Headaches are a common complaint in patients presenting for professional care, including chiropractic management. Patients with headaches seek chiropractic care because they find manipulation or adjustments applied to the cervical spine and upper back region are highly effective in reducing the intensity, frequency and duration of the headache pain. This is because the cervical spine / neck, is often the origin of the headache as the three nerves in the upper neck (C1, 2 and 3) pass through the thick, overly taught neck muscles in route to the scalp / head. When the muscles of the neck are in spasm, the nerves get “pinched” or squeezed by the overly tight muscles resulting in headache pain. Each nerve runs to a different part of the head and therefore, pain may be described as “…radiating over the top of head (sometimes into the forehead and eyes),” or, into the head and over the ear, sometimes reaching the temple. Also, an area located in the back and side of the head is the area where the C1 nerve innervates, so pain may also be reported in that location. When more than one of the C1-3 nerves is pinched, the whole side to the top of the head may be involved.
In the October 2009 issue of The Spine Journal, Western States Chiropractic College, Center for Outcomes Studies, reported benefits are obtained with the utilization of spinal manipulation in the treatment of chronic cervicogenic headaches. The word “chronic” means at least 3 months of headache pain has been present. This new study compared 2 different doses of therapy using several outcome measures including the pain grade, the number of headaches in the last 4 weeks and the amount of medication utilized. Data was collected every 4 weeks for a 24 week period and patients were treated 1-2 times/week and separated into either an 8 or a 16 treatment session with half the group receiving either spinal manipulative therapy or a minimal light massage (LM) control group.
The results of the study revealed the spinal manipulation group obtained better results than the control group at all time intervals. There was a small benefit in the group that received the greater number of treatments with the mean number of cervicogenic headaches reduced by 50% in both pain intensity and headache frequency.
The importance of this study is significant as there are many side effects to medications frequently utilized in the treatment of headaches. Many patients prefer not taking medications for this reason and spinal manipulation therapy (SMT) offers a perfect remedy for these patients. Couple SMT with dietary management, lifestyle modifications, stress management, and a natural, vitamin/herbal anti-inflammatory (such as ginger, turmeric, boswellia) when needed, a natural, holistic approach to the management of chronic headaches is accomplished.
Monday, January 18, 2010
Friday, January 15, 2010
Spinal Stenosis: Symptoms and Treatment Options
According to the Mayo Clinic website…
Spinal stenosis is a narrowing of one or more areas in your spine — most often in your upper or lower back. This narrowing can put pressure on your spinal cord or on the nerves that branch out from the compressed areas.
Spinal stenosis can cause cramping, pain or numbness in your legs, back, neck, shoulders or arms; a loss of sensation in your extremities; and sometimes problems with bladder or bowel function. Spinal stenosis is most commonly caused by osteoarthritis-related bone damage. Spinal narrowing doesn't always cause problems. But if the narrowed areas compress the spinal cord or spinal nerves, you're likely to develop signs and symptoms. These often start gradually and grow worse over time.
The most common spinal stenosis symptoms include:
Pain or cramping in your legs. Compressed nerves in your lower (lumbar) spine can lead to a condition called pseudoclaudication, false claudication or neurogenic intermittent claudication, which causes pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down, but it persists if you continue to stand upright.
Another type of intermittent claudication (vascular claudication) occurs when there's a narrowing or blockage in the arteries in your legs. Although both types of claudication cause similar symptoms, they differ in two important ways: Vascular claudication becomes worse when you walk uphill and improves when you stand still. Pseudoclaudication is usually worse when going downhill and gets better when you lean forward or sit down.
Radiating back and hip pain. A herniated disk can narrow your spinal canal and compress nerves in your lumbar spine, leading to pain that starts in your hip or buttocks and extends down the back of your leg. The pain is worse when you're sitting and generally affects only one side. You may also experience numbness, weakness or tingling in your leg or foot. For some people, the radiating pain is a minor annoyance, but for others, it can be debilitating.
Pain in your neck and shoulders. This is likely to occur when the nerves in your neck (cervical spine) are compressed. The pain may occur only occasionally or it may be chronic, and it sometimes can extend into your arm or hand. In addition, the spinal cord is sometimes compressed, which can result in lower extremity weakness and difficulty walking. You also may experience headaches, a loss of sensation or muscle weakness.
Loss of balance. Pressure on the cervical spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.
