Over three hundred freshmen college students underwent an examination of their hip joints and were asked whether or not they suffered from neck pain. The results showed that the young adults with asymmetrical hip mobility were nearly three times more likely to also suffer from neck pain.
Journal of Manipulative and Physiological Therapeutics, July 2013
Low back pain (LBP) is a reality in most of our lives at one point or another. It can range from being a “nag” to being totally disabling. While we use Active Release Techniques and traditional chiropractic adjustments at Denver Chiropractic Center, home exercise is an important part of our protocol.
Let’s look at some exercises for the low back that can be done from a SITTING position so that they can be: 1) Performed in public (without drawing too much attention) and 2) Repeated every one to two hours with the objective to AVOID LBP from gradually getting out of control (STOP the “vicious cycle” so LBP stays “self-managed”).
RULES: 1) DON’T do any exercise that creates SHARP pain; 2) Stay within “reasonable” pain boundaries; 3) DO these multiple times a day WHEN you feel tight, stiff, sore (take 10-30 sec. every hour rather than 15 min. twice a day).
SITTING LOW BACK EXERCISE OPTIONS:
1) SITTING BEND OVERS: 1) Slowly bend forward from a seated position and attempt to reach the floor; 2) Spread the knees as needed to allow for a full range of motion; 3) Hold for 3-10 seconds or until it feels “loose.” 4) Do the opposite – sit and arch your low back as far back as is comfortable. Repeat frequently for short hold-times – make it “fit” your time limitations/schedule!
2) SITTING HIP / BACK STRETCH: 1) Cross your leg; 2) Raise the knee to the opposite shoulder; 3) Arch the lower back until you feel an increase stretch in your buttocks; 4) Twist your trunk to the side the knee is raised; 5) Move your knee up/down and around to “feel” for the tightest “knots” and “work” them loose; 6) Modify by bending forward 7) REPEAT on the opposite side.
3) SITTING TRUNK ROTATIONS: 1) Slowly twist your shoulders and trunk to one side while keeping your knees straight; 2) Reach back and pull for additional stretch if comfortable; 3) Hold for 3-10 seconds or, until it feels “loose;” 4) REPEAT on the opposite side.
Remember, DO these MANY times a day (at least once every hour). We have many others as well (ask us)! We realize you have a choice in whom you consider for your health care and we sincerely appreciate your trust in choosing Denver Chiropractic Center for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.
An information article published by The Journal of the American Medical Association suggests patients consider chiropractic care as an option to treat low back pain. They also noted that back surgery is usually not indicated and should only be performed if other therapies fail.
JAMA, April 2013
Copyright Denver Chiropractic Center
Spinal adjustments resulted in almost immediate improvement for headaches that originate in the neck. As a treatment for tension-type headaches, spinal adjustments resulted in significantly fewer side effects and longer-lasting relief than prescribed medication.
Duke University, January 2001
Chiropractic: Neck Pain Relief Faster and Cheaper.
In a randomized study including 183 patients with neck pain, participants were selected to receive spinal mobilization, physiotherapy, or general practitioner care. Clinical outcomes revealed that patients experienced faster recovery with spinal mobilization, with a total cost of care 33% lower than physiotherapy or general practitioner care.
British Medical Journal, April 2003
CTS, Exercise, and Chiropractic
Carpal Tunnel Syndrome (CTS) is a condition characterized by numbness, tingling, and/or pain located on the palm side of the wrist, hand and into the index, third, and half of the ring finger. It’s caused by pressure exerted on the median nerve as it passes through the “tunnel” located in the wrist. The “floor” of the tunnel is a ligament while the “walls” are made up of eight small carpal bones that lock together in the shape of a tunnel. There are nine tendons (tendons attach muscles to bones allowing us to move our fingers), sheaths covering the tendons, blood vessels, and the median nerve that ALL travel through the tunnel, so it’s packed pretty tight. ANYTHING that increases the size of any of these structures or anything “extra” that shouldn’t be there can increase the pressure inside the tunnel, pinch the median nerve, and result in the classic numb/tingling symptoms that wake people up at night, or interfere with work or driving.
