Tag Archives: mechanicsburg pa chiropractor

Carpal Tunnel Treatment Options.

12 Dec

The goal of any treatment approach for Carpal Tunnel Syndrome (CTS) is to return the patient to normal. That means addressing all OTHER health related conditions that can cause CTS such as diabetes, hypothyroidism, birth control pill use, pregnancy, rheumatoid arthritis (and many of the other related arthritic-like disorders), as well as double or multiple crush (pinched nerve) syndromes. That’s right! CTS can be caused by MANY other conditions besides simply overusing the arms and hands. When overuse PLUS any of the above mentioned conditions “gang-up” on you, managing BOTH is necessary.

One “universal” goal in CTS treatment is to reduce inflammation. This can be accomplished by several approaches: 1) STOP, reduce, and/or modify the causing activity. Examples include repetitive use of a hammer, screw driver, stapler, assembly line work, typing/computer work, driving with a firm grip on the steering wheel, bicycle riding, and MANY more! The key to successful management of CTS is to slow down, stop/rest, and for long-term success, change how the task is performed (modify the work station). 2) Wearing a cock-up wrist splint. This is usually restricted to night time use since we cannot control our wrist position while sleeping and the pressure inside the carpal tunnel “normally” doubles at the extremes of the wrist forwards or backwards. Thus, keeping the wrist straight at night significantly reduces or eliminates the numbness/tingling that can cause multiple sleep interruptions. It can also be worn during the day IF it doesn’t interfere with the person’s activity. If the activity requires frequent bending of the wrist, you’ll end up fighting against the wrist splint and that can actually worsen your CTS! 3) Ice cupping or massage. Freeze water in a Styrofoam or paper Dixie cup (like home-made popsicles) and peel away the top third to expose the ice. Rub it over the palm side of the wrist until you feel numbness. At first, it will feel Cold, followed by Burning, Aching, and finally Numbness (hence the acronym, “C-BAN”). The length of time to achieve numbness is usually three to five minutes, but make sure you quit at the point of numbness as the next stage is frostbite! 4) Anti-inflammatory nutrients. An anti-inflammatory diet is one that is rich in fruits, vegetables, lean meats, omega-3 fatty acids, and avoids glutens, omega-6 fatty acids (fast foods, etc.), and refined carbohydrates (sweets, sodas, etc.). Also, there are many REALLY GOOD nutritional supplements that can effectively reduce inflammation without the typical side-effects that affect the stomach, liver, or kidneys which are common to NSAID drugs like aspirin, ibuprofen, or Aleve. Also, NSAIDs can inhibit an important chemical (a prostaglandin) that is needed for healing, and therefore, it can actually slow down the healing process (so try the nutritional approaches first)! Nutritional options include proteolytic enzymes, Bromelain, papain, bioflavonoid, Vitamin C, Vitamin D, Vitamin E, Coenzyme Q10, and many more.

Treatment options beyond those mentioned above are typically surgical, IF you decide to go to a surgeon. However, chiropractic care includes identifying and treating the source(s) of nerve irritation, as it is often more than just nerve pinching at the carpal tunnel. Other common locations of median nerve entrapment includes the pronator teres muscle in the forearm just past the elbow on the palm side, less often at the shoulder, and again quite frequently in the neck where the nerve exits the spine. If these areas of nerve pinching are not released, recovery is less likely (with or without surgery)! Bottom line, you can always have surgery but you can’t “un-do it.” Try chiropractic first as it’s the least invasive, least costly, and often the quickest way to find relieve from CTS!

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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How To Stay Cold and Flu Free This Year.

12 Dec

The Most Important Principles For Staying Young: 

How To Stay Cold and Flu Free This Year –  For A Younger YOU®

 Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

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.

We YOU Docs love fall: crisp days, chilly nights (chilly enough for chili), the beginning of basketball, the end of re-runs (all new Dr. Oz shows!), and tackling all those projects we never touched last summer. There’s just one spoiler (well two): colds and flu. 

 In addition to washing your hands 20 times a day (a great start), these two tips can make a mega-difference: 

 Get enough of our favorite vitamin, D3 (the most active form of vitamin D). Healthy levels make you half as likely to get a cold or flu. If a flu bug gets you anyway (viruses are wily buggers), you won’t feel crummy for nearly as long. Why isn’t yet clear, but D’s anti-inflammation powers may reduce the infection. Take 1,000 IU a day.

 Get your 8 hours a night. Sleep may be the most underestimated cold fighter out there. You’ll catch far fewer colds if you habitually log eight hours of ZZZs a night. Getting less than seven hours makes you three times more likely catch a cold than getting eight. If you sleep poorly, repeatedly waking and falling off, you’re five times more likely to catch a cold. 

