Wednesday, December 29, 2010

Health Update: Low Back Pain

What Causes Low Back Pain?

I can’t tell you how many times a day this question is asked! Obviously, there are MANY causes of low back pain (LBP) but you may be surprised about some of the following:

1. Trauma: Let’s start with the easy one – falling down, over lifting, twisting, pushing, pulling, bending over, sporting activities, work activities, sex, sneezing, raking, shoveling……OK, I could fill the page with possible injuries that can cause LBP so I’ll stop here. We’ve all sprained an ankle or a finger and based on statistics, most of us have also suffered from LBP as a result of a single event injury. These types of injuries include sprains (ligament injuries), strains (muscle/tendon injuries), disk injuries (tears, ruptures), and include many possible findings including subluxations (areas where vertebrae stop working well together or have shifted from their proper location). When there is radiating leg pain that travels below the knee, a pinched nerve may be involved, often caused by disk pressure or a combination of things.

2. Insidious or, “I don’t know what I did!”: Believe it or not, this is probably the most common cause of LBP we see as the majority of people can’t recall anything as causing their LBP. The “cause” in these cases often stems from a series of events that accumulate to a point where pain/swelling occurs, often hours or even days after several over-use activities may have been performed. Thus, more investigation into the activities that preceded the onset of LBP needs to be considered. We can usually uncover several possible culprits but we can’t ever be 100% certain that we’re right about the cause(s). In some cases, people will wake up with LBP, while others don’t have it until they’ve been active.

3. Biomechanical causes: This category might be involved in the 2nd category discussed but deserves a separate discussion because of the many possibilities. First, we are 2 legged / not 4 legged animals and that by itself puts a lot of pressure on our lower backs. In fact, 2/3rds of our weight is carried from the waist up and as a result, just bending over for a pencil can, “…throw the back out.” For example, a 180# person lifts about 120# of body weight just by bending forward! Another common problem is one leg being shorter than the other. It has been reported that 87% of us have unequal leg lengths and when the shift measures 7-9mm (about ¼ inch), the probability of back, hip, or sciatica pain is 2x greater. When the difference is 16mm, there is an 8x greater chance of having back trouble. The “fix” in this case can be quite simple as using heel lifts in the short leg shoe. Flat feet and ankle pronation can also create an unstable pelvis and can contribute to LBP so foot orthotics can also be very helpful in the management of LBP. Obesity (body mass index >30) has been identified as a risk factor for a lot of conditions including LBP and a weight management program can be highly effective.

4. Dangerous loading activities: It has long been known that jobs where 50-100# is lifted or carried, especially if frequently handled, have an increase in occurrence of LBP. Using proper lifting methods is very important in jobs like this!

Tuesday, December 28, 2010

Weekly Health Update

Courtesy of:
Advanced Wellness
(732) 719-8148

101 Great Ways to Improve Your HealthMental Attitude: Social Class And Depression Treatment.  Current treatments for depression don't help working-class and poor patients as much as they help middle-class patients improve their ability to function at work. Depression has a profound impact on an individual's productivity. That's particularly true for those in lower social classes and with low levels of education.
Psychiatric Services, Nov 2010

Health Alert: Kicking It All!  The American Cancer Society's annual Great American Smokeout took place on November 18. Cigarette sales have declined for decades, but smokeless tobacco sales have grown 7% annually over the last four years. Using smokeless tobacco products is not a safe way to quit or safer than smoking. The use of these products just shifts the risk of cancer to the mouth, head, and neck. Use of cigarettes and smokeless tobacco is the leading cause of cancers of the head and neck, which can result in partial or full removal of the lip, tongue, cheek, and portions of the throat, including the voice box. Smokeless tobacco users run the same risks of heart disease, high blood pressure, and addiction as cigarette users, but an even greater risk of oral cancer.
American Academy of Otolaryngology - Head and Neck Surgery, November 2010

Diet: Red Meat And Cancer Risk.  A possible link between red meat and esophageal cancer; and a link between DiMelQx and cancer in the stomach close to the esophageal opening was found. DiMelQx is a compound, a type of heterocyclic amine (HCA) found in red meat after it is cooked at high temperature. Those who eat red and processed meats have a 79% higher risk of developing esophageal cancer.
American Journal of Gastroenterology, October 2010

Exercise: Flat Abs?  Here are a few exercises and tips to help flatten your abs. Improve Your Posture. Slouch and your stomach pooches. For better posture while standing, align your ears over your shoulders, shoulders over hips, hips over knees, and knees over ankles. Keep the fronts of the shoulders open like a shirt on a hanger, instead of a shirt on a peg and draw your navel to your spine. Try the Canoe Twist. Sit upright, interlace your fingers over your stomach to create a solid grip. Exhale, and sweep the interlocked hands, arms, shoulders, and chest to the left, as if "rowing a canoe." Inhale and return to the starting position. Exhale and perform the movement to the right. Alternate for 20 repetitions.
WebMD Feature: Tips for Flat Abs

Chiropractic: Happy Backs!  This is a satisfaction survey of chiropractic care within a military hospital, from a Canadian Armed Forces Pilot Project. Chronic low back pain accounted for most presentations to the chiropractic clinic. The majority of military personnel (94.2%) and referring physicians (80.0%) expressed satisfaction with chiropractic services.
Military Medicine, June 2006

Wellness/Prevention: Tea And Your Heart. Drinking three cups of tea per day was associated with a decrease of 11% in the incidence of myocardial infarction, or heart attack.
American Journal of Epidemiology, 2001

"I can accept failure, but I can't accept not trying."
~ Michael Jordan

Health Update: Fibromyalgia

Fibromyalgia: How Do I know I Have It?

“I wake up every morning with this stiff, sore lower back pain. When I roll over to get out of bed, I feel like a log and almost have to fall out of bed. When I finally get to my feet, I’m all bent over and can’t stand upright for what seems like forever! It takes a couple of hours before it gradually loosens up enough so I don’t have to shuffle with each step. I was told by a friend that I might have something called fibromyalgia and should ask my chiropractor. What do you think?”

