Fibromyalgia: "Why Won't The Pain Stop?"

Fibromyalgia (FM) is a chronic condition that does not limit itself to just one area, but rather it manifests as a generalized, whole body condition where basically everything hurts. The diagnosis is typically made by exclusion, or by eliminating all other possible conditions as there is no single blood test or diagnostic test for FM. Unless other conditions that are test sensitive are present at the same time, most tests come back negative.  Of course, this leaves the FM patient upset because, “….no one can figure out what’s wrong with me.” We all seem to want a test to prove what we have is “real.”
            Unfortunately, in the real world, no blood test, x-ray, or exam procedure is 100% accurate (sensitive and specific), so even when tests return positive, there can be “false positives” that are caused by many things such as drug induced test alterations and/or other conditions that alter the same test. On the other hand, there are “false negatives,” so even though the test came back negative, it’s still possible that the problem one is present but the test may just not be sensitive (accurate) enough to detect it.  FM is one of those conditions where only after a myriad of tests have been run and come back negative, can the diagnosis of FM be made with some degree of confidence.
            Essentially, we have to prove that you don’t have something else causing similar symptoms before we can confidently (or at lease more confidently) diagnose you with fibromyalgia. To complicate this further, in “secondary FM,” the cause of FM is known and is due to an underlying condition such as rheumatoid arthritis, lupus, hypothyroid, HIV, cancer, as well as physical trauma such as after a car accident or a work injury. When an accident is involved, the symptoms may be more confined to one area (then called “regional FM”) making the diagnosis even more challenging as the classic 11 of 18 tender points may not hold up in these cases.
            Finally, there are doctors out there that simply don’t “believe in” the condition and may say to the FM patient, “…there is no such thing, it’s all in your head, you simply have learn how to live with it. There’s nothing that can be done.” Well, they actually may be partially right – that is, the “…it’s all in your head” part (don’t get mad… just wait!). Another finding that is well-published in peer review literature is the concept called central and peripheral “sensitization.” This occurs when increased incoming sensory information from injured skin, muscles, and/or organs, in a sense bombard areas in the central nervous system (spinal cord and brain) leaving it “sensitized” or, more sensitive to “normal” incoming information.  This is because the threshold or tolerance to normal incoming sensory stimuli is reduced and results in increased muscle pain commonly described by patients with FM.
            To better illustrate this, hypersensitivity or central sensitization was found in people after a whiplash injury.  They recruited 14 whiplash patients and 14 “normals” to compare their responses when stimulating the leg (the non-injured area) as well as the neck (injured area). Theoretically, if central sensitization didn’t exist, the responses to the exact same stimulus on the healthy leg of both the whiplash patients and the normal subjects would be equal. Instead, what was found was that the whiplash patients had significantly lower pain thresholds for 2 of 3 tests (a single electrical stimulus in the muscle, repeated electrical stimulation in the muscle and on the skin, but not from heat when applied to the skin). Each pain threshold was measured at the neck and leg before and after local anesthesia was applied to the painful, sore neck muscles. In the whiplash cases, the lower pain threshold was found when stimulating both skin and muscles at the healthy leg and at the injured anesthetized neck equally. That proves that the central nervous system (brain and spinal cord) has a “pain memory” which lowers the threshold so the whiplash patients feel pain more intensely and quicker than the non-injured people. This can help patients understand the answer to the question, “…why won’t this pain go away?” This pain memory or hypersensitization is similarly found in FM patients.

Chiropractic care, in conjunction with the best fibromyalgia diet, and specific fibromyalgia exercises, can go a long way when it comes to effective fibromyalgia treatment.

Wanting to be Healthy vs. Planning to be Healthy

One of the most valuable lessons I have learned is that there is a difference between wanting to be healthy and planning to be healthy.
First of all...everyone WANTS to be healthy...but just wanting is NOT enough.
Just like wanting to be successful is not enough...everyone desires that.
You have to have the will to plan to be successful...the discipline to learn what it takes from successful people and to put in the necessary time learning and spoon feeding yourself information that is necessary to advance in this direction. Then you need to put this information to use...day in and day out...refining and perfecting it as you go. This is not easy and takes time and energy, and dedication...which is why so few reach the top.
Well...the same is true with achieving optimum health. You have to have the will...the desire to express life to it's fullest...which is not possible unless you have your health.
I have spent my career teaching whoever is willing to listen about the principles of natural healing and creating the conditions of health. According to these principles health is a spontaneous occurrence when the conditions are right. Creating the right conditions is the key and takes planning and ongoing implementation.
The beauty of creating the conditions of health is that YOU are the one in charge. You steer your own ship...either in the direction of health...or in the direction of illness with every lifestyle decision you make. What you eat, how often you exercise, how much water you drink, your pillow, your chair at work, how you relax, what you think, what you read, and what you believe...to name a few...are all conditions of health...and you have control over all of them.
When you consider that over 70% of the dollars in the US that are spent on health-care each year are spent to treat conditions that were preventable (diseases of excess), it makes me think...as a nation are we planning to be healthy...or planning to be sick?
The answer is obvious...it's in the statistics. But since you have control over your own lifestyle choices you don't have to be a statistic. I know you want to be healthy...but are you planning to be healthy? 

Carpal Tunnel Syndrome and Night Pain

Have you ever woken up in the middle of the night and noticed your hand sleeping to the point where you had to get out of bed and shake or flick your fingers to alleviate the numbness? If the numbness was primarily on the thumb-side half of your hand, it may have been carpal tunnel syndrome that woke you up. So, the question is, why is it such an issue at night?
To properly answer this question, let’s get familiar with the anatomy of the wrist.  There are 2 bones that make up the forearm – the ulna (on the pinky side) and the radius (on the thumb side). Just beyond that, there are two rows of four bones each called the carpal bones for a total of 8 small bones that make up the wrist joint. These carpal bones are arranged in a horseshoe or tunnel shape. When you look down at your wrist and wiggle your fingers quickly, you can see all the movement that occurs on the palm side of the wrist.  That’s a lot of movement!  You can also see the muscles on the upper half of the forearm moving rapidly as the fingers wiggle.
            There are 9 muscle tendons that travel through the carpal tunnel, as well as some blood vessels and most important, the median nerve sits on top of all those moving tendons. Just beneath the floor of the tunnel is a ligament called the transverse carpal ligament. The tendons inside the tunnel are surrounded by lubricating sheaths that make it easier for the tendons to slide back and forth as we wiggle our fingers, grip to open a jar, type on a computer, play a musical instrument, or so on. Without the tendon sheaths, the friction between the rubbing tendons would quickly build up heat, resulting in swelling, pain and numbness.  However, in spite of the lubricating function of the sheaths, when we work our fingers and hands too much, swelling and inflammation does occur.
            So, why do we have numbness at night when we aren’t working, gripping and moving our fingers repetitively? The answer lies in how we sleep. Since we are asleep, we cannot control where we position our hands and wrists. Most of us curl up in a ball and tuck our hands under our chin or someplace cozy.  Normally, when we bend our wrists, the pressure inside the carpal tunnel doubles. However, a carpal tunnel patient already has a higher level of pressure in their wrist. So, when a carpal tunnel patient bends their wrist in the exact same way, the pressure goes up even more – that is, 3, 4, 5, or more times than a normal person without their wrist bent. That is why a wrist “cock-up” splint works so well at night!  It keeps the wrist straight so we can’t bend it.  Often, this allows the CTS patient to sleep through the night instead of waking up 2, 3, or more times with numbness, tingling, and/or pain on the thumb half of the hand.

