What are Tension Headaches

At some point, everyone will have a headache, whether it’s from stress, lack of sleep, hormonal related or even self-induced after having way too much fun the night before! In fact, 9 out of 10 Americans suffer from headaches.  For the most part, headaches are not indicative of a dangerous condition, but they can be.  The focus of this Health Update is to discuss the most common form of headache – the tension-type headache or, TTHA.

Tension-type headaches (TTHA) are defined by the Mayo Clinic as  “a diffuse, mild to moderate pain that’s often described as feeling like a tight band around your head.” Ironically, even though this is the most common form of headache, the causes of TTHA are not well understood. These are sometimes described as muscle contraction headaches but many experts no longer think muscle contractions are the cause.  They now feel that “mixed signals” coming from nerve pathways to the brain are the cause and may be the result of “overactive pain receptors.”

Regardless of the cause, the triggers of tension headaches are well known and include stress, depression/anxiety, poor posture, faulty awkward work station set-ups, jaw clenching and many others. Risk factors for TTHA include being a woman (studies show that almost 90% of woman experience tension headaches at some point in life) and being middle aged (TTHA’s appear to peak in our 40s, though TTHA’s are not limited to any one age group). Complications associated with TTHA’s may include job productivity loss, family and social interaction disruption, and relationship strain.  The diagnosis is typically made by excluding other dangerous causes of headaches and when all the test results return “normal,” the diagnosis of TTHA is made.

Treatment utilizing over the counter medications can be effective so long as side effects of stomach irritation and/or liver and kidney issues don’t arise. Controlling stress by trimming out less important duties or “…taking on less” can help.  Meditation, biofeedback and relaxation therapy are also great! An “ergonomic” assessment of a workstation and how it “fits” the headache patient can also yield great results.  Chiropractic is a GREAT choice compared to standard medical care, especially when side effects to medications exist.  This is because manipulation of the cervical spine addresses the cause of the headache and doesn’t just try to “cover up” the pain.  In 2001, Duke University reported compelling evidence that spinal manipulation resulted in almost immediate improvement for those with headaches that originate in the neck with significantly fewer side effects and longer-lasting relief compared to commonly prescribed medication. Chiropractic treatment approaches include (partial list): spinal manipulation, mobilization techniques, exercise training, dietary and supplementation education / advice, lifestyle coaching and ergonomic assessments.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES!

CALL PAIN FREE GREAT POSTURE FOR A FREE NO-OBLIGATION CONSULTATION !  262-251-8306

Fibromyalgia – How To “Live With” FM

Fibromyalgia (FM) is a condition that produces widespread pain that can literally change the life of a FM patient, but as they say, “..life must go on!”  There are treatment options out there, that can greatly improve your life without drugs or surgery.   But, this Health Update is dedicated to discussing ways to treat yourself, in order to make your FM as manageable as possible. Ways to gain self-control of FM include the following:

1. Exercise:  There are two forms of exercise you should include in your self-management program. One is light aerobic exercises such as walking and/or water exercises with the objective to increase your heart rate. The other is strength training with a low weight / high repetition approach emphasizing the part of the exercise where you slowly release the weight back to the start position (the eccentric part of the exercise).  Here is a list of tips from the National Fibromyalgia Association that should help:
   1. Start slow – don’t overdo it the first few times you exercise as post-exercise soreness is normal but, it’s exaggerated in the FM patient.
   2. Listen closely to your body’s feedback! Increase the activity according to your tolerance – NOT TOO QUICKLY!
   3. Start with only a few minutes of gentle exercise and work your way up.
   4. Walking is a GREAT form of exercise.  It can be done inside (in the winter, for example), outside, and/or in water (to reduce weight bearing loads).
   5. Track your progress by keeping a log of what and how much you’re doing. This can be accomplished by wearing a pedometer (that measures steps), a heart monitor (that measures pulse rate), and keep track of the distance and time, when possible.  Make notes how you felt during and after the exercise.
   6. Stretch lightly before and after exercising.
   7. Keep your chiropractor informed and work as a “team” to advance your program.
2. Sleep:  A poor sleep pattern is the “norm” for FM patients. The pain associated with FM usually interferes with sleeps, which leads to more pain followed by more sleep disturbance – it’s a vicious cycle that needs to be broken. The National Sleep Foundation and others recommend the following steps to help us sleep:
   1. Stick to a sleep schedule. Go to bed at a similar time each night, even on weekends.
   2. Room temperature – keep it cool, not too warm!
   3. Caffeine – avoid this especially towards evenings (coffee, tea, soda, and/or chocolate).
   4. Alcohol – avoid before bedtime as it can keep you awake.
   5. Exercise – in the afternoon, NOT before bedtime.
   6. Nap as needed but ONLY briefly – like 20 min. max.!
   7. Be comfortable – wear soft PJ’s and consider a white noise machine.
   8. Bedtime routine – consider reading, listening to soft music – whatever works for you! Once you find a routine that works, stick with it!
3. Diet: Talk to your chiropractor about food allergy, gluten sensitivity, diabetes, thyroid function, medication/vitamin use and any other unique issues that pertain to you.
4. Emotional control: Engage your family, good friends, your healthcare providers, and consider FM support groups.  Meditation, deep breathing and visualization exercises as well as cognitive therapy can also be very effective.

