Chiropractic

Sleep Tips for Fibro 1-5

~ Dr. Robert Speirs DC ~ Leave a comment

In-bed-after-no-sleep

​Last week, we discussed the connection between sleep disturbance and the presence of widespread pain found with fibromyalgia (FM). This month’s topic will center on how we can improve our sleep quality with the goal of feeling restored upon waking in the morning!

1)  NOISE & LIGHT: Block out noise with earplugs or a sound machine and light with window blinds, heavy curtains, and/or an eye mask. The light emanating from the LED or LCD from TVs, DVRs, or stereos has been found to suppress the pineal gland’s melatonin production (the “sleep hormone”) and thus can interfere with sleep, so try to keep them away from the bedroom. However, a small night light can assist for nighttime bathroom callings!

2) FOOD: Avoid large meals at least two hours before bedtime. Try a glass of milk, yogurt, or a small protein snack if hunger overcomes you. Milk is unique as it contains the amino acid L-tryptophan, which studies show, helps people sleep!

3)  EXERCISE: Aerobic exercise during the day is HIGHLY therapeutic. It reduces stress, reduces pain, reduces depression, and wakes us up! Avoid heavy exercise within three hours before bedtime. Exercise on a REGULAR basis to promote high-quality deep sleep.

4)  SLEEP HABITS: Develop good sleeping habits by going to bed at a regular time. Avoid napping in the late afternoon. A “POWER NAP” of no more than 10-15 minutes, ideally about eight hours after waking, is a GOOD THING as it can help you feel refreshed.

5)  MENTAL TASKS: Avoid mentally stimulating activity one hour before bedtime to calm the brain.

 

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

Migrane Control? How?

~ Dr. Robert Speirs DC ~ Leave a comment

Migrane

​Migraines can be life-altering! They can stop us from being able to enjoy a child’s piano recital, participate in family events, go to work, or simply do household chores! Wouldn’t it be nice to have ways to self-manage these miserable, often disabling headaches? Here are some options!

1. RELAXATION THERAPY: Search for a calm environment, turn off the lights (photophobia, or light sensitivity, is a common migraine complaint), minimize sound/noise (due to “hyperacusis”), and sleep if possible. Monitor the room temperature and/or use hot/cold compresses to the head and/or neck regions to relax tight muscles (heat) and reduce pain and swelling (cold). Similarly, a warm shower or bath can have similar beneficial effects.

2. SLEEP WELL: Migraines can interfere with falling asleep, they can wake you up during the night, and they are often triggered by NOT getting a good night’s sleep. To improve your sleep quality: a) Establish regular sleeping hours. Wake up and go to bed at consistent times every day, including weekends. b) Keep daytime naps short (20-30 min. max). c) “Unwind” at the end of the day – try soothing music, a warm bath, or reading a favorite book (avoid suspenseful movies). d) Don’t eat/drink too much before bedtime as heavy meals, caffeine, nicotine, and alcohol can interfere with sleep. e) Don’t exercise intensely before bedtime (stretching is fine). f) Eliminate distractions in the bedroom, including TV and bringing work to bed. Close the bedroom door and use a fan to muffle out distracting noises. g) If you take any medications, check for known side effects, as many contain caffeine or other stimulants that can interfere with sleep – including some meds that treat migraines! Talk to your doctor and pharmacist!

3. EAT WELL: Be consistent about when you eat and don’t skip meals (fasting increases the risk for migraine). Keep a food journal to figure out your migraine triggers and avoid foods that commonly trigger migraines like chocolate, aged cheeses, caffeine, and alcohol. Try eliminating these and see how you feel!

4. EXERCISE REGULARLY:  This is MOST IMPORTANT for migraine management as it facilitates sleep cycles and stimulates the release of endorphins and enkephlins that help block pain. It also helps fight obesity, which is another risk factor for headaches.

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.

CTS Exercises?

