Weekly Health Update

Mental Attitude: Risks For Quitting College.
40% of students in the US fail to get a bachelor's degree within 6 years at the college where they began. Surprisingly, events such as a death in the family and students' failure to get their intended major did not have a significant influence. The critical event with the most influence was depression. Other reasons include recruitment by an employer or another institution; losing financial aid or experiencing a large increase in tuition or living costs; unexpected bad grades; and roommate conflicts.
Journal Organizational Behavior and Human Decision Processes, Feb 2011

Health Alert: Cough It Up.
Research has linked over-the-counter cough and cold products to poisoning or death in hundreds of children, ages 2 and younger. Studies also show these medicines do little to control symptoms. In 2008, the FDA formally recommended OTC cough and cold products not be given to children under age 2. 61% of parents of children ages 2 and younger gave their children OTC cough and cold medicine within the last 12 months. More than half of parents report their child's doctor says OTC cough and cold medications are safe for children under 2.
University of Michigan Health System, Feb 2011

Diet: Too Fat!
The rate of obesity among children and adolescents in the US has nearly tripled between the1980s and 2000s. Childhood obesity can lead to diabetes, high blood pressure, heart disease, sleep problems, cancer, liver disease, skin infections, asthma and other respiratory problems later in life.
Pediatrics Journal, February 2011

Exercise: The "Skinny" on Exercise.
Exercise boosts blood circulation and the delivery of nutrients to your skin, helping to detoxify the body by removing toxins. As exercise boosts oxygen to the skin, it helps increase the production of collagen, the connective tissue that keeps your skin elastic.
Mayo Clinic, Feb 2011

Chiropractic: Headache Help!
A study compared 6 weeks of chiropractic adjusting for tension-type headaches to 6 weeks of medical treatment with amitriptyline, a medication often prescribed for severe tension headache pain. Chiropractic patients experienced fewer side effects (82.1%) and only chiropractic patients continued to report fewer headaches when treatment ended.
JMPT, 1995

Wellness/Prevention: Zinc!
The cold accounts for 40% of sickness absence from work and millions of school days missed each year. Zinc taken within a day of cold symptoms can reduce severity and shorten the length of illness. At 7 days after onset, a higher proportion of people who took zinc reported no cold symptoms compared to those who took a placebo.
The Cochrane Library, Feb 2011

Weekly Health Update

Mental Attitude: A Positive Attitude Helps.
Joint replacement patients who have a positive mindset prior to surgery are more likely to have better functional outcomes. Patients with poor pre-operative emotional health, poor coping skills, little social support and who are anxious are at risk for less functional improvement after total knee replacement.
American Academy of Orthopedic Surgeons, 2011

Health Alert: On Your Knees!
10 million Americans suffer from knee osteoarthritis (OA). Due to obesity and symptomatic knee OA, Americans over the age of 50 will, in total, lose the equivalent of 86 million healthy years of life. Reducing obesity to the year 2000 levels would prevent 173,000 cases of coronary heart disease, 711,000 cases of diabetes and 270,000 total knee replacements. It would save 19.5 million years of life among US adults aged 50-84.
Annals of Internal Medicine, February 2011

Diet: Can Cartoons Make Kids Eat Brussels Sprouts?
Characters like Shrek, Donkey or Princess Fiona on food packaging, particularly cereals, can influence children to choose sugary items that provide little to no nutritional value. When there is no licensed cartoon character on the box, kids prefer a cereal whose name suggests healthy eating rather than sugar consumption.
Annenberg School for Communications, University of Pennsylvania, Feb 2011

Exercise: Walk It Off.
Because exercise helps use up oxygen, it causes your body to burn stored fat. If you walk 4 miles a day, 4 times a week, you can burn 1,600 calories a week. If you don't change your diet at all and walk that same distance for six months, you'll lose about 12 pounds. Walk that same distance for a year and you'll drop about 24 pounds!
Mayo Clinic

