Tag Archive for: Denver Back pain

Carpal Tunnel Syndrome – Nutritional Considerations

Carpal Tunnel Syndrome (CTS) is a condition where the median nerve that arises in the neck and travels through the shoulder, arm, and into the hand becomes compressed. Compression of the median nerve results in tingling, numbness, pain and/or weakness that affects the 2nd, 3rd, and thumb-side half of the 4th fingers. It can wake sufferers up in the middle of the night, forcing them to have to shake the hand and flick the fingers to “wake it up.” This can occur multiples times a night, making for a long next day! We’ve discussed chiropractic management strategies such as manipulation/mobilization of the neck, shoulder, elbow, wrist and hand, the use of a cock-up splint (especially at night and at times when driving), but more information regarding the use of nutritional supplementation is lacking; hence the purpose of this Health Update!

 

Let’s look at what we are trying to accomplish by nutritional approaches for CTS:

  1. Anti-inflammation: Because of stomach, liver, and kidney side effects, NSAIDs such as ibuprofen, aspirin, and others may not be your best choice. Rather, consider Turmeric (300 mcg), Ginger (100 mg), Boswellia (100 mg), Rosemary (100 mg), Bioflavonoid (100 mg), Bromelain (50 mg), Vitamin C (1-3 grams/day), Vitamin E (400 IU/day), Vitamin D3 (2000-5000 IU/day), Vitamin B-complex (especially B6, 9, and 12).
  2. Muscle relaxation: Calcium (1500mg/day), Magnesium (400 mg/day), Potassium, valerian root (vervain), B-Complex, L-Arginine, Rosemary, Catnip, Kava root, Chamomile, Cayenne Pepper, Horseradish, Lavender, Licorice, Devil’s Claw.
  3. Nerve repair: Folate (B9), B12 (cobalamin), Vitamin D3, B1 (Thiamin; minimum: 1.2mg/day), B5 (Pantothenic acid), B3 (niacin; minimum 16 mg/day), B12.
  4. Managing systemic conditions:

a)      Diabetes (dysinsulinism): Chromium (picolinate or choloride), Alpha-Lipoic Acid, Omega-3 Fatty Acids (1000 mg of EPA & DHA), Coenzyme Q10, Polyphenols (dark chocolate, green tea), Botanicals (plant extracts such as garlic, prickly pear, aloe vera, fenugreek, bitter melon and ginseng).

b)     Thyroid dysfunction (hypothyroid): B-Complex (100 mg of B1, 3, 5, & 6 3x/day; B2, 50 mg 2x/day; B12 1000-2000 mcg/day; Selenium and iodine, Anti-oxidants (Selenium, Vit. C, Vit. E) Copper, thyroid extract, organic iodine.

c)      Obesity (BMI>30): Childhood obesity: Vit. D (ages 1-13, 5 mcg/day), B12, Vit. C, Fiber, Calcium (an extra 300mg of Calcium= >2 lb. weight drop); other fat soluble vitamins (Vit. A, E, and K), iron (iron is more commonly deficient in obese children and adults and can lead to fatigue and poor mental health and memory function).

  1. Other considerations: General health: paleo diet, sleep quality, and exercise (see below).

 

You may notice that there is a lot of overlap in many of these vitamin recommendations. If one were to give nutritional recommendations for general health purposes, the anti-inflammatory “big 5” might include 1. A good quality multi-vitamin mineral, 2. Magnesium (often with calcium as a combined supplement), 3. Omega-3 fatty acids; 4. Vitamin D; and 5. Coenzyme Q10. For CTS specifically, the addition of a B complex seems consistently recommended above.  Controlling weight will reduce CTS risk and decrease the risk of acquiring type II diabetes which increases CTS risk by itself. Perhaps an “ideal diet” for everyone might include eating plenty of fruits, vegetables, lean meats, and the elimination of gluten (grains) – referred to by some as the “anti-inflammatory diet,” paleo diet, caveman diet, and Mediterranean diet. Fortifying a great diet with vitamins is the “take-home” concept!

Low Back Pain and Travel Tips

Low back pain (LBP) and the discussion of traveling tips will be concluded this month. Please refer to the last 2 months for other great traveling tips. Keep a copy of these in your travel bag!

