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

What is Spinal Stenosis?

Spinal Stenosis means narrowing of the spinal canal.  Narrowing of the spinal canal can cause many different symptoms.  These symptoms include, low back pain, neck pain, pain in the arms and legs, numbness in the arms and legs, muscle cramping and weakness.  These symptoms come from a common cause, so it is helpful to understand why they happen.

The spine contains the spinal cord.  The spinal cord is made of soft nerve tissue.  The nerve tissue sends messages from the brain out to the body and from the body to the brain.  When the spinal canal narrows, it can compress the spinal cord.  When the cord is compressed, the messages going back and forth from the brain and body get altered.  This causes pain, weakness and numbness in the affected area.

The next logical question is, “what can be done about it ?”  From a medical standpoint, surgery is recommended to open up the spinal canal.  Usually a piece of a spinal bone or spinal disc is removed in order to create more space for the spinal cord and nerve tissue.  It sounds easy, but these procedures do have serious risks and have a low success rate.

The latest research on spinal surgery is saying that it should only be attempted after six months of conservative (non-surgical) treatment is done.  If the conservative treatment doesn’t help, then surgery can be attempted.

Chiropractic care can be very helpful for spinal stenosis cases.  You see, part of the problem in spinal stenosis patients is that their spinal alignment causes the spinal cord to be stretched. In areas where the canal is narrowed, this creates more pressure on the cord.  Re-aligning the spine takes the stretch off the cord and allows it to move freely in narrowed areas of the spine.  Removing the stretch relieves a lot of the symptoms and can allow the patient to avoid surgery.

For more information on non-surgical, non-grug solutions for spinal stenosis, log on to: www.newbackpainreliefinfo.com

What Happens in “Whiplash?”

Whiplash is a slang term for an injury that occurs to the neck after the head has been literally “whipped” either forwards and backwards or sideways after a sudden jar. Therefore, this can occur from a slip / trip and fall, a bar room brawl, as well as from the classic car accident or motor vehicle collision. But what REALLY happens in a “whiplash” injury? To answer this, let’s talk about: 1. The mechanism of injury; 2. The different types of injuries; and 3. The treatment options.

1. The Mechanism of injury: Let’s take the example of a rear-end crash from a motor vehicle collision (MVC). In this scenario, the “target” vehicle is struck from behind by the “bullet” vehicle propelling it forwards.

All of this occurs in LESS TIME than what we can NORMALLY voluntarily contract a muscle, which takes about 500 msec., so even when we anticipate the impending crash and we brace ourselves, we can’t really stop our neck from going through these movements.

2. Types of injuries: The term “sprain” refers to ligament (tough non-elastic tissue that holds bone to bone) injury and “strain” muscle/tendon (elastic tissues that move our bones) injury. There are 3 grades of sprain & strains (mild, moderate, and severe).  When these tissues are injured, there is usually a loss of movement and neck pain but not arm numbness or pain. When there is nerve injury, there is arm pain, numbness &/or weakness and generally, this is more serious but usually manageable without the need for surgery. When fractures occur, it’s either stable or unstable and may require surgery &/or a rigid collar.

3. Treatment: Most whiplash injuries are safely managed by chiropractic approaches (fractures are the exception).  Studies have shown that early movement results in a better result than wearing a collar or, not allowing movement. Therefore, gentle mobilization and manipulation approaches “…as soon as tolerated” favor a better outcome or result. There are many different techniques we use to help speed up the recovery process. Prompt treatment is important!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH! FOR A FREE NO-OBLIGATION CONSULTATION CALL 262-251-8306 Or log on to: www.painfree-greatposture.com

Carpal Tunnel Syndrome and Risky Jobs

Carpal Tunnel Syndrome or CTS, is one of many “repetitive strain injuries” or RSI’s and it’s one of the most common work place injuries, second only to low back pain!  The term “Carpal Tunnel Syndrome” was first used in 1939 and since the 1950’s, this disabling overuse injury to the hand has been one of the most frequent work injuries reported. So, what jobs carry the greatest risk for developing CTS?

Basically, any job that requires fast, repetitive movements of the hands with little rest can be considered a potential “risky job.”  A partial list of the causes of RSI’s including CTS are: stress, tension/tightness of the arm muscles, inflammation of the wrist tendons, repetitive movements like keyboard/mouse work, poorly designed workstations, poor posture including awkward wrist/hand positions required on the job, heavy lift/carry workloads, vitamin deficiencies, and neck / spine complaints. Couple these jobs with age > 50, and being female – especially if she takes oral contraceptives (as they retain fluids), during pregnancy or menopause.

Here’s a list of jobs we can consider “risky”:

• Typists: When typing speeds reach 60 words / minute, for 8 hrs a day, there can be up to 25 tons of pressure each day exerted in the wrist. Frequent breaks are NEEDED!

• Computer users: The proper position is feet flat on the floor (adjustable chair necessary), arms at the side with elbows bent slightly MORE THAN 90 degrees; sitting up “tall” in the chair (prop a pillow, water bottle, or rolled up towel behind your back if necessary), tuck in the chin (avoid chin poking), and MOST IMPORTANT – TAKE BREAKS AS NEEDED.

