Tuesday, March 16, 2010

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome (CTS) – Can It Be Prevented?

Carpal Tunnel Syndrome or CTS is a very common problem affecting many workers and is one of the most costly conditions afflicting today’s workforce.  It is most often caused by repetitive activity using rapid movements of the arms and hands and can lead to work loss and disability when not properly managed.  CTS occurs when the median nerve that travels through the carpal tunnel (CT) located on the palm side of the wrist becomes pinched by the swelling of the 9 tendons that also travel through the CT and essentially, pinch the nerve up against the transverse carpal ligament.  This results in numbness, tingling and/or pain of the index, middle and forth fingers.

Other symptoms include sleep interruptions where shaking and flicking of the fingers is required to allow for a return to sleep.  This is frequently caused by sleeping with the wrist in a cocked position, increasing the pressure inside the already swollen carpal tunnel.  This is why a cock-up wrist splint usually helps as it disallows the wrist from bending to the extremes and the nerve is not pressured or pinched as much.  Other symptoms include weakness of the grip, making it a challenge to unscrew a jar, open a door, and even sometimes turn the key when starting a car.  Driving can also be affected as the hands often fall asleep while holding onto a steering wheel.

Pain can also affect the rest of the arm and sometimes the neck area.  The median nerve can also be pinched in more than one place and may include the neck, shoulder, elbow as well as the wrist making it necessary to have all the areas treated for a satisfying result.

People at greatest risk are women > men, workers who handle small tools, computer workers, fast repetitive line workers, and people older than 40 years of age.  People with other health conditions including rheumatoid arthritis, Lymes disease, rubella, pregnancy, birth control pill use, diabetes mellitus and menopause are at an increased risk of developing CTS.  Certain foods such as caffeine, tobacco, and/or alcohol may also contribute to CTS.

Though treatment is very important –the sooner the better- prevention is most important.  In fact, some simple approaches can make a big difference!  Some of these include modifying the position of a computer chair, keyboard, monitor, or mouse (work station modifications), alternate between different tasks to reduce the repetition of work, stretch your forearms and fingers before, during and after work, and treat any underlying conditions.  When symptoms first occur, these recommendations, as well as wearing a night wrist cock-up splint and seeing your chiropractor, will often reverse the condition without difficulty.  If you wait too long and nerve damage occurs, it becomes a more challenging process to manage CTS and at times, even surgery will not be very helpful.

Some of the non-surgical treatment approaches you might expect from your chiropractor include joint manipulation and/or mobilization applied to the neck, wrist, elbow and/or shoulder, the application of physical therapy modalities such as ultrasound, electrical stim, and/or low level laser therapy (“light” therapy), as well as the use of wrist splints.

The University of Maryland Medical Center cites two research articles on chiropractic treatment for CTS. They report good results are usually obtained and that these good results continued for at least 6 months after treatment ended.  The same reference also recommends nutrition and supplements in the management of CTS.  Some of these include: eliminate food allergens (often milk, cheese, eggs, ice cream, glutens/wheat-grains, soy, corn, and preservatives) and eating foods high in B-vitamins (dark leafy greens like spinach, kale, and sea vegetables), anti-oxidants (fruits – blueberries, cherries, tomatoes; vegetables – squash, bell peppers),  avoiding refined foods, using olive oil and adding omega 3 fatty acids to the diet (fish oil).  Other vitamins including a multivitamin, B complex, Vit. C, alpha-lipoic acid, MSM, resveratrol, Vit. D, Co-Q10, magnesium can also really help.

We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for CTS, chiropractic care is a logical first choice and we would be honored to offer our services to you.


Monday, March 15, 2010

Health Update: Fibromyalgia

Fibromyalgia – Does This Sounds Familiar?

“I am exhausted and hurt all over.  I can’t get to sleep at night and when I do, I wake up at the drop of a dime.  I went to my doctor and they ran some blood tests and took some x-rays and said that nothing was wrong.  I just don’t know what is wrong or what to do about it.”

This is a classic history obtained from a patient suffering from fibromyalgia or FM.  Because the onset of fibromyalgia is slow and gradual, it is common for patients to postpone visiting their health care provider until the symptoms are quite significant. The diagnosis may also be delayed as many healthcare providers do not feel fibromyalgia is a legitimate medical condition and minimize the symptoms frequently categorizing them as "depressed," which postpones an appropriate diagnosis and treatment.