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​CTS Stretch

Carpal Tunnel Syndrome (CTS) is the leading cause of numbness to the middle three fingers and thumb and affects millions of Americans each year. There are MANY potential causes of CTS, and these causes can be unclear or multi-factorial. We have discussed the importance of night splints and what chiropractic can do for CTS in the recent past. This month, let’s look at what YOU can do for CTS.
“Self-help” concepts are VERY important as they empower YOU to gain control of your condition’s signs and symptoms, thus placing less reliance on those of us who manage (in this case) CTS. There is a time for “PRICE” or, Protect, Rest, Ice, Compress, Elevate, such as when most activities make symptoms worse. This is the time for splinting, reducing activities of daily living (which sometimes includes work restrictions), and the use of ice cupping or massage. Patients should initiate movement or exercise-based approaches as soon as such activities can be tolerated. Here are four different exercises you can do:
1. Fist / “Bear Claw” / Open Wide Hand: This is a three-step exercise, and you can start or stop on any of the three “steps.” A. FIST:  Make a fist and squeeze as tightly as tolerated; B. BEAR CLAW: Starting from the fist position (A), open only the palm of the hand (keep your thumb and fingers bent but straighten the big knuckle joints at the base of the fingers); C. OPEN WIDE: Straighten and spread ALL your finger joints by opening up your hand as much as possible and feel for a good stretch in the palm. HOLD each position for one to five seconds (vary the “speed” of moving between the three positions – fast, medium, and slow; emphasize what feels best if you have a preference). Repeat five to ten times or until your hands feel looser.
2. “Church Steeple”: Place your hands together in front of you (“prayer position”) touching the pads of the thumbs and all four fingertips together and spread your fingers as wide as possible. Next, separate your palms as far as you can while applying pressure against your finger/thumb tips and repeat. Alter the speed and number of repetitions until your hands feel stretched out.
3. “Shake and Flick”: Simply shake your hands as if you just washed them and you’re shaking the water off to “air dry” them. Again, alter the speed and reps until they feel loosened up.
4. Forearm Stretches: Place one arm out in front, elbow straight, and fingers pointed straight, palm up (first set). Reach with the opposite hand and pull the fingers, hand, and wrist down and back towards you until you feel a strong “pull” in your forearm muscles. Hold until the forearm muscles feels stretched (5-10 seconds). Repeat this with the palm facing down for the second set to stretch the opposite (extensor) forearm muscles.
Do these on each side two to three times each (even the “good” side) EVERY HOUR (or as often as possible). Think about what you do on a daily basis and if you work in a repetitive manner (on the job or a hobby at home), try to do these exercises DURING THE REPETITIVE ACTIVITY to help keep your symptoms from getting out of control. If you can alter the position or speed of a work or avocational activity, do so for long-term prevention purposes!
If you cannot gain control of your CTS condition, you may need additional treatment options of which chiropractic offers a safe, non-surgical approach.
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.

10 Quick Back Pain Tips

~ Dr. Robert Speirs DC ~ Leave a comment

​

Low back pain (LBP) is VERY likely to affect all of us at some point in life. The question is, do you control IT or does IT control you? Here are ten “tricks” for staying in control of “IT!”
1)  STRETCH: When you’re in one position for a long time (like sitting at your desk), SET your cell phone timer to remind yourself to get moving and stretch every 30-60 minutes! Mornings are a great time to stretch.
2)  BE SMART: Do NOT place your computer monitor anywhere other than directly in front of you. Shop carefully for a GOOD supportive office chair that is comfortable and a good fit.
3)  POSTURE: For sitting, sit as upright as comfortably possible keeping your chin tucked in so the head stays back over the shoulders.
4)  SHOE WEAR: Avoid wearing heels greater than one inch high (2.54 cm). A supportive shoe that can be worn COMFORTABLY for several hours is ideal! Generally, the “skimpier” the shoe, the worse the support, so don’t “skimp” on shoe wear!
5)  SMOKING: Carbon monoxide from cigarette smoke competes with oxygen at each cell in the body literally suffocating them, which makes the healing process more difficult.
6)  WEIGHT: Your body mass index (BMI) should be between 18.5 and 25. Search the internet for “BMI Calculator” and plug in your height and weight to figure out yours.  BMI is a reliable indicator of body fatness and a great way to determine where you are at for goal setting.
7)  ANTI-INFLAMMATION: Common over the counter (OTC) medications include ibuprofen and naproxen. However, recent studies show these types of medications (NSAIDS) may delay the healing process. A healthier choice is ginger, turmeric, and bioflavonoids, which are commonly bundled together in a supplement. Eat fresh fruits, veggies, lean meats, and food rich in omega-3 fatty acids. Vitamin D, magnesium, and coenzyme Q10 are also smart choices. AVOID FAST FOOD as they tent to be rich in omega-6 fatty acids, which can promote inflammation.
8)  ICE: This could be included in #7 but deserves its own space. Ice reduces swelling while heat promotes it. Try rotations of ice every 15-20 minutes for about an hour three times a day to “pump” out the swelling!
9)  STAY ACTIVE: Balance rest with physical activity like exercise or simply going for a walk. The most important thing is to move your body around.
10)  STRENGTHEN: Core stabilizing exercises (sit-ups, planks, quadruped) and BALANCE exercises are VERY important!

Standing Posture Tips

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Standing Posture Tip

While sitting for prolonged periods of time can be hard on your back, the same can be said for prolonged standing.

If you must stand in one place for awhile, try keeping one foot slightly in front of the other, with your knees slightly bent.

This position helps to take the pressure off your low back

Fibromyalgia and Sleep

~ Dr. Robert Speirs DC ~ Leave a comment

​Is there a connection between fibromyalgia (FM) and sleep disturbance? Let’s take a look!

FM is a condition that causes widespread pain and stiffness in muscles and joints. Patients with FM often experience chronic daytime fatigue and some type of sleep problems like getting to sleep, staying asleep, and/or feeling restored in the morning upon waking. The National Institutes of Health estimates between 80-90% of those diagnosed with FM are middle-aged women, although it can affect men and happen at any age. As little as 10-20 years ago, it was hard to find a doctor who “believed” in FM, and it was common for the patient to be told that their pain “was all in their head.” FM has now been studied to the point that we know it is a real condition, and it affects between 2-6% of the general population around the world.

