Tag Archive for: Denver Chiropractor

Low Back Pain and Common Mistakes (Part 2)

Last month, we started a great discussion on “what NOT to do” for low back pain (LBP). Let’s continue that focus this month!

5. STAY STILL: You’ve heard, “…don’t do that – you’ll get a bad back!” There is something to be said about being careful, but one can be too cautious as well. In order to determine how much activity vs. rest is appropriate, you have to gradually increase your activities by keeping track of how you feel both during and after an activity. If you do notice pain, it may be “safe” to continue depending on the type and intensity of the pain. In general, a sharp, knife-like pain is a warning sign that you should STOP what you’re doing, while an ache is not. Until you’re comfortable about which type of pain is “safe,” start out with the premise, “…if in doubt, stop.” If the recovery time is short (within minutes to hours), then no “harm” was done. If it takes days to recover, you overdid it. Think of a cut on your skin – if you pick at it too soon, it will re-bleed, but if you are careful, you can do a lot of things safely without “re-bleeding.” Talk to us about the proper way to bend, lift, pull, push, and perform any activity that you frequently have to do that often presents problems. There is usually a way to do that activity more safely!

6.  SURGERY IS A “QUICK FIX”: Though in some cases this may inevitably be the end result for your back condition, most of the time, it is not needed. As a rule, don’t jump to a surgical option too soon. It’s tempting to view surgery as a “quick fix,” but non-surgical care at least for 4-6 weeks and maybe several months is usually the best approach. As the old saying goes, you can’t “un-do” a surgery, so wait. UNLESS there are certain warning signs such as: a) bowel or bladder weakness &/or, b) progressive neurological losses (worsening weakness in the leg). If there are no “surgical indicators” meaning, no instability, no radiating leg pain, and only low back pain that is non-specific and hard to isolate what is generating the pain, DO NOT have surgery as the chances of improvement following surgery drops off dramatically in this group. There are guidelines that we all should follow and they all support non-surgical care initially for 4-6 weeks. Chiropractic is one of the best options cited in these guidelines because it’s less costly, involves less time lost from work, and chiropractic carries the highest patient satisfaction.

7. DON’T STRETCH – IT’S HARMFUL: You may have heard or read that stretching can actually increase or worsen your time if you’re a runner, reduce your ability to lift heavy weight (if you’re a weight lifter), or cycle as fast.  Though this seems obviously silly, there IS a growing body of evidence that has found this TO BE TRUE! HOWEVER, it appears (at least at present), that is applies primarily to static, long hold stretching and NOT to dynamic exercising like jumping jacks, toy-soldier like high kicks, or core stabilization. Moreover, no study YET has found a negative effect for non-athletic competitive activities or for low back pain specifically. A good general rule is, if you feel better after exercising, or in this case stretching, it’s probably better for you than not. Also, as stated last month, there is a “right vs. wrong” time to exercise and WAY to exercise. For example, when LBP occurs in flexion but reduces in extension, there is plenty of evidence published that performing exercises INTO the direction of pain relief is VERY helpful. So until you hear differently, KEEP ON STRETCHING, but follow our advice!

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

More great health info for you.

Mental Attitude: Sibling Fighting Linked To Mental Health Issues.
Fights between siblings (either verbal or physical) are so common they’re often dismissed as simply part of growing up. However, a new study finds that sibling aggression is associated with significantly worse mental health in children and adolescents. In some cases, the effects of sibling aggression on mental health were equal to those of peer aggression.
Pediatrics, July 2013

Health Alert: Third-hand Smoke a Danger!
Cigarette smoking has long been associated with risks to human health. Subsequent research has confirmed the dangers of second hand smoke. Now, scientists are noting the risk of environmental pollutants that persist even after the second hand smoke has cleared. These pollutants remain on the surfaces of buildings, furniture, floors, clothing, and other items exposed to smokers and are being referred to as third-hand smoke. Recent studies link DNA damage to third-hand smoke.
Mutagenesis, March 2013

Diet: Early Introduction of Solid Food Increases Type 1 Diabetes Risk.
Infants have an increased risk of developing type 1 diabetes later in life if they’re started on solid food before the age of four months.
JAMA Pediatrics, July 2013

Exercise: To Lose Fat, Don’t Eat Before Workout.
Exercising on an empty stomach may not be such a bad idea. Researchers found that cyclists who trained without eating beforehand burned significantly more fat than their counterparts who ate before training.
Journal of the American College of Sports Medicine, April 2010