Fibromyalgia: A Detailed Patient Description

Fibromyalgia (FM) is surrounded by much controversy in what establishes a diagnosis, what are the consistent historical features, and most importantly, what can be done about it – the treatment strategies.  Doctors seem polarized, either they “believe in it” or don’t. The result is a frustrated patient because after multiple attempts, they can’t get a straight answer from their health care provider. Consequently, the patient doesn’t know where to turn.  A very important article, published in September 2011, discusses from the patient’s point of view, their experience in living with this condition.
            The study consisted of 6 female patients diagnosed at a university hospital with FM, which by the way, means all other conditions that create similar symptoms have to be “ruled out” or, considered first. Therefore, many tests are typically run to make sure there isn’t some other serious underlying condition hiding behind the symptoms associated with FM. As a background, the authors describe FM as “…a chronic syndrome with no cure.” Because of this, they state, “…a thorough understanding of the illness experience is therefore key in the palliative care of patients…” They acknowledge that care givers of FM patients often include chiropractors and other manual therapists and knowledge of the “…meaning and reality of living with this condition” is reported as being ESSENTIAL for all health care providers who manage FM patients. The focus of the study was to carefully look at the personal, occupational, and social impact of the condition on patients’ lives and their views about the future. Structured interviews with each participant were analyzed.
            Results showed that FM impacted all aspects of life with 4 main themes arising from the data: 1) Personal life impact; 2. Occupational life impact; 3. The forecasted impact on future life; 4. Social interaction impact. Specifically, most of the participants had stopped working and felt useless. Leisure activities were greatly affected, as many described opting to not participate in various leisure oriented activities (such as going for walks, shopping, attending social events). FM was described as altering family bonds with some being made stronger while others were destroyed, resulting in separation and/or divorce. FM patients were reported to be “relieved” when a diagnosis was “finally” made, as it marked an end to a period of uncertainty. The participants were often ambivalent to interaction and despite some positive points, frustration prevailed from “perceived incomprehension” or, not really understanding why they feel the way they do. At times, this made it hard to discuss their symptoms and personal experiences. This study reveals the negative impact of FM and how complex and individual that is.
            What is important about this study is that it alerts those of us who treat FM that we need a more efficient diagnostic process and we need to be better educated so that we can provide a multifaceted treatment option approach as each FM patient’s needs vary because of how each patient “deals with” the condition. We need to really listen to the patient to determine what treatment goals they are interested in and we must create treatment plans that center around those needs and desires, possibly including checklists so everyone stays on task as it’s quite easy to become distracted by the symptoms of FM. We are sharing this information with you so that you can feel comfortable approaching us with the many concerns and issues that surround FM.

Why a Chiropractor Should Be On Your Car Accident Recovery Team

Anyone who has survived a car accident will tell you that the recovery process can be long and difficult.  There is paperwork, legal activities, not to mention the various medical situations that may arise.  For many, the road back to a full and healthy life can take a great deal of time to travel.

It is important as you travel on the road to full recovery that you have the expert help you need.  There are many people there to help you, family and friends, and the various professionals that you will work with to get your body in full health.  If the car accident has caused a neck injury or whiplash, a chiropractor can offer immense help during the recovery process.
Whiplash, as it is commonly called, is simply a neck sprain, or another type of injury to the neck area.  Specifically, damage occurs within the joints between the vertebrae, discs, ligaments, cervical muscles and possibly the nerve roots.  A sudden, abrupt jerking motion of the head causes the cause of these injuries, which is often experience during a car accident.
The symptoms that can develop over time, and sometimes can be delayed for 24 hours or more after the car accident.  In most cases, people who are suffering from whiplash can exhibit one or more of the following symptoms:

• Headaches
• Pain in the shoulder, or between the shoulder blades
• Neck pain and stiffness
• Lower back pain
• Pain or numbness in the arm and hand
• Dizziness
• Ringing in ears
• Difficulty concentrating
• Fatigue
• Irritability

The symptoms of whiplash are truly varied, and some of them can be indicator of other conditions or diseases.  Therefore, a full diagnosis should be made by your chiropractor prior to the start of treatment.  In most cases, injuries like whiplash, which affect the soft tissues, will not be visible on standard X-rays.  Instead, specialized imaging tests, such as CT scans or magnetic resonance (MRI) is often used as a diagnostic tool.
Once whiplash is properly diagnosed by your chiropractor, effective treatment can begin. Perhaps one of the most effective means of treating whiplash is through chiropractic manipulation of the spinal column and neck area.  In fact, a study conducted by Woodward and others in 1996, and published in the industry magazine Injury indicated that nearly 93% of the patients studied were found to have a statistically significant improvement in pain and discomfort, and relative movement ability after chiropractic care.  Symptoms ranging from headaches to back pain, even related extremity pain in the arms and hand showed marked improvement over a short term of chiropractic care.
Time and time again, the experience of chiropractors and their patients have reflected these impressive results.  Many people suffering from the long-term effects of a car accident have used the skills of a qualified professional to find relief from their symptoms.
Given the available data, and the many cases of people finding relieve for their soft tissue injuries beyond what a normal doctor can do, is it any wonder why many people turn to chiropractors as a viable option for recovery?  It is our sincerest hope that you are never injured in a car accident.  However, if the unforeseen does occur, having a qualified chiropractor on your recovery team can make all the difference in the world.

Health is Precious

It's easy to take good health for granted. The reason for this is because when we do things that do not promote long term health, such as drink, smoke, expose ourselves to too much stress, not get enough rest, or eat junk food...we don't necessarily pay the price for our poor decisions now...we pay the price later.
Most of us know the things that are good and bad as far a lifestyle choices. What we don't know is how quick a steady dose of poor decisions can manifest into a disease process, such as diabetes, heart disease, or cancer, that we do not even know is happening...often times until it's too late.
Did you know that half the time a fatal heart attack is the first symptom of heart disease? That's right...many people develop heart disease, which is mostly a disease of excess and poor lifestyle choices, don't know it, and suffer a fatal heart attack as the first sign or symptom. The others are lucky...they survive and are given another chance to do something about it. Some do...most don't.
It is very common for very successful people to ignore their health as they seek wealth. Only to find out later that health is true wealth. For without it, one is unable to enjoy life to it's fullest.
My favorite quote says it all:
"When Health is absent, Wisdom cannot reveal itself.  Art cannot become manifest.  Strength cannot be exerted.  Wealth is useless and Reason powerless" - Herophilus, 300 B.C.
Bottom Line: The lifestyle choices you make today matter. Once we become adults we are the stewards of our own health. Life is like a cafeteria. You can have whatever you want...but there is always a price to pay for your decisions...and the deserts are always at the front of the line. Sure, health is your natural state...but you must care for it and safeguard it against illness day in and day out with healthy choices. Why? Because Health is Precious.

