What to do about FM #pain?

Fibromyalgia (FM) is a very common condition affecting approximately ten million Americans (2-4% of the population)—with a ratio of about four women to each man with the disease. Part of the diagnosis and treatment challenge is that many of the complaints associated with FM occur in ALL of us at some point, such as fatigue, generalized whole body aches/pains, non-restorative sleep, depression, anxiety, etc. So what is the difference between the FM sufferer and those without it? Let’s take a look!

The primary distinction between patients with FM and the “rest of us” has to do with the word “chronic.” This term means “…persisting for a long time or constantly recurring; long-standing, long-term.” In fact, the term “fibromyalgia” is described as a complex chronic pain disorder that causes widespread pain and tenderness that may present body wide or migrate around the body. It is also known to “wax and wane over time,” meaning it flares up and down, off and on.

The diagnosis of FM is typically made by eliminating every other possible cause. Hence, after blood tests and x-ray or other imaging, the ABSENCE of other problems helps nail down the diagnosis of “primary fibromyalgia.” Then there is “secondary fibromyalgia,” which is DUE TO a known disorder or condition such as after trauma (like a car accident), rheumatoid arthritis, migraine headache, irritable bowel syndrome, “GERD” (which is heart burn due to reflux), pelvic pain, overactive bladder, tempromandibular joint dysfunction (jaw pain, with or without ringing in the ears), or stress. It’s also often accompanied by anxiety, depression, and/or some other mental health condition.

It should be clearly understood that there is no “cure” for FM. It has also been widely reported in many studies that the BEST management approach for FM is through a TEAM of healthcare providers. This team is frequently made up of primary care doctors, doctors of chiropractic, massage therapists, mental / behavioral specialists, physical therapists, and perhaps others (acupuncturist, nutritionist, stress management specialists, and more).

The “general” treatment approach is typically done with medications, cognitive behavioral therapies (CBT), gentle exercise, and manual therapies. Additionally, patients are encouraged to participate in the healing process via self-management strategies that focus on reducing stress and fatigue, optimizing diet, and developing a consistent sleep habit.

Think of the role of the chiropractor as a strong member of the team. A doctor of chiropractic can offer many of the known methods of managing FM described above, as their training includes diet and nutrition, stress management, exercise training, and ability to provide “whole person care.” Treatments delivered in the chiropractic setting like spinal manipulation, mobilization, and massage offer GREAT relief to FM patients! Again, coordinating care between various providers is the best approach, but you need someone willing and able to do that. A doctor of chiropractic is a great choice!

It is very difficult to manage FM on your own. Let a doctor of chiropractic tailor a treatment plan that is appealing to you and your specific interests. Managing FM is definitely NOT a “…one size fits all” approach like an inhaler is for asthma. Each individual’s situation is too highly unique!60+ Yoga

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Can Chiro Help My Headache?

Migrane

Everyone, well at least almost everyone, has had headaches from time to time, and we all know how miserable they can make us feel. In fact, at some point in time, 9 out of 10 Americans suffer from headaches that range between mild and dull to throbbing, intense, and debilitating, sometimes to the point of requiring bed rest in a dark, quiet room.

The common reflex is to reach for that bottle of pills and pray the headache subsides so you don’t have to call in sick and lose another day of productivity when you have so much to do. Unfortunately, between the side effects of many medications designed to help headaches and the pain associated with the headache, this approach is frequently NOT the answer. So what is?

The good news is that many studies have identified spinal manipulation therapy (SMT), the main type of care utilized by chiropractors, as being very effective for popular types of headaches—in particular tension-type headaches that arise in the neck. An important 2001 study reported that SMT provided almost immediate relief for headaches that arose in the neck with SIGNIFICANTLY fewer side effects and longer-lasting results compared with commonly prescribed medications.

Another interesting study that found similar results included tracking the prevalence/frequency of headaches after treatment stopped. The authors of the study reported the patients receiving SMT had continued to experience sustained benefits throughout the following weeks, and even months, in contrast to those in a medication treatment group where headaches came back almost immediately after they discontinued treatment.

The most commonly prescribed medication for tension-type headaches are non-steroidal anti-inflammatory drugs (NSAIDs). Common over-the-counter options include ibuprofen (Advil, Nuprin, etc.) and Aleve (Naproxen). For those who can’t take NSAIDs because of blood thinning and/or stomach-liver-kidney problems, doctors commonly prescribe acetaminophen (Tylenol), but it can be hard on the liver and kidneys, especially when taken over time.