To answer this inquiry, let’s first define fibromyalgia (FM) so that we can compare the two properly. FM is a condition that is diagnosed basically by eliminating all other possible causes, including inflammatory joint conditions, by running various blood tests such as an arthritic profile. This usually includes tests for rheumatoid arthritis, gout, lupus, and infection. A Lymes disease test is often included as that condition can often manifest as a chronic back condition from any cause. There are essentially no blood tests, x-ray or other imaging tests, or neurological tests that can specifically diagnose FM. It is when all these tests come back negative, that the diagnosis of FM is then entertained. The history is probably the most important aspect of the clinical encounter that helps in the diagnosis of FM. Most of these patients will report that the onset is gradual, often present for years. There is usually no specific cause though there are specific conditions (such as irritable bowel syndrome, trauma, rheumatoid arthritis and others) that can result in “secondary fibromyalgia” where the cause is well known. The big differentiating historical feature is the presence of widespread, whole body pain – NOT just low back pain, as reported in the first paragraph above. In FM, there is often pain in the legs, arms, torso, back, neck and these people basically, “…hurt all over.” Typically there is no radiating pain down the leg or arm that follows a specific nerve pathway and no exam findings of neurological deficits. Another unique feature of FM includes sleep dysfunction. In many cases, sleep interruptions occur 2, 3 or more times a night, often with difficulty in returning back to sleep. The quality of pain is often described as numbness, tingling, burning, achy, deep, boring, and most importantly generalized in location (all over the body). The intensity is usually reported as high (>6/10 pain scale scores). The past history usually includes multiple visits to many different types of doctors and many attempts at different medications is common – most of which do not help significantly.

Even with these unique historical features that are consistent with the diagnosis of FM, it is still necessary to “rule out” other conditions by running tests as previously described. This is especially important when FM is secondary to other conditions as FM can get “lost” in the shuffle, overshadowed by the other condition.

Treatment for FM includes many of the same methods for treating other musculoskeletal conditions. Spinal manipulation, soft tissue release techniques (massage therapy, trigger point therapy, myofascial release), and various forms of physical therapy (low level laser therapy – LLLT, ultrasound, interferential electrical current – IFC, and pulsed magnetic therapy can also improve function, reduce pain, and reduce the need for medications. Cognitive therapy, addressing psychosocial issues, can also be very effective. One of the most important treatment approaches is exercise. This has been consistently described as being an important form of care for the FM patient. In addition, dietary management using an anti-inflammatory diet (gluten free diet) and supplementation (a multiple vitamin, calcium/magnesium, omega 3 fatty acids, Vit. D, and CoQ10) can also be very effective.

We recognize the importance of including chiropractic in your treatment and realize you have a choice of providers. If you, a friend or family member requires care for FM, 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.

Tuesday, December 14, 2010

Health Update: Low Back Pain

Low Back Pain
and Bone Density

So, what does bone density have to do with low back pain? The relationship between bone density and back pain is quite intimate. In fact, when the degree of bone density declines to the point of fracture, back pain becomes very real. The classic condition and cause of spinal pain associated with the loss of bone density is compression fracture.

Compression fractures occur when the strength of the bone decreases to a point where minor trauma and sometimes, no trauma whatsoever can result in fracture. Compression fractures affect the vertebral body (front of the spine) most often in the upper lumbar or lower thoracic spine but the pain associated with these types of fractures frequently radiates into the low back and pelvic region. In the elderly osteoporotic spine, these types of fractures usually do not result in spinal cord injury or nerve damage but this is quite the opposite when compression fractures occur in younger, normal bone density individuals. This is because when the bone is dense (or normal), the vertebral body basically explodes or bursts shifting some of the bony fragments back into the spinal canal where the spinal cord is located. When bone density decreases, there is no bursting of fragments – only collapse, resulting in pain but no neurological damage. Besides pain, another problem with compression fractures is that the once upright or vertical spine is now bent and angles forward shifting the patient’s weight to the front. This shift places yet more pressure on both the fractured vertebra and the surrounding vertebra which increases the risk of fracture to the surrounding adjacent vertebra. Therefore, multiple compression fractures are not uncommon when brittle bones occur from osteoporosis.

So who is more at risk for osteoporosis? The usual predictors include age, (older than 65), gender (female), race (Asian or Caucasian), low body weight, and previous fracture. Others include smoking, previous use of corticosteroids, a family history of fracture, excessive alcohol use, and rheumatoid arthritis. Additionally, vitamin D deficiency, thyroid or parathyroid increased function, and celiac disease (gluten intolerance) as well as poor balance (repeated falls), muscle weakness and a DEXA (dual-energy X-ray absorptiometry) T-score of -1.1 to -2.4 (osteopenia) or -2.5 or greater (osteoporosis) are also important predictors of brittle bone disease or osteoporosis. To best determine your risk using these factors, go to FRAX ( developed by the World Health Organization (WHO) to determine your 10-year fracture probability (do not just use of the T-score on the DEXA scan).

Video: Bone Density Screening

From a treatment standpoint, it depends on the age of the patient, the degree of osteoporosis, and whether fracture has already occurred. In the younger, osteopenic person (that is, no fractures have occurred yet but bone density is low), non-medication approaches such as weight bearing exercise, no smoking, calcium / vitamin D supplementation, and minimize the other risk factors described above may be the proper choice. For others already with fracture, medication (bisphosphonates such as Actonel, Boniva, & Fosamax) may be appropriate. Further, injecting a cement into the bone (called kyphoplasty) may be appropriate for some.

We realize you have a choice in healthcare providers. If you, a friend or a 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.

Friday, December 10, 2010

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome:
Why Braces?

For those of you who have had Carpal Tunnel Syndrome, you probably know all about braces. These are devices worn on the wrist that stop you from bending the wrist up or down. They may be worn anytime of the day if they don’t interfere too much with one’s current activity but are especially worn at night. One might think it would be more important to wear these during day when we are active and moving our fingers and hands a lot as we go about our normal work or play activities – not at night when we’re basically just laying there doing nothing but sleeping, right? Wrong! It’s more important to wear these at night. This is because we cannot control our hand/wrist position at night as we tend to curl up in a ball when we sleep and the wrist gets cocked up or down, often to the end point of the range. So, why is this so bad? To answer that question, let’s look at the chart below on the left.

