Tag Archives: Health

A Practical Tool for Assessing Health and Longevity

30 Mar

As we age, it is natural to become more concerned about our longevity, especially if we have
experienced health challenges or engaged in unhealthy behaviors earlier in life. One way to assess probabilistic
near-term (under five years) and long-term (10–25 years) mortality risk is to use an assessment known as the
Deficit Index, also called the Frailty Index. Essentially, the index evaluates health across many different
domains. Each item is scored as 0 (not present), 0.5 (a mild or partial problem), or 1 (a severe or fully present
problem). The individual deficit scores are added together and then divided by the total number of items
assessed (61 in this example) to produce a final index value between 0 and 1. Below are commonly included
deficit domains:

  • Chronic Medical Conditions: Hypertension, diabetes mellitus, coronary artery disease, stroke or TIA,
    osteoarthritis, osteoporosis, chronic lung disease, chronic kidney disease, cancer (current or past)
  • Activities of Daily Living (ADLs): Difficulty bathing, dressing, transferring, using the bathroom,
    feeding, shopping, managing medications, managing finances, preparing meals, using transportation
  • Mobility & Physical Performance: Difficulty walking one block, difficulty climbing stairs, slow
    walking speed, poor balance, use of cane/walker/wheelchair, fall/s within previous year
  • Symptoms & Somatic Complaints: Chronic pain, fatigue or low energy, shortness of breath, dizziness,
    poor appetite, sleep problems, urinary incontinence
  • Cognitive Function: Memory complaints, difficulty concentrating, diagnosed mild cognitive
    impairment, dementia, difficulty following instructions
  • Psychological & Emotional Health: Depressive symptoms, anxiety, low mood most days, anhedonia,
    high perceived stress, poor coping skills
  • Sensory Impairments: Poor vision (even with correction), poor hearing, difficulty communicating due
    to sensory loss
  • Nutrition & Body Composition: Unintentional weight loss, low BMI, sarcopenia or muscle weakness,
    difficulty chewing or swallowing
  • Social & Environmental Factors: Living alone, social isolation, limited social support, financial strain,
    low physical activity, limited access to care
  • Laboratory & Physiological Abnormalities: Anemia, elevated inflammatory markers, abnormal
    glucose regulation, low vitamin D, reduced kidney function markers
    In population studies, scores below 0.10 are considered robust and associated with low mortality risk
    over the next 10–20+ years; scores of 0.10–0.15 are considered pre-frail and associated with low five-year
    mortality but increased 10–20 year risk; scores of 0.15–0.25 indicate moderate frailty and a substantially
    elevated 5–10 year mortality risk, with many studies showing a roughly 50–70% chance of death within the
    next decade; scores of 0.25–0.40 indicate severe frailty and high near-term mortality, with up to a 50% chance
    of death within ~3 years and very high five-year mortality; and scores of 0.40 or higher indicate extreme frailty
    and are associated with very high 1–3 year mortality and markedly shortened survival.
    Importantly, this assessment and others like it are not intended to predict exactly how many years any
    one individual has left. Rather, they help visualize how multiple health factors combine to reflect overall
    biological aging and vulnerability. The goal is not fatalism, but insight, so that efforts to improve strength,
    nutrition, mobility, mental health, sleep, and social connection can reduce frailty, improve quality of life, and
    potentially extend both lifespan and health span.

Brent Binder M.S., D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

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Sleep Is Essential for Good Health

