Weekly Health Update

Mental Attitude: Chewing Gum?
Students who chewed gum for 5 minutes before taking a test did better on the test than non-gum-chewing students. "Mastication-induced arousal" is credited for the boost, which lasted for just the first 20 minutes of testing. Many studies have shown that any type of physical activity before an examination can produce a performance boost; this study points out that even mild physical activity can bring on such a boost. Chewing gum gave the subjects multiple advantages, but only when chewed for five minutes before testing, not for the duration of the test, so you can't chew gum and think productively at the same time.
Appetite, Jan 2012

Health Alert: Graceful Age.
The number of people over the age of 90 in the US will reach 9 million by 2050. To put the number in perspective, there were 720,000 people age 90 years or over in 1980, and today there are nearly 2 million. 74.1% of persons over 90 are women, with 88.1% of those being Caucasian. An average person who has lived to 90 years of age has a life expectancy today of 4.6 more years (versus 3.2 years in 1929-1931), while those who pass the century mark are projected to live another 2.3 years.
U.S. Census Bureau, Jan 2012

Diet: Calories And Protein.
In a study on overfeeding, researchers observed those in a low protein diet group gained considerably less weight (6.97 lbs) compared to 13.3 lbs in the normal protein diet group and 14.4 lbs in the high protein diet group.
JAMA, Jan 2012

Exercise: Good Reasons.
Exercise helps you to maintain your resting metabolic rate and reduces the risk of developing colon cancer. Exercise also increases your tissues' responsiveness to the actions of insulin (i.e., improves tissue sensitivity for insulin), helping to better control blood sugar, particularly if you are a Type II diabetic.
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: Chiropractic Before Surgery?
A lumbar diskectomy is one of the most common spine surgical procedures, with an average charge of $7,841, not including lost wages and productivity. A recent study suggests that many patients will improve with nonoperative therapy (such as chiropractic manipulation) and that a trial of conservative management before surgery is appropriate.
Spine Journal, June 2010

Wellness/Prevention: Another Cup Of Tea.
Green tea contains catechins, polyphenolic compounds that are known to exert numerous protective effects, particularly on the cardiovascular system. Green tea catechins at doses ranging from 145 to 3,000 mg per day taken for 3 to 24 weeks led to statistically significant reductions in total and LDL ("bad").
Journal of the American Dietetic Association, Nov 2011

Weekly Health Update

Mental Attitude: Not So Smart At 45?
A human's ability to remember data, to reason, and to understand things properly can begin to worsen at 45 years old (not at 60 years old, as previously believed). Mental reasoning among males aged 45-49 dropped by 3.6%, and 9.6% in the 65-70 age group. Among females, the decline was 3.6% for those aged 45-49, and 7.4% among those aged 65-70. This demonstrates the importance of promoting healthy lifestyles, particularly cardiovascular health, as there is emerging evidence that "what is good for our hearts is also good for our heads." Risk factors linked to cognitive decline: hypertension, obesity and high cholesterol levels.
British Medical Journal, Jan 2012

Health Alert: The Uninsured!
Lack of health insurance is associated with less preventive care, delays in diagnosis and unnecessary deaths. However, insurance status doesn't affect the quantity (or value) of imaging services received by patients in a hospital, in-patient setting. Uninsured hospital in-patients who underwent imaging received the same number of imaging services as insured persons. The uninsured received fewer interventional and image-guided procedures but more computed tomography (CT) studies.
Journal of the American College of Radiology, Jan 2012

Diet: Diet And Brain Shrinkage.
Elderly people with higher levels of vitamins B, C, D, E and omega 3 fatty acids in their blood had better performance on mental acuity tests and less of the brain shrinkage typical of Alzheimer's disease. Consistently worse cognitive performance was associated with a higher intake of the type of trans-fats found in baked and fried foods, margarine, fast food and other less-healthy dietary choices.
Neurology, Jan 2012