Loss of bowel or bladder function (cauda equina syndrome). In severe cases, nerves to your bladder or bowel may be affected, leading to partial or complete urinary or fecal incontinence. If you experience either of these problems, seek medical care right away.
Treatment Options:
The most common traditional treatment for spinal stenosis is surgery. The type of surgery will be dependent on the primary cause of your stenosis. The causes can include disc protrusions/herniations, thickening of the ligaments withing the spinal canal, osteoarthritis of the spinal joints, and other space occupying lesions within the spinal canal. If the primary cause of your stenosis is due to a disc bulge, protrusion, or herniation, then the DRX 9000 Non-Surgical Spinal Decompression system may be able to reduce the severity of your spinal stenosis and relieve your symptoms. Call our office for a free consultation and assessment of your MRI or CT scan with Dr. Gordon. Call us at 734-9995.
Spinal stenosis is a narrowing of one or more areas in your spine — most often in your upper or lower back. This narrowing can put pressure on your spinal cord or on the nerves that branch out from the compressed areas.
Spinal stenosis can cause cramping, pain or numbness in your legs, back, neck, shoulders or arms; a loss of sensation in your extremities; and sometimes problems with bladder or bowel function. Spinal stenosis is most commonly caused by osteoarthritis-related bone damage. Spinal narrowing doesn't always cause problems. But if the narrowed areas compress the spinal cord or spinal nerves, you're likely to develop signs and symptoms. These often start gradually and grow worse over time.
The most common spinal stenosis symptoms include:
Pain or cramping in your legs. Compressed nerves in your lower (lumbar) spine can lead to a condition called pseudoclaudication, false claudication or neurogenic intermittent claudication, which causes pain or cramping in your legs when you stand for long periods of time or when you walk. The discomfort usually eases when you bend forward or sit down, but it persists if you continue to stand upright.
Another type of intermittent claudication (vascular claudication) occurs when there's a narrowing or blockage in the arteries in your legs. Although both types of claudication cause similar symptoms, they differ in two important ways: Vascular claudication becomes worse when you walk uphill and improves when you stand still. Pseudoclaudication is usually worse when going downhill and gets better when you lean forward or sit down.
Radiating back and hip pain. A herniated disk can narrow your spinal canal and compress nerves in your lumbar spine, leading to pain that starts in your hip or buttocks and extends down the back of your leg. The pain is worse when you're sitting and generally affects only one side. You may also experience numbness, weakness or tingling in your leg or foot. For some people, the radiating pain is a minor annoyance, but for others, it can be debilitating.
Pain in your neck and shoulders. This is likely to occur when the nerves in your neck (cervical spine) are compressed. The pain may occur only occasionally or it may be chronic, and it sometimes can extend into your arm or hand. In addition, the spinal cord is sometimes compressed, which can result in lower extremity weakness and difficulty walking. You also may experience headaches, a loss of sensation or muscle weakness.
Loss of balance. Pressure on the cervical spinal cord can affect the nerves that control your balance, resulting in clumsiness or a tendency to fall.
Loss of bowel or bladder function (cauda equina syndrome). In severe cases, nerves to your bladder or bowel may be affected, leading to partial or complete urinary or fecal incontinence. If you experience either of these problems, seek medical care right away.
Treatment Options:
The most common traditional treatment for spinal stenosis is surgery. The type of surgery will be dependent on the primary cause of your stenosis. The causes can include disc protrusions/herniations, thickening of the ligaments withing the spinal canal, osteoarthritis of the spinal joints, and other space occupying lesions within the spinal canal. If the primary cause of your stenosis is due to a disc bulge, protrusion, or herniation, then the DRX 9000 Non-Surgical Spinal Decompression system may be able to reduce the severity of your spinal stenosis and relieve your symptoms. Call our office for a free consultation and assessment of your MRI or CT scan with Dr. Gordon. Call us at 734-9995.
Thursday, January 14, 2010
Carpal Tunnel Syndrome (CTS) – What, Why, How?
What? Carpal Tunnel Syndrome or CTS, is the most common of the peripheral nerve conditions where the median nerve is compressed or pinched at the wrist. The resulting symptoms include numbness/pain in the wrist, thumb, fingers (index, third, and part of fourth), multiple sleep interruptions due to hand/finger numbness requiring frequent shaking and flicking, difficulty in gripping or pinching such as buttoning a shirt, threading a needle, lifting a coffee cup, frequent dropping of objects, and the inability to perform work duties. Pain can even shoot up the arm towards the shoulder and into the neck. Because there are 9 tendons over which lies the median nerve that pass through the rather tight tunnel made up of the 8 carpal bones of the wrist, even a little swelling can create CTS.
