Health Update: Neck Pain

The Neck and Headache Connection 
       

        When we hear the term headache, we don't usually think about the neck. Rather, we focus on the head, more specifically, "...what part of the head hurts?" But, upon careful questioning of patients, we usually find some connection or correlation between neck pain and headaches.      
        The key to this connection can be found in looking at the anatomy of the neck. There are 7 vertebrae that make up the cervical spine and 8 sets of nerves that exit this part of the spine and innervate various parts of the head, neck, shoulders and arms, all the way to the fingers. Think of the nerves as electric wires that stretch between a switch and a light bulb. When you flip on the switch, the light illuminates. Each nerve, as it exits the spine, is like a switch and the target it travels to represents the light bulb. So, if one were to stimulate each of the nerves as they exit the spine, we could "map" exactly where each nerve travels (of course, this has been done).  When we look specifically at the upper 3 sets of nerves that exit the spine (C1, C2, and C3), we see that as soon as they exit the spine, they immediately travel upwards into the head (the scalp). Like any nerve, if enough pressure is applied to the nerve, some alteration in nerve function occurs and usually a sensory change is noted (numbness, tingling, pain, burning, etc.). If the pressure continues, these symptoms can last for a long time. These types of headaches are often called "cervicogenic headaches" (literally meaning headaches that are caused by the neck). These can be caused by the nerves getting pinched by tight muscles through which they travel as they make their way to the scalp.

        Another connection between the neck and headaches includes the relationship between 2 of the 12 cranial nerves and the first three nerves in the neck described above. These types of headaches usually only affect one half of the head - the left or right side. One of the cranial nerves is called the trigeminal nerve (cranial nerve V). Because the trigeminal nerve innervates parts of the face and head, pain can also involve the face. Another cranial nerve (spinal accessory, cranial nerve IX) can also interact with the upper 3 cervical nerve roots, resulting in cervicogenic headaches. People with cervicogenic headaches will often present with an altered neck posture, restricted neck movement, and pain when pressure is applied to the base of the skull or to the upper vertebrae. Other than a possible numbness, there are no clinical tests that we can run to "show" this condition, though some patients may report scalp numbness or, it may be found during examination.

        Though medication, injections, and even surgical options exist, manipulation applied to the small joints of the neck, especially in the upper part where C1-3 exit, works really well so why not try that first as it's the least invasive and, VERY EFFECTIVE! In some cases, a combination of approaches may be needed but many times, chiropractic treatment is all the patient needs for a successful outcome.

        We realize that you have a choice in where you choose 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.

        We realize that you have a choice in where you choose 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.

Health Update: Fibromyalgia

 

Fibromyalgia: What Water Exercises Can I Do?

        Fibromyalgia (FM) is a condition associated with tight, sore muscles with generalized, whole body pain, which can dramatically affect a person's lifestyle.  However, there are ways to fight back!  Last month, we discussed the benefits of water exercises and this month, we're going to illustrate some specific exercises that can be performed in water. Remember to start slow and gradually introduce more exercises (as well as repetitions and the length of exercise time) AFTER you have proven to yourself that the previous exercises are well tolerated. MOST IMPORTANT, have fun with these, and modify them as needed to make them "yours."

Diving Forward
Prep: Arms straight, stretched out from sides, palms forward.
Action: Push hands together, then outward.

Diving Downward
Prep: Arms straight, stretched out from sides, palms down.
Action: Swing hands down and inward across front, then outward; repeat down and inward behind back, then outward.

Squats
Prep: Legs straight.
Action: Bend at knees to lower body down, then up.

High Kick
Prep: Legs straight, pointing forward
Action: Swing one leg forward to backward; repeat with other leg.

Backward Kick
Prep: Legs straight, hold onto support.
Action: Ben one knee to raise foot backward, then down; repeat with other knee.

Deep-water Walking
Prep: Start in a dog-paddling position
Action: Climbing motions with both arms and legs.

Horizontal Walking
Prep: Legs straight, floating face down holding stairs.
Action: Bend one knee forward and back, then other knee.