YOU MAY BE A CANDIDATE FOR DRUG-FREE OF FIBROMYALGIA! FOR MORE INFORMATION LOG ON TO: www.stopyourfibronow.com

Carpal Tunnel Syndrome and Exercise

We have discussed the topic of Carpal Tunnel Syndrome (CTS) exercises previously but this topic is so important, it warrants another look at this subject from a different perspective.  Please keep in mind there are many exercises that will help patients with CTS, including a general, aerobic exercise program where walking, elliptical, stepping, cycling, rowing, swimming and more will facilitate either directly or indirectly.  In other words, just “staying in shape” will greatly enhance your health and is therapeutically beneficial for many conditions, including CTS.  Remember, if your BMI (Body Mass Index) is over 25 (especially 30) and/or, if your waist size is greater than 35” and especially 40”, the risk of CTS increases significantly.  Therefore, diet and exercise are important components of improving your overall health– including conditions like CTS! Here are 5 exercises and/or suggestions for managing CTS:

1. Circles : This exercise will strengthen the wrist & forearm muscles, increase the wrist’s range of movement/flexibility, and decreases wrist pain. This can be done multiple times a day as a “mini-break” from keyboard/computer work, as well as a “morning warm-up.”  Slowly rotate your wrist/hand from a palm up to a palm down position and repeat up to 10 times.

2. Prayer Stretch:  Stretching helps to breakup adhesions that form in the carpal tunnel.  Place the palms together, fingers straight & pointing up (prayer position).  Keeping the heels of the hands together, slowly lower the hands and raise the elbows so that the angle at the wrist decreases. Push your fingers together for 5 sec. Hold for 10 seconds and repeat up to 10 times, depending on time availability.  Do this multiple times a day.

3. Strengthening:  Using a hand weight or TheraTubing, assume the same position as #1 above and slowly raise the weight or stretch the tubing by flexing the wrist with the palm in each of 4 positions: palm up, thumb up, palm down and pinky up. Use your opposite hand to support your wrist with the pinky up exercise

4. Ergonomics:  Consider modifying your workstation, especially if your monitor is off to a side or too high, if your elbows are bent more than 90°, if your forearms are digging into the edge of the desk, use a trackball mouse so your arm can stay still, consider a larger screen, and an “ergonomic” keyboard (one that is not flat); use a “good” chair with adjustable arms to rest the forearms on.

5. Posture: Sit “tall”, relax your shoulders (no shrugging), feet flat on the floor, and take mini-breaks” at your workstation.  If you have to, set a timer for every 30-60 minutes that will remind you to stretch.

Two more “tricks” that really help: 1. Reduce your stress on the job – treat others like you would like to be treated (get along with your co-workers); 2. Enjoy your job!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME!

For more information log on to: www.relieffromcarpaltunnel.com

Low Back Pain and Spinal Fusions

You may think it’s odd to discuss low back pain (LBP) from the perspective of spinal fusion because as chiropractors, we do not perform surgery. So, why discuss it?  It is important that we discuss research like this so you can make informed treatment decisions after you’ve considered all the facts.  Now, there are certainly times when a surgical procedure for back and leg pain is necessary and appropriate for some patients. But the problem is, there are also some patients who have been told they need spinal surgery when, in fact, they may be better off NOT proceeding with surgery. So, the question is, what happens to those patients who elect not, vs. those who do choose to proceed with surgery?

