Neck Pain – Where Does it Come From?

Neck pain is a very common problem that can come from, well, a lot of places.  It can come from laying crooked while watching TV, it can come from sleeping in a draft, it can come as a response to a cold or flu, it can hurt because of a sinus infection (“referred pain”); it can arise from an injury like car accidents, it can come from over lifting or carrying, it can come from pinching the phone between your ear and shoulder, or it can even come from “stress.” Rare, but dangerous, causes include bleeding inside the head during a stroke or, neck pain due to a heart attack. Obviously, these must be emergently evaluated and treated. There is even a category of causation called “insidious” or “idiopathic” which means we DON’T KNOW where the neck pain is coming from! It’s important to understand that neck pain is a symptom, not a disease which means we have to identify the cause…if we can!  This is why a detailed evaluation is required.

These are some common causes of neck pain (please refer to the pictures below):

1. Degenerative Disk Disease (DDD): Over time (years), repeated injuries to the neck can result in DDD. The small “shock absorbers” that lie between the vertebral bodies lose their water retaining capabilities, become narrow, and less flexible, which is a common source of neck pain (and stiffness).
2. Mechanical Neck Pain: Any condition that does not involve the pinching of nerves can be placed in this category. There are 2 small joints called “facets” that lie in the back of the vertebra that are a common source of neck pain. “Sprains” or injury to ligaments that hold bones together and “strains” or, injury to muscles and/or tendons that move the bones are also grouped here.
3. Pinched nerves: Results in pain down the arm. There are 2 primary causes:
   1. Herniated disk (HD): Think of a disk like a jelly donut. When the jelly “leaks” out and pinches a nerve (resulting in arm pain), that’s an HD.
   2. Bone spurs off the front of the facets &/or back edge of the vertebra can also pinch a nerve, resulting in the classic arm pain.
4. Spinal stenosis: (2-types)
   1. Central: A narrow spinal canal pinches the spinal cord creating pain, numbness and/or weakness in the arms &/or legs.
   2. Lateral: Narrowing of the hole where the nerve exits creating arm pain, numbness or weakness, if the nerve is pinched (like an HD).

Of course, there are many other causes of neck pain, but these are quite common and should be first considered when evaluating a patient with neck pain.  Non-drug, non-surgical alternatives should always be considered first !

YOU MAY BE A CANDIDATE FOR NON-DRUG NON-SURGICAL CARE FOR NECK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306 For Even More Information Log On To: www.painfree-greatposture.com

Is Chiropractic Safe?

Many people will not see a chiropractor because they think it is unsafe.  I understand completely.  The idea of moving bones around just doesn’t sound very good.

But, the fact remains that chiropractic is very safe and certain conditions will only respond to chiropractic care.  There is no drug that will re-align a bone and take pressure off a nerve.  Surgery sometimes can, but its an awfully risky and expensive thing to undergo, especially when you consider that a few adjustments may be all that’s needed.

Here are the facts:
Dangerous side effects are extremely rare. (1)  Media reports of stroke after chiropractic adjustments are not based on science. (2) However, minor side effects, such as muscular soreness after treatment are common. (3)  They are usually temporary (less than 48 hours) and generally handled with ice or topical analgesics.

In my clinical experience, about 2/3 of all the patients I treat, do not experience any soreness after treatment.  About 1/3 will, and it will subside after the initial 3 to 6 treatments.  The patients that get sore, usually have severe or chronic conditions. The reaction is very similar to a headache you might get after a visit to the orthodontist.  The soreness they feel, is a reaction to the alignment changes made by the adjustments.

The thing to focus on, is the benefits.  In many cases, chiropractic can help where nothing else can.

