Avoiding whiplash and how to treat it

October 26, 2010 By

Last week I almost hit three deer on two different occasions while driving to work. I have also driven through torrential rain and witnessed a van hitting and cracking a telephone pole.

Accidents happen all the time and while modern cars can often withstand quite a bit of “injury”, the human body often can not.

Your head weighs 8 to 10 pounds; if your seat belt is fastened, the force of a collision can cause your head to whip forward and back or side to side. Accidents are at times unavoidable, but there are things you can do to decrease the chance of sustaining a whiplash injury.

  • Always fasten your seat belt.
  • Position your head rest to “catch” your head, which means it should be right in the center of your head. Positioning it too high or too low can actually cause or worsen a whiplash injury.
  • Position your seat properly. You should be sitting up straight and the seat should be as close to your head as possible to lessen the distance between your head and the seat upon impact.
  • Be aware of your surroundings — which means no calling, texting, eating, putting on makeup, etc.

If you do sustain a whiplash injury, get checked out by a medical professional. Some of the symptoms of whiplash: blurred vision, dizziness, jaw, shoulder or neck pain, headaches, vertigo, memory loss, irritability, sleeplessness, fatigue.

Most pain associated with whiplash is caused by tense muscles. When the neck is forced back and forth in a jarring motion, such as the type caused by a car accident, muscles and ligaments in the area are stretched beyond their normal limits. In severe instances, the supportive muscles of the spine are torn. Muscles in the surrounding area then tighten to try and support the injured tissues. This limits range of motion and causes strain on those muscles which are not being used to bearing the extra load. This causes more pain.

Muscle pain is your chiropractor’s specialty, so get checked out. And be careful out there.

Monica S. Nowak, DC
The Chiropractic Center of Canaan
176 Ashley Falls Road
Canaan, CT 06018
860-824-0748

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Back Talk – Acute Injuries

October 8, 2010 By

Last weekend my husband, my brother, his children and a few friends and I went to Pulaski, N.Y. to see the salmon run. My brother rolled his ankle while walking down to the river. His ankle swelled to the size of a melon which got me thinking: Do people know the best way to care for an injury like that?

The first thing to know is that there are two basic types of injury — acute and chronic. An acute injury is defined as one that has rapid or sudden onset. The pain is typically short-lived. A chronic injury is one that develops over time and is long-lasting.

When treating an acute injury, you use cold; when treating a chronic injury, you use heat.

Acute injuries are often accompanied by swelling and inflammation; the application of ice will help reduce those symptoms and the pain. You can usually ice an injury as often as you like but here is the key: only apply the ice for 15 minutes at a time; then allow the skin to warm up in between applications. And do not place the ice directly on your skin; the best thing to do is wrap it in a towel.

If you apply ice for longer than 15 minutes, your body’s natural defenses will kick in and try to warm the area by bringing more blood there. At that point, the ice pack will do the opposite of what you want it to do. It will cause more swelling.

Chronic injuries are often accompanied by sore, still muscles or joint pain. This type of pain can be relieved by warming the injury to increase elasticity of the joint connective tissues and to stimulate blood flow. Heat can be applied for 15 to 20 minutes at a time.

And, of course, sports injuries and the pain that accompanies them can also be treated by a chiropractor.

Monica S. Nowak, D.C.
Chiropractic Center of Canaan
176 Ashley Falls Road
Canaan, CT 06018
860 824-0748

Reprinted with permission from the writer.

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Getting backpacks right

September 9, 2010 By

Quite literally, we are talking about backs in this Back Talk column – specifically about children’s backs and their school backpacks.

The backpack might seem like the least important thing for a parent to worry about in the hectic days before school starts, but keep in mind that even very young children wear their packs every day, nine months a year.

And, when those backpacks fit incorrectly, it can add pressure to a child’s neck, shoulders and back.

Here are some tips to prevent neck and back pain/strain.

* Choose a lightweight material. You might have to replace it sooner but it won’t add to your child’s already heavy load.

* Wide padded shoulder straps help distribute the weight of the pack more evenly.

* Children should carry no more than 10 to 20 percent of their body weight. Their bodies are still developing muscles, bones and their attachments are only equipped to support a small amount of weight without taxing them. Would you be comfortable carrying an 80 pound briefcase to work? For many children, this means working with a parent to figure out which one can remain on campus, in a desk or locket.

