A "PAIN FREE" Dinner Seminar for Your Friends and Family Members!!

Due to such an incredible demand for information on becoming pain free, our first "Pain Free" seminar was booked solid, with a total of 50 guests, within just a few hours. There were so many callers who wished to hear about the non-surgical, non-invasive techniques we offer, that Dr. Butler has decided to host a second "Pain Free" dinner seminar.

This dinner is the ideal setting for your friends, family members or co-workers, who are suffering from chronic back pain, stenosis, arthritis, neuropathy or herniated discs, to learn about the Butler Spine Program - a revolutionary new treatment that has a 90% success rate. Also, a special offer will be made at the dinner to save them thousands of dollars on the cost of the program.

The free gourmet dinner and "Pain Free" presentation will be held at Portobello's Banquets on Tuesday, November 1st at 6:00pm. Please let all of your friends and family who are suffering from any of these conditions know that help is on the way! Seating is limited, so have them reserve their spot today by calling us at (862) 226-0928.

As always,
The Staff at Oakland Spine and Rehab.

Weekly Health Update

Mental Attitude: Don't Look At Me!
Depressed people tend to avoid eye contact in social situations and in experimental settings, whereas happy people actively seek eye contact. Sad people avoiding eye contact may lead to them shunning certain social situations. Although this may reduce anxiety caused by the situation itself, it may actually increase social isolation and deepen their already depressed mood.
British Journal of Psychology, Sept 2011

Health Alert: Hospital Staff Carry MRSA Superbug.
60% of doctors' and 65% of nurses' uniforms carry dangerous bacteria. In a 2009 report, rates of postoperative sepsis, or bloodstream infections, increased by 8%; postoperative catheter-associated urinary tract infections increased by 3.6%; and rates of selected infections due to medical care increased by 1.6%. 1 in 5 security cards carried by hospital doctors were contaminated with a variety of pathogenic bacteria, including the superbug MRSA, which kills thousands every year.
Health and Human Services Department, 2009

Diet: Ginger Extract.
Whole ginger extract has promising cancer-preventing activity in prostate cancer. Ginger extract had significant effects in stopping the growth of cancer cells, and inducing cell death in a spectrum of prostate cancer cells. Animal studies revealed the extract did not show significant toxicity to normal tissues, such as bone marrow. Research showed tumor regression up to 60%. Humans would have to consume about 3 1/2 ounces of whole ginger extract a day to get the benefits.
British Journal of Nutrition, Aug 2011

Exercise: Good Reasons.
Exercise reduces vulnerability to various cardiac dysrhythmias (abnormal heart rhythms), improves the likelihood of survival from a myocardial infarction (heart attack), and helps overcome jet lag.
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: What A Headache.
"Cervical migraine is the type of headache most frequently seen in general practice and also the most frequently misinterpreted. It is usually erroneously diagnosed as classical migraine, tension headache, [or] vascular headache. Such patients have usually received an inadequate treatment and have often become neurotic and drug-dependent." (Note: Manipulation is effective in patients with cervicogenic headaches.)
Ragnar Frykholm, Neurosurgeon, 1972

Wellness/Prevention: Fish Oil For A Healthy Mind.
Researchers found positive associations between fish oil supplements and cognitive function, as well as differences in brain structure between users and non-users of fish oil supplements. The findings suggest possible benefits of fish oil supplements on brain health and aging.
International Conference on Alzheimer's Disease

Oakland Spine & Rehabilitation is Proud to Welcome Jon Moshenberg, DPT

O.S.R. has added yet another expert to our staff. We welcome Jon Moshenberg, DPT to our physical therapy department. Jon brings with him years of experience working with a variety if techniques and specializing in manual therapy. He is a graduate of one of the most prestigious physical therapy schools in the country and brings the latest science and techniques to our physical therapy department. We are thrilled that he has joined our dedicated team. For our patients who currently receive physical therapy, you will receive the same amazing quality of care you have come to expect from us.

