The Many Faces of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) was first reported in the late 1800’s and the first surgery was noted in 1933. In the beginning, CTS surgery was rarely performed, reportedly because the nerve pinch was present somewhere before the median nerve reached the wrist or carpal tunnel. In brief, possible compression sites include the cervical nerve roots (C5-7), the brachial plexus, thoracic outlet, above the elbow, in the proximal and/or mid forearm, and finally at the wrist/carpal tunnel.

Estimating the frequency of CTS is challenging due to the fact that the pinch or entrapment may include more than one area before the wrist resulting in double and multiple crush syndromes. One European study reported the incidence of CTS at 5.8% in women and 0.6% in men while another reported 3.4% in the United States. Even the causation of CTS is all over the board. For example, the annual incidence of CTS in automobile workers ranges between 1-10%, while in a fish processing plant, it was reported to be as high as 73%! To make this even more challenging, the cause of CTS is commonly associated with other conditions such as diabetes and pregnancy. In diabetics, CTS ranges between 14% and 30% and those who are pregnant have a 2% incidence. Even harder to report is the incidence of median nerve pinching proximal to the wrist as this ranges between as little as 1% to as high as 75% for pronator tunnel syndrome in already symptomatic women. Gender is also a factor as women are reported to be four times more likely to develop CTS than men. If there is NO other condition associated with CTS, the term “idiopathic” is applied, and this reportedly occurs 43% of the time.

Another issue making CTS a challenge to diagnose is the many risk factors associated with it, and sometimes studies are published that contradict one another about the possible risk factors. There are studies that report CTS is more likely to occur with conditions including: 1) Jobs or activities associated with wrist flexion or extension; 2) Hysterectomy without ovary removal; 3) Obesity; and 4) Varicosities in men. Some studies indicate risk criteria such as: 1) Use of birth control pills; 2) Age at menopause; 3) Diabetes; 4) Thyroid dysfunction; 5) Rheumatism; 6) Typing; and, 7) Pinch grasping. One study reported the highest incidence to occur in those with previous wrist fracture (Colles’ fracture), and common conditions included rheumatoid arthritis, hormonal agents or ovary removal, diabetes, and pregnancy. Another study reported obesity and hypothyroid as being risk factors, but not all studies support that theory. Certain medications have been reported to be associated with higher CTS risk including: 1) Insulin, 2) Sulfonylureas (diabetes meds); 3) Metformin; and 4) Thyroxin.

As doctors of chiropractic, we perform a thorough history, examination, and offer MANY non-surgical, non-pharmaceutical ways of treating CTS. Some of these approaches include: 1) Joint and soft tissue manipulation of the neck, shoulder, elbow, forearm, wrist, and hand; 2) Wrist splinting, especially at night; 3) Vitamin B6 and anti-inflammatory nutrients; 4) Home exercises for the neck, arm and hand; 5) Work station/ergonomic evaluations; 6) Dietary counseling for various conditions listed previously; 7) Co-management with primary care, rheumatology, neurology, orthopedics, and others.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we would be honored to render our services.

Weekly Health Update—Chiropractic: Research Supports Chiropractic Care.

Mental Attitude: Facebook Photos Cause Anxiety and Eating Disorders.
A new report reveals that college women who spend more time on Facebook than their peers exhibit a higher frequency of appearance-focused behaviors and report more eating pathologies. The study's authors explain, "Facebook merges powerful peer influences with broader societal messages that focus on the importance of women's appearance into a single platform that women carry with them throughout the day. As researchers and clinicians attempt to understand and address risk factors for eating disorders, greater attention is needed to the emerging role of social media in young people's lives."
International Journal of Eating Disorders, March 2014

Health Alert: FDA Clears First Device to Prevent Migraines.
The United States Food and Drug Administration (FDA) has granted STX-MED, a Belgian company, permission to begin marketing a headband-like, battery-powered device called Cefaly that can be worn to prevent migraines. The device is positioned in the center of the forehead and applies an electric current to the skin to stimulate branches of the trigeminal nerve, which has been associated with migraine headaches. Its developers believe it is in an important step in managing migraines.
U.S. Food and Drug Administration, March 2014

Diet: Omega-3 Fatty Acids Improve Children's Sleep.
A new study suggests that higher blood levels of the omega-3 fatty acid DHA in children are associated with better sleep, less bedtime resistance, less anxiety about sleep, and less waking during the night. According to the authors of the study, omega-3 blood levels in seven to nine-year-olds are alarmingly low which may lead to poor sleep and problems with both behavior and learning.
Journal of Sleep Research, March 2014

