Pain Relief Chiropractic

Fibromyalgia (FM) management must include dietary considerations, just ask ANY FM sufferer! Last month, we concentrated on the types of foods that reduce inflammation, but the question remains, what foods should we go out of our way to avoid? In other words, what should we NOT eat (and why)? Let’s take a look!

As we all know, it’s MUCH EASIER to simply grab a cookie, a chocolate bar, or go through the drive-through at McDonald’s and eat on the fly. This has become “the rule” for many of us as we trim down our meal times to fit in other tasks. We seem to have our priorities mixed up and have become preoccupied in our busy lives using the excuse that “…eating simply takes too long.”

The “avoid” list starts with stop eating junk food. It’s like pollution to our body as it clogs and clutters up our digestive system and the absorbed by-products include “bad” fat like trans-fats & saturated fats that can damage the heart. These fats are found in highly processed foods, red meats, and high-fat processed meats like bacon and sausage. Many of these meats are also high in salt, another “no-no” for heart health reasons, particularly for those with high blood pressure. Other sources of saturated fat include lamb, pork, lard, butter, cream, whole milk, and high-fat cheese. Some plant sources of saturated fat include coconut oil, cocoa butter, palm oil, and palm kernel oil. The U.S. Department of Agriculture’s 2005 Dietary Guidelines recommends that adults get 20-35% of their calories from fats. At a minimum, we need at least 10% of our calories from fat.

Other foods to avoid are white flour-based foods such as bread and pasta. This is primarily because white flour is derived from grains which are gluten rich (wheat, oats, barley, rye) and as we discussed last month, very inflammatory to our body! Simply avoiding gluten can be the nucleus of a great diet with benefits like increased energy, less mental fog, and weight loss without really trying! Sugar is also found in many products that we like eating. It’s found in juices, soda, pastries, candy, most desserts, as well as pre-sweetened cereals. Even ketchup has sugar in it! Another “bad guy” comes from the nightshade family of plants that includes tomatoes, eggplant, potatoes (but NOT sweet potatoes), sweet and hot peppers, ground cherries (a small orange fruit similar to a tomato), and Goji berries. These plants contain a chemical alkaloid called solanine that triggers pain in some people.

Weight reduction is another way to reduce pain and inflammation. If your Body Mass Index is over 25, (“Google” a BMI calculator and check yours) then you may need to lose weight! There are MANY diets one can follow, but to keep it simple embrace one approach first and see what kind of results you get. Try the “Paleo diet” as it is a gluten-free approach. The Mediterranean diet is similar and then there is the Aitkin’s Diet, the Zone Diet, etc., etc. Try eliminating the three most abused unhealthy foods in your diet (like soda, ice cream, chocolate, etc.) as that too can yield great results. Make sure your thyroid is working properly if you can’t lose weight with these approaches. Simply put, foods high in sugar, saturated fat, and white flour cause overactivity of our immune system which can lead to joint and muscle pain, fatigue, and damage to blood vessels.

Eliminating these foods and eating the foods discussed last month is good for all of us, not JUST those suffering from fibromyalgia!

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

Anti-inflammatory foods can be broken down into four categories: 1) Fruits and vegetables; 2) Protein Sources; 3) Fats and Oils; and 4) Beverages.

In the fruits and vegetables category, whole fruits, berries, and vegetables in general are rich in good things like vitamins, minerals, fiber, anti-oxidants, and phytochemicals. In particular, green and brightly colored vegetables and whole foods (such as broccoli, chard, strawberries, blueberries, spinach, carrots, and squash) are great choices.

Besides being low in calories, high in fiber, rich in vitamin/minerals and more, berries EVEN taste good! For example, one cup of strawberries contains >100mg of vitamin C (similar to a cup of orange juice), which helps our immune system function. One cup of blueberries includes a little less vitamin C but it has minerals, phytochemicals, and anti-oxidants at only 83 calories per cup. A cup of cranberries has only 44 calories (it can also help with bladder infections), and a cup of raspberries has 64 calories and has vitamin C and potassium. Less common, but equally nutritious, are loganberries, currants, gooseberries, lingonberries, and bilberries. Put these, or a mixture of these, on salads, yogurt, or a whole grain cereal and enjoy a VERY satisfying snack or meal! The health benefits of phytochemicals and flavonoids include cancer prevention, bladder infection treatment, and may even help your eyesight (such as from lutein in blueberries and raspberries).