* Show them how to pack their bags ergonomically. Heavy items should be closest to their back. Use multiple compartments so that the load doesn’t sway from side to side.

* Make sure your children are wearing their backpacks correctly. They should be worn over both shoulders, high on the back (2 inches above the waistline) and have them buckle the waist strap if their pack has one.

No one is saying that backpacks are going to cause major illnesses or dysfunction in a child. But, packs can contribute to future neck and back problems.

So, check in with your children, ask them if they have any pain and/or numbness in their neck, shoulders, arms, back and/or legs. Children should not have any pain at any age, it’s just not normal.

If they are experiencing pain, try a natural alternative: chiropractic. It can help them adjust their spine and skeleton before any problems become permanent.

Monica S. Nowak, DC
The Chiropractic Center of Canaan
176 Ashley Falls Road
Canaan, CT 06018
860 824-0748

Reprinted with permission

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No pain, better game

August 17, 2010 By

My father has become an avid golfer. He plays every Tuesday — and then comes to see me, suffering from back and joint pain.

When I ask him if he warmed up before playing, he demonstrates his stretching routine by whipping his upper body back and forth. Clearly, this routine isn’t working.

Golfers exert a huge amount of effort, repetitively pounding on specific joints (usually on one side of the body). Among other ailments, this can lead to “golfer’s elbow.”

Warming up your joints is essential. Slow stretching lubricates the joints and warms the muscles surrounding them, to prevent tearing of ligaments, tendons, and other soft tissues.

To prevent injury, golfers should do exercises to strengthen the muscles supporting the joints used in golfing. That means they should do exercises to strengthen their shoulders, arms, wrists, legs, knees, ankles, abdominals and low back.

Many of our clients are golfers who compete in weekend tournaments without any preparation — and then wonder why, at the end of two grueling days, they are so sore they can barely move.

Golfers should straighten up, too. Good posture is key to achieving a great golf swing, and it is important to spinal health.

Golf also requires spinal flexibility, so try some yoga. You might be surprised at the improvements they bring to your game.

And if you still have pain after you play, visit a chiropractor. Chiropractors have extensive training in the biomechanics of human movement, so if after playing you feel pain in specific joints or muscles, you probably need those joints adjusted.

People don’t normally think of chiropractic for elbows and knees, but chiropractic is very effective in mobilizing smaller joints and relieving pain.

Your chiropractor can not only treat those repetitive stress injuries but can possibly redirect your swing pattern, improving your game while getting you out of pain.

Monica S. Nowak, DC
The Chiropractic Center of Canaan
Monica Nowak, DC and Peter Markowicz, DC
176 Ashley Falls Road
Canaan, CT 06018
860-824-0748

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FIBROMYALGIA and CHIROPRACTIC

August 2, 2010 By

Over the past 25 years that I have been in practice there has been a slow but steady increase in the number of patients that upon entering my office relate that they have fibromyalgia also known as fibromyalgia syndrome or FMS. Some of these patients have been diagnosed by a healthcare professional and some have relied on self-diagnosis, which can be dangerous as I will discuss below. There has been a lot of controversy over FMS from is it a real entity, what exactly is wrong, how to diagnose it and to how to treat it. As a chiropractic physician the question put to me is “how can chiropractic help me with my fibromyalgia?”

Let’s first discuss a bit about what FMS is considered to be. FMS was first recognized by the American Medical Association as a diagnosis in 1987 even though it has been around for much longer than that. The name “fibromyalgia” implies pain and inflammation of the muscles and connective tissues of the body but this is an inaccurate label because there aren’t any actual problems in these particular structures, they just happen to be where the patient “feels” the pain and discomfort. On biopsy of these tissues in a patient considered to have FMS they do not show any inflammatory changes. Also, FMS symptoms do not respond well to anti-inflammatories e.g. prednisone as again these structures are themselves not inflamed. Much like having a pinched nerve in the neck or lower back that sends the pain down the arm or leg; the pain is only felt there, the problem is in the spine itself. The “problem” in FMS appears to be in the central nervous system. The problem in the central nervous system is in the area that controls the bodies sensitivity to pain. The ability to filter or dampen the nerve impulses for pain is impaired and thus stimuli that would not normally be interpreted by the body as painful are. No one knows for sure why this breakdown occurs but it is thought that this part of the central nervous system becomes “burned out” from the body dealing with significant stressful situations. This can be in the form of physical and/or emotional stress. Physical traumas such as auto accidents, which have seemingly been the trigger for some of my patients, or having to deal with stressful family or personal situations over a long period of time can be the underlying cause of this “burn out” situation in the central nervous system. Thus, FMS can be considered to be a post traumatic stress disorder or PTSD.