In the chart (above left), you are looking at a cross section of the wrist through the carpal tunnel. This illustrates the many structures that are inside the tunnel making it very compact or tight. Notice the small white circles in the middle of the tunnel. Those are the tendons that pass through the tunnel – there are 9 of those and they attach the muscles in our forearms (on the palm side) to our fingers so we can shake someone’s hand or carry a suitcase (grip). Just to the left of center, on top of all the tendons sits the median nerve, which is just below the “roof” of the tunnel (the transverse carpal ligament). Now, normally, the pressure inside the carpal tunnel will approximately double when we bend our wrist, putting more pressure on the nerve and pushing it into the roof (ligament), which creates the numbness and/or weakness in our grip. But in the CTS sufferer, there is already more pressure in the tunnel due to the swollen tendons so when the wrist is flexed or extended, the pressure goes up much more the twice – more like 6 times more pressure – hence, more symptoms. So, if we’re sleeping with our wrist bent either way, the pressure pushing the nerve against the roof is a lot more than normal – 6x more! Now, can you see the reason for the “night splint?” It is VERY effective in keeping the wrist straight or “in a neutral position,” which is needed to allow the nerve to NOT be pinched so it can heal.

Video: Carpal Tunnel Syndrome

Regarding braces, there are MANY different kinds of braces available and deciding which one to use is no easy task, not to mention the fact that they come in different sizes! When you are treated for CTS at this office, we will fit you with the proper size brace, if it’s necessary. We realize you have a choice in 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.

We hope this information is useful to you or someone you care about. For more information, visit us at or call us directly 732.719.8148 for a free consultation.

Thursday, December 9, 2010

Health Update: Whiplash

Interesting Facts
About Whiplash

We all know the most common causes of “whiplash” are injuries that typically arise from automobile accidents or, motor vehicle collisions (MVC’s) although whiplash can also occur from slip and fall and virtually, any injury where your head is whipped backwards. But there are many things about whiplash you may not be aware of, which is the reason for this month’s Heath Update on whiplash.

For example, did you know the effect whiplash has on public health (in general) is tremendous? The number of cases occurring annually is frequently quoted as 1,000,000 per year, but this is based on an outdated (1971) and incomplete dataset. A more recent figure of 3 million per year is considered to be more accurate because it’s based on several governmental databases and it accounts for the expected number of unreported cases by the NHTSA (National Highway Traffic Safety Administration).  That’s a huge difference!  The updated figure accounts for whiplash victims not attended to by emergency medical services. In less catastrophic accidents, the injured party may not appear to be significantly injured at the scene of the MVC and decline emergency care and hence, the MVC will to unreported to a governmental data collection center.

Video: Whiplash Health Update

Another interesting study surveyed over 3500 chiropractors who were asked if they commonly applied cervical (neck) spinal manipulation to patients who had known herniated discs or protruded discs (in their neck). Over 90% of the chiropractors indicated they found it safe and effective to utilize cervical adjustments (manipulation) in this patient population. It is VERY important for you to know this as frequently, you may be told by your medical doctor (or next door neighbor), “…don’t let anyone crack your neck!” Now, you can rest assured that in the experience of MANY chiropractors (not just me), significant benefits can be achieved by this treatment approach.  Moreover, the sooner neck adjustments are applied, the better the results - so don’t wait to get a chiropractic treatment after an MVC!

Another interesting study investigated the “proper” or “best” seated position in a car during a rear-end collision, based on an analysis of many previously published studies on this topic.  Because the seated position of the person involved in a MVC is related to the degree of the injury, the factors studied included the angle of the seat back, seat-bottom angle, the density of the foam in the seatback, the height above the floor [of the knees], and the presence of armrests in cars.  They found that the seat back angle of 110-130 degrees reduced disc pressure and low back muscle activity but 110 degrees – MAX. – was found to minimize the forward positioning of the head. A 5 degree downwards tilt of the seat bottom further reduced the pressure in the low back discs and muscle activity as measured by an EMG Test (electromyography).  The use of armrests and the use of a lumbar support were also found to be important to reduce injuries associated with MVCs.  This combination was reported to be optimum for all of us to use in order to minimize the bodily injury in a rear-end MVC. Other important factors included firm dense foam in the seat back, an adjustable seat bottom (for angle, height, and front to back distance), horizontal and vertical lumbar support adjustments (…best if they pulsate to reduce the static load encountered in a crash), seat shock absorbers, and seat adjustments for front to back to adjust for different patient heights.

We hope this information is helpful. We realize you have a choice in where you go for your health care needs.  We truly appreciate your consideration in allowing us to help you through this potentially difficult process.

Visit us at or call us directly 732.719.8148 for more information and a Free consultation.

Tuesday, November 9, 2010

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome
Why is it so common?

Carpal tunnel syndrome or, CTS, is a condition where a nerve (called the median nerve) is compressed in a relatively tight or restricted space (called the carpal tunnel), resulting in altered nerve function that includes numbness and weakness. In order to fully understand what CTS is, let’s devote this Health Update to better understanding the anatomy of the carpal tunnel.

Video: Carpal Tunnel Syndrome


The carpal tunnel is made up from 8 bones (2 rows of 4 carpal bones that are stacked on top of each other) that are arranged in the shape of a horse shoe. The “roof” of the tunnel is a ligament (transverse carpal ligament) that stretches tightly across the two ends of the horseshoe completing the formation of a tunnel – actually, an upside down tunnel when looking at the palm side of the wrist). The contents of the tunnel include 9 tendons and their covering (sheath), blood vessels and on top of all that just under the roof is the median nerve – the culprit that creates most of the symptoms of CTS. The cause of CTS is simply anything that causes the contents inside the tunnel to swell, which then compresses the median nerve up into the roof or ligament, pinching the nerve. This can create numbness, tingling, the falling asleep sensation and weakness. It’s important to point out that the median nerve starts out from the neck, passes through the shoulder, past the elbow, through the wrist’s carpal tunnel and ends in the hand – specifically fingers 2,3, and 4. Therefore, the ENTIRE nerve must be looked at for all CTS cases as pinching can occur anywhere along its course from the neck to the hand.

It’s said that pictures say a thousand words, so let’s take a look...