Exercise: Good Reasons.
Exercise helps to relieve constipation, expands blood plasma volume, reduces the risk of developing prostate cancer and helps to combat substance abuse.
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: Posture and Health.
Posture and normal physiology are interrelated. Posture affects and moderates every physiological function from breathing to hormonal production. Abnormal posture is evident in patients with chronic and stress related illnesses. Homeostasis and nervous system function are ultimately connected with posture.
American Journal of Pain Management

Wellness/Prevention: Licorice And Tooth Decay.
Two substances in licorice (licoricidin and licorisoflavan A) kill the bacteria responsible for tooth decay and gum disease, the leading causes of tooth loss in children and adults.
Journal of Natural Products, Jan 2012

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The best thank you we can receive is a referral!

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Weekly Health Update

Mental Attitude: Emotions Not On My Sleeve?
Contrary to what many scientists think, all people do not have the same set of biologically "basic" emotions and those emotions are not automatically expressed on the face. People do not scowl only when they're angry or pout only when they're sad. For example, people do a lot of things when they're angry, sometimes they yell and sometimes they smile.
Current Directions in Psychological Science, Jan 2012

Health Alert: Ten Ways To Decrease Cancer Risk!
1.) Max BMI of 25; 2.) 5 or more servings of fruits & veggies daily; 3.) 7 or more portions of complex carbs daily; 4.) decrease processed foods & refined sugars; 5.) limit alcoholic drinks to 1/day for women and 2/day for men; 6.) limit red meat to no more than 3 oz daily; 7.) decrease fatty foods, particularly animal fats; 8.) limit intake of salted foods & use of salt in cooking; 9.) eliminate tobacco use; 10.) practice sun safety/recognize skin changes.
American Cancer Society

Diet: Soy And Hot Flash.
According to a placebo-controlled study, daily doses of a soy germ-based nutritional supplement containing S-equol decreased menopausal symptoms 59%, including significantly reducing hot flash frequency after 12 weeks. It is believed that S-equol, produced from the isoflavone daidzein during the fermentation of soy germ, interacts with specific estrogen receptors to promote the improvement in menopausal symptoms.
Journal of Women's Health, Jan 2012

Exercise: Colds And Exercise.
Different levels of exercise can significantly increase or decrease your chances of catching a cold. If you tend to be a couch potato, then you will catch 2-3 colds per year, on average. Regular moderate exercise can reduce the risk of catching cold-like infections by 33% (this effect has been shown to be the result of the cumulative effect of exercise leading to long-term improvement in immunity). Prolonged strenuous exercise, such as marathons, can make an individual more susceptible to catching colds. We are constantly exposed to viruses, but it is our immune system that determines whether we get sick or not.
Association for Science Education Conference, Jan 2012

Chiropractic: Avoid Surgery?
A patient with a symptomatic lumbar disk herniation should consider spinal manipulation before surgery.
JMPT, Oct 2010

Wellness/Prevention: Cancer Rates Dropping.
In the last 20 years, one million deaths from cancer have been avoided. From 1990-2008, death rates dropped 23% in males and 15% in females.
CA: A Cancer Journal for Clinicians, Jan 2012

The Whiplash Syndrome: Ringing in the Ears

The term "whiplash" usually brings to mind neck pain, headaches and/or a stiff neck. However, there are other symptoms associated with whiplash that we don't usually think of, such as ringing in the ears or, tinnitus. In the absence of whiplash, there are many people who experience an occasional ringing or sound of some sort in their ears. The ringing may seem to keep time with the heartbeat or, in cadence with breathing and is more common over the age of 40, and more common in men. The sound can be a buzzing, ringing, roaring, hissing or high pitched noise that usually lasts only seconds or minutes at the most. So, think of those times when you've noticed tinnitus and ask yourself, "...how would that affect me if that noise never stopped or lasted for hours?"