As always, if you, a family member, or a friend is in need of physical therapy for treatment of an injury or after surgery, Oakland Spine & Rehabilitation is here to help. A referral is the greatest thank-you that our patients can give us!

Dr. Brad & Staff

Weekly Health Update

Mental Attitude: Don't Worry Be Happy.
The more you stay positive and happy in life, the better chance you have of avoiding a stroke. Optimistic people have a healthier immune system, faster wound healing, and a lower risk of heart disease. So don't worry, be happy.
Journal of The American Stroke Association and The Mayo Clinic, Aug 2011

Health Alert: Strokes On The Rise?
From 1995-2008, ischemic stroke incidence rose 50% for males age 35-44; 46% for males age 15-34; and 51% for boys age 5-14. For females age 35-44, ischemic stroke incidence rose 29%; 23% for females age 15-34; and 3% for girls age 5-14. One in three ischemic stroke patients aged 15-34 had three stroke factors, while half of 35-44 year olds with ischemic stroke had hypertension. Risk factors said to be linked to stroke risk include family history; having had a previous stroke; having had a transient ischemic attack; African Americans and those of Hispanic or Asian/Pacific Island descent have a higher risk of stroke; birth control pills; cardiovascular disease; cocaine usage; diabetes; heavy alcohol consumption; hypertension; high cholesterol; high amino acid levels in the blood; obesity/ overweight; smoking; being over 55 years of age.
Annals of Neurology, Aug 2011

Diet: Prune Power?
In the US, 8 million women have osteoporosis because of the sudden cessation of ovarian hormone production at the onset of menopause. In the first 5-7 postmenopausal years, women are at risk of losing bone at a rate of 3-5% per year. In a study, the group of women who consumed dried plums had significantly higher bone mineral density in comparison with the group of women who ate dried apples. This was due, in part, to the ability of dried plums to suppress the rate of bone resorption, or the breakdown of bone, which tends to exceed the rate of new bone growth as people age..
British Journal of Nutrition, Aug 2011

Exercise: Good Reasons.
Exercise reduces your anxiety level, helps control blood pressure in people with hypertension, and protects against "creeping obesity" (the slow, but steady weight gain that occurs as you age).
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: Happy Patients!
In this study, the average intake pain rating of patients cared for by Doctors of Chiropractic was 6.2 of 10, and the average discharge score was 1.9 of 10. 95% of the patients rated their care as "excellent."
Journal of Manipulative Physiological Therapeutics, Feb 2011

Wellness/Prevention: Ancient Bugs.
When they were developed less than a century ago, scientists were surprised at how fast bacteria developed resistance to antibiotic drugs. Recently, researchers discovered antibiotic resistant genes in bacteria recovered from 30,000-year-old permafrost. This shows antibiotic resistance is a natural phenomenon predating the modern clinical antibiotic use.
Nature, Sept 2011

Your Friends and Family Are Invited to a FREE GOURMET DINNER!

In conjunction with Friends and Family Month, Dr. Butler will be hosting a "Pain Free" dinner seminar. The seminar will introduce the new, non-surgical, non-invasive technology that is available to treat the pain associated with Stenosis, Neuropathy, Herniated Discs, and Arthritis. Your friends and family will discover what new research is saying about the causes of these conditions and which cutting-edge treatments have been created to reverse the causes of their pain.

The free gourmet dinner and "Pain Free" presentation will be held at Portobello's Banquets on Wednesday, October 19th at 6:00pm. Please let all of your friends and family who are suffering from these conditions know that help is on the way! Seating is limited, so have them reserve their spot today! We are more than happy to put your friends and family members on the guest list, so please have them call us today at (862) 226-0928.

As always,
The Oakland Spine & Rehab Staff

Thinking About the Flu Shot? Read This First.

If you are considering a flu vaccine I have news for you - do your homework first. To help out with this I recommend you go the the web site of Dr. Mercola. He has been on the cutting edge for years and has arguably the worlds largest natural health web site. Go to the following web site and in the search box type "Flu Shot" and see what you find.

www.mercola.com

Watching your back,
Dr. Brad

Whiplash and Vision: What's The Connection?

