Weekly Health Update

Mental Attitude: Social Class And Depression Treatment.
Current treatments for depression don't help working-class and poor patients as much as they help middle-class patients improve their ability to function at work. Depression has a profound impact on an individual's productivity. That's particularly true for those in lower social classes and with low levels of education.
Psychological Science, Nov 2010

Health Alert: Kicking It All!
The American Cancer Society's annual Great American Smokeout took place on November 18. Cigarette sales have declined for decades, but smokeless tobacco sales have grown 7% annually over the last four years. Using smokeless tobacco products is not a safe way to quit or safer than smoking. The use of these products just shifts the risk of cancer to the mouth, head, and neck. Use of cigarettes and smokeless tobacco is the leading cause of cancers of the head and neck, which can result in partial or full removal of the lip, tongue, cheek, and portions of the throat, including the voice box. Smokeless tobacco users run the same risks of heart disease, high blood pressure, and addiction as cigarette users, but an even greater risk of oral cancer.
American Academy of Otolaryngology - Head and Neck Surgery, November 2010

Diet: Red Meat And Cancer Risk.
A possible link between red meat and esophageal cancer; and a link between DiMelQx and cancer in the stomach close to the esophageal opening was found. DiMelQx is a compound, a type of heterocyclic amine (HCA) found in red meat after it is cooked at high temperature. Those who eat red and processed meats have a 79% higher risk of developing esophageal cancer.
American Journal of Gastroenterology, October 2010

Exercise: Flat Abs?
Here are a few exercises and tips to help flatten your abs. Improve Your Posture. Slouch and your stomach pooches. For better posture while standing, align your ears over your shoulders, shoulders over hips, hips over knees, and knees over ankles. Keep the fronts of the shoulders open like a shirt on a hanger, instead of a shirt on a peg and draw your navel to your spine. Try the Canoe Twist. Sit upright, interlace your fingers over your stomach to create a solid grip. Exhale, and sweep the interlocked hands, arms, shoulders, and chest to the left, as if "rowing a canoe." Inhale and return to the starting position. Exhale and perform the movement to the right. Alternate for 20 repetitions.
WebMD Feature: Tips for Flat Abs

Chiropractic: Happy Backs!
This is a satisfaction survey of chiropractic care within a military hospital, from a Canadian Armed Forces Pilot Project. Chronic low back pain accounted for most presentations to the chiropractic clinic. The majority of military personnel (94.2%) and referring physicians (80.0%) expressed satisfaction with chiropractic services.
Military Medicine, June 2006

Wellness/Prevention: Tea And Your Heart.
Drinking three cups of tea per day was associated with a decrease of 11% in the incidence of myocardial infarction, or heart attack.
American Journal of Epidemiology, 2001

Happy Holidays Office Hours

Our office will be CLOSED for the Christmas holiday, Friday, Dec. 24th, and for the New Year weekend, Friday, Dec. 31.

We will, however, be OPEN both Tuesdays from 9am to 12pm & 3pm to 6pm to accommodate any patients who may be missing their Friday appointments due to our holiday closings.

PLEASE call our office to reschedule your Friday appointments. Our extra hours on both Tuesdays will enable us to accommodate your needs.

Wishing you and your family Happy Holidays and a Healthy New Year!

Sleep Away Back Pain?

Dear Patients and Friends,

If you have back pain, there is an interesting study you should know about. It might help you get out of pain - while you sleep.

Here's what it's all about: If you don't know how important sleep is, you should. This month's newsletter mentions the results of a study that found subjects who slept 8.5 hours a night lost 55% more weight than subjects who only slept 5.5 hours per night.

Many studies have shown there are negative effects on your health if you don't get enough sleep. Now, a new study says the bed you choose is very important and affects back pain.

That may be nothing new to you since you probably spend approximately one-third of your life sleeping (or trying to sleep). It makes complete sense that your bed will affect back pain.

But what may be new to you is what this study said about which bed you should choose.

The study said it is indeed possible to increase the quality of sleep and reduce pain and discomfort in your back depending on the sleep surface (bed) you use. And the sleep surface you choose should be based on the position you sleep in.

