Usually, there is not one specific cause of headaches so treatment can focus on various areas.  For example, muscles that attach to the base of the skull in the neck and upper back are often very short and tight, resulting in pressure or a squeezing effect on the surrounding nerves and blood vessels — resulting in headaches.  Chiropractic treatment includes methods aimed at reducing the tightness found in the joints and muscles. One of these approaches is called spinal manipulation or “adjustments” where the joints in the neck are moved to restore motion and reduce joint fixations. By relaxing the muscles and tension between the joints, the nerves in the neck are less pressured which, in turn, can reduce headaches.  The top three nerves that exit the upper neck travel into the head and are often the culprit behind the onset of headaches.  The second nerve from the top is the one responsible for causing radiating pain over the top of the skull which communicates with other nerves sometimes causing the pain behind the eye.

Another chiropractic approach in the management of headaches includes soft tissue therapy where trigger points found in tight muscles are addressed through various forms of massage and mobilization methods.  Manual traction of the head and neck can also be highly effective in reducing the tension found in headache sufferers.  Exercises are often taught to the headache patient with significant benefits reported.  Some of these, such as range of motion exercises with and without resistance (example: pushing your head into your hand during neck movements) and posture re-training (chin tucks - reducing the forward head position), help address the limited motion problems of the neck. Cervical (neck) traction performed by placing a rolled up towel placed behind the neck while lying on the back so that the head can hang off the side of the bed can also be very helpful.  Another neck traction approach is the use of a unit that hangs off a door where water is placed in a plastic bag calibrated for weight for 15 minutes at a maximum tolerated weight. This can be of great benefit as it can be performed at home at your convenience multiple times a day or, as needed.

Other treatment approaches that chiropractic utilizes include stress management (such as biofeedback, relaxation instructions, meditation, visualization and others), diet modifications (as certain foods can trigger headaches), nutritional supplementation (such as fish oil, Vit. D, feverfew and others), and sleep restoration.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future

Group 1: Patients with a “coat-hanger” pain distribution (neck and upper shoulders) and loss of neck range of motion (ROM), but no neurological deficits;

Group 2: Patients with neurological problems (arm/hand numbness and/or weakness) plus neck pain and ROM loss); and,

Group 3: Patients who reported severe neck pain but had normal neck ROM and no neurological losses.

The average time from injury to first treatment was 12 months and an average of 19 treatments over a 4 month time frame was utilized.  The patients were graded on a 4-point scale that described their symptoms before and after treatment.

Grade A patients were pain free;

Grade B patients reported their pain as a “nuisance;”

Grade C patients had partial activity limitations due to pain; and

Grade D patients were disabled.

Here are the results:

Group 1: 72% reported improvement as follows: 24% were asymptomatic, 24% improved by 2 grades, 24% by 1 grade, and 28% reported no improvement.

Group 2: 94% reported improvement as follows: 38% were asymptomatic, 43% improved by 2 grades, 13% by 1 grade, and 6% had no improvement.

Group 3: 27% reported improvement as follows: 0% were asymptomatic, 9% improved by 2 grades, 18% by 1 grade, 64% showed no improvement, and 9% got worse.

This study is very important as it illustrates how effective chiropractic care is for patients who have sustained a motor vehicle crash with a resulting whiplash injury.  It’s important to note the type of patient presentation that responded best to care had neurological complaints and associated abnormal neck range of motion.  This differs from other non-chiropractic studies where it is reported that patients with neurological dysfunction responded poorly when compared to a group similar to the Group A patient here (neck/shoulder pain, reduced neck ROM, and with normal neurological function).  We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through this potentially difficult process

1)    The muscles (the musculoskeletal system): tender, achy, stiff, tight muscles, trigger or tender points all over the body;

2)    The nerves (the nervous system): headaches, light headedness, sleep disruption, depression, anxiety, numbness/tingling (overlaps with the cardiovascular system);

3)    The stomach and intestines (the gastrointestinal system): diarrhea, constipation, irritable bowel, leaky gut, heart burn, lack of appetite, abdominal cramping;

4)    Breathing (the respiratory system): hyperventilation, rapid / shallow breathing patterns;