Patients that have FMS usually have a wide range of symptoms the most common of which are- hurt all over, insomnia, fatigue, depression and anxiety. Many also complain of difficulties with concentration and memory and may experience what many refer to as “fibrofog”. The list of symptoms that have been associated with FMS can be quite lengthy and can almost seem like any symptom you have can be attributed to FMS. Herein lies the biggest problem with a fibromyalgia diagnosis. Because that list of symptoms is so wide ranging someone who has been labeled as having FMS will just assume that any symptom they have is due to it. This can be dangerous as those symptoms may well be from some other underlying illness that is now going to be ignored as the patient assumes that they already know the reason for it. Even the more common symptoms associated with FMS may well be from some other illness or condition. Thus a diagnosis of FMS is usually arrived at through the process of elimination of all other possible causes of the patient’s problems. Other conditions that could give similar symptoms include- hypothyroidism, anemia, Lyme disease, rheumatoid arthritis, hormonal imbalances, allergies as well as numerous other illnesses. That is why it is extremely important to rule out other conditions first as they may be treatable and would therefore go untreated ultimately leading to other health problems if it is just lumped in as a “fibro” symptom. Thus, the person who self diagnoses as having FMS, is doing the worst injustice to themselves as they may have some other treatable condition that is just going to worsen over time. Once all other possible causes are eliminated then a diagnosis of FMS can be considered. The standard accepted criteria for diagnosing FMS, after the elimination process, is having widespread pain in all four quadrants of the body for a minimum of three months and must also have pain in at least 11 of 18 tender points in specific body locations on the application of pressure.

Now, lets get back to the original question, “how can chiropractic help me with my fibromyalgia?” First of all, as stated above, a patient should not just assume that any symptom they have is due to FMS. I have many patients say “there is nothing you can do for me my pain is from fibromyalgia”. Even though you may have FMS you are still entitled to good old-fashioned neck and back pain that may be from sprain/strains, disc related problems or even arthritis. All of which have nothing to do with FMS and can most certainly be treated in my office. They may also have an underlying carpal tunnel syndrome, tennis elbow, bursitis, and many other pain producing conditions not related to FMS that also respond well to chiropractic care. If it is determined that the problems with which the patient presents are indeed related to fibromyalgia and not from other causes then here is what I can do to help them. First of all, as a chiropractor, my number one form of treatment is spinal or extremity manipulation. Manipulations help to restore mobility to joints that may have been lost or reduced due to the tightness of the surrounding muscles as a response to the underlying pain feelings that the patient has. All joints are designed to move and to lose even some of that mobility can cause them to experience discomfort which just adds to that experienced from FMS. I usually also recommend 5-Hydroxytryptophan to help with sleep. Loss of sleep from FMS is the proverbial chicken or the egg scenario. It’s not really known if the lack of good sleep is a trigger for FMS or if having FMS affects the patient’s sleep. Regardless of which comes first to help the patient to have improved restorative sleep is certainly a plus. Also, along the lines of nutrition I recommend taking Magnesium and Malic acid as well as Omega-3 fatty acids all of which has shown some promise for relieving FMS symptoms. Further, a change in diet shifting from processed foods to eating whole foods and preferably organic (without additives, pesticides, hormones or antibiotics) is helpful not only for FMS but for your general overall health. Exercise is also important. Typically, a lot of physical exercise can be aggravating to a FMS patient so I usually recommend low impact type exercises e.g. water exercises, Pilates or especially Yoga which is very good for helping the joints of the body to keep mobile.

In summary, you always want to make sure that you have eliminated all other possible causes of your symptoms before accepting a diagnosis of FMS. Then, once it is established that you have true fibromyalgia, then it would behoove you to seek out natural treatment alternatives such as chiropractic. All you really have to lose is your pain.