This is much different than just prescribing one bed for all cases of back pain. If the results of this study hold true - different beds should be used for different positions.

So, if you have back pain, it is a good idea to speak with your Chiropractor and figure out which type of bed will be best for you. And if you have any questions, feel free to give us a call at (201) 651-9100.

Getting quality sleep might not only relieve your back pain... it might help you live a healthier, happier life.

Sincerely,
Dr. Brad Butler

Weekly Health Update

Mental Attitude: TV Makes You Fear Sickness.
Watching TV and its heavy dose of medical content in news and drama can lead to more concern about personal health and reduce a person's satisfaction with life. Millions watch medical shows such as Grey's Anatomy and House. Evidence has shown the mass media is powerful in disseminating health knowledge and changing health attitudes and behaviors through such programming. This may lead people to think they are more likely to suffer from the maladies presented on TV. Previous research showed TV viewing can cause people to be less satisfied with their lives because it makes them more materialistic and causes them to overestimate other people's possessions compared to their own.
Mass Communication and Society, September 2010

Health Alert: BPA Levels In Food.
The amount of Bisphenol A (BPA) in fresh and canned food as well as food wrapped in plastic packaging, were almost 1,000 times higher than the "tolerable daily intake" levels set by the EPA. BPA is associated with cardiovascular disease and diabetes in exposed workers, and food is a major exposure source. We know of no studies reporting BPA in US fresh food, canned food, and food in plastic packaging in peer reviewed journals.
American Chemical Society, Nov 2010

Diet: Beet On The Brain.
Drinking beet juice can increase blood flow to the brain in older adults, which could help decrease the risk of dementia. High concentrations of nitrates are found in beets, as well as in celery, cabbage and other leafy green vegetables, like spinach and some lettuce. When you eat high-nitrate foods, good bacteria in the mouth turn nitrate into nitrite. Nitrites help open blood vessels, increasing blood flow and oxygen.
Nitric Oxide: Biology and Chemistry, November 2010

Exercise: Energy Drinks When Exercising?
The US is the world's largest consumer of energy beverages by volume, and consumption is primarily among the ages 11-35. The most common ingredient is caffeine, which ranges from 50-500mg per 16-ounce serving. "One energy beverage during exercise is safe for most healthy individuals. Excess consumption and consumption with other caffeine-containing beverages or alcohol may lead to adverse effects and possibly death," reports John Higgins, MD, author University of Texas Medical School in Houston.
Mayo Clinic, November 2010

Chiropractic: Pain And Itching.
Researchers found the nerve cells that are active when we experience heat pain are also associated with itching. Extreme itching is a common complication following operations and burns. Eczema and other skin disorders can also lead to itchiness. Greater knowledge of the underlying factors paves the way for developing new forms of treatment for itching, for example, activating pain fibers to reduce itching.
Neuron, Nov 2010

Wellness/Prevention: How Much Sleep For Kids?
Newborn baby, up to 18 hours; 1-12 months of age, 14-18 hours; 1-3 years of age, 12-15 hours; 3-5 years of age, 11-13 hours; 5-12 years of age, 9-11 hours; teenagers, 9-10 hours.
Annals of Internal Medicine October, 2010

The Lazy Person's Way To Weight Loss…

Study Says: SLEEP MORE To Drop Pounds!

Are you lazy? Come on - it's just the two of us. You can admit it and it will be our little secret!

Well, even if you aren't "lazy," I'm sure you look for the quickest and easiest way to get things done.

For example, if you had these two weight loss programs - that work equally as well - which one would you pick...

1. You have to wake up at 5:00 a.m. every day and run 5 miles, then you eat almost nothing for breakfast, then almost nothing for lunch, then you workout like a dog for 2 hours after work, and eat a teeny tiny dinner. Then, you go to bed and do it all over again tomorrow. And you do this every day. Or…
2. You take a pill, sleep late... and wake up skinny.

Obviously, you'd probably choose #2. Any sane person would - as long as the "pill" was safe.

Anyways, you get the point.

Well, there is no "pill" that works like that. But, a study has just been published that claims sleeping is a very important part of weight loss.

