Fibromyalgia: Exercise Recommendations

Health Update: Fibromyalgia

Fibromyalgia (FM) is a chronic condition that affects the muscles of the body in a generalized way, producing pain that is usually located in many areas. This widespread pain can impact many aspects of one's life and disrupt jobs, hobbies, and relationships.

Last month, we discussed dietary strategies that can be employed to minimize the inflammatory process in the body.

This month, we will continue the concept, "...what else can I do to help myself?" When you adopt the dietary recommendations described last month with the exercise recommendations that will be presented here, this combination will have a dramatic effect on minimizing the activity disabling qualities of fibromyalgia.

Let's break exercise down into three categories: strengthening, stretching, and aerobics. It is recommended you choose exercises from each category that are most appealing to you so you can develop a "regular habit" with these approaches. Recognize that as long as you're breathing, you will need to exercise. It's not like, "...once I get into shape, I can stop and enjoy my healthy condition that I've worked hard to achieve." Hence, make exercise automatic - something that you "look forward" to doing (not dreading). Presented here are three categories of exercises - choose several from each category and mix them up - and do it EVERY DAY!!! * Bruegger's Stretch: Sit up VERY straight, extend the arms back (straight elbows) spread fingers, tuck chin, breath full/slowly and repeat 3 times.

Note, we can help teach these to you if you're not sure how to do these!

We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

What Isn't Carpel Tunnel Syndrome?

That's a strange question....well, maybe not as crazy as it sounds! Knowing what isn't carpal tunnel syndrome, or CTS, may help you avoid an unnecessary surgery for a condition that looks very similar to CTS. Because CTS is such a common problem, it's not uncommon for other conditions to be mistakenly called "CTS." Because of that, subsequent surgical treatment will fail.

So, what are similar conditions you should know about? You'll be surprised at the possibilities: Pronator tunnel syndrome, cubital tunnel syndrome, radial tunnel syndrome, thoracic outlet syndrome, cervical radiculopathy, peripheral neuropathy, De Quervain's Disease, fracture/trauma, degenerative joint disease (osteoarthritis), ganglion cysts, rheumatoid arthritis (RA), serum lupus erythymatosus (SLE), scleroderma, syringomyelia, multiple sclerosis, pregnancy, obesity, hypothyroid, gout, diabetes mellitus, Paget's Disease, acromegaly, mucopolysaccharidoses, eosinophilic fasciitis, hyperlipidemia...

Obviously, you get the picture. There are MANY conditions that can either contribute and/or "cause" CTS. So, let's discuss how we can determine what the condition is that may be causing CTS. CTS is "likely" if none of the above causes or contributes to these symptoms of CTS:

1. Numbness/tingling in the distribution of the median nerve in the hand only (not forearm) affecting the 2nd and 3rd (sometimes part of the 4th) fingers.

2. The need to shake and "flick" your fingers repeatedly during certain activities such as writing, sleeping, typing, driving, reading/holding a book / newspaper.

3. Waking up at night due to numbness.

4. Difficulty buttoning a shirt, picking up fine things, unscrewing a jar, riding a bike and more.

It may be necessary and appropriate to have some blood tests performed to help "rule out" (that means, "...get rid of..") some of the above long list of conditions. Some of these blood tests include (but are not limited to): a sedimentation rate (ESR), rheumatoid factor (RA), ANA antibody test (for SLE), uric acid (for gout), glucose (for diabetes mellitus), thyroid profile (for hypothyroid), lipid profile and even a Lyme's disease test to rule out the possibilities of that! If any of these blood test return "positive," get those conditions treated FIRST before consenting to CTS surgery so you can avoid having a poor / unsatisfying result.

Remember, you can always have surgery later, but you can't "undo" the surgery after the fact (if it doesn't help).

Therefore, why not consider a non-surgical treatment FIRST and if that fails, AND, blood tests prove none of the above conditions are present, THEN you can feel more comfortable that no underlying condition is present that is causing or adding to CTS. Some of the common non-surgical treatments you can expect from our chiropractic approach for CTS include: wrist manipulation / mobilization, active release technique (ART) applied to the flexor forearm muscles, night wrist splint use, low level laser therapy, activity modifications, ergonomic or work station modifications. Once you're sure no other underlying metabolic cause or contributor is present, call us and we will help you with our non-surgical, no negative side-effect treatment approach!

We realize 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.

Tip Of The Month

Do You Know The Two Times You Should Not Eat Sugar?
Plus: Study shows Tylenol PM® and other common medications cause brain problems...

Do you know the two times you should not eat sugar? If you do not, eating sugar at these two times of the day can strain your system and wreak havoc on your strength, fitness and health. In just a moment, you will discover these two very important times.

But first, here's some important news about... Common Over The Counter Medications And Brain Damage...

According to a July 13, 2010 issue of Neurology, drugs called anticholinergics block acetylcholine, a nervous system neurotransmitter, and are widely-used medical therapies. They are sold over the counter under various brand names such as Benadryl®, Dramamine®, Excedrin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®. Other anticholinergic drugs, such as Paxil®, Detrol®, Demerol® and Elavil® are available only by prescription.

Older adults most commonly use drugs with anticholinergic effects as sleep aids and to relieve bladder leakage problems. Researchers from the Indiana University School of Medicine conducted a 6 year study with 1,652 African-Americans over the age of 70 with normal cognitive function.

Results: "We found that taking one anticholinergic significantly increased an individual's risk of developing mild cognitive impairment and taking two of these drugs doubled this risk. This is very significant in a population, African-Americans, already known to be at high risk for developing cognitive impairment," said Noll Campbell, PharmD, first author of the study.