Chiropractic: Take A Deep Breath.
Breathing is a function most people do not associate with spinal health. A case published in the 1980s involved a 53-year-old man with a 20-year history of chronic obstructive pulmonary disease. More than 14 months after starting chiropractic care, the amount of air he was able to forcibly exhale in one complete breath (a measure called "forced vital capacity") and the amount of air he could move in the first second of that complete breath (called "forced expiratory volume in one second") had both improved substantially (1 liter and 0.3 liters, respectively). This case is part of a growing body of literature indicating that improved lung volumes often accompany improved spinal health through chiropractic care
Chiropractic Technique, 1991

Wellness/Prevention: Dance Your Way To Cancer Prevention.
Exercise makes your body stronger. By choosing a fun workout, like dance classes, it's easier to get the 30 minutes of daily exercise you need to maintain a healthy weight, which may reduce your chances for some types of cancer.
University of Texas MD Anderson Cancer Center, February 2011

Weekly Health Update

Mental Attitude: It Could Be In Your Head.
Your emotional response to challenging situations can predict how your body responds to stress. People with high levels of anger and anxiety showed greater increases in a marker of inflammation than those who remained relatively calm. This could help explain why some people with high levels of stress experience chronic health problems. Over time, these emotionally-reactive individuals may be more vulnerable to inflammatory diseases, such as cardiovascular disease.
Brain, Behavior, and Immunity, February 2011

Health Alert: Time To Get Healthy!
A shortage of oncologists and the rising cost of chemotherapy and radiation therapies and imaging tests are making delivering quality cancer care increasingly difficult. By 2020, the shortage of oncologists in the US will be between 2,350 and 3,800, which represents a capacity of between 9.5 million and 15 million office visits.
Cancer, March 2011

Diet: Vitamin E And Pneumonia.
Vitamin E decreased pneumonia risk by 69% among those who had the least exposure to smoking and who also exercised. In contrast, vitamin E increased pneumonia risk by 79% among those who had the highest exposure to smoking and who did not exercise. Over half of the participants were outside of these two subgroups and vitamin E did not affect their risk of pneumonia.
Clinical Epidemiology, February 2011

Exercise: Fat Burner!
Muscles are metabolically active, so the more muscle mass, the more calories you burn even when you're not working out. For each pound of muscle you add, you will burn an extra 35-50 calories per day. Every 5 pounds of muscle added will burn 175-250 calories a day, or an extra pound of fat every 14-20 days.
Mayo Clinic

Chiropractic: Better Immune System?
Ronald Pero, Ph.D., chief of cancer prevention research at New York's Preventive Medicine Institute and professor of medicine at New York University, performed one of the most important studies showing the positive effect chiropractic care can have on the immune system and general health. In his initial 3-year study of 107 individuals who had been under chiropractic care for 5 years or more, the chiropractic patients had a 200% greater immune competence than people who had not received chiropractic care.
The Chiropractic Journal, August 1989

Wellness/Prevention: A Leg Up?
9 million Americans over the age of 50 have peripheral arterial disease. Symptoms: 1. Claudication (fatigue, heaviness or cramping in the leg muscles that occurs during activity and goes away with rest). 2. Foot or toe pain at rest that often disturbs sleep. 3. Skin wounds or ulcers on the feet that are slow to heal. Risk increases if you: smoke, or used to smoke, have diabetes, have high blood pressure and/or abnormal blood cholesterol, if you're African American or have a Vascular disease.
Foundation, February 2011

Tension-Type Headaches

At some point, everyone will have a headache, whether it's from stress, lack of sleep, hormonal related or even self-induced after having way too much fun the night before! In fact, 9 out of 10 Americans suffer from headaches. For the most part, headaches are not indicative of a dangerous underlying condition, but they can be (...a topic for a future "Health Update"). The focus of this Health Update is to discuss the most common form of headache - the tension-type headache or, TTHA.