Exercise: Just Do It.
Regular physical activity/exercise is one of the most important things you can do to improve your health. It can help control your weight, lower your risk for heart disease, lower your risk for type 2 diabetes and metabolic syndrome, lower your risk for some cancers, strengthen your bones and muscles, improve your mental health and mood, improve your ability to do daily activities and prevent falls, and increase your chance of living longer."
Centers for Disease Control and Prevention, February 2011

Chiropractic: Research Supports Chiropractic Care.
Commentary by Dr. Scott Halderman of the Department of Neurology at the University of California, Irvine in response to an evidence report on the effectiveness of manual therapies, including spinal manipulation: "There was a time, not long ago, when there was little or no evidence to support the practice of manipulation that is the mainstay of chiropractic practice… There has, however, been a rapid growth in the number of clinical trials that have studied the effectiveness of manipulation, mobilization, and massage over the past 20 years and… there is now little dispute amongst knowledgeable scientists that manipulation is of value in the management of back pain, neck pain, and headaches that make up 90% or more of all patients who seek chiropractic care."
Chiropractic & Osteopathy, February 2010

Wellness/Prevention: TVs in Bedrooms Linked to Childhood Obesity.
A recent report reveals that children who have a televisions in their bedroom are much more likely to be overweight. Researchers hypothesize that bedroom televisions may disrupt a child's sleep pattern and past studies have shown that reduced sleep or poor sleep quality may be a cause of weight gain in children. The authors add that the American Academy of Pediatrics recommends against children having televisions in their bedroom.
JAMA Pediatrics, March 2014

Whiplash Anatomy

Whiplash is an injury commonly associated with motor vehicle collisions (MVC) caused by a rapid forward and backward “whipping” of the neck. What varies between each case is the degree of injury and what anatomical parts of the neck are actually injured. Let’s take a look at the spine so we can better understand where the pain actually comes from…

The cervical spine is made up of seven moving vertebrae. The top vertebra (C1) is called the atlas and is shaped like a ring. This ring shape allows the head to rotate left and right so we can check traffic, carrying on conversation with someone sitting off to the side, and so on. It pivots around a peg called the “dens” of C2, or the axis, and the function of these first two vertebrae is very important. This is because the upper most three nerves that exit through this part of the cervical spine innervate the head and dysfunction here may be the cause of some headaches. Chiropractic adjustments concentrate a great deal on restoring function to this area. The C4-6 vertebrae make up the most mobile region of the spine in the forward and backwards directions. Generally, the greater the mobility, the lesser the stability, and because of this, injury to this area is quite common. We often see arthritis in this region first and we focus on keeping the areas that are less mobile (areas above and below C4-6) as mobile as possible. The upper back/lower neck area includes the rib/vertebrae joints, which are also commonly involved in whiplash injuries. Chiropractic adjustments applied to this region also help to restore function and mobility. The thoracic spine is made up of 12 vertebrae and includes the rib cage as well as the shoulder blades (scapulae). This area is sometimes neglected during treatment as the main focus is often placed on the more painful areas of injury like the neck. The lumbar spine consists of five vertebrae and is also frequently overlooked as an injured area due to the distance away from the neck. However, seat belts frequently injure the breast, chest, mid-back, and/or low back regions.

There are several tissues that could be injured. The ligaments — the tough, non-elastic tissue that holds bone to bone — function to maintain stability between the vertebrae. The articular capsule is also made of ligaments and is a frequently injured area, which generates pain with movement of the head and neck. Muscles and the tendon attachments are elastic and function to move the structures. Stability is facilitated by good muscle tone and strength and is a strong focus of treatment. Injury to these structures are called, “…soft tissue injuries,” and make up the majority of whiplash associated disorders (WAD II category).

The intervertebral disks are made up of a fibroelastic cartilage on the outside and a more liquid-like center that functions as shock absorbers between the vertebrae. Injury to the disk includes tears, cracks, and/or fissures where the liquid center part can migrate through and can rupture. Injury to the nervous tissues includes the free nerve endings when the articular capsule is “sprained.” Nerve root injuries are most commonly “pinched” or compressed by a “ruptured disk” and send pain, numbness, and/or muscle weakness to specific areas of the arm and/or hand. These injuries are classified as WAD III injuries and usually carry a worse prognosis than WAD II injuries.