In the Unites States (US), about 1 out of 20 people will suffer from CTS. Caucasians have the highest incidence rate and women are affected more than men by a 3:1 ratio between ages of 45-60 years old. Only 10% of the reported cases of CTS are under 30 years old. Occupational CTS (as of 2010) affects 8% of US workers with 24% attributed to manufacturing industry jobs. This equates to approximately 3.1 million cases of work-related CTS in 2010. The risk of developing CTS increases with age, diabetes, hypothyroid, pregnancy, taking birth control pills, having an inflammatory arthritis, being obese, pinched nerves in the neck, thoracic outlet, elbow, and others. Therefore, managing CTS requires a thorough evaluation in order to assure accuracy in the diagnosis. With this background information, let’s look at the question, WHAT CAN YOU DO TO HELP CTS? One answer is, don’t age – good luck with that! In addition to keeping your weight under control, exercise can be VERY effective and YOU can be in charge of that process, but we have to teach you the exercises.
1) The Carpal Stretch (“nerve gliding”): Place your palm on the wall near shoulder height with the fingers pointing down at the floor and press the palm of the hand flat on the wall. Lastly, reach across with the opposite hand and pull your thumb back off of the wall and hold for 5-15 seconds.
2) The Wrist Extensor Stretch: Do the same as #1 but place the back of the hand on the wall in front of you, again fingers pointing downward. Here, there is no need to stretch the thumb.
3) The “Bear Claw”: Make a fist and then open up the hand. Keep the small finger joints flexed while extending the knuckles at the base of each finger straight (not bent). Repeat 5-10x.
4) Putty Squeeze: Simply squeeze putty in your hand for two to five minutes until fatigued.
5) Yoga has been shown to reduce pain and improve grip strength in CTS patients!
Now the question, “…can these exercises prevent surgery?” The answer is “maybe.” They certainly help in some cases, but a multi-dimensional treatment plan is the BEST approach. This includes: 1) Chiropractic manipulation of the hand, wrist, elbow, shoulder, and neck; 2) Active Release Techniques of the muscles in the forearm, upper arm, shoulder, and neck; 3) Cock-up wrist splint to be used at night, and in some cases, at times during the day; 4) Ergonomic management of your work station or situation (to minimize repetitive insult to the area); 5) Nutritional support that may include an anti-inflammatory diet and nutrients (vitamins, minerals, herbs, etc.), and 6) Managing any contributing conditions like diabetes, hypothyroid, and/or the others. Here’s the
GOOD NEWS: CHIROPRACTIC can manage these six steps, though some cases will require co-management with primary care and/or specialist.
We realize you have a choice in whom you consider for your health care and we sincerely appreciate your trust in choosing Dr. Glenn Hyman’s Denver Chiropractic Center for those needs. If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.
In last month’s Health Update, we discussed fibromyalgia (FM) management from a multi-modal approach, which included dietary recommendations to reduce inflammation. We’ll cover this topic in more detail this month…
Anti-inflammatory foods can be broken down into four categories: 1) Fruits and vegetables; 2) Protein Sources; 3) Fats and Oils; and 4) Beverages.
In the fruits and vegetables category, whole fruits, berries, and vegetables in general are rich in good things like vitamins, minerals, fiber, anti-oxidants, and phytochemicals. In particular, green and brightly colored vegetables and whole foods (such as broccoli, chard, strawberries, blueberries, spinach, carrots, and squash) are great choices.
Besides being low in calories, high in fiber, rich in vitamin/minerals and more, berries EVEN taste good! For example, one cup of strawberries contains >100mg of vitamin C (similar to a cup of orange juice), which helps our immune system function. One cup of blueberries includes a little less vitamin C but it has minerals, phytochemicals, and anti-oxidants at only 83 calories per cup. A cup of cranberries has only 44 calories (it can also help with bladder infections), and a cup of raspberries has 64 calories and has vitamin C and potassium. Less common, but equally nutritious, are loganberries, currants, gooseberries, lingonberries, and bilberries. Put these, or a mixture of these, on salads, yogurt, or a whole grain cereal and enjoy a VERY satisfying snack or meal! The health benefits of phytochemicals and flavonoids include cancer prevention, bladder infection treatment, and may even help your eyesight (such as from lutein in blueberries and raspberries).