For more information on the safety of chiropractic, log on to: www.chiropracticissafe.com

REFERENCES
(1)    SPINE: 15 February 2008 – Volume 33 – Issue 4S – pp S176-S183
(2)  Lauretti W. The Comparative Safety of Chiropractic. In Daniel Redwood, ed., Contemporary Chiropractic. New York: Churchill Livingstone, 1997, p. 230-8.
(3)  SPINE: 1 October 2007 – Volume 32 – Issue 21 – pp 2375-2378

Fibromyalgia, C-reactive Protein and Your Heart

C-reactive Protein (CRP) is a protein that increases in the blood stream as a response to injury and inflammation.  Fibromyalgia sufferers often have elevated levels of CRP and it can be a sign of a major systemic inflammatory problem.  Lowering these levels can be a big key to relieving the wide-spread body pain.

CRP also turns out to be a good predictor of heart disease.  A study appearing in the Journal of the American Nutraceutical Association (2005;8(1)43-44), involving more than 27,000 women, found that CRP was a better predictor of cardiovascular disease than LDL (bad) cholesterol.

High CRP levels double the likelihood of death from a heart attack. And, it increases the likelihood of cancer by a factor of 1.65.

Again, people with chronic pain often have elevated levels of CRP.  These people need to know that if these levels are left unchecked, it can lead to a higher risk of heart disease and cancer later in life.

CRP levels can be lowered by increasing intake of anti-oxidant vitamins like Vitamin C and E.  Also, increasing levels of omega-3 fatty acids in the diet and lowering Omega-6 fatty acids can lower CRP levels.  Other anti-oxidant compounds can be helpful as well.

A C-reactive protein blood test is an easy routine test.  I include it in the blood panels I order because the information is so important.  It can make a big difference in your health.

For more information on chronic pain log on to www.fibroreliefinfo.com .

Fibromyalgia: How Do I know I Have It?

To answer this question, let’s first define fibromyalgia (FM).  FM is a condition that is diagnosed basically by eliminating all other possible causes, including inflammatory joint conditions. Lab testing includes tests for rheumatoid arthritis, gout, lupus, and infection.  X-ray and MRI’s may be ordered to rule out disc problems, fractures, tumors and infections.

There are essentially no blood tests, imaging studies or neurological tests that can specifically diagnose FM.  It is when all these tests come back negative, that the diagnosis of FM is used. The history is probably the most important tool that helps to diagnose FM.  Most of these patients will report that the onset is gradual, often present for years. There is usually no specific cause, though there are specific conditions (such as irritable bowel syndrome, trauma, rheumatoid arthritis and others) that can result in “secondary fibromyalgia”.

The big differentiating feature is the presence of widespread, whole body pain – NOT just low back pain or neck pain or headaches, etc.  In FM, there is often pain in the legs, arms, torso, back and neck.   These people basically, “…hurt all over.” Typically there is no radiating pain down the leg or arm that follows a specific nerve pathway.

Another unique feature of FM includes sleep dysfunction. In many cases, sleep interruptions occur 2, 3 or more times a night, often with difficulty in returning back to sleep. The quality of pain is often described as numbness, tingling, burning, achy, deep, boring, and most importantly generalized in location (all over the body). The intensity is usually reported as high (>6/10 pain scale scores).  The past history usually includes multiple visits to many different types of doctors.   Many attempts at different medications is common.   Most medications do not help.

Even with these unique historical features, it is still necessary to “rule out” other conditions by running tests. This is especially important when FM is secondary to other conditions as FM can overshadowed by other conditions.  It is important to find doctors that have the experience to diagnose it and treat it effectively.

Treatment for FM includes many of the same methods for treating other musculoskeletal conditions.  Spinal manipulation, various forms of physical therapy and low level laser therapy – LLLT, can improve function, reduce pain, and reduce the need for medications.  In addition, dietary management using an anti-inflammatory diet (gluten free diet) and supplementation (a multiple vitamin, calcium/magnesium, omega 3 fatty acids, Vit. D, and CoQ10) can be very effective.

YOU MAY BE A CANDIDATE FOR DRUG_FREE RELIEF FROM FIBROMYALGIA! FOR MORE INFORMATION LOG ON TO: www.stopyourfibronow.com

Carpal Tunnel Syndrome: Why Braces?