Using the pictures here, familiarize yourself with the words and re-read the 2nd paragraph above, periodically looking at these pictures until you feel you understand where everything goes.  Once you’ve accomplished that, you’ll be able to better appreciate CTS, how the anatomy relates to the condition, and appreciate the need to reduce the swelling inside the tunnel when symptoms occur.  The treatment is simple: “PRICE” – P protect R rest I ice C compress E elevate – accomplished by bracing (especially at night), ice cup massage (5 min. until numb 5x/day), rest (light duty work), and therapy (see your chiropractor!).

To find out if you are a candidate for their customized treatment approach call 732.719.8148 or visit us at or

Monday, October 11, 2010

Good Head Posture Will Help

What is “Good Head Posture?”

Have you ever noticed how many people have terrible posture? One of the most common faulty postures is called “forward head carriage” or “anterior based occiput.” Other terms are “hump back” or slouching. There are several reasons for this common postural fault. One is the weight of the head is, on average, approximately 10-13 pounds and if it’s positioned too far forwards, the muscles in the upper back and neck tighten up much more than normal, fatigue and become painful. Also, the muscles that attach to the skull have different degrees of strength. They also attach and pull at different angles, contributing to the common forward head carriage posture. The muscles of the chest are much stronger than those in the mid and upper back and tend to pull our shoulders forward. The following pictures offer a good view of both a faulty posture as well as a “good” posture. Notice the forward shift in the line in the pictures of poor posture and backwards shift in the good posture pictures.

As you can see, the weight of the head is back over the shoulders and the shoulder posture is appropriately positioned back in the image titled “Good Head Posture.”
Forward Head Carriage 

Good Head Posture



Forward shoulders

Good Shoulders Posture

It is important to understand correcting Forward Head Carriage takes time – in fact, it takes a minimum of 3 month before this becomes an automatic new “habit.” Of course, it could take longer or, completely fail IF you are not VERY conscientious about CONSTANTLY reminding yourself to position your posture as shown above in the “Good Head Posture” image (above). An exercise based on this posture correction technique is performed by retracting your chin / head as far back as you can and holding that position for 5-10 seconds. Doing this multiple times a day, between the time you maintain a partial chin tuck (“Good Head Posture”) position will further facilitate the posture retraining process.

Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy. To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit

Monday, September 20, 2010

Health Update: Low Back Pain

Simple “On-The-GO” Low Back Exercise

101 Great Ways to Improve Your Health    “Doc, I try to do my exercises but I have to hit the ground running in the morning….to get the kids ready for the school bus….I have morning meetings….I’m not a morning person….I’m pulled in 100 directions during the day….I forget about them until I’m in bed….I exercise on my job and that’s enough…."

    I’m sure we’ve all rationalized our inability to keep up with exercises, especially after our episode of low back pain (LBP) subsides. In fact, only about 4% of LBP patients continue doing their exercises after their pain subsides. That means 96% of us with chronic, recurring low back pain DO NOT exercise even though we know we should.  We feel bad, even guilty for not exercising.  So, what can we do to “trick” ourselves into being more compliant with our low back exercises?

    First, let’s accept the fact that most of us cannot consistently “fit in” exercise into our busy schedules.  With that said, the TIMING of when to do the exercise may be more important than even doing them at the same time every day. In other words, do a few exercises when you need them the most. For example, if you’re working at a computer for more than 1 hour, and you start to feel back pain from the prolonged sitting – especially if your work station set up is less than ideal – do one or two sitting exercises right at your work station, BEFORE your back pain gets any worse. If you wait too long, the exercises may not be of much benefit. Setting a timer next to your screen that beeps every hour is a good reminder to do one or two simple exercises and only takes a minute or two.  Many inexpensive digital watches can be set to beep on the hour/every hour or, you can set a “timer” to beep after 60 minutes as a “gentle” reminder.  Some cell phones also have a timer feature. Here are three sit down low back exercise options (try them all and decide which one(s) feel most productive/helpful):

1.    “Crossed Knee Stretch”: Cross your legs; pull the crossed knee towards your opposite shoulder (feel the pull in your buttocks); arch your low back and at the same time, twist or rotate to the side of the crossed knee. Hold for 5-10 seconds and repeat up to 3 times.  Repeat this on the opposite side.
2.    “Sit Twists”: Reach across with your right hand and grasp your left leg at mid-thigh. Twist/rotate your back to the left and pull with your arm. Hold 5-10 seconds / repeat 3 times. Repeat this on the opposite side.
3.    “Sit Floor Touches”:  Bend over as if to touch the floor or tie a shoe.  Hold 5-10 seconds.

    If you do the math, it would take a minute for #1 and #2, 30 seconds for #3 (total 2.5 min.).  If that’s too long, hold for 5 seconds.  If that’s too long, do 1 rep, not 3.  You get the idea…..MAKE IT WORK!  Modify the dose to fit your schedule or ability to stretch.  If you do this AT THE TIME you start to feel tight or sore, you can PREVENT a LBP episode!

    Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy.  To find out if you are a candidate for their customized treatment approach call 732.719.8148 or visit

Sunday, August 22, 2010


Courtesy of:
Advanced Wellness Marlboro, New Jersey
Free Consultations:  (732) 719-8148

101 Great Ways to Improve Your Health
Mental Attitude:
Ways To Reduce The Risk Of Depression - Part II! 3. Yoga, meditation, prayer, psychotherapy: Studies show these practices can reduce stress, 4. Reduce alcohol consumption. People who feel stressed may drink too much; alcohol is a known mood suppressor.  
Karen Bruno

Health Alert: Traffic-Related Air Pollution Affects Heart Rate Variability! Patients with pre-existing heart or lung disease who are exposed to high levels of traffic-related air pollutants have reduced heart rate variability (a risk factor for sudden cardiac death).
Journal of Occupational and Environmental Medicine, July 2010

Diet: Worst Foods In Your Freezer - Gourmet Ice Cream. Even if you stick to the modest 1/2 cup serving size suggested, eating gourmet ice cream can send your daily totals of saturated fat, total fat and calories into overload. A one-half cup serving of Ben & Jerry's Chocolate Chip Cookie Dough has 260 calories, 14 grams of fat, 9 grams saturated fat, 65 milligrams cholesterol and 23 grams sugar. A more typical serving for most of us is one cup, which doubles the totals for fat, calories, cholesterol and sugar. Instead, try lower-fat, lower-sugar and lower-calorie ice cream.
Elaine Magee, MPH, RD