It is well established that sleep disturbance frequently occurs after surgery, which usually normalizes as time passes. One study used a group of healthy women who were deprived of sleep (particularly slow wave sleep) for three days to see if there was a link between sleep disturbance and pain. Results confirmed that the women experienced a decrease in pain tolerance and increased levels of discomfort and fatigue after three days—the same symptoms found among FM sufferers!

Fibromyalgia may have NO known cause, or it can be triggered by other conditions such as repetitive stress injuries, car crash injuries, and other forms of trauma. FM also appears to run in families though it’s still NOT clear if this is a true genetic link or caused by shared environmental factors. Some feel FM is a rheumatoid condition, and though FM is NOT a true form of arthritis, it has been found that people with arthritis are more likely to have FM.

FM sufferers frequently suffer from conditions such as irritable bowel syndrome, chronic fatigue syndrome, migraine headaches, arthritis, lupus, and major depressive disorders. Approximately 20% of FM patients have depression and/or anxiety disorders, and a link between chronic pain and depression exists and seems to play a role in people’s perception of pain.

Because conditions such as sleep apnea can result in symptoms similar to FM, it’s recommended that patients suspected of FM keep a sleep/sleepiness diary in order to rule out sleep apnea as a cause for their condition.

There are many “tips” for improving sleep quality, which we will dive into next month, as these may prove VERY HELPFUL in the management of FM!

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

Teens & Headaches? What?

~ Dr. Robert Speirs DC ~ Leave a comment

Migrane

​In 2016, researchers at Curtin University in Perth examined the seated posture and health data of 1,108 17-year olds in an effort to determine if any particular posture increased the risk of headaches/neck pain among late adolescents.

Among four posture subgroups—upright, intermediate, slumped thorax, and forward head—the researchers observed the following: participants who were slumped in their thoracic spine (mid-back region) and had their head forward when they sat were at higher odds of having mild, moderate, or severe depression; participants classified as having a more upright posture exercised more frequently, females were more likely to sit more upright than males; those who were overweight were more likely to sit with a forward neck posture; and taller people were more likely to sit upright.

While they found biopsychosocial factors like exercise frequency, depression, and body mass index (BMI) ARE associated with headaches and neck pain, their data did not suggest any one particular posture increased the risk of neck pain or headaches more than any other posture among the teenagers involved in the study.

This is noteworthy as studies with adults do indicate the risk for neck pain and headaches is greater in individuals with poor neck posture. In particular, postures such as forward head carriage, pinching a phone between the ear and shoulder, and prolonged neck/head rotation outside of neutral can all increase the risk of cervical disorders. This suggests that in younger bodies, the cause of neck pain and headaches may be multifactoral and not limited to just poor posture and that treatment must address all issues that may increase one’s risk for neck pain/headaches in order to reach a desired outcome.

The good news is that chiropractic has long embraced the biopsychosocial model of healthcare, looking at ALL factors that affect back and neck pain and quality of life. Through patient education, spinal manipulation, mobilization, exercise training, the use of modalities, and more, chiropractors can greatly help those struggling with neck pain and headaches!

Non-surgical Options

~ Dr. Robert Speirs DC ~ Leave a comment

​CTS SUrgery

Continuing with our information on Carpal Tunnel Syndrome, today we will look at non-surgical treatment approaches for carpal tunnel syndrome (CTS) aim to remove pressure on the median nerve where it’s pinched. In a recent review of the literature published on “passive modalities” (non-surgical treatment approaches) for CTS, researchers reviewed studies published between 1990 and 2015 for information on which non-surgical treatment approaches work best. Topping the list is the use of various types of night splints – wrist braces worn at night to prevent bending of the wrist during sleep. The evidence found that night splints were less effective than surgery in the short-term (up to six months) but more effective over the long-term (at 12 and 18 months)!
They did not find studies with a “low risk of bias” (no randomized controlled trial-types of studies) regarding other passive modalities such as ultrasound and electrical stim and hence, they conclude that better quality studies must be conducted before conclusions can be made regarding most of the passive modalities frequently utilized in the management of CTS.
A 2010 study found mobilization treatments and exercises (tendon gliding & nerve gliding) were helpful WHEN patients complied with the treatments and the recommended exercises. Manual therapies, or “hands-on” treatments, are a feature of chiropractic care. Chiropractic treatment for patients with CTS also includes night bracing in addition to manipulation, mobilization, exercise training, nutrition, and ergonomic / workstation modifications, and whole body health awareness.
Doctors of chiropractic understand these non-surgical approaches have limitations. This is why they work with allied healthcare providers when pharmaceutical and/or surgical intervention is appropriate. They may also frequently consult with neurologists for tests such as EMG/NCV (an electrical test that measures the degree of nerve damage) to better understand the patient’s condition. In short, chiropractic offers a multi-modal approach of care, and chiropractors will work with others in the patient’s best interest.
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.