 And if you don’t like Vitamin D3 and sleep, then let us warn you of The Dangers of Driving While Under the Influence of a Bad Cold.  

 If your nose looks like a radish and your eyes are more watery than chicken soup at a bad diner, the only equipment you should be operating is a thermometer (but maybe not a mercury one). The common cold, it turns out, is an automobile accident waiting to happen. The sneezing, tearing, fever, and puffy eyes make your reactions behind the wheel as slow and unsteady as a party-goer who’s pounded back several drinks… at least, that’s what a UK team reports.

One reason: A single sneeze lasts two to three seconds and your eyes automatically close during it. If you’re driving 70 miles an hour  (about 110 kilometers an hour) and go ah-ah-ah-choo, you’re driving blind for 315 feet (about 100 meters). You don’t need us YOU Docs to tell you that’s scary. 

North Americans get 1 billion colds each year so you can bet many sneezing, blowing, dripping drivers will be bobbing and weaving down highways. Don’t be one. 

What if you have a ferocious cold and absolutely have to go someplace? Do not take the nearest cold medicine without first checking the warning label. Many contain decongestants that can make you nod off or respond slower. Instead, pick up the phone and ask a friend or a taxi service for a lift.

Once you’re back on your feet, stave off your next “battle of the sinuses” with this trio of cold-fighters: Get eight hours of sleep nightly, take 1,000 IU of virus-fighting vitamin D3 daily, and wash your hands like a maniac.

Thanks for reading and feel free to send more questions at youdocs@gmail.com.

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  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

 Feel free to continue to send questions to youdocs@gmail.com. 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 a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

 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.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime. 

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Fibromyalgia Diagnosis: A Breakthrough!

12 Dec

Confirming the diagnosis of fibromyalgia (FM) is challenging, as there are no blood tests to verify accuracy of the diagnosis like so many other disorders. However, blood tests are needed when FM is suspected to “rule in/out” something else that may be mimicking FM symptoms. Also, FM is often associated with other disorders that are diagnosed by blood testing, so it is still necessary to have that blood test. So what is the CURRENT recommendation for diagnosing FM?

The American College of Rheumatology (ACR) developed criteria for diagnosing FM in 1990 and has updated it since then. The original 1990 criteria included the following: 1) A history of widespread (whole body) pain for three months or more; and 2) The presence of pain at 11 or more of 18 tender points which are spread out over the body. The main criticism regarding this approach has come from the poor accuracy and/or improper methods of testing the 18 tender points. As a result, this examination portion of the two main criteria has been either skipped, performed wrong, or mis-interpreted. This left the diagnosis of FM to be made based on symptoms alone. Also, since 1990, other KEY symptoms of FM have been identified that had previously been ignored including fatigue, mental fog (“cognitive symptoms”), and the extent of the body pain complaints (“somatic symptoms”).

As a result, it has been reported that the original 1990 approach was too strict and inaccurate because too many patients with FM were missed – 25% to be exact – by using this method. In 2010, the diagnostic approach was modified by using two different questionnaires: 1) The “Widespread Pain Index” or (WPI), which measures the number of painful body regions; and 2) the development of a “Symptom Severity” scale (SS). The MOST IMPORTANT FM diagnostic variables included the WPI score and scores of “cognitive symptoms,” which includes the “brain fog” common with FM, unrefreshed sleep, fatigue, and the  number of “somatic symptoms” (other complaints). The Symptom Severity scale (SS) incorporates these four categories and is scored by adding the totals from each category.  By using both the WPI and the SS, they correctly classified 88.1% of FM cases out of a group of 829 previously diagnosed FM patients and non-FM controls!

What’s important is that this NEW approach does NOT rely on the “old” physical exam requirement of finding at least 11 of 18 tender points. Because FM patients traditionally present with highly variable symptoms, removing the challenge of determining the diagnosis by physical examination is very important! Plus, now we can TRACK the outcomes of the FM patient to determine treatment success both during and after care. Since the 2010 approach has been released, it has been published in multiple languages and is starting to be used in primary care clinics. Recently, in July 2013, a study reported that the Modified ACR 2010 questionnaire is highly sensitive and specific for diagnosing FM, and its future use in primary care was encouraged. What is most exciting about this is that a referral to a rheumatologist may not be needed since this tool can be easily administered by primary care physicians, which include chiropractors!

In past health updates, we have discussed the need for a “team” of health care providers to best manage the FM patient. This multidisciplinary approach offers the FM patient multi-dimensional treatment strategies that encompass manual therapies, physical therapies, nutritional strategies, pharmacology, exercise, and stress management, cognitive management, and behavioral management. Now, with the release of the Modified ACR 2010 criteria, we can diagnose FM more accurately, track progress of the patient, and make timely modifications to the treatment plan when progress is not occurring. This is a “win-win” for the patient, providers/health care team, and the insurer!