In fact, research from the University of Chicago showed dieters who slept for 8.5 hours lost 55 percent more body fat than dieters who slept only 5.5 hours.

The authors of the study stated, "Lack of sufficient sleep may compromise the efficacy of typical dietary interventions for weight loss and related metabolic risk reduction."

Researchers think sleep may affect levels of a hormone called ghrelin. Increased levels of this hormone have been shown to increase appetite and increase fat retention. The subjects in this study who slept less claimed to be hungrier than those who slept more. According to the study's authors: "Together, these results suggest that the loss of sleep at times of limited food intake amplifies the pattern of ghrelin-associated changes in human hunger, glucose, fat utilization, and energy metabolism." It should be noted the sample size in this study was small and further research on this subject is needed to make definitive conclusions. While we are on the weight loss topic, here's another study you might find interesting...

Diet & Exercise?

USA Today reports two-thirds of people in the United States are overweight. "Overweight" is defined as being 30 or more pounds over a healthy weight. This means 66% of Americans, because of their weight, are at higher risk for Type 2 Diabetes, heart disease and even some types of cancer. That's why it is so important to lose weight if you are overweight. New research published online in the Journal of the American Medical Association compared exercise combined with diet versus diet only.

Here's what researchers found... At six months, people in the diet-and-exercise group lost an average of 24 pounds and had better reduction in belly fat and liver fat than those in the delayed-exercise group, who lost an average of 18 pounds. After a year, people in the diet-and-exercise group lost 27 pounds compared to 22 pounds in the delayed-exercise group. "This shows that a traditional diet-and-exercise program can work for people who are very obese," says lead author, Bret Goodpaster, an Associate Professor of Medicine at the University of Pittsburgh. Most participants in the study lost between 30-40 pounds... but a handful lost nearly 100.

Recently, a study published in the September 2008 Journal of Obesity raised a few eyebrows. The study contrasted diet versus exercise for weight loss and concluded that, even though exercise may be good for strengthening bones and muscles, improved mental health and mood, lowering blood pressure, improved cholesterol levels and reduced the risk of cardiovascular disease, diabetes, breast cancer and colon cancer... it may not be the best thing for weight loss. According to one of the study's authors: "We would love to say that physical activity has a positive effect on weight control, but that does not appear to be the case." This obviously contradicts the previous study mentioned in this newsletter, at least on the surface. This is one of the problems with studies - they are often conflicting, which is why common sense must enter into your decision-making process.

Researchers in the last study mentioned the reason exercise may not have been effective in weight less is because an increase in exercise may cause people to eat more. This clearly does not mean exercise is not effective - it means people were unable to control what they ate. Just because some people use a little exercise as an excuse to eat whatever they want does not mean exercise is not effective.

"All Natural" Foods That Are Far From All Natural

We all want to eat as healthy as possible, but with time constraints and money issues, eating right can be very difficult. Now there is one more hurdle you must watch out for...

And that hurdle is: Food companies making blatantly false claims about their products. For example, Ben & Jerry's seems to be a great company. They contribute greatly to many causes such as family farmers, climate change, etc. - all great stuff. But, their claim that their ice cream is made from "all natural" ingredients is false.

According to food.change.org; "The Center for Science in the Public Interest (CSPI) recently asked Ben & Jerry's to remove the 'all natural' stamp from its ice cream containers, claiming that ingredients like high fructose corn syrup, alkalized cocoa, and hydrogenated oil are far from natural. These ingredients are, in fact, quite heavily processed." Ben & Jerry's heeded CSPI's demands and agreed to remove the "all natural" label from its ice cream containers.

Ben & Jerry's may be the one taking heat from CSPI, but the ice cream maker is hardly alone in its misuse of the "all natural" label. Other ice-cream makers like Edy's/Dreyer's, Breyer's, Friendly's, Turkey Hill, and more do the same exact thing. This problem is not isolated to just ice cream. The real problem is that while the U.S. Department of Agriculture regulates the "all natural" claim, they have no real definition of what an "all natural" food item is.

