Meds or Chiro first?

Head and Neck

Although both medication and chiropractic are utilized by neck pain sufferers, not everyone wants to or can take certain medications due to unwanted side effects. For those who aren’t sure what to do, wouldn’t it be nice if research was available that could answer the question posted above? Let’s take a look!

When people have neck pain, they have options as to where they can go for care. Many seek treatment from their primary care physician (PCP). The PCP’s approach to neck pain management usually results in a prescription that may include an anti-inflammatory drug (like ibuprofen or Naproxen), a muscle relaxant (like Flexeril / cyclobenzaprine), and/or a pain pill (like hydrocodone / Vicodin). The choice of which medication a PCP recommends hinges on the patient’s presentation, patient preference (driven from advertisements or prior experiences), and/or the PCP’s own preference.

Although it’s becoming increasingly common to have a PCP refer a neck pain patient for chiropractic care, this still does not happen for all neck pain patients in spite of strong research supporting the significant benefits of spinal manipulation to treat neck pain. One such study compared spinal manipulation, acupuncture, and anti-inflammatory medication with the objective of assessing the long-term benefits (at one year) of these three approaches in patients with chronic (>13 weeks) neck pain. The study randomly divided 115 patients into one of three groups that were all treated for nine weeks. Comparison at the one-year point showed that ONLY those who received spinal manipulation had maintained long-term benefits based on a review of seven main outcome measures. The study concludes that for patients with chronic neck pain, spinal manipulation was the ONLY treatment that maintained a significant long-term (one-year) benefit after nine weeks of treatment!

In a 2012 study published in medical journal The Annals of Internal Medicine, 272 acute or sub-acute neck pain patients received one of three treatment approaches: medication, exercise with advice from a health care practitioner, or chiropractic care. Participants were treated for twelve weeks, with outcomes assessed at 2, 4, 8, 12, 26, and 52 weeks. The patients in the chiropractic care and exercise groups significantly outperformed the medication group at the 26-week point AND had more than DOUBLE the likelihood of complete neck pain relief. However, at the one-year point, ONLY the chiropractic group continued to demonstrate long-term benefits! The significant benefits achieved from both exercise and chiropractic treatments when compared with medication make sense as both address the cause of neck pain as opposed to only masking the symptoms.

With results of these studies showing acute, subacute, as well as chronic neck pain responding BEST to chiropractic care, it only makes sense to TRY THIS FIRST!

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Whole Body Approach to Fibromyalgia

Fibromyalgia is a complicated disorder that’s difficult to diagnose because it involves multiple body systems. As a result, there are a myriad of factors in the body that can play a role in a patient’s symptoms. That said, it’s best to take a whole body approach when it comes to treating a complex condition like FM, starting with the nervous system.

When a patient presents to a chiropractor, the initial examination will look at the body as a whole and will not be limited the main area of complaint. This includes a postural examination in regards to individual leg length (to see if one is shorter); the height of the pelvis, shoulder, and occiput (head); and a gait assessment to evaluate the function of the foot, ankle, knee, hip/pelvis, spine, and head.

Because the nervous system is housed in the spine and cranium, chiropractors specifically look at how the spine compensates for abnormal function elsewhere in the body. When spinal segmental dysfunction is present, altered neurological function often coincides, which results in the symptoms that drive people to the office.

The benefits of spinal manipulative therapy (SMT)—the primary form of treatment delivered by doctors of chiropractic—have been recognized by all other healthcare professions including medical doctors, physical therapists, and osteopathic physicians. In fact, referring patients to chiropractors for SMT has become very commonplace in the healthcare environment. Research has proven SMT to be a FIRST course of care and highly recommended for MANY complaints, especially low back, mid-back, and neck pain, headaches, and many more!

Because fibromyalgia (FM) involves the WHOLE BODY—hence its definition of “wide spread pain,” chiropractic offers a unique approach because it too benefits the whole body by restoring function to the nervous system. For example, when balance is off due to a short leg (this affects 90% of the population to some degree), it can tilt the pelvis, which then places stress on the spine so that it must curve (scoliosis) to keep the head level. Correcting the short leg with a heel lift can restore balance to the pelvis, take pressure off the spine, and relieve some of a patient’s pain symptoms.

In prior articles, we have looked at the many benefits chiropractic offers the FM patient in addition to SMT and other manual therapies. Some of these include tips for improving sleep, exercise training (very important in managing FM), diet—specifically an anti-inflammatory diet (rich in anti-oxidants)—and supplementation (such as magnesium, malic acid, omega-3 fatty acids, vitamin D3, Co-enzyme Q10, and more).

Most importantly, studies show that the FM patient is BEST served when a “team” of healthcare professionals work together on behalf of the FM patient. Depending on a patient’s needs, the team can include a doctor of chiropractic, a primary care doctor, a massage therapist, a clinical psychologist, and others.

