One of the reported causes of both migraine and tension headache is cervical muscle tension and spinal joint abnormalities in the neck. When considering treatment for headaches, whether it’s a tension-type or migraine, there are many choices available. The question is, which of the many options offer the best benefit?
One study compared the effectiveness of physical therapy (PT) to that of relaxation and thermal biofeedback (RTB). Both groups were treated using one of these approaches, and if at least a 50% improvement was not achieved, the other form of treatment was then utilized. Results were calculated at 3, 6, and 12 month timeframes. The PT group of 30 females used standard physical therapy approaches that included:
• Posture correction for alignment of head and spine
• Cervical range of motion for neck and shoulders
• Isometric strengthening of the neck
• Flare-up management techniques
• Active self mobilization of the spine
• Whole body stretching
The goal was to target muscular abnormalities and those in this group were to perform the above twice per day for 30 min. The RTB group were instructed in relaxation and thermal biofeedback (RTB) treatment that focused on muscle relaxation, breathing exercises, and the use of a thermal feedback device that determines when the subject’s temperature changes telling them if they are successfully relaxing. The participants were to practice at home and utilized audiotapes for relaxation and monitor success with the portable biofeedback unit.
Using the PT approaches, only 13% reported a successful outcome compared to 51% in the RTB group. In the follow-up of 3, 6 and 12 months, both groups reported continued benefit. When the subjects reported less than 50% benefit with either method, they were given the other treatment option, and the PT approach achieved a 47% success rate and the RTB 50%. These findings suggest that treatments that focus on muscle tension reduction (such as the RTB group) might result in a better outcome compared to only addressing posture, range of motion and flexibility. However, as illustrated in the follow-up group, PT did have a positive beneficial effect. An important point – the subjects in the RTB group demonstrated the ability to reduce migraine pain and the associated disability by using a self-applied form of care. When teaching the patient to self-manage their condition by instruction and training, the greater the likelihood is for a successful outcome.
Chiropractic focuses on many self-management training procedures including (but not limited to) the training of the use of ice vs. heat, exercises, proper methods of bending and lifting, as well as posture and strength. The use and instruction of relaxation is also a commonly recommended form of care, which this study found to be most beneficial.
For more information visit www.backsmarthealth.com or call us for a Free consultation 770-888-4288.
Thursday, January 14, 2010
Thursday, December 31, 2009
Does Chiropractic Care Work? What Do The 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).”
For more information visit www.backsmarthealth.com or call 770-888-4288 for a Free Consultation.
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).”
For more information visit www.backsmarthealth.com or call 770-888-4288 for a Free Consultation.
Tuesday, November 10, 2009
Carpal Tunnel Syndrome (CTS) A New Treatment Approach
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 of numbness/pain in the wrist, index, third, and forth fingers, multiple sleep interruptions, frequent shaking and flicking of the hand/fingers, difficulty in gripping or pinching such as buttoning a shirt, threading a needle, lifting a coffee cup, frequent dropping of objects, the inability to perform work duties – especially fast, repetitive work tasks can have a devastating effect on a person’s quality of life.
While treatments traditionally have involved activity modification, night splints, anti-inflammatory medication, and in advanced/severe cases surgery, a recent study comparing different vitamin approaches reports promising results with the use of alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA). This combination was described as a logical early stage treatment aimed at “neuroprotection” or, to limit and correct nerve damage caused by CTS. The doses utilized for 90 days in 112 subjects with moderately severe CTS were 600 mg/day of ALA and 360 mg/day of GLA. This combination was compared against a commonly recommended multiple vitamin B complex that included 150 mg of B6, 100 mg of B1, and 500 mcg of Vit B12 per day for the same 90 day period. Questionnaires regarding CTS symptoms and function and electromyography (EMG) were utilized to track the outcomes in the study. The ALA/GLA treated group was statistically significantly improved when compared to the other B-complex vitamin approach. This included significant improvements in both symptom scores and functional impairment compared to only a slight improvement in the vitamin B group. Similarly, EMG was significantly improved in the ALA/GLA and unchanged in the vitamin B group.