 

BE PROACTIVE WITH THE AIRLINES: 1. Get an aisle seat. Request an aisle seat out of “medical necessity.” By stating it this way, the airlines will go out of their way to find you an aisle seat. It is easier to exit the seat in case you have to use the restroom or an emergency occurs. It also allows you to get up and walk around for exercise, which can reduce the irritation of LBP and reduce the chances of blood clots. We can provide a letter to travel with stating that you have LBP, which can help you get special considerations. 2. Request a wheelchair. Make sure the airline knows you would like a wheelchair. They will handle your carry-on, get you through security quicker, and get you to and from the gate in a safe, timely manner. Typically this request is done at the time you make your reservation, but you can also tell a flight attendant prior to landing and they will have it arranged by the time you de-plane at your arrival site. Since there is no way to know how long the security line will be or how long the distance will be between gates or to baggage claim, having a wheel chair pre-arranged is wise. 3. Request a row of seats. Typically, if the plane isn’t full, you can ask for a row of seats that are empty so you can put the arm rests up and spread out, lay down and be much more comfortable. 4. Recline your seat. Depending on your type of low back condition, you may feel most comfortable either in a vertical upright position or reclined position. Some seats, such as in the exit row or last row, do not recline so ask when booking your flight or when you check-in to make sure your seat is adjustable. 5. Stay stretched. Prolonged sitting has many negative effects on muscles, joints, and circulation. Performing stretches from sitting or standing can help a lot, especially on long flights. Ask us to show you some easy-to-perform exercises that can be done in confined spaces! 6. Pre-board. This option allows you to board the plane first and gives you extra time. 7. Handicapped parking sticker. Consider this if walking is challenging for you. We can assist you in this effort and it will allow you to park close to the entrance at the airport. 8. Get a seat assignment. Getting “bumped” is common practice these days due to airlines purposely over-booking. If you do not initially obtain a seat assignment, call the airlines immediately to obtain a seat. Getting bumped can mean a delay for a couple hours up to a couple days!

 

SIT WITH SUPPORT: 1. Back Support. Using a special back support (if possible) or even a rolled up towel, pillow, or airline blanket between your back and seat can really help decrease low back pain. A small water bottle (tighten the cap!) is also a good option. The “bottom line” is comfort. If it feels good and relieving, it will be of benefit and help you. 2. Sit “supported.” Sitting with your knees bent at a right angle (90°) pushing your feet into the floor can be relieving and offer good support, especially during take-offs and landings. Also, stretch your legs out straight periodically under the seat ahead of you. You may have to place your briefcase or carry-on behind your legs, in front of your seat to open up the space so you can stretch out. Lastly, drink plenty of water, slip your shoes off at times, get up and walk periodically, carry a note from us for special needs, and most importantly, ENJOY YOUR FLIGHT!!!

Save your hands (video); after 6 months, I’m ready to go (pic), & the 1-Page Health News….

After 6 months of training (off and on) Dr. Hyman is getting ready for Xterra Beaver Creek this Saturday. Meanwhile, Dr. Stripling is conquering the kettlebell world one swing at a time. And lots of you are doing lots of races. It’s a busy time of year here at Denver Chiropractic Center! We’ll get right to the 1-Page Health News…

Hard to believe, but this is where this season started- on the trainer in the basement in January!

Weekly Health Update
Week of: Monday, July 15th, 2013

“He who has health, has hope; and he who has hope, has everything.”
~ Thomas Carlyle

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Mental Attitude: Brain Health.
A recent study recommends that doctors treating patients for type 2 diabetes also take cardiovascular disease (CVD) risk factors into consideration. The combination of type 2 diabetes and CVD can put patients at a higher risk for long-term cognitive dysfunction, even with CVD at subclinical levels.
Journal of Diabetes and Its Complications, June 2013

Health Alert: Summer Heat!
Extreme heat causes 658 deaths a year in the United States. That’s more than tornadoes, hurricanes, floods, and lightning combined. The Centers for Disease Control and Prevention urges Americans to take measures to stay cool, remain hydrated, and to keep informed. When the weather gets extremely hot, body temperatures can rise, causing brain damage, organ damage, and even death. When the human body cannot compensate and cool itself properly, it is more susceptible to heat-related illness. 69% of deaths from heat exposure occur at home, and in 91% of these homes there is no air-conditioning. Most of the victims live alone or are unmarried and 72% of them are male.
Centers for Disease Control and Prevention, June 2013