5)    The heart (the cardiovascular system): racing heart rate - palpitations, feeling cold all the time, numbness/tingling (overlaps with the nervous system);

Because of the multiple systems involved, there are many challenges to managing Fibromyalgia.  Studies suggest a balance between several approaches works best.  Some of these approaches include biomedical treatments, organ-specific treatments, and cognitive interpersonal treatments.  Within these categories, the following can be broken down further:

1)    General - those treatments directed at the whole body such as anti-inflammatory measures.  These include (but are not limited to) medications (corticosteroids, NSAID’s - such as Advil, Aleve) and nutrients (ginger, turmeric, boswellia, Vitamin D, and others).  Other anti-inflammatory measures include diet, such as the Paleo Diet or “caveman diet.”  This diet eliminates grains or flour-based products from the diet.  That means no more breads, pastas, crackers, cookies - anything made with flour.  This approach emphasizes consuming fruits, vegetables, grass-fed lean meats and fish.  The main ingredients in grains that are of concern in the Paleo Diet are gluten and lectins

2)    Central - those treatments directed at the chemical factors in the brain that control mood, depression, anxiety and so on.  These include (but are not limited to) medications (tricyclic antidepressants, muscle relaxers like Cyclobenzaprine, SSRI, SNRI and Trmadol) and certain nutrients (neurotransmitter support such as 5-HTP - tryptophan, DHEA, phenylalanine, and others).

3)    Psychotherapy and active behavioral therapy - treatments that are supportive of nervous system such as cognitive behavior therapy, aerobic exercise, patient education, multidisciplinary therapy, hypnotherapy, biofeedback, and strength training.

4)    Passive physical intervention - chiropractic therapy, massage therapy and other forms of manual therapy, and acupuncture.

The goal of this article is to look at fibromyalgia from a holistic perspective so that those struggling with FM and similar conditions can better appreciate the concept of multidisciplinary treatment, of which chiropractic care plays a significant role.  Coordination of care and finding the “right” health care providers cannot be over-emphasized.

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

The answer, like the cause is - you guessed it - multifactorial.  Since we can’t change our genetics, we’ll have to accept that one.  But, we can change our BMI by keeping our weight to a reasonable amount.  In an April 2010 study from Norway, 60,000 men and women provided BMI information and 20.9% of the men and 26.3% of the women indicated they had chronic low back pain. The authors found a direct relationship to a high BMI and an increased prevalence of LBP.  Similar results attributing obesity to LBP were also reported in a meta-analysis published in January 2010 in the American Journal of Epidemiology (2010; 171(2):135-154).

So, what is, “…a reasonable amount of weight?”  When using the BMI, a BMI of 18.5 to 25 is considered “normal,” while 25-30 is described as overweight and >30 represents obesity.  We should also mention anything LESS than 18.5 is considered underweight and that’s not good either as many nutritional needs of the body are compromised and too little weight can negatively affect bone health leading to osteoporosis and a myriad of other problematic health issues.

You may be wondering what a body mass index or BMI is, as its quite important and is quickly gaining respect in the medical world.  In fact, it has been suggested to include the BMI along with the other “vital signs” pairing it up with blood pressure (BP), pulse, breathing rate, height, weight, and temperature.  The BMI is a formula of height and weight and it’s a rough calculation of our total body fat, which is related to the risk of disease and death.  However, according to the National Heart, Lung and Blood Institute (NHLBI) it’s a little more complicated than that as people with greater muscle mass (such as a body builder) will have a higher BMI, suggesting they are overweight. At the other end of the spectrum, older individuals who have lost muscle mass may be still be overweight but their BMI will not reflect that.

The NHLBI reports 3 factors of importance when defining obesity and its many negative health effects, including the increased prevalence of LBP.  The 3 factors are: 1) The BMI; 2) The waist measurement; 3) The presence of other negative health factors including: high BP, high LDL-cholesterol, low HDL-cholesterol, high triglycerides, high blood sugar, a family history of heart disease, physical inactivity and smoking cigarettes.  If you have a waist size >35″ for woman, >40″ for men, AND 2 or more risk factors, simply put, you MUST lose weight!  Even a small weight loss of 10% (such as 30# if you’re 300#), will help lower your risk of developing diseases associated with obesity such as heart disease, high cholesterol related diseases, stroke, certain types of cancers and type 2 diabetes.