Whiplash Facts

Whiplash Facts: Part II

Whiplash if not treated properly can lead to ongoing pain and disability...even in mild cases. Of special concern are children who are often overlooked because they do not complain much. Anyway, last month we were unable to cover all the important whiplash facts you should know...here are the rest:
 1. Much has been published on the association between ongoing whiplash symptoms and litigation. There is now plenty of evidence that ongoing whiplash injury related symptoms occur regardless of the presence or absence of litigation.
2. The concept of a delay in symptoms means minimal injury is dispelled. In fact, it’s considered “the norm” that symptoms are delayed.
3. Mild traumatic brain injury (MTBI) or post-concussive syndrome can occur as a result of whiplash trauma. The good news is that, in most cases, recovery occurs within the first 3 months.
4. In the European Spine Journal, a recent study reported that between 1 and 2 years after a whiplash injury, 22% of patients’ conditions worsened. Condition deterioration at the 2 year mark has also been reported in other studies.
5. More detailed studies that followed whiplash patients through time, reported that 45% remain symptomatic at 12 weeks (3 months) and 25% at 6 months. Others reported the recovery time in most “minor cases” is 8 weeks (2 months), time to stabilization (not recovery) in the more severe cases was 17 weeks (4 months), and in the most severe category, 20.5 weeks (5 months). Hence, the concept that whiplash, like all other injuries heal in 6-12 weeks is challenged (note, there is little support for this common myth).
6. Each year, approximately 1.99 million Americans are injured in motor vehicle collisions.
7. Since 1990, a mean of 40% of a pool of whiplash patients from all vectors of collision (that is, rear, front or side impacts) were still symptomatic at a 2 year follow up. 59% of ONLY rear-end collision patients remained symptomatic at a 2 year follow-up.
8. Although these estimates vary, approximately 10% of WAD (whiplash associated disorders) injured subjects become disabled to a point of not being able to continue working.
9. Children who sustain whiplash injuries display sleep disturbances, nightmares, difficulty talking to parents and friends (brain injury), mood changes, poor academic performance and fears of participating in higher impact sports. Moreover, children tend to be overlooked in the evaluation and treatment process since they tend to complain less.
10. If the size of the 2 impacting vehicles is the same, an 8 MPH impact produces 2 times the force of gravity. When the bullet vehicle is larger than the target vehicle, the difference increases dramatically. 

Natural Relief for Neck Pain from Arthritis

If you have ever had neck pain or headaches, and you’ve gone to see you doctor, they may have told you that either “your X-rays are normal” or “you have arthritis in your neck, but it’s part of the normal aging process.”
So let me ask you this... if arthritis of the neck is the normal aging process, why don’t all your joints have arthritis? Are your shoulders or your hips fine? Aren’t they the same age as your neck?
I see a lot of X-rays, and arthritis of the neck is one of the most common findings in patients over age 40. Also called cervical arthritis, it's basically wear and tear, or degeneration of the vertebrae (bones) in the neck.
What Causes Arthritis of the Neck?
Have you ever been in a fender bender? You know, one of those "minor" accidents that really didn't cause too much damage? Maybe you had a little dent in the bumper or the fender of your car, but you were OK?
If you have arthritis in your neck and have ever been in a fender bender, there's a good chance that slight accident started the problem you are experiencing now.
No one ever told you that, did they?
Any accident that has enough force to damage your car, will damage your spine. But because we "feel OK" afterwards, we tend to ignore it and not get it checked out.
When you are in a car that is hit, the impact throws your head either forward, backward, or to the side. Since your head weighs about as much as a bowling ball, the entire injury puts a lot of strain on the delicate neck, and can cause the curve that gives your neck strength and stability to straighten out.
Once that happens, you are pretty much guaranteed to have arthritis in your neck 10-20 years down the road. Unless you fix it.
You can also get arthritis if you have bad posture, where your head juts forward and your shoulders are rolled forward. This puts excess pressure on the spine, and causes it to wear out faster.
Think of it this way... try holding a bowling ball in your hands with your arms straight out in front of you. Hard to do, right? That's because there is more strain on your arms with the weight out in front of you.
The same thing happens with your neck. Your head should be right over your shoulders. If it's too far forward, it puts extra pressure on the spine, and can cause arthritis if left that way.
Symptoms of arthritis in the neck

• Neck stiffness
• Headaches
• Numbness, tingling, pain or weakness in the hands
• Spasms in the neck muscles, shoulders, and upper back
• Pain in the lower back or legs (especially if your spinal cord is being pushed on)
• Strange, unexplained symptoms anywhere in the body (again, if the spinal cord is being impinged anywhere)

A mild case of arthritis can be helped with non-invasive treatments like chiropractic care, or osteopathy. Acupuncture can help arthritis pain as well, especially if yours is a mild case. Find a practitioner who is comfortable teaching you exercises that will help restore the proper curve to your neck, and who will address your posture to correct anything there that is contributing to the extra strain.
Moderate to severe cases are harder to treat with non-invasive treatments, but can still be successfully helped; it just takes a little longer.
If there are bone spurs and the discs have thinned, we may be able to drop pain levels, but we won't be able to fix the bone spurs. With the proper home traction tools, you may be able to help heal your discs a bit, depending on how thin and dried out they are.


Traditional Medical Management of Arthritis
The traditional medical management of arthritis of the neck usually consists of NSAID's for inflammation and pain, and muscle relaxers to help the spasms. These osteoarthritis drugs can have some serious side effects, so take them with caution, and they were not designed for long term use.
If medications don't work, the next step is often cortisone injections into the neck. While the cortisone will help with inflammation, it may only be temporary (I've had people tell me they had relief for only 12-24 hours). A side effect of cortisone injections is that they will cause the stabilizing tissues of the spine (ligaments and tendons) to wear out faster, ultimately leading to a more unstable neck and further arthritis!
If you have arthritis of the neck, there is hope. If it's mild case, you may be able to reverse some of the damage, and you can definitely fix the postural distortions that are making it worse.

Can Chiropractic Help Knee Pain?

You don't have to be a world-class athlete to struggle with knee pain. Many normal daily stresses can cause knee discomfort, difficulty walking, and a decrease in your quality of life right here in Peoria. This helps to explain why more than half a million Americans undergo knee replacement surgery every year.

The knee is essentially a hinge joint, which means that it only moves in two directions, open and closed (compared to your shoulder, which can move in all directions). However, it is certainly not a simple joint.

The knee joint is made of four bones: the femur (thigh bone), the tibia (shin bone), the patella (kneecap), and the fibula (ankle bump). All four bones are dynamically involved in knee movement and proper function. But since most of these bones are long bones, knee pain is often caused clinically by problems in other joints: the ankle, the hip, and the low back. Dysfunction in those other joints change the way the knee operates, and knee pain can arise.

Suppose you sprain an ankle. You're unable to bear weight on that foot, so you begin to limp, putting your body weight on your other leg. You also lean to the other side, changing the angle of the weight as it presses down on your knee. The knee is unable to adapt so quickly to such a drastic change in stress. Although your limp will become less gradual over the weeks as your ankle sprain heals, your knee has already paid the price.

Knee pain can be caused by a wide variety of muscles, ligaments, menisci, nerves, and bones in the leg. Knee pain can also be caused by nerve problems and disc problems in the lower back. It is important to have your knee examined by a physician, since your knee condition can only be properly treated once it is identified.

How We Can Help Your Knee Pain

The chiropractic adjustment is designed to add motion into joints in order to affect the nervous system. The knee tends to respond in remarkable ways to the chiropractic adjustment.

- Osteoarthritis, a common form of arthritis, is most commonly found in the knee. Chiropractic adjustments have been found effective in reducing symptoms and improving knee function in patients with osteoarthritis of the knee.
- The nerves which supply the muscles around the knee arise in the low back. Chiropractic adjustments to the low back may directly affect the behavior of the thigh muscles, improving recovery times.
- Chiropractic management oulined in the Activator Methods protocol ensures that your knees, ankles, and hips are checked for dysfunction at every visit. This is especially important for athletes such as runners, joggers, and walkers, given the complex relationship between these joints.
- The Activator instrument has proven effective in multiple anecdotal and recorded meniscus tear cases by reducing the stress placed on the meniscus, allowing the meniscus to repair and heal itself.

Dr. Payrovan will perform a thorough examination of your lower extremity and spine. After an appropriate diagnosis is reached, he may suggest chiropractic adjustments, postural changes, nutritional supplements, footwear alterations, or additional therapies.

Before deciding on knee replacement surgery, consider pursuing non-invasive conservative care for your knee pain. The decision on treatment is yours.

Is Chiropractic Safe?