That question was addressed in a study where a total of 1450 patients injured at work were followed over a 2-year time frame. There were a total of 725 patients who proceeded with the fusion surgery and the other 750 elected NOT to have the surgery. A fusion surgery can be described as when two or more vertebra are fused together, usually because there are neurological problems such as shooting leg pain, weakness and/or numbness in one or both legs.  The conditions treated in this study included herniated disks, degeneration of the disk, and radiating leg pain. There were primarily 3 factors that were compared between the two groups, namely, 1) ability to return to work; 2) disability (the inability to work), and 3) opiate (narcotic) drug use. Other factors compared included the need for re-operations, complications, and death.

The results showed, in general, those who proceeded with surgery had significantly more problems compared to those who did not have surgery.  For example, only 26% returned to work, compared to 67% returned to work.  The total number of days off work were 1140 vs. 316 days, respectively.  There were 17 vs. 11 deaths, respectively and, 27% of the surgical group required re-operations with a 36% complication rate. Also, there was a 41% increase in the use of narcotic medication with 76% continuing the use after surgery.

Again, there are times when surgery is absolutely the right choice.  Those times include when there is a loss of bladder or bowel control, progressively worsening neurological symptoms in spite of non-surgical care, and of course, unstable fractures, cancer/tumor and infections. But that’s about it!

In other words, if you don’t have one of the before mentioned conditions which do require surgery, don’t be too quick to jump at the chance of “getting it fixed” with surgery. As the study suggests, the post-surgical results favor those who elected NOT to have surgery.  Also, when in doubt, don’t trust the opinion of only one surgeon – always get a 2nd or even 3rd opinion.  It is also very important to consider your current level of function.  This includes your ability to do your desired tasks. Unless there is a significant loss in that ability, consider additional time with non-surgical treatment.  The non-surgical treatment you can expect to receive from chiropractic includes (but may not be limited to) spinal manipulation, exercise training, dietary counseling, and job modification information.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN!  FOR MORE INFORMATION LOG ON TO: www.newbackpainreliefinfo.com

Gluten Free Cooking – Questions and Answers

Dr. Paul Kramer appears as a guest on “What’s Cookin’” w/ KC Thorson.  Dr. Kramer and KC reveal secrets about gluten free eating, that most people (even doctors) don’t know !

Including:

• What is Gluten ?
• Who should avoid gluten ? and why ?
• What diseases are associated with gluten in the diet ?
• What are some alternatives to gluten ?

And, much, much, more !

At the end of the show KC cooks some fabulous gluten-free spaghetti.

To see the show, log on here!

How to Choose a Good Shoe?

Every shoe company has their own little twist on what makes their shoe better.  You see bigger cushions, arch supports, odd shaped soles, inflatable shock absorbers and just about anything a shoemaker can dream up.

But, what makes a good shoe ?  And, how do you know if a shoe is really good for you ?

As I have written in other articles, arch supports are no good.  Contrary to what shoe companies, orthotic makers and many doctors say, arch supports do nothing to treat or prevent injury.  This is not just my opinion.  The British Journal of Sports Medicine did an extensive study of footwear in 2008.  They concluded that there is no scientific evidence anywhere, that arch supports either treat or prevent injury.

You can also test whether arch supports are good for your body.  Stand barefoot and walk around, take deep breaths, stand on one foot, move side to side or any movement you want to test.  Then put your arch supports on.  You will notice that it is more difficult to do any movement you choose while wearing arch supports.  (Yes, even your breathing can feel more restricted.)

So, when you look for a shoe, make sure the inside is level from side to side.

Also, make sure the back of the heel of the shoe is the highest point.  If any part of the shoe is higher than the heel, it will cause your shoulders to droop when you walk.

Make sure the shoe is wide enough across the toes.  If it is too tight, not only does it hurt your foot, it will cause balance problems.  You can test this by putting on a tight pair of shoes and standing for a while.  You will notice that you sway more in tight shoes.