The classic definition as defined by the American College of Rheumatology includes at least a three-month duration of symptoms with the presence of 11 out of 18 potential tender points although diffuse, widespread pain not necessarily restricted to these exact locations may also represent an appropriate diagnostic finding in fibromyalgia.

Fibromyalgia is more common in females and affects approximately 2% of the population in the United States. The risk of developing fibromyalgia increases with age, usually developing during early and middle adulthood but can also develop in children and older adults. Other risk factors include a positive family history where one may be more likely to develop FM if a relative suffers with the same condition.

A major risk factor of developing fibromyalgia includes is disturbed sleep pattern and this remains controversial as to whether sleeping disorders are a direct cause or simply the result of fibromyalgia. However, in either case, people with FM cannot obtain deep "restorative" sleep and feel fatigued and tired upon waking in the morning. Sleep disorders including sleep apnea and restless leg syndrome are often present in patients with fibromyalgia.

Certain conditions such as rheumatoid arthritis, irritable bowel syndrome, hypothyroid, and other endocrine/hormonal conditions may preceded the onset of fibromyalgia in which case the condition is considered "secondary fibromyalgia." Hence, a diagnostic evaluation usually includes a blood test for hypothyroid, autoimmune diseases such as rheumatoid arthritis, and a complete blood count to rule out infections and/or anemia. In most cases, these tests prove negative and the diagnosis is made by excluding other possible primary conditions.

Other causes can include physical and/or emotional trauma where a high-level of stress can trigger this condition. Although experts still debate why patients with fibromyalgia hurt so intensely, the current explanation centers around a theory called central sensitization. This is essentially a lower pain threshold where patients with FM feel pain much sooner than those without it because of increased sensitivity in the brain and/or spinal cord to incoming pain signals.

Treatment of FM relies on a multidiscipline, multifactorial approach including stress reduction, obtaining enough sleep, exercising regularly, pacing yourself, and maintaining a healthy lifestyle, including diet and exercise. Medications to facilitate sleep, treat depression and any other underlying medical conditions may be appropriate. Other highly effective treatments, according to the Mayo Clinic website, include chiropractic treatment, massage therapy, and/or acupuncture. The concepts of chiropractic treatment includes restoring movement in restricted spinal joints resulting in improved nerve function and subsequently, improved overall function and reduced pain. Chiropractic care also includes soft tissue therapies, physical therapy modalities, nutritional counseling, patient education and many utilized in-house massage therapy. We recognize the importance of including chiropractic in your treatment of FM and realize you have a choice of providers. We would be honored to be part of your management team.

Health Update: Headaches

What Is It and What Can I Do About It?

“I woke up this morning with an excruciating headache.  I thought the top of my head was going to blow off!”  “I notice as the day goes on, tightness in my neck worsens and I get a headache usually by 2-3pm.” “I don’t know if I can do my work with my headaches.”

These are common patient history entries we frequently receive at our clinic.  Headaches are one of the most common complaints prompting patients to visit a health care provider.  Many patients ask, “...what is a headache?”  The National Institutes of Health (NIH) describe four types of headache: vascular, muscular contraction or tension, traction and inflammatory.

The most common form of a vascular headache is migraine.  Migraine sufferers usually complain of severe pain on one or both sides of the head, nausea or vomiting and sometimes visual changes.  There is often a heightened sensitivity to light or noise prompting migraine sufferers to lay in a dark, quiet room until the migraine passes.  Women are more likely to suffer from migraines than men and the severity of symptoms can be so extreme that all activity must be stopped until it passes.

The next most common type of vascular headache is the toxic headache produced by a fever.  Other vascular headache types include “cluster” headaches, which are characterized by repeated episodes of intense pain that start in one spot and spread out from that spot.  These may only last a few minutes to an hour but carry a very high level of pain and activity intolerance.  Another common type of vascular headache is that resulting from high blood pressure.

Muscle contraction or tension headaches involve tightening of the facial and neck muscles.  These often start in the neck and radiate over the top or to the sides of the head.  The muscles in the neck are usually extremely tight and tender and often, moderate pressure applied with the finger or thumb to these muscles will prompt radiating pain into and/or over the top of the head.  This can also result in significant activity intolerance but usually not as severe as migraine or cluster headaches.

Traction and inflammatory headaches result because of other conditions that range from a sinus infection to a stroke.  These types of headaches can serve as a warning sign of a more significant or serious condition.  Another example is meningitis as well as other conditions affecting the sinuses, spine, neck, ear, and teeth.