I just received a question from a blog reader asking "If Chiropractic Was Safe?"...so I decided to write a post about it. I have read that the chances of getting struck by lightning are greater than suffering a stroke from a chiropractic adjustment (a rare event)...which is what most are concerned about.
Heck...more people have strokes while driving or getting their hair shampooed at a hair salon than in a chiropractic office. Having a stroke is more about risk factors and lifestyle choices than chiropractic adjustments.
My malpractice insurance which is for the highest of limits is only $2000 per year. And we all know that insurance rates are based on incidence statistics.
Sure...it's possible to get sore from chiropractic adjustments...after-all it is physical. I try to reduce the odds of soreness by always starting out light and building up the intensity slowly per patient tolerance. We use ice at at the clinic and at home to reduce the likelihood of soreness.
We are also careful to consider the age, over-all physical condition, and pain levels of the individual patient. Patient comfort is a primary concern of ours. In fact...our chiropractic patients tell us they really look forward to their adjustments...especially the warm-up stretches and massage.
Yes, there is always the chance someone can get really sore...but it is the exception and not the rule.
Heck...if you start a new exercise program you can get sore. But if you are smart, you start off easy and build up the intensity slowly over time giving your body a chance to adapt. We apply these same rules to chiropractic adjustments. We never try to force anything...even if the patient wants us to...it's just not worth it.
So YES...chiropractic is safe. It's also very gentle and effective...and affordable too.
Chiropractic is also very efficient. A typical chiropractic patient will usually have multiple areas of concern...such as neck pain, low back pain, and shoulder pain. A chiropractor can work on all three areas at the same time. This is why chiropractic patients are often amazed when they first discover chiropractic. Amazed that so many seemingly unconnected chronic ailments can start to feel so much better so quick.

Consumer Reports ranks chiropractic #1 for Back Pain.

Bottom Line: It's normal to wonder if chiropractic is safe...and it's smart to do your homework. Hopefully this information can help you make an informed decision. Do yourself and your family a favor...consider chiropractic...it's the smart thing to do!

Carpal Tunnel Syndrome: What is it?

Carpal Tunnel Syndrome (CTS) is a condition that results from pressure applied to the median nerve on the palm side of the wrist that causes numbness, tingling, weakness, and/or muscle damage affecting the thumb side of the hand and fingers, including the thumb, index, 3rd and thumb side of the 4th finger. There is literally a tunnel through which 9 tendons and their sheaths, some blood vessels, and most importantly, the median nerve travel through to get to the thumb and fingers. As these tendons slide back and forth in their sheaths, friction can build up, leading to swelling when fast, repetitive finger related work is performed, such as working on a computer, especially for prolonged time frames without proper ergonomics and rest periods.  The “syndrome” starts when the swelling occurs and the numbness/tingling/weakness complaints begin.
            There are many causes of CTS.  Most commonly, CTS occurs in people whom perform fast, repetitive motions including (but not limited to):  typing on a computer keyboard, using a computer mouse, sewing, driving, assembly line work, painting, writing, use of hand tools, sports such as racquetball or handball, and playing musical instruments. Many of these tasks involve bending or twisting of the wrists (think of a violin or flute player and you get the picture). CTS most often occurs in people 30-60 years old, affects women more than men and, can be either caused or contributed by other conditions such as fracture/trauma to the wrist or hand, arthritis of the wrist, diabetes, alcoholism, hypothyroid, kidney failure and dialysis, menopause, premenstrual syndrome (PMS), and pregnancy, infections, obesity, rheumatoid arthritis, SLE, and others.
            Symptoms most commonly include numbness or tingling in the thumb-side palm, thumb, 2nd, 3rd, and thumb half of the 4th fingers. The symptoms can extend to the elbow or higher to the neck or shoulder, can affect both hands (but one is usually worse than the other), and can interfere with daily activities such as buttoning shirts, opening jars, holding onto the steering wheel, riding a bike, working with the hands, etc.
            During an initial examination, we will often check your sensation with a sharp pointed object, percuss (tap) over the palm-side wrist, ask you to hold your hands back to back and palm to palm while counting the seconds to numbness, test grip strength, and also check the neck, shoulder and elbow as these areas refer pain back and forth. Sometimes, he or she will order an EMG to test the nerve’s damage. Conservative chiropractic treatment is highly effective and DEFINITELY should be done FIRST, before injections, medications, or surgery!
It's also important to know that the median nerve, which is the nerve involved with CTS, originates in the neck. Pressure on the median nerve (roots) in the neck can cause the same symptoms as true carpal tunnel syndrome. This is why a true carpal tunnel expert will always examine you from the neck to the finger tips on both sides. The reality is...true CTS is rare...the primary cause of most carpal tunnel symptoms are pinched nerves in the neck.

Do Chronic Sinus Problems Cause Headaches?

During this time many of our patients have had sinus related headaches.  You know, these are the headaches that hurt over the sinuses (above the eyes or in the cheek bones next to your nose) and, when you blow your nose, it’s not pretty!  Sinus infections often lead to sinus headaches – wouldn’t you say that’s a true statement?

            A recent November 2011 study begs to differ. Researchers took 58 patients with a diagnosis of “sinus headache” made by their primary care physician and asked them the following questions:

1. Have you had a previous diagnosis of migraine or tension-type headache?
2. Is their clinical evidence of a sinus infection during the past 6 months?
3. Is there the presence of  “mucopurulent secretions” (that’s the “not so pretty stuff” when we blow our nose)?

            All 58 patients clearly seemed to have chronic sinusitis with an acute flair up and were given complete thorough examinations by a neurologist and an ears, nose, throat specialist (otolaryngologist) on a monthly basis for 6 months during treatment. The surprising results showed that final diagnosis in these 58 cases were 68%, 27% and 5% of the patients really had migraine, tension-type headache and chronic sinusitis with recurrent acute episodes, respectively. Treatment during the 6 months included antibiotic therapy in 73% of the patients with tension-type headache and 66% with migraine. Sinus endoscopy (taking a look up the sinuses with a scope – ouch!) was performed in 26% of the patients, and therapeutic nasal septoplasty (surgery!) was performed in 16% of the migraine patients and 13% of patients with tension-type headache (a pretty BIG mistake, wouldn’t you say?).  The conclusion was that many patients with self-described or primary care physician diagnosed “sinus headaches” have no sinonasal abnormalities, but instead, met the criteria for migraine or tension-type headache.
            So, what does this mean?  Well, for one thing, too many antibiotics are prescribed for tension-type or migraine headaches and have no place in the treatment process of these two common headache categories.  Side effects of antibiotics include (but are not limited to):  stomach and intestinal irritation, nausea, and if one is allergic to the antibiotic, a potentially life-threatening condition call anaphylactic shock.  Let’s not forget to mention that sinus surgery was performed in 29% of the cases where the sinuses were NOT causing the headaches and we all know the risks of undergoing anesthesia and surgery can include death and infections, among other problems.
            Chiropractic was reported to be a wise choice in the treatment of headaches by several publications, one of which provided a large review of the literature on the “Effectiveness of manual therapies: the UK evidence report,” released in 2010 (http://chiromt.com/content/18/1/3). In this report, both migraine and cervicogenic-type (headaches that start in the neck) headaches were found to have strong research support for manipulation or, chiropractic adjustments. In this day and age, you can be very confident that choosing chiropractic services for headache treatment is a wise, safe, and very cost-effective approach for a very disabling condition.

            We realize that you have a choice in where you choose your health-care 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.

Your Chronic Back Pain: Are You Attached To It?