In whiplash, "post concussive syndrome" (PCS) can affect up to 20-30% of patients who have had a mild head injury with resulting left over, long-term problems. Interestingly, eye movements have a close relationship to the function of the brain and can be an accurate measure for determining the presence of PCS as well as a good barometer for tracking the recovery process. The correlation between eye movement and PCS was studied by a group of New Zealand researchers using 2 groups of 36 patients each - those with PCS who showed good recovery vs. those who did not at a 3-5 month point after their accident. The method of evaluating this included neuropsychological evaluations using various tools that assess memory, reading, recall, use of numbers, and other brain function tests. They found the worse PCS patient group had poorer brain function test results and the correspondingly worse eye movement tests. Most interesting was that the gr oup who had a better psychological recovery, STILL HAD eye movement abnormalities. This suggested, in spite of seemingly good recovery, injury to the brain persisted. They also stressed importance of the correlation between the psychological test abnormalities now have a specific biological marker which can be used as a clinical "tool" and, that PCS is NOT merely a psychological condition.

PCS symptoms include headaches, dizziness, poor concentration, memory loss, irritability, mood swings and these and other symptoms vary between patients with PCS. This makes the assessment process challenging since each patient is rather unique in how PCS portrays itself. To make this more challenging, these symptoms can last for the first few hours after a motor vehicle collision with a mild closed head injury to days, weeks, months and even years after the injury, some with complete loss work capabilities and significant life impact. The World Health Organization first clinically recognized PCS in 1992, with the American Psychiatric following in 1994. Another diagnostic challenge is that the conventional tests such as CT scans and MRI scans usually do not display abnormalities in most patients with PCS, thus doctors must rely on psychological tests to establish the diagnosis and track recovery (or lack thereof). More recently, spe cial tests such as functional MRI, diffusion tensor imaging, MR spectroscopy and arterial spin labeling can help detect functional, structural, or perfusion changes in the brain but these tests are costly and not routinely available in most clinical settings. There are also criticisms that these less available/costly tests can't track changes in function very well. Similarly, there exists criticism of neuropsychological test results being affected by uncontrollable factors such as age, education, state of employment, economic status, depression, malingering, and litigation.

The good news is that most patients with PCS largely resolve by 1-3 months post-injury. However, this reported rate of recovery relies on neuropsychological tests, which loses their ability to detect PCS with the passage of time. The benefits of being able to detect brain injury which include complex reflex pathways and different parts of the brain through the measurement of eye movement is very important as no other method has yet been found to be as accurate and, is completely independent of intellectual ability and neuropsychological injury. The ability for eye movements to show abnormality at 3-5 months post-injury is tremendous!

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, 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.

Weekly Health Update

Mental Attitude: Money Can Be Depressing?
Rates of depression are higher in countries with higher per capita incomes. 121 million people worldwide have depression. Severe depression can lead to suicide and causes 850,000 deaths every year. The United Sates and France had the highest depression rates. Higher incomes can be related to more work hours and a lowered quality of life. 15% of people in high-income countries were likely to become depressed during their lifetime, compared with 11% of those in low or middle-income countries.
British Medical Journal, Aug 2011

Health Alert: You Are Getting Very Sleepy.
Insomnia affects 23% of US workforce, costing $63.2 billion annually. Insomnia is a condition characterized by difficulty falling asleep and remaining asleep. It includes a wide spectrum of sleep disorders, from not enough sleep to lack of quality sleep.
Sleep, Aug 2011

Diet: Bad Habits?
People entering the movies were given a bucket of either just-popped, fresh popcorn or stale, week-old popcorn. Moviegoers who didn't usually eat popcorn at the movies ate much less stale popcorn than fresh popcorn. Moviegoers who typically had popcorn at the movies ate about the same amount -- regardless it was fresh or stale. When we've repeatedly eaten a food in an environment, our brain comes to associate the food with that environment and we keep eating as long as those environmental cues are present.
Personality and Social Psychology Bulletin, 2011