Exercise: Toning Shoes? Can a pair of shoes help you burn more calories, tone your bottom and curb joint pain? These shoes have an unstable, strongly curved sole. Walking in them is like exercising on a balance or wobble board in the gym. Advocates say the instability forces you to use muscles you otherwise would not use (namely those is your feet, legs, butt, and abs), possibly resulting in weight loss. The shoes can also change your posture and gait and take pressure off of achy, overused joints.
Denise Mann

Chiropractic: Ligaments! Try this: Bend your finger off to the side and then let go. Does it staymisaligned? Of course not! How come? The answer is ligaments. It simply takes time for joints to berealigned due to the special elastic properties of ligaments. This is why it can take several adjustmentsover time to correct a misaligned spine or create stability and normal range of motion.

An Effect Of Alcohol Consumption. Alcohol calories are empty caloriesbecause the body can't use them as energy. The liver is forced to break alcohol down into fatty acids,which then accumulate in the liver. Liver cells and brain cells actually die from excessive exposure toalcohol.
Elaine Magee, MPH, RD

Quote: “Never let the fear of striking out get in your way.” ~ Babe Ruth

Monday, August 16, 2010


Courtesy of:
Advanced Wellness
(732) 719-8148

Follow Dr. Cilea's Blog for Updated Insight on Current Health Issues

101 Great Ways to Improve Your HealthMental Attitude: Massage, Physiological State and Chronic Headaches. Researchers have shown the psychological and physiological state of patients with tension headaches improves within 24 hours after receiving a 30-minute massage on trigger points in the neck.
Journal of Manipulative Physiological and Therapeutics, September 2009

Health Alert: Antifungal Properties Of Vitamin B3! Infections by the yeast Candida albicans represent a public health problem and a common complication in immunodeficient individuals such as AIDS patients, cancer patients undergoing chemotherapy and recipients of organ transplants. C. albicans enzyme, (Hst3), is essential to the growth and survival of the yeast. Nicotinamide, a form of vitamin B3, strongly reduced C. albicans virulence.
Institute for Research in Immunology and Cancer, University of Montreal, July 2010

Diet: Worst Foods in Your Fridge - Hot Dogs and Sausage.  "Processed meats" like hot dogs and sausage are a staple in many homes. Hot dogs and sausage tend to contain lots of sodium (520-680 milligrams per 2-ounce serving) and fat (up to 23 grams total fat and 7 grams saturated fat per serving). According to the Centers for Disease Control (CDC), most Americans take in more than double the recommended amount of sodium. Substitute with lower-fat and lower-sodium meats (roasted poultry, pork tenderloin, roast beef and shrimp) or grilled vegetables (portabella mushrooms, eggplant, or roasted red pepper). Or, try lower-fat options like "light" franks, turkey kielbasa, or soy-based sausage substitutes.
Elaine Magee, MPH, RD

Exercise: Reduce Heart Disease Risk! In the US, 81.1 million adults (one out of every three) have a heart or blood vessel disease. A combination of counseling, extended follow-up with a healthcare provider and self-monitoring of diet and exercise is the most effective way to help embrace lifestyle changes that can lower your risk for heart and cardiovascular diseases.
Circulation: Journal of the American Heart Association, July 2010

Chiropractic: The Amazing Human Body! Your body wards off sickness and heals itself 24 hours a day, 7 days a week. That is why taking good care of it is so important (especially, before you get sick). Periodic chiropractic check-ups and adjustments can keep your body healthy, fit and feeling good.

Wellness/Prevention: Symptoms Are Not An Indicator Of Health. If you are symptom free, are you perfectly healthy? Consider the healthy looking person who suddenly dies of a heart attack. Obviously they were not healthy.

Quote: "It is a terrible thing to see and have no vision." ~ Helen Keller

Monday, August 9, 2010


Courtesy of:
Advanced Wellness Marlboro, New Jersey
(732) 719-8148

101 Great Ways to Improve Your HealthMental Attitude: Anxiety Increases Risk Of Complications For Heart Disease Patients. Patients with heart disease who also suffer from an anxiety disorder have a 74% higher risk of having a heart attack, heart failure or stroke.
Archives of General Psychiatry, July 2010.

Health Alert: Chance Of Surviving Once-Deadly Cancers Doubled Since 1970s. People diagnosed with breast, bowel and ovarian cancers, and non-Hodgkin's lymphoma, are twice as likely to survive at least 10 years after diagnosis than people diagnosed in the early 1970s. 77% of women diagnosed with breast cancer are likely to live for at least another 10 years compared with less than 40% in the 1970s; for bowel cancer, the figure has gone from 23% to 50%, and for ovarian cancer it has risen from 18 to 35%. 51% diagnosed today with non-Hodgkin's lymphoma are likely to live at least another 10 years compared to 22% forty years ago; and the 10-year survival rate for Hodgkin's lymphoma is predicted to go up from under 50% to 80%.
Cancer Research UK

Diet: Worst Foods In Your Fridge - Soda and Other Sweet Drinks. Sweetened beverages are simply "empty calories." Soda, sweet tea and fruit drinks contribute no nutrients, but lots of calories. We don't compensate by eating less when we drink sweet drinks, so these are truly "extra" calories. Plain water is best for hydrating and should be your primary beverage. Green and black teas hydrate and contribute healthy antioxidants. Skim or 1% milk also has key nutrients, such as calcium, vitamin D, B-12, potassium and magnesium.
Elaine Magee, MPH, RD

Exercise: Physical Activity Lowers Risk of Dementia, Especially in Men. People who performed moderate to heavy levels of physical activity have about a 40% lower risk of developing any type of dementia. People who reported the lowest levels of physical activity are 45% more likely to develop any type of dementia, compared to those who reported higher levels of activity.
Alzheimer's Association International Conference on Alzheimer's Disease 2010

Chiropractic: Another Analogy! Chiropractors are like orthodontis; correcting subluxations (misaligned or chronically fixed joints of the spine) is similar to straightening teeth. Since both teeth and bones are held in place by strong ligaments, they simply take time to change.