Because there are many contributing causes of CTS, a multi-dimensional treatment plan will usually yield the best long-term results. Because repetitive motion / cumulative trauma are often associated with the onset and perpetuation of CTS signs and symptoms, ergonomic issues must be addressed. This includes perhaps a period of time when slower “light duty” work is necessary and consideration for workstation modifications, when feasible. Because most people do not ‘run to the doctor’ with the early signs of CTS, over time, many CTS patients develop abnormal movement patterns by minimizing hand/wrist motions. Instead, they start to shrug the shoulder and lean the body to one side. Hence, management addressing neighboring joint problems at the elbow, shoulder, and neck is needed. A condition called “double-crush” where the nerve is pinched in more than only at the wrist but also at the elbow, shoulder, and/or neck results in a significantly worse CTS presentation. These patients require treatment at all areas involved, not just at the wrist if long-term, satisfying results are to be obtained.
Metabolic conditions including diabetes mellitus, hypothyroid, obesity, pregnancy, the use of birth control pills, and others also contribute or, can even by themselves cause CTS. Chiropractic has traditionally viewed the body as a whole, treating the person from the ground upwards paying attention to posture, leg length, pelvic tilt, shoulder and head tilt. The use of manipulation of not only the wrist and hand, but also the elbow, shoulder, neck and back has yielded the best results rather than focusing only on the hand/wrist. The traditional use of night splints, work station/ergonomic modifications, as well as diet and exercise are also commonly addressed by chiropractors when managing CTS patients. We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care and we realize there are many healthcare options available. If you, a friend or family member requires care for CTS, we would be honored to offer our services.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME! FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288
Or Visit us at www.backsmarthealth.com
While treatments traditionally have involved activity modification, night splints, anti-inflammatory medication, and in advanced/severe cases surgery, a recent study comparing different vitamin approaches reports promising results with the use of alpha-lipoic acid (ALA) and gamma-linolenic acid (GLA). This combination was described as a logical early stage treatment aimed at “neuroprotection” or, to limit and correct nerve damage caused by CTS. The doses utilized for 90 days in 112 subjects with moderately severe CTS were 600 mg/day of ALA and 360 mg/day of GLA. This combination was compared against a commonly recommended multiple vitamin B complex that included 150 mg of B6, 100 mg of B1, and 500 mcg of Vit B12 per day for the same 90 day period. Questionnaires regarding CTS symptoms and function and electromyography (EMG) were utilized to track the outcomes in the study. The ALA/GLA treated group was statistically significantly improved when compared to the other B-complex vitamin approach. This included significant improvements in both symptom scores and functional impairment compared to only a slight improvement in the vitamin B group. Similarly, EMG was significantly improved in the ALA/GLA and unchanged in the vitamin B group.
Because there are many contributing causes of CTS, a multi-dimensional treatment plan will usually yield the best long-term results. Because repetitive motion / cumulative trauma are often associated with the onset and perpetuation of CTS signs and symptoms, ergonomic issues must be addressed. This includes perhaps a period of time when slower “light duty” work is necessary and consideration for workstation modifications, when feasible. Because most people do not ‘run to the doctor’ with the early signs of CTS, over time, many CTS patients develop abnormal movement patterns by minimizing hand/wrist motions. Instead, they start to shrug the shoulder and lean the body to one side. Hence, management addressing neighboring joint problems at the elbow, shoulder, and neck is needed. A condition called “double-crush” where the nerve is pinched in more than only at the wrist but also at the elbow, shoulder, and/or neck results in a significantly worse CTS presentation. These patients require treatment at all areas involved, not just at the wrist if long-term, satisfying results are to be obtained.
Metabolic conditions including diabetes mellitus, hypothyroid, obesity, pregnancy, the use of birth control pills, and others also contribute or, can even by themselves cause CTS. Chiropractic has traditionally viewed the body as a whole, treating the person from the ground upwards paying attention to posture, leg length, pelvic tilt, shoulder and head tilt. The use of manipulation of not only the wrist and hand, but also the elbow, shoulder, neck and back has yielded the best results rather than focusing only on the hand/wrist. The traditional use of night splints, work station/ergonomic modifications, as well as diet and exercise are also commonly addressed by chiropractors when managing CTS patients. We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care and we realize there are many healthcare options available. If you, a friend or family member requires care for CTS, we would be honored to offer our services.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME! FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288
Or Visit us at www.backsmarthealth.com
Wednesday, September 30, 2009
Chiropractic and Headaches
“I can’t believe how much my head hurts!” I’ve been laid off from work for the last 3 weeks and worried about making my mortgage payment this month – I think the stress is getting out of control! Pain starts in my neck and radiates into my head eventually making my whole head hurt, especially behind my eyes. There are times I feel like my head might explode! I can’t stand loud noises or even normal noise. Over the counter medications aren’t touching it and I can’t drive if I take some of the medications my doctor prescribed. I don’t know what to do next.”