Exercise: Runners Drinking Too Much?
50% of recreational runners may be drinking too much fluid during races. 37% of runners drink according to a preset schedule or to maintain a certain body weight and 9% drink as much as possible. Expert guidelines recommend runners drink only when thirsty. 30% incorrectly believe they need extra salt while running, and 57% drink sports drinks because the drinks have electrolytes that prevent low blood sodium. However, main cause of low sodium is drinking too much water or sports drinks during exercise, which can dilute the sodium content of blood to abnormally low levels. This can cause a potentially fatal condition called exercise-associated hyponatremia. Symptoms of hyponatremia include: nausea, vomiting, headache, confusion, loss of energy, muscle weakness, spasms or cramps. In extreme cases, the condition can lead to seizures, unconsciousness and coma.
British Journal of Sports Medicine, June 2011

Chiropractic: Careful.
In work-related nonspecific low back pain, the use of health maintenance care (treatment after initial disability was resolved) provided by Physical Therapist (PT) or Medical Physician (MD) services was associated with a higher disability (injury) recurrence than in the use of Chiropractic (DC) services.
Journal of Occupational and Environmental Medicine, April 2011

Wellness/Prevention: Shorter Colds.
Zinc lozenges may shorten the duration of common cold episodes by 40%.
Open Respiratory Medicine Journal, Aug 2011

Neck Pain: What Can I Do About It?

Neck pain is one of those conditions that affect most people at some point during their lifetime. All you have to do is ask just about anyone, "...have you ever had neck pain?" Then again, maybe you shouldn't since you'll probably get overloaded with way too much information from several people willing to share every little detail with you. Because of the way we are anatomically built, the neck is particularly vulnerable to injury (it has to hold up an average head weight of 15 pounds which can be quite a job, especially when we slump or slouch and that 15 pound weight falls forwards). Injury to the neck can result in minimal symptoms all the way to complete disability, making it one of the most common reasons people see doctors of all varieties for help. Couple neck pain with headaches and now you have a real potential for disrupting lifestyles. With simple causes like poor posture, stress, work station problems or long hours at a computer, not to mention anxiety, depression and more, it's no wonder ost of us have needed help for neck pain at some point in time. So, the question remains, "...what can I do about it?"

From a chiropractic standpoint, manipulation, massage and other soft tissue techniques, and several forms of physiological therapeutics (such as ultrasound, electric stimulation, light - low level laser therapies), all work great! But, instead of (or, in addition to) things that WE do to you, let's discuss things we can teach YOU to do on your own. There is a long list of aids that help neck pain that you can self-manage, of which some include: a home traction device, cervical pillows, exercises, posture retraining, stress management, work station modifications, work/job analysis and subsequent modifications, and more. Most important is that YOU are in control of your own management program. All you need is a little motivation (your job) and proper training (our job). Many of these "self-help approaches" include an apparatus or device of some sort, which are technically coined, "hard durable medical supplies." More specifically:

1. Cervical traction units include (but are not limited to) inflatable collars, seated over-the-door traction units, laying on the back varieties, as well as towel traction. The concept here is that you are stretching the neck vertebra apart and if it's done proper, it should feel good! Don't do it if it doesn't or, reduce the weight until it does feel good. Another type of traction is placing a fulcrum (dense foam triangle) behind the neck while lying allowing the head to hang off the edge of the bed.
2. Cervical pillows share the common concept of being contoured to fit the neck and head. These are thicker on the edge so the gap between the neck and shoulder point is filled in so the head is pointed straight ahead. There are many types of contoured pillows including water pillows, foam, inflatable, buckwheat, rice, and other types. However, a word of caution is in order: you may not like it at first as it can take 3-4 nights to get used to it. But, once you do, you'll miss your pillow when you're not able to travel with it.
3. Exercises. Place your hand against your head and push into the hand, allowing the head to "win" as you move through the full range of motion (forwards, backwards, sideways and rotation). Don't forget stretching, other strengthening exercises, and fine motor control exercises are important as well. We'll have to pick this topic up again in the near future.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck 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.