Protein sources include fish/seafood, especially oily ocean fish like salmon and tuna, as these are rich in omega-3 fatty acids. Soy and soy foods like tofu and tempeh as well as legumes are great plant sources of protein, though some doctors may recommend staying away from soy. Nuts such as walnuts, almonds, pecans, and Brazil nuts are also great protein sources.

Fats and Oils: Omega-3 fatty acids can be found in flax seeds, canola oil, and pumpkin seeds, as well as cold-water oily fish. Other fats that are anti-inflammatory include monounsaturated fatty acids, which are found in olive oil, avocados, and nuts and have been found to be cardiovascular disease “friendly” as well. Other healthy oils include rice bran oil, grape seed oil, and walnut oil.

Beverages: Our bodies need water! Of course, tap, sparkling, or bottled water are great sources of water. So are 100% juices, herbal tea, low-sodium vegetable juice, and if tolerated, low or non-fat milk.

Meal suggestions include: Breakfast – oatmeal with fresh berries and walnuts; Snacks – whole fruits, nuts, seeds, and fresh vegetables; Lunch and Dinner– choose fish and less fatty red meats; cook with olive and canola oil; load up a salad with fresh vegetables and fruit, avoid deep fried foods – rather, bake, broil, poach, or stir-fry instead. Fill up HALF of your dinner plate with dark green or brightly colored vegetables. Avoid the following: junk food, high-fat meats, sugar (sodas, pastries, candy, rich desserts, and sweetened cereals), highly processed foods, trans-fats and saturated fats (i.e., bacon and sausage), and white flour products (get 100% whole grain instead). Some research suggests not eating “nightshade plants” like tomatoes and eggplant.

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

Exercise therapies have been identified as one of the most effective forms of treatment for Fibromyalgia (FM). Unfortunately, in a study of 121 newly diagnosed FM patient files, less than half included an exercise recommendation. This statistic is alarming! This month’s article will focus on recent FM studies supporting the benefits of exercise.

The first study looked at the immediate effects of a 6-mo. combined exercise program and its impact on quality-of-life, physical function, depression, and aerobic capacity in 41 FM females. Also, it studied the impact of starting and stopping the program. A group of 21 women were placed into the exercise group and 20 into the control group. Questionnaires and a physical fitness screen were used to measure the outcome or benefits of the program vs. no intervention at baseline (initial), and after 6 months of exercise training followed by 6 months of no exercise training over a 30 month timeframe. Results highly favored the exercise training group over the control group in all parameters both during the exercise training (immediate effects) and during the no exercise 6 month time frames (long-term benefits).

A Chicago-based pilot (small-scaled) study evaluated the use of aerobic conditioning (VO2 max.) on 26 FM subjects at baseline and after a 12-week home-based aerobic exercise program. The exercises included a 30 minute program at 80% of the maximum heart rate, and also measured pain, disability, depression and stress. Results showed those who successfully completed the 12-week program demonstrated an increase in aerobic conditioning, and a trend towards less pain, disability and stress reduction. Those who were unable or unwilling to participate had significantly higher pain, disability and a trend toward more depression at baseline vs. those that completed the program. The conclusions suggest aerobic exercises benefits the FM patient’s quality of life and, VO2 max is a useful marker for measuring exercise benefits. Also, those scoring initially high in the pain, disability, depression/stress measures were more likely to fail and may benefit from a more comprehensive guided program.

Another study looked at the effects of a 3x/week, 16-week exercise program in a chest-high pool of warm water measuring global symptoms and exercise adherence (compliance) levels. A group of 60 middle-aged FM women were compared to 20 healthy, similarly age matched females before and after a 16 week aquatic exercise program that included strength training, aerobic training and relaxation exercises. Tender point count, health status, sleep quality, physical endurance, psychologic and cognitive function were measured and, compliance at 12-months was studied. Again, the results revealed statistical improvement in most of the parameters tested in the FM exercise group and, 23 of the 60 were still exercising at 12 months. Again, the conclusions favor the need for exercises in the management of FM.

As noted in the initial paragraph, in spite of all the positive research support for including exercise training in FM patients, less than half of newly diagnosed FM suffers are given exercises as part of their treatment plan. The need for exercises to be part of the FM treatment plan is clear, and training needs to be initially structured to enhance compliance.