The NIH suggests, when headaches occur ≥3 times a month, that “… preventive treatment is usually recommended.” Certainly, in some cases, medication may be indicated but only after ruling out a more serious condition and after exhausting less invasive treatments that carry fewer side effects.

The American Chiropractic Association recommends:
1) avoid long time periods of staying in one position (computer, sewing machine, reading, etc.) and take stretching/neck range of motion exercise breaks every ½ to 1 hour
2) Exercise – walking, low impact aerobics
3) Avoid teeth clenching (due to straining the temporomandibular – TMJ, or jaw joint)
4) Drink lots of water – stay hydrated.

Chiropractic care may include spinal manipulation (adjustments), nutritional advice (dietary suggestions, vitamin/mineral options such as a B complex), exercise, posture retraining, and relaxation techniques.  If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  If headaches are a problem, doesn’t a trial of chiropractic make sense prior to utilizing a more risk oriented treatment option?  We look forward in serving you and your family.

CALL TODAY. 732-984-9597

Health Update: Whiplash

Whiplash – The Importance of Seatbelts

Whiplash is a very common problem afflicting millions of people each year. In fact, there are more than 6 million car accidents each year in the United States alone. Death associated with car accidents occurs every 12 minutes and each year, motor vehicle collisions (MVC) kill 40,000 people. For people aged between 2 and 34 years old, MVCs are the leading cause of death.   Another sobering statistic is somebody is injured in a car crash every 14 seconds and about 2 million people receive permanent injuries in car crashes each year. Over a five-year period, over 25% of ALL drivers were involved in a motor vehicle collision. 

The cost of car accidents averages $1000 for each American per year resulting in a $164.2 billion total cost each year in the United States.  Approximately 250,000 children are injured and car crashes, meaning approximately 700 kids are injured daily. Car crashes are the leading cause of acquired disability.   Hopefully, these rather startling statistics have gotten your attention.  Last month, we discussed various effective ways of reducing the likelihood of even being in a motor vehicle collision (MVC). As an appropriate follow-up, this discussion will cover seatbelts and their role in injury prevention and life-saving capabilities.

In general, the available evidence available is clear – seat belts save lives! Regarding backseat passengers, wearing a seatbelt is 44% more effective at preventing death than riding unrestrained. Similarly, for those positioned in the rear of a van or sport utility vehicle, the use of rear seatbelts is 73% better at preventing a fatal outcome during a car crash. In more than one half of all fatal car accidents, the victims are not properly restrained. The National Highway Traffic Safety Administration (NHTSA) in 2008 reported the use of seatbelts increased 1% over 2007 with 83% of drivers wearing their seat belts. The use of seatbelts increased to 90% on highways versus 80% on surface streets (in town). In states where rear seatbelts are required, 85% of adult backseat passengers complied versus states not mandating rear seat seatbelt use where only 66% of the passengers complied. The NHTSA has launched a campaign, "Click It or Ticket" and has provided a guide to seatbelt safety promoting the proper use of the seatbelt and have provided the following safety seatbelts tips:

Make sure your seat belt fits snugly. Seat belts worn too loosely can cause broken ribs or injuries to your abdomen.
Place the lap belt low on your hipbones and below your belly. Never put the lap belt across your belly.
Place the shoulder belt across the center of the chest between the breasts.
Never slip the upper part of the belt off your shoulder. Seat belts that are worn too high can cause broken ribs or injuries to your belly.
The most effective safety protection available today for passenger vehicle occupants is lap/shoulder seat belts combined with air bags.

There is a common myth that seatbelts cause injuries at low speeds and therefore, it is better to not wear the seatbelt when simply traveling in town. There is overwhelming evidence in almost all circumstances, seatbelts save lives, even at low speed collisions. Because the forces that occur in low-speed crashes are transferred to the contents due to the lack of crushing metal and less vehicle damage, the occupants of a car struck at a low speed can be thrown about significantly… striking the windshield, side window and other contents inside the car. We realize that you have a choice in where you choose for your health care services.  If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you.  


Friday, March 12, 2010

Health Update: Low Back Pain

Back School 101:  3 Ways To Prevent Making Your Back Pain Worse

Chiropractic care for patients with low back pain (LBP) not only includes spinal manipulation or adjustments but also patient education in regards to heat/ice, performing daily activities and exercise.

