Category Archives: Chiropractic

Pain? Discomfort? Fatigue? Your Workspace Could be a Culprit.

In today’s day and age, most of us can’t avoid spending way too many hours in front of a computer monitor.  Unfortunately, the posture and repetitive movement that this encourages is one that causes excessive stress on body parts like the hands, wrists, elbow, shoulders, neck, and back. This contributes to discomfort, fatigue and even outright pain.

Fortunately, there is a way to limit this stress put on your body and potentially reduce or eliminate the discomfort and fatigue.  This is done through the implementation of proper ergonomics.  Ergonomics is a discipline that involves arranging the environment to fit the person in it. This can be done anywhere but for the sake of this post, we will hit you with a few easily implementable tips for the office setting.

CHAIR

Adjust the height of the chair so feet rest flat on the floor, the thighs are parallel to the floor, and the knees are about the same level as the hips.

Adjust height of armrests so the arms can rest at your sides during typing, allowing for relaxation and a natural “drop” of the shoulders.  Shoulders should not be elevated in anyway by the armrests.

MONITOR

The top of the screen should be at or just below eye level when you are seated in an upright position to avoid encouragement of forward translation of the head and shoulders.  The monitor should also be directly in front of you to avoid excessive twisting of the neck.

KEYBOARD AND MOUSE

The angle between your elbows and forearms should be as close to 90 degrees as possible, with forearms parallel to the floor and keyboard directly in front of you.

Try to avoid resting your wrists or hands on the edge of the keyboard while typing or on the mouse when you are not using it.  While using the mouse, make sure your wrist is in a neutral position.

The mouse, keyboard, and every other thing on your desk that you frequently use should be positioned close to you to avoid excessive reaching.

AVOIDING EYE STRAIN

You may be unaware of it, but little changes can help you avoid unwanted eye strain throughout the day.  This eye strain can lead to headaches and increased forward head posture.

Monitor should be approximately 18-30 inches from the eyes (depending on the size of the monitor).

Reduce Glare by:

Positioning the monitor at a right angle from the window.

I know you love that window in your office, but closing the blinds also reduces the glare.

The worktop surface should have a matte finish (think desk blotter if you have a shiny desk).

GET UP AND MOVE

It is imperative that you break up the long periods of sitting.  Sitting is actually one of the worst positions for your back and can also lead to blood pooling in legs and feet.  Taking a quick break from sitting every 20 to 40 minutes is key.

Practice “dynamic sitting.”  Make sure there is enough room underneath the desk to move your legs.  If you do find yourself seated for extended periods of time, utilize a lumbar support or a rolled towel to support the natural curve of your lower back.

Getting up and walking to the bathroom or to get some water (the two go hand in hand and you should be drinking more water anyway) are an easy way to keep it moving.  If you need to stay at your station, simply stand up and perform a stretch like the Bruegger’s Stretch demonstrated here:

http://www.youtube.com/watch?v=EvwvbXrf6LU

Please do not underestimate the power of some of these simple changes.  Anytime I work with a patient, we always address the work station set-up through pictures provided by the patient or checking it out in person.  If you’re curious about your personal space or feel like those around you would benefit from a work space makeover, please contact me as we are now accepting patients and providing free ergonomic evaluations for all local businesses.  This is a standard part of your individual treatment plan when you become a patient, but a free office wide evaluation can be done as well.

As with all things, proper ergonomics is just one piece of the puzzle.  Couple this with a thorough chiropractic evaluation addressing overall posture, balance and any other issues you may have going on and you are making a strong proactive statement about regaining control of your health and ultimately your life.  Again, feel free to contact me if you’re interested in getting started.

Remember, a proper, less strenuous work station promotes better posture and less discomfort.  Better posture promotes better breathing (more oxygen) and less needless strain on numerous muscles, each leading to less fatigue and pain, and clearer, more creative thinking.  This means your work gets done faster and at a higher level.  Sounds like a bonus for employee and employer alike.

Mental Health: A New Perspective

In today’s world of news channels and smart phones providing constant information, it is almost impossible not to be inundated with every little detail of each event.  The ones that receive the most coverage are generally the negative stories, as it seems like one heinous act is committed in an attempt to top its seemingly un-topable predecessor.