WHY? There are many possible causes but in general, whether it’s swelling, a spur, or a metabolic condition, the common denominator is median nerve pinch in the confined space within the carpal tunnel. A common cause of swelling can occur with performing repetitive motion work such as line assembly, meat packing, carpentry, and so on, and over time, the tendons inside the tunnel inflame or swell and the median nerve is pressed into the ligament that crosses over the roof of the tunnel on the palm side of the wrist. Once the contents inside the carpal tunnel swell, all positions of the wrist other than neutral or, holding the wrist in line with the forearm further increases the pressure inside the tunnel. That is why sleeping with the wrist cocked in any direction often wakes up CTS patients. Those most at risk are women over 50 years of age. CTS can also be associated with other health conditions including (but not limited to) Lyme’s Disease, inflammatory arthritis, and hormone-related conditions including pregnancy, taking birth control pills (BCPs), hypothyroidism, diabetes, and menopause. Lifestyle issues that affect CTS may include high caffeine intake, smoking, alcohol consumption, as well as obesity.
HOW? So the key question is how are we going to help those with CTS? First, we must identify all the possible reasons why CTS developed in the first place and manage those issues. Therefore, an ergonomic (work place) assessment or, discussing and possibly observing the patient at work can be very helpful. Sometimes, a few simple changes to a work station such as moving the monitor of a computer in line with the keyboard/mouse or adjusting the height of the computer can really help. Changing a tool handle type (pistol vs. straight grip), propping up a part that is frequently worked on, moving the product closer to where it is being assembled, eliminate overhead reach requirements, standing on a raised platform, and so on, may be most important in long term results. Identifying and treating any condition that may be participating in the cause like thyroid disease, diabetes, medication (like BCPs), and weight management, is very important. Wearing a night splint is also very productive. Unique to chiropractic, treatments include manipulation of the neck, shoulder, elbow, forearm, wrist and fingers, “cold” laser therapy (decreases inflammation and promotes healing of damaged nerve tissue), soft-tissue therapy including massage, mobilizing the forearm muscles and tendons, teaching carpal stretch and other upper extremity exercises, and nutritional counseling. Strategies here can include eliminating any suspected food allergy related products including dairy, glutens (wheat, oats, barley, rye), soy, corn, trans-fats, preservatives and some chemical additives. Increasing B-vitamins (especially B6), by increasing dark leafy vegetables and, increasing antioxidants including fruits and veggies. An anti-inflammatory vitamin regimen of fish oil, vitamin D3, magnesium, CoQ10, and a multiple vitamin/mineral may facilitate as well. Once CTS is controlled, preventing a recurrence is important by promoting good posture, exercise, and sticking with the life style adjustments described above. If you, a friend or family member requires care for CTS, we would be honored to render our services. For a free consultation, call our office at 386-734-9995.
WHY? There are many possible causes but in general, whether it’s swelling, a spur, or a metabolic condition, the common denominator is median nerve pinch in the confined space within the carpal tunnel. A common cause of swelling can occur with performing repetitive motion work such as line assembly, meat packing, carpentry, and so on, and over time, the tendons inside the tunnel inflame or swell and the median nerve is pressed into the ligament that crosses over the roof of the tunnel on the palm side of the wrist. Once the contents inside the carpal tunnel swell, all positions of the wrist other than neutral or, holding the wrist in line with the forearm further increases the pressure inside the tunnel. That is why sleeping with the wrist cocked in any direction often wakes up CTS patients. Those most at risk are women over 50 years of age. CTS can also be associated with other health conditions including (but not limited to) Lyme’s Disease, inflammatory arthritis, and hormone-related conditions including pregnancy, taking birth control pills (BCPs), hypothyroidism, diabetes, and menopause. Lifestyle issues that affect CTS may include high caffeine intake, smoking, alcohol consumption, as well as obesity.