Diet: Cholesterol-Lowering Diet.
People who ate a Nordic diet had lower levels of harmful LDL cholesterol, higher levels of “good” HDL cholesterol, fewer fat particles in the blood, and therefore, had a decreased risk of cardiovascular disease. The healthy ‘Nordic diet’ contains berries, root vegetables, legumes, cabbage, nuts, game, poultry, fish, rapeseed oil, and low-fat dairy products.
Lund University, June 2013

Exercise: Only 12 Measly Minutes?
Only 20% of American adults get enough exercise and just 12 minutes of exercise each week is enough to stay fit! (95% of you who read this email exceed that greatly). Four minute bursts of vigorous physical activity three times each week can elevate oxygen intake levels, lower blood pressure, and decrease glucose levels.
PLOS One, June 2013

Chiropractic: Neck Pain Relief.
Three groups received either spinal manipulative therapy from a chiropractor, pain medication (over-the-counter pain relievers, narcotics and muscle relaxants), or exercise recommendations. After 12 weeks, 57% of those who met with a chiropractor and 48% who exercised reported at least a 75% reduction in pain, compared to 33% of the people in the medication group.
Annals of Internal Medicine, January 2012

Wellness/Prevention: Lifestyle Changes.
The four lifestyle factors that lead to a healthy heart are regular exercise, eating a Mediterranean-style diet, maintaining a normal weight, and not smoking. Adopting these four lifestyle behaviors protected against coronary heart disease as well as the early buildup of calcium deposits in heart arteries, and reduced the chance of death from all causes by 80 percent over an eight-year period.
American Journal of Epidemiology, June 2013
Video link: Dr. Stripling shows you how to protect your hands during the long work day. Carpal Tunnel Syndrome will be September’s Condition of the Month in our office. So here’s a little preview …

 

Common Questions about Cervical Disk Herniations

Last month, we discussed the topic of neck pain arising from cervical disk herniations. The focus of this month’s Health Update is common questions that arise from patients suffering from cervical disk derangement.

1. “What can I do to help myself for my herniated disk in my neck?” The mnemonic device “PRICE” stands for Protect, Rest, Ice Compress, and Elevate is a good tool to use in the acute stage of many musculoskeletal conditions.

  • Protect your health by NOT placing yourself in an environment that is likely to harm you, such as playing sports or doing heavy yard work. That is, think about what you do BEFORE you do it and if sharp, radiating pain occurs, STOP and assess the importance of what you are doing. Use the concept, “…don’t pick at your cut.” This means if you want the injury to heal, don’t keep irritating it!
  • Rest is similar. Limit your activities to those that can be done without increasing symptoms, especially radiating pain.
  • Ice – The use of ice reduces swelling/inflammation, which reduces pain and promotes healing. Alternate it every 15-20 minutes (on/off/on/off/on) several times a day. You can also use contrast therapy (Ice/heat/ice/heat/ice) at 10/5/10/5/10 minute intervals to “pump” out the swelling.
  • Compress – The use of a collar worn backwards, if it’s more comfortable that way, can literally “take the load off.” the neck and disks. There are even inflatable collars which are pumped up with air to traction the neck. Other forms of traction will be discussed further.
  • Elevate – The concept of raising the ankle to the height of the heart so swelling can drain out of the ankle is the classic example of “elevation.” In the neck, the traction concept may apply once again.

2. “I don’t want to have surgery if I can help it. What can you do as a chiropractor to help me?” This is one of our primary goals, and in fact, the goal of ALL health care providers, even surgeons! Chiropractic offers anti-inflammatory measures: ice, herbal anti-inflammatory agents (ginger, turmeric, bioflavonoid, curcumin, bromelain, Rosemary extract, Boswellia Extract, and more), digestive enzymes taken between meals, muscle relaxant nutrients (valerian root, vitamin D, a B complex, chamomile, magnesium, and others) as well as other non-pharmaceutical options. Treatments consist of manual manipulation, mobilization, traction (for home and office), modalities such as laser and low-level laser, electrical stimulation, magnetic field, ultrasound, and others.

Most important is having a “coach” guide you through the stages of healing by first addressing the acute inflammatory stage (first 72 hrs), the proliferative or reparative phase (up to 6-8 weeks), followed by the remodeling phase (8 weeks to 1 or 2 years) and finally, the contraction phase (lifetime – includes the natural shortening of scar tissue). If manual traction reduces neck and arm pain, the use of home traction is very effective. Options include sitting over-the-door traction, laying down versions, and mobile traction collars (discussed previously).