World's Greatest Hockey Player Needs a Chiropractor to Get Back on the Ice

Below you will find a link to a Sports Illustrated Article explaining how the greatest hockey player in the world eventually found a cure to the effects of his concussion. If you are not hockey fans, let me tell you that Sidney Crosby is likely to be one of the greatest to ever live. However, his legacy was in serious peril after a hit he took last year knocked him out for the rest of the year suffering from the effects of a concussion. The symptoms confounded the medical team that was comprised of some of the country's top neurologists, orthopedists and sports medicine experts. They just couldn't figure it out.

Until .........

Well, you'll just have to read it to believe it, but rest assured - throughout the article you will find so called "Medical Experts" telling us it's a fluke.

Getting Inside the Head of Sidney Crosby by David Epstein & Michael Farber

Watching your back,
Dr. Brad

Fibromyalgia: Why Water Exercises?

Fibromyalgia (FM) is a condition associated with tight, sore muscles but no one REALLY knows where FM comes from or why it picks on certain people and not others. Some feel it's caused by lack of sleep, specifically deep sleep, eventually resulting in chronically tight muscles. Others theorize it's the underlying stress of a person's lifestyle that leads to the tight muscles. Either way, tight muscles lead to poor blood flow through the muscle and just like pumping up a blood pressure cuff too high and not releasing the tourniquet effect quick enough, pain results when the muscle is starved from lack of oxygen. Dr. Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical Center, wrote that many people (especially FM patients) tense their muscles and probably don't even realize it, which reduces blood flow to the muscles, resulting in pain. So, the question is raised, how can the FM patient get their muscles t o relax so blood can flow through, bringing it the necessary amount of oxygen to the muscle so it doesn't hurt?

One method of muscle relaxation is exercise. When the pulse rate increases, more blood reaches the muscle, which reduces pain. The studies are clear that walking, stretching and strength training all help reduce fibromyalgia pain. Exercise also relieves fatigue, helps sleep quality and reduces depression - WHAT A GREAT ANSWER for the FM patient! The key is finding the right combination of exercises and how much should one do. Our advice is to START SLOW and gradually increase the dose once you've proven good tolerance to the last workout session. Consider flexibility exercises (stretching) such as Yoga classes, walking around the block, or even playing golf (initially a few holes, then 9 and eventually a full round).

Many FM patients have found water exercises are uniquely helpful because of the weight reduction or buoyancy effect. This is especially true for the overweight FM patient as land-based exercises may be too traumatic on the feet/ankles, knees, hips, or low back. Also, warm water can be quite comforting. Another nice advantage of water exercises is that you can do these anywhere, as long as there is a pool! The exercises can be taught in a formal water exercise class, which is a good place to start if one is available locally or through a health care service. Studies from Spain report that water exercises improve the FM patient's quality of life not just for the moment, but also over the long term! Over a 12-week timeframe, they discovered women who exercised in warm water for 60 minutes, 3 times per week improved both mentally and physically, had less FM related pain, and more energy ("vitality"). They reported less depression and found an im proved desire to be sociable. The KEY for exercise to be successful is to increase the pulse rate. As Dr. Cope pointed out, a 20 minute, four times per week workout can make a big difference!

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

Carpal Tunnel Syndrome: What Can You Do For It?

Carpal tunnel syndrome or CTS, is a common condition that drives many patients to chiropractic clinics asking, "...what can chiropractic do for CTS?"