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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Neck Pain and Chiropractic.

12 Dec

Neck pain represents a major problem for people throughout the world with considerable negative impact on individuals, families, communities, health care systems, and businesses. Up to 70% of the general population will have neck pain at some point in their life. Recovery within the year from neck pain ranges between 33% and 65%, AND relapses are common throughout the life time of the neck pain patient. Generally, neck pain is more common in women, higher in high-income countries, and higher in urban regions. The greatest risk of developing neck pain occurs between 35 and 49 years of age. Since neck pain, very similar to low back pain, is very common and likely to recur over and over again, the question is, what is the best course of action regarding treatment?

A recent study on neck pain patients compared the effectiveness of manual therapy performed by a chiropractor, physical therapy performed by a physical therapist (PT), and medical care performed by medical physician (MD). The success rate determined at the seventh week was TWO TIMES BETTER for the manual therapy/chiropractic group (68.3%) compared to the medical care group. Those receiving manual therapy also had fewer absences from work compared to both the medical and PT treated groups. Lastly, both the manual therapy and PT groups used less pain relief medication compared to the medically treated group. Another study looked at the multiple approaches that chiropractors use for treating patients with neck pain to determine the “best” approach a chiropractor can use. They reported 94% had improvement or less neck pain after just one treatment when the mid-back (thoracic spine) was also adjusted. Similarly, after receiving two treatments over a one week time frame, the group receiving midback adjustments (vs. the group who did not) reported lower pain and disability scores. A similar study concluded that the best results occurred when the neck, upper back/lower neck, and mid-back were adjusted. This group, when compared to neck adjustments alone, reported greater reductions in disability scores. Thus, having the cervical spine, upper back, and mid-back all adjusted appears to yield quicker, more satisfying results than neck adjustments alone.

What about the role of exercise in the management of neck pain patients? In November 2012, a systematic review of manual therapies for nonspecific neck pain reported that the addition of neck exercises to a treatment plan provided more benefits than spinal manipulation alone. Similarly, in September 2012 (The Annals of Internal Medicine), chiropractic adjustments were compared against exercise and pain medication treatment groups involving 272 patients tracked over a one-year time frame after a 12-week treatment. Both the chiropractic and exercise groups experienced the most significant pain reduction when compared to the medication treated group with more than double the likelihood of complete pain relief. The chiropractic and exercise groups also had the best short and long term results, but ONLY the chiropractic group found the benefits to last a year or more. The authors (Bronfort, et. al) reported the success of chiropractic treatment stems from its ability to address the CAUSE of the problem rather than simply addressing the symptoms!   

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck 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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Whiplash “Basics.”

12 Dec

Whiplash is a non-medical term typically describing what happens to the head and neck when a person is struck from behind in a motor vehicle collision. Let’s look at some basic facts about whiplash:

Before cars, trains were the main source of whiplash and was called “railroad spine.”

Better terms for whiplash injuries include “cervical acceleration-deceleration” (CAD) which describes the mechanism of the injury, and/or the term “whiplash associated disorders” (WAD), which describes the residual injury symptoms.

Whiplash is one of the most common non-fatal injuries involved in car crashes.

There are over one million whiplash injuries per year due to car crashes alone.

An estimated 3.8 per 1,000 people per year have a whiplash injury.

In the United States alone, 6.2% of the population has “late whiplash syndrome” (symptoms that do not resolve at one year).

1 in 5 cases (20%) remain symptomatic at one year post-injury of which only 11.5% returned to work and only 35.4% of that number returned to the same level of work after 20 years.

The majority of whiplash cases occur in the fourth decade of life, females>males.

Whiplash can occur from slips, falls, and brawls, as well as from horse-riding, cycling injuries, and contact sports.

Injury from whiplash can occur at speeds of 15 mph or less.

In the “classic” rear end collision, there are four phases of injury (time: 300msec)

Initial (0msec) – before the collision (the neck is stable)

Retraction (1-150msec) – “whiplash” starts where the head/neck stay in the original position but the trunk is moving forwards by the car seat. This is where the “S” shaped curve occurs (viewing the spine from the side).

Extension (150-200msec) – the whole neck bends backwards (hopefully stopped by a properly placed head rest).

Rebound (200-300msec) – the tight, stretched muscles in the front of the neck propels the head forward immediately after the extension phase.

We simply cannot voluntarily contract our neck muscles fast enough to avoid injury, as injury to the neck occurs within 500msec. and voluntary contraction or bracing takes 800msec or longer.

Injury is worse when the seat is reclined as our body can “ramp” up and over the seat and headrest. Also, a springy seat back increases the rebound affect.