To find out more about how I treat foot problems, balance disorders and back pain: log on to:  www.painfree-greatposture.com and order a free report.

Should I Use Ice Or Heat For My Sciatica?

Ice, Ice, Ice.  I can’t say that enough.  You should use ice for any acute injury.  This includes an acute flare-up of a chronic problem, like sciatica.

For a long time medical doctors have debated whether someone should use ice or heat.  Both can relieve pain.  In fact, in my clinical experience, pain is probably better relieved with heat.  But pain relief isn’t the most important factor in the decision of which to use.

You see, ice decreases circulation to an area.  If the area is injured, it will decrease swelling.  Heat increases circulation.  If you use it on an injured area, it will increase swelling.  Swelling causes further damage to the injured area and more pain.

Although heat does have a temporary soothing effect following an injury, it actually increases pain 30 minutes following the application. (1)

When people put heat on an injured area, in this case their back, the pain gets relieved somewhat.  After say a half hour, the injured person takes the heat off.  Then 30 minutes later the pain comes back worse than before.  So… they put the heat back on… the area gets more swollen, but the pain is somewhat relieved.  The person takes the heat off again and in 30 minutes or less, the pain comes back worse than ever.  Usually, the person will then decide to keep a heating pad on constantly, in order to not feel the pain.  This creates so much swelling that within 24 hours the person is incapacitated.  They can’t stand up, sleep, walk or drive.

When a person ices an injury, the pain may not be relieved as much, but the swelling is reduced.  It may not relieve the problem completely, but it will make the injured area much easier to treat.  In fact, patients who use ice instead of heat were found to heal in less than half the amount of time.  (2)

Why do medical doctors and nurses continue to tell patients to use heating pads ?  I have no clue. The research on this is clear. And, the research is coming from the medical profession not chiropractic.

I had a sciatica patient recently who used a heating pad on her back 24/7 at the advice of her medical doctor.  After a month of this, she couldn’t walk without assistance.  She had called her medical doctor’s office to get an appointment, but they said she would need to go to pain management.  Why pain management ? To get a shot to REDUCE THE SWELLING.

Anyway, my advice is to use ice and if the problem isn’t going away, see doctor who understands musculoskeletal problems like sciatica.

Should you never use heat ?  I respond to this question with a hesitant no.  There are some indications for heat, but in my opinion, you should be examined by someone prior to using it.  And, the application of heat, like ice, should be staggered.  20 minutes on, an hour or two off.  You should never use the constant heat of a heating pad.  And, if you notice that when you take the heat off, the pain is worse a short time later, stop using it.  The heat is making the area more swollen.

In fifteen years of practice, I have seen only one person get in trouble using ice.  He put an icepack directly on his skin and he got frostbite.  (so always have a towel or clothing between skin and an icepack)  In those same years, I average seeing two patients a month, that have over used a heating pad to the point they can’t stand up.

For more information on how I treat back pain, log on to: www.newbackpainreliefinfo.com.

(1)   McDonald, Lundgren, Thieme, A Practical Guide to Therapeutic Modalities, p.40
(2)   Hocutt, Jaffe, Rylander, Beebe, Am Journal Med 10:316-319, 1982

How Much Does Back Surgery Cost?

According to the Virginia Healthcare and Hospital Association, the average spinal surgery without complications costs $77,107.  If the surgery has complications, it ranges from $117,901 to $260,584.  This does not include doctors fees.

Of course, this does not include human costs like pain, suffering, time spent in rehabilitation, time spent away from family, lost activities like sports and hobbies, continued pain after surgery, doctors visits and on and on.

As a contrast, according to Chiropractic Lifecare of America, an insurance organization,  the average course of chiropractic treatment, for the same conditions, is $3,799.

Quite a difference.

If you consider the success rates of surgery when compared to chiropractic, it’s a wonder anyone has spinal surgery at all.

For more information on low back pain, degenerative disc disease, spinal stenosis and sciatica, log on to www.newbackpainreliefinfo.com

Mild Traumatic Brain Injury – What’s That?