        Of course, there are many other maneuvers that can be done in water.  Simply walking in water at various depths works well.  Another good/easy exercise is taking empty 1 gallon milk jugs with the caps on and squat down in the shallow end of a pool so only your neck is exposed and move your arms underwater back and forth in different directions, at different speeds, gradually increasing the speed of the movement.  
         If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

Health Update: Low Back Pain

 

 Low Back Pain: Spondylolisthesis

        Low back pain can arise from many conditions, one of which is a mouthful: spondylolisthesis. The term was coined in 1854 from the Greek words, "spondylo" for vertebrae and "olisthesis" for slip. These "slips" most commonly occur in the low back, 90% at L5 and 9% at L4. According to www.spinehealth.com and others, the most common type of spondylolisthesis is called "isthmic spondylolisthesis," which is a condition that includes a defect in the back part of the vertebra in an area called the pars interarticularis, which is the part of the vertebra that connects the front half (vertebral body) to the back half (the posterior arch). This can occur on one, or both sides, with or without a slip or shift forwards, which is then called spondylolysis. In "isthmic spondylolisthesis," the incidence rate is about 5-7% of the general population favoring men over women 3:1. Debate continues as to whether this occurs as a result genetic predisposition verses environmental or acquired at some point early in life as noted by the increased incidence in populations such as Eskimos (30-50%), where they traditionally carry their young in papooses, vertically loading their lower spine at a very young age. However, isthmic spondylolisthesis can occur at anytime in life if a significant backward bending force occurs resulting in a fracture but reportedly, occurs most frequently between ages 6 and 16 years old. 
        Often, traumatic isthmic spondylolisthesis occurs during the adolescent years and in fact, is the most common cause of low back pain at this stage of life. Sports most commonly resulting in spondylolisthesis include gymnastics, football (lineman), weightlifting (from squats or dead lifts) and diving (from over arching the back). Excessive backward bending is the force that overloads the back of the vertebra resulting in the fracture sometimes referred to as a stress fracture, which is a fracture that occurs as a result of repetitive overloading over time, usually weeks to months.
        If the spondylolisthesis lesions do not heal either by cartilage or by bone replacement, the front half of the vertebra can slip or slide forwards and become unstable. Fortunately, most of these heal and become stable and don't progress. The diagnosis is a simple x-ray, but to determine the degree of stability, "stress x-rays" or x-rays taken at endpoints of bending over and backwards are needed. Sometimes, a bone scan is needed to determine if it's a new injury verses an old isthmic spondylolisthesis. 
        Another very common type is called degenerative spondylolisthesis and occurs in 30% of Caucasian and 60% of African-American woman (3:1 women to men). This usually occurs at L4 and is more prevalent in aging females. It is sometimes referred to as "pseudospondylolisthesis" as it does not include defects in the posterior arch but rather, results from a degeneration of the disk and facet joints. As the disk space narrows, the vertebra slides forwards. The problem here is that the spinal canal, where the spinal cord travels, gets crimped or distorted by the forward sliding vertebra and causes compression of the spinal nerve root(s), resulting pain and/or numbness in one or both legs. The good news about spondylolisthesis is that non-surgical approaches, like spinal manipulation in particular, work well and chiropractic is a logical treatment approach!
        We realize you have a choice in who you choose to provide 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.

How Stress Is Ruining Your Life!

      
   Did you know there are relaxation techniques that can do wonders to relieve your stress?  With times being so tough, who doesn't need a good way to calm down and feel better?   
A lot of people just ignore stress.  But, stress is much bigger problem than most people think -- it's actually a killer.   

Why Is Stress Such A Killer?

        Stress changes body chemistry and these changes, over time, can lead to all kinds of chronic (and deadly) diseases.

        Stress weakens your body's natural immune system and makes you susceptible to the common cold, the flu and many other germs.

        According to Care2..."In the US, stress-related problems cost the economy up to $300 billion dollars per year, with $7,500 dollars per person lost per year to stress, whether through absenteeism or decreased productivity. According to the American Psychological Association and The American Institute of Stress, over 19 million Americans are affected by stress; 77 percent suffer from physical symptoms, and 73 percent from emotional and psychological symptoms. And by one account...  it is on the rise."

        Obviously, stress is not something that should just be "shrugged off." 

