Tag Archives: mechanicsburg pa chiropractor

Low Back Pain and Common Mistakes.

14 Dec

We often read about what to do for low back pain (LBP), but do we look at LBP from the perspective of “what NOT to do!”

ICE vs. HEAT: If you ask your doctor, “what’s better for my back, ice or heat?” the answer is either one or the other or, “…whichever you like better.” This leaves the LBP patient at a loss of who or what to believe. So, let’s settle this once and for all. Ice should be tried first because it will rarely make the LBP worse, whereas heat can. Ice is an “anti-inflammatory” agent, meaning it reduces swelling. Ice reduces congestion or pushes painful chemicals and fluids that accumulate out of the injured area when there is inflammation and usually feels good (once it’s numb), maybe not initially because it’s cold. Heat does the opposite of ice. It’s a vasodilator meaning it pulls fluids INTO the area. Sure, it feels “good” initially, but often people will say it makes them worse later. That’s because the additional fluid build up in an already inflamed area is kind of like throwing gasoline on a fire. When LBP is chronic (it’s been there >3 months), heat MAY be preferred. Contrast therapy or, alternating between the two can work as an effective “pump” pushing out fluids (with ice) and pulling in fluids (with heat). Here, start and end with ice so the first and last things done are “anti-inflammatory.”

IGNORE YOUR LBP: The comment, “I was just hoping it would go away,” has been used by all of us at some point. Though LBP can get better over time, it’s simply impossible to know when or if it will. If you have suffered from back pain previously, then you already know that getting in quickly for a chiropractic adjustment BEFORE the reflex muscle spasm sets up can stop the progression, often before it reaches a disabling level. If you want to reduce the chances of missing work or a golf game due to LBP, come in immediately when the “warning signs” occur – you know, that ‘little twinge’ in your back that’s telling you, “…be careful!”

BED REST: There is a time for rest and a time for exercise, but knowing what to do when is tricky. Another “true-ism” is the best exercise when done too soon may harm you, but when done at the right time will really help. So, here are some general guidelines: a) no more than 24-48 hours of mostly bed rest; b) walking is usually a great, safe starting activity after or even during the first 48 hours; c) avoid activities that create sharp pain (like bend, lift, twist combinations); d) use ice or contrast therapies a lot during that initial 48 hours; e) follow our exercise instructions and treatment plan – we’ll guide you through this process.

FOCUS ON X-RAY OR MRI FINDINGS: Did you know that about 50% of us have bulging disks, and 20% of us have herniated disks in our low back and yet have NO pain? That’s right! Many of us have “disk derangement” but no symptoms whatsoever. Similarly, the presence of arthritis on x-rays may have no relationship to an episode of LBP. It’s easy to blame an obvious finding on an image for our current trouble, but it may be misleading. In fact, it can even make a person fearful of doing future activities that may be just fine or even good for us. The WORST thing for some types of arthritis is to do nothing. That will just lead to more stiffness and pain! More later!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Carpal Tunnel Syndrome & Herbs.

14 Dec

Carpal Tunnel Syndrome (CTS) is a condition caused by the compression of the median nerve as it travels through the carpal tunnel in the wrist. The “source” of median nerve compression can be soft tissue swelling, such as tendonitis, bursitis, synovitis, capsulitis, etc. Last month, we discussed nutritional supplementation for CTS in general. This month, the focus is on specific herbs that can help this potentially disabling condition.

Chamomile functions as a natural “tranquilizer.” It’s used for muscle pain (as a relaxant), but can also help other problems such as menstrual disorders, headaches, and tension. Chamomile facilitates relaxation of tight muscles and has an anti-inflammatory property that soothes cramps.

Kava Root is an herbal plant that is well known for its muscle relaxing benefits. It is particularly helpful with extreme muscle pain.

Valerian is a very effective relaxant that dates back to the medieval times for curing ailments associated with muscle spasms such as muscle cramps and neck problems.

Catnip is also a natural muscle relaxant, and is a member of the mint family. It is used as a sedative and muscle relaxer. Headaches due to tension have been treated using a poultice containing catnip. Catnip has also been found to reduce swelling in joints and reduce soft tissue injuries such as tendonitis, bursitis, and capsulitis.

Cayenne Pepper is a popular herb used in cooking and can be found in many recipes. Cayenne pepper has been found to significantly relieve the pain of muscle cramping.