22 Dec

Sleep is a fundamental biological necessity that supports vital processes such as brain waste
clearance, immune regulation, and nutrient metabolism. While the body can recover from an occasional
night of poor rest, frequent sleep disruption can set the stage for chronic disease. Experts estimate that
about ten percent of adults meet the criteria for insomnia, while another twenty percent experience
occasional insomnia symptoms, highlighting just how widespread sleep problems are.
There are three key ingredients for healthy sleep: quantity, quality, and consistency. Adults
generally need seven to nine hours of rest each night, with the required amount gradually decreasing with
age. If you find yourself sleeping in on weekends or relying on naps to catch up, that’s a clear sign you’re
not getting enough sleep during the week. But the number of hours alone doesn’t tell the whole story. The
body cycles through several stages of sleep—from light to deep to rapid eye movement—and waking
repeatedly during the night can interrupt these cycles, leaving you feeling tired even after spending
sufficient time in bed. Equally important is maintaining a regular sleep schedule. Going to bed and
waking up at the same time each day, even on weekends, helps regulate the body’s circadian rhythm, the
internal clock that governs hormone release, body temperature, and alertness. When this rhythm is stable,
it becomes easier to fall asleep, stay asleep, and wake feeling refreshed.
And no, that morning cup of coffee can’t make up for poor sleep. In fact, an analysis of data
concerning more than 88,000 adults in the UK Biobank study found that inadequate or irregular sleep is
associated with 172 diseases, including dementia, Parkinson’s disease, and diabetes. For 42 of these
conditions—among them liver cirrhosis, fibrosis, and age-related frailty—poor sleep more than doubles
disease risk. Remarkably, the researchers estimate that insufficient or irregular sleep accounts for roughly
20% of the overall risk profile in 92 of these conditions, suggesting that sleep regularity may play an even
greater role in long-term health than sleep duration alone.
To set the stage for better sleep, experts emphasize lifestyle and environmental factors that
support the body’s natural rhythms. A nutrient-rich diet, regular physical activity, limited alcohol and
caffeine intake, and effective stress management all contribute to more restful sleep. Exposure to natural
light during the day and minimizing blue light from screens in the evening help reinforce the body’s
natural light–dark cycle. Keeping the bedroom dark, quiet, and cool promotes deeper rest, while
maintaining a consistent bedtime strengthens the brain’s expectation of when to release sleep-related
hormones. If snoring, gasping, or frequent awakenings are a problem, a sleep specialist can evaluate for
conditions such as sleep apnea.
Finally, when pain interferes with sleep, addressing the source is essential. Research shows a
bidirectional relationship between poor sleep and musculoskeletal pain—particularly low back pain—
meaning that inadequate rest can worsen discomfort, and discomfort can further erode sleep quality. In
such cases, consulting a doctor of chiropractic can be an important step toward breaking this cycle and
restoring both comfort and healthy sleep.
Pain Relief Chiropractic

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Midlife Carpal Tunnel Syndrome

11 Dec

Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed or restricted
as it passes through the wrist. Early on, this may cause mild, intermittent tingling, numbness, or pain in
parts of the hand, but over time, symptoms can become more frequent and activity-limiting. While CTS
can develop at any age, it’s most common during midlife due to the convergence of three key factors:
occupational stress, hormonal and metabolic changes, and age-related anatomy.
When we perform frequent, repetitive hand movements, the tendons that run through the carpal
tunnel glide back and forth against one another. Over time, the lubricating sheaths surrounding these
tendons can become inflamed and sustain micro-injuries that need time to recover. However, occupations
or hobbies that involve non-neutral wrist positions, high gripping forces, or vibration exposure often
provide little opportunity for rest. After years—or decades—of repetitive stress, minor irritation can
progress into chronic inflammation that’s difficult to ignore or manage with over-the-counter remedies.
In addition to repetitive movement, hormonal changes and worsening metabolic health during
midlife increase CTS risk. Chronically elevated blood sugar can thicken connective tissue (including the
transverse carpal ligament) and increase fluid retention, both of which reduce space inside the carpal
tunnel and place pressure on the median nerve. Poor metabolic health also damages the microvessels that
supply the nerve and fuel systemic inflammation that can narrow the tunnel even further. Women face an
added risk during this stage of life, as changes in estrogen and thyroid hormones can make tissues less
elastic and more vulnerable to shear forces.
Age-related changes compound the problem. As we grow older, damaged tissues heal and
regenerate more slowly. Tendons thicken, ligaments stiffen, and the myelin sheath that insulates nerves
can begin to thin, leaving the median nerve more susceptible to compression at the carpal tunnel. Muscle
mass naturally declines as well, reducing the stabilizing forces around the wrist. These changes affect not
only the carpal tunnel itself but the entire course of the median nerve—from the neck and shoulder down
through the elbow and forearm—meaning that restriction anywhere along its path can heighten sensitivity
to compression at the wrist.
Fortunately, all is not lost. Although we can’t stop the aging process, we can control occupational
and metabolic risk factors. Adjusting tools to maintain a neutral wrist position, scheduling regular microbreaks, and performing nerve-gliding or wrist-mobility exercises can help reduce pressure in the tunnel.
Supporting overall metabolic health is equally important: limit sugary drinks and ultra-processed foods,
increase fruit and vegetable intake, take daily walks, and aim for 150 minutes of moderate activity plus
two resistance-training sessions per week.
Finally, chiropractic care can help restore normal motion to the wrist and surrounding joints,
reducing strain on the median nerve along its entire pathway. Your chiropractor can also teach you the
most effective exercises for symptom management and guide you on ergonomic adjustments to keep your
wrists healthy long-term.
Brent Binder, D.C.