Before we discuss the association of tinnitus with whiplash, let's review some facts about tinnitus. There are two primary types of tinnitus: Pulsatile and Nonpulsatile. Pulsatile tinnitus is often caused by sounds created either by blood flow problems in the face or neck, muscle movements near the ear, or changes in the ear canal. The non-pulsatile tinnitus is usually caused by nerve problems involving hearing in one or both ears. The later is sometimes described as a sound coming from inside the head. The most common cause of tinnitus is from hearing loss that occurs from aging - technically called presbycusis. However, it can also occur from living or working in a loud environment. Tinnitus can occur with many types of hearing loss and can be a symptom of almost any ear disorder. Other common causes include earwax buildup, certain medication side effects (aspirin, antibiotics), too much caffeine or alcohol intake, ear infections - which can lead to rupture of the eardrum, dental problems, TMJ or jaw problems, following surgery or radiation therapy to the head or neck, a rapid change in environmental pressure (airplane rides, elevators, scuba diving), severe weight loss from malnutrition or dieting, bicycle riding with the neck extended for lengthy timeframes, high blood pressure, nerve conditions (MS, migraine headache), as well as other conditions such as acoustic neuroma, anemia, labyrinthitis, Meniere's disease, otosclerosis and thyroid disease. The good news is that most of the time, tinnitus comes and goes and does not require treatment. When tinnitus is associated with other symptoms, does not get better or go away, or is in only one ear, it is wise to consult with us. Spinal manipulation and other chiropractic treatment approaches are often VERY helpful in resolving tinnitus with the benefits of avoiding the need for medications, all of which carry secondary side effects. Chiropractic approaches are also highly effective when tinnitus is accompanied by dizziness or vertigo, usually requiring treatment applied to the upper neck area.

So, how does whiplash cause tinnitus? There are primary as well as secondary causes that can give rise to tinnitus after whiplash. After looking at the long list of causes above, direct trauma to the head such as hitting the side window, the back of the seat, the steering wheel, mirror and/or windshield makes obvious sense. Secondary causes often involve the TMJ or jaw which is commonly injured in whiplash. By itself, TMJ can cause ear pain, tinnitus, vertigo (dizziness), hearing loss, and headaches. Because many nerves that innervate the neck and head arise from the neck as well as from the cranial nerves, spinal manipulation of the neck as well as certain cranial manipulations can have a dramatic benefit in treatment of whiplash induced tinnitus.

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.

The Neck & Shoulder Pain Relationship

Given the close anatomical proximity between the neck and shoulder, it's no wonder the two are intimately related. In our hectic lifestyles of driving, hunching over computers, talking on the phone, not to mention stress arising from multiple sources, the muscles in the neck, upper back and shoulders seem to tighten up and hurt at the same time. The question is, between the neck and the shoulder, which one is the "chicken" and which is the "egg?"

The neck gives rise to the nerves that innervate the head (C1-3 nerve roots), the shoulders (C4-5), and the arms (C5-T2). Hence, there are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), and 6 sets in the lumbar or low back region and 5 sets in the sacrum, all of which travel to a specific destination allowing us to move our muscles and to feel hot, cold, sharp, dull, vibration and position sense. When these nerves get pinched or irritated, they lose their function and the ability to feel, making it challenging to button a shirt, thread a needle, or pick up small objects. It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, the nerves arising from the neck, when pinched, can have a dramatic effect on our ability to carry out our desired activities in which the shoulder, arm and hand use is required.

On the other hand, when the shoulder is injured (such as a rotator cuff tear), this can also result in neck problems. There are several ways pain from the neck affects the shoulder and vice versa. When the shoulder is injured, pain "information" is relayed to the brain starting at the nerve endings located in the area of the shoulder injury, transmitting impulses between the shoulder and the neck, and finally from the neck to the sensory cortex of the brain. That information is processed and communication to the motor cortex prompts nerve signals to be sent back to the shoulder through the neck and to the injured area (in this case, the shoulder). A reflex muscle spasm often occurs as a result, serving as kind of an "internal cast" as the muscle spasm tries to protect the injured shoulder. This can become a "vicious cycle" or never-ending "loop" until the reflex is interrupted (perhaps by a chiropractic adjustment).