With the in-depth coverage, the analyzation of the criminal’s profile becomes a focus.  More specifically and recently, their mental health (and medications) are called in question.  Are all of these people inherently evil or is there something going on with their hard-wiring that makes them see the world the way they do, and ultimately do the things they do?

Along the same lines we have conditions that have traditionally been labeled and treated as psychological problems.  ADD, OCD, addictions, depression, anxiety and a bad temper are conditions that we as society have a hard time understanding.  Often the individual is looked at as weaker, and those on the outside sometimes question the actual legitimacy of the concept of mental illness as a whole.

All of this falls under the category of mental health.  And as stated, traditionally this has fallen into the realm of relying on psychological and/or psychiatric treatment.  However, there is mounting evidence pointing toward physiological deficiencies in the individual’s brain as the potential reason for these issues.  This is promising as research has also shown that you can improve brain function.  This reinforces the theory of changing your brain to change your life.

The basis of this theory has been supported by the use of SPECT (single photon emission computed tomography) which allows us to view blood flow and the distribution of activity levels throughout the brain.  The pioneers of this technology utilized it to view functional images of people who had problems with dementia, depression, schizophrenia, drug use and head injuries, and compare them with the images of normal brains.

What they found was various locations of deficient brain activity could be correlated with certain mental conditions or personality flaws.  Even more exciting is that therapies exist to target specific deficient regions, and have been implemented with success throughout the country.  This provides additional understanding and more importantly, hope.

Thanks to the documented results of these imaging studies, patients and their families are able to actually see the underlying brain problem that is essentially driving the emotional and behavioral symptoms.  Rather than blame themselves for having a weak character or mental illness, patients are able to better understand the origin of their issues and receive more targeted, effective treatment.

The following is an excerpt from the book: “Change Your Brain, Change Your Life,” a New York Times Bestseller written by Dr. Daniel G. Amen:

“Your brain is the hardware of your soul.  It is the hardware of your very essence as a human being.  You cannot be who you really want to be unless your brain works right.  How your brain works determines how happy you are, how effective you feel, and how well you interact with others.  Your brain patterns help you (or hurt you) with your marriage, parenting skills, work, and religious beliefs, along with your experiences of pleasure and pain.  If you are anxious, depressed, obsessive-compulsive, prone to anger, or easily distracted, you probably believe these problems are “all in your head.”  In other words, that you believe your problem is purely psychological.  However, research that I and others have done shows that the problems are related to the physiology of the brain – and the good news is that we have proof that you can change that physiology.”

This is truly powerful stuff.  What this means to all of us on a practical level is that there is hope.  We all don’t have access to the SPECT technology of imaging, but what this research has shown us is that depressed areas of the brain correlated with certain conditions or traits, can have their level of activation increased by way of targeted therapies.

Bridging this to my area of practice, the utilization of functional neurology provides the practitioner with the tools to do just what we described above.  By performing a series of non-invasive tests and observations on a patient, the potential area of brain imbalance can be identified.  In and out of office therapies can then be intentionally directed at that area in attempt to boost the function of the brain and thus the overall capabilities of the individual’s life.

If you have any of the above described conditions or are simply interested in looking into unlocking your full potential, please do not hesitate to contact my office (contact information provided to the upper right), as I’d love to work with you.  If you’re not in my area, look for a chiropractor who utilizes functional neurology and go check it out for yourself.

The research and evidence is mounting.  Help and hope does exist.  The ball is in your court to take the first step.

A Sign of Progress: AMA Endorses Chiropractic for Low Back Pain

About two weeks ago I was scanning the Florida Chiropractic Society’s website when I saw an article stating that the AMA (American Medical Association) recently came out with a report stating that chiropractic care should be sought prior to resorting to surgery.  This is actually a big deal due to the fact that the AMA has been a longtime opponent of the chiropractic profession as a whole.

(This isn’t some chiropractic conspiracy theory, this is fact.  Look up the Wilk v. AMA anti-trust suit or better yet check out the documentary Doctored for an interesting and somewhat disturbing history lesson.)

My initial reaction to this headline was one of surprise and refreshment. This is a sign of progress that the mainstream medical community is acknowledging chiropractic care as effective, and better yet, the option to be pursued prior to seeking surgical intervention.

The article specifically states that patients try chiropractic services and other conservative options such as acupuncture and physical therapy for the treatment of low-back pain.  According to the article, surgery is not usually needed and should only be considered if other therapies have failed.