 

 

Chiropractic & Headaches

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According to the World Health Organization, headaches are among the most common disorders of the nervous system affecting an estimated 47% of adults during the past year. Headaches place a significant burden on both quality of life (personal, social, and occupational) and financial health. They are usually misdiagnosed by healthcare practitioners, and in general, are underestimated, under-recognized, and under-treated around the world. So, what about chiropractic and headaches… Does it help?

Suffice it to say, there are MANY studies showing chiropractic care helps headache sufferers. For instance, in a review of past research studies using an “evidence-based” approach, chiropractic treatment of adults with different types of headaches revealed very positive findings! Researchers note that chiropractic care helps those with episodic or chronic migraine headaches, cervicogenic headache (that is, headaches caused by neck problems), and tension-type headaches (chronic more than episodic). There appears to be additional benefit when chiropractic adjustments are combined with massage, mobilization, and/or adding certain types of exercises, although this was not consistently studied. In the studies that discussed adverse or negative effects of treatment, the researchers noted no serious adverse effects.

In patients suffering from athletic injuries, particularly post-concussion headache (PC-HA), chiropractic care can play a very important role in the patient’s recovery. With an estimated 1.6 to 3.8 million sports-related brain injuries occurring each year, approximately 136,000 involve young high school athletes (although some argue this is “grossly underestimated”).

Several published case studies report significant benefits for post-concussion patients after receiving chiropractic care, some of which included PC-HA from motor vehicle collisions, as well as from slips and falls. For example, one described an improvement in symptoms that included deficits in short-term memory as well as attention problems. In this particular study, a six-year-old boy fell from a slide in the playground, and after 18 months of continuous problems, underwent a course of chiropractic care. After just three weeks of care, his spelling test scores improved from 20% to 80% with even more benefits observed by the eighth week of care!

Another case study looked at a 16-year-old male teenager with a five-week-old football injury who had daily headaches and “a sense of fogginess” (concentration difficulties). He reported significant improvement after the second visit, with near-complete symptom resolution after the fifth visit (within two weeks of care). After seven weeks of care, he successfully returned to normal activities, including playing football.

Dizziness and vertigo are also common residuals from concussion and were present in a 30-year-old woman just three days following a motor vehicle accident. She also complained of headache, neck pain, back pain, and numbness in both arms. The case study noted significant improvement after nine visits within an 18-day time frame.

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.

What is CTS?

If tingling/numbness primarily affects your thumb, index, third, and ring fingers, it very well could be carpal tunnel syndrome, or CTS. Chances are you’ve probably had this condition for months or even longer but it’s been more of a nuisance than a “major problem” and therefore, you probably haven’t “bothered” having it checked out. Let’s take a look at some “facts” about CTS!

WHAT IS CTS? CTS is basically a pinched nerve (the median nerve) that occurs on the palm side of the wrist that innervates the three middle fingers and the thumb on the palm side. This nerve starts in the neck, runs through the shoulder to enter the arm, and travels down the palm side forearm through the carpal tunnel. The carpal tunnel is made up by eight small bones (called “carpal bones”) that form the roof and walls of the tunnel. The floor of the tunnel is a ligament called the transverse carpal ligament. The median nerve lies immediately on the floor, and deeper inside the tunnel are nine tendons that connect the muscles of our forearm to the fingers, which allow us to make a fist and grip. When swelling occurs inside the tunnel, the nerve is pinched against the floor (ligament) and symptoms occur.
SYMPTOMS OF CTS: Symptoms typically start gradually with tingling, numbness, burning, itching, or a “half-sleep” feeling in the palm of the hand, thumb, and middle three fingers. The fingers can feel swollen and weak, though “swelling” is usually NOT visible. CTS can occur in one or both hands, but it is usually worse in the dominant hand. Initially, you may only notice symptoms at night or in the morning. As CTS worsens, sleep interruptions, grip weakness, difficulty distinguishing hot from cold, increased pain, pain radiating up the arm, and more may occur.
CAUSES OF CTS: There are many causes of CTS that often occur in combination: 1) Heredity or genetics — being born with a smaller wrist than others; 2) Trauma — a fall on the arm/hand (sprain or fracture); 3)  Overuse of the arms/hands (like repetitive line work, serving tables, or using a computer), 4) Hormonal causes — during menstruation, with pregnancy, during menopause, diabetes, hypothyroid, overactive pituitary gland; 5) Rheumatoid arthritis; 6) Fluid retention; 7) Cysts, tumors, or spurs inside the tunnel; 8) Vibrating tools, 9) Hobbies such as knitting, sewing, crocheting; 10) sports; or 11) an “Insidious” or unknown cause!
CTS RISK FACTORS: 1) Gender: Women are three times more likely to develop CTS, possibly because they generally have a smaller carpal tunnel than men, in addition to hormonal differences; 2) Diabetes or other metabolic disorders; 3) Adults, especially >50 years old; 4) Job demands.
CTS DIAGNOSIS: Your doctor of chiropractic will review your patient history and then evaluate the neck, shoulder, arm, and hand, as ALL can be involved in producing CTS-like symptoms. He/she may also order blood tests (to check for diabetes, thyroid levels, rheumatoid arthritis, etc.) and/or an EMG/NCV (electromyogram/nerve conduction studies) to test for nerve damage.
We will FINISH THIS interesting discussion next month covering: Treatment, prevention, 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.
480px-Carpal_Tunnel_Syndrome

 

Winnipeg’s Top 5 New Restaurants

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As a food lover it is always nice to see critics agreeing with your choices for top restaurants. This year my top 4 new restaurants in Winnipeg are all named as part of Ciao’s top 5. I have had the chance to try Cordova yet but it is certainly on my list….