Another means by which both areas become injured has to do with modifications in function. We tend to change the way we go about our daily chores when an injury occurs to the shoulder, such as putting on a coat differently by leaning over to the opposite side. These functional changes can also give rise to neck pain. Because of this reflex cycle, as well as the close anatomic relationship between the neck and shoulder, not to mention the "domino effect" of soft-tissue injuries which seem to change the function at the next joint level, it's not surprising that both the neck AND the shoulder require simultaneous treatment for optimal treatment benefit. However, the good news is, regardless which one is the "chicken or the egg," chiropractic treatments of shoulder injuries will almost always include the neck and vice versa.

Weekly Health Update

Mental Attitude: Sleeping Problems?
People who are poor sleepers exert a ton of energy trying to force sleep. Sleep is something that has to naturally unfold, so the more you engage in behaviors to try to sleep, the less likely you're going to fall asleep.
Behavior Therapy, Dec 2011

Health Alert: Acid Reflux Up!
Reports of acid reflux experienced at least once a week have increased by 47% in the last decade. The prevalence of any acid reflux symptoms rose 30%, while the more severe symptoms rose by 24%. There is concern that these findings will lead to an increase in cancer of the esophagus, a once rare but now more common malignancy that is very difficult to treat. Acid reflux, also known as gastro-esophageal reflux, is where the stomach contents (food and acidic digestive juices) escape upward into the esophagus. This can irritate the esophagus and cause heartburn and other symptoms. Being overweight is a risk factor for acid reflux.
Gut, Dec 2011

Diet: Depression And Vitamin D.
Because depression affects one in 10 adults in the US and low levels of Vitamin D have been linked to depression, researchers suggest that screening for vitamin D levels in depressed patients and perhaps screening for depression in people with low vitamin D levels might be useful. Vitamin D levels are now commonly tested during routine physical exams, and they are accepted as risk factors for a number of other medical problems such as autoimmune diseases; heart and vascular disease; infectious diseases; osteoporosis; obesity; diabetes; certain cancers; and neurological disorders such as Alzheimer's and Parkinson's diseases, multiple sclerosis, and general cognitive decline.
Mayo Clinic Proceedings, Jan 2012

Exercise: Good Reasons.
Exercise helps to alleviate depression and increases your ability to adapt to cold environments.
Surgeon General's Report on Physical Activity and Health, 1996

Chiropractic: What Did He Say?
"The quality of healing is directly proportional to the functional capability of the central nervous system to send and receive nerve messages."
~ Janson Edwards, MD. PhD

Wellness/Prevention: Don't Smoke, Be Happy!
Smokers have concerns that their quality of life may deteriorate if they stop smoking. However, a study found, in the long term, smokers who successfully quit experience no such deterioration due to quitting. If anything, they see some noticeable improvements. Specifically, compared with those who continued to smoke, quitters scored higher on measures of overall quality of life, health-related quality of life and positive emotions, both one year and three years on. They also felt they had fewer stressors by the third year.
Annals of Behavioral Medicine, Jan 2012

Fibromyalgia: The Challenges of Diagnosis

Fibromyalgia (FM) is a chronic condition where the diagnosis is made by elimination since there are no specific lab tests for diagnosing FM. In the past, we've discussed the different types of FM, the lack of good diagnostic tests, many management recommendations derived from interviews with FM patients, and more.