The emphasis here should be on the bolded phrase above.  For many conditions, surgery is not usually needed and the risk often outweighs the reward.  A clear picture of what’s best for the patient becomes clouded when third party payers form alliances with the medical community and all too willingly cover these procedures.  This diverges from a patient centered care plan and directs us towards a dangerous, money motivated business at the patient’s expense.

Other examples of this include current scientific evidence not supporting the medical necessity for surgical intervention in idiopathic juvenile scoliosis, yet the procedure continues to be performed highly due to it being reimbursed by insurance.  These are kids we are talking about here.

Another example is the ever so popular carpal tunnel surgery. I cannot tell you how many people I’ve met that were advised to undergo this procedure.  Not taking into account that this condition is highly misdiagnosed and responds extremely well to conservative care.  Yet the procedure is pushed for a profit and the alternatives are dismissed as “quacks” despite the low success rate of the surgical procedure.

Last week I met a gentleman that had undergone back surgery (spinal fusion at L5-S1) and it wasn’t pretty. He had a well localized, non-radiating pain in his lower back for approximately three years, which lead him to a consult with a surgeon.

Since the surgery, this poor soul has now developed a new, more intense, stabbing pain in a different location (right SI Joint).  He wears a brace, limps slowly with an awkward, dragging gait, and can no longer carry out many of his activities of daily life, including lifting and standing for too long.  What’s worse is that the surgeon reassured him of his well-being pre-op, boasting a convoluted and misleading 90% success rate.

Did you know that the failure rate of back surgery is so high that there is an actual diagnosis and medical code for it?  Failed back surgery syndrome or post laminectomy syndrome is a name given to the condition when pain (many times worse than before) persists long after surgery.  Now an individual is left with an irreversible structural change and the dreaded thought of repeated surgeries.

Yesterday I received a text from a longtime friend advising me to check out Dr. David Hanscom on coasttocoastam.com. Dr. Hanscom is an orthopedic spinal surgeon who has turned to a more natural and holistic initial approach to chronic pain after being disheartened by a system filled with multiple surgeries on the same patient.  He discusses how in med school they are taught the aforementioned 90% success rate for spinal surgery, when in actuality he and all his colleagues were boasting a 25% success rate at best.

The hopeful sign of progress here is the symbolism of a potential rectifying reversal of the medical model.  The current status quo has patients opting for pills or surgery prior to traveling the conservative route.

Too often we see patients come in the door helpless and ravaged from trying everything else first.  Doesn’t it make sense to go the non-invasive, non-habit forming and side effect-less route first? Shouldn’t we be trying everything possible before cutting someone open and inserting hardware or providing them with life altering pills?

I commend the AMA for no longer ignoring the facts and shedding light on the truth, even if it does have the potential to cut into their piece of the pie.  Recognizing chiropractors as a top alternative for back pain is a start, but if you read my posts, you know we can do so much more.  Understanding and taking advantage of the intricate relationship the spine and our joints have with the nervous system opens the door to potentially effect almost all bodily function and provides physiological explanation for the previously mislabeled “chiropractic miracles.”

Manual practitioners like chiropractors should not be considered “alternative” at all, but the exact opposite.  A well trained chiropractor can provide explanations and potential treatments for numerous ailments well beyond back and neck pain.  Pigeonholing the profession to one or two conditions is a disservice to all and leaves the door open for continued reliance on harmful drugs and risky surgeries.

But like I said, it’s a start.

The good thing is, you have the choice to pursue both options.  The information is out there.  The treatment is available.  It is your responsibility to choose.  Don’t get me wrong, sometimes drugs or surgery are necessary and can be life saving.  However, in many cases, they should be considered the “alternative” or last resort, and non-invasive therapies like chiropractic, the first line of defense.

REFERENCES

http://jama.jamanetwork.com/article.aspx?articleid=1681414

http://www.chiroaccess.com/Articles/Idiopathic-Juvenile-Scoliosis–Surgery.aspx?id=0000349

http://www.ncbi.nlm.nih.gov/pubmed/1840393

Feet Hurt? Could be Plantar Fasciitis

Are you or someone you know plagued by a mysterious pain in the arch of your foot?  (Sounds like the start of an attorney’s commercial.)  Is it a sharp pain that starts in the heel and is usually worse when you get out of bed in the morning?  Is the tip of your heel tender to the touch, or does it hurt the arch of your foot to bend back your big toe?  If you answered yes, you may be suffering from something called plantar fasciitis.