Exercises to stretch and strengthen the neck are also very important in reducing neck pain as well as preventing recurrences. If in spite of all the best efforts of this non-surgical care approach should ongoing neurological loss and relentless symptoms continue, we will coordinate care with physiatrists for possible injection therapy and pharmaceuticals, with neurology for further testing (such as EMG/NCV – a nerve test), and/or neuro- or orthopedic surgery – THE LAST RESORT!

We realize that you have a choice in where you receive your healthcare services.  If you, a friend or family member requires care for neck pain, 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. 303.300.0424 office@denverback.com

 

Car Accidents and neck pain (a.k.a. Whiplash)

Whiplash refers to an injury to the neck resulting from a rapid movement, usually associated with a motor vehicle collision (MVC). However, it can occur with a slip and fall injury, a bar room brawl, during a sports event like being tackled in football, among other things. For the sake of this discussion, we will stick with the classic example of a rear-end MVC.

 Mechanism of injury: So what really happens during the MVC that causes injury? The answer centers around movement of the neck which exceeds the normal tissue’s stretch limits, sometimes referred to as “the elastic barrier.” When the MVC occurs, during the first 100-200 milliseconds the trunk supported by the back of the car seat rapidly moves forwards leaving the head unprotected in its original position resulting in a backward glide or motion of the head and neck. Next, the head (which weighs about 12-15 pounds) drops back (HOPEFULLY) into the headrest stopping the motion, but if the head rest is too far back (>1/2 inch) or too low, then the head keeps going backwards until the tissues in the front of the neck stretch to the point of either stopping the motion or tearing (or both).

Next, the highly stretched front of the neck muscles, ligaments, disks, and tendons (in a “crack the whip” like manner) propel the head forwards to the point of over stretching the tissues in the back of the neck, which similarly stops the movement &/or tears. The degree of injury depends on many things, but is notably worse in the long-necked, skinny female where the “crack the whip” reaction is the greatest. Several factors determine the degree of injury, including the “G-Force,” or the amount of energy produced during the impact. The greater the G-force applied to the head/neck, the greater the potential for injury.

The G-force affecting the occupants inside the vehicle is related to many things: the speed of the crash, the size of the two vehicles (worse if a large automobile hits your smaller car), the angle and springiness of the seat back, the amount of energy absorbed by crushing metal vs. no damage to the vehicles (worse when there is no damage as all the energy is transfer to the occupants), whether the head was rotated or looking straight at impact, and more. The KEY to all of this is that we cannot voluntarily contract our muscles quicker than 800-1000 msec and the whiplash process is over after about 500 msec, so we can’t effectively “guard” or protect ourselves against injury even if we try by bracing ourselves before the MVC!

            Type of injury: The classic injury is called a sprain (ligament tear) and strain (muscle and/or muscle tendon tear) to either or both the front of the neck and/or back of the neck. Sprains and strains come in 1st, 2nd, and 3rd degree tears, getting progressively worse as more tissue is torn. Please refer to previous issues of the Whiplash Health Update where the anatomy is reviewed so you can “picture” this properly.

            Prognosis: The length of time to recovery or maximum improvement varies by the amount of tissue damage. A “prognosis scale,” first introduced in 1995 and validated by 2001, showed that in Type 1 injuries pain without loss of neck motion healed the quickest. Type 2 injuries where neck movement was reduced after the MVC (but no neurological findings occurred) healed next quickest. Type 3 injuries, which included BOTH motion and neurological loss, healed the slowest and had the worst long-term outcomes. Other factors enter into this, of course.

We will continue this “Whiplash 101” discussion next month…

We realize you have a choice in where you receive your healthcare services.  If you, a friend or family member requires care for whiplash, 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.

Our most watched video ever: Dr. Glenn & the bear, 4th of July week, and the 1-Page Health News

It was last year, 4th of July week up at Beaver Creek when I, Dr. Glenn Hyman, encountered my first bear. Having grown up in New Jersey it was a big deal to me. The video I shared reigns as our most watched video ever, and the link is below. The panicky guy who sounds an awful lot like me was some other person.

Next week, I’ll be back up in Beaver Creek for 4th of July week. This will be my second annual personal Xterra Beaver Creek training camp. If you’re up in the Vail / Beaver Creek area and want to ride the course next week, shoot me an email.