Is your chronic back pain  giving you something to do? After all...now you can talk about your back pain. You can avoid things you don't want to do because of your low back pain or your neck pain.
You don't have to exercise because it makes your back pain worse. And food is really the only pleasurable activity you can handle...so you can justify the extra weight you are carrying around because of your chronic back pain.
But when it comes to treatment...your just not sure what to do. You go from doctor to doctor and your back pain history is now a short story. You do everything but take action to make it better. If this sounds like you...You May Be Mentally Attached To Your Back Pain. 
If you could only make a decision...you need to do more research. You need to talk to your medical doctor. You need to talk to your insurance company. You need to think about it. You need to do everything but what you should be doing...and that's taking action to get better.
I believe at least half the battle of getting rid of chronic back pain is making the decision to get rid of it...then following through with your decision.
Not only do I believe this...I know this to be true from 7 years of experience as a practicing chiropractor in Dallas. The bottom line is this...Nothing Happens Until Something Moves. What needs to move is YOU...into action.

Will A Herniated Lumbar Disc Heal On It's Own?

I have been treating herniated discs in Dallas for over 7 years now.
I have helped hundreds of herniated disc patients return to more normal lifestyles...some have had complete recoveries.
During this time...one of the most common questions I have been asked is...
Will my herniated lumbar disc heal by itself?
And, this is a great question...and the answer is...maybe. Some do-some don't.
Heck...there are people every day that suffer herniated discs in the low back and never even know it.
It's the patients that know they have herniated discs that are not responsive to conventional treatment methods that are the problem. They are a small subset of the overall pool of people who have a herniated disc.
Why is this? Well...I guess it's just the way the disc is positioned in the spinal canal or nerve channels. The disc fragments can get lodged in there in such a way that the body is unable to heal itself. This traps the nerve roots or puts pressure on the spinal cord, which can cause severe low back pain, sciatica, and all kinds of other problems.   
Sometimes, traditional chiropractic can be very effective treatment for lumbar disc herniations. But sometimes it does nothing. 
At my office, we incorporate Chiropractic and Active Release Techniques (ART) to successfully manage most lumbar disc syndromes. 
So yes, herniated discs do repair themselves when they can...but when they can't they need some help...and it doesn't have to be back surgery either. In fact...some say back surgery is a thing of the past. I don't know about that...I think we need both surgical and nonsurgical treatments for everything.

Whiplash Fact you should know!

In whiplash research, many articles have been published that conflict or contradict each other. The goal of this blog post is to report the “facts” about whiplash.

• It is more common to have a delay in the onset of whiplash symptoms. Symptoms may start about two hours after the initial injury or it may take days, weeks, or months before you feel anything.
• For whiplash caused by car accidents, the severity depends on the force of the impact, the way you were seated in your car, and if you were properly restrained using a shoulder and seat belt.
• Tests show the soft tissues in your neck sustain injury at a threshold of 5 mph. That means if you're rear-ended at 5 mph or slower, you have a lower chance of getting whiplash. However, most rear-end car accidents happen at speeds of 6-12 mph.
• If you've been in a car accident, it’s a good idea to be evaluated even if your car didn't get damaged and you don't feel any pain.
• Although whiplash is most often associated with car accidents, you can also get whiplash from sports such as snowboarding, boxing, football and gymnastics.
• The concept of “no car damage = no injury” is COMPLETELY false. Most cars can withstand collisions of up to 10 MPH and as pointed out above, only in collisions < 5 MPH are you less likely to be injured. Collisions that occur between 6-12 MPH cause the highest percentage of whiplash injuries (which is below the threshold of car damage in most cases). Also, the energy of the impact is transferred to the contents inside the car when there is no vehicular damage (that means you).
• Mild traumatic brain injury (MTBI) can occur in motor vehicle collisions even if the head does not hit an object inside the car, although it’s more common when there is a head strike. The symptoms associated with MTBI are often referred to as “Post Concussive Syndrome.”
• Approximately 10% of whiplash injured patients become totally disabled.
• Of the studies published since 1995, over 60% of whiplash patients required long-term medical care.
• Risk factors for long-term symptoms associated with WAD include: rear impacts, loss of the cervical lordosis curve, pre-existing degenerative arthritis, use of seat belts & shoulder harness (low speed impacts only), poor head restraint position or shape, non-awareness of the impending collision, female (especially long slender neck), head rotation at impact.

We realize you have a choice in where you choose your healthcare

5 simple steps to Prevent Back Pain

I have come up with 5 simple ways to prevent back pain that I teach my patients and seminar attendees that seem to work great for most people. Here they are:
1. Maintain a normal body-weight. Your body is not designed to carry excess weight. It wears down the joints and spinal discs and results in the spinal muscles having to work harder than they should day in and day out. When you consider that 2/3 of Americans are overweight or obese, it's no wonder back pain is so prevalent. I prefer a plant based diet...but this is not necessary to maintain a normal body-weight...discipline is.
2. Use correct sleeping posture. When you are on your back you should be using a cervical pillow designed to support the arch in your neck, and you should have another pillow under your knees so that
you have a slight bend in your knees. This relaxes the ow back muscles. The cervical pillow actually works to correct an maintain your neck curve. When you are on your side the cervical pillow is designed to keep your neck straight. Put a pillow between your legs to keep the rest of the spine straight. If you are a side sleeper only they make a special pillow for you. We prefer and sell Tempur-Pedic Pillows.
3. Exercise on a regular basis. Our body's are designed to get lots of exercise. We are built to be running around the jungle all day hunting for food. All the muscles, cells, tissues, glands, and organs function best with regular exercise. Note: There is recent research that suggest that people who sit at a desk all day...even those that exercise are 2x more likely to die of a heart attack. So even if you go to the gym...figure out ways to move around more. Take lots of breaks and stretch and move, use the stairs whenever you can, walk to and from places more frequently, play with your kids, etc.
4. Use proper Ergonomics at home and at work. In this computer and electronics age, kids start very young putting themselves in akward postions slumped over with their heads hanging down. They do this for hours. Then these poor habits carry over into school and college and into the work force. Most of the people we treat at our San Francisco Chiropractic clinic spend the majority of their day at a desk in front of a computer. There is a way to optimize the position you are in to minimize wear and tear on the spine with proper ergonomics. For sure you want to take frequent breaks and stretch and move around.
5. Visit a chiropractor for regular check-ups. Chiropractors locate, identify, and correct spinal misalignment's and disturbances that result as a natural of living in a modern day world. Sure, you can take action using the tips above to reduce your odds of back pain. But the smart ones use chiropractic as a tool to keep the spine balanced and in alignment. After-all...the spine houses and protects your lifeline, the spinal cord, which carries all the signals from the brain to the body. Regular chiropractic visits should start young and continue throughout your life. Chiropractic adjustments will help keep your back healthy and strong. It's a wise investment. Consumer Reports ranks chiropractic #1 for back pain.

So there you go. Sure there is yoga, and Pilate's, and weight lifting...but those can be lumped into the exercise category. A lot of this is common sense, but you would be surprised how many back pain patients are not doing any of the 5 back pain prevention measures. My goal is to teach my patients about these 5 steps and to help them implement them.

Backpacks and Back pain

Backpacks are supposed to alleviate pain, not create it. But when worn incorrectly, they can cause you or your child to adopt postures that may give rise to spine problems. As 90% of students wear backpacks, a little knowledge on the relationship between backpacks and back pain may be in order. Below are 10 tips on how to avoid back pain for kids (and adults) who wear backpacks.

1. Observe Your Child's Spine

Heavy packs may cause kids to change their spinal position to accommodate the load. This can result in back pain, and at worst, the possibility of temporarily compressed discs and posture problems. Studies show that backpack wearers tend to begin adapting their posture once the weight of the pack reaches about 26 lbs. At an estimated 20% of the child’s weight, a backpack load may even begin to interfere with breathing. So observe your child's spine when she’s got her pack on and adjust the load according to the other tips in this article.