Ben & Jerry's voluntarily removed the "all natural" label from its products. Others have not.

Do You Or Your Kids Eat McDonalds?

This is a shock - but not surprising. Manhattan artist, Sally Davies, photographed a McDonald's Happy Meal every day for 6 months. The results? The Happy Meal did not appear to age. There was no mold or evidence of decay. In fact, the pictures at 6 months show it to look as fresh as the day it was bought.

Here's something even more shocking: Wellness educator and nutrition consultant, Karen Hanrahan, has kept a McDonald's hamburger since 1996 to illustrate its nonexistent ability to decay. Aside from drying out a bit and having "the oddest smell," it apparently hasn't changed much in the past 12 years.

Something to think about before stopping at the drive-thru...

And don't forget, if you ever have any questions or concerns about your health talk to us. Contact us with your questions. We're here to help and don't enjoy anything more than participating in your lifelong good health.

Health Update: Whiplash! Do I Need an Attorney?

When you hear the word, "whiplash," it brings to mind many different thoughts - motor vehicle collision (MVC), neck pain, headaches, concussion, jaw pain, litigation, car damage estimates - possibly a new car, medical costs, doctor's appointments, sleepless nights, and more. Questions typically asked when a MVC occurs include the following:

1. Do I need to get an attorney?
2. What can I expect for recovery time from my neck pain?
3. Why is it taking so long to get my car fixed?
4. Should I talk to the insurance company when they call?
5. I have to give a deposition next week. What is that?
6. My case didn't settle and we're going to court. How do I prepare for that?
7. The insurance company is offering $XXXX.XX for a settlement. What do you think my problems will be down the road?

Let's take a look at these!

1. Should you obtain the services of an attorney? If you want to significantly reduce your stress when it comes time to negotiating with the insurance company, especially towards the end of the process, then YES! Needless to say, you HAVE TO seek council if you plan to not settle and need to go to court. However, you do not have to get an attorney immediately unless you just don't want to deal with the insurance company at all. Typically, it's worth having an attorney as they are experienced in "...the process."
2. Recovery from neck pain can vary between a simple strain at 2-6 weeks to a herniated disk that may require surgery. We recommend you ask us this question about once a month as it will help you decide about this as well as questions 1 and 7.
3. The insurance company may delay the payment of the car repair costs for a number of reasons. Until the insurance company inspects the car's damages, they will not authorize the repair shop work, which can take weeks!
4. If you have hired an attorney, he/she will communicate for you. If not, it is appropriate for you to communicate with the insurance company. The important thing is to NOT settle the claim until you're sure you can do all of your pre-MVC activities without difficulty or pain, which often can take a full year or more.
5. These are call "discovery depositions" where you will be asked questions about the accident such as, where you hurt, what you can and can't do since the MVC, what tests and treatment you've received and what the results were. Your attorney will tell you the strengths and weaknesses of your case. The deposition "process" is quite easy and there is no reason to feel intimidated. Most attorneys are very courteous and will treat you kindly so don't worry unnecessarily!
6. Preparing for court is similar except you can't ask questions - they ask & you answer! Your attorney will tell you to answer only the question being asked and your attorney will later be able to ask you to clarify what was "left out." Always be kind, courteous, and NEVER let the other attorney get you angry!
7. See #2 above. If you have ongoing radiating pain in your arm (from your neck) or leg (from your low back), the "prognosis" for complete recovery is less favorable. Similarly, if you have ligament damage in your neck, there will probably be an accelerated pace of arthritis formation that may not bother you much for 5-10 years or longer but may later in life. We, as your expert witness, will describe your "impairment" and bring this to the jury's attention.

We hope this information is appreciated! We realize that you have a choice in where you go for your health care needs. We truly appreciate your consideration in allowing us to help you through this potentially difficult process.

Health Update: Headaches - How Does Chiropractic Work?

Headaches are a common complaint at chiropractic clinics. There are many causes of headaches, some of which are "idiopathic" or, unknown. Some headaches arise from "vascular" (blood vessels) causes such as migraine and cluster headaches. These often include nausea and/or vomiting and can be quite disabling and require rest in a dark, quiet place sometimes for a half or a whole day. Another type of headaches can be categorized as "tension" headaches. These usually result from tightness in the muscles in the neck and upper back caused from stress, work, lack of sleep, sinusitis, trauma such as whiplash, and others.