Head over to Ciao Winnipeg (Link below) and check out their top 5 new restaurants in Winnipeg.

Ciao’s Top 5 New Restaurants In Winnipeg

 

My Hip Hurts….

hip FAI

​Is it a labral tear? 

One of the structures that is frequently blamed for hip pain is called the labrum—the rubbery tissue that surrounds the socket helping to stabilize the hip joint. This tissue often wears and tears with age, but it can also be torn as a result of a trauma or sports-related injury.

The clinical significance of a labral tear of the hip is controversial, as these can be found in people who don’t have any pain at all. We know from studies of the intervertebral disks located in the lower back that disk herniation is often found in pain-free subjects—between 20-50% of the normal population.  In other words, the presence of abnormalities on an MRI is often poorly associated with patient symptoms, and the presence of a labral tear of the hip appears to be quite similar.

For instance, in a study of 45 volunteers (average age 38, range: 15–66 years old; 60% males) with no history of hip pain, symptoms, injury, or prior surgery, MRIs reviewed by three board-certified radiologists revealed a total of 73% of the hips had abnormalities, of which more than two-thirds were labral tears.

Another interesting study found an equal number of labral tears in a group of professional ballet dancers (both with and without hip pain) and in non-dancer control subjects of similar age and gender.

Another study showed that diagnostic blocks—a pain killer injected into the hip for diagnostic purposes to determine if it’s a pain generator—failed to offer relief for those with labral tears.

Doctors of chiropractic are trained to identify the origins of pain arising from the low back, pelvis, hip, and knee, all of which can mimic or produce hip symptoms.  Utilizing information derived from a careful history, examination, imaging (when appropriate), and functional tests, chiropractors can offer a nonsurgical, noninvasive, safe method of managing hip pain.

“Other” Causes of Low Back Pain

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Between 80% and 90% of the general population will experience an episode of lower back pain (LBP) at least once during their lives. When it affects the young to middle-aged, we often use the term “non-specific LBP” to describe the condition. The geriatric population suffers from the “aging effects” of the spine—things like degenerative joint disease, degenerative disk disease, and spinal stenosis. Fractures caused by osteoporosis can also result in back pain.

The “good news” is that there are rare times when your doctor must consider a serious cause of LBP. That’s why he or she will ask about or check the following during your initial consultation: 1) Have you had bowel or bladder control problems? (This is to make sure a patient doesn’t have “cauda equina syndrome”—a very severely pinched nerve.) 2) Take a patient’s temperature and ask about any recent urinary or respiratory tract infections to rule out spinal infections. 3) To rule out cancer, a doctor may ask about a family or personal history of cancer, recent unexplained weight loss, LBP that won’t go away with time, or sleep interruptions that are out of the ordinary. 4) To rule out fractures, a doctor may also take x-rays if a patient is over age 70 regardless of trauma due to osteoporosis, over age 50 with minor trauma, and at any age with major trauma.
Once a doctor of chiropractic can rule out the “dangerous” causes of LBP, the “KEY” form of treatment is giving reassurance that LBP is manageable and advise LBP sufferers of ALL ages (especially the elderly) to KEEP MOVING! Of course, the speed at which we move depends on many things—first is safety, but perhaps more importantly is to NOT BECOME AFRAID to do things! As we age, we gradually fall out of shape and end up blaming our age for the inability to do simple normal activities. Regardless of age, we must GRADUALLY increase our activities to avoid the trap of sedentary habits resulting in deconditioning followed “fear avoidant behavior!”
Here are a few “surprising” reasons your back may be “killing you”: 1) You’re feeling down – That’s right, having “the blues” and more serious mood disorders, like depression, can make it more difficult to cope with pain. Also, depression often reduces the drive to exercise, may disturb sleep, and can affect dietary decisions—all of which are LBP contributors. 2) Your phone – Poor posture caused by holding a phone between your bent head and shoulder (get a headset!) or prolonged mobile phone use can increase your risk for spinal pain. 3) Your feet hurt, which makes you walk with an altered gait pattern, forcing compensatory movements up the “kinetic chain” leading to LBP. 4) Core muscle weakness, especially if you add to that a “pendulous abdomen” from being overweight—this is a recipe for disaster for LBP. 5) Tight short muscles such as hamstrings, hip rotator muscles, and/or tight hip joint capsules are common problems that contribute to LBP. Stretching exercises can REALLY help!