Heat vs. Ice: This topic is controversial, as often, patients will be told by their friends and family to use the opposite of what we may recommend to our patients. In general, when pain is present, there is inflammation… so use ice to reduce swelling and pain. When heat is inappropriately utilized during this inflammatory phase of healing, vasodilation or, an increase in blood supply to the already swollen injured area often results in an increase in pain. The use of heat may be safely applied later in the healing process during the reparative phase of healing, but as long as pain is present, using ice is usually safer and more effective.

Daily Activities: Improper methods of performing sitting, bending, pulling, pushing, and lifting can perpetuate the inflammatory phase, slow down the healing process, and interfere/prevent people from returning to their desired activities of daily living, especially work. Improperly performing these routine activities is similar to picking at scab since you’re delaying the healing process and you can even make things worse for yourself.

Exercise: There are many exercises available for patients with low back pain. When deciding on the type of exercise, the position the patient feels best or, the least irritating is usually the direction to emphasize.

More specifically, for those who feel a reduction in pain when bending forward (referred to as "flexion-biased"), flexion exercises are usually indicated. Examples of these include raising a single knee to chest, double knee to chest, posterior pelvic tilts, sitting forward flexion, and hamstring stretches.

When bending backwards results in pain reduction (referred to as "extension-biased"), standing and bending backwards, performing a sagging type of push-up ("prone press-up"), laying backwards on large pillows or on a gym-ball are good exercises. The dosage or duration exercises must be determined individually and it is typically safer to start with 1 or 2 exercises and gradually increase the number as well as repetition and/or hold-times. If sharp/"bad" pain is noted, the patient is warned to discontinue that exercise and report this for further discussion with their chiropractor. It is normal and often a good sign when stretching/"good" pain is obtained at the end range of the exercise.

We recognized the importance of patient education in our approach to managing low back pain cases, and look forward in serving you and your family presently and, in the future.

Monday, March 8, 2010

Childhood Obesity and Healthy Eating

Eat your vegetables, don’t drink too much soda, get some exercise.  We all know what we should be doing, but few of us actually stick to what we know.  In fact, it is rare that you will find a family that sticks to a healthy diet, limits the amount of time in front of the computer or TV and encourages regular exercise.  Childhood obesity is becoming an epidemic in the Unites States.

According to data from CDC and NHANES surveys from 1976-1980 and 2003-2006, obesity rates in children from 2-5 years old has risen from 5.0% to 12.4%, 6-11 years old from 6.5%-17.0% and in children from 12-19 years old from 5.0%-17.6%!  This drastic raise in obesity rates is increasing the risk of cardiovascular disease (such as high blood pressure and high cholesterol) and Type 2 (Adult onset) Diabetes in children. 

Several factors are contributing to the increase in these obesity rates.  First of all, there is a drastic imbalance between the amount of calories consumed and calories burned on a daily basis.  High caloric foods such as fast foods and those which are processed have little nutritional value and are unable to be broken down easily by the body.  Foods and drinks with high sugar content are easily converted to fat.  Also, most children lead a sedentary lifestyle.  One study found that children between the ages of 8-18 years old spend a little over 3 hours per day watching T.V., DVD’s, playing video games or spending time on the computer.

Environmental and behavioral factors are also contributing to the obesity rates in children.  Young children are easily influenced at home, in school and their community.  It is essential that as parents, you give your children the proper guidance and healthy eating habits.  Family meals are a comforting ritual for both parents and kids.  Children like the predictability of a family meal and parents like the time spent with their children.  This is also a great way to introduce health eating habits.  Children who are raised in families that have regular meals together have been shown to be more likely to eat more fruits, vegetables and grains, are less likely to snack on unhealthy foods and are even less likely to use alcohol and smoke.

Whether you have a toddler or a teen, here are five of the best strategies to improve nutrition and encourage healthy eating habits:
1)Have regular family meals.
2)Serve a variety of healthy foods and snacks
3)Be a role model by eating healthy yourself.
4)Avoid battles over food.
5)Involve the kids in the process

By making some simple changes in your family eating habits, you are greatly reducing the risk of poor health for your children, now and in the future.

Thursday, March 4, 2010

Spinal Decompression DRX 9000 with Dr. Joseph Cilea

Should my children see a Chiropractor?