Chiropractic: Chiropractic Adjustments Produce Immediate Changes on MRI.
Compared to acute low back pain patients who received either non-manipulative care or no treatment, MRIs of patients who received two weeks of spinal manipulation showed the most substantial improvement in spinal gapping in the facet joint (L4/5 and/or L5/S1). This supports the premise that adhesions (think internal “scar tissue” that restricts healthy joint motion) formed in these small spinal joints are released by spinal manipulation, thus restoring normal joint motion and ultimately reducing pain and improving the patient’s function.
Journal of Manipulative and Physiological Therapeutics, April 2013

Wellness/Prevention: Deadly Belly Fat.
According to Dr. Robert R. Henry, a leading endocrinologist and professor of medicine at the University of California at San Diego, belly fat is toxic to the body. Fat around the midsection secretes chemicals that spark a cascade of intricate interactions that can weaken your heart, damage your blood vessels, dampen your immunity, and inevitably, if you continue to gain weight, will shorten your life or will lessen your ability to enjoy it to the fullest.
Prevention, June 2013

Fibromyalgia – Where Does the Pain Come From?

Fibromyalgia (FM) is a very strange condition. Can you think of any other condition that creates so many symptoms and yet all the blood and imaging tests are negative? FM symptoms include chronic fatigue, muscle aches and pains, depression, sleep disturbance, memory affects, and more. The degree or severity of FM varies from mild to severe, leaving some totally disabled and distraught. So, the question of the month is, where does the pain come from?

Since the usual markers of injury are negative (that is, blood and other tests), we can tell you first that the pain is NOT coming from damaged tissue such as muscle, bone, organs, and the like. If it did, abnormal enzymes &/or inflammatory tests would result. Rather, the origin of pain appears to be arising from within the central nervous system. That is to say, there are portions of the brain and spinal cord where pain signals are received and when they reach a certain level or threshold, the sensation is felt. When the sensory input is below that level, it will not be felt. In fact, there are MANY MORE incoming sensory signals that are NOT felt compared to those that are. This “thermostat-like” function is vital so we DO NOT feel everything that arrives to the brain. This is why we don’t feel the clothes hanging from our backs or the shoes on our feet (unless the laces are tied too tight!). It’s been said that if we DID “sense” all the incoming signals we would, in a sense, “…short circuit.”

In the FM patient, this thermostat is “messed up.” It is set lower than what is considered normal, and as a result, patients do sense or feel more than they should. This “nervous system overload,” sometimes referred to as a “sensory storm,” occurs in the FM sufferer. A more fancy term called “central sensitization” can be searched and you will find a LOT to read about this interesting subject (check it out)!

So how does this hypersensitive situation start? Fibromyalgia is classified into two main categories – type I and type II. In type I, or primary FM, the cause is unknown. The cause could include one’s genetic make-up, but the bottom line is, we really don’t know. In type II or, secondary FM, some other known condition or situation can be identified such as irritable bowel syndrome, rheumatoid arthritis, after a trauma, or following an illness or infection. Some also feel the lack of sleep or sleep loss can cause FM. This is because it takes about four hours of sustained sleep to reach deep sleep, and because of frequent sleep interruptions, the person never reaches deep sleep. Over time, deprived of the relaxing deep sleep benefits, the body gradually tightens up, “re-setting the thermostat” and too much sensory information reaches the brain, resulting in overload, and a heightened pain level is perceived. Studies have shown that when sleep is restored, many FM patients gradually improve and function better. This focus on sleep restoration is important in the management strategies of FM treatment. We all know our tolerance to just about everything suffers when we are over-tired, similar to the toddler who cries at the drop of a dime when they need a nap.

Chiropractic adjustments, certain nutrients like melatonin, valerian root, and vitamin B complex can facilitate sleep restoration. Treatment for sleep apnea can also help patients with FM. As we’ve said before, FM is usually multi-factorial and including chiropractic in the FM treatment “team” is essential for a satisfying result!

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

“Harder than a Half-Ironman,” Dr. Glenn’s Race Report (pic), and the 1-Page Health News (w/video)

My friend and fellow Altitude Multisport club member Justin Chester summed up Xterra Beaver Creek perfectly, “That’s harder than a Half-Ironman!” I don’t know about that since I’ve never done a Half-Ironman. But I do know this: Beaver Creek, for such a posh place, serves up one tough off-road triathlon course. For the record, I did the Sprint version.

I’m never too focused to high-five my kids at the bike-run transition!

