Sleeping With Chronic Pain

Just about everyone with chronic pain has problems sleeping.  Some of the latest research on chronic pain shows a connection between the two.  The research is showing that when you are sleeping poorly, you feel more pain.

Some doctors say that chronic pain (like fibromyalgia) comes from the sleep disturbance.  Others say that you don’t sleep well because you are in pain.  I like to take a different approach.  I think you need to treat both at the same time.

Get the patient out of pain as much as possible and at the same time, help to get them to sleep better.  You would be surprised at how much sleep can improve, even if you haven’t slept well in years.

Here are some quick tips that can help you sleep better:

1. Change your mattress.  If your mattress is over ten years old, it’s a goner.  They just don’t last longer than ten years.  If its over five years old, it could be bad.  Look for signs of pitting.  Mattresses should be firm.  Do not use pillow tops, exotic foams or water beds-all are bad for your spine and will create more pain.
2. Change your pillow.  If you sleep on your back, sleep with a very small pillow or none at all.  If you are on your side, sleep with a large pillow.  Stay off your stomach- it’s bad for your spine.
3. If you nap, take short naps during the day- less than one hour.  Try to take it before 3 o’clock.  This will minimize any disturbance to your night sleeping.
4. Watch what you feed your brain before you go to sleep.  Read and watch calming things.  You don’t want horror stories, political arguing, violence or intense sadness going through your mind when you are trying to relax.
5. Keep your head cool and your feet warm.  This is a little tidbit from Japanese medicine that I find works.  I don’t know why, but it does.

If you can’t sleep or wake up feeling lousy, check one of the above.  If you are doing well with everything above and you still are having problems, you may be in too much pain to relax.  You should be treated by someone who knows about chronic pain and sleep disorders.  If you get out of pain, you’ll sleep better.

For more information on chronic pain disorders, log on to:  www.stopyourfibronow.com or  www.newbackpainreliefinfo.com

Swimmer’s Shoulder Secrets

Swimmer’s shoulder is a term for tendonitis of the shoulder caused by strenuous swimming.  The condition involves the biceps tendon, which gets inflamed as a result of it moving around in a groove it sits in.  During swimming motions, the tendon slides back and forth in the groove, which irritates and swells the tendon.

Normally, treatment is designed to get the swelling down.  This usually involves icing and rest.  After the swelling subsides, the symptoms get better.  Then a program designed to strengthen the muscles of the shoulder girdle can help to keep it from re-occuring.

As a swimmer, I have had a few bouts with swimmer’s shoulder.  So I can empathize with those who suffer from it.  Based on my own experiences, I can tell you that the “normal” treatments offered for swimmer’s shoulder, only take you so far.  They really don’t fix the underlying problems that make you prone to getting it.

So here are some secrets I have found, that have worked for me and my patients.

1. Work on your posture.  If you stand with your head in front of your shoulders, it changes the way your shoulder moves and you will put more stress on the rotator cuff muscles and biceps tendon.  In effect, you never let those structures rest when you are out of the pool.  Without the proper recovery, you are constantly straining your shoulder and it will never heal.
2. Have someone (preferably trained) massage the back of your arm and shoulder.   A typical scenario for swimmer’s shoulder is the triceps, latissimus and teres muscles get overworked from pulling so much.  These muscles fatigue and go into spasm causing the shoulder to become imbalanced.   This gives the pain in the front of the shoulder, but the primary problem is in the back of it.  You will typically find trigger points in the triceps area and in the back of the armpit.
3. Switch up your strokes.  Front Crawl (freestyle) is the stroke used most often in training.  But, if it is used exclusively, without training other muscle groups, it can cause problems in the shoulders.  Switch up with backstroke and other strokes whenever you can.
4. Improve you strokes.  Faulty stroke mechanics often lead to shoulder problems.  The power in swimming comes from the core, not exclusively from the shoulders.  There are many philosophies of coaching.   But the information I like best comes from www.totalimmersion.net .
5. Consider chiropractic treatment when you have swimmer’s shoulder.  Surgery for swimmer’s shoulder is not all it’s cracked up to be.  The rehab is long and you just aren’t the same after.  Chiropractic treatment can fix most cases of swimmer’s shoulder in a surprisingly short period of time, without the risks and side effects of surgery.

For more information on chiropractic treatment log on to www.painfree-greatposture.com

Fibromyalgia – Tips From Real Patients

We have discussed fibromyalgia (FM) from many perspectives but what we haven’t done yet is listen to what actual FM patients have to say about what works and what doesn’t work.  Rather than reading about what “the experts” say about FM and what to do for it, let’s take a different perspective – let’s talk to those who have FM and hear what they have to say about the “do’s and don’ts.”