Protein sources include fish/seafood, especially oily ocean fish like salmon and tuna, as these are rich in omega-3 fatty acids. Soy and soy foods like tofu and tempeh as well as legumes are great plant sources of protein, though some doctors may recommend staying away from soy. Nuts such as walnuts, almonds, pecans, and Brazil nuts are also great protein sources.
Fats and Oils: Omega-3 fatty acids can be found in flax seeds, canola oil, and pumpkin seeds, as well as cold-water oily fish. Other fats that are anti-inflammatory include monounsaturated fatty acids, which are found in olive oil, avocados, and nuts and have been found to be cardiovascular disease “friendly” as well. Other healthy oils include rice bran oil, grape seed oil, and walnut oil.
Beverages: Our bodies need water! Of course, tap, sparkling, or bottled water are great sources of water. So are 100% juices, herbal tea, low-sodium vegetable juice, and if tolerated, low or non-fat milk.
Meal suggestions include: Breakfast – oatmeal with fresh berries and walnuts; Snacks – whole fruits, nuts, seeds, and fresh vegetables; Lunch and Dinner– choose fish and less fatty red meats; cook with olive and canola oil; load up a salad with fresh vegetables and fruit, avoid deep fried foods – rather, bake, broil, poach, or stir-fry instead. Fill up HALF of your dinner plate with dark green or brightly colored vegetables. Avoid the following: junk food, high-fat meats, sugar (sodas, pastries, candy, rich desserts, and sweetened cereals), highly processed foods, trans-fats and saturated fats (i.e., bacon and sausage), and white flour products (get 100% whole grain instead). Some research suggests not eating “nightshade plants” like tomatoes and eggplant.
If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing Denver Chiropractic Center. 303.300.0424.
Fifty patients with neck and arm pain caused by an MRI-confirmed cervical disk herniation received chiropractic adjustments over a 90-day period. After two weeks, 55.3% of patients reported their pain had significantly improved. This number rose to 68.9% after one month and 85.7% after three months of care. No adverse events were reported.
Journal of Manipulative and Physiological Therapeutics, October 2013
Last month, we covered what Carpal Tunnel Syndrome (CTS) is, its symptoms, causes, who is at risk, and how it’s diagnosed. This month, we’ll center our focus on CTS treatment.
How is CTS treated? For the best success, treatment should begin as early as possible. Unfortunately, most people wait a long time before they get to the point where the symptoms interfere with daily activity enough to prompt them to act quickly and make an appointment. Once the cause or causes of CTS are determined, treatment can address ALL the presenting contributing conditions. The FIRST course of care should be NON-SURGICAL, though this is not always practiced – so be aware! Non-surgical care includes the following:
Chiropractic:
Manipulation: This usually includes adjusting the small bones of the hand, the wrist, the forearm, elbow, shoulder, and/or the neck.
Active Release Techniques: This includes loosening up the overly tight forearm muscles where the median nerve runs through (on the palm side of the forearm).
Nutritional: Nutrients such as vitamin B6 have been shown in studies to be effective in some cases. Also, anti-inflammatory herbs (ginger, turmeric, bioflavinoids) and / or digestive enzymes (bromelain, papain, and others) taken between meals are quite effective.
Anti-inflammatory: The first important distinction is that ice can be very effective depending on how long the CTS has been present. In particular, ice cupping or rubbing ice directly on the skin over the carpal tunnel is the most effective way to use ice as an anti-inflammatory agent. When doing so, you will experience four stages of cooling: Cold, Burning, Achy, Numb or, “C-BAN.” It’s important to remember this as you are REALLY going to want to quit in the burning/achy stages when it feels uncomfortable. Once the skin over the wrist / carpal tunnel gets numb (which takes about four to five minutes) QUIT as the next “stage” of cooling is FROST BITE! Most medical practitioners promote the use of NSAIDs (non-steroidal anti-inflammatory drugs) like Advil, aspirin, or Aleve. However, these carry negative side effects including gastritis (burning in the stomach that can lead to ulcers), or liver and/or kidney damage. Try the nutritional anti-inflammatory approach FIRST as they are extremely helpful without the bad side effect potential!