As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:

1. A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work - especially if it's fast and repetitive. Your doctor will also need to learn about your "co-morbidities" or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.
2. A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.
3. Treatment can include manipulation, soft tissue release, PT modalities (eg., electric stim., ultrasound).
4. Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

Here are some of the things that you, the CTS sufferer can self-manage:

• A Carpal tunnel splint is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.
• Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times/day) such as:
  A. The "Bear claw" (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand)
  B. Tight Fist/open hand (fully open - spread and extend the fingers and then make a fist, with the hand).
  C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm - hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch!
  D. Wrist range of motion (dorsiflexion/palmar flexion) - Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times.
  E. Wrist range of motion (pronation/supination) - Place forearm and whole hand on table-- elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times.
  F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed.
  G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down.
  H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.
• Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

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.

What Will Your 3 Boxes Look Like?

"One hundred years from now it will not matter what kind of car I drove, what kind of house I lived in, how much was in my bank....but the world may be a little better because I was important in the life of a child." - Forest Whitcraft

Last week, one of our patients lost his father. Knowing this gentleman, not just as a patient, but also from my golf club, he is the kind of person who has very good character and values - a family guy. So when I heard the news, I knew his Dad must have been a great guy. I imagined the family and friends pouring in and showing their admiration for the life he lived and the respect of someone who did it the right way.

It reminded me of a speech I had heard years ago in Chiropractic college called, "The Three Boxes". It went something like this - "It doesn't matter how successful you become in life. It doesn't matter how many material possessions you acquire in your lifetime, or how much money you have in the bank when you die. All people, rich and poor, can be reduced down to three boxes after they pass away:

The first box is the box for your body. Whether it's a coffin or urn, your physical body is reduced to a box.

The second box is the box that goes to Goodwill or a similar charitable organization. Most of your material possessions - the clothes you had, car you drove, flat screen TV, etc.- end up getting sold or donated to people more needy. Most of your material possessions have little emotional meaning to the people who care most about you....

The third, and final box, is the box filled with memories that your loved ones fill with pictures, special keepsakes and the little things that bring back the strongest emotional memories. Your goal in living a successful life is to make the third and final box count. Filling the third box with SIGNIFICANT memories throughout your life is what will make the biggest impact on the people that care about you the most. Following your passions will fill up your final box with a lifetime of meaningful memories which will inspire people to CELEBRATE your life by carrying on some of you where ever they go."

"Laugh when you can, apologize when you should, and let go of what you can't change. Kiss slowly, forgive quickly, play hard, take chances, give everything and have no regrets. Life is too short to be anything but happy!" - Anonymous

Watching your back,
Dr. Brad

Low Back Pain: Where Is My Pain Coming From?

Low back pain can emanate from many anatomical locations (as well as a combination of locations), which always makes it interesting when a patient asks, "...doc, where in my back is my pain coming from?" In context of an office visit, we take an accurate history and perform our physical exam to try to reproduce symptoms to give us clues as to what tissue(s) may be the primary pain generators. In spite of our strong intent to be accurate, did you know, regardless of the doctor type, there is only about a 45% accuracy rate when making a low back pain diagnosis? This is partially because there are many tissues that can be damaged or injured that are innervated by the same nerve fibers and hence, clinically they look very similar to each other. In order to improve this rather sad statistic, in 1995 the Quebec Task Force published research reporting that accuracy could be improved to over 90% if we utilize a classification approach where low back conditions are divided into 1 of 3 broad categories:

1. Red flags - These include dangerous conditions such as cancer, infection, fracture, cauda equina syndrome (which is a severe neurological condition where bowel and bladder function is impaired). These conditions generally require emergency care due to the life threatening and/or surgical potential.
2. Mechanical back pain - These diagnoses include facet syndromes, ligament and joint capsule sprains, muscle strains, degenerative joint disease (also called osteoarthritis), and spondylolisthesis.
3. Nerve Root compression - These conditions include pinching of the nerve roots, most frequently from herniated disks. This category can include spinal stenosis (SS) or, combinations of both, but if severe enough where the spinal cord is compromised (more commonly in the neck), SS might then be placed in the 1st of the 3 categories described above.