For those of you who have had Carpal Tunnel Syndrome, you probably know all about braces. These are devices worn on the wrist that stop you from bending the wrist up or down.  They may be worn anytime of the day if they don’t interfere too much with one’s current activity but are especially worn at night. You might think it would be more important to wear these during day when you are active and moving your fingers and hands a lot- as you go about your normal work or play activities – not at night when you’re basically just laying there doing nothing but sleeping, right?  Wrong! It’s more important to wear these at night. This is because you cannot control your hand position at night as you tend to curl up in a ball when you sleep and the wrist gets cocked up or down. So, why is this so bad?  Let’s look at the chart below on the left.

In the chart (above left), you are looking at a cross section of the wrist through the carpal tunnel.  This illustrates the many structures that are inside the tunnel making it tight. Notice the small white circles in the middle of the tunnel. Those are the tendons that pass through the tunnel – there are 9 of those and they attach the muscles in our forearms (on the palm side) to our fingers, so we can shake someone’s hand or carry a suitcase (grip). Just to the left of center, on top of all the tendons, sits the median nerve, which is just below the “roof” of the tunnel (the transverse carpal ligament). Now, normally, the pressure inside the carpal tunnel will approximately double when we bend our wrist, putting more pressure on the nerve and pushing it into the roof (ligament), which creates the numbness and/or weakness in our grip. But in the CTS sufferer, there is already more pressure in the tunnel due to the swollen tendons so when the wrist is flexed or extended, the pressure goes up much more the twice – more like 6 times more pressure – hence, more symptoms. So, if we’re sleeping with our wrist bent either way, the pressure pushing the nerve against the roof is a lot more than normal – 6x more!  This is the reason for the “night splint.”  It is VERY effective in keeping the wrist straight, which is needed to allow the nerve to NOT be pinched, so it can heal.

YOU MAY BE A CANDIDATE FOR NON-SURGICAL CARE FOR CARPAL TUNNEL SYNDROME!  FOR MORE INFORMATION LOG ON TO: www.relieffromcarpaltunnel.com

What Many People Don’t Know About Chiropractic And What We Can Do For YOU

Dr. Paul Kramer here.  In just a moment I’m going to tell you some very interesting information about Chiropractic that most people do not know – but more importantly – what it can do for you and how it might even change your life.

This is really good stuff… especially if you have back pain now or have ever had back pain in the past.

But first, there is something else you should know about.  I think you’ll really like it.

Did you the use of Aspirin dates all the way back to around 400 B.C.?  It’s true.  The father of medicine, Hippocrates, who lived sometime between 460 B.C. and 377 B.C., left historical records that included the use of the bark of the willow tree to treat fever, headache and various pains.

It wasn’t until 1829 that scientists started figuring out what was going on.  That’s when they discovered a compound called salicin in the willow plant was responsible for the pain relief.

In that same year, scientists were able to turn salicin into salicylic acid.  The problem was that salicylic acid was very rough of the stomach and mouth… which limited its use.  Then, in 1853 a German scientist named Charles Frederic Gerhardt buffered (neutralized) the harshness of the acid by coating salicylic acid with sodium and acetyl chloride.  Although it worked, it was time consuming and Gerhardt stopped working on it because he didn’t think it was worth it.

OOOOPS!

In 1897 a German pharmacist working for a German pharmaceutical company Bayer, started looking for a solution for his father’s rheumatism.  His name was Felix Hoffmann and he “re-discovered” Gerhardt’s work and in 1899 patented a “new” pain reliever under the name Aspirin.

As a quick and interesting aside: During that same month, Hoffmann synthesized heroin by accident.  His discovery of heroin obviously didn’t end up working out as well as aspirin! But, one of the truly remarkable thing about all this is:

Scientists did not have a clue how aspirin worked until 1971!  In that year, John Vane theorized how it worked for which he was awarded a Nobel prize in 1982.

