Trigger points in the trapezius muscle.

The trapezius muscle is a large diamond shaped muscle located in your back. This muscle is often overloaded due to poor sitting posture or excessive exercise. When this occurs trigger points will form. These points can cause back, neck, and shoulder pain. Trigger points in the upper traps are a leading cause of headache.

Advertisements

Fibromyalgia Diet?

01-signs-healthy-fats-mufa

Folks suffering with fibromyalgia (FM) commonly complain that certain foods can make their symptoms worse. How common is this? One study reported 42% of FM patients found that certain foods worsened their symptoms!

Because FM affects each person differently, there is no ONE FM diet or, “…one size fits all” when it comes to eating “right” for FM. Patients with FM usually find out by trial and error which foods work vs. those that consistently don’t. However, remembering which foods do what can be a challenge so FIRST, make a three column FOOD LOG with the following headings: BETTER, NO CHANGE, WORSE. This will allow you to QUICKLY review the list as a memory refresher.

According to Dr. Ginevra Liptan, medical director of the Frida Center for Fibromyalgia (Portland, OR) and author of Figuring Out Fibromyalgia: Current Science and the Most Effective Treatments, there are some common trends she’s observed through treating FM patients. Here are some of her recommendations:

PAY ATTENTION TO HOW FOOD MAKES YOU FEEL: It is quite common to have “sensitivities” to certain foods, but this is highly variable from person to person. Examples of problematic foods/ingredients include: MSG (commonly used in Chinese food), other preservatives, eggs, gluten, and dairy. Dr. Liptan HIGHLY recommends the food journal approach! She also recommends including a note about the type of symptoms noticed with each “WORSE” food, as symptoms can vary significantly.

ELIMINATE CERTAIN FOODS: If you suspect a certain food may be problematic, try an elimination challenge diet. That means STOP eating that food for six to eight weeks and then ADD it back into your diet and see how you feel. Remember, FM sufferers frequently have irritable bowel syndrome, also known as IBS, and this approach can be REALLY HELPFUL! Food allergies may be part of the problem, and your doctor may refer you for a consult with an allergist and/or a dietician. They will also discuss the “anti-inflammatory diet” with you.

EAT HEALTHY: In general, your diet should emphasize fruits and vegetables and lean protein. Pre-prepare food so you have something “healthy” to reach for rather than a less healthy snack when you’re hungry and tired. Consider “pre-washed” and pre-cut up vegetables; try quinoa rather than pasta. Consume anti-fatigue foods and eat multiple small meals daily vs. one to two large meals. Protein snacks (like a hardboiled egg or oatmeal – GLUTEN FREE) help a lot! Eat breakfast and include protein. Also, GET ENOUGH SLEEP (at least seven to eight hours and be consistent)!

SUPPLEMENTS: Consider a good general multi-vitamin, calcium and magnesium, omega-3 fatty acids, vitamin D3, and Co-Enzyme Q10. There are others, but this represents a great place to start. Remember to check any medication you may be taking with these/any suggestions before taking supplements!

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

Fibromyalgia and Sleep

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!

Whiplash; what can I expect?

HA20.png

Whiplash, or “Whiplash Associated Disorders” or WAD, is the result of a sudden “crack the whip” of the head on the neck due to a slip and fall, sports injury, a violent act, or most commonly, a motor vehicle collision (MVC), particularly a rear-end collision. In describing “what can I expect” after a whiplash injury, one thing is for certain, there are many faces of whiplash, meaning the degree of injury can range from none to catastrophic depending on many factors, some of which are difficult or impossible to identify or calculate. Let’s take a closer look!

Even though the good news is that most people injured in a car crash get better, 10% do not and go on to have chronic pain, of which about half have significant difficulty working and/or doing desired everyday activities. There is a “great debate” as to the way experts describe “chronic whiplash syndrome” (CWS) as well as how these cases should be managed. Some feel there is something PHYSICALLY wrong in the CWS patient, especially if severe neck or head pain persists for more than one year. There is some proof of this as Dr. Nikolai Bogduk from the University of Newcastle in Australia and colleagues have used selective nerve blocks to anesthetize specific joints in the neck to determine exactly where the pain is generated. The patient then has the option to have that nerve cauterized or burned and pain relief can be significant in many cases. Dr. Bogduk and his group admit that these CWS patients have more psychological symptoms, but they feel this is the result of pain, not the CAUSE.

On the other hand, experts such as Dr. Henry Berry from the University of Toronto report the EXACT OPPOSITE. He argues that it’s not JUST the physical injury that has to be dealt with but also the person’s “state of mind.” Dr. Berry states that when stepping back and looking at all the complaints or symptoms from a distance, “…you see these symptoms can be caused by life stress, the illness ‘role’ as a way of adjusting to life, psychiatric disorders, or even [made up by the patient].” Berry contends that it’s important to tell the patient their pain will go away soon, advises NO MORE THAN two weeks of physical therapy, and sends people back to work ASAP.