Determining which tissues are injured, managing the acute, subacute, and chronic stages of healing and facilitating self-management strategies are the primary goals of chiropractic treatment of the whiplash injured patient.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for Whiplash, we would be honored to render our services.

Weekly Health Update—Chiropractic: More Cost-Effective.

Mental Attitude: Angry Outbursts Increase Heart Attack Risk!
Researchers at Harvard University report that heart attack risk increases nearly five times and stroke risk increases nearly three times in the two hours following at outburst of anger. Author Dr. Elizabeth Mostofsky adds, "Although the risk of experiencing an acute cardiovascular event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger. This is particularly important for people who have higher risk due to other underlying risk factors or those who have already had a heart attack, stroke, or diabetes."
European Heart Journal, March 2014

Health Alert: Diarrheal Infection in Children Linked to Antibiotics.
According to the Centers for Disease Control and Prevention (CDC), the majority of severe and potentially fatal pediatric diarrhea cases caused by Clostridium difficile infection (C. difficile) are linked to recent antibiotic treatments. Based on surveys of parents, 73% of children who suffered from a C. difficile infection were recently prescribed antibiotics to treat ear, sinus, or upper respiratory infections. Past studies have shown that at least half of upper respiratory infections do not require antibiotic treatment. The overuse of antibiotics places children at risk, as the antibiotics kill both bad and natural flora in the digestive system and create an imbalance that may allow a C. difficile infection to grow out of control and release toxins that inflame the gut. Dr. Tom Frieden, the Director of the CDC, writes, "When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections."
Pediatrics, March 2014

Diet: Eating Too Much Protein in Middle-Age Could be Harmful.
A new study suggests that a high protein diet (>1.2g protein per kg of body weight consumed per day) increases the risk of cancer, diabetes, and death among middle-aged adults. Lead author Dr. Valter Longo writes, "We studied simple organisms, mice, and humans, and provide convincing evidence that a high-protein diet - particularly if the proteins are derived from animals - is nearly as bad as smoking for your health."
Cell Metabolism, March 2014

Exercise: Exercising During Pregnancy Reduces Weight Gain & Associated Illnesses.
Research involving 963 pregnant women shows that moderately intense supervised exercise starting at the prenatal consultation helps women avoid excessive weight gain during pregnancy while also reducing associated illnesses such as gestational diabetes and hypertension. The researchers state, "We wish to emphasize the importance of maintaining the health of pregnant women, as well as their children, by reaching an optimum weight; hence the importance of [physical exercise]."
Mayo Clinic Proceeding, December 2013

Chiropractic: More Cost-Effective.
Considering effectiveness and cost together, chiropractic care for low back and neck pain is highly cost-effective and represents a good value in comparison to other treatments, including medical care.
Mercer Health and Benefits, October 2009

Wellness/Prevention: Enjoy a Nap.
Taking an afternoon nap has been associated with benefits including improved alertness and performance, fewer accidents and mistakes, and a psychological boost to help one feel both relaxed and rejuvenated.
National Sleep Foundation, 2013

Fibromyalgia in Men?

Fibromyalgia (FM) can’t occur in men because it’s a woman’s disease, right? In fact, if a man claims to have FM, then he is simply lying (probably just trying to get out of working and/or on disability), right? Unfortunately, that's what MANY people (and even some doctors) believe!

Though it is true that FM is primarily a women’s disease, actually nine times more likely, it does INDEED affect men. FM affects 2-4% of the population (an estimated 5 million adults) in the United States (US) with as few as 10% of victims being men. But, that’s still 500,000 men in the US alone, and that doesn’t include an estimated 20% that go undiagnosed (mostly because “men are men”)! The onset, like that for women, can occur, “…out of the blue.” Case studies show a man (or woman), can be highly engaged in an active lifestyle that may include golfing, bowling, or working on a hobby car, when suddenly and for no apparent reason, intense chronic pain can arise and, “…take over the life” of this previously very healthy, vibrant, active man.

We’ve all learned that FM is diagnosed primarily by excluding other disorders after running many tests including x-rays, various scans, lab tests, and more. When all the tests come back negative, the diagnosis of FM is even then only sometimes entertained. The word, “SOMETIMES” should be strongly emphasized as MANY doctors, as well as the general public, STILL have a hard time wrapping their heads around the diagnosis of fibromyalgia. This happens even more when a male patient presents with the FM cluster of symptoms. A male patient may attend a FM support group and be the only man in the room. The National Fibromyalgia Association has only one male board member who reportedly was not initially welcomed! This particular male reported that a neurologist refused to see him, as he did not support the diagnosis and openingly accused him of trying to get disability payments. He stated that it was particularly challenging to find professional care as well as community support. Even his best friend, a doctor, told him that men couldn’t get FM!