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

Fibromyalgia (FM) is a condition that (typically)  evolves slowly over time and often occurs for no apparent reason. The diagnosis is usually made by excluding other conditions leaving you with a diagnosis that in the absence of anything else, “….must be fibromyalgia.” Of course, the problem with that approach is that we all want to know, “…what caused this problem to start with?” In the end, we typically have to accept the fact that, “…it just did,” and move on to, “…now what are we going to do about it?”

A multi-disciplinary (involving several different types of doctors and approaches) treatment approach has been found to work well with Fibromyalgia patients. This approach may include medications from a primary care doctor who is aware and sensitive to this potentially disabling condition, massage therapy from a muscle relaxation point of view, clinical psychology when the stresses associated with FM become overwhelming and out of control, and chiropractic to quarterback joint mobility, diet management, exercise training, modality use, as well as offering foot orthotics. Coordinated care effort utilizing several disciplines is what is reported to be the most successful approach.

Because chiropractic embraces the concept of treating the whole person, this premise fits perfectly in the treatment plan for the FM patient since the entire body is considered, not just a specific area or system. In this approach, we assess posture, movement, alignment, and function and implement treatments to improve each of those areas.

During the postural assessment, because we are a 2-legged species, the feet must be carefully assessed for function and alignment. If you watch people walk, you will often see their ankles roll in with each step and for some, this can be quite dramatic where the ankle rolls in almost hitting the floor. What’s interesting is that most people don’t even know they are doing it! The truth is, most people with flat feet (technically called pes planus) and rolling-in ankles (or, ankle pronation) don’t have any foot pain or symptoms associated with the altered function. In fact, people with very high arches (pes cavus) usually have more foot pain than the flat footed person. If you look at shoes of those of us who pronate (which is about 80% of us), the wear pattern is usually quite excessive on the outer corner of the heel. Sound familiar? It is very common! So, why bother “fixing” ankle pronation if it doesn’t hurt? The answer is that biomechanical function is altered and it negatively affects the rest of the body quite significantly. Here’s what happens. When the ankle rolls in, the knee has to “knock” inwards, the hip has to impinge inwards, the pelvis on that side drops and the spine has to compensate for the pelvic drop and bend away from that side. Watch the shoulders and head sway back and forth as the pronated/flat footed person walks the next time you’re walking at the grocery store, mall, or airport.

So, how does the use of foot orthotics help the FM patient? It has been reported that it takes up to seven times more energy to walk when the ankles pronate excessively. Chronic fatigue is a frequent complaint in the FM patient, and the less energy expended from walking, the more energy will be left over for other daily tasks. Also, the biomechanical stresses on the ankle, knee, hip, and spine will be smaller from wearing foot orthotics, correcting the excessive side-to-side strain on the various joints. The journal Clinical Rheumatology recently reported a significant benefit when foot orthotics were used in the treatment of FM. The bottom line is that this is a VERY SIMPLE FIX and when so much of FM is so difficult to treat, this a no brainer!

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

Fibromyalgia (FM) symptoms are characterized by chronic generalized pain, and can include debilitating fatigue, sleep disturbance, joint stiffness, numbness or tingling, bowel/bladder dysfunction, and sometimes effects our ability to process thought clearly (cognitive dysfunction).  It can come on fast, almost overnight, or, develop very slowly over years of time. This highly variable onset makes establishing a diagnosis very challenging, and can also sometimes take years before the diagnosis is firmly established. In fact, the term “fibromyalgia” was not formally recognized as a diagnosis by the American College of Rheumatology and American Medical Association until 1987, and it remains a diagnosis made by excluding other diseases!

POPULAR MYTHS

MYTH: “Your symptoms are all in your head.” TRUTH: FM is a “MEDICAL DISORDER” where the nervous system’s ability to process pain is different when compared to those who don’t have FM. Why there is a difference between individuals is the big question. Some research suggests these brain processing differences may be the result of childhood stress, or prolonged or severe stress.

MYTH: “Only lazy, inactive people get fibromyalgia.” TRUTH: Research shows this not to be the case. In fact, most people with FM are focused and driven, and that stress associated with that intense drive may play a significant role in the development of FM symptoms.