HOW? So the key question is how are we going to help those with CTS? First, we must identify all the possible reasons why CTS developed in the first place and manage those issues. Therefore, an ergonomic (work place) assessment or, discussing and possibly observing the patient at work can be very helpful. Sometimes, a few simple changes to a work station such as moving the monitor of a computer in line with the keyboard/mouse or adjusting the height of the computer can really help. Changing a tool handle type (pistol vs. straight grip), propping up a part that is frequently worked on, moving the product closer to where it is being assembled, eliminate overhead reach requirements, standing on a raised platform, and so on, may be most important in long term results. Identifying and treating any condition that may be participating in the cause like thyroid disease, diabetes, medication (like BCPs), and weight management, is very important. Wearing a night splint is also very productive. Unique to chiropractic, treatments include manipulation of the neck, shoulder, elbow, forearm, wrist and fingers, “cold” laser therapy (decreases inflammation and promotes healing of damaged nerve tissue), soft-tissue therapy including massage, mobilizing the forearm muscles and tendons, teaching carpal stretch and other upper extremity exercises, and nutritional counseling. Strategies here can include eliminating any suspected food allergy related products including dairy, glutens (wheat, oats, barley, rye), soy, corn, trans-fats, preservatives and some chemical additives. Increasing B-vitamins (especially B6), by increasing dark leafy vegetables and, increasing antioxidants including fruits and veggies. An anti-inflammatory vitamin regimen of fish oil, vitamin D3, magnesium, CoQ10, and a multiple vitamin/mineral may facilitate as well. Once CTS is controlled, preventing a recurrence is important by promoting good posture, exercise, and sticking with the life style adjustments described above. If you, a friend or family member requires care for CTS, we would be honored to render our services. For a free consultation, call our office at 386-734-9995.
Wednesday, January 13, 2010
Does Chiropractic Work? - What Do Insurance Companies Say?
If chiropractic care helps patients get better faster and costs the patient and/or insurance company less, shouldn’t EVERY low back pain patient FIRST see a chiropractor before any other type of doctor? That is in fact, what should be done, based on a recent report!
On October 20, 2009, a report was delivered on the impact on population, health and total health care spending. It was found the addition of chiropractic care for the treatment of neck and low back pain “…will likely increase value-for-dollar in US employer-sponsored health benefit plans.” Authored by an MD and an MD/PhD, and commissioned by the Foundation for Chiropractic Progress, the findings are clear; chiropractic care achieves higher satisfaction and superior outcomes for both neck and low back pain in a manner more cost effective than other commonly utilized approaches.
The study reviews the fact that low back and neck pain are extremely common conditions consuming large amounts of health care dollars. In 2002, 26% of surveyed US adults reported having back pain in the prior 3 months, 14% had neck pain and the lifetime prevalence of back pain was estimated at 85%. LBP accounts for 2% of all physician office visits where only routine examinations, hypertension, and diabetes result in more. Annual national spending is estimated at $85 billion in the US with an inflation-adjusted increase of 65% compared to 1997. Treatment options are diverse ranging from rest to surgery, including many various types of medications. Chiropractic care, including spinal manipulation and mobilization, is reportedly also widely utilized with almost half of all patients with persisting back pain seeking chiropractic treatment.
In review of the scientific literature, it is noted that 1) chiropractic care is at least as effective as other widely used therapies for low back pain; 2) Chiropractic care, when combined with other modalities such as exercise, appears to be more effective than other treatments for patients with neck pain. Other studies reviewed reported patients who had chiropractic coverage included in their insurance benefits found lower costs, reduced imaging studies, less hospitalizations, and surgical procedures compared to those with no chiropractic coverage. They then utilized a method to compare medical physician care, chiropractic physician care, physiotherapy-led exercise and, manipulation plus physiotherapy-led exercise for low back pain care. They found adding chiropractic physician care is associated with better outcomes at “…equivalent to an incremental cost-effectiveness ratio of $1837 per QALY (Quality-adjusted Life Year).”
When combined with exercise, chiropractic physician care was also found to be very cost-effective when compared to exercise alone. This combined approach would achieve improved health outcomes at a cost of $152 per patient, equivalent to an “incremental cost-effectiveness ratio of $4591 per QALY.” When comparing the cost effectiveness of chiropractic care with or without exercise even at 5 times the cost of the care they utilized in their analysis, it was still found to be “substantially more cost-effective” compared to the other approaches. It will be interesting given these findings if insurance companies and future treatment guidelines start to MANDATE the use of chiropractic FIRST – it would be in everyone’s best interest!
If you, a family member or a friend require care, 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. To contact our office directly, call 386-734-9995. For more information, check out our website at www.DrGordonOnline.net, or go to www.FCAChiro.org for a listing of chiropractors in your area.
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