• Musicians: If you think about it, what task requires faster, repetitive movements of the fingers in awkward positions?  For example, playing a flute. Or, how about piano, trumpet, saxophone, guitar, violin, drums… wait a minute!  Just about every instrument requires awkward hand positions and fast repetitive movements!  It’s no wonder a large percentage of musicians develop CTS / RSIs! Again, the secret is taking meaningful breaks and stretching and when it’s uncontrolled, come see us (but DON’T wait too long)!

• Line workers: There are many types of jobs where standing on a line while working in fast/repetitive environments such as assembling an engine, packing cookies, pushing wires into a harness, inserting screws, packing meat or fish, using vibrating tools, carpentry tasks such as screw driver use, hammering, sawing, lifting/carrying materials……..you get the picture!  These jobs are notorious for CTS!

• Other RSI’s: include tennis elbow, golfer’s/bowler’s elbow, cubital tunnel syndrome (numbness in the pinky), de Quervain’s disease (thumb tendonitis), and sports injuries (sprains/strains). Postal workers, cake decorators, dentists and hygienists, as well as waiters are all at risk for developing CTS.

The bottom line is: 1. Take multiple breaks. 2. Work at your own pace. 3. Wear a wrist brace at night. (If recommended) 4. See a chiropractor to loosen up those tight hand, forearm, shoulder and neck joints and muscles to relieve nerve pressure. DON’T jump right to surgery – it’s the “last resort.”

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

What Patients Can Expect From Chiropractic Care: Answers to Common Medical Questions

How long will it take for a patient to get relief ?
According to guidelines developed by independent researchers (1), patients should expect improvement in their conditions within the first 12 visits.  They may not be completely healed in this amount of treatment, but they should have symptomatic and functional improvement.  If no improvement is made in this amount of time, then chiropractic is not the modality of choice for them.

Most acute cases are resolved in 12 visits or less.

Severe acute, sub-acute and chronic cases will take longer, usually between two and six months to resolve.  These cases will have improvements in the first twelve visits, but not complete resolution.

Treatments are given 3 to 5 times per week at the beginning.  Treatment frequency is lessened as the patient progresses.

What are the potential side effects of treatment ?
Dangerous side effects are extremely rare. (2)  Media reports of stroke after chiropractic adjustments are not based on science. (3)

However, minor side effects, such as muscular soreness after treatment are common. (4)  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.  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 and the soreness they feel is a reaction to the alignment changes made by the adjustments.  The reaction is very similar to a headache after a visit to the orthodontist.

What types of conditions respond well to chiropractic care ?
The conditions that respond best are musculo-skeletal problems involving the spine.  This has the largest body of literature showing effectiveness.  This would include back pain, neck pain, headaches, migraines, sciatica, radiating pain, degenerative disc disease and stenosis.  A smaller body of research and my own clinical experience has shown a marked effectiveness for carpal tunnel syndrome and fibromyalgia.

What types of patients respond well to chiropractic care ?
A patient that has not responded well to standard medical treatments, and is willing to try something different, is usually a good candidate for chiropractic.

Patients who are scared of, or biased against chiropractic, generally are not good candidates.  They typically will not allow the necessary procedures to be done, and will not follow home care instructions.

You and your patients can learn more about our office at www.painfree-greatposture.com

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

Physician, Heal Thyself

I often tell patients that everything I tell you to do, I do, have done, or would do if I was in your situation.

I have had all the chiropractic procedures that I do with you, done to me.  I do all the home instructions for sitting, sleeping and standing.  I also take a lot of nutritional supplements.

Which brings me to my next topic.  Over the last couple of months I wasn’t quite feeling myself.  I just didn’t have my usual spark.  So, I went and had some blood work done.  (One of the advantages of being a doctor is you can order the tests yourself.)

Well, everything looked good except two tests.  My hemoglobin A1C was slightly elevated, which means I’ve been eating a little too much sugar the last few months.

And, get this, my vitamin D level was a 29.  It should be 40 minimum and probably 60 for optimum health.  Yes me, Dr. Vitamin D who tells everyone to take it and get it tested and everything else.  29, that stinks !

So, out came the vitamin D drops and I’m taking 6000 iu’s a day for three months and I’ll test again.  Also, I’ve been cutting the carbs down.

In the mean time, I feel a lot better.  I have been sleeping better and I have better pep.  So, I am very glad I took my own advice.

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

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 .

Medical Treatments for Disc Disease Unproven

According to an article written in the leading medical journal relating to spine issues, SPINE, medical treatments for disc disease are unproven. (1)

The article states “None of the emerging techniques for the treatment of degenerative disc disease (DDD) – spinal fusion techniques, disc replacement, intradiscal electrothermal therapy – finds unequivocal validation in the scientific literature.  Scientific evidence doesn’t prove that these treatments “are superior to natural history or non-operative treatment.”

What this means is; surgery doesn’t give any better outcomes than if you do a non-surgical treatment or no treatment at all.