So, what can you expect from a visit to a chiropractor for your headaches? The typical approach begins with a thorough history and examination with an emphasis of evaluating the neck and its associated function. Your doctor of chiropractic may also perform tests designed to reduce pain and some that provoke a pain response to identify the “pain generator” or cause!

Because each patient is unique, the type of care provided will be individually determined based on the findings, the patient’s age, comfort, and preference of both the provider and patient.

So, the next time you find yourself reaching for pills because of headaches, remember that there are better options! Give chiropractic a try. You’ll be GLAD you did!!!

We realize you have a choice in whom 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 requires care for neck pain or headaches, we would be honored to render our services.

Carpal Tunnel Syndrome #2

Healthcare providers tend to agree that in non-emergency situations, patients with conditions like Carpal Tunnel Syndrome (CTS) should try non-surgical treatments before consulting with a surgeon. The “PRICE” concept, that is Protect, Rest, Ice, Compress, & Elevate can be applied to most injuries, including CTS, especially in the acute/inflammatory stage. However, many of these principles also apply in the chronic stage (more than three months) of CTS.

PROTECT: For the CTS patient, many doctors commonly prescribe a wrist cock-up splint to be worn overnight, which may surprise some of you! During the day, depending on the type of work you do, a wrist splint can actually get in the way and result in increased symptoms, and at times, cause bruising at both ends of the splint (mid-forearm & mid-hand). The primary reason to use the splint at night is that one cannot control the position of their wrist during sleep, and it can often wind up bent. This increases the pressure inside the carpal tunnel up to six to eight times more than normal, potentially causing enough pain and tingling to disturb sleep. The splint guarantees a neutral wrist position, which significantly improves sleep quality and allows healing to occur.

REST: The use of a splint allows the swollen median nerve to heal. However, in order to allow the wrist to rest so inflammation can subside and the condition can fully heal, patients often need to modify their daily activities, at least for a short time. This may require job restrictions, especially if the occupation involves a fast repetitive motion type of tasks and/or forceful gripping.

ICE: The use of an “ice cup”—or an ice cube held with a washcloth to protect the fingertips from getting cold—is by far the most effective approach. Rub the ice directly on the skin over the carpal tunnel so that you experience the four stages of cooling: Cold, Burning, Aching, and Numb (C-BAN). This usually takes about four minutes, and it’s important to stop when numbness occurs, as the next stage of cooling is frostbite. This can be repeated multiple times a day and is often as effective as cortisone shots with fewer side effects (and less pain!).

COMPRESS: The wrist cock-up splint can offer some compression, but an elastic carpal tunnel wrist band will not usually interfere with most activities of daily living. Some versions include a thumb loop to keep the wrist band in place, but that may get in the way. A version without the thumb loop also works very well.

EXERCISE: Exercises performed at home and work can significantly help manage the condition. (Note: For injuries like a sprained ankle, E typically stands for ELEVATE, though it’s not practical for the CTS patient.)

Tune in next month for the unique techniques that chiropractic offers to the non-surgical care of CTS as well as the importance of preventative measures and research.

We realize you have a choice in whom 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 requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

 

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What is Cervical Spondylosis?

CSpine

Cervical spondylosis (CS) is another term for osteoarthritis (OA) of the neck. It is a common, age-related condition that you will probably develop if you live long enough. Or, if you suffered a neck injury as a youth, it can develop within five to ten years of the injury, depending on the severity. According to the Mayo Clinic, CS or OA affects more than 85% of people over 60 years old, and that is probably a conservative estimate!

Common symptoms associated with CS/OA vary widely from no symptoms whatsoever to debilitating pain and stiffness. For example, when CS crowds the holes through which the nerves and/or spinal cord travel, it creates a condition called spinal stenosis that can result in numbness, tingling, and/or weakness. In severe cases, this can even affect bowel or bladder control (which is an EMERGENCY)!

CS occurs when the normal slippery, shiny cartilage surfaces of the joint(s) gradually thin and eventually wear away. Bone spurs often form, which results from the body trying to stabilize an unstable joint. In some cases, the spurs can actually fuse a joint, which often helps reduce pain. (Bone spurs can also form if the intervertebral disks or shock-absorbing pads between the vertebrae are injured or become dehydrated due to arthritic conditions.)

Risk factors associated with CS include: aging, injury, years of heavy lift/carry job demands, and jobs and/or hobbies that require the neck to be outside of a neutral position (like years of pinching a phone between the ear and shoulder). Genetics and bad habits (like smoking) also play a role in CS. Obesity and inactivity also worsens the severity of CS symptoms.