2. Lessen the Load In The Backpack

Most kids carry between 10% and 22% of their body weight in their back packs. Research shows that heavy loads may cause spinal discs to compress. As the weight of the backpack increases, so may the degree of disc compression. Experts recommend a backpack’s load be no more than 10% of the child’s weight.

3. Carry Only What Is Necessary

Help your child manage the amount of heavy items she carries in her pack. Encourage her to stop at her locker and switch books out frequently. Consider purchasing a second set of textbooks to keep at home.

4. Organize The Backpack Properly

When you carry anything out away from your body, it takes more effort, and places stress on your joints and muscles. A good strategy is to put the heaviest items on the inside of the pack, close to your back. Carry the little things, like calculators, pens and loose paper toward the outside.
Also, backpacks come with a number of features to make it easier to carry heavy loads. One great item is a rolling back pack. Transporting heavy items like a backpack is a breeze when wheels are involved.

5. Get a Backpack With Padded Shoulder Straps

Many people complain about neck and shoulder pain when they wear a heavy backpack. Padded shoulder straps may be just the feature you’re looking for! The padded shoulder straps are generally wider than the more basic type, and may help even out the distribution of the pack's weight. This, along with the cushioning provided by the padding, may help to avoid pinching of the trapezius muscle so common with the basic type of strap.

6. Use Both Straps When You Wear a Backpack

Whether it’s fashion or convenience that propels your child to sling his pack over one shoulder, know that such a practice can contribute to the development of poor posture habits. It can also cause pain on the side of the body that has to take the weight of the entire pack.

7. Center the Backpack Load

Studies show that loads of 18 lbs or more may create a temporary side-to-side curve in the spine. You can help your child by placing items so there is equal weight on either side of the pack.

8. Tighten the Straps of the Backpack

One thing that can make backpacks seem heavier and more cumbersome than they are is to wear them with loose shoulder straps. Loose straps causes the pack to move around as you move. This may cause muscles to work harder than usual. By cinching the straps to fit your frame, you secure the pack. Balancing the weight should be easier this way.

9. Wear a Waist Belt

Some packs come with waist belts. Waist belts take a portion of the load off the shoulders. By supporting some of the weight lower down, where the mechanical advantage is better, you may decrease neck pain and back pain above the waist.

10. Ask Your Child if She Has Back Pain

Encourage your kid to tell you about her aches and pains. Most of the time, the pain will be attributable to the pack. But there is the chance that the back pain is a symptom of an underlying condition or disease. Back pain during childhood increases the risk for back pain during adulthood. If adjusting the weight (and its distribution) of the pack and counseling your child on managing the load during the day doesn’t alleviate their back pain, see a doctor.

Whiplash-Which Treatment works Best?

Whiplash, or better termed, cervical acceleration-deceleration disorder (CAD) is primarily an injury to the soft tissues of the neck – that is, the muscles, their tendon insertions, and the ligaments that hold the joints firmly together.  Neck pain is a very common health problem that affects between 10–15% of the population and drives people to all types of health care providers. We have previously discussed the reasons why whiplash /CAD injuries occur, the examination process and the prognosis aspects...but the argument continues as to what treatment methods work the best when managing patients with CAD.

            In the May 21, 2002 issue of the Annals of Internal Medicine, a group of medical doctors and PhD’s reported on neck pain treatment comparing traditional medical and physical therapy approaches verses spinal manipulation. In the study, they compared three common neck pain treatment approaches in a group of 183 patients with chronic neck pain (patients who had neck pain for more than 3 months). The 3 methods included traditional medical care which included medication utilization and rest, manual therapy (chiropractic adjustments) and physical therapy (active exercise training). After 7 weeks of treatment, the percentage of patients who felt either totally resolved (cured) or much improved were 68.3% receiving manual therapy / chiropractic care, 50.8% receiving physical therapy, and 35.9% receiving medical care. The author, Jan Lucas Hoving, PhD reports that manual therapy / chiropractic was found to be more effective than the other 2 methods “…on almost all outcome measures,” not just a few! Further, although PT scored better than traditional medical care, “…most of the differences were not statistically significant,” meaning, not that much better.  The authors appropriately reported that further study was needed to better understand the differences between methods.

            In 2008, the “Decade Task Force” reviewed 10 years of studies on the treatment of neck pain and found similar results and referenced many studies that indicated spinal manipulation for neck pain, headaches, whiplash, and other neck related conditions was one of the most effective methods and that patients with neck pain should be given the option of receiving manual therapy / chiropractic before other approaches as it was found to be less expensive, faster in obtaining satisfying results (shorter course of disability), and most effective in terms of long-term benefits.

            This comparison discussion is by no means meant to minimize the importance of medical and PT care. However, there appears to be a bias among patients with neck pain to seek medical care first when the studies clearly show chiropractic care is the preferred method. Hence, the purpose of this article is to educate the reader that their choice in treatment for neck pain should favor chiropractic care FIRST, not last. In fact, the sooner manipulation can be applied to the injured joints of the neck, typically the faster the results.  For example, long term disability and chronic neck pain can occur from prolonged use of a cervical collar as the structures tighten and stiffen up from being immobile - unable to move because of the collar.  Unless there is some unstable condition to the neck (fracture, grade 3 ligament tear, progressive neurological loss, etc.), studies support manipulation / early mobilization of the neck joints after injuries like whiplash verses wearing a cervical collar and rest. 

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

Why do so many people have back pain?

At any given point in time over 31 million Americans are suffering with low back pain. One half of all working Americans admit to having back pain each year. Experts estimate that over 80% of us will experience a back problem at some point in our lives. Why?
Well, when you consider that up to 70% of the population is overweight or obese, and obesity is a primary cause of back pain, we would have to consider obesity as a primary cause of back pain.
In addition, the typical American diet (high fat, high animal protein, processed foods, sugar)  which is responsible for the obesity epidemic is also pro-inflammatory, meaning it creates an internal environment in the body that constantly triggers your immune response, which is very harmful to your organs, joints, and tissues.
There are also other causes of inflammation .
This chronic inflammation can lead to conditions such as arthritis, spinal degeneration, and disc disease...as well as many organic disorders.
Then, there are the normal sports injuries, car accidents, bad posture habits, and work injuries that injure the low back...and this is a big number.
An often overlooked cause of low back pain is mental stress or the psychological component. This is more common than most doctors realize and needs to be considered as a primary cause of back pain.
What is the best treatment for low back pain?
Since most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer...chiropractic makes the most amount of sense (at least in my biased opinion).
Chiropractic is mechanical...it's physical...it's done by hand to correct physical misalignments (mechanical) of the spine. If you have a pebble in your shoe...that's physical. The solution is not chemical. Sure,  you can take a drug (chemical) so you don't feel the pebble...but to fix the problem you need to remove the pebble (physical).
You also want to look at your lifestyle choices. If you are eating the typical American diet (or anything close) and are carrying too much weight and have chronic inflammation...this can lead to physical misalignment's that keep re-occuring. Most good chiropractors can help you lose weight. 
Many back pain patients are also out of shape and de-conditioned. Making regular exercise a part of your life can help with acute and chronic low back pain. Your chiropractor can also help put together an exercise plan for you.
For every effect there is a cause. For every cause there is an effect. Sure, low back pain can often be hard for doctors to understand and treat...but for your chiropractor, it's business as usual.