Wellness/Prevention: Don’t Wait Until It’s Too Late! Do you have a plan for health? Often, people wait until they are sick or injured to take care of themselves. A balanced diet, moderate exercise, proper sleep, a positive mental attitude (decreasing stress), and chiropractic care can be part of an excellent plan to increase your chances of staying healthy and decreasing your risk of illness.

Quote: "That we are not much sicker and much madder than we are is due exclusively to that most blessed and blessing of all natural graces, sleep."
~ Aldous Huxley

Sunday, August 8, 2010

Health Update: Carpal Tunnel

Exercises For Carpal Tunnel Syndrome

101 Great Ways to Improve Your Health Carpal tunnel syndrome (CTS) is a common condition resulting in hand and sometimes neck and arm complaints. This can include numbness or tingling in the fingers, leading to dexterity problems such as difficulty buttoning clothing or picking up small objects. There are also issues with strength loss / weakness noticed such as when turning door knobs, opening jars, and even problems with turning the key to start a car. One big problem with CTS is people often wait too long before having it treated thinking it will “…go away” or disappear just like it started. CTS rarely gets better without some form of treatment and seeing a chiropractor makes perfect sense prior to considering surgical intervention.

So, the question remains, “what can I do for CTS?” There are several things a CTS sufferer can do to help manage this condition. Some risk factors such as gender and age cannot be changed but other factors can be changed including taking “mini-breaks” throughout the work day and/or work station modifications, managing weight as obesity (defined as a BMI >30 and a waist size >35” for women and >40” for men), wearing a wrist splint, as well as performing exercises to stretch the wrist area.

A study out of the University of Oklahoma reported 2 out of 3 patients with mild to moderate CTS avoided surgery by performing specific exercises. The concept of a 5-minute warm-up stretch each day before starting the workday is similar to a runner stretching before a run to prevent injury.

Step A: Extend and stretch both wrists and fingers acutely as if they
are in a standing push-up position. Hold for a count of 5.

Step B: Straighten both wrists and relax fingers.

Step C: Make a tight fist with both hands.

Step D: Then, bend both wrists down while keeping the fist. Hold for a
count of 5.

Step E: Straighten both wrists and relax fingers, for a count of 5.

Step F: Then, let your arms hang loosely at the side and shake them
for a few seconds.

This exercise should be repeated 10 times and can be repeated several times a day.

Chiropractic is a perfect choice when considering a health care provider for the treatment of CTS as these exercises can easily be taught to you at our office. In addition, many other non-surgical treatment options for CTS are available.

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.


Monday, August 2, 2010

Health Update: Fibromyalgia

Fibromyalgia Challenges

Fibromyalgia (FM) is a condition that usually affects different organ systems in the body, causing a number of symptoms. Some of these include:
  1. The muscles (the musculoskeletal system): tender, achy, stiff, tight muscles, trigger or tender points all over the body
  2. The nerves (the nervous system): headaches, light headedness, sleep disruption, depression, anxiety, numbness/tingling (overlaps with the cardiovascular system)
  3. The stomach and intestines (the gastrointestinal system): diarrhea, constipation, irritable bowel, leaky gut, heart burn, lack of appetite, abdominal cramping
  4. Breathing (the respiratory system): hyperventilation, rapid / shallow breathing patterns; 
  5. The heart (the cardiovascular system): racing heart rate – palpitations, feeling cold all the time, numbness/tingling (overlaps with the nervous system)

Because of the multiple systems involved, there are many challenges to managing Fibromyalgia.  Studies suggest a balance between several approaches works best.  Some of these approaches include biomedical treatments, organ-specific treatments, and cognitive interpersonal treatments.  Within these categories, the following can be broken down further:

  1. General – those treatments directed at the whole body such as anti-inflammatory measures.  These include (but are not limited to) medications (corticosteroids, NSAID’s – such as Advil, Aleve) and nutrients (ginger, turmeric, boswellia, Vitamin D, and others).  Other anti-inflammatory measures include diet, such as the Paleo Diet or “caveman diet.”  This diet eliminates grains or flour-based products from the diet.  That means no more breads, pastas, crackers, cookies – anything made with flour.  This approach emphasizes consuming fruits, vegetables, grass-fed lean meats and fish.  The main ingredients in grains that are of concern in the Paleo Diet are gluten and lectins
  2. Central – those treatments directed at the chemical factors in the brain that control mood, depression, anxiety and so on.  These include (but are not limited to) medications (tricyclic antidepressants, muscle relaxers like Cyclobenzaprine, SSRI, SNRI and Trmadol) and certain nutrients (neurotransmitter support such as 5-HTP – tryptophan, DHEA, phenylalanine, and others).
  3. Psychotherapy and active behavioral therapy – treatments that are supportive of nervous system such as cognitive behavior therapy, aerobic exercise, patient education, multidisciplinary therapy, hypnotherapy, biofeedback, and strength training.
  4. Passive physical intervention – chiropractic therapy, massage therapy and other forms of manual therapy, and acupuncture.

The goal of this article is to look at fibromyalgia from a holistic perspective so that those struggling with FM and similar conditions can better appreciate the concept of multidisciplinary treatment, of which chiropractic care plays a significant role.  Coordination of care and finding the “right” health care providers cannot be over-emphasized.

We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, 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.