It is all too often that I am adjusting a child and another nearby patient says to me “I had no idea that you can adjust children, why do they need chiropractic care?”. Well, in my opinion, all children should be adjusted! Many spinal problems that affect adults began as early as birth. Even “natural” child birth places significant stress on the spinal column and developing nervous system. Theses stresses on the nervous system have often been traced to be directly related to common infantile disorders such as colic, nursing difficulties, chronic ear infections, sleep disturbances and allergic reactions. As the infant grows, learning to hold their head upright, sitting, crawling and walking, all pose an opportunity in spinal development where minor trauma may adversely affect spinal alignment and the nervous system.

As your children grow up, they learn new skills such as riding a bike, playing sports and interactive video games, all of which carry the possibility of causing mild spinal misalignments (subluxations). If neglected, the injuries during this period of rapid growth may lead to more serious problems later in life. Subtle trauma throughout childhood will affect the future development of the spine leading to impaired nervous system function. Because the nervous system controls and coordinates the function of all systems: circulatory, respiratory, digestive, hormonal and immune system; any aspect of health may be impaired by nerve interference.

Through a thorough case history and examination, chiropractors are able to determine if subluxations are present. Chiropractic adjusting techniques are modified to fit your child’s size and weight. They are both gentle and specific to the child’s developing spinal structures. In fact, most parents tell me that their children look forward to their next visit and really enjoy the treatment! They also report that their children experience a greater level of health while under regular chiropractic care.

So, like I said at the beginning of this article, it is imperative to have all children checked for spinal misalignment. Many of you reading this article have experienced the power of chiropractic care, not just for pain relief, but for when you have been sick or run down, suffering from allergies or asthma. Give your children every advantage that you can to allow them to grow up as health and happy as possible.

Pediatric Chiropractics

As the weather warms up, it comes time to dust off that catcher’s mitt, clean those soccer cleats and get out the bathing suits. There is a sense of excitement in the air. One that can only be described as Spring and Summer. During this time of year, many families will spend countless hours at the baseball diamond, soccer field, swimming pool and even the playground. But, did you know that this is also a time of the year when many new injuries can occur in your children?

In the United States, about 30 million children and teens participate in some form of organized sports, and about 3 million injuries occur each year, which cause some loss of time and participation. Almost one-third of all injuries incurred in childhood are sports-related injuries. By far, the most common injuries are sprains and strains. Obviously, some sports are more dangerous than others. For example, contact sports such as football can be expected to result in a higher number of injuries than a non-contact sport such as swimming. However, all types of sports have a potential for injury, whether from the trauma of contact with other players or from overuse or misuse of a body part. Did you know that most organized sports-related injuries (about 60 percent) occur during practice and not the actual game? Also, children who are less developed than a more mature child of the same age and weight are more at risk for injury. Hormones even have an affect of injury rate in children. Before puberty, boys and girls carry approximately the risk of sports related injuries. However, during and after puberty, boys are at a greater risk.

In preparation for this exciting time of year, parents must take precautions to reduce the risk of traumatic and overuse injuries in their children. Everyone knows that proper warm ups, stretching and cool downs are essential. But, did you know that dehydration is a major cause of muscle injury. Sports and other vigorous activities can cause excessive fluid loss from perspiration. Sodium depletion has also been associated with muscle injury. Loss of sodium, the most abundant chemical constituent of body fluids outside the cell, is usually a function of dehydration. To reduce the risk of injury due to dehydration, follow these simple rules.

1)No soda! Sugar will increase the rate of dehydration.
2)Drink 4-6 8oz glasses of water per day minimum.
3)Mix your favorite sports drink 50/50 with water to replace electrolytes including sodium.

Another simple step that you can take to help reduce the risk of injury is to have your child check by a qualified pediatric chiropractor. Probably more than any other health profession, chiropractic’s approach to health closely relates to the needs of the athlete. Most sports involve body contact, fast starts and stops and positioning that places an unusual amount of strain on the structural system. Pediatric chiropractors give special attention to the spine, joints, muscles, tendons, ligaments and nerves. Chiropractic is a natural health care method that stresses the importance of keeping all the systems of the body functioning efficiently so the player enjoys peak performance, minimum risk of injury and fast recovery. Many world class and Olympic athletes, as well as most professional sports teams, have retained sports chiropractors to provide care to enhance their performance.

Call our office today to set up a consultation with Dr. Beck to assess and correct the possible risk of injuries that your children may face this sports season. Dr. Beck is a board certified diplomat in clinical chiropractic pediatrics.