This history is classic for the diagnosis of a tension-type of headache (TTH). As unemployment rates reach new highs and stress levels climb, it is no wonder more and more people are presenting with this condition. Even prior to the recession, TTH was the most common type of headache experienced by adults affecting 10-65% of the population. The impact on daily living by TTH is significant as it disrupts daily activities, quality of life, and work. These types of headaches, according to the International Headache Society (HIS), can last from 30 minutes to 7 days, do not include nausea/vomiting but may include increased sensitivity to light or noise (rarely both at the same time). The most common frequency is less than 15 TTH’s/month.
Medication has been the primary medical form of treatment and some patients require the regular use of certain medications, even when headaches are not present - - as in some cases, it’s too late to start meds once the headache starts. In these cases, Amitriptyline has been the most frequently prescribed medication and it’s considered the drug of choice for TTH. Chiropractic spinal manipulation (CSM) has been reported to be helpful in a number of prior studies. One reported equal benefit as Amitriptyline with 6 weeks of treatment.
A recent publication conducted a study using a new design where TTH sufferers with more than 10 headaches per month were randomly assigned to one of four groups: 1) cervical spinal manipulation (CSM) + amitriptyline, 2) CSM + placebo (fake) amitriptyline; 3) sham CSM + real amitriptyline; or 4) sham CSM + placebo amitriptyline. That way, one can determine which of the two or, the combination of both is most beneficial. An initial period of 4 weeks was followed by a 14 week treatment period. A headache diary was used to track headache frequency in the last 28 days of the treatment period. Nineteen completed the study and the combined effect carried the most statistically significant result with a close second with CSM alone. A larger sample size was recommended for a more statistically powerful evaluation.
This study is important as CSM by itself was found to be at least as (if not more) effective than Amitriptyline alone, which is the medication of choice for TTH. Hence, if CSM or Amitriptyline alone are not found to be satisfying, the combination of the two is strongly supported by this study.
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 look forward in serving you and your family presently and in the future.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES!
FOR A FREE NO-OBLIGATION CONSULTATION
This history is classic for the diagnosis of a tension-type of headache (TTH). As unemployment rates reach new highs and stress levels climb, it is no wonder more and more people are presenting with this condition. Even prior to the recession, TTH was the most common type of headache experienced by adults affecting 10-65% of the population. The impact on daily living by TTH is significant as it disrupts daily activities, quality of life, and work. These types of headaches, according to the International Headache Society (HIS), can last from 30 minutes to 7 days, do not include nausea/vomiting but may include increased sensitivity to light or noise (rarely both at the same time). The most common frequency is less than 15 TTH’s/month.
Medication has been the primary medical form of treatment and some patients require the regular use of certain medications, even when headaches are not present - - as in some cases, it’s too late to start meds once the headache starts. In these cases, Amitriptyline has been the most frequently prescribed medication and it’s considered the drug of choice for TTH. Chiropractic spinal manipulation (CSM) has been reported to be helpful in a number of prior studies. One reported equal benefit as Amitriptyline with 6 weeks of treatment.
A recent publication conducted a study using a new design where TTH sufferers with more than 10 headaches per month were randomly assigned to one of four groups: 1) cervical spinal manipulation (CSM) + amitriptyline, 2) CSM + placebo (fake) amitriptyline; 3) sham CSM + real amitriptyline; or 4) sham CSM + placebo amitriptyline. That way, one can determine which of the two or, the combination of both is most beneficial. An initial period of 4 weeks was followed by a 14 week treatment period. A headache diary was used to track headache frequency in the last 28 days of the treatment period. Nineteen completed the study and the combined effect carried the most statistically significant result with a close second with CSM alone. A larger sample size was recommended for a more statistically powerful evaluation.