Making the Headache and Neck Connection

When we hear the term headache, we don’t usually think about the neck. Rather, we focus on the head, more specifically, “…what part of the head hurts?” But, upon careful questioning of patients, we usually find some connection or correlation between neck pain and headaches.
The key to this connection can be found in looking at the anatomy of the neck. There are 7 vertebrae that make up the cervical spine and 8 sets of nerves that exit this part of the spine and innervate (connect to and control) various parts of the head, neck, shoulders and arms, all the way to the fingers. Think of the nerves as electric wires that stretch between a switch and a light bulb. When you flip on the switch, the light illuminates. Each nerve, as it exits the spine, is like a switch and the target it travels to represents the light bulb. So, if one were to stimulate each of the nerves as they exit the spine, we could “map” exactly where each nerve travels (of course, this has been done). 
When we look specifically at the upper 3 sets of nerves that exit the spine (C1, C2, and C3), we see that as soon as they exit the spine, they immediately travel upwards into the head (the scalp). Like any nerve, if enough pressure is applied to the nerve, some alteration in nerve function occurs and usually a sensory change is noted (numbness, tingling, pain, burning, etc.). If the pressure continues, these symptoms can last for a long time. These types of headaches are often called “cervicogenic headaches” (literally meaning headaches that are caused by the neck). These can be caused by the nerves getting pinched by tight muscles through which they travel as they make their way to the scalp.
These muscles are usually tight in people that spend the majority of their day in front of a computer...especially if they have developed Forward Head Posture.
Another connection between the neck and headaches includes the relationship between 2 of the 12 cranial nerves and the first three nerves in the neck described above. These types of headaches usually only affect one half of the head – the left or right side. One of the cranial nerves is called the trigeminal nerve (cranial nerve V). Because the trigeminal nerve innervates parts of the face and head, pain can also involve the face. Another cranial nerve (spinal accessory, cranial nerve IX) can also interact with the upper 3 cervical nerve roots, resulting in cervicogenic headaches. People with cervicogenic headaches will often present with an altered neck posture, restricted neck movement, and pain when pressure is applied to the base of the skull or to the upper vertebrae. Other than a possible numbness, there are no clinical tests that we can run to “show” this condition, though some patients may report scalp numbness or, it may be found during examination.
Though medication, injections, and even surgical options exist, manipulation applied to the small joints of the neck, especially in the upper part where C1-3 exit, works really well so why not try that first as it’s the least invasive and, VERY EFFECTIVE! In some cases, a combination of approaches may be needed but many times, chiropractic treatment is all the patient needs for a successful outcome.

Car Accidents and Mild Traumatic Brain Injury

We have been providing treatment for whiplash for almost 7years now. The scenario below is very common with whiplash trauma:
When you woke up today, you thought this was like any other Friday. You’re on your way to work, and traffic is flowing smoother than normal.  Suddenly, someone crashes into the back end of your car and you feel your head extend back over the headrest and then rebound forwards, almost hitting the steering wheel with your forehead. It all happened so fast. After a few minutes, you notice your neck and head starting to hurt in a way you’ve not previously felt.   When the police arrive and start asking questions about what had happened, you try to piece together what happened but you’re not quite sure of the sequence of events.  Your memory just isn’t that clear. Within the first few days, in addition to significant neck and headache pain, you notice your memory seems fuzzy, and you easily lose your train of thought. Everything seems like an effort and you notice you’re quite irritable. When your chiropractor asks you if you’ve felt any of these symptoms, you look at them and say, "…how did you know? I just thought I was having a bad day – I didn’t know whiplash could cause these symptoms!"
            Because these symptoms are often subtle and non-specific, it’s quite normal for patients not to complain about them. In fact, we almost always have to describe the symptoms and ask if any of these symptoms “sound familiar” to the patient.
            As pointed out above, patients with Mild Traumatic Brain Injury (MTBI) don’t mention any of the previously described symptoms and in fact, may be embarrassed to discuss these symptoms with their chiropractor or physician when they first present after a car crash.  This is because the symptoms are vague and hard to describe and, many feel the symptoms are caused by simply being tired or perhaps upset about the accident.  When directly asked if any of these symptoms exist, the patient is often surprised there is an actual reason for feeling this way.
The cause of MTBI is due to the brain actually bouncing or rebounding off the inner walls of the bony skull during the “whiplash” process, when the head is forced back and forth after the impact. During that process, the brain which is suspended inside our skull, is forced forwards and literally ricochets off the skull and damages some of the nerve cells most commonly of either the brain stem (the part connected to the spinal cord), the frontal lobe (the part behind the forehead) and/or the temporal lobe (the part of the brain located on the side of the head). Depending on the direction and degree of force generated by the collision (front end, side impact or rear end collision), the area of the brain that may be damaged varies as it could be the area closest to initial impact or, the area on the opposite side, due to the rebound effect. Depending on which part of the brain is injured, the physical findings may include problems with walking, balance, coordination, strength/endurance, as well as difficulties with communicating (“cognitive deficits”), processing information, memory, and altered psychological functions.
The good news is that most of these injuries will recover within 3-12 months but unfortunately, not all do and in these cases, the term, “post-concussive syndrome” is sometimes used.
We realize you have a choice in where you choose your health-care 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 presently and, in the future.

Carpal Tunnel Syndrome and Ergonomics

The word, “Ergonomics” is thrown around a lot when it comes to Carpal Tunnel Syndrome (CTS). The term ergonomics comes from the Greek ergon, meaning “work”, and nomos, meaning “natural laws.” By definition, ergonomics means, “…the study of efficiency in working environments.” Wikipedia describes it as, “…the study of designing equipment and devices that fit the human body, and its cognitive abilities.” The International Ergonomics Association offers this definition: “Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance.”
            The study of ergonomics is not new as it dates back to Ancient Greece with substantial evidence that, in the 5th century BC, ergonomic principles were applied to tool design, jobs and workplaces. Examples include Hippocrates giving surgeons recommendations on how to arrange their table and tools during surgery.
            Some ergonomic concepts we can employ on a daily basis include:

1. Take frequent breaks, every half-hour if possible, but at least every 60 to 90 minutes. Get up, stretch and walk around. If nothing else, perform stretches while sitting in your work chair.
2. Maintain “good posture” (tuck in the chin and hold the retracted position).      
3. Evaluate your workstation: proper sitting position, how you hold the phone, keyboard/monitor positions, type & position of the mouse, reaching requirements, avoid twist/bending the wrists.
4. When grasping/gripping, use the whole hand – not just the fingers or thumb tips alone.
5. Keep cutting instruments sharp (scissors, knives, etc.) and maintain locks on hinged knives.
6. Consider modifications if tools are too heavy, buttons too high, too much required force, etc.
7. Stay in shape as obesity is a risk factor for carpal tunnel syndrome.
8. Rotate job tasks rather than continuing with one task until finished (less repetition)!
9. Communicate with your supervisor and HRO person about improving the workplace.

Whiplash Facts You Should Know!

In whiplash research, many articles have been published that conflict or contradict each other. The goal of this blog post is to report the “facts” about whiplash.