Oregon Health Sciences University School of Medicine’s Dr. Michael D. Freeman, whose expertise lay in epidemiology and forensic science, disagrees with Dr. Berry stating that the scientific literature clearly supports the physical injury concept and states, “…the idea that it is a psychological disturbance is a myth that has been perpetuated with absolutely no scientific basis at all.” Dr. Freeman states that 45% of people with chronic neck pain were injured in a motor vehicle crash (which includes three million of the six million of those injured in car crashes every year in the United States).

Here’s the “take home” to consider: 1) CWS occurs in about 10% of rear-end collisions; 2) Some doctors feel the pain is physically generated from specific nerves inside the neck joints; 3) Others argue it’s a combination of psychological factors and care should focus on preventing sufferers from becoming chronic patients.

Many studies report that chiropractic offers fast, cost-effective benefits for whiplash-injured patients with faster return to work times and higher levels of patient satisfaction.

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 Whiplash, we would be honored to render our services.

Trigger points in the gluteus Maximus muscle.

The gluteus Maximus muscle makes up your buttock. It’s is a powerful hip extensor and thus used heavily during activities such as walking, running, and climbing up stairs. Most atheletes abuse this muscle. When overworked trigger points will form, and these points will cause pain to be felt in the hip, sacrum and the as well as deep in the gluteal area. Litterally a pain in the butt!! Trigger points won’t release on their own and require interventions like trigger point massage.

Fibromyalgia sleep tips

In-bed-after-no-sleep

Last month, 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.

6)  MENTAL CLARITY: Avoid bedtime worries. Try NOT to think about things that are upsetting. Substitute positive thoughts, experiences, and/or visualize favorite hobbies that free up the mind. Try to avoid discussing emotional issues before bedtime.

7)  PETS: They are GREAT companions but NOT in the bed at night! Not only can pets kicking and moving disturb rest, their dander can stir up allergies and interfere with sleep.

8)  TEMPERATURE: A well-ventilated and temperature controlled (54-74° F or 12.2-23.3° Celsius) bedroom is “key.”

9)  BEDROOM “RULES”: The bedroom is for two things: physical intamacy and sleeping. If you wake up in the middle of the night, go to another room and read a book or watch TV until you feel sleepy.

10)  AVOID STIMULANTS: AVOID nicotine, caffeine, coffee, chocolate, tea, soft drinks, and various over-the-counter or prescription medications in the late evening, unless under instruction from your physician.

11)  RELAXATION TECHNIQUES: Try one (there are many) and practice it at bedtime.

12)  REFRAIN FROM DRINKING ALCOHOL: Alcohol is a nervous system depressant and can HELP you fall asleep, BUT a rebound withdrawal can cause nightmares and night sweats. Avoid this close to bedtime (switch to water!).

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

Can a low speed crash cause injury?

22

There is certainly a lot of interest in concussion these days between big screen movies, football, and other sports-related injuries. Concussion, traumatic brain injury (TBI), and mild traumatic brain injury (mTBI) are often used interchangeably. Though mTBI is NOT the first thing we think about in a low-speed motor vehicle collision (MVC), it does happen. So how often do MVC-related TBIs occur, how does one know they have it, and is it usually permanent or long lasting?

Here are some interesting statistics: 1) The incidence rate of fatal and hospitalized TBI in 1994 was estimated to be 91/100,000 (~1%); 2) Each year in the United States, for every person who dies from a brain injury, five are admitted to hospitals and an additional 26 seek treatment for TBI; 3) About 80% of TBIs are considered mild (mTBI); 4) Many mTBIs result from MVCs, but little is known or reported about the crash characteristics. 5) The majority (about 80%) of mTBI improve within three months, while 20% have symptoms for more than six months that can include memory issues, depression, and cognitive difficulty (formulating thought and staying on task). Long-term, unresolved TBI is often referred to as “post-concussive syndrome.”

In one study, researchers followed car crash victims who were admitted into the hospital and found 37.7% were diagnosed with TBI, of which the majority (79%) were defined as minor by a tool called Maximum Abbreviated Injury Scale (MAIS) with a score of one or two (out of a possible six) for head injuries. In contrast to more severe TBIs, mild TBIs occur more often in women, younger drivers, and those who were wearing seatbelts at the time of the crash. Mild TBI is also more prevalent in frontal vs. lateral (“T-bone”) crashes.

As stated previously, we don’t think about our brains being injured in a car crash as much as we do other areas of our body that may be injured—like the neck. In fact, MOST patients only talk about their pain, and their doctor of chiropractic has to specifically ask them about their brain-related symptoms.

How do you know if you have mTBI? An instrument called the Traumatic Brain Injury Questionnaire can be helpful as a screen and can be repeated to monitor improvement. Why does mTBI persist in the “unlucky” 20%? Advanced imaging has come a long way in helping show nerve damage associated with TBI such as DTI (diffuse tensor imaging), but it’s not quite yet readily available. Functional MRI (fMRI) and a type of PET scanning (FDG-PET) help as well, but brain profusion SPECT, which measures the blood flow within the brain and activity patterns at this time, seems the most sensitive.

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 Whiplash, we would be honored to render our services.