Tension-type headaches (TTHA) are defined by the Mayo Clinic as "a diffuse, mild to moderate pain that's often described as feeling like a tight band around your head." Ironically, even though this is the most common form of headache, the causes of TTHA are not well understood. These are sometimes described as muscle contraction headaches but many experts no longer think muscle contractions are the cause. They now feel that "mixed signals" coming from nerve pathways to the brain are the cause and may be the result of "overactive pain receptors."

Regardless of the cause, the triggers of tension headaches are well known and include stress, depression/anxiety, poor posture, faulty awkward work station set-ups, jaw clenching and many others. Risk factors for TTHA include being a woman (studies show that almost 90% of woman experience tension headaches at some point in life) and being middle aged (TTHA's appear to peak in our 40s, though TTHA's are not limited to any one age group). Complications associated with TTHA's may include job productivity loss, family and social interaction disruption, and relationship strain. The diagnosis is typically made by excluding other dangerous causes of headaches and when all the test results return "normal," the diagnosis of TTHA is made.

Treatment utilizing over the counter medications are often effective so long as side effects of stomach irritation and/or liver and kidney issues don't arise. The use of heat and/or cold is often helpful as some prefer one over the other. Alternating between ice and heat is sometimes most effective. Controlling stress by trimming out less important duties or "...taking on less" can help. Yoga, meditation, biofeedback and relaxation therapy are also great! An "ergonomic" assessment of a workstation and how it "fits" the headache patient can also yield great results. Other highly effective therapies include acupuncture, massage therapy, behavior and/or cognitive therapy as well as of course, chiropractic! Chiropractic is a GREAT choice compared to standard medical care, especially when side effects to medications exist. This is because manipulation of the cervical spine addresses the cause of the headache and doesn't just try to "cover up" the pain. In 2001, Duke University reported compelling evidence that spinal manipulation resulted in almost immediate improvement for those with headaches that originate in the neck with significantly fewer side effects and longer-lasting relief compared to commonly prescribed medication. Chiropractic treatment approaches include (partial list): spinal manipulation, trigger point therapy, mobilization techniques, exercise training, physical therapy modality use, dietary and supplementation education / advice, lifestyle coaching and ergonomic assessments.

We realize you have a choice in where you choose your healthcare services. 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.

Fibromyalgia: How To Live With "FM"

Fibromyalgia (FM) is a condition that produces widespread pain that can literally change the life of a FM patient, but as they say, "..life must go on!" Therefore, this Health Update is dedicated to discussing ways to empower you with tips to make FM as least activity restricting as possible. Ways to gain self-control of FM include the following:

1. Exercise: There are two forms of exercise you should include in your self-management program. One is light aerobic exercises such as walking and/or water exercises with the objective to increase your heart rate. The other is strength training with a low weight / high repetition approach emphasizing the part of the exercise where you slowly release the weight back to the start position (the eccentric part of the exercise). Here is a list of tips from the National Fibromyalgia Association that should help:
   • Start slow - don't overdo it the first few times you exercise as post-exercise soreness is normal but, it's exaggerated in the FM patient.
   • Listen closely to your body's feedback! Increase the activity according to your tolerance - NOT TOO QUICKLY!
   • Start with only a few minutes of gentle exercise and work your way up.
   • Walking is a GREAT form of exercise. It can be done inside (in the winter, for example), outside, and/or in water (to reduce weight bearing loads).
   • Track your progress by keeping a log of what and how much you're doing. This can be accomplished by wearing a pedometer (that measures steps), a heart monitor (that measures pulse rate), and keep track of the distance and time, when possible. Make notes how you felt during and after the exercise.
   • Stretch before and after exercising.
   • Keep your chiropractor informed and work as a "team" to advance your program.
2. Sleep: A poor sleep pattern is the "norm" for FM patients. The pain associated with FM usually interferes with sleeps, which leads to more pain followed by more sleep disturbance - it's a vicious cycle that needs to be broken. The National Sleep Foundation and others recommend the following steps to help us sleep:
   • Stick to a sleep schedule. Go to bed at a similar time each night, even on weekends.
   • Room temperature - keep it cool, not too warm!
   • Caffeine - avoid this especially towards evenings (coffee, tea, soda, and/or chocolate).
   • Alcohol - avoid before bedtime as it can keep you awake.
   • Exercise - in the afternoon, NOT before bedtime.
   • Nap as needed but ONLY briefly - like 20 min. max.!
   • Be comfortable - wear soft PJ's and consider a white noise machine.
   • Bedtime routine - consider reading, listening to soft music - whatever works for you! Once you find a routine that works, stick with it!
3. Diet: Talk to your chiropractor about food allergy, gluten sensitivity, diabetes, thyroid function, medication/vitamin use and any other unique issues that pertain to you.
4. Emotional control: Engage your family, good friends, your healthcare providers, and consider FM support groups. Meditation, deep breathing and visualization exercises as well as cognitive therapy can also be very effective.