Today, over 70 million pounds of aspirin are produced annually all over the world making it the world’s most widely used drug… and scientists still theorize about the exact mechanisms of aspirin.

So what’s all this have to do with Chiropractic and your back pain?

Here’s what:  Believe it or not – Chiropractic and aspirin have many things in common.

First — they can both be traced WAY back in history.

In fact, Hippocrates, who used a form of aspirin back in 400 B.C., also used a form of spinal manipulation.… and so did ancient Egyptians and many other cultures.

But, it was not until 1895 that D.D. Palmer invented “Chiropractic.”   Chiropractic was new and different because Palmer theorized the nervous system controlled every function of the body and Chiropractic adjustments (specific spinal manipulations) removed interference to blocked or pinched nerves.  This, in turn, not only relieved pain… it helped the entire body function better and heal from all sorts of illnesses and diseases.

Just like willow bark and eventually aspirin, spinal manipulation got results and became very popular… but the mechanisms were not understood.

But here’s were Chiropractic & Aspirin differ –in a very big way…

Doctors and scientists had no clue how aspirin worked – but it was hailed by the medical community as a wonder drug and mass-produced.

Doctors and scientists were not sure how Chiropractic worked – so it was branded unscientific and quackery.

Seems a little unfair – don’t you think?

Thank goodness in many areas, research has finally caught up with Chiropractic!

For example, Chiropractic’s ability to help relieve back pain is well researched.  It is a safe, effective and cost-effective way to relieve back pain.

How Does Chiropractic Work?…FUNNY YOU SHOULD ASK:

Many times when you have back pain it is caused by a spinal joint sprain – or “subluxation.”  Ligaments and discs hold two bones together to form a joint.  A sprain occurs when a joint is over stretched.

This can happen due to small micro traumas over several years or one acute event like a car accident, sports injury or slip and fall.  When the ligament becomes stretched and injured joints do not function properly, delicate nerve fibers can be injured.

Over time, even if untreated, pain can go away even though the spinal joint is not functioning properly.  This can lead to flare-ups in the future and degeneration as the joint moves improperly and wears out.  This is why something small – like bending over to pick up a pencil – can cause severe back pain.

Chiropractic adjustments and treatments are designed to re-align spinal bones in order to take pressure off ligaments, discs and nerve tissue..  This allows the spine to heal better.

Here’s a simple way to look at it:

If you broke your arm and didn’t get  the bone set properly – it would heal out of place and crooked.  The pain might go away in the short term – but there would most likely be big problems in the future.  The best thing to do is put everything in place and then let it heal properly.

Chiropractors are experts at getting your spinal bones and joint “in place” and working properly so they can heal correctly.

Chiropractors are also experts at keeping spines functioning properly to minimize future problems – much like periodic Dental check-ups and cleaning prevent tooth decay and loss down the road.

So, if you have back pain, you might want to try something that has a history starting in 400 B.C. with the father of medicine – Hippocrates – and has been practiced, improved and proven to help back pain.

If you do, just give us a call at 262-251-8306 and we will help you in any way that we can; conservatively and affordably!

Or log on to www.newbcakpainreliefinfo.com

What is the Best Mattress for Your Back?

Contrary to what to what most mattress store salesmen will tell you, firm surfaces are better for your back.  Soft mattresses allow your body to slump and curve into positions that put stress on the discs and joints.  As a result, you will wake up with pain.

Almost all the mattresses out there are too soft.  I think the basic reason everything is made so soft is that soft materials cost more and it justifies the expense of a mattress.  Firm mattresses are usually cheaper.

Good firm mattresses are often ruined by putting a pillow top on them.  Don’t use pillow tops.

All the exotic foam mattresses like Swedish, memory or tepur are too soft as well.  Many people who get these will have relief from pain when sleeping, but will wake up groggy and dizzy.  They will feel this way until their spine starts to tighten up as they get active.  Once it does this, they won’t feel groggy, but they will feel pain.  This is an effect of having too little support for the spine during sleep.