One of the many causes of FM involves the autoimmune system, thus suggesting that FM may be an autoimmune disease. In summary, the autoimmune system is very important system for all of us, as it controls the means by which our body fights off unwanted foreign particles like viruses, bacteria, and a host of other triggers that can negatively affect our body. The autoimmune process is best explained by example: Let's say a certain type of food is eaten to which the person has an allergy. As particles from that food are absorbed into the blood stream, the body senses that something is wrong -foreign particles are there that shouldn't be there. As a result, our body produces antibodies, which function like an army trained to "fight" the foreign particles. If the body's autoimmune system handles it without a problem, the person may not even know anything is "wrong" or that this process is going on. However, if the foreign particle is not handled easily or properly, all kinds of symptoms can occur. In this food allergy example, stomach pain, nausea, cramping, diarrhea and perhaps hives on the skin may even occur. Another common autoimmune example occurs in the spring when flowers bloom, grass grows, trees bud, and so on. Many of us suffer from what is commonly referred to as "hay fever" and possible symptoms include a runny nose, itchy watery eyes, and sneezing (lots of it).

FM is sometimes thought to be associated with rheumatoid arthritis but the scientific evidence is not in full agreement with this theory either. More consistent evidence for causation seems to support the following possibilities: 1. Following trauma or injury. 2. A central nervous system origin (the topic of last month's FM Health Update). 3. Changes in muscle metabolism. 4. A decrease in muscle blood flow.

However, there are still those who support the cause of FM being triggered by an infectious agent like a virus in susceptible people, even though no specific agent has yet to be identified. For those who state that FM is not an autoimmune disease, they do admit FM may have an "autoimmune component" to it. One study reported, "...that scientists have discovered a new antibody in the blood of many FM patients," which was reported in the Journal of Rheumatology. Subsequently, a new test was developed for detection of the "Anti-Polymer Antibody" (APA) that was reportedly found in more than 60% of FM patients with severe symptoms. The idea of a specific blood test for FM is certainly welcomed by all experts and clinicians who manage FM as a reported $16 billion/year in direct medical costs are associated with FM. Unfortunately, when comparing the APA levels in FM patients to those with rheumatoid arthritis and controls with neither, the APA levels were not able to distinguish between the groups. Unfortunately, until better testing methods are developed, doctors and researchers will continue to look for the "gold standard" FM test.

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: Prevention

People who spend a lot of time performing activities that require a high level of force, repetition, or use vibrating tools are at risk of developing carpal tunnel syndrome (CTS). Other activities such as driving, playing musical instruments, knitting, using a sander, screw drivers, air wrenches, waitress work, or assembling small parts are also associated with increased CTS risk. The good news: there are ways we can reduce the risk of developing CTS. Some of these include the following:

1. Stay Healthy: There are many conditions that contribute to the onset and/or make CTS worse. Exercise, maintain a healthy weight (Body Mass Index - BMI - of 25 or less), stop smoking (or better yet, never start), take your thyroid medication (if indicated), keep your blood sugar normal (obesity leads to diabetes which often worsens CTS), and do your carpal tunnel exercises multiple times a day.
2. Ergonomics: Use "ergonomic" principles when arranging your workstation such as sitting properly at your home and work computers. The placement of your desk, the computer monitor, the keyboard (consider a convex keyboard rather than the flat type), the mouse (and type of mouse - the track ball mouse requires no arm movement, only the thumb), paperwork space and location. The type of chair and its height are also very important. Avoid desks that have sharp edges as they can compress the forearms and pinch the CTS nerve.
3. Posture: The position in which you sit is important! Sit in an upright position, head/chin tucked in, feet on the floor or on a box, elbows resting on adjustable arms of the chair bent about 90 degrees, and keep your wrists fairly straight/neutral. Avoid slouching, reaching out with the elbows less than 90 degrees, head shifted forwards and shoulders rounded and feet not positioned under you. When you talk on the phone, STRONGLY consider a headset! Pinching the phone between your shoulder and ear with your head bent sideways for any length of time is a ticket to disaster for developing CTS and/or other types of cumulative trauma disorders (pinched nerves in the neck, shoulder tendonitis/bursitis, elbow tendonitis and more).
4. Plan your activities: Pay careful attention to your daily routine for activities that may increase your risk of developing or perpetuating CTS. For example, these activities can increase your chance of developing or worsening CTS: playing a musical instrument, knitting, carpentry, playing video or computer games for hours, working on cars, operating vibrating tools, using forceful gripping such as spray bottles, using a crutch, cane, wheelchair, engaging in certain sports such as long-distance cycling that load the arm and hand, skiing - waterskiing requires a firm grip on the handle and snow skiing requires firm gripping on the ski pole.
5. Sleep: It is impossible to control the position we put our hands/wrists in at night. Therefore, it is essential to wear wrist splints so we avoid bending the wrists in our sleep. Many of us curl up in a ball and tuck or bend the wrists and hands under our chin. In a "normal" wrist, the pressure inside the carpal tunnel DOUBLES when we bend our wrists! If we have CTS, the pressure goes up exponentially or, 6-8 times because of the increased pressure that's there already because of the CTS. Use a pillow that is designed for you, we'll help you with that!
6. Take a break! It's important to pace yourself if your work or play includes fast, repetitive activities. It's easy to get lost into what you're doing so a timer to remind you that an hour has gone by and to take a break is a wise purchase. There are computer programs that flash on your screen, "Time to stretch!" Some of these may include the actual exercise so you don't forget what to do. If not, talk to us about what exercises are good to do either at the workstation and/or at home for CTS.

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.

Low Back Pain & Spinal Manipulation: How Does It Work?

For many years, Chiropractic has been at the forefront of treating low back pain (LBP) with both greater patient satisfaction and less lost time at work when compared to other non-surgical treatment approaches. There have been many explanations as to why chiropractic manipulation therapy (CMT) works but many of these studies include other treatment modalities or methods and the benefits are ,therefore, not clearly derived only from CMT. A recent study has tried to clear this up and the results are very interesting!

This study included two chiropractors and two physical therapists (PT) from Canada and the US. What is unique about this study is that they measured clinical or symptomatic improvement by tracking improvement in activity tolerance using a standard questionnaire commonly used by chiropractors and PTs all over the world, as well as changes in the spinal stiffness using a valid/reliable instrument before and after CMT was utilized. The importance of these findings is that only CMT was utilized and hence, other forms of treatment commonly utilized by chiropractors did not cloud the findings. There were 48 patients included in the study and the initial 2 treatments were administered 3-4 days apart, followed by an assessment 3-4 days after the 2nd treatment. Assessments were also performed before and after each treatment. The assessments included use of the questionnaire and a stiffness measurement using the special instrument. Also, "recruitment of the lumbar multifidus muscle" (a muscle in the low back that helps stabilize the trunk or core) was measured by ultrasound. After each treatment, significant improvement was found in the overall pain level and in reduced spinal stiffness (which remained improved 3-4 days after the last/second treatment).

The study conclusions revealed less pain, more activity tolerance and less spinal stiffness after the administration of the 2 treatments. The greatest clinical improvement was found in those who had the most dramatic reduction in stiffness after each treatment. They found that the level of muscle recruitment was directly related to the degree of spinal stiffness. They also found that patients who received thrust manipulation (CMT) had immediate improvements with reduced pain, stiffness and improved muscle recruitment measurements. However, this same effect was NOT obtained when non-thrust mobilization techniques were used. This means many non-thrust manual techniques such as mobilization, massage, and other soft tissue release methods do not create the immediate benefits that were produced by thrust manipulation.

With this new information, we are now able to explain with confidence to patients the reasons why they typically feel better after the spinal adjustment. The patient can then appreciate receiving an answer that makes clear sense and has been "proven." It's important to realize that the "bonus" of receiving chiropractic care for low back pain includes not only just pain reduction, but more importantly, improvement in tolerating activities such as vacuuming, washing dishes, golfing, walking and of course, working.

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.