If you need to get in to see me here at Denver Chiropractic Center, call today 303.300.0424. I’m in all this week and out all next week.

Dr. Stripling will be in next Monday and Tuesday, and half of Wednesday before we close for the long 4th of July weekend.

Here is the 1-Page Health News:

Mental Health: Depression and Stroke Risk in Middle-Aged Women.
A 12-year study of over 10,000 middle-aged Australian women found that those who suffered from depression had nearly double the risk of stroke compared to non-depressed women in their same age group. The American Heart Association encourages everyone to learn how to recognize a stroke. Think F.A.S.T: F-Face Drooping. A-Arm Weakness. S-Speech Difficulty. T-Time To Call 9-1-1 (or the appropriate emergency services number if you’re outside the United States).
American Heart Association, May 2013

Diet: Brain Rewards.
Restricting food intake increases the reward value of food, particularly high-calorie and appetizing food. The more successful people are at caloric-restriction dieting, the greater difficulty they will face in maintaining the restriction. Dieting by skipping meals and fasting is less successful than weight loss efforts characterized by intake of low energy, dense, healthy foods. If people want to lose excess weight, it would be more effective to consume healthy, low-sugar foods during regular meals, rather than go for long periods of time without eating.
NeuroImage, May 2013

Exercise: It’s Not Too Late To Cut Heart Failure Risk!
In an eight year study, middle-aged participants drastically reduced their risk of heart failure up to 40% by increasing their cardiovascular fitness level.
American Heart Association, May 2013

Chiropractic: No Headaches!
Spinal manipulative therapy (aka adjustments) is an effective treatment for tension headaches. In a study, patients who received adjustments continued to benefit from care even four weeks after treatment concluded. This is in contrast to patients who received pharmaceutical therapy; they reverted to baseline values when checked a month after treatment ended.
Journal of Manipulative and Physiological Therapeutics, 1995

Wellness/Prevention: Fish Oil, Your Heart, and Stress.
A new study finds that regular consumption of Omega-3 fatty acids (most commonly found in cold water fish like Salmon) improves cardiovascular health by dulling the connection between mentally stressful events and cardiovascular functions like heart rate, blood pressure, the fight-or-flight response, and blood flow. Those who frequently find themselves in stressful situations may benefit from adding Omega-3s to their diet.
American Physiological Society, May 2013
Video link: Dr. Glenn and the bear!

Denver Chiropractic Center Weekly Health Update

“If you want others to be happy, practice compassion.
If you want to be happy, practice compassion”
~ Unknown
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Mental Attitude: The Elderly and Facebook.
Elderly adults who learned to use Facebook on a daily basis scored 25% better on tests measuring their cognitive abilities than their peers who did not.
University of Arizona, February 2013

Health Alert: Baby Boomers Vs. Preceding Generation!
As each generation grows older, they believe they are healthier than the previous generation. However, the baby boomers are unable to make this claim. Compared to the preceding generation at the same stage of their lives, fewer have “excellent” health (13% vs. 32%), more have high blood pressure (75% vs. 35%), and more are obese (36% vs. 25%).
JAMA Internal Medicine, February 2013

Diet: The Southern Diet and Stroke.
People from the American South are 20% more likely to have a stroke than those from other parts of the country, and the Southern diet may be to blame. People who eat Southern style food high in fat, sugar, and salt at least 6 times a week were at 41% higher risk for a stoke. People whose diets consisted of fruits, vegetables, and whole grains at least 5 times a week were 29% less likely to have a stroke.
American Stroke Association, February 2013

Exercise: Tai Chi?
Tai Chi may reduce falls among adult stroke survivors. Tai Chi is a martial art dating back to ancient China that includes physical movements, mental concentration, and relaxed breathing.
American Stroke Association, February 2013

Chiropractic: Recommended For Back Pain.
The Royal College of General Practitoners’ 2009 recommendation for treating non-specific low back pain advises doctors to advocate exercise and manipulation (such as chiropractic care) before pharmacological (drug) therapies and more invasive treatments (like surgery).
National Institute for Health and Clinical Excellences, 2009

Wellness/Prevention: Sunshine and Rheumatoid Arthritis.
Routine exposure to the sun, especially ultraviolet B (UVB) rays, may decrease the risk of rheumatoid arthritis. Those with the most elevated rates of exposure were 21% less likely to develop rheumatoid arthritis than who had less exposure.
Annals of the Rheumatic Diseases, February 2013

Who replaced Miss Keri, Denver Chiropractic Center shows you how to help your own ankle sprain, and the one-page health news.