Anatomically, fascia is fibrous, connective tissue that surrounds our muscles, blood vessels and nerves.  Physiologically, it is there to either bind some of our internal structures together or to allow various structures to slide smoothly over one another.  Specifically, our plantar fascia runs on the bottom (or plantar side) of our feet, from our heel to a row of bones before the toes called the meta-tarsals.

For various reasons this fascia can become strained or stretched leading to inflammation, irritation and pain.  It accounts for approximately 15% of all adult foot pain cases and is prevalent in 10% of runners (noted as the second most common overuse injury of the foot).  If you suffer from this or would like to take proactive steps to prevent this, here is a list of tips to help you out:

1) DROP THE WEIGHT

Obesity is a risk factor for the origination and sustainment of this condition.  This one is fairly simple to comprehend.  If you’re packing more pounds, there is more of a load to bear on your body, including the arches of your feet.

2) PRONATION MAY NOT BE THE ISSUE

Many of you have probably heard the term “pronation” before.  This is actually a natural and necessary process that occurs when we walk or run in order to transfer the load, provide more balance and optimal position for the big toe to effectively push off.

Prior to placing too much stock in a previous “pronator” label, one should look to strengthen and stabilize the hips, glutes and muscles of the foot (particularly the flexor hallicus brevis) in order to more efficiently and evenly distribute the load.

3) TAKE A SEAT

Activities that require spending a long time on your feet can also lead to and/or aggravate plantar fasciitis.  This is a similar mechanism to the obesity problem.  More time on the feet equals more of a load being transferred and absorbed by the feet.  Now, if you’re flat footed, overweight and on your feet all the time, you’re obviously increasingly susceptible to this issue.

Other risk factors noted include poor arch support in your shoes, limited dorsiflexion of the foot and tight hamstrings.  While Clarke Chiropractic and Wellness (and many other manual practitioners) can assist you in increasing the dorsiflexion in your foot and loosening up those hamstrings, the use of various shoe inserts to address pronation and arch support should be pursued with caution.

Make sure you see a professional who has the technology to scan your foot and design an insert tailor made to your unique foot.  Going the cheap route and picking up an insert from the Wal-Mart can cause more harm than good.

If the preceding pointers don’t do the trick, or you feel as though you are beyond the point of these “do it yourself” measures, there is good news.  An estimated 95% of plantar fasciitis cases respond to conservative care.  Even more uplifting is the fact that there is a manual method of stripping the fascia that I have personally utilized on numerous patients with outstanding results.  If you’re tired of the constant pain and discomfort and would like to try a fresh approach, please feel free to contact me and we’ll work to together in an attempt to resolve the issue.

In related news, I am excited to announce that Clarke Chiropractic and Wellness will be accepting appointments within the next couple of weeks.  The updated contact information will be found at the top right corner of the page.  I thank you all for following the website and look forward to working together in the future.

REFERENCES

http://www.ncbi.nlm.nih.gov/pubmed/7805100

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884155/

http://en.wikipedia.org/wiki/Fasciae

What is an “Adjustment?”

The term chiropractic is practically synonymous with the term adjustment. Many people swear by that relief providing crack or pop delivered by their chiropractor. But what is happening here? Why does it feel so good? This week’s post will provide a brief explanation of what an adjustment is and a couple of things that take place physiologically.

First off, an adjustment, also referred to as a manipulation takes place when a force is applied, mainly to a joint, in order to deliver stimulation to that area or beyond. Although not always necessary for an adjustment to occur, the crack or cracking you hear is known as a cavitation.

Many of our joints are lined with synovial fluid that keeps them lubricated and assists in smooth movements. Due to the contour of the bones and cartilage that make up each joint, a bubble lined with synovial fluid and filled with gas forms. When a joint is taken slightly beyond its end range that bubble has the potential to pop and thus you have your satisfying crack. Eventually gas and pressure refills the joint and another synovial bubble is re-established. This is not instantaneous and the reason why immediate successive cavitations are rare.

So let’s now take a look at some of the physiological explanations for the potential benefits the adjustment can provide. If you’ve received an adjustment before, you most likely have experienced a release of tight musculature. Whether it be a stiff neck, stiff back, or headache, introducing a stimuli that causes a spazzing muscle to relax can seem life saving.