Saturday, July 31, 2010


Courtesy of:
Advanced Wellness in Marlboro, New Jersey

101 Great Ways to Improve Your HealthMental Attitude: Too much stress may lead to major depression! Chronic stress leads to elevated hormones such as cortisol, the "stress hormone," and reduced serotonin and dopamine levels. At proper levels, these hormones regulate sleep, appetite, energy and sex drive, and allow expression of normal moods and emotions. When the stress response fails to shut off and bring these hormones to normal levels, it can lead to depression in susceptible people.
Karen Bruno, June 2010

Health Alert: Alarming Hours For Physicians! Resident physicians averaging five or fewer hours of sleep per night were 1.5 times more likely to commit errors. Hours for resident physicians must be limited to 16 consecutive hours and 80 hours per week, with at least one 24-hour off-duty period per 7-day period, without averaging. Everyone becomes impaired after sufficient lack of sleep. Sleep loss impairs brain function, concentration and coordination, and increases the risk of error. 24 hours without sleep slows average reaction time 100%, leading to impairment similar to alcohol intoxication.
American Academy of Sleep Medicine, June 2010

Diet: Brown Rice vs. White Rice. 70% of rice eaten in the US is white. Two or more servings of brown rice weekly lowers the risk of type 2 diabetes by 11%. Five or more servings of white rice weekly increases the risk by 17%. Replacing white rice with brown rice lowers the risk by 16% overall. Replacing white rice with whole grains (barley and wheat) reduces the risk by 36%.
Archives of Internal Medicine, June 2010

Exercise: Stretching Exercises At Your Desk For Your Upper Body. Sit up tall in your chair, or stand up. Stretch your arms overhead and interlock your fingers. Turn the palms to the ceiling as you lift your chin up, tilt your head back and gaze up at the ceiling, too. Inhale, exhale, release.

Chiropractic: Revitalize With Chiropractic. Chiropractic allows for proper blood flow throughout your body, which in turn delivers nutrients to all your cells. As cells slough off and die (think skin cells), new ones constantly replace them. This is good news as 10-50 trillion cells are replaced in your body every day.
Gray’s Anatomy

Wellness/Prevention: Good News For Tea Drinkers! Consumption of the equivalent of 2.5 cups (or more) of tea per day was associated with a 60% drop in rectal cancer risk, as compared to women who drank less than 1.2 cups of tea per day. Women who drank 1.2-2.5 cups of tea per day had a 52% reduction in the risk of rectal cancer.
Epidemiology, July 2003

Quote: “I am always doing what I can’t do, in order that I may learn how to do it.” ~ Pablo Picasso

Monday, July 19, 2010

Health Update: Chronic Whiplash

“The Only Proven Effective Treatment” for Chronic Whiplash?

101 Great Ways to Improve Your HealthYou may have wondered, “If I get hurt in a car accident, who should I go to for treatment of my whiplash problem?” This can be quite a challenge as you have many choices available in the healthcare system ranging from drug-related approaches from anti-inflammatory over-the-counter types all the way to potentially addicting narcotic medications. On the other side of the fence, there are nutritional based products such as vitamins and herbs as well as “alternative” or “complementary” forms of treatment such as chiropractic, exercise, and meditation, with many others in between. Trying to figure out which approach or perhaps combined approaches would best serve your needs is truly challenging. To help answer this question, one study reported the superiority of chiropractic management for patients with chronic whiplash, as well as which type of chronic whiplash patients responded best to the care. The research paper begins with the comment from a leading orthopedic medical journal stating, “Conventional [meaning medical] treatment of patients with whiplash symptoms is disappointing.”

In the study, 93 patients were divided into three groups consisting of:

Group 1: Patients with a “coat-hanger” pain distribution (neck and upper shoulders) and loss of neck range of motion (ROM), but no neurological deficits;
Group 2: Patients with neurological problems (arm/hand numbness and/or weakness) plus neck pain and ROM loss); and,
Group 3: Patients who reported severe neck pain but had normal neck ROM and no neurological losses.

The average time from injury to first treatment was 12 months and an average of 19 treatments over a 4 month time frame was utilized. The patients were graded on a 4-point scale that described their symptoms before and after treatment.

Grade A patients were pain free;
Grade B patients reported their pain as a “nuisance;”
Grade C patients had partial activity limitations due to pain; and
Grade D patients were disabled.

Here are the results:

Group 1: 72% reported improvement as follows: 24% were asymptomatic, 24% improved by 2 grades, 24% by 1 grade, and 28% reported no improvement.
Group 2: 94% reported improvement as follows: 38% were asymptomatic, 43% improved by 2 grades, 13% by 1 grade, and 6% had no improvement.
Group 3: 27% reported improvement as follows: 0% were asymptomatic, 9% improved by 2 grades, 18% by 1 grade, 64% showed no improvement, and 9% got worse.

This study is very important as it illustrates how effective chiropractic care is for patients who have sustained a motor vehicle crash with a resulting whiplash injury. It’s important to note the type of patient presentation that responded best to care had neurological complaints and associated abnormal neck range of motion. This differs from other non-chiropractic studies where it is reported that patients with neurological dysfunction responded poorly when compared to a group similar to the Group A patient here (neck/shoulder pain, reduced neck ROM, and with normal neurological function). We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through this potentially difficult process.


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Courtesy of:
Advanced Wellness in Marlboro, New Jersey

101 Great Ways to Improve Your HealthMental Attitude: Alcohol and Depression. One third of people with major depression also have an alcohol problem. In many cases, depression may be the first to occur. Children who are depressed are more prone to develop alcohol problems once they reach adolescence. Teens who've had an episode of major depression are twice as likely start drinking alcohol than those who have not had an episode of major depression. Depression may be a particularly significant trigger for alcohol use in women as women are more than twice as likely to start drinking heavily if they have a history of depression.
National Institute on Alcohol Abuse and Alcoholism

Health Alert: Calcium And Risk Of Osteoporosis And Hypertension In Postmenopausal Women. Postmenopausal women who have a low calcium intake show a higher risk of developing both osteoporosis and hypertension than those who consume higher levels of calcium.
European League Against Rheumatism, June 2010

Diet: Mayonnaise Alternatives. A 1/4 cup serving of Mayonnaise can include up 360 calories and 40 grams of fat. Try using a lower-calorie condiment instead (mustard, BBQ sauce, salsa chili or taco sauce) or switch to a light mayonnaise (35 calories and 3.5 grams of fat per tablespoon) or pare down the portion of real mayonnaise to a couple of teaspoons (60 calories and 6.7 grams of fat). Elaine Magee, MPH, RD Exercise: Ride Your Bike! Exercise is important for older adults. It keeps you strong, burns calories, helps maintain a lower weight, improves flexibility, contributes to balance and maintains bone strength. The best exercise builds lean muscle and promotes endurance, flexibility and maintains stability. Exercise declines with age, yet cyclists show a smaller decline than those involved in gym activities. Cycling is safe, with fewer risks of more strenuous exercises.
To Your Health, July 2009

Chiropractic: Circulate Your Blood! Your body has 60,000 miles of blood vessels! Adjustments help maintain your flexibility and joint mobility, which in turn allows for better blood flow. Blood flow is important as it delivers vital nutrients (oxygen, water and food) to all of your cells.