The article goes on to state “It should be emphasized that all of the aforementioned procedures for low back pain have unpredictable outcomes;  therefore these procedures should only be considered after failure of at least six months, and with the full understanding of patients who are well informed about the potential advantages, disadvantages and unpredictable outcomes.”

That means you should try other treatments for at least six months prior to considering surgery because spinal surgery is unpredictable and often harmful.

The most effective form of treatment for chronic low back problems is chiropractic care. (2)  Unfortunately, surgeons often will not recommend chiropractic care due to competitive professional bias.

To find out more about non-surgical treatment for low back pain, log on to: www.newbackpainreliefinfo.com or www.painfree-greatposture.com

(1)   An H, Boden S, Kang J et.al., Spine 2003; 28(15s):s24-s25
(2)   Meade, MD Br Med J; 311:349-351

Fibromyalgia And Your Upper Neck

How can a spinal problem possibly contribute to your fibromyalgia symptoms? As with many disorders, especially pain, the nervous system is involved. The nervous system can get affected thorough structural changes in the spinal column. The classic one is the disk bulge producing a painful sciatic nerve. But, there are also other ways to interfere with the function of nervous system.

When viewing the neck from the side, there should be a forward curve with your head above your shoulders, not in front of them. When forward head carriage is present or when there is a reduction in this forward arch, this may cause additional strain to the upper cervical spine or spinal cord, allowing delicate nerves to be compromised. Chiropractic care should improve your posture if this forward head carriage is present.

The upper neck can also be influenced by mal-alignment  of the upper vertebrae, such as the atlas. This small bone supports the weight of the skull and is necessary for the great rotational range of motion of the neck.

During neck trauma, the head and neck can be put through a violent range of motion that causes the soft tissues (muscles and ligaments) to tear. Blows to the head, childhood or sports injuries and even poor sleeping posture, can cause the upper neck vertebrae to displace, injuring the soft tissues of the joint. Swelling and inflammation can also be a source of irritation to the nervous system. Scar tissue can develop after trauma, which may affect the precise movements of the upper neck.

The atlas surrounds the spinal cord and as it displaces, it can also pull or tether the spinal cord through attachments of delicate ligaments (dentate). This could cause irritation to the nervous system.

The disorders of poor posture and displaced vertebrae can be assessed through x-rays. Range of motion tests are necessary to see how your function may be affected. In some patients, fibromyalgia symptoms can improve substantially. However, most people will need a comprehensive approach that also incorporates an exercise program and nutritional or weight loss support. Chiropractic care is a natural alternative for those who wish a drug-free and non-invasive approach. It carries few risks of side effects and is balanced by the potential to help patients who also have spinal disorders contributing to their poor health.

YOU MAYBE A CANDIDATE FOR DRUG FREE RELIEF! FOR MORE INFORMATION LOG ON TO: http://www.stopyourfibronow.com

Carpal Tunnel Syndrome – Why is it so common?

Carpal tunnel syndrome or, CTS, is a condition where a nerve (called the median nerve) is compressed in a relatively tight or restricted space (called the carpal tunnel), resulting in altered nerve function that includes numbness and weakness.  In order to fully understand what CTS is, let’s devote this Health Update to better understanding the anatomy of the carpal tunnel.

The carpal tunnel is made up from 8 bones (2 rows of 4 carpal bones that are stacked on top of each other) that are arranged in the shape of a horse shoe.  The “roof” of the tunnel is a ligament (transverse carpal ligament) that stretches tightly across the two ends of the horseshoe completing the formation of a tunnel – actually, an upside down tunnel when looking at the palm side of the wrist).  The contents of the tunnel include 9 tendons and their covering (sheath), blood vessels and on top of all that just under the roof is the median nerve – the culprit that creates most of the symptoms of CTS.  The cause of CTS is simply anything that causes the contents inside the tunnel to swell, which then compresses the median nerve up into the roof or ligament, pinching the nerve. This can create numbness, tingling, the falling asleep sensation and weakness.  It’s important to point out that the median nerve starts out from the neck, passes through the shoulder, past the elbow, through the wrist’s carpal tunnel and ends in the hand – specifically fingers 2,3, and 4.  Therefore, the ENTIRE nerve must be looked at for all CTS cases as pinching can occur anywhere along its course from the neck to the hand.

It’s said that pictures say a thousand words, so let’s take a look!

Using the pictures here, familiarize yourself with the words and re-read the 2nd paragraph above, periodically looking at these pictures until you feel you understand where everything goes.  Once you’ve accomplished that, you’ll be able to better appreciate CTS, how the anatomy relates to the condition, and appreciate the need to reduce the swelling inside the tunnel when symptoms occur.  The treatment is simple: “PRICE” – P protect R rest I ice C compress E elevate – accomplished by bracing (especially at night), ice cup massage (5 min. until numb 5x/day), rest (light duty work), and therapy (see your chiropractor!).

We realize that you have a choice in who you are considering for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME!  FOR MORE INFORMATION LOG ON TO WWW.RELIEFFROMCARPALTUNNEL.COM