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

Weekly Health Update

Mental Attitude: Delay Alzheimer's!
Mastering a second language seems to delay getting Alzheimer's as bilingual patients did not contract Alzheimer's until 5 years later than monolingual patients. Even if you're not bilingual, there are other ways to exercise the brain like word games, crosswords, word search.
Ellen Bialystok, York University, Feb 2011

Health Alert: Too Much Drinking!
5.9% of adolescents ages 12-14 drank alcohol in the past month and 44.8% received their alcohol for free from their family or at home. People who begin drinking alcohol before the age of 15 are six times more likely to develop alcohol problems than those who start at age 21 and older.
Substance Abuse and Mental Health Administration, Feb 2011

Diet: Allergic To Food?
17 million people in Europe suffer from food allergies, with 3.5 million younger than 25 years old. Allergies in children under 5 have doubled over the last ten years and trips to the emergency room for severe anaphylactic reactions have increased seven-fold. Allergic reactions are probably increasing due to changes in nutrition patterns, exposure to environmental factors such as cigarette smoke and changes in lifestyle.
European Academy of Allergy and Clinical Immunology, Feb 2011

Exercise: New Toy.
A wireless device, the iSense, can predict and detect the status of muscles during training. The iSense helps optimize performance by building the bridge between what the brain is telling the athlete and what the muscles are actually doing. The iSense device detects the tiny electrical signals muscles produce when contracting. Muscle fatigue can promote muscle growth, but can also cause serious injury when the level of fatigue is high. When muscle fatigue is not detected soon enough, it can often lead to pain and injuries. The system will guide the user during training to act as a warning device, to avoid unnecessary strain on the muscles and avoid injury.
Essex University, AlphaGalileo Foundation

Chiropractic: Watch Your Back!
Half of working Americans suffer from back pain each year. 25% of American adults reported they suffered from back pain for at least a day within the last three months and lower back pain is the 5th most common reason people visit the doctor.
CDC

Wellness/Prevention: Wear A Helmet.
Severe head trauma is the most frequent cause of death and severe disability in skiers and snowboarders and accounts for 15% of all skiing and snowboarding related injuries. Injuries include epidural hematoma, subdural hematoma, other traumatic intracranial hemorrhage, skull fractures and cervical spine injury. Helmet use reduces head injuries 35%, with another study suggests head injury reductions range from 15-60%. Helmet wearers decreased the need for neurosurgical procedures, length of hospital stay, and incidence of death.
Journal of Neurosurgery: Pediatrics, March 2011