Horseradish has been reported to relieve extreme muscular stress involved in cramps and muscle pain. One approach is mixing a few drops of horseradish oil in bath water to reduce soreness associated with muscle aches.

Lavender flower oil is well known as a very effective muscle relaxant that provides relief caused by muscular tension. Using a circular motion while massaging the oil over the achy muscle can be particularly soothing. In addition to the mind/body relaxation benefits, an increase in circulation allows the tense muscles to relax and heal.

Licorice has the ability to reduce inflammation associated with muscle pain.

Devil’s Claw is a very popular anti-inflammatory herb that dates back to the 18th century for the treatment of arthritis and many other painful conditions. It’s also used as an effective muscle relaxer.

Peppermint oil has been used to treat conditions associated with muscles aches. Pouring some drops of peppermint oil in a hot bucket of water to soak a foot, ankle or lower leg (possibly combined with Epson salt) can be very relieving.

Other natural muscle relaxants include Cramp bark, Passiflora, Bergamot, Cardamom, Basil, Ginger root, and others.

It is appropriate to COMBINE these natural herbal approaches with other treatments that are known to work well in the treatment of CTS. Chiropractic can provide: 1. Manipulation and mobilization of the neck, shoulder, elbow forearm, wrist, hand, and fingers; 2. Cock-up splints to be worn at night and at times during the day such as driving; 3. Physical therapy modalities such as electric stim, ultrasound, light or laser therapy, magnetic field; 4. Work station and other ergonomic modification recommendations; 5. Exercise training, and more.

We realize you have a choice in who 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 require care for CTS, we would be honored to render our services.

 

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Fibromyalgia – Do We Know The Cause?

14 Dec

Fibromyalgia (FM) is a condition that is characterized by widespread pain, fatigue and an increased pain response. Symptoms can include tingling of the skin, muscle spasms, weakness in the arms and legs, nerve pain, muscle twitching, bowel disturbances, chronic sleep disturbances, and more. So, what can cause such a widespread, whole body condition? Though the “cause” of FM is unknown, several hypotheses have emerged. Here is what we know:

The brains of FM patients: Structural and functional differences have been identified in the brains of FM vs. healthy individuals. What is unclear is whether these identifiable brain changes cause the FM symptoms or are the result of an unknown cause. Some experts have reported that the abnormal brain findings may be the result of childhood stress, or prolonged, severe stress at any time in life. An area commonly affected is called the hippocampus, which plays a crucial role in maintaining cognitive functions, sleep regulation, and pain perception.

Lower pain threshold: Due to an increased reactivity of pain-sensitive nerve cells in the spinal cord and brain (called “central sensitization), FM patients feel pain sooner and worse than non-FM subjects.

Genetic predisposition: It has been reported that FM is often found in multiple family members. This genetic propensity also includes other conditions that often co-exist in FM patients such as chronic fatigue syndrome, irritable bowel syndrome (IBS), and depression.

Stress & lifestyle: Stress by itself may be an important cause of FM. It is not uncommon to develop FM after suffering from post-traumatic stress disorder. An association between physical and sexual abuse both in childhood and adulthood has also been identified. Poor lifestyle issues including smoking, obesity, and lack of physical activity increase the risk of developing FM.

Dopamine dysfunction: Dopamine is a chemical needed for neurotransmission and plays a role in pain perception. It is also connected to the development of restless leg syndrome (RLS), which is a frequent complaint of FM patients. Medications found effective for RLS such as pramipexole (also used for the treatment of Parkinson’s disease) can be helpful for some FM patients.

Abnormal serotonin metabolism: Another neurotransmitter, serotonin, regulates sleep patterns, mood, concentration, and pain and can be involved in causing FM. Decreases in other neurotransmitters (especially norepinephrine), when combined with serotonin depletion, can especially cause FM (more so in women than men). Hence, medications like duloxetine (Cympalta) originally used to treat depression and painful diabetic neuropathy, have been found to help FM patients, especially women.

Deficient growth hormone (GH) secretion: Abnormal levels of GH have been found in FM patients, but studies report mixed results when treating FM with GH.

Psychological factors: Strong evidence supports the association of FM and depression. Similarities include neuroendocrine abnormalities, psychological characteristics, physical symptoms and similar treatment benefits using the same approach (medication, counciling, etc.).

Physical Trauma: Trauma can increase the risk of FM. One report found a direct association with neck trauma and increased risk of developing FM.