David D. Godwin, D.C.
Salisbury Chiropractic
www.salisburychiropractic.us
Salisbury, NC
704-633-9335

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Back Talk

July 27, 2010 By

Summer fun is here and so is summer yard work. Be kind to your spine and take the proper precautions when working hard in your back yard.

First, hydrate. Your body is 70% water and your nervous system is 90% water. Water feeds your body, discs, ligaments and joints.

Position yourself properly. Being bent over, kneeling for long periods of time or lifting and hauling heavy objects can put a strain on your back, shoulders and neck. Bend your knees when lifting; use a kneeling board or stool; and get help with the big stuff.

Rest. Take breaks. Stretch before any strenuous activity and in-between doing them. Warming up your muscles can significantly reduce your chance of injuring yourself. The job may take you a little longer, but your back will thank you in the lung run.

And, finally — get adjusted. Visit your local chiropractor to realign your spine and get that much-needed muscle work done to balance out all that summer “fun”.

People too often put more care and attention into their cars and homes than their own bodies. We only have one and if you take care of yours, it will take care of you.

Monica S. Nowak, DC
Chiropractic Center of Canaan
176 Ashley Falls Road
Canaan, CT 06018
860 824-0748
www.PeterMarkowiczDC.com

Above article reprinted with permission from Monica S. Nowak, DC

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HEALTH CARE REFORM – A perspective

June 30, 2010 By

According to the Centers for Medicare and Medicaid Services, the Affordable Care Act that was passed by Congress and signed by President Obama will provide Medicare recipients better health care and ensure accountability so people — not insurance companies — will have greater control over their own care.

Present benefits will not change, yet necessary improvements to the system are vital if we are to keep the Medicare system strong and solvent. Changes are reported to occur in the form of cost savings and benefits, with a focus on quality of care.

Open enrollment this fall will provide people with a choice between the original Medicare plan and a new Medicare Advantage program. There will be no change in eligibility. Benefits will include more affordable prescription drugs. Those who enter the Part D “donut hole” will receive a one time $250 rebate check if they are not already receiving Medicare Extra Help, with checks issued monthly throughout the year as beneficiaries enter the coverage gap. If the coverage gap is reached, recipients will receive a 50% discount next year when buying Part D covered brand name prescription drugs. And, additional savings will be received over the following 10 year period until the coverage gap is closed in 2020.

Free services to include annual examinations, colorectal cancer screening and mammography will be provided. This has not been the case to date. Future plans lean toward patients being able to choose the physician they want to see, not the physician they have been assigned to. Additional financial support will be provided to community health centers, allowing them to serve an additional 20 million new patients.

New resources through the Elder Justice Act will work toward preventing and combating elder abuse and neglect in nursing homes. A voluntary insurance program known as CLASS will help pay for home care and long-term support.

Insurance companies will not be allowed to deny coverage because of pre-existing conditions for children beginning in September 2010 and for adults in 2014. And, insurance companies will not be allowed to establish financial lifetime limits on coverage beginning this September. Also beginning in September there will be an expansion of limits for young people to remain on their parents’ insurance plans until they reach the age of 26.

There is no question that annual Medicare spending will continue to increase as it has in the past; however, because of programs enacted that will address fraud and abuse, spending will occur at a slower pace than it has in the past.

In eight years senior citizens can expect to save up to $200 a year in annual premiums and an additional $200 a year in co-insurance costs than they might have paid prior to enactment of the new law. Those individuals earning $85,000 ($170,000 for married couples) can be expected to pay higher premiums than on lower income earners.

I’m not naïve enough to thing everything will be perfect. There will be kinks and obstacles, mountains to climb and bridges to cross. The Government may stub its collective toes along the way. But, it’s a start and I for one can give my endorsement to President Obama and his attempt to help the nation become a stronger one, both financially and from a health perspective.

A. Miller
Medical Assistant, Ret.

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Scoliosis

May 31, 2010 By

Most of you are familiar with the term scoliosis. You are aware that it involves some type of curving of the spine; although most people are not familiar with the reasons why someone develops it and what can be done to treat it. As a chiropractor it is very common for someone to enter my office with some degree of a spinal curvature. In fact, it is rare to see a truly straight spine. That is one reason that back pain is such a common malady. Scoliosis can be present in adults as well as children even though most scolioses present in adults most likely began when they were adolescents. In order to understand what a scoliosis is lets first take a look at what a normal spine should look like.