Consider the following great “pearls of wisdom” for those suffering from FM:

• Stick to a schedule—it helps.
• Know when you’re pushing too much, and listen to what your body is telling you.
• Keep a journal every day about what you do and how you feel.
• Focus on the 4 P’s: pacing, problem solving, prioritizing, and planning.
• Work on your communication skills, and don’t be afraid to ask for what you need.
• Exercise and diet are very important.
• Acknowledge your limits—recognize what you can and can not do.
• Exercise if you can—swimming helps me because it’s easier on the joints.
• Don’t overdo it or your symptoms will really kick in.
• Know your limitations—if you’re tired, know when to rest.
• Join a support group—or even start one yourself.
• Stay informed—there’s a lot of research and helpful information out there.
• Find a doctor who really sits down and listens to you and understands your pain.
• Use your friends and family as support.
• Learn about Fibromyalgia by reading up on the subject.
• Accept help when you need it.
• Wear a sweat suit when you exercise on the stationary bike; the heat may help to soothe your muscles.
• Sleep is very important. Try not to nap during the day so you can sleep better at night.
• It’s important to take your medication as prescribed.
• Balance your meals with a low-fat, high-protein diet. Drink plenty of water.
• Stretching, swimming and walking may help you deal with the pain.
• Keep moving and enjoy life.
• Exercise! Keep those muscles and bones flexed and firm. But do not overdo it!
• Write down the things that may have brought about your pain.
• Keep this list on your refrigerator as a reminder.
• This is just one way to help you manage the severity of your next “bad” day.
• List the people you can rely on ahead of time to help you on your “bad” days.
• Just knowing that you have backup may help reduce your stress.
• Your support network can help with completing important tasks.
• For example, on a “bad” day, ask them to run an errand or pick up your children from school.
• Sometimes, they could just be there to listen.

With all the above in mind, you may also consider alternative treatments for your fibromyalgia.  There are some excellent pain relieving therapies available, that most doctors don’t know about.

YOU MAY BE A CANDIDATE FOR DRUG-FREE TREATMENT FOR FIBROMYALGIA!

FOR MORE INFORMATION LOG ON TO: http://www.stopyourfibronow.com

Can Carpal Tunnel Syndrome Cause Other Injuries?

Carpal Tunnel Syndrome (CTS) is a very common complaint often associated with repetitive motion related jobs. There are 9 tendons traveling down the arm from the elbow that “merge” or come together in the relatively tight carpal tunnel, kind of like when 4 lanes of traffic suddenly narrow into 1 lane. We all know what happens when there is road construction during rush hour – traffic comes to a screeching halt and you have to sit there and wait, and wait, then move an inch or two, painfully waiting to reach the end of the construction zone. However, when its not rush hour, traffic may not slow down much at all because there simply aren’t many cars on the road. This analogy is VERY similar to CTS as the 9 tendons and median nerve are the lanes of traffic that merge together as they travel through the tight carpal tunnel in the wrist. When a worker, let’s say a typist, works long hours at the computer typing as fast as possible (like heavy traffic during rush hour), the repetitive rubbing of the tendons in the tunnel creates friction, heat, swelling, and eventually pinching of the nerve resulting in the classic numb thumb and first four fingers. They have to stop shake their hands and flick their fingers to get the them to “wake up” and then they can resume typing again, but have to stop and go and shake/flick the hands/fingers several times during the day. As a result, they either have to take a break and rest or, compensate by shifting their body into different positions in attempt to reduce the strain on the wrist tendons.

Some of the ways we shift in attempt to reduce strain includes raising the elbows away from the sides of the body, shrugging the shoulders up towards the ears, moving the head and neck into different positions like poking the chin out, slouching, plus combinations of all or some of these. Over time, these compensatory faulty postures end up straining the other surrounding joints and when this occurs, the collection of all painful areas is referred to as “cumulative trauma disorders” or, CTDs. As you can see, it’s important to treat or manage the CTS condition early on so we can avoid the progression into the other CTDs or else, treatment will also have to address many other conditions such as (partial list): tennis and/or golfer elbow (tendonitis), shoulder tendonitis, neck or cervical strain, and/or radiating neck to arm pain (cervical disc injury with radiation of pain into the arm). CTDs can also be a contributing cause to mid and low back pain.  As these conditions gradually occur, the longer it takes to stop the progression and sometimes, many of these conditions can become permanent.

There are a lot of ways we can avoid the cascade of events that lead to CTS and other CTDs, some of which include: 1. Early intervention (treatment) – chiropractic care works particularly well at this stage. 2. Taking “mini-breaks” during the work day such as a 1-minute every 30-60 minutes to stretch the neck, shoulders, forearms, hands and fingers. 3. Performing specific carpal tunnel / wrist stretches (placing the palm of the hand on a wall at shoulder level, keep the elbow straight, pointing the fingers down towards the floor). 4. Wearing a splint, especially at night (this prohibits extreme wrist bent positions and the numbness feeling that can wake us up at night). 5. Modifying a workstation, such as moving the computer monitor so the neck/head point straight ahead. Work station modifications can also reduce awkward hand/wrist positions that overload the tendons of the wrists by lowering the mouse and/or keyboard if they are too high, or padding a sharp countertop edge to prevent it from digging into the forearm and further pinching the nerve.