Small bowel bacterial overgrowth: This can contribute to FM and may explain the association with IBS. The autoimmune response to the presence of bacteria resulting in FM symptoms has been hypothesized in these cases.

CONCLUSION: As previously stated, it is clear that a “team” of providers is needed to effectively treat FM. We’d be honored to be part of your team!

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

 

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Headaches and Chiropractic Care.

14 Dec

Did you know that 9 out of 10 Americans suffer from headaches? There are many different types of headaches with a multitude of symptoms including achy, throbbing, nausea, vomiting, dizziness, numbness, blinding, noise, light and/or odor sensitivity, and more. The causes of headaches can include genetics (familial traits like migraine headaches), stress or tension (probably one of the most common), environmental (allergies, seasonal, bright sunlight, loud noises, certain foods), behavioral (insomnia, excessive exercise, blood sugar problems, depression), and many more.

Environmental factors can “trigger” the onset of a headache. About 95% of headache sufferers have “primary headaches” such as tension, migraine, or cluster headaches. The other 5% may be caused by other physical conditions or problems and the headache serves as a “warning sign” that something else is wrong. The “key” in the 5% of potentially dangerous types of headaches is to pay attention to when there is a rapid onset (“…it came out of nowhere fast!”), if they are very intense, and are “different” from other headaches previously suffered. When nervous system symptoms occur that are unusual for that person, such as lapses in memory, the person is not responding, rapid onset of dizziness, balance disturbance,  and/or a “blinding sharp pain,” these should trigger a warning sign that something specific and potentially dangerous may be causing the headache.

For the main 95% of headaches sufferers, neck tension is a common complaint with the headache. Research supports that spinal manipulative therapy (SMT), the primary form of care utilized by chiropractors, is an effective option for tension headaches. A 2001 Duke University study reported that SMT resulted in almost immediate improvement for those headaches originating in the neck, had fewer side effects, AND longer-lasting relief of tension-type headaches compared to those receiving commonly prescribed medication. Another study found that SMT was effective, not only for relieving the headache, but had a sustained benefit AFTER it was discontinued after a 4-week treatment period. This was NOT seen in a similar tension-type headache group receiving prescribed medication treatment only.

Here is how to help yourself:

Improve your posture: Most of us are “chin pokers” and “slouchers.” The weight of the head pulls on the neck and upper back muscles and when held in that fixed position while driving, typing, watching TV, the static muscle tension can create a headache.

Take “mini-breaks” every 30-45 minutes from static fixed positions and perform some exercises. A good stretch is to reach over to the opposite side of the head and gently pull to stretch the sides of the neck. Repetitively, poke and tuck your chin in & out to stretch different muscle fibers. Then, add flexion, extension and/or rotation to the same movements for about 10 sec./side. Try it now!

Avoid clenching your teeth and shrugging your shoulders. We do these things without being conscious that we’re even doing it. Those static loads play havoc with our neck muscles.

Drink plenty of water – at least 8 oz., 8x/day (more when exercising or pregnant). If you want to be more accurate, take your current weight and divide by 2. (Eg., 130# person = 65oz./day; 190# = 95oz./day).

If you have chronic headaches, COME SEE US! This is what we do, and it helps A LOT!

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

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Chiropractic Care of Children.

12 Dec
Dr. Binder & Neela

Dr. Binder & Neela

Chiropractic techniques are not limited to any particular group. We see patients of all ages, sizes, genders, ethnicities, and so on. So, is the care of children “different” than chiropractic care applied to adults? If so, how?

There are studies that review the treatment of musculoskeletal (MSK) conditions such as low back pain, non-MSK conditions such as asthma, and chiropractic care of infants, adolescents, and teenagers for a variety of conditions. The management techniques utilized by chiropractors for children vary across the profession, but typically, they are modified methods of those applied to adult patients. When one thinks of “chiropractic care,” the immediate image is that of spinal manipulation where a high velocity, low amplitude “thrust” is made and joint cavitation occurs (the release of gas creating a cracking sound similar to knuckle cracking). Chiropractic treatment can also include dietary advice, nutritional or herbal supplement recommendations, posture correction, exercise training, and the use of physiological therapeutic modalities (like electric stim, light, ice, heat, traction, ultrasound, and more). Behavioral counselling may be included, depending on the patient’s condition and the individual training the chiropractor has focused on, especially on a post-graduate level. Chiropractors, like many health care providers, have post-graduate board certification options, of which pediatrics is one of many. Looking at research for children and chiropractic, here is what the current literature base supports:

Pediatric care: There is evidence that chiropractic methods, when properly modified and applied, are safe. However, more research is needed to determine what the current practice model should be for this patient group.