Prompt treatment is better than waiting for a long time. Manipulation is a highly effective (i.e., COME SEE US!) treatment option.

We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for whiplash, 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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Don’t Wash Your Chicken!

11 Dec

Dr. Michael F. Roizen

Co-Author of 4 #1 NY Times Bestsellers including: YOU Staying Young.

The Owner’s Manual For Extending Your Warranty (Free Press)

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.

Don’t Wash That Chicken:  A new campaign, “Don’t Wash the Chicken,” (it’s not a joke, Google it) was launched by researchers at Drexel University to alert you to the risks of washing raw chicken before you plop it in a pan to cook. Most people do that to remove contamination. But, rinsing the bird can splash Salmonella or Campylobacter bacteria or both onto adjacent surfaces, cutting boards, knives, plates in your sink, and other food. Around 200,000 folks a year come down with at-home food poisoning caused by those bacteria and have to deal with diarrhea, fever, cramps, and vomiting.  Or worse, hospitalization and risk of serious (even deadly) side-effects.

Tip for the day? Just unwrap, cut, and cook your chicken at 165 degrees in its deepest areas (you’ll need a meat thermometer—and afterwards wash that thermometer well too, but carefully so as not to splash). All raw meat has bacteria on it, and proper cooking wipes ’em out.  Wash any surface the chicken did touch with soap (it’s a great bacteria slayer), or Clorox and water. Store chicken and all meats in individual (double) plastic bags in the fridge to avoid leakage!

Other food safety tips:

Keep raw chicken meat separate from produce, and keep each variety of produce separate from others.

Maintain a fridge temp of 40°F or lower.

Wash your hands with soap and water for at least 20 seconds after handling food or when switching from handling one type of food to another.

Maybe next month we’ll do more on food safety, but I want to give you a follow up on the potential Alzheimer’s breakthrough we recently wrote about (many of you sent us emails asking for a follow-up). Bexarotene and Alzheimer’s Follow Up… Last year, March I think it was, I wrote:

“[Probably] no subject is more emotional to women and important to men than keeping your memory and brain functioning. So it was with interest that I got an email forwarded from my wife with the subject line “Alzheimer’s Breakthrough!” Now, I didn’t even bother to open that email for a day because I have seen that type of headline before and such a subject usually mean BS (bad science). But I WAS BLOWN AWAY.   I couldn’t believe the study – Three different mice models of Alzheimer’s disease treated to an already approved FDA drug given by gavage (that is pushed down into the stomach of the test mice like you would take a pill); and their beta amyloid plaque melted away.  More importantly, the mice had return of cognitive function, or at least as best as that can be tested in mice.  And such was based on a predicted response by the drug in turning on the Apo E gene.  As it was an approved drug, we may know very quickly if this works in humans.” 

Since March of last year, Bexarotene has undergone trials in several other laboratories to see if these results could be replicated before it went into human trials. Like many things, there were mixed results. Half the time, there was a decrease in some anatomic markers of Alzheimer’s (often not plaque size but commonly the amount of soluble amyloid in the brain).  Better than that, there appeared to be improvements in cognitive function in the one study that tested it (these studies were reviewed in Nature in May of this year). There was enough uncertainty that it was unclear whether or not human trials would proceed… But, since this is a devastating disease with no drug that gets at the basis of the ailment, the Cleveland Clinic Las Vegas Lou Ruvo Center on Brain Health is starting a study of 20 patients to see if any biomarker by radiograph (sensitive scans are now available that can measure plaque burden), and/or cognitive testing improvements can be detected.  If so, pharma firms may look for a relative of Bexarotene to bring to market because this drug, while approved for use for some lymphomas, has some pretty serious side effects.  Jeff Cummings, MD, PhD is leading the study group.  Keep reading these columns, we’ll keep you informed, and thanks for reading. Feel free to send more questions–you can always send us questions at 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  (and get updates on the latest and most important medical stories  of the week) on twitter @YoungDrMike. 

Feel free to continue to send questions to youdocs@gmail.com. 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 a new web site: YOUBeauty.com  and its companion BeautySage.com the only site we know of where you can find skin products proven to meet the claims (opened for business on June 1st, 2012), and a new book: YOU: The Owner’s Manual for Teens.

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.healthradio.net  Saturdays from 5-7 p.m . E-mail him questions at YouDocs@gmail.com.   He is the co-author of 4 #1 NY Times Best Sellers including : YOU Staying Young and YOU: The Owner’s Manual. He is Chief Medical Consultant to the two year running Emmy award winning Dr Oz show– The Dr Oz show is #2 nationally in daytime TV.  See what all the fun is about, and what he, The Enforcer, is up to. Check local listings or log onto DoctorOz.com for channel and time. And for more health info, log onto youbeauty.com anytime.

 

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