Carpal Tunnel Syndrome and Exercise

We have discussed the topic of Carpal Tunnel Syndrome (CTS) exercises previously but this topic is so important, it warrants another look at this subject from a different perspective. Please keep in mind there are many exercises that will help patients with CTS, including a general, aerobic exercise program where walking, elliptical, stepping, cycling, rowing, swimming and more will facilitate either directly or indirectly. In other words, just "staying in shape" will greatly enhance your health and is therapeutically beneficial for many conditions, including CTS. Remember, if your BMI (Body Mass Index) is over 25 (especially 30) and/or, if your waist size is greater than 35" and especially 40", the risk of CTS increases significantly. Therefore, diet and exercise are important components of improving your overall health- including conditions like CTS! Here are 5 exercises and/or suggestions for managing CTS:

1. Circles
   This exercise will strengthen the wrist & forearm muscles, increase the wrist's range of movement/flexibility, and decreases wrist pain. This can be done multiple times a day as a "mini-break" from keyboard/computer work, as well as a "morning warm-up." Slowly rotate your wrist/hand from a palm up to a palm down position and repeat up to 10 times.
2. Prayer Stretch
   Stretching helps to breakup adhesions that form in the carpal tunnel. Place the palms together, fingers straight & pointing up (prayer position). Keeping the heels of the hands together, slowly lower the hands and raise the elbows so that the angle at the wrist decreases. Push your fingers together for 5 sec. Hold for 10 seconds and repeat up to 10 times, depending on time availability. Do this multiple times a day.
3. Strengthening
   Using a hand weight or TheraTubing, assume the same position as #1 above and slowly raise the weight or stretch the tubing by flexing the wrist with the palm in each of 4 positions: palm up, thumb up, palm down and pinky up. Use your opposite hand to support your wrist with the pinky up exercise
4. Ergonomics
   Consider modifying your workstation, especially if your monitor is off to a side or too high, if your elbows are bent more than 90°, if your forearms are digging into the edge of the desk, use a trackball mouse so your arm can stay still, consider a larger screen, and an "ergonomic" keyboard (one that is not flat); use a "good" chair with adjustable arms to rest the forearms on.
5. Posture
   Sit "tall" with your chin tucked in (no "chin poking!"), relax your shoulders (no shrugging), feet flat on the floor or on a box, and take mini-breaks" at your workstation. If you have to, set a timer for every 30-60 minutes that will remind you to stretch.

Two more "tricks" that really help: 1. Reduce your stress on the job - treat others like you would like to be treated (get along with your co-workers); 2. Enjoy your job!

We realize you have a choice in who 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 require care for CTS, we would be honored to render our services.

Whiplash Facts

Whiplash is a fairly common condition that occurs when the neck is suddenly forced forwards and backwards, usually from motor vehicle collisions. Before 1928, whiplash was sometimes called "railway spine" as it was used to describe injuries that occurred to people involved in train accidents. Since 1928, much has been studied and reported about this condition and in 1995, the term, "whiplash associated disorders" or WAD, was introduced. The WAD classification of whiplash patients includes 3 main category (WAD I, II and III) and a few years later, WAD II was broken into 2 sub-categories (WAD I, IIa, IIb, III). This occurred because some patients in WAD II took a longer time to heal than others. Here are the basic definitions of WAD I, II, III:

1. WAD I: Patients have complaints but no objective findings meaning we cannot reproduce your pain during our examinations
2. WAD IIa: Patients have complaints with objective findings but a normal range of movement of the neck and no neurological findings (normal strength and sensation ability)
3. WAD IIb: Same as WAD IIa except here, neck movements are decreased
4. WAD III: Here, neurological abnormal findings (weakness and/or sensation) are present.
5. WAD IV: Includes fractures and dislocations. Because of this unique difference, this category is often left out of the research that uses this category system to determine prognosis of the WAD case.

This system is very useful as it has the ability to predict the results in a case long before the conclusion of the case.