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Chiropractic Treatment for Chronic Rhinosinusitis?

4 Dec

Chronic rhinosinusitis is a long-term inflammation of the nasal and paranasal sinus mucosa
lasting twelve weeks or more, characterized by at least two of the following symptoms: nasal
congestion, facial pressure or pain, reduced sense of smell, and/or nasal discharge. It’s estimated that
about 1 in 10 adults worldwide are affected, though prevalence may be higher in some regions due to
genetic, cultural, and environmental factors that contribute to persistent inflammation of the nasal
and sinus lining.
Contributing factors can include allergic or environmental irritants—from household
allergens to air pollution—structural issues such as a deviated nasal septum, enlarged turbinates, or
nasal polyps that obstruct sinus drainage, recurrent infections, immune dysfunction, asthma, and even
gastroesophageal reflux. It’s highly likely that two or more of these are present in a patient, making
each case somewhat unique and often requiring a tailored, multidisciplinary approach to resolve
symptoms.
Standard treatment usually starts with intranasal corticosteroids and nasal saline irrigation,
with the option of adding antibiotics, systemic steroids, antihistamines, decongestants, or leukotriene
modifiers. The data show that up to 90% of chronic rhinosinusitis patients without nasal polyps
respond to this approach, though the success rate falls to 50–70% in the presence of nasal polyps. For
the 10–20% who don’t respond to conventional treatment, the patient may receive referral to see if
they are a candidate for functional endoscopic sinus surgery aimed at enlarging the sinuses to restore
proper drainage and ventilation.
For patients who don’t tolerate certain medications, wish to avoid surgery, or continue to
experience symptoms even after undergoing functional endoscopic sinus surgery, there is limited
evidence that some hands-on therapies provided by chiropractors may be of benefit. A 2024
systematic review reported that manual therapies—including cervical soft tissue manipulation,
cervical myofascial release, cervical high-velocity/low-amplitude thrust manipulation (HVLA-TM),
thoracic muscle energy, scapular release, thoracic HVLA-TM, cranial techniques, and lymphatic
drainage—may help reduce head and neck congestion, improve lymphatic and venous outflow,
normalize autonomic tone, enhance respiratory mechanics and immune function, and decrease
perceived facial pressure and headache.
While chiropractors in most jurisdictions are recognized as portal-of-entry healthcare
providers—meaning patients can see them directly without referral—chronic rhinosinusitis may, in
some regions, fall outside the direct chiropractic scope of practice. In such cases, co-management
with the patient’s physician is advised, and chiropractic care should be provided on an adjunctive
basis consistent with local regulations.
Brent Binder, D.C.

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Risk Factors for Postpartum Low Back Pain