The cause of FM remains elusive. Why do so few men compared to women suffer from FM? Though certain types of viral infections, trauma after car accidents, and emotional stress have all been reported to trigger FM, it can also strike without warning. According to Dr. Muhammad B. Yunus, MD (professor of medicine at U. of Illinois, College of Medicine), FM is characterized by an imbalance of brain chemicals described as, “…a neurochemical disease.” He found that FM patients have higher than average levels of substance P (a neurotransmitter that signals pain), and lower levels of serotonin (a neurotransmitter that inhibits pain). Genetics and hormones (particularly estrogen, which is higher in women) also play a role both with causing the disease and with the gender discrepancy found in FM. Estrogen has also been found to reduce pain thresholds, a problem associated with FM, thus making women more susceptible to the disease. Like in women, men can have similar complications including (but not limited to) chronic fatigue, difficulty sleeping, headaches, irritable bowel syndrome, restless leg syndrome, and memory and concentration problems. But, it has been reported that men with FM usually have less wide-spread or, “…hurt all over” pain and may not suffer from as much fatigue, but in some cases, can still be more disabled from FM than women. Depression and suicidal thoughts are reportedly common in men with FM. Prompt diagnosis and treatment continues to be the recommended course in order to obtain ideal management results!

As chiropractors we can offer management, treatment, exercise training, dietary consultation, and coordinate care.

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

Weekly Health Update—Chiropractic: High Prevalence of Back Pain in High School Sports.

Mental Attitude: Alzheimer's Deaths Larger than Reported.
A new report suggests that Alzheimer’s disease contributes to an estimated 500,000 deaths per year in the United States. However, according to the Centers for Disease Control and Prevention, only 83,494 Alzheimer’s deaths were reported in 2010, pointing to incorrect identification of the underlying cause of death. Study author Dr. Bryan D. James writes, "Death certificates often list the immediate cause of death, such as pneumonia, rather than listing dementia as an underlying cause… Determining the true effects of dementia in this country is important for raising public awareness and identifying research priorities regarding this epidemic."
Neurology, March 2014

Health Alert: For Younger Prostate Cancer Patients, is Surgery a Better Option than Waiting?
Among younger men who are diagnosed with prostate cancer, mortality rates are over 40% lower for those who are treated surgically compared with those who follow watchful waiting (relying on changes in symptoms to determine if/when further treatment is needed). The authors of this study add that patients must assess the risks with the operation, such as incontinence and impotence, with what they may gain from having the surgery based on age, other diseases, and desires.
New England Journal of Medicine, March 2014

Diet: Is Saturated Fat Really that Bad?
For years, healthcare providers have recommended following a diet low in saturated fat to reduce the risk of heart disease. New research claims that such a diet does not curb heart disease or prolong life. According to Dr. James DiNicolantonio, there is insufficient evidence to suggest that reducing saturated fat consumption can decrease the risk of heart disease. He explains, "The increase in the prevalence of diabetes and obesity in the [United States] occurred with an increase in the consumption of refined carbohydrates, not saturated fat. There is no conclusive proof that a low-fat diet has any positive effects on health."
Open Heart, March 2014

Exercise: Exercise Improves Brain Power.
Recent research shows that aerobic exercise improves activity in certain areas of the brain as well as the connectivity of those structures. Researchers found that the more fit a person is, the stronger the connectivity in the brain and the better they are at multitasking, planning, prioritizing, and strategizing.
American Association for the Advancement of Science, March 2013

Chiropractic: High Prevalence of Back Pain in High School Sports.
Low back pain is a surprisingly common complaint among young athletes. A study from Finland analyzed 464 teenage athletes from a variety of sports and found that 54.9% experienced back pain during the previous year but only about a quarter sought treatment.
Journal of Sports Medicine, April 2014

Wellness/Prevention: New Smartphone Case Measures Vital Signs.
Azoi, an American technology company, has just announced a smartphone case that measures blood pressure, heart rate, temperature, and blood oxygen levels. This new health tracker is called Wello and works by using several sensors located in the case that attaches to your smartphone. Wello can also connect to other health and fitness devices, including pedometers and sleep monitors. Hamish Patel, CEO and founder of Azoi, says that Wello can help individuals monitor their vital signs, possibly allowing earlier detection of heart disease and other health problems.
American Academy of Urgent Care Medicine Technology Hub, March 2014

Chiropractic & Exercise vs. OTC Medication for Neck Pain?