The good news is that even though most of us will have CS, it is usually NOT a disabling condition. However, CS may interfere with our normal activities. Depending on its location, pain may feel worse in certain positions, like when sneezing or coughing or with movements like rotation or looking upwards.

Stiffness is a common symptom, which can vary with weather changes. Too little as well as too much activity can be a problem, but the BEST way to self-manage CS is to keep active! Range of motion exercises, strength training, and walking all help reduce the symptoms of CS.

Doctors of chiropractic are trained to identify CS/OA. Gentle manipulation, mobilization, nutritional counseling, exercise training, modalities (and more) can REALLY HELP!

I have Low Back Pain. Why?

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Low back pain (LBP) can arise from disks, nerves, joints, and the surrounding soft tissues. To simplify the task of determining “What is causing my LBP?” the Quebec Task Force recommends that LBP be divided into three main categories: 1) Mechanical LBP; 2) Nerve root related back pain; and 3) Pathology or fracture. We will address the first two, as they are most commonly managed by chiropractors.
Making the proper diagnosis points your doctor in the right direction regarding treatment. It avoids time wasted by treating an unrelated condition, which runs the risk of increased chances of a poor and/or prolonged recovery. Low back pain is no exception! The “correct” diagnosis allows treatment to be focused and specific so that it will yield the best results.
Mechanical low back pain is the most commonly seen type of back pain, and it encompasses pain that arises from sprains, strains, facet and sacroiliac (SI) syndromes, and more. The main difference between this and nerve root-related LBP is the ABSENCE of a pinched nerve. Hence, pain typically does NOT radiate, and if it does, it rarely goes beyond the knee and normally does not cause weakness in the leg.
The mechanism of injury for both types of LBP can occur when a person does too much, maintains an awkward position for too long, or over bends, lifts, and/or twists. However, LBP can also occur “insidiously” or for seemingly no reason at all. However, in most cases, if one thinks hard enough, they can identify an event or a series of “micro-traumas” extending back in time that may be the “cause” of their current low back pain issues.
Nerve root-related LBP is less common but it is often more severe—as the pain associated with a pinched nerve is often very sharp, can radiate down a leg often to the foot, and cause numbness, tingling, and muscle weakness. The location of the weakness depends on which nerve is pinched. Think of the nerve as a wire to a light and the switch of the nerve is located in the back where it exits the spine. When the switch is turned on (the nerve is pinched), and the “light” turns on—possibly in the outer foot, middle foot, inner foot, or front, back or side of the thigh. In fact, there are seven nerves that innervate or “run” into our leg, so usually, a very specific location “lights up” in the limb.
Determining the cause of your low back pain helps your doctor of chiropractic determine which treatments may work best to alleviate your pain as well as where such treatments can be focused.

Why Crack?

Shrug

We all know what it’s like to have neck pain—whether it’s after a long drive, pinching the phone between the head and shoulder, star-gazing, or from talking to someone who is seated off to the side. There are many causes of neck pain, but the question of the month is, how do chiropractic adjustments help neck pain? Let’s take a look!

Chiropractic, when broken down into its fundamental Greek derivatives, means “hand” (cheir) and “action” (praxis). The technique most often associated with chiropractic is spinal manipulation where a “high velocity, low amplitude” thrust is applied to specific vertebrae in the spine, which does several things: 1) It restores mobility in an area with restricted movement; 2) It stimulates the sensory “neuroreceptors” in joint capsules, which has a muscle relaxing reflex effect; 3) It can affect surrounding neurological structures in certain parts of the spine such as the parasympathetic (cranial & sacral regions) and sympathetic (mid-back) nervous systems, which can have beneficial effects on the digestive system, cardiovascular system, and other body systems not typically thought about when seeking chiropractic care.

Joint manipulation is not new, as it can be traced back to as early as 400 BCE. The profession of chiropractic began in the later 1800s and has grown in popularity ever since. There is now an overwhelming body of evidence that supports spinal manipulation as both a safe and highly effective treatment for neck and back pain, headaches, and many other maladies.

It’s important to note that there are many different types of manual therapies that chiropractors utilize when caring for neck pain patients. There are “low-velocity, low amplitude” or non-thrust techniques that do NOT produce the “crack” that is frequently associated with chiropractic adjustments. The term “mobilization” is often used when referencing these non-thrust methods, and this often incorporates a combination of manual traction (pulling of the neck), left to right and front to back “gliding” movements usually starting lightly and gradually increasing the pressure as tolerated. In many cases, a doctor of chiropractic may utilize a combination of manipulation and mobilization as well as “trigger point therapy” (applying sustained pressure over tight “knots” in muscles), depending on a patient’s needs.