We also realize you have a choice in who you choose for 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.

            If this history sounds familiar, you may be suffering from carpal tunnel syndrome or CTS.  It’s a very common disorder affecting millions each year.  Its also one of the biggest problems for certain types of industries such as meat packaging plants, textile manufacturers, and virtually any job that requires fast, repetitive movements commonly used on assembly lines in many lines of work. 

            CTS is the result of pinching of the Median Nerve as it travels from the neck into the arm, through muscles in the forearm and into the hand through the carpal tunnel.  Pressure on the nerve at any of these locations can create the symptoms of CTS. This tunnel is quite small in size and included inside the tunnel are 9 tendons, blood vessels, and the median nerve. When the muscles of the forearms and hands are overworked, they inflame and swell.  Because the carpal tunnel is normally so tight, the increased swelling inside the tunnel pushes and pinches the median nerve creating the classic pain, numbness, tingling, and sometimes burning sensations often described by people suffering with CTS. 

            Certain situations make people more vulnerable or prone to develop CTS.  CTS is more common in woman than men by 3 or 4:1.  This is partially because women’s bone structure is smaller and therefore their Carpal Tunnel is smaller too. 

            Women also experience fluid retention or build up during menstruation leading to symptoms like swollen fingers and swollen and painful breasts. Swelling in the already tight, confined space of the carpal tunnel will increase their susceptibility for developing CTS.  Another hormone related cause or contributing factor is the use of birth control pills (BCPs).  Since there are many different types of BCPs and each woman is unique and different, finding the BCP with the “right balance” of hormones where the swelling side effect is minimized is very important and should be discussed with the doctor who prescribed the BCPs. 

            Age (>50 years) is also a risk factor and with our aging work force, this is becoming a big issue.  Other conditions like hypothyroid, diabetes, certain types of arthritis, and hypertension / congestive heart failure where an increase in fluid retention occurs can also increase the chance of developing CTS.  Obviously, occupation type plays an important role as previously mentioned.  Many jobs today require the use of computers and we’re finding the position of the monitor, the keyboard and mouse, are very important. 

            Chiropractic management of CTS includes wrist, forearm/elbow, shoulder and neck adjustments, corrective exercises, the use of night splints, and an anti-inflammatory diet. Also, correcting the “ergonomic factors” or, job-related causes is of utmost importance.  This is why a chiropractor who treats all of these areas and has the specialized knowledge about CTS is the perfect choice of health care providers. If you, a friend or family member require care for CTS, we would be honored to render our services.

The amount or degree of damage to the soft tissues - that is, the muscles, tendons, ligaments, and disks of the neck — will be the deciding factors as to how much rest vs. activity should be initially performed.  If there are no fractures, dislocations or other injuries resulting in an unstable cervical spine (neck), studies have shown rest and a soft collar is actually harmful when compared to early return to activity and exercises.  Chiropractic treatment, which essentially exercises the joints of the neck, has been shown to speed recovery when performed sooner rather than later after a whiplash injury.  A handy way to classify the injury includes four categories: 1) Pain with no significant abnormal clinical findings; 2) Pain with mild clinical findings and range of motion loss; 3) Pain with neurological injury (resulting in radiating arm pain); and 4) Pain associated with fracture and/or dislocation.  Those suffering with category 1 or 2 injuries should minimize rest, collar use, proceed with life’s activities and not be afraid to do desired activities.  More aggressive exercise and, utilizing chiropractic adjustments as soon as possible is very effective in the first two categories of injury.  Category 4 (fractures and dislocations) injuries require the use of a rigid collar usually for 4-6 weeks as rest/protection is imperative. Category 3 demands careful monitoring by your chiropractor as neurological problems like arm pain and numbness, muscle strength weakness, must be watched during the healing process.  The use of ice is helpful with all four categories of injury and exercise training is important and can be started sooner in the first two categories of injury.