“Boy, my neck is killing me! Honey, where is the ibuprofen?” Isn’t this the FIRST thing people think of when they have an ache or pain? The general public does NOT usually think, “…boy, do I need to see my chiropractor – my neck is killing me!” So, the question of the month is, which one is better, chiropractic or over-the-counter (OTC) medication? Let’s take a look.

Though this question has been discussed for years (just search: “chiropractic vs. NSAIDs”), a recent study looked specifically at this question, which will be the main focus of this Health Update. The study points out that it has been estimated that 75% of Americans will experience neck pain at some point in their life. For years, spinal manipulation has been criticized as being ineffective or providing limited benefits. Meanwhile, ads on TV, in magazines, and almost everywhere you look, show someone reaching for aspirin, ibuprofen, or even narcotics to manage their pain.

However, this new research clearly supports that seeing a chiropractor and/or engaging in light exercise can bring neck pain relief more effectively than relying on pain medications! Researchers even found that the benefits of chiropractic adjustments were still favored A YEAR LATER when comparing the differences between the spinal manipulation and medication treated groups! Moderate acute neck pain is one of the most frequent complaints prompting appointments at primary care/medical clinics and is estimated to account for millions of doctor visits per year. In some cases, pain and stiffness occurs without a known cause and there is no “standard” medical treatment. Though physical therapy, pain medication, and chiropractic have all been utilized for neck pain, until now no one had compared the benefits of each in a single study.

The study consisted of 272 neck pain subjects split up into three groups: 1) Chiropractic group (approximately 20-minute treatments an average of 15 times); 2) Pain medication group (meds included acetaminophen, and in some cases stronger prescription meds including narcotics and muscle relaxants); 3) Physical Therapy group (consisting of meeting twice and receiving advice and exercise instruction at 5-10 repetitions up to eight times a day).

At the end of three months, the chiropractic and exercise group did significantly better than those who took drugs. Approximately 57% of those receiving chiropractic management and 48% of those who did the exercises reported at least 75% reduction in pain vs. 33% of people in the medication group. A year after the treatment period ended, the numbers decreased to 53% in the chiropractic and exercise groups, compared to 38% in pain medication group. The chiropractic group received the highest scores in patient satisfaction at all time points. An interesting downside noted in the medication study group was that the subjects had to use a progressively greater amount of medication at a progressively increased frequency to manage their pain. Stomach trouble is the most common side effect of NSAIDs (leading to ulcers) as well as liver and kidney problems. Another interesting finding was that the subjects in the medication treated group felt less empowered, less active, and less in control over their own condition compared with those in the other two groups.

This study points out the benefits of two treatment approaches that chiropractors commonly utilize: spinal manipulation and exercise training/advice!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for neck pain, we would be honored to render our services.

Weekly Health Update—Chiropractic: Improved Motion

Mental Attitude: Mentally Ill More Often Victims of Violence.
According to a new report, mentally ill adults 50% more likely to be victims of violence than perpetrators of violence. Study author Dr. Sarah Desmarais writes, "We hear about the link between violence and mental illness in the news, and we wanted to look not only at the notion that the mentally ill are a danger to others, but the possibility that they are also in danger."
American Journal of Public Health, February 2014

Health Alert: People with Sleep Apnea at Higher Risk for Pneumonia.
Researchers followed 34,000 patients (7,000 with sleep apnea and 27,000 without sleep apnea) for eleven years and compared the occurrence of pneumonia in each group. They discovered individuals with sleep apnea have a 20% greater risk for pneumonia than those without sleep apnea.
Canadian Medical Association Journal, March 2014

Diet: Students Eating More Fruits & Vegetables.
New research suggests that the updated 2012 guidelines for school lunches have resulted in increased fruit and vegetable consumption by lower-income students. Researchers report that in the school year following the adoption of the 2012 guidelines, fruit consumption increased 23% while vegetable intake increased 16%. Lead researcher Dr. Juliana Cohen adds, "There is a push from some organizations and lawmakers to weaken the new standards. We hope the findings, which show that students are consuming more fruits and vegetables, will discourage those efforts."
American Journal of Preventive Medicine, March 2014