This study is important as CSM by itself was found to be at least as (if not more) effective than Amitriptyline alone, which is the medication of choice for TTH. Hence, if CSM or Amitriptyline alone are not found to be satisfying, the combination of the two is strongly supported by this study.
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 look forward in serving you and your family presently and in the future.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR HEADACHES!
FOR A FREE NO-OBLIGATION CONSULTATION
CALL 770-888-4288
Or visit us at http://www.backsmarthealth.com/
Monday, September 21, 2009
Carpal Tunnel Syndrome (CTS) – What Else Could It Be?
In our clinic, we see patients frequently with CTS. If is a very common condition and usually responds well to the non-surgical chiropractic treatment approaches including hand, wrist, elbow, shoulder and/or neck manipulation, Myofascial release techniques, wrist splint use – especially at night, work station evaluation and modifications, physiotherapy modality use, such as electrical stimulation, low level laser therapy, pulsed ultrasound, therapeutic exercises, as well as other treatment approaches.
CTS symptoms include numbness, tingling, or half asleep sensations in the hand involving the palm and 2nd, 3rd, and thumb side of the 4th fingers. Sometimes, there is weakness in the grip strength with frequent dropping of objects or difficulty unscrewing jars commonly reported. Waking at night and needing to shake or flick the fingers to “…wake them up” is common. Driving due to holding onto the steering wheel with the wrist bent, holding a book or newspaper, buttoning a shirt, and threading a needle, can all become challenging when the median nerve which goes through the carpal tunnel is pinched. Because there are 9 tendons along with the median nerve that travel through the tunnel, fast repetitive movements of the hands and fingers is frequently associated with the onset of CTS. What makes treatment of CTS challenging is that most patients wait WAY TOO LONG before they go for help and nerve damage can occur as a result.
So, what happens when CTS does not respond to these or other treatment approaches? Also, what can be done if, after CTS surgery, problems still persist? The answer to these questions rests in obtaining a thorough evaluation of the condition including a detailed history and examination and, consideration of a different or concurrent condition. For example, from an anatomy standpoint, a pinched nerve in the neck, thoracic outlet (shoulder) and/or elbow (pronator tunnel syndrome), may be the primary issue, not CTS alone or, sometimes at all. If BOTH CTS and a pinched nerve above the wrist are present, the “double or multiple crush syndrome” must be addressed in order for a successful and satisfying outcome to occur.
Another nerve called the ulnar nerve can create numbness and weakness in the hand and can be confused with CTS. Because only about 50% of patients with hand numbness can accurately report the location of the symptoms, diagnosing compression of the ulnar nerve is essential as a CTS release will NOT help those with ulnar neuropathy. The most common location for pinching the ulnar nerve is at the inner or medial elbow near the “funny bone,” referred to as the cubital tunnel. It can also be compressed at the wrist, neck, or combinations of these resulting in a double or multiple crush syndrome. We’ve had many patients present with “carpal tunnel” that were not CTS at all but rather, ulnar nerve compression conditions.
Therefore, when considering treatment options for CTS and/or other nerve compression syndromes affecting the upper limb, it is imperative that a thorough evaluation of the presenting patient be performed so time is not wasted treating an unrelated condition and to obtain a satisfying outcome. We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care. We realize there are many health care options available and truly appreciate the confidence shown by our patients when choosing our clinic for their health care needs. If you, a friend or family member requires care for CTS, we would be honored to offer our services.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME! FOR A FREE NO-OBLIGATION CONSULTATION CALL OUR CUMMING GEORGIA OFFICE 770-888-4288
Or vistit us at www.backsmarthealth.com
CTS symptoms include numbness, tingling, or half asleep sensations in the hand involving the palm and 2nd, 3rd, and thumb side of the 4th fingers. Sometimes, there is weakness in the grip strength with frequent dropping of objects or difficulty unscrewing jars commonly reported. Waking at night and needing to shake or flick the fingers to “…wake them up” is common. Driving due to holding onto the steering wheel with the wrist bent, holding a book or newspaper, buttoning a shirt, and threading a needle, can all become challenging when the median nerve which goes through the carpal tunnel is pinched. Because there are 9 tendons along with the median nerve that travel through the tunnel, fast repetitive movements of the hands and fingers is frequently associated with the onset of CTS. What makes treatment of CTS challenging is that most patients wait WAY TOO LONG before they go for help and nerve damage can occur as a result.