The most common category is mechanical back pain of which "facet syndrome" is the most common condition. This is the classic patient who over did it ("The Weekend Warrior") and can hardly get out of bed the next day. These conditions can include tearing or stretching of the capsule surrounding the facet joint due to performing too many bending, lifting, or twisting related activities. The back pain is usually localized to the area of injury but can radiate down into the buttocks or back of the thigh and can be mild to very severe.

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.

Weekly Health Update

Mental Attitude: Attention & Self-Control.
You're trying to decide what to eat for dinner. Should it be the chicken and broccoli or the super-sized fast-food burger? Making that choice is a complex neurological exercise that can be influenced by a simple shifting of attention toward the healthy side of life. When you decide what to eat, not only does your brain need to figure out how it feels about a food's taste versus its health benefits versus its size or even its packaging, but it needs to decide the importance of each of those attributes relative to the others... and it needs to do all of this more-or-less instantaneously. When thinking about healthiness, people were less likely to eat unhealthy foods, whether or not they deemed them to be tasty, and more likely to eat healthy-untasty foods. Being asked to think about healthiness led subjects to say "no" to foods more often than they did when asked to make decisions naturally.
Journal of Neuroscience, July 2011

Health Alert: Pharmaceutical Ads Do Not Follow FDA Guidelines.
A survey of 192 pharmaceutical ads in biomedical journals found that only 18% were compliant with FDA guidelines; 57.8 % failed to quantify serious risks, including death; 48.2% lacked verifiable references; and 28.9% failed to present adequate efficacy quantification.
Public Library of Science, Aug 2011

Diet: Increase In Food Allergies.
8% of children have food allergies, with almost 40% reporting severe reactions, an increase of 18% from 10 years ago. Peanut allergies among children have tripled, going from 1 in 250 in 1997 to 1 in 70 in 2008.
Center for Disease Control and Prevention, 2011

Exercise: Good Reasons.
Exercise assists in efforts to stop smoking, helps you to relax, can help improve short-term memory in older individuals, and helps relieve many of the common discomforts of pregnancy (backache, heartburn, constipation, etc.).
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: Backpack Pains?
Backpacks that are too heavy or used improperly can pull on ligaments and muscles, causing aches and pains in the neck and back, resulting in acute or chronic back pain. Things to look for in a backpack: Wide, padded, and adjustable shoulder straps; two straps; padded back; lightweight with a lot of compartments.
University of Medicine New Jersey, Sept 2011

Wellness/Prevention: Wash Your Hands!
Healthcare workers wash their hands about a third to a half of the time they come into contact with patients and germs. This study used 2 signs: 1. "hand hygiene prevents you from catching diseases." 2. "hand hygiene prevents patients from catching diseases." The patient sign increased soap use by 33%, and workers were 10% more likely to wash their hands. The sign about personal risks did no good.
Psychological Science, Sept 2011

FRIENDS AND FAMILY MONTH!

Dr. Butler has declared October "Friends and Family Month." Over the last few months we have received many referrals and requests for information from patients who desperately want to help a friend or family member in need. We all would like to see our loved ones living a pain free life. Here at Oakland Spine and Rehab, we pride ourselves on helping our patients not only feel better without the use of pain medication, but also live a healthier life. If you know someone who would benefit from any of the many treatments that we offer, have them come in to meet with the doctors. During "Friends and Family Month," if you refer a patient into our office, they will receive their exam, X-Rays, and first treatment absolutely FREE! (A $480 value.) As a "thank-you" from Dr. Butler, you will be entered into our Referral Reward Program.

The first level of the Referral Reward Program you will receive a $25 gift card. When you refer a second patient, you will move up to the second level of the program. You will receive a $50 gift card at this level. Once you refer three friends or family, you will receive a $100 gift card and acceptance into our V.I.P. level, which would entitle you to 10% off of all services in the future!

