in the acute/inflammatory stage. However, many of these principles also apply in the chronic stage (more than three months) of CTS.

PROTECT: For the CTS patient, many doctors commonly prescribe a wrist cock-up splint to be worn overnight, which may surprise some of you! During the day, depending on the type of work you do, a wrist splint can actually get in the way and result in increased symptoms, and at times, cause bruising at both ends of the splint (mid-forearm & mid-hand). The primary reason to use the splint at night is that one cannot control the position of their wrist during sleep, and it can often wind up bent. This increases the pressure inside the carpal tunnel up to six to eight times more than normal, potentially causing enough pain and tingling to disturb sleep. The splint guarantees a neutral wrist position, which significantly improves sleep quality and allows healing to occur.

REST: The use of a splint allows the swollen median nerve to heal. However, in order to allow the wrist to rest so inflammation can subside and the condition can fully heal, patients often need to modify their daily activities, at least for a short time. This may require job restrictions, especially if the occupation involves a fast repetitive motion type of tasks and/or forceful gripping.

ICE: The use of an “ice cup”—or an ice cube held with a washcloth to protect the fingertips from getting cold—is by far the most effective approach. Rub the ice directly on the skin over the carpal tunnel so that you experience the four stages of cooling: Cold, Burning, Aching, and Numb (C-BAN). This usually takes about four minutes, and it’s important to stop when numbness occurs, as the next stage of cooling is frostbite. This can be repeated multiple times a day and is often as effective as cortisone shots with fewer side effects (and less pain!).

COMPRESS: The wrist cock-up splint can offer some compression, but an elastic carpal tunnel wrist band will not usually interfere with most activities of daily living. Some versions include a thumb loop to keep the wrist band in place, but that may get in the way. A version without the thumb loop also works very well.

EXERCISE: Exercises performed at home and work can significantly help manage the condition. (Note: For injuries like a sprained ankle, E typically stands for ELEVATE, though it’s not practical for the CTS patient.)

Tune in next month for the unique techniques that chiropractic offers to the non-surgical care of CTS as well as the importance of preventative measures 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

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