So "how does chiropractic work?" To answer this, let's first discuss what we do when the headache patient comes in. First, the history is very important! Here, we'll ask "how/when did the headaches start. This may glean the actual cause of headaches such as a car accident or injury of some sort. Next, we'll ask about activities that increase or create the headache, which gives us ideas of how we might help manage the headache patient. For example, when certain activities precipitate the onset of a headache, we will modify the work station and/or give specific exercises on a regular schedule to keep the neck tension under control. When information gathered about what decreases or helps the neck pain and headaches, we will recommend treatments often that can be done at home such as a home traction unit. This would be suggested if we are told that "...pulling on my neck feels great!" The quality of pain (throbbing = v ascular, ache and tightness = neck), intensity of pain (0-10 pain scale), and timing (worse in the morning vs. evening) help us track change after treatment is rendered, usually gathered once a month. The examination includes blood pressure which can in itself create headaches when high, looking in the eyes to view the blood vessels in the back of the eye to make sure there is no evidence of increased pressure against the brain, ears - to see if there is an infection or wax blockage. This can help if there is dizziness and/or balance loss. We will sometimes listen to the throat as well as the heart to see if there may be a blockage, a valve problem, or other issues. Neck muscle tightness (spasm) will be evaluated along with the range of motion, paying particular attention to the positions/directions that increases and decreases pain, especially those that decrease pain. Nerve function by checking reflexes, sensation and muscle strength as well a s correlating information like positions that decrease arm or leg pain will be included as any position that reduces pain in the arm or leg must be incorporated into an exercise. X-rays may include bending "stress" views so that ligaments (that hold bones together) can be evaluated for "laxity" (torn and unstable). When this is found, we avoid adjustments to these vertebrae.

As you can see, if is very important do a thorough evaluation so headache patients can be properly managed. Treatment approaches include: 1. Adjustments; 2. Soft tissue therapy (trigger point stimulation, myofascial release); 3. Posture correction exercises and other exercises; 4. Education about job modifications; 5. Co-management with other health care providers, if medication or injection therapy is needed.

We realize you have a choice in healthcare providers. If you, a friend or family member requires care for headaches, 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.

Health Update: Fibromyalgia: How Do I Know I Have It?

"I wake up every morning with this stiff, sore lower back pain. When I roll over to get out of bed, I feel like a log and almost have to fall out of bed. When I finally get to my feet, I'm all bent over and can't stand upright for what seems like forever! It takes a couple of hours before it gradually loosens up enough so I don't have to shuffle with each step. I was told by a friend that I might have something called fibromyalgia and should ask my chiropractor. What do you think?"

To answer this inquiry, let's first define fibromyalgia (FM) so that we can compare the two properly. FM is a condition that is diagnosed basically by eliminating all other possible causes, including inflammatory joint conditions, by running various blood tests such as an arthritic profile. This usually includes tests for rheumatoid arthritis, gout, lupus, and infection. A Lymes disease test is often included as that condition can often manifest as a chronic back condition from any cause. There are essentially no blood tests, x-ray or other imaging tests, or neurological tests that can specifically diagnose FM. It is when all these tests come back negative, that the diagnosis of FM is then entertained. The history is probably the most important aspect of the clinical encounter that helps in the diagnosis of FM. Most of these patients will report that the onset is gradual, often present for years. There is usually no specific cause though there are specific conditions (such as irritable bowel syndrom e, trauma, rheumatoid arthritis and others) that can result in "secondary fibromyalgia" where the cause is well known. The big differentiating historical feature is the presence of widespread, whole body pain - NOT just low back pain, as reported in the first paragraph above. In FM, there is often pain in the legs, arms, torso, back, neck and these people basically, "...hurt all over." Typically there is no radiating pain down the leg or arm that follows a specific nerve pathway and no exam findings of neurological deficits. Another unique feature of FM includes sleep dysfunction. In many cases, sleep interruptions occur 2, 3 or more times a night, often with difficulty in returning back to sleep. The quality of pain is often described as numbness, tingling, burning, achy, deep, boring, and most importantly generalized in location (all over the body). The intensity is usually reported as high (>6/10 pain scale scores). The past history usually includes m ultiple visits to many different types of doctors and many attempts at different medications is common - most of which do not help significantly.