What is the best mattress?  Anything that’s firm.  I tell my patients to go to the store and ask for the firmest mattress they have.  In today’s world of mattresses, that will do it.  I haven’t found any that are too hard.  I often tell my back pain patients to sleep on the floor and 90% of them are surprised to find out how comfortable it is.

If you feel that the surface is too hard adjust your pillow height until the pressure is relieved.  If you are a side sleeper you will need your pillow to be higher.  If you sleep on your back, the pillow must be very flat.  Sometimes even just a few layers of a towel is all you need.

You should never undergo any type of treatment on your spine without addressing your mattresses and pillows.  Any treatment will be doomed to fail if you don’t let your spine properly rest and heal.

To find out more about how I treat back pain, log on to www.newbackpainreliefinfo.com

How Do I Know When My Mattress Is Going Bad?

There are a few ways to know if your mattress is going bad.

First, if it is more than ten years old, stick a fork in it, its done.  Its shot, its gone.  I don’t care what its was made out of, it won’t last ten years.

Second, if its between five and ten years old, it is suspect.  It might still be good, but you need to evaluate it a little closer.  Does it look like its sagging?  Are there pits in it?  Do you feel pain in the morning?  If so, something is wrong with the mattress.

Sometimes you can flip it, sometimes you can put a board between the mattress and box-spring, you can even try switching sides with your partner.  But, these are stopgap measures that will get you by until you can get a better mattress.

What kind of mattress should you get?

The firmer the better.  As firm as you can. This flies in the face of every mattress salesman in the country, but my clinical experience, the clinical experience of other doctors and the research shows that a firm surface is best.

Most of the stuff on the market today is way too soft.  The exotic foams they use make it like sleeping on a bag of marshmallows.  Not good for the spine.

For more information on pillows, mattresses and spinal health log on to my web-site www.painfree-greatposture.com.

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

What Causes Whiplash?

The most common causes of “whiplash” are injuries that arise from automobile accidents or motor vehicle collisions (MVC’s). So, let’s chat about why and how this happens in a “typical” MVC.  You are stopped at a red light, patiently waiting for the light to turn green and suddenly, you hear the screech of tires followed by a sudden jolt as the car from behind collides into the back of your vehicle.  By reflex, you may turn your head to the right to look in the rearview mirror to see what is happening.  Even if you see the inevitable collision prior to the impact, the sudden jolt occurs so fast that you really don’t have a chance to adequately brace and you feel yourself being forced back into the seat and headrest followed by a rebound forwards.  Since you always wear your seatbelt, you feel the restraint across your chest and lap belts tighten as you’re propelled forward.  The seat belt stops you from hitting the steering wheel or worse, propelling you forward through the windshield but by now, the damage has been done!  This ALL occurs in less than 500 milliseconds – you cannot voluntarily contract your muscles this fast, which means even if you had time to prepare yourself for the impact by bracing, you can’t stop the whiplash effect!

In a recent study, it was found the muscles in the front of the neck contract first at about 100 ms, which is 25 ms too late to prevent ligament or muscle damage, and they reach their peak stretch at 150ms (see 3rd from the left picture above).  The muscles in the back of the neck start contracting soon thereafter but are injured more than the muscles in the front of the neck around the 300ms point.  The reason for this is because as the head rebounds forwards, the muscles in the back of the neck are in the process of tightening up or shortening at the same time they are being stretched – NOT a good combination! This is one reason why many people injured in MVC’s complain of neck pain greater in the back of the neck.  This also helps explain why headaches are common symptoms associated with whiplash as the upper 3 nerves that exit the top of the spine in the neck go into the head/scalp and are compressed or squeezed by the tight muscles in the back of the neck when they are injured which results in headaches.