A “normal” spine when viewed from the front or from behind should appear straight up and down. When viewed from the side there should be three apparent curves. There should be a curve towards the front of the body in the neck or cervical region, this is a lordotic curve; a curve towards the back of the body in the middle back or thoracic region, a kyphotic curve; and a curve towards the front in the lower back or lumbar region, again a lordotic curve. It is the alteration of the straight up and down posture of the spine that constitutes a scoliosis; that is when the resultant curve is greater than ten degrees.

Most curvatures, greater than 80% of the time, are of unknown causes or idiopathic. Sometimes trauma, tumors, neurologic disorders or birth anomalies affecting the shape of the bones of the spine may be the underlying cause. In a lot of cases the cause may be as simple as having one leg congenitally shorter than the other, which can also happen post-leg fracture or by having inequalities of the feet. Most people who have scoliosis have curves less than twenty degrees which are not usually of any great clinical significance other than they can contribute to back pain. These are not of any great concern as long as they are stable and not progressing. These curves do have the ability to progress rapidly, especially in children and adolescents, and particularly in young girls who have not yet had their first menses. They therefore need to be monitored closely early on in those situations.

Scolioses are generally found on spinal screenings which are commonly done in the school systems. Parents may notice that their child has one shoulder or hip higher than the other or that one pants leg needs to be hemmed a bit higher. Also, there may be a noticeable “hump” on one side of the spine while a child is bent over at the waist. Sometimes the curves may be very subtle and may be missed during a mass screening as is done in the schools so I always encourage my patients to bring their children in so that I can screen them also. If a curvature is found x-rays are generally performed to assess the degree and extent of the curve and to see if the cause of it can be determined. Occasionally a MRI of the spine may be necessary to rule out any pathology that may be instigating the problem.

Scoliosis can affect the patient’s quality of life by restricting movements, causing pain and restricting lung and heart function. In some cases there can even be psychological scarring as the curves can be disfiguring affecting the patient’s self-esteem.

Treatment for scoliosis primarily depends on the degree of the curvature. When a curve is mild, generally less than 25 degrees, the patient is monitored with periodic screenings and x-rays to insure that the curve is not progressing. As long as the curve does not appear to be progressing no treatment is needed unless the patient is experiencing pain. If the curve does progress to between 25 to 45 degrees then the patient may be a candidate for bracing. Bracing can help stop the progression of a curve but won’t reverse it. If the curve progresses to beyond 45 degrees then surgery is generally performed which usually entails the implantation of a metal rod to stabilize the curvature.

As a chiropractor, my role in the treatment of scoliosis, involves the early detection and treatment of the subsequent pain that my be present as a result of the condition. Spinal manipulation has not been shown to be effective for stopping or reducing scoliosis but it can help restore some of the mobility that is lost due to the abnormal positions that are assumed by the vertebrae and thus help in relieving some of the pain that the patient may have. Another role that I can play is in determining if the scoliosis is present due to a leg length deficiency or inequalities in the feet. I have seen this many times over the years in my practice. These conditions can usually be addressed with orthotics or by simply adding height inside the shoe of the short leg. Another recommendation I make is to do stretching and mobility exercises which is best addressed by joining a yoga class.

The key to scoliosis is the early detection of such. It is a condition that can be potentially life threatening if it is progressive and left unchecked. Luckily, most scolioses are not of the progressive type and never need any intervention. If you should have any concerns you should discuss them with your chiropractor or primary care physician.

Dr. David D. Godwin
Chiropractic Physician
Salisbury, NC
704-633-9335
www.salisburychiropractic.us

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Low back pain

May 24, 2010 By

Low back pain (LBP) affects almost all adults at some point in their lives. Moreover, back pain among adolescents is on the rise. There is a tremendous cost, both financially and personally with chronic back pain. 2.5% of all medical expenditures are spent on LBP. Individuals with LBP have medical expenditures 60% higher than those without.

A common question may be what is my diagnosis? Is it lumbar sprain, lumbago, sciatica, stenosis, herniated disc etc? Medical research demonstrates that in only about 15% of all cases of LBP there is a specific pathoanatomical diagnosis. When an MRI is performed on pain free individuals there are a large percentage with bulging discs 55-80%, herniated discs 25-35%. At age 35 there is a 40% chance you will have visible arthritis on an X-Ray before your symptoms begin. At age 70, the likelihood is 100%. Therefore, these tests typically do not guide treatment for LBP.