Even with these unique historical features that are consistent with the diagnosis of FM, it is still necessary to "rule out" other conditions by running tests as previously described. This is especially important when FM is secondary to other conditions as FM can get "lost" in the shuffle, overshadowed by the other condition.

Treatment for FM includes many of the same methods for treating other musculoskeletal conditions. Spinal manipulation, soft tissue release techniques (massage therapy, trigger point therapy, myofascial release), and various forms of physical therapy (low level laser therapy - LLLT, ultrasound, interferential electrical current - IFC, and pulsed magnetic therapy can also improve function, reduce pain, and reduce the need for medications. Cognitive therapy, addressing psychosocial issues, can also be very effective. One of the most important treatment approaches is exercise. This has been consistently described as being an important form of care for the FM patient. In addition, dietary management using an anti-inflammatory diet (gluten free diet) and supplementation (a multiple vitamin, calcium/magnesium, omega 3 fatty acids, Vit. D, and CoQ10) can also be very effective.

We recognize the importance of including chiropractic in your treatment 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.

Health Update: Carpal Tunnel Syndrome: Why Braces?

For those of you who have had Carpal Tunnel Syndrome, you probably know all about braces. These are devices worn on the wrist that stop you from bending the wrist up or down. They may be worn anytime of the day if they don't interfere too much with one's current activity but are especially worn at night. One might think it would be more important to wear these during day when we are active and moving our fingers and hands a lot as we go about our normal work or play activities - not at night when we're basically just laying there doing nothing but sleeping, right? Wrong! It's more important to wear these at night. This is because we cannot control our hand/wrist position at night as we tend to curl up in a ball when we sleep and the wrist gets cocked up or down, often to the end point of the range. So, why is this so bad? To answer that question, let's look at the chart below on the left.

In the chart (above left), you are looking at a cross section of the wrist through the carpal tunnel. This illustrates the many structures that are inside the tunnel making it very compact or tight. Notice the small white circles in the middle of the tunnel. Those are the tendons that pass through the tunnel - there are 9 of those and they attach the muscles in our forearms (on the palm side) to our fingers so we can shake someone's hand or carry a suitcase (grip). Just to the left of center, on top of all the tendons sits the median nerve, which is just below the "roof" of the tunnel (the transverse carpal ligament). Now, normally, the pressure inside the carpal tunnel will approximately double when we bend our wrist, putting more pressure on the nerve and pushing it into the roof (ligament), which creates the numbness and/or weakness in our grip. But in the CTS sufferer, there is already more pressure in the tunnel due to th e swollen tendons so when the wrist is flexed or extended, the pressure goes up much more the twice - more like 6 times more pressure - hence, more symptoms. So, if we're sleeping with our wrist bent either way, the pressure pushing the nerve against the roof is a lot more than normal - 6x more! Now, can you see the reason for the "night splint?" It is VERY effective in keeping the wrist straight or "in a neutral position," which is needed to allow the nerve to NOT be pinched so it can heal.

Regarding braces, there are MANY different kinds of braces available and deciding which one to use is no easy task, not to mention the fact that they come in different sizes! When you are treated for CTS at this office, we will fit you with the proper size brace, if it's necessary. We realize you have a choice in health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend or family member require care for CTS, we would be honored to render our services.

Health Update: Low Back Pain and Bone Density

So, what does bone density have to do with low back pain? The relationship between bone density and back pain is quite intimate. In fact, when the degree of bone density declines to the point of fracture, back pain becomes very real. The classic condition and cause of spinal pain associated with the loss of bone density is compression fracture.