• It is more common to have a delay in the onset of whiplash symptoms. Symptoms may start about two hours after the initial injury or it may take days, weeks, or months before you feel anything.
• For whiplash caused by car accidents, the severity depends on the force of the impact, the way you were seated in your car, and if you were properly restrained using a shoulder and seat belt.
• Tests show the soft tissues in your neck sustain injury at a threshold of 5 mph. That means if you're rear-ended at 5 mph or slower, you have a lower chance of getting whiplash. However, most rear-end car accidents happen at speeds of 6-12 mph.
• If you've been in a car accident, it’s a good idea to be evaluated even if your car didn't get damaged and you don't feel any pain.
• Although whiplash is most often associated with car accidents, you can also get whiplash from sports such as snowboarding, boxing, football and gymnastics.
• The concept of “no car damage = no injury” is COMPLETELY false. Most cars can withstand collisions of up to 10 MPH and as pointed out above, only in collisions < 5 MPH are you less likely to be injured. Collisions that occur between 6-12 MPH cause the highest percentage of whiplash injuries (which is below the threshold of car damage in most cases). Also, the energy of the impact is transferred to the contents inside the car when there is no vehicular damage (that means you).
• Mild traumatic brain injury (MTBI) can occur in motor vehicle collisions even if the head does not hit an object inside the car, although it’s more common when there is a head strike. The symptoms associated with MTBI are often referred to as “Post Concussive Syndrome.”
• Approximately 10% of whiplash injured patients become totally disabled.
• Of the studies published since 1995, over 60% of whiplash patients required long-term medical care.
• Risk factors for long-term symptoms associated with WAD include: rear impacts, loss of the cervical lordosis curve, pre-existing degenerative arthritis, use of seat belts & shoulder harness (low speed impacts only), poor head restraint position or shape, non-awareness of the impending collision, female (especially long slender neck), head rotation at impact.

Iliotibial Bands: How to Prevent Injuries

The Iliotibial Band, or IT Band as it is commonly referred to, is a fibrous, thick connective tissue.  It begins at the hip bone and runs down the outside of the thigh and attaches at the shin bone.  The IT Band works in conjunction with the thigh muscles to provide stability when the legs are moving.

Friction occurs when the IT Band passes over the bony outside section of the knee as the leg bends and straightens.  Runners commonly experience discomfort or pain when the IT Band becomes irritated or inflamed.  Typically, their feet strike the ground just as the IT Band passes across that hard outside part of the knee which can cause pain to be felt on the outside of the knee, the thigh or the hip.  The intensity of pain may increase when descending stairs and hills.

Other factors can contribute to IT Band injuries:

weak hip muscles

tight or inflexible thigh and buttock muscles

overuse

over pronation

excessive hill running

running on slanted/curved surfaces                      

Being proactive and knowledgeable can help avoid IT Band problems.  There is an abundance of exercises that target key muscles and movements that will increase flexibility.  Another important factor in preventing injuries is using proper form.

 
Prevention of IT Band injuries can be greatly improved by including various strength training exercises along with rehabilitation and stretching routines. Below is a list of common hip and thigh strengthening exercises that you can do by yourself:
 

• Walking lunges
• Yoga for runners low lunge
• Split squats with fitness ball
• Squats with resistance band raises

 
At the end of the day every runner wants to run injury free. As we discussed earlier, the hips and IT Bands are prone to injury if you have excessive tightness and/or weak muscles. Training should include ample stretching and strengthening followed by a foam roller massage for the serious runner who puts in a lot of weakly mileage (a lot can vary by individual but generally means anything above 20 miles per week).  Use the foam roller to massage and stretch out the IT Band and the surrounding tissues.  Make sure the foam roller is densely packed  and has a consistency more like wood.  Use your body weight and gravity to massage.  Pain should be felt in those areas during massage to know it is being done correctly.  The pain indicates an area of tightness.

Runners can also use myofascial massage/release to work out pain and tightness. Starting early and being consistent with the above techniques should improve your chances of running healthy and pain free for the long term.
 

An exercise program is essential to being fit in body, mind and spirit.  Let us guide you to a long, healthy running experience.

How Does Spinal Degeneration Happen?

Patients are often surprised when they see the level of spinal degeneration that they have on x-ray or MRI. The first question is always "How did this happen to me?"
Well...spinal degeneration is the opposite of generate, which means "grow".
When we stop growing we begin to degenerate...and this happens to everything.
So is spinal degeneration normal?
Yes, to a certain extent...just like a certain amount of tread wear on a tire is normal as long as the conditions are right...such as a normal front end alignment, good brake pads and shocks, normal road conditions, and of course your driving habits.
The most common form of spinal degeneration is from abnormal wear and tear...or what chiropractors call subluxation degeneration, which comes from spinal misalignment's (vertebral subluxations) that are left undetected and uncorrected. And for the most part, this process starts when we are very young.
What happens is, the spinal bones lose their normal position which creates abnormal forces on the spinal structures such as the spinal discs, ligaments, facet joints, and vertebral end plates. These abnormal forces (along with a cascade of inflammatory and chemical responses) cause the structures to breakdown prematurely leading to spinal degeneration and degenerative disc disease (DDD).
In addition, lifestyle choices we make (I refer to this as our "context")  such as the food we eat , the amount of exercise we get, smoking, drinking, stress, rest, etc., can also contribute towards spinal degeneration. The healthier the lifestyle, the better.
Side Note: The typical American diet (and 70% of us are overwight or obese) is rich an animal protein,  processed foods, chemicals, and toxins, which can lead to chronic inflamation, obesity, and spinal degeneration.
In a nutshell...we reflect the quality of our context. Just like the pond in your backyard reflects the quality of it's context...or a river, or an ocean, or the planet.
So what can I do to make sure my spine does not degenerate prematurely or if it already has, slow the degeneration down?
The first thing you should do is get a spinal exam from a chiropractor...one that specializes in posture. You want to find out if you have a short leg also, foot pronation, or a rotated pelvis...these are all part of a good spinal exam. If you are out of alignment, follow your chiropractors recommendations to fix the problem...then get checked every so often to maintain the changes.
Depending on the severity of your condition and your desire to change (the primary factor), your chiropractor can help you modify your lifestyle choices and get you on the right track.
As I chiropractor and family doctor, I want to teach my patients about the causes of vertbral subluxation, as well as treat the subluxations themselves. This way the changes are more permanent.
So, Yes...spinal degeneration can happen quick....especially when we get older. But chiropractic and a healthy lifestyle can slow it down and help you enjoy a long active life :-)

How do you know if you have a herniated disc?

Often times back pain patients are concerned that they may have a herniated or slipped discin their back or neck...especially if there was a trauma involved...how would they know?

Well...if you have pain radiating down your arm or leg (sciatica) you should be concerned. If it hurts when you cough, laugh, or sneeze, you may have a disc herniation. Or, if you have loss of grip strength, arm or leg weakness...or foot drop, you could have a lumbar or cervical disc bulge or herniation.

A herniated disc can also cause numbness or tingling in the extremities, as well as hot or cold sensations...or just abnormal sensations.

Your nerves transmit sensory and motor input to and from the brain. Herniated or bulging discs put physical pressure on the nerves and can cause loss of sensation and motor function.

Sure, a herniated disc can happen all at once from a trauma. But what's more likely to happen is a disc herniation from long term wear and tear from spinal degeneration and misalignment's. Just like a tire can blow if it hits a curb...or it can blow from driving too hard over time with the front end out of alignment.

And get this...you may or may not have any neck or back pain with a disc herniation.

Actually...you could have a disc herniation and not even know it. In fact, most people that have disc herniations never even develop signs or symptoms. That's right...only a small percentage of people that suffer disc herniations ever even know they have them. This is because not all herniated cervical or lumbar discs cause symptoms or loss of function.

However...of the herniated disc patients that do develop symptoms such as back pain, sciatica, numbness, tingling, or weakness...some of them become  chronic and severe...some severely disabled.

So, knowing if you have a disc herniation is very difficult. Because even all the signs and symptoms I described above can be caused by other things, especially after acute trauma.

The gold standard for confirming the presence of a disc herniation in the spine is MRI.

If it turns out you have a herniated disc in your back there are surgical and non-surgical options. 

Chiropractic care is probably your best natural solution...then non-surgical spinal decompression...or a combination of both. You may or may not need medical care...it just depends on the nature and severity of your condition.