What can you do if you sustain a whiplash injury?  The first order of self-help is the use of ice.  This is a much better choice over the use of heat as ice reduces swelling and pain while heat can increase swelling because it brings in more blood flow into an already swollen area.  The heat may feel good during its use but most patients report the pain either returns shortly thereafter or feels worse.  Ice and heat can be alternated but ice should be emphasized by using ice for 10 minutes, heat 5 minutes, and repeat the ice / heat / ice approach starting and ending with ice. One session usually equals 40 minutes (ice/heat/ice/heat/ice for 10+5+10+5+10, respectively, = 40 min.), and several sessions can be repeated each day.  The old adage of “ice for 24 hours followed by heat” does NOT apply here as ice or “contrast therapy” of ice/heat/ice/heat/ice can be performed for as long as there is pain or, for several weeks or longer.  The good news is that you will never hurt yourself by using ice but, you can make it hurt worse by using heat too soon so, when in doubt, use ice!  The next, very important, recommendation is to utilize exercises to stretch and strengthen the neck and upper back region. The “general rule” of exercise is slow repetitions staying within “reasonable” boundaries of pain.  That is, a good, stretch type of pain is encouraged while avoiding sharp pain.  We have discussed several very practical neck stretches and strengthening exercises previously and we will again address this in the future. Posture correction of chin tucks, keeping your head back over your shoulders is very helpful as well. We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you.

In order to further appreciate why the low back is so vulnerable to injury, some basic understanding of anatomy is needed.  When we’re born, the back is made up of 33 segments of which 5 fuse by the time we’re about 18 years old to make up the sacrum (bottom of the spine) and 4 fuse to make up the coccyx (tail bone), leaving 5 lumbar (low back), 12 thoracic (mid-back) and 7 cervical (neck) vertebra.  These are stacked up on top of each other like building blocks and are connected to each other by a shock absorbing disk in the front and two smaller facet joints in the back, acting like a tripod.  In the low back, we’re supposed to bear about 80% of our weight in the front and 20% in the back but, if our abdominal muscles are a bit out of shape and the pelvis rotates forwards, the curve in the low back increases and overloads the back of the vertebra (facets) making them vulnerable to injury.  The disk becomes injured when we bend/lift/twist. This can tear the outer tough fibers of the disk, allowing the central more liquid-like material to leak out.  If this happens, the leaking or “herniated” disk can put pressure on the nerve that exits the spine and travels down our leg.  If the pain pattern includes the back of the leg, it’s commonly referred to as “sciatica.”

OK, enough about anatomy.  What can we do to reduce the chances of having periodic low back pain? Obviously, staying in shape is very important. Certain muscles of the body must be tight to keep us upright or standing.  These muscles need to be stretched on a regular basis. For example: the hamstring muscle.  We’ve all had to perform hurdler types of exercises and remember how tight they feel!

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

This is a common complaint occurring as a result of a whiplash injury, but it’s not commonly known, leaving those who are suffering wondering, “…what’s wrong with me?”  Whiplash is an injury that classically occurs as a result of a car crash at any speed, even at low speed!  This is because at low speed, there is little to no damage to the car, and the forces from the crash are not absorbed by the crushing metal.  As a result, those forces are transferred to the contents inside the car - that is, the passengers.  This sometimes results in a significantly greater injury compared to crashes that occur at twice the speed because the latter results in crushing metal. The actual injury that occurs in whiplash is caused by the sudden, rapid movement of the head resulting in varying degrees of injury to the neck, as well as to the contents inside the skull - that is, the brain.  The brain literally “bangs” into the inside walls of the skull when the head is rapidly accelerated during a car crash.  The resulting injury is a concussion.  What’s interesting is that most patients injured in a car crash often don’t mention a concussion nor is it usually asked about at the doctor’s office as other, more obvious injuries are dwelt with. The condition is usually referred to by one of two names:  post-concussive syndrome or mild traumatic brain injury (MTBI).

“Doctor, when I’m reading a book or magazine, sometimes I have to re-read the passage several times before it sinks in.  It’s as though I lose my concentration and I can’t focus on what I just read.  The other day, I was talking to a group of co-workers and I lost my place in the middle of the discussion and had to ask, ‘…now where was I?’  I notice this is happening a lot since the car accident.”