YOU MAY BE A CANDIDATE FOR DRUG FREE, SURGERY FREE TREATMENT OF CARPAL TUNNEL SYNDROME!  FOR MORE INFORMATION LOG ON TO: www.relieffromcarpaltunnel.com

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

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.

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

Fibromyalgia Facts

Fibromyalgia (FM) is a condition that is characterized by widespread, generalized pain “all over” the body that does not follow any specific anatomical pathway like the course of a nerve, muscle, or blood vessel. It is often diagnosed only after all other conditions have been eliminated by using various testing approaches such as blood tests, x-ray, CT or MRI Scans, and others.  Controversy exists between health care providers (HCP’s) as some believe that FM either doesn’t exist at all or if it does, it’s grossly over diagnosed while others feel most patients have some form or degree of FM.  Because of this common split in beliefs, patients may be treated poorly by those non-believing HCP’s, which often alienates them from seeking further care for FM.

Recent literature suggests FM is disorder of “central pain processing” or, a specific situation where the pain threshold (the point where pain is felt) is reached sooner than what is normal.  Fibromyalgia has been classified into 2 separate groups – primary and secondary FM.  Primary FM is diagnosed when no known cause can be identified while secondary FM is related to a specific cause such as a disease or condition.  Conditions that have been reportedly associated with FM include irritable bowel syndrome (IBS), TMJ (jaw disorders), chronic low back pain, and headaches. There are genetic as well as environmental factors associated with FM.  Researchers have found that there is a strong familial component with 1st degree relatives where an 8 fold greater risk of developing FM compared to the general population exists. These people are also more likely to have one of the other associated conditions previously mentioned (IBS, TMJ, headaches). Environmental factors can lead to FM in 5-10% of the cases. Some of these include physical trauma such as car accidents, following infections such as parvovirus, Epstein-Barr virus, and Lyme disease. Psychological stress, hormonal alterations such as hypothyroid, drug side effects, vaccination reactions and certain catastrophic events such as war are included in the “environmental factors” category. Gender differences include woman being 2-3 times more likely to suffer from FM than men.

So, what are the treatment options for FM? Typically, if you go to a medical doctor, you can expect various forms of drug therapy – possibilities include anti-depressants, anti-anxiety meds, and sleep aids but with these, watch out for grogginess, side effects and some habit forming/dependency problems. Pain killers or analgesics – opioides are NOT appropriate but often prescribed and narcotics can also be habit forming. Tylenol is perhaps the safest but is not very effective.  Anti-inflammatory include aspirin, ibuprofen but watch for stomach irritation and blood thinning problems. Dr. Christopher Morris, MD reports that drug treatments for FM have, “…very limited success in providing significant improvement in most patients.”  He recommends behavior modification for sleep improvement, exercise (walking, water exercises, strength training, yoga, tai chi, Qi Gong), as well as cognitive behavioral therapy, massage therapy, chiropractic, acupuncture, biofeedback, hypnosis, and dietary modification.  Examples of dietary changes include avoiding foods with certain additives including MSG (monosodium glutamate) and aspartame where in one study, “complete resolution” of FM symptoms was reported.

Patients with FM NEED a “quarterback” to guide them in their management of FM and chiropractic is the PERFECT choice as many of these holistic approaches are utilized or can be coordinated through our office.

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 CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR MORE INFORMATION LOG ON TO: WWW.STOPYOURFIBRONOW.COM

Dizziness and Balance Disorders-Is There a Link to Neck Injury?

Dizziness and loss of balance are a common reason people go to see their medical doctor.  It can be caused by a number of different conditions.  Inner ear infections, tumors, allergies and reactions to medications are all common causes.  But are there other causes ?  Maybe something your doctors might not know about ?

An article appearing in a Germen medical journal, confirms that injuries to the neck can sometimes cause dizziness and balance disorders.  It states:

“After cervical sprain, not only pain and neuropsychological disturbances may occur, but also the following sequelae: cervical dystonia, and torticollis, dizziness, hearing loss for low frequencies, dysphonia and globus.”[Globus is a sensation of something stuck or of a lump or tightness in the throat.]

They recommend spinal manipulation as treatment for these problems.  The article goes on to say: “Except for dystonia the symptoms often respond to manipulation of a blocked articulation between occiput and atlas or axis and the third cervical vertebra.”

If you are suffering from dizziness or a balance disorder, and your doctor hasn’t found the cause, you may want to be checked for a neck problem.  A chiropractor is your best source for this type of treatment.  Make sure your doctor has experience in treating these problems and can screen you for these specific neck issues prior to initiating treatment.

For more information on how we treat dizziness and balance disorders log on to: www.stopvertigonow.com

Information for this article was taken from:
Whiplash, Hearing Loss, and Upper Cervical Manipulation [“Little known sequelae of sprains of the cervicalspine”]
Schweiz Rundsch Med Prax.
[This is a German journal, and the article is in German. The abstract is also in English]
December 2, 1999
88(49):2021-4.
Kaeser HE, Ettlin T.