We have discussed the cause of whiplash in previous articles and what happens when we are hit from behind unexpectedly. In essence, we cannot guard against the abnormal forces that occur in the neck as it all happens faster than we can voluntarily contract our muscles. Also, the myth about no car damage = no injury is just that - a myth! In fact, in low speed impacts, less damage to the car transfers greater forces to the contents inside because the energy of the force is not absorbed by crushing metal (elastic vs. plastic deformity).

Symptoms of whiplash vary widely. Most common symptoms include neck pain and stiffness, headache, shoulder pain/stiffness, dizziness, fatigue, jaw pain, arm pain, arm weakness, visual disturbances, ringing ear noises, and sometimes back pain. If symptoms continue and chronic WAD occurs, depression, anger, frustration, anxiety, stress, drug dependency, post-traumatic stress syndrome, sleep disturbance, and social isolation can occur.

Diagnosis is based on the history, physical exam, x-ray, MRI, and if nerve damage occurs (WAD III), an EMG. Treatment includes rest, ice and later heat, exercise, pain management and avoiding prolonged use of a collar. Chiropractic includes all of these as well as manipulation, mobilization, muscle release methods, and patient education. Prompt return to normal activity including work is important to avoid the negative spiral into long term disability.

We realize you have a choice in where you receive your health care needs and we truly appreciate your consideration in allowing us to help you through that potentially difficult process.

Low Back Pain and Spinal Fusions

You may think it's odd to discuss low back pain (LBP) from the perspective of spinal fusion because as chiropractors, we do not perform surgery and so, why discuss it? It is important that we discuss research such as this so we can make the informed treatment decisions with our patients after we've considered all the facts in each specific case. Now, there are certainly times when a surgical procedure for back and leg pain is necessary and appropriate for some patients, but the problem is, there are also some patients who have been told they need spinal surgery when, in fact, they may be better off NOT proceeding with surgery. So, the question is, what happens to those patients who elect not, vs. those who do choose to proceed with surgery?

That question was addressed in a study where a total of 1450 patients injured at work were followed over a 2-year time frame. There were a total of 725 patients who proceeded with the fusion surgery and the other 750 elected NOT to have the surgery. A fusion surgery can be described as when two or more vertebra are fused together, usually because there are neurological problems such as shooting leg pain, weakness and/or numbness in one or both legs. The conditions treated in this study included herniated disks, degeneration of the disk, and radiating leg pain. There were primarily 3 factors that were compared between the two groups, namely, 1) ability to return to work; 2) disability (the inability to work), and 3) opiate (narcotic) drug use. Other factors compared included the need for re-operations, complications, and death.

The results showed, in general, those who proceeded with surgery had significantly more problems compared to those who did not have surgery. For example, only 26% returned to work, compared to 67% returned to work. The total number of days off work were 1140 vs. 316 days, respectively. There were 17 vs. 11 deaths, respectively and, 27% of the surgical group required re-operations with a 36% complication rate. Also, there was a 41% increase in the use of narcotic medication with 76% continuing the use after surgery.

Again, there are times when surgery is absolutely the right choice. Those times include when there is a loss of bladder or bowel control, progressively worsening neurological symptoms in spite of non-surgical care, and of course, unstable fractures, cancer/tumor and infections, but that's about it! In other words, if you don't have one of the before mentioned conditions which do require surgery, don't be too quick to jump at the chance of "getting it fixed" with surgery. As the study suggests, the post-surgical results favor those who elected NOT to have surgery. Also, when in doubt, don't trust the opinion of only one surgeon - always get a 2nd or even 3rd opinion. It is also very important to consider your current level of function or, your ability to do your desired tasks and, unless there is a significant loss in that ability, consider additional time with non-surgical treatment. The non-surgical treatmen t you can expect to receive from chiropractic includes (but may not be limited to) spinal manipulation, exercise training, physical therapy modalities (ice, heat, electrical stimulation, ultrasound, traction, etc.), dietary counseling, and job modification information.

We realize you have a choice in who you choose to provide your healthcare services. If you, a friend or 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.