This week we welcome our new office manager Natalie who is taking the reins from Keri. We look forward to working with Natalie for a long time. This week, as we’re all digging out from the snow, we have another video from Dr. Stripling. He’s covering ankle sprains. We treat lots of ankle sprains at Denver Chiropractic Center. As scar tissue affects the injured ankle, it’s left stiff and painful. By using Active Release Techniques to break up the scar tissue, and using some appropriate re-training techniques, we can usually dramatically shorten the time it takes for sprained ankles to heal.

 

Mental Attitude: No Interruptions Please. Short interruptions (such as the few seconds it takes to silence that buzzing smart phone) have a surprisingly large effect on one’s ability to accurately complete a task. Interruptions of just three seconds can double your chances for making errors. Journal of Experimental Psychology: General, January 2013

Health Alert: American Health. Americans have shorter life expectancy and higher rates of injury and disease than citizens of other industrialized countries. A 2011 report showed that the US ranked 50th in life expectancy. In most health issues (infant mortality, teenage pregnancies, sexually transmitted diseases, heart disease, chronic lung disease, disability, obesity, diabetes, drug-related deaths, homicides, injuries, and HIV/AIDS), the US is either at the bottom or near the bottom of the list of industrialized nations. Institute of Medicine and the National Research Council, January 2013

Exercise: Not At School! In the 1920s, 97% of US college students were required to take Physical Education (PE); today, that number is at an all-time low of 39%. 34% of adolescents and teens ages 12-19 are overweight and 17% are obese. These rates have roughly doubled since 1980. The median PE budget for schools in the US is $764 per school year in K-12 and 61% of PE teachers report an annual budget of less than $1,000. Obesity will cost the US $344 billion in medical- related expenses by 2018, about 21% of the nation’s total health-care spending. Research Quarterly for Exercise and Sport, January 2013

Chiropractic: Inflammation! Inflammation is your body’s natural response to injury and is part of the healing process. However, if proper care is not received, inflammation can hinder the healing process and may lead to scarring, improper motion, and additional pain. Signs of inflammation include: pain, heat, redness, swelling, and loss of function. Chiropractic adjustments and care can reduce inflammation and pain naturally!

Quote: “A healthy attitude is contagious but don’t wait to catch it from others. Be a carrier.” ~ Tom Stoppard

Video: Dr. Stripling’s Ankle sprain video can be found on our blog by clicking here.

This week’s 1-Page health News from Denver Chiropractic Center

Health Alert: High Fructose Corn Syrup and Type-2 Diabetes. Researchers found a 20% higher proportion of the population has diabetes in countries with high use of High Fructose Corn Syrup (HFCS), like the United States, compared to countries that do not, like the United Kingdom. The United States has the highest consumption of HFCS at 55 lbs (~25 kg) per year per person. The United Kingdom consumes 1.1 lbs (~.5 kg) per year per person.

Global Public Health, November 2012

Diet: Food Advertising. Childhood obesity has tripled in the past 30 years. Food companies spend $10 billion a year marketing in the United States, and 98% of that is on foods high in fat, sugar, or sodium.

Journal of Pediatrics, November 2012

Exercise: Walk Much? The more moderate physical activity (like brisk walking) you do, the better. Compared to doing nothing at all, seventy five minutes of vigorous walking per week was linked to living an extra 1.8 years. Walking briskly for 450 minutes or more per week was found to provide most people with a 4.5-year longer lifespan. The longer people spent each week being moderately active, the greater their longevity. Heart, November 2012

Chiropractic: Keep Your Disks Healthy. In normal healthy disks, the nerves (sinuvertebral) only sense pain on the periphery or outer regions of the disk. In grossly degenerated disks, nerves may penetrate into the center (nucleus) of the disk and be more vulnerable to degeneration and/or inflammation. Lancet, 1997

Wellness/Prevention: Cell Phone Addiction. Cell phone and instant messaging addictions are driven by materialism and impulsiveness and can be compared to consumption pathologies like compulsive buying and credit card misuse. Cell phones may be used as part of the conspicuous consumption ritual and may also act as a pacifier for the impulsive tendencies of the user. Impulsiveness plays an important role in both behavioral and substance addictions.

Journal of Behavioral Addictions, November 2012