Tip of the Month

 

Meditation For Pain Relief
 

        Not too long ago, meditation was WAY out of the mainstream.  But, things have changed. For example, according to the Times Of India, in April, 2011, a study by the researchers at the Wake Forest Baptist Medical Center indicated that a person can attain at least 40 percent decrease in pain intensity and 57 percent in pain unpleasantness merely by practicing [meditation] techniques regularly. This reduction in pain was actually found to be better than morphine and other pain-relieving drugs. Magnetic resonance imaging showed increased brain wave activity (responsible for pain reduction) in study participants after meditation. Scientists could see WHAT was happening - but they did not understand HOW, until now...According to recent research published at the Brain Research Bulletin, investigators from Harvard, MIT and Massachusetts General Hospital have identified a possible answer. They suggested the explanation probably lies in alpha wave manipulation in the brain. Researchers said, by practicing the techniques of mindfulness meditation for a period of eight-weeks or above, you can control the activity of these brain waves. Looking into meditation may not only be a possible way to relieve pain, it can also relieve stress. And, relieving stress can, in turn, relieve pain. It's amazing how everything works hand-in-hand.

Did You Know?

        The type of light bulbs we use and where our lights are positioned can have a profound effect on our sleep. Our bodies are highly sensitive to the lighting around us. In nature, lighting changes with the days, the seasons and the moon cycles. For humans in the past, these cycles signified what times were best for hunting, fishing, planting and harvesting, and of course, for waking and sleeping. These days, electronic lighting allows us to accomplish more than ever before at any time we like. With electronics like televisions, computers and smart phones, we have more we can do in our spare time than ever before. But, these also keep us awake. 

        It's no coincidence that chronic sleep deprivation and sleeping disorders are also more common than ever. These sleep problems impact our quality of life in a big way. When we don't get enough sleep, our mental function, our moods, our productivity and our long-term health greatly suffer. Fortunately, we can help get our sleep back on track by applying a few key lighting tips that make a big difference:  

1. Low lights after sunset. This is crucial to help your body recover a natural circadian rhythm. After the sun goes down, avoid the use of overhead lights and instead use lamps at table height. This simulates the firelight our ancestors would have been exposed to after dark, whereas overhead lights simulate sunlight and prevent your body from realizing it's time to rest.
2.  Use low-watt bulbs. No need for bright, 100-watt bulbs in the evenings. For the last one to two hours before bed, use bulbs with a lower light output.
3.  No blue before bed. Blue lighting simulates daylight. In the evenings, use bulbs that give off more yellow light. Lamp shades in gold or red tones can help simulate natural evening light and help you get to sleep.
4.  Cut back on electronics before bed. Research shows that using electronics like televisions, computers or cell phones before bed contributes to sleep problems. Limit their use in the hour or two before bedtime. (If you need to use the computer at night, there is free software you can download to help your computer's light simulate the natural light cycles of your region.)
5.  Block window light. Street lamps or flood lights can shine through windows and are sometimes as bright as daylight! Get some curtains that block out light if you have trouble with light shining through your windows at night.
6.  Bright lights in the morning. Did you know the light you see in the morning can affect your sleep at night? Expose yourself to the bright morning light as soon as you wake up if possible. If you can't get outdoors, try a sun lamp for 15 to 30 minutes in the morning. Many report that sun lamps are very effective for restoring natural sleep cycles.

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome - What Can You Do For It?

        Carpal tunnel syndrome or, CTS, is a common condition that drives many patients to chiropractic clinics asking, "...what can chiropractic do for CTS?" 

        As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:

1. A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work - especially if it's fast and repetitive.  Your doctor will also need to learn about your "co-morbidities" or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.
2. A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.
3. Treatment can include manipulation, soft tissue release, PT modalities (eg., electric stim., ultrasound).
4. Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

        Here are some of the things that you, the CTS sufferer can self-manage:

• A Carpal tunnel splint  is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.
• Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times / day) such as: A. The "Bear claw" (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand) B. Tight Fist / open hand (fully open - spread and extend the fingers and then make a fist, with the hand). C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm - hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch! D. Wrist range of motion (dorsiflexion/palmar flexion) - Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times. E. Wrist range of motion (pronation/supination) - Place forearm and whole hand on table-- elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times. F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed. G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down. H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.
• Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

        We realize you have a choice in who you consider 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.