There is an obvious value for imaging studies if there is a suspected fracture, cancer or unusual or prolonged symptoms that have failed to respond to conservative treatment. In the case of simple mechanical LBP, Geer Physical Therapy uses a detailed history and a movement based exam to help classify your symptoms. We then match your movement impairments and functional limitations with specific treatments. This approach has been shown to be favorable vs. conventional treatment.

Feel free to contact me if you have any questions regarding our approach to LBP.

Mike Mangini PT OCS CMP
Geer Physical Therapy
99 S Canaan Rd
Canaan CT 06018
860-824-3820
mmangini@geercares.org

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Mercury fillings

May 17, 2010 By

AN INTERVIEW WITH DR. LIVINGSTONE, THE HOLISTIC DENTIST
(First appeared in Natural Nutmeg, January 2008, reprinted with permission by Dr. Thomas Livingstone)

Q: What are some concerns regarding mercury fillings?
A: First, mercury fillings are not stable and react to hot or cold temperatures. So, every time you drink something hot, the filling will expand and every time you drink something cold, the filling will contract. This can eventually crack the enamel of the tooth. In addition, when you drink a hot beverage, mercury can vaporize and this material is ingested. The body changes mercury from a non-toxic to a toxic substance in the cellular membrane to eliminate it from the body.

Q: How can one determine if they have mercury toxicity from their fillings?
A: Some people process mercury effectively and others don’t process it well at all. Hair, urine and blood analysis can be checked for toxicity. If mercury is passed through the urine and not stored in the hair, then we know that individual can process mercury. If we find mercury in a hair sample, then we know they are not eliminating it.

Q. Should individuals with mercury fillings have them removed?
A. That is up to the individual, but in my opinion mercury doesn’t belong in the human body. It may depend on how many mercury fillings they have, however. If a mercury filling needs to be replaced because of deterioration, it should be replaced with another material.

Q: What other materials are options for dentists to use besides mercury fillings?
A: There are numerous bonded materials that dentists can use to fill cavities. However, they are harder to work with, about 20-40% more expensive and typically insurance does not cover these types of materials. One type is crushed quartz and an epoxy binder which is the same color as your teeth and doesn’t expand or contract or release toxins into the body.

Q: What are the symptoms of mercury toxicity?
A. Some of the symptoms include a metallic taste in your mouth, bad taste after eating, lethargy, frequent headaches, and fever. However, be aware that there are probably 50 or 60 symptoms that a person may exhibit.

ON THE SUBJECT OF PERIODONTAL DISEASE

Q: Is it normal for your gums to bleed while flossing or brushing your teeth?
A: No, this is not normal and it typically signals gum disease. This can result in loss of bone support around your teeth and the formation of pus pockets. It may also be a cause of bad breath.

Q: What can I do to stop my gums from bleeding?
A: Some initial things to do would be to use a baking soda type toothpaste and/or rinse with a warm salt-water solution. The salt content will kill any bacteria by changing the pH of the mouth. Have your dentist check for healthy gum attachment to your jaw. There should be no more than 2-3 mm pockets; otherwise the bone may be dissolving from around the teeth. The next step would be a cleaning under the gum with a special solution that your dentist would perform. Your dentist will flush the pockets, remove any tartar and bacteria and the gums should tighten up.

Q: Is this a hereditary problem?
A: It can be genetic. However, sometimes it happens in smokers or other individuals who are prone to a fast buildup of tartar.

Q: What else can be done to prevent this from happening?
A: Some individuals can benefit from taking certain supplements as described below:
Vitamin C. 4-6 g/day (but cut back if develop diarrhea)
Coenzyme Q10: 30 mg dose, open the capsule and sprinkle half in mouth and rub
on gums. Take the rest internally.
Vitamin E: 400 IU/day
Garlic: 6-8 capsules/day
Flossing is essential and one can benefit from having more frequent cleanings performed by your dentist. If you have tartar buildup, you might benefit from getting your teeth cleaned every 3-4 months.

Dr. Thomas Livingstone
Canaan Gentle Dental Care
Canaan, CT 06018
(860) 824-0751

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