So, what happens when CTS does not respond to these or other treatment approaches? Also, what can be done if, after CTS surgery, problems still persist? The answer to these questions rests in obtaining a thorough evaluation of the condition including a detailed history and examination and, consideration of a different or concurrent condition. For example, from an anatomy standpoint, a pinched nerve in the neck, thoracic outlet (shoulder) and/or elbow (pronator tunnel syndrome), may be the primary issue, not CTS alone or, sometimes at all. If BOTH CTS and a pinched nerve above the wrist are present, the “double or multiple crush syndrome” must be addressed in order for a successful and satisfying outcome to occur.
Another nerve called the ulnar nerve can create numbness and weakness in the hand and can be confused with CTS. Because only about 50% of patients with hand numbness can accurately report the location of the symptoms, diagnosing compression of the ulnar nerve is essential as a CTS release will NOT help those with ulnar neuropathy. The most common location for pinching the ulnar nerve is at the inner or medial elbow near the “funny bone,” referred to as the cubital tunnel. It can also be compressed at the wrist, neck, or combinations of these resulting in a double or multiple crush syndrome. We’ve had many patients present with “carpal tunnel” that were not CTS at all but rather, ulnar nerve compression conditions.
Therefore, when considering treatment options for CTS and/or other nerve compression syndromes affecting the upper limb, it is imperative that a thorough evaluation of the presenting patient be performed so time is not wasted treating an unrelated condition and to obtain a satisfying outcome. We take pride in providing quality, evidence-based care and appreciate the opportunity to do so when patients choose our clinic for their care. We realize there are many health care options available and truly appreciate the confidence shown by our patients when choosing our clinic for their health care needs. If you, a friend or family member requires care for CTS, we would be honored to offer our services.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR CARPAL TUNNEL SYNDROME! FOR A FREE NO-OBLIGATION CONSULTATION CALL OUR CUMMING GEORGIA OFFICE 770-888-4288
Or vistit us at www.backsmarthealth.com
Wednesday, September 16, 2009
Headaches From The Neck?
Cervicogenic headache is the term used to describe a headache that has its cause in the neck region. It used to be thought headaches were caused by something in the head itself, but researchers have now learned that neck injuries can produce head pain.
A study from Norway (Acta Neurol Scand 2007;Nov.20; Sjaastad O, Bakketeig LS) showed that about 4% of the population will have this type of headache. Taking medications to cover the pain will not ultimately correct a mechanical neck problem.
The symptoms of a cervicogenic headache are as follows: one-sided head pain and same side shoulder and arm pain. Patients also have limited mobility of the neck region. Rarely a patient may also have a migraine trait such as nausea, vomiting, or throbbing sensations. Because of these different signs from a typical migraine headache a physician may have overlooked the neck as a potential source for the cause of your head pain. Self-diagnosing your headache can be even worse since potentially serious causes of your head pain, such as high blood pressure may go undiscovered and left untreated. In any case it’s unlikely that your headache has been caused by a deficiency of pain pills in your diet. There are also unintended side effects that have to be considered when weighing any health care option.
Another study from Norway (Funct Neurol 2007;22:145; Drottning M, Staff PH, Sjaastad O) looked at causes of cervicogenic headaches, specifically whiplash injuries of the neck. In this study, 587 whiplash patients were followed over a six-year period. About 8% of the whiplash sufferers developed a cervicogenic headache six weeks after the initial trauma. Thirty-five percent of these patients were still suffering six years later.
Our clinic specializes in the treatment spine-caused head pain especially cervicogenic headache. To determine this we have to perform a comprehensive examination of your spine to see if sprains of your cervical or thoracic joints are present and review whether you’ve suffered a trauma in years past that could have affected the posture and mobility of these delicate spinal structures.
For patients who do not go down the road of medications for treating their head pain chiropractic care can be a more healthful option.
For more information or to schedule a consultation visit our website http://www.backsmarthealth.com or call 770-888-4288
A study from Norway (Acta Neurol Scand 2007;Nov.20; Sjaastad O, Bakketeig LS) showed that about 4% of the population will have this type of headache. Taking medications to cover the pain will not ultimately correct a mechanical neck problem.