Exercise: Yoga Good for Breast Cancer Patients.
Breast cancer patients undergoing radiation may benefit from yoga. Investigators found a sharp decline in cortisol levels among breast cancer patients who practiced yoga. Cortisol is a stress hormone and increased cortisol levels are associated with worse breast cancer outcomes. The study suggests that practicing yoga helps to regulate cortisol levels. Lead author Dr. Lorenzo Cohen explains, "Combining mind and body practices that are part of yoga clearly have tremendous potential to help patients manage the psychosocial and physical difficulties associated with treatment and life after cancer, beyond the benefits of simple stretching."
Journal of Clinical Oncology, March 2014

Chiropractic: Improved Motion.
Compared with both supervised exercise and a home exercise self-care program, spinal manipulation performed by a Chiropractor resulted in the greatest improvements in spinal motion among back pain sufferers.
The Spine Journal, March 2014

Wellness/Prevention: High Vitamin D Levels May Improve Breast Cancer Survival.
A new study suggests that breast cancer patients who have higher blood levels of vitamin D are twice as likely to survive the disease compared to patients with lower blood levels of vitamin D. Researchers found that breast cancer patients in the United States have an average blood level of vitamin D of 17 ng/ml. Based on their findings, patients with breast cancer may benefit from having vitamin D blood concentrations measured and adjusted to within a normal range of 30-80 ng/ml. Study co-author Dr. Heather Hofflich adds, "The study has implications for including vitamin D as an adjuvant to conventional breast cancer therapy."
Anticancer Research, March 2014

The “Aging” Lower Back – Part 1

Low back pain (LBP) can arise from many causes. Nearly everyone has or will suffer from LBP at some point in time, though it is most common in the 30-year-old to 50-year-old group and it affects men and women equally. However, what about the elderly population and low back pain? Let’s discuss back pain unique to the geriatric population...

We’ve all heard of the “wear and tear” factor as it applies to clothing, automobiles, shoes, and tires, but it affects our bones and joints too! A condition that none of us can fully avoid is called osteoarthritis (OA). OA is the “wear and tear” factor on our joints, particularly the smooth covering called hyaline cartilage located on the surfaces of all moving joints. It’s the shiny, silky smooth surface that we’ve all seen at the end of a chicken leg when we separate it from the thigh. Osteoarthritis is the wearing away of that shiny, smooth surface and it can eventually progress to “bone-on-bone” contact where little to no movement is left in the affected joint. Bone spurs can also occur and be another potential generator of back pain. OA is NOT diagnosed by a blood or lab test but rather by an accurate history, physical examination, and ultimately, an x-ray. However, when the low back is affected by OA, it may not even hurt! Yes, in some cases, there may be a significant amount of OA on an x-ray and that patient may not have significant problems. Or the opposite can occur and some patients with very little arthritis can have a lot of back trouble. It’s FREQUENTLY very confusing. The “take-home” message with OA is that, in and of itself, it does not always generate pain. This is why the history, physical examination, and the response to treatment (chiropractic adjustments, exercise, and possibly some lifestyle changes in diet and activity) are MORE important than the amount of arthritis found on the x-rays. Ultimately, we will ALL get OA sooner or later. It’s usually a slow, gradual process that may slowly change our activity level. Ironically, KEEP MOVING is the best advice we can give to the patient with OA.

There are a number of conditions associated with OA that affect the spine and respond well to chiropractic treatment. Degenerative disk disease (DDD) is one of those conditions found in association with OA. In fact, another name for OA is “degenerative joint disease” (DJD)! The normal anatomy of the intervertebral disk (IVD) consists of a thick, tough outer layer of fibroelastic cartilage and a central “nucleus” that is more liquid-like and allows the IVD to function like a shock absorber. As we age, the water content gradually “dries up” and the shock absorbing quality is lost.

As chiropractors, we address OA (DJD) and DDD with a number of HIGHLY EFFECTIVE treatments but most important (in many cases) is the use of spinal manipulation or adjustments. “Exercising the joint” with manipulation and mobilization reduces the tightness and stiffness associated with OA and DDD. Exercises are also important and can give the OA/DDD patient a way of controlling this condition on their own. Diet, activity modification/encouragement, and periodic adjustments help a lot! Next month, we will continue this discussion!

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend, or family member requires care for back pain, we would be honored to render our services.