Compression fractures occur when the strength of the bone decreases to a point where minor trauma and sometimes, no trauma whatsoever can result in fracture. Compression fractures affect the vertebral body (front of the spine) most often in the upper lumbar or lower thoracic spine but the pain associated with these types of fractures frequently radiates into the low back and pelvic region. In the elderly osteoporotic spine, these types of fractures usually do not result in spinal cord injury or nerve damage but this is quite the opposite when compression fractures occur in younger, normal bone density individuals. This is because when the bone is dense (or normal), the vertebral body basically explodes or bursts shifting some of the bony fragments back into the spinal canal where the spinal cord is located. When bone density decreases, there is no bursting of fragments - only collapse, resulting in pain but no neurological dam age. Besides pain, another problem with compression fractures is that the once upright or vertical spine is now bent and angles forward shifting the patient's weight to the front. This shift places yet more pressure on both the fractured vertebra and the surrounding vertebra which increases the risk of fracture to the surrounding adjacent vertebra. Therefore, multiple compression fractures are not uncommon when brittle bones occur from osteoporosis.

So who is more at risk for osteoporosis? The usual predictors include age, (older than 65), gender (female), race (Asian or Caucasian), low body weight, and previous fracture. Others include smoking, previous use of corticosteroids, a family history of fracture, excessive alcohol use, and rheumatoid arthritis. Additionally, vitamin D deficiency, thyroid or parathyroid increased function, and celiac disease (gluten intolerance) as well as poor balance (repeated falls), muscle weakness and a DEXA (dual-energy X-ray absorptiometry) T-score of -1.1 to -2.4 (osteopenia) or -2.5 or greater (osteoporosis) are also important predictors of brittle bone disease or osteoporosis. To best determine your risk using these factors, go to FRAX (www.sheffield.ac.uk/frax) developed by the World Health Organization (WHO) to determine your 10-year fracture probability (do not just use of the T-score on the DEXA scan).

From a treatment standpoint, it depends on the age of the patient, the degree of osteoporosis, and whether fracture has already occurred. In the younger, osteopenic person (that is, no fractures have occurred yet but bone density is low), non-medication approaches such as weight bearing exercise, no smoking, calcium / vitamin D supplementation, and minimize the other risk factors described above may be the proper choice. For others already with fracture, medication (bisphosphonates such as Actonel, Boniva, & Fosamax) may be appropriate. Further, injecting a cement into the bone (called kyphoplasty) may be appropriate for some.

We realize you have a choice in healthcare providers. If you, a friend or a 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.

Did You Know?

Shoppers who do not regularly wash their reusable grocery bags may be placing themselves and their families at heightened risk of food borne illness.

It is estimated there are about 76,000,000 cases of food borne illness in the United States every year. Most of these illnesses originate in the home from improper cooking or handling of foods. Reusable bags, if not properly washed between uses, create the potential for cross-contamination of foods.

Only 3 percent of shoppers wash their reusable grocery bags out regularly. Most shoppers don't use separate bags for meat and produce, and some shoppers even use their bags for toting objects other than food. Contamination potential exists when raw meat products and foods traditionally eaten uncooked (fruits and vegetables) are carried in the same bags, either together or between uses. This risk can be increased by the growth of bacteria in the bags.

Washing the bags by machine or hand reduces bacterial presence to nearly zero.

"Baby It's Cold Outside" Clothing & Food Drive

Help us donate to the less fortunate this holiday season.

Donate your unwanted winter apparel (in good condition), as well as non-perishable food. Items will be distributed to food pantries, charities and community organizations, such as Jersey Cares, Goodwill, The Salvation Army and local New Jersey community groups.

Simply place your donated items in our Clothing & Food Drive Drop-off Box at 350 Ramapo Valley Road in Oakland and we’ll take care of the rest.

Non-Perishable Food Items:
Such as: Cereals, Canned Fruits & Vegetables, Soups, Gravies, Juice Boxes, Coffee, Tea, Jam, Crackers, Cookies, Rice, Pasta, Potato Flakes, Stuffing, Baby Food, etc...

Clothing in Good Condition:
Winter Coats, Hats, Gloves & Scarves

Drive ends January 10, 2011.
Your participation would be greatly appreciated by so many.