Diet: An ant-inflammatory diet, like the Paleo-diet or gluten free diet, serves as a great tool in reducing the inflammatory markers in the body. Though only 7-10% of the population has celiac disease (gluten intolerance), it’s been estimated that over 80% of us are gluten “sensitive.” Reducing systemic inflammation can make a BIG DIFFERENCE in the management of many conditions including CTS!
Mechanical: Wrist “cock-up” splints can also be REALLY HELPFUL, especially for nighttime use. The reason for this is because when our wrist is bent forwards or backwards, which frequently occurs when sleeping, the pressure inside the carpal tunnel increases, and over time (minutes to hours), the increased pressure in the tunnel exerts compression on the median nerve which then creates numbness into the thumb, index, third and half of the fourth finger, which can wake you up out of a sound sleep. Keeping the wrist straight at night prevents you from curling your wrist under your jaw while sleeping.
Ergonomic Modifications: Changing your work station (computer station, line position, machine controls, pace or rate of repetitive movements, and more) is VERY effective.
WE have a great track record with Carpal Tunnel Syndrome at Denver Chiropractic Center. Call us 303.300.0424.
Whiplash (or the rapid acceleration forwards followed by deceleration or sudden stopping of the moving head during the whiplash event) occurs at a speed that is so fast, we can’t prepare for it. In other words, by the time it takes us to voluntarily contract a muscle to guard ourselves against injury, that rapid forward/backwards “whipping” of the head and neck is already over! When considering the details of the injury event, sometimes we lose focus on what REALLY matters. Is there a way to reduce the chances for a long-term chronic, disabling, neck pain / headache result? Last month, we found out that the long-term use of a cervical collar is NOT a good idea. What are some other ways to prevent long-term disability?
A very interesting study investigated the first 14 days of treatment during the acute stage of whiplash neck sprain injuries following a car accident. The researchers wanted to determine what long-term consequences resulted from two different treatment approaches. In one group (201 patients, 47% of the total group), the patients were encouraged to, “…act as usual,” and continue in their normal daily, pre-injury activities. The patients in the second group were given time off from work and were immobilized in a soft cervical collar during the first 14 days after the car crash. At the end of the 14 days, there was a significant reduction of symptoms between the first visit to the fifteenth day (24 hours after the 14 day initial treatment time frame in both groups). However, when evaluated at the six-month point, the group that continued their normal daily routine, did not take time off work, and did not wear a collar had, “…a significantly better outcome,” compared to the other group. This study supports that over-treatment with a collar and time off from work “sets people up” for adopting a “sick role” where the patient is overly-focused on their problem. This study parallels what we discussed last month and embraces the chiropractic philosophy to staying active, exercise, don’t use a collar, and the use of manipulation which exercises joints and keeps them from stiffening up, thus reducing pain and the fear of doing activity!
Another study looked at different presenting physical factors that might be involved in the development of long-term handicaps after an acute whiplash injury in a group of 688 patients. They measured these physical factors at three, six, and twelve month intervals and found the relative risk for a disability a year after injury increased with the following: 1) A 3.5 times disability increase with initial high pain intensity of neck pain and headaches; 2) A 4.6 times increase with initial reduced neck movement or ranges of motion; and 3) A 4 times greater chance with initial multiple non-painful complaints (such as balance disturbance, dizziness, concentration loss, etc.). In yet another study, both physical and psychological factors were found to predict long-term disability. These included initial high levels of reported pain and poor activity tolerance, older age, cold sensitivity, altered circulation, and moderate post-traumatic stress.
The “bottom line” is that as chiropractors who also use Active Release Techniques, we are in the BEST position to treat and manage whiplash injured patients based on the type of care we perform and offer. We promote exercise of muscles and joints, encourage activity not rest, and minimize dependence on medication, collars, and other negative treatment approaches.