As always,
Oakland Spine and Rehab Staff

Breaking Back Pain News

SURVEY SAYS CHIROPRACTIC OUTPERFORMS OTHER BACK PAIN TREATMENTS – EVEN MEDICATION

SURVEY SAYS!!!! If you have back pain... you are probably old enough to remember Richard Dawson first yelling that phrase on the popular 70s and 80s game show, The Family Feud. If not - it doesn't matter - you just learned something interesting about American pop culture and game show history.

So, What Does The Survey Really Say?

According to an August 9, 2011 article on chiroeco.com, "In a new survey, chiropractic outperformed all other back pain treatments including prescription and over-the-counter medications, deep-tissue massage, yoga, and Pilates. According to the American Chiropractic Association (ACA), this news reinforces the use of conservative care options as a first line of defense against pain.

The survey, released by a leading consumer product rating and survey publisher in late July, found that 65 percent of those surveyed using chiropractic care for back pain said it helped a lot. Only 53 percent of respondents using prescription medications found them as helpful.

"Additionally, about half of those surveyed who are using deep-tissue massage, yoga or Pilates said those treatments helped a lot and only 28 percent of respondents using over-the-counter medications reported that they helped a lot.

"Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain."

One serious eye-opener was that only 28% of respondents said over-the-counter medications helped a lot.

It has been known for quite some time that common over-the-counter non-steroidal anti-inflammatory medications (NSAID) have serious side effects. One of these side effects is that an estimated 16,500 people die every year.

Natural, conservative options like Chiropractic, deep tissue massage, yoga, and Pilates are most likely better and safer choices when it comes to relieving back pain.

What About Neck Pain And Headaches?

Neck pain is very common and it can make your life miserable. If you suffer from headaches... there is a very good chance you suffer from a common type of headache called "cervicogenic headache." This type of headache is caused by a problem in your neck.

One way to tell you might suffer from cervicogenic headaches is to identify if any neck motions cause the headaches or increase their severity.

Also, take a good look at yourself in the mirror. Does your head tilt to one side? Is your head posture bad? In other words, does your head stick out in front of you instead of sitting back over your torso? You'll probably need a trained eye (like your Chiropractor's) to see that one.

What Helps This Type Of Headache?

According to an "evidence report" published by Duke University researchers,"Cervical spinal manipulation was associated with improvement in headaches in two trials involving patients with neck pain and/or neck dysfunction and headache. Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headaches when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. However, among patients without a neck pain/dysfunction component to their headache syndrome - that is, patients with episodic or chronic tension-type headaches - the effectiveness of cervical spinal manipulation was less clear."

What 66% Of Mothers Can Do To Strengthen Their Baby's Immune System

According to the Centers for Disease Control and Prevention, only 38 percent of Rhode Island mothers nurse their babies six months after birth. The national average is 44 percent.

State Health Director, Michael Fine, says the state hopes to raise the percentage of Rhode Island mothers nursing at six months to 60 percent by 2020.

Many experts believe breast feeding is one of the most important things a mother can do to help her baby develop a strong, natural immune system.

Hand Sanitizers May Put You At Risk For Viruses

According to Medical News Today, "New research has found that hand sanitizers are not as effective as soap and water in health care settings at preventing viral outbreaks. In fact, they may even be responsible for outbreaks of seriously contagious viruses. As a common alternative to using soap and water, hand sanitizers are often regarded as being the most efficient way to cleanse hands."

In February, a survey was presented at an American College of Preventative Medicine meeting. "The survey focused on 161 long-term care facilities and found that the preferential use of hand sanitizers over hand soap was linked to a higher risk of outbreaks of the highly infectious norovirus, a virus responsible for the majority of acute gastroenteritis cases.

"The study found that norovirus outbreaks were far more rampant in facilities where staff favored hand sanitizer use. In facilities where norovirus outbreaks occurred, members of staff were six times more likely to use hand sanitizers than soap and water for cleansing their hands."

The misuse and improper use of antibiotics is known to create super bugs that are immune to antibiotics. It is unclear if hand sanitizers are doing the same damage.

Best bet: Wash your hands with soap and warm water.

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.