This can be very embarrassing, frustrating, and scary for patients suffering with MTBI. Other symptoms associated with this include difficulty in focusing (blurred vision), headaches, having difficulty in pronouncing certain words (”tongue twisted”), having difficulty in understanding what was said, difficulty remembering numbers or groups of numbers like phone numbers, addresses, birthdates, and so on.  These symptoms can range from mild to severe and can be very disruptive, making work and everyday tasks challenging. 

How long does it last? MTBI can completely clear up in 2 to 6 months without problems or, it can hang on for 2 years or longer, and may even become a permanent residual from the car crash.  In one study, continued problems after a 2 year time frame were reported in close to 20% of those injured 2 years earlier.  This study suggests that about 1 out of 5 may continue to suffer with MTBI and the associated brain-related problems for at least 2 years following a car crash.  However, another study reported the long term “higher cognitive function” (such as the ability to communicate through written or spoken language) is usually not affected by whiplash injuries.  However, they preface that with by reporting that a more commonly injured group with more mild brain problems was found.

As chiropractors, we are trained to do a thorough history, orthopedic and neurological examination, and ask specific questions about mild traumatic brain injury.  It is important to discuss this information with those suffering from whiplash injuries as frequently, MTBI patients think something is “…seriously wrong” and harbor unnecessary anxiety.

We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you

            So what does this have to do with CTS?  This analogy depicts what essentially happens when CTS occurs.  Picture an assembly line worker packaging cookies.  The cookies come out of the oven 6 rows deep at a rapid pace.  There are normally 6 people working the line, 3 on each side, but for the last two weeks, one of the workers has been out on maternity leave and no one was assigned to that position… leaving 5 workers doing the work 6 people usually share.  Let’s say, conservatively, there are 25 cookies packaged per minute.  In 60-minutes, 1500 cookies (25×60) are packaged; in an 8 hour day 12,000 cookies are packed, and in a 40 hour work week, 48,000 cookies are packaged (by each worker)!  That’s a lot of fast, repetitive movements requiring bending forward and reaching, gripping, and moving the cookies into a tray and then stacking the trays.

            If there are workers absent or the employer decides to speed up the line and force overtime, most of the workers will reach their limit and hurt.  Especially those with other problems that make them more susceptible to CTS like low thyroid function, diabetes, obesity, age over 50, inflammatory arthritis, when taking birth control pills…..you get the picture!.  Hence, when working too fast, just like when there are too many cars on the road during rush hour, the fast paced work inflames the tendons in the carpal tunnel and pinches the nerve. This creates pain and numbness/tingling that either slows the worker down or completely forces him/her to have to take time off from the job.  When working at a slower, more comfortable pace, there is less friction between the carpal tunnel tendons and, therefore, no or significantly less nerve compression and CTS signs or symptoms, just like driving through the construction site without slowing down when avoiding rush hour.

            Why is this?  CTS occurs frequently in people who perform fast, repetitive hand movements like our cookie factory worker.  That’s because there are 9 tendons attaching the muscles located in the upper forearm (on the palm side) to the fingers in the hand.  These tendons travel very close together, especially as they pass through the carpal tunnel of the wrist.  These tendons allow us to pick things up (grip and pinch), shake hands, hold babies delicately and function normally in our daily activities.  As these 9 tendons pass through this tight tunnel, when it’s “rush hour” or, when fast, repetitive work is occurring, these 9 tendons rub together and they heat up, swell and the pressure inside the tunnel increases.  Because the nerve (median nerve) passes through the same tunnel, as the tendons swell, the nerve is pinched or pressed up against the border of the tunnel and numbness / tingling occurs into the palm and fingers 2-4.  We find ourselves dropping things, having a hard time buttoning clothes, threading a needle, opening jars, holding onto a steering wheel, and frequently, we wake up at night needing to shake and flick our fingers to “…wake them up.”     

            Because these symptoms gradually appear, we usually don’t run to our doctor until several months (and sometimes years) after the symptoms have been present.  This makes it more challenging to treat CTS and all patients with these symptoms are encouraged to seek treatment as soon as problems start.  There are frequently other problems in the neck, shoulder, and elbow because we tend to compensate, move differently and use other muscles when there is pain so the elbow, shoulder and neck become involved and require attention. This is why a chiropractor who treats all of these areas is the perfect choice. If you, a friend or family member require care for CTS, we would be honored to render our services