Dr. Campbell is a Clinical Pharmacist with Wishard Health Services. "Simply put, we have confirmed that anticholinergics, something as seemingly benign as a medication for inability to get a good night's sleep or for motion sickness, can cause or worsen cognitive impairment, specifically long-term mild cognitive impairment which involves gradual memory loss. As a geriatrician I tell my Wishard Healthy Aging Brain Center patients not to take these drugs and I encourage all older adults to talk with their physicians about each and every one of the medications they take," said Malaz Boustani, M.D., IU School of Medicine Associate Professor of Medicine, Regenstrief Institute Investigator and IU Center for Aging Research Center Scientist.

Did You Know?

Vitamin D deficiency is widespread among infants and most pediatricians remain unaware of the problem. Only 5 to 13 percent of breast-fed infants receive at least 400 IU of Vitamin D per day, the amount currently recommended by the American Academy of Pediatrics.

Human breast milk is actually relatively low in Vitamin D, probably because during our evolutionary history most babies got plenty of exposure to sunlight. An infant would need to drink 32 ounces of fortified formula per day to get 400 IU of Vitamin D, an amount that is probably unrealistic for young children.

The body produces Vitamin D when exposed to UV-B radiation from sunlight. The nutrient is essential for the development and maintenance of bones and the immune system, and deficiency can increase the risk of soft or brittle bones, infection, cancer, heart disease and autoimmune disorders.

It is recommended that infants get no direct sunlight at all for the first six months of life, and that they wear protective clothing and sunscreen beyond that age. This effectively rules out the healthiest, most reliable source of this essential nutrient. Making matters worse, only 1 to 13 percent of children under the age of one take a Vitamin D supplement.

Do You Know These Facts About Drinking Coffee?

Do you want to walk up to someone you've never met and tell them something about themselves and be right more than 50% of the time?

If you do, all you have to do is tell them they drank coffee today.

More than half of Americans drink coffee every single day.

In fact, according to CBS news, "After oil, coffee is the second most valuable commodity in the world. More than 50 percent of Americans drink coffee every day -- 3 to 4 cups each, more than 330 million cups a day and counting." Many people use coffee as a crutch to wake up every day. I'm sure you've heard someone say, "I'm worthless until I have my first cup."

It's also common to see people drink coffee before they work out. If you've spent any time in gym, you've probably seen people actually drinking coffee during their workout!
But is all this coffee drinking good?

The answer is yes... and no...

A recent U.S. News and World Report article claims caffeine could be an asset to your workout. The article states, "Yes, a caffeine kick could be a valuable addition to your pre-exercise routine, delaying muscle fatigue and keeping you focused and energetic."

Then it goes on to warn, "You don't want to overdo it, though. Sleep problems, headaches, irregular heartbeat, high blood pressure, or maybe even a heart attack can result." WOW! We're not sure the benefits outweigh the risks.

Bottom line: Caffeine is a drug and ALL drugs have side effects. Most people make the mistake and believe if something is "natural," then it is safe (or at least safer than a drug). Snake venom is natural. So is Mercury. Some of the most toxic substances known to man are natural.

So, the big question for you is: do you really think it is a good idea to use a stimulant every single day of your life? It is entirely up to you.

Simple "On-The-Go" Low Back Exercise

Health Update: Low Back Pain

"Doc, I try to do my exercises but I have to hit the ground running in the morning....to get the kids ready for the school bus....I have morning meetings....I'm not a morning person....I'm pulled in 100 directions during the day....I forget about them until I'm in bed....I exercise on my job and that's enough...."

I'm sure we've all rationalized our inability to keep up with exercises, especially after our episode of low back pain (LBP) subsides. In fact, only about 4% of LBP patients continue doing their exercises after their pain subsides. That means 96% of us with chronic, recurring low back pain DO NOT exercise even though we know we should. We feel bad, even guilty for not exercising. So, what can we do to "trick" ourselves into being more compliant with our low back exercises?

First, let's accept the fact that most of us cannot consistently "fit in" exercise into our busy schedules. With that said, the TIMING of when to do the exercise may be more important than even doing them at the same time every day. In other words, do a few exercises when you need them the most. For example, if you're working at a computer for more than 1 hour, and you start to feel back pain from the prolonged sitting - especially if your work station set up is less than ideal - do one or two sitting exercises right at your work station, BEFORE your back pain gets any worse. If you wait too long, the exercises may not be of much benefit. Setting a timer next to your screen that beeps every hour is a good reminder to do one or two simple exercises and only takes a minute or two. Many inexpensive digital watches can be set to beep on the hour/every hour or, you can set a "timer" to beep after 60 minutes as a "gentle" reminder. Some cell phones also have a timer feature. Here are three sit down low back exercise options (try them all and decide which one(s) feel most productive/helpful):

"Crossed Knee Stretch": Cross your legs; pull the crossed knee towards your opposite shoulder (feel the pull in your buttocks); arch your low back and at the same time, twist or rotate to the side of the crossed knee. Hold for 5-10 seconds and repeat up to 3 times. Repeat this on the opposite side.

"Sit Twists": Reach across with your right hand and grasp your left leg at mid-thigh. Twist/rotate your back to the left and pull with your arm. Hold 5-10 seconds / repeat 3 times. Repeat this on the opposite side.

"Sit Floor Touches": Bend over as if to touch the floor or tie a shoe. Hold 5-10 seconds. If you do the math, it would take a minute for #1 and #2, 30 seconds for #3 (total 2.5 min.). If that's too long, hold for 5 seconds. If that's too long, do 1 rep, not 3. You get the idea.....MAKE IT WORK! Modify the dose to fit your schedule or ability to stretch. If you do this AT THE TIME you start to feel tight or sore, you can PREVENT a LBP episode!

We realize you have a choice in where you choose your healthcare services. 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.