MYTH: “There are no effective fibro treatments.” TRUTH: The good news is that as more studies on FM arise, we are beginning to understand more about FM, resulting in more effective treatments. The “catch” is that what works for one individual may not work for another making it essential to find a “good doctor” (or rather, a good team of health care providers) who is willing to listen and continually try different approaches until an effective management approach is found.

COEXISTING CONDITIONS

There are some specific conditions that go hand in hand with FM, and though it’s not clear which comes first (FM or the condition), a clear relationship has been established. Some of these co-existing conditions include irritable bowel syndrome, arthritis (several different types can be associated), chronic fatigue syndrome, various sleep disorders, post-traumatic stress syndrome, anxiety, depression, and others. Often, blood and other lab tests come back negative and hence, the diagnosis is made by excluding those other conditions. What is MOST important is that to feel your best, these other conditions also need to be managed.

TREATMENT

As stated above, the management of FM is aimed at all the condition(s) affecting the person with FM. This is why a multidiscipline “team” of health care providers is so important, as we all have our own emphasis and perspective on what to do for patients. Options include: a clinical psychologist to manage the chemical and hormonal imbalances, a primary care doctor whom “believes in FM,” and a chiropractor to manage the musculoskeletal issues of FM. Other alternative approaches such as massage therapy, Yoga classes, and acupuncture can also provide significant relief. Nutritional counseling is also highly effective in the management strategy of FM. Most important is the fact that coordination between these various approaches be supervised. Since we deal with the whole person, chiropractors are the PERFECT CANDIDATE for that job!

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

Fibromyalgia (FM) is a disorder that includes widespread musculoskeletal pain along with fatigue, sleep disturbance, memory changes, mood changes and more. Studies show that FM amplifies or increases painful sensations by changing the way the brain processes pain signals. FM is NOT a psychological disorder that only people with a troubled past or present acquire. Nor is it due to being inactive or lazy. If ANY doctor suggests that, PLEASE find a different doctor who understands the pathogenesis of FM. Unfortunately, this can be a challenge!

FM symptoms can begin after a physical trauma, surgery, an infection and/or after a significant stress experience. It can also just gradually appear over time without an obvious triggering event. Women are more vulnerable to acquire FM than men. Many FM patients have other conditions that may be associated with FM including (but not limited to) headache, TMJ, irritable bowel syndrome, anxiety, depression, thyroid/hormonal imbalances, endometriosis, and more.

Though the cause of FM may not be clearly identified, studies suggest there are a variety of factors that work together resulting in FM. Some of these include genetics, infections and physical and/or emotional trauma. Because FM tends to run in families, there may be certain genes or genetic mutations (changes that occur to genes) that make one more susceptible to developing FM. Infections appear to be a trigger for developing or aggravating FM. Post-traumatic stress disorder and less obvious physical or psychological trauma has been linked to the development of FM.  The amplified or heightened pain response has been termed, “central sensitization,” meaning, increased sensitivity to normal pain stimulation in the central nervous system (brain and spinal cord). Because of this heightened nervous system response, what normally isn’t processed as pain in the non-FM person, does reach and exceed the pain threshold in the FM patient (sort of like when amputation of a limb occurs and the brain still “thinks” there is a limb and “phantom pain” is felt). Studies show that repeated pain signals result in an abnormal increase in certain brain chemicals (called neurotransmitters). As a result, the brain’s pain receptors seem to develop a “memory” of the pain and become “sensitized” or they overreact to the pain signal input and pain is felt at an increased intensity. Certain risk factors come into play with developing FM, some of which include: your sex (female), family history (increased risk if other family members have FM), and rheumatic diseases such as rheumatoid arthritis and lupus.

Tests to establish the diagnosis of FM are few. In 1990, the American College of Rheumatology established 2 criteria for diagnosing FM. The first is widespread pain lasting at least 3 months, and the second is the presence of at least 11 out of 18 positive tender points. Since then, less emphasis has been placed on the exact number of tender points, while ruling out other possible underlying conditions that might be causing the pain is now utilized. There is no lab test to confirm a diagnosis of FM, but blood tests including a complete blood count, an ESR, and thyroid function tests are commonly done to rule out other conditions that have similar symptoms. Treatment is best approached by a “team effort” combining the skills from multiple disciplines including a primary care doctor who “believes in FM” and is willing to work with chiropractors, and others. Exercising, pacing yourself, accepting your limitations, yoga, psychological counseling, nutritional counseling, and having strong family/friend support are all important in the management of FM.

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