Children & adolescents: There is currently research support for treatment of this patient population for some MSK conditions, particularly low back pain. Again, additional, high-quality studies are needed to further support this category.

Non-musculoskeletal care (children & adolescents): Conditions such as colic, otitis media, asthma, nocturnal enuresis (bed wetting), and attention deficit hyperactivity disorder, all require additional high-quality studies before firm conclusions can be made. At present, there is little data to support or refute the effectiveness of chiropractic care for these conditions. However, the authors do recommend that a chiropractor may play a role on the pediatric healthcare team. They suggest that it is appropriate to utilize a four to six treatment “trial” to determine effectiveness of care for a colicky infant where all other serious diagnoses have been excluded. Similarly, in cases of enuresis and asthma, chiropractic may have a role on the management team. A call for more research is a common recurring theme for the management of non-MSK conditions.

ADHD in children and adolescents: One focused systematic review reported the need for more high-quality research in this area before conclusions can be made either for or against the utilization of chiropractic care for ADHD.

Possible adverse effects: In review of (again) limited studies in this area, chiropractic care appears to have little negative issues associated with it. Serious side effects are reported as “rare.”

Bottom line: Though more research is needed, in the absence of underlying pathology, chiropractic care may be considered as part of the pediatric management team for a four to six visit trial to determine treatment effectiveness.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family both presently and in the future.

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Low Back Pain: Surgery vs. Chiropractic?

12 Dec

Low back pain (LBP) is the second most common cause of disability in the United States (US) and a very common reason for lost days at work with an estimated 149 million days of work lost per year. The total cost associated with this is astronomical at between $100-200 billion/yr, of which 2/3rds are due to decreased wages and productivity. More than 80% of the population will have an episode of LBP at some point in their lifetime. The good news is that 95% recover within two to three months of onset. However, some never recover which leads to chronic LBP (LBP > 3 months), and 20-44% will have a recurrence of LBP within one year with lifetime recurrences of up to 85%! What this means is that most of us have, have had, or will have LBP, and we’ll get it again! So the question is, what are we going to do about it?

Surgery has traditionally been considered a “last resort” with less invasive approaches recommended first. Chiropractic adjustments and management strategies have traditionally faired very well when compared to other non-surgical methods like physical therapy, acupuncture, and massage therapy. But, is there evidence that by receiving chiropractic treatment, low back surgery can be avoided? Let’s take a look!

A recent study was designed to determine whether or not we could predict those who would require low back surgery within three years of a job-related back injury. This is a very important study as back injuries are the most common occupational injury in the US, and few studies have investigated what, if any, early predictors of future spine surgery after work-related injury exist. The study reviewed cases of 1,885 Washington state workers, of which 174 or 9.2% had low back surgery within three years. The initial predictors of surgery included high disability scores on questionnaires, greater injury severity, and seeing a surgeon as the first provider after the injury. Reduced odds of having surgery included: 1) <35 years old; 2) Females; 3) Hispanics; and 4) those who FIRST saw a chiropractor. Approximately 43% of workers who first saw a surgeon had surgery compared to ONLY 1.5% of those who first saw a chiropractor! WOW!!! This study supports the FACT that IF a low back injured worker first sees a chiropractor vs. a surgeon, the likelihood of needing surgery in the three years after the injury would be DRAMATICALLY reduced! In fact, the strongest predictor of whether an injured worker would undergo surgery was found to be related to who they saw first after the injury: a surgeon or a chiropractor.

If this isn’t enough evidence, another recent study (University of British Columbia) looked at the safety of spine surgery and reported that (taken from a group of 942 LBP surgical patients): 1) 87% had at least one documented complication; 2) 39% of the 87% had to stay longer in the hospital as a result; 3) 10.5% had a complication during the surgery; 4) 73.5% had a post-surgical complication (which included: 8% delirium, 7% pneumonia, 5% nerve pain, 4.5% had difficulty swallowing, 3% nerve deterioration, 13.5% wound complication); 5) 14 people died as a surgical complication. Another study showed lower annual healthcare costs for those receiving chiropractic vs. those who did not. The “take-home” message is clear: TRY CHIROPRACTIC FIRST!!!

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family both presently and in the future.

 

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