1 Dec

It’s estimated that as many as 50–70% of new mothers experience low back pain and
related disability, which can hinder their ability to carry out daily activities such as household
chores, self-care, and meeting the physical demands of infant care—including feeding, lifting,
and carrying. When severe enough, these physical limitations can contribute to stress, anxiety,
and postpartum depression, further interfering with the mother’s ability to bond with her
newborn and diminishing her overall quality of life. What are the underlying causes of
postpartum low back pain?
Interestingly, some risk factors may be present even before conception. Research
suggests that being overweight or obese, physically inactive, or exposed to occupational risk
factors such as whole-body vibration, poor ergonomics, and frequent lifting can set the stage for
low back pain both during pregnancy and after delivery. Women with a prior history of low back
pain are also at elevated risk for symptoms during and following pregnancy.
As the baby grows, the center of mass shifts forward in the body. To compensate, the
pelvis tilts anteriorly and the lumbar spine increases in lordosis, placing added stress on the
lumbar intervertebral disks and facet joints. The stretching of the abdominal muscles can reduce
spinal stability, while hormonal changes that prepare the pelvis for childbirth can increase joint
laxity, further affecting stability in the lower spine and pelvic region. To compound these effects,
expectant mothers may experience fluid retention, deconditioning from reduced activity, sleep
positions that strain the lower back, and psychosocial factors such as stress and anxiety that
heighten pain perception.
Childbirth itself can also contribute to postpartum low back pain. The physical effort of
pushing during delivery can strain the lower back, and the hormonal changes that allow for
ligamentous laxity during pregnancy may persist afterward, leaving the spine more susceptible to
mechanical stress. In cases of cesarean delivery, factors such as spinal anesthesia, post-surgical
immobilization, and prolonged bedrest can further delay recovery and exacerbate pain.
Unfortunately, it’s a common misconception that postpartum low back pain will simply
resolve on its own. In reality, studies suggest that up to 1 in 5 new mothers with low back pain
will develop chronic symptoms lasting a year or longer. While some risk factors for postpartum
low back pain are beyond a woman’s control, others—such as maintaining an active lifestyle,
avoiding prolonged inactivity, and seeking chiropractic care to help restore proper joint motion
and function in the lumbar spine during and after pregnancy—can play a key role in prevention
and recovery.
Brent Binder, D.C.

4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

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Move More for a Longer, Healthier Life

20 Nov

As we age, we often shift our focus toward healthy lifestyle habits not just to extend life, but to preserve independence and remain free of chronic disease and disability well into later years. While maintaining a healthy weight, eating a nutritious diet, and tracking lab values are all important, a study published in October 2024 suggests that physical activity—specifically how much we move throughout the day—may be the single best predictor of longevity.

One practical way to stay active is by using an activity tracker, whether it’s a traditional pedometer or one of the newer smart watches and rings that have become popular. There is an old business adage that what gets measured gets improved, and recent studies suggest that this applies to physical activity as well. In March 2023, researchers reported that sedentary adults who wore activity trackers and received reminders about their daily steps increased their step count by an average of 5,000 per day within three months. A similar effect has been seen in children, who boosted their activity by roughly 1,500 steps a day when given a tracker of their own.

The widely quoted goal of 10,000 steps a day may have started in the 1960s as a marketing slogan for a Japanese pedometer, yet modern research suggests it is not far off as a benchmark for health. A large analysis of 57 studies led by researchers at the University of Sydney found that averaging about 7,000 steps a day was associated with a 47% reduction in the risk of premature death, along with lower risks of dementia, depression, and cardiovascular disease. Other work suggests that the longevity benefits of walking may level off at around 16,000 steps a day. For those who are sedentary, goals like 5,000, 8,000, or 10,000 daily steps may seem daunting at first, but the most important point to remember is that some movement is always better than none, and with time and consistency, more is always possible.

Daily step counts capture overall movement, but higher-intensity activity remains essential for building stronger muscles and bones, improving balance, and unlocking health benefits that everyday walking alone cannot provide. Current guidelines recommend at least 150 minutes of moderate-to-vigorous exercise each week, along with resistance training twice a week. Participating in sports or recreational activities is a particularly effective way to meet these goals, as they not only challenge the heart, lungs, and muscles, but also engage the mind and senses and provide valuable opportunities for social connection.

Before beginning any new fitness routine, it is important to check with your healthcare provider to ensure the activities are safe for your individual health profile. And if pain or stiffness begins to interfere with your ability to move more, a doctor of chiropractic may be able to help restore comfortable movement and reduce limitations, allowing you to progress to an active lifestyle that supports long-term health and independence.

Pain Relief Chiropractic

4909 Louise Drive Suite 102

Mechanicsburg, PA 17055

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