When you woke up today, you thought this was like any other day.  You packed the kid’s lunches and off to school they went.  You’re on your way to work and everything is on schedule- it’s a good day!  You are stopped at a red light when out of nowhere, someone crashes into the back end of your car and you feel your head snap back over the headrest and then bounce forwards, almost hitting the steering with your forehead. Everything goes blank for a second or two. “What just happened?”  Initially, you’re in “shock,” and after checking to make sure you’re not bleeding, you notice that your neck and head are hurting in a way that’s new to you.  When the police arrive and start asking you questions about what had happened, you try to piece together the sequence of events of the collision but you’re not quite sure how it all fits together.  Your memory just isn’t real clear. Within the first few days, significant neck pain and headache overshadow everything else but you begin to notice that you’re ability to “think clearly” is just not quite right.  Your memory seems fuzzy, you lose your train of thought easily, sometimes in the middle of a discussion, and you are tired – really tired! Taking a nap several times a day is needed. The other day, you were discussing a project with a group of co-workers and you had to ask “…now where was I?” several times during the discussion as you lost your place in the middle of a thought.

Mild traumatic brain injury or, MTBI, is exactly what is described above.  Many patients do not even mention these things to their chiropractor when they present after a car crash as it’s hard to describe these symptoms and many feel it’s just because they are tired or upset about the accident.  When directly asked if any of these symptoms exist, the patient is often surprised and say, “…how did you know?” They are even more surprised when they learn there is an actual reason and explanation for feeling this way. Most of the time, the patient has to be asked if these symptoms exist! This is actually “normal” behavior for those suffering from MTBI.

To better understand how this occurs, think of the more catastrophic situation where the person hits their head to the point of creating an internal bleed and is unconscious. In this case, it’s easier to appreciate the presence of a “brain injury.” With severe head trauma, the person usually has significant memory loss, having no memory of the accident and maybe worse, not being able to recognize family or friends.  Losing the memory of days, weeks, months or years of time is common with these severe head injuries.  However, in MTBI, there is less bruising to the brain and consequently, there are less severe symptoms.  Though the symptoms are similar, MTBI is in a way, a mild form of the above.  With MTBI, the person does NOT have to hit their head on anything to bruise the brain. This is because the speed at which the head is propelled forward and back literally slams the brain into the inside walls, creating the bruising.  Because the brain is suspended inside our skull, damage to some of the nerve cells occurs, most commonly the brain stem, the frontal lobe and/or the temporal lobe. 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. Recognizing these symptoms and managing MTBI in a coordinated approach with a neuropsychologist is sometimes needed.

We realize that you have a choice in where you seek help for your health care needs and we truly appreciate your consideration in allowing us to help you through that potentially difficult process.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH! FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306

I Hurt My Back After Shoveling Snow- Ice or Heat ?

I am asked this question all the time.  Should I use ice or heat if my back is hurting. ? The answer is “ICE”.

Ice reduces swelling.  When muscle or ligament tissues are injured, blood vessels get injured as well.  The injured blood vessels let blood leak out and it causes swelling.  The swelling gets bigger and bigger until the amount of pressure outside the injured blood vessel equals the pressure inside.  The swollen tissue gets stretched, it can be damaged further and the amount of pain increases.

Ice causes the muscles surrounding larger blood vessels to contract.  This allows less blood to get to the cold area.  Less blood means lower blood pressure at the site where there is an injury.  This means that less blood will leak out of the injured vessels and therefore less swelling.

Heat increases circulation and can cause swelling in injured tissues.  Heat makes larger blood vessels expand.  This increases the pressure in the injured area and causes more blood to leak out of injured vessels.  More swelling, more pain, no fun for the patient.

Whenever someone sprains an ankle, injures a shoulder, breaks a bone, etc. they always put ice on it to control swelling.  If you didn’t use ice, or worse if you used heat, a sprained ankle could swell to the size of a softball in no time.  But, for some reason, people like to treat the back differently.  Patients are often told to use heat; probably because it feels better when it is applied; especially during cold winter months.  This is bad advice.  Heat makes the back swell and it can take weeks for the swelling to go down.  People who use heat, often end up having to go to the emergency room because the pain gets so bad they can’t walk.

So, even if it doesn’t feel good after you have been shoveling snow, use ice.

For more information on back pain log on to: www.newbackpainreliefinfo.com