Wellness/Prevention: Tea's Role In Oral Health. Flavonoids in tea may inhibit the plaque-forming ability of oral bacteria and the fluoride in tea may support healthy tooth enamel. In a study, hamsters were fed water with Black Tea extract developed up to 63.7% fewer dental caries (also known as tooth decay or cavity) than hamsters fed just water.
Journal of Indian Society of Pedodontics and Preventive Dentistry, 2000
International Journal of Food Sciences and Nutrition, 2003

Quote: “Holding on to anger is like holding on to a hot coal with the intent of throwing it at someone else; you are the one who gets burned.” ~ Buddha

Thursday, July 15, 2010

Health Update: Headaches

Headaches: Causes and Treatment

101 Great Ways to Improve Your Health       Few conditions leave their victims as miserable and agitated as headaches.  There are many causes of headaches including stress, odors, bright lights, noise, fatigue, certain foods, hormonal shifts, allergies, as well as genetic predisposition.  With all the possible causes of headaches, it’s not surprising many people seek help from many different approaches such as conventional medical therapies like pharmaceuticals and injections.  Others prefer a non-drug treatment approach such as chiropractic, massage therapy, acupuncture, and nutritional counseling.

Usually, there is not one specific cause of headaches so treatment can focus on various areas.  For example, muscles that attach to the base of the skull in the neck and upper back are often very short and tight, resulting in pressure or a squeezing effect on the surrounding nerves and blood vessels -- resulting in headaches.  Chiropractic treatment includes methods aimed at reducing the tightness found in the joints and muscles. One of these approaches is called spinal manipulation or “adjustments” where the joints in the neck are moved to restore motion and reduce joint fixations. By relaxing the muscles and tension between the joints, the nerves in the neck are less pressured which, in turn, can reduce headaches.  The top three nerves that exit the upper neck travel into the head and are often the culprit behind the onset of headaches.  The second nerve from the top is the one responsible for causing radiating pain over the top of the skull which communicates with other nerves sometimes causing the pain behind the eye.

Another chiropractic approach in the management of headaches includes soft tissue therapy where trigger points found in tight muscles are addressed through various forms of massage and mobilization methods.  Manual traction of the head and neck can also be highly effective in reducing the tension found in headache sufferers.  Exercises are often taught to the headache patient with significant benefits reported.  Some of these, such as range of motion exercises with and without resistance (example: pushing your head into your hand during neck movements) and posture re-training (chin tucks – reducing the forward head position), help address the limited motion problems of the neck. Cervical (neck) traction performed by placing a rolled up towel placed behind the neck while lying on the back so that the head can hang off the side of the bed can also be very helpful.  Another neck traction approach is the use of a unit that hangs off a door where water is placed in a plastic bag calibrated for weight for 15 minutes at a maximum tolerated weight. This can be of great benefit as it can be performed at home at your convenience multiple times a day or, as needed.

Other treatment approaches that chiropractic utilizes include stress management (such as biofeedback, relaxation instructions, meditation, visualization and others), diet modifications (as certain foods can trigger headaches), nutritional supplementation (such as fish oil, Vit. D, feverfew and others), and sleep restoration.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.



Courtesy of:
Advanced Wellness in Marlboro, New Jersey

101 Great Ways to Improve Your HealthMental Attitude: Multivitamins Can Add Sparkle. Non-elderly adults who took multivitamins and minerals had significantly improved mental health, reduced subjective stress and increased 'vigor', with a strong trend towards an overall improvement in mood. According to David Kennedy, PhD of Northumbria University, "There is a wealth of evidence that suggests a relationship between micro-nutrients and psychological functioning. Vitamin C, for example, is the brain's most prevalent antioxidant and is found at its greatest concentrations in neuron-rich areas."
Northumbria University, May 2010

Health Alert: Got Health Insurance? Many non-elderly adults in the US lack health insurance. 20% of men ages 18-64 (21.2 million) are uninsured, compared with 17.2 million women in the same age group. Those most likely to lack health insurance are younger, unmarried men. Men are less likely to have health insurance than women at every age range. Married men lack health insurance in greater numbers than married women before the age of 65, with 18.4% of married men from the age of 26-34 lacking insurance.
Center for Economic and Policy Research, Institute for Women's Policy Research, June 2010

Diet: Cheese Found To Improve The Immune Response Of The Elderly. Cheese can help preserve and enhance the immune system of the elderly persons by acting as a carrier of probiotic bacteria. Daily intake of probiotic cheese can slow the age-related deterioration of the immune system known as immunosenescene. This deterioration means the body is unable to kill tumor cells and reduces the immune response to infections. Infectious diseases, chronic inflammation disorders and cancer are hallmarks of immunosenescene.
FEMS Immunology & Medical Microbiology, May 2010

Exercise: Stretching Exercises At Your Desk For The Shoulders And Upper Back. Extend one arm out straight in front of you. Grab the elbow of the outstretched arm and pull it across your chest, stretching your shoulder and upper back muscles. Hold. Release. Stretch out the other arm in front of you -- repeat.

Chiropractic: How Important Is An Adjustment? “90% of the stimulation and nutrition to the brain is generated by the movement of the spine” 
~ Dr. Roger Sperry (Nobel Prize, Brain Research, 1981)

Wellness/Prevention: The Fear Of Falling. One in four people over age 70 suffer from gait disturbance. Gait disturbance is defined as unsteadiness during walking that is worse than the normal slowing of old age. Fear is often a precipitating or aggravating factor. A vicious cycle often arises in which fear of falling leads to avoidance of movement. This can result in reduced fitness, lower confidence in one's own balance, increased fear, and increased danger of a fall. Depression and a markedly impaired quality of life can result.
Deutsches Aerzteblatt International, May 2010

Quote: "No Illness which can be treated by diet should be treated by any other means."
~ Moses Maimonides (1135-1204)