Overall, I had a good day. My swim was slower than last year, possibly related to my lack of swim training this year. I guess I shouldn’t have taken 7 months out the pool after last season? The bike and run were about the same as last year (maybe a tad slower). Overall I was only 4 minutes off of last year’s time. I’ll take it! Next up is Xterra Indian Peaks at Eldora ski resort this coming Saturday. That’s right, 2 Saturdays in a row.

Weekly Health Update
Week of: Monday, July 22th, 2013
“A healthy outside starts from the inside.”
~ Robert Urich

Mental Attitude: Obsessed With Forbidden Pleasures.
When individuals are forbidden from everyday objects, their minds and brains pay more attention to them. Obsession is not as strong if others are also denied. When an object is forbidden to a group, the allure of the object drops dramatically. This helps to explain why group diet programs can be more successful than dieting alone.
Cognitive, Affective and Behavioral Neuroscience, June 2013

Health Alert: Kids Poisoned.
Every 10 minutes a child in the United States is taken to the Emergency Room because of poisoning from swallowing a prescription or over-the-counter medicine. The most common drugs associated with children’s poisoning include those used to treat diabetes, high cholesterol (statins), pain (opioids), and cardiovascular diseases (beta blockers).
Pediatrics, June 2013

Diet: Soda, Illegal Drugs, and Teeth.
Drinking large quantities of soda can be as damaging to your teeth (tooth erosion) as methamphetamine and crack cocaine use. Tooth erosion occurs when acid wears away tooth enamel. Without enamel, teeth are more susceptible to developing cavities, as well as becoming sensitive, cracked, and discolored. The citric acid present in both regular and diet soda is known to have a high potential for causing tooth erosion. The ingredients used in preparing methamphetamine can include extremely corrosive materials such as battery acid, lantern fuel, and drain cleaner. Crack cocaine is also highly acidic in nature.
General Dentistry, June 2013

Exercise: Quantity Over Frequency?
A study of over 2,300 Canadian adults found that those who exercised 150 minutes over just a few days of the week received the same health benefits as those who spread out 150 minutes of exercise over the entire week.
Physiology, Nutrition, and Metabolism, June 2013

Chiropractic: Success!
A study compared the effectiveness of manual therapy (performed by a Chiropractor), physical therapy (performed by a Physical Therapist), and medical care (delivered by a Medical Physician) for patients with neck pain. The success rate at 7 weeks was twice as high for the chiropractic therapy group (68.3%) compared to the medical care group. Patients receiving chiropractic therapy had fewer absences from work than patients receiving physical therapy or medical care for their neck pain. Manual therapy and physical therapy also resulted in statistically significant less analgesic (pain relief medication) use.
Annals of Internal Medicine, 2002

Wellness/Prevention: Prevent Stress.
Among women who reported stress, 40% had psychosomatic symptoms in the form of aches and pain in their muscles and joints, 28% suffered from headaches or migraines, and 28% reported gastrointestinal complaints. (Note- I’m sure men would have reported even more complaints, as everyone knows women are the tougher gender.)
University of Gothenburg, June 2013

As always, thanks for reading,

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.

Hippocrates and chiropractic care

Chiropractic may only be 114 years old, but spinal manipulation has been around for thousands of years. Massage and manipulation are two of the oldest remedies known to man. In fact, the first pictures depicting spinal manipulation were discovered in prehistoric caves in Point Le Merd in southwestern France. These drawings depicted crude, non-specific attempts to manipulate the spine that date back to 17,500 bc. The ancient Chinese were using manipulation in 2700 bc. and James Cyriax, in his Textbook of Orthopedic Medicine, included a picture of a Buddhist temple with a statue over 2,000 years old showing manipulation of the lumbar spine.

More recently, Hippocrates (460-377 bc), the father of Greek medicine said, “Get knowledge of the spine, for this is the requisite for many diseases.” He wrote over seventy books on healing and was a proponent of spinal manipulation. This great physician was also the first to deal with the anatomy and the pathology of human spine. In his books, he provides a precise description of the segments and the normal curves of the spine, the structure of the vertebrae, the tendons attached to them, the blood supply to the spine, and even its anatomic relations to adjacent vessels. Hippocrates devised two apparatuses, known as the Hippocratic ladder and the Hippocratic board, to reduce displaced vertebrae.

Hippocrates believed only nature could heal and it was the duty of a physician to remove any interference preventing the body from healing. Hippocrates taught that the essence of life and the ability of the body to heal was the result of a vital spirit.