The reason this occurs is due the fact that most of our skeletal muscles attach either directly or indirectly to a joint. During an adjustment, when a joint is taken to and beyond that end range that I mentioned, the muscles that attach to that to that joint (directly or indirectly) are stretched.

This stretching stimulates receptors called GTOs (Golgi Tendon Organs) that are located in the tendons of the muscle. The GTOs send a signal back to the spinal cord by way of your peripheral nerves, that sends a signal back out to that same muscle that was stretched, inhibiting or relaxing that muscle. So now those tight trapezius muscles causing a stiff neck, or those over-contracted sub-occipital muscles contributing to a tension headache are “turned off” due to the fast stretch provided by the adjustment, and thus relief is experienced.

Another powerful and extremely beneficial therapeutic mechanism served up by an adjustment is that of an analgesic or pain killer. We have certain nerves that pick up the sensation of nociception or pain. This can be for a variety of reasons, but very often is due to physical trauma or inflammation. (The chemicals released by your body during inflammation actually stimulate these nociceptive nerves.)

The nerve fibers that transmit this nociceptive signal, synapse or connect in the spinal cord where the signal is sent north to the brain, where it is perceived as pain. Fortunately for us, these nociceptive nerve fibers are small and slow and can be over-ridden by their larger, faster counterparts. This is a phenomenon called closing the physiological pain gate. This gate can be closed in your spinal cord due to collateral connections and shared pathways of our nerves. Due to the fibers that transmit non-painful stimuli, including touch, being bigger and faster, they have the ability to cut off or close the gate on the transmission of nociception and thus the perception of pain.

You may have experienced this fascinating phenomenon before by shaking or rubbing your hand after banging it against something. By shaking or rubbing, you stimulated these bigger, faster fibers and thus closed the physiological pain gate in your spinal cord. You are provided temporary relief because the signal that would normally stimulate your brain to perceive pain in brain has been blocked in the spinal cord.

The way in which an adjustment has a strong influence on the pain gate is due to the fact that our joints are heavily populated with sensory receptors called mechanoreceptors. More so than any other region of our body as a matter of fact, with the joints of the spine being the most densely populated. These mechanoreceptors transmit their signal by way of fibers bigger and faster than those pain producing fibers. When stimulated by an adjustment, especially one where the aforementioned joint bubble pops, you are bombarded by sensory input and provided with arguably the most powerful way of manually closing the pain gate.

(It should be noted that we are always looking beyond the pain and into what is causing that pain. However, while investigating and addressing the underlying cause, the adjustment is capable of providing some much desired relief for the patient.)

Perhaps most importantly though is what the adjustment can do for us centrally. When I say centrally, I am referring to our master control center, the brain. As covered in previous posts on functional neurology, our brain is made up of two separate but interconnected hemispheres. For various reasons, these hemispheres can become imbalanced, leaving one side functioning at a lower level. This can manifest itself in a countless numbers of ways from constipation or sexual dysfunction, to an over or under active immune system.

Due to in depth study and subsequent mapping of our internal wiring, decreased function of our left or right cerebral hemisphere (aka hemisphericity) can be ascertained through observation of various forms of outward signs and symptoms. The side of the body that which these outward expressions take place offers clues to a possible deficit on the corresponding side of the brain. Things such as posture, accuracy and quickness of movements, pupillary response to light, etc. can all be measured and used to form a diagnosis and subsequent treatment plan.

An adjustment is one of the strongest tools in addressing a potential hemisphericity for a variety of reasons. One is due to the extremely high number of mechanoreceptors located within a joint, leading to an extremely powerful stimuli delivered to the spinal cord and up to the brain.

The second reason the adjustment can be such a powerful tool is due to the knowledge of our internal wiring. When I say internal wiring I am speaking specifically of the pathways that the sensory input travels from joint to our brain. We know that sensory input or an adjustment from one side of the body will ultimately cross over and affect the opposite side of our brain.

What this all means is that if a right sided deficit is discovered in the brain, an adjustment to the left side of the body can be delivered knowing that it should reach and stimulate the right side of the brain. There are many ways that this influence on central function can be confirmed such as measuring the size of our blind spots, but these are other topics for another post. The point is that the adjustment has been shown through research to have a direct effect on the level of functioning of the brain. And that my friends is some powerful stuff.