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

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH! FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306 FOR MORE INFORMATION LOG ON TO: www.TheChiropracticImpactReport.com

1. http://www.injurytv.com/muscle.html

2. http://journals.lww.com/spinejournal/Abstract/2007/04010/Musculotendon_and_Fascicle_Strains_in_Anterior_and.9.aspx
Musculotendon and Fascicle Strains in Anterior and Posterior Neck Muscles During Whiplash Injury
Vasavada, Anita N. PhD; Brault, John R. MS; Siegmund, Gunter P. PhD
Spine: 1 April 2007 – Volume 32 – Issue 7 – pp 756-765

3. http://www.jbiomech.com/article/S0021-9290(02)00458-X/abstract
Volume 36, Issue 4, Pages 473-482 (April 2003)
Rapid neck muscle adaptation alters the head kinematics of aware and unaware subjects undergoing multiple whiplash-like perturbations
Gunter P Siegmundab, David J Sandersona  , Barry S Myersc, J Timothy Inglisad

Fibromyalgia: The Dirty Dozen of Exercise

Fibromyalgia (FM) is a common chronic condition that affects millions of people.  The overview of the symptoms is widespread pain in the muscles accompanied by pain, fatigue, and “…just feeling wiped out!”  Sleep deprivation is a common problem and some feel sleep loss for any reason — stress, past injury, current illness, etc. — can result in FM and restoring sleep is a key component to treatment.  Here are 14 key points to consider to effectively “manage” or gain control of FM (as there is no “cure”):

1. Keep Moving: Exercise of a REGULAR BASIS. The presence of pain is NOT a reason to NOT exercise – a common mis-belief about FM.  Exercise is not only good for your muscles but it also helps improve the circulation, maintain bowel regularity, and reduce stress.
2. Talk To Your Doctor: Always discuss your fitness plans with us, your chiropractor! It’s important to have a structured plan to follow and most importantly, START SLOWLY!
3. “Learn” Your Limitations: Around the house, at work and in the gym, learn what you can handle by slowly introducing new activities into your routine. Don’t feel guilty about taking multiple breaks during your day!
4. Remember to Stretch: To improve flexibility, improve muscle tightness, and reduce pain, gentle stretching exercises are VERY rewarding! These can be done at any time of the day and also as a “warm up” and “cool down” before and after your exercise session.
5. Make It Fun: Choose exercises that appeal to you such as bicycling, swimming, or walking – make it fun!  Exercise in a location that is appealing such as walking in a park, or in the woods.  Take your dog (or the neighbor’s dog) for a walk. Try to achieve thirty minutes of movement-based exercise each day.
6. Set Realistic Goals: Don’t try to run a marathon on your first day of exercise. You need to determine what you can handle by gradually introducing the activity. For example, start with a 5 or 10 minute walk and set a goal of 30 minutes by the end of the 1st or 2nd week. Then work on speed or pace. Make sure the exercises you choose do not aggravate your condition further.
7. Make Sleep a Priority: Restless, non-restoring sleep is a common complaint of FM patients. Exercise can really help faulty sleep patterns. Set a sleep schedule – go to bed and wake up at the same time each day. Also, talk to us about nutritional options.
8. Block Out Distractions: Use ear plugs, “noise machines,” or an eye mask to block out sleeping distractions.
9. AVOID Caffeine: Coffee, chocolate or caffeine rich soda can disrupt sleep patterns well into the night. Avoid these for at least four [4] hours before bedtime.
10. Reduce Stress: Just struggling with FM is stressful enough!  Yoga, meditation, deep breathing and relaxation exercises can be extremely helpful is reducing stress.
11. Learn To Say No: It’s OK to say “no.” We’re all too busy but with FM, additional worries and stress really take their toll!
12. Socialize Wisely: Socialize with people who have a positive attitude – choose your friends wisely.  Remember, the glass is always at least “half-full!”

We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, 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.

YOU MAY BE A CANDIDATE FOR REAL RELIEF FROM FIBROMYALGIA  FOR MORE INFORMATION LOG ON TO: www.stopyourfibronow.com