The symptoms of a cervicogenic headache are as follows: one-sided head pain and same side shoulder and arm pain. Patients also have limited mobility of the neck region. Rarely a patient may also have a migraine trait such as nausea, vomiting, or throbbing sensations. Because of these different signs from a typical migraine headache a physician may have overlooked the neck as a potential source for the cause of your head pain. Self-diagnosing your headache can be even worse since potentially serious causes of your head pain, such as high blood pressure may go undiscovered and left untreated. In any case it’s unlikely that your headache has been caused by a deficiency of pain pills in your diet. There are also unintended side effects that have to be considered when weighing any health care option.
Another study from Norway (Funct Neurol 2007;22:145; Drottning M, Staff PH, Sjaastad O) looked at causes of cervicogenic headaches, specifically whiplash injuries of the neck. In this study, 587 whiplash patients were followed over a six-year period. About 8% of the whiplash sufferers developed a cervicogenic headache six weeks after the initial trauma. Thirty-five percent of these patients were still suffering six years later.
Our clinic specializes in the treatment spine-caused head pain especially cervicogenic headache. To determine this we have to perform a comprehensive examination of your spine to see if sprains of your cervical or thoracic joints are present and review whether you’ve suffered a trauma in years past that could have affected the posture and mobility of these delicate spinal structures.
For patients who do not go down the road of medications for treating their head pain chiropractic care can be a more healthful option.
For more information or to schedule a consultation visit our website http://www.backsmarthealth.com or call 770-888-4288
Tuesday, September 1, 2009
The Many Faces of Low Back Pain
Have you experienced low back pain lately? There are many causes of low back pain which need to be properly and thoroughly evaluated. The obvious cause may be attributed to specific activity, especially one that has not been performed in quite some time. This may include a sports injury, gardening or yard work related injury, or, it may result from the accumulation of multiple smaller activities that you are not use to doing. Sometimes, the cause of low back pain can be obscure and difficult, if not impossible, to determine. In these cases, a thorough history is important. For example, Lyme’s disease can create the classic low back pain presentation and its diagnosis is dependent on a blood test. Don’t be fooled by the fact that the patient may not be an outdoors type of person, “…and couldn’t possibly have been in contact with a tic.” Many inactive patients have pets that can transfer the deer tic larva into a home and transfer it to a sedentary, non-active person. If the cause of LBP is difficult to determine, Lyme’s disease may be worthy of investigation.
Another cause of low back pain can arise from certain medications. In a July 2009 journal article, muscle fiber damage was found in 57% of patients taking drugs associated with lowering cholesterol, referred to as statins. Typically, health care providers rely on a blood test that is suppose to detect the breakdown of muscle tissue called CPK (creatine phosphokinase) when statin-related muscle damage is suspect. However, in their study, only one in 44 patients with muscle damage caused by statin drugs was abnormal! According to the researchers, muscle pain associated with statin drug treatment has been dismissed as a “minor” side effect by both doctors and patients. In fact, the American College of Cardiology and the American Heart Association have published guidelines recommending continuing statin therapy, “…as long as circulating levels of CPK do not exceed 10 times the upper limit of normal (1,950U/L).” To see if that is was a good recommendation, CPK was tested in 10 healthy volunteers who had never taken statins, 10 control subjects matched by age, 15 patients with clinically diagnosed myopathy from statins but had stopped the statin therapy at least 5 weeks prior to the study, 29 patients with a history of statin-associated myopathy who remained on statin therapy and 19 patients with long-term statin therapy but no muscle complaints. Significant muscle damage (>2% of the biopsied muscle sample) was NOT seen in any of the control patients not taking statins. However, it was seen in 1 of the 19 patients on long-term statin therapy who reported no muscle symptoms as well as 25 of the 44 with myopathy (57%). More importantly, all but 3 patients who quit statin therapy because of related muscle pain reported their symptoms disappeared within days of quitting the statin medication. Also, the rate of significant muscle damage was about equal in those with myopathy still taking the statin meds (55%), and those who had quit the medication 60%. The severity of muscle damage was not related to the length of time the statin med was used or, with higher doses of statins.
The point of this discussion is that low back pain may be related to causes other than an injury or trauma to the back and that a thorough history from the patient must be obtained, especially when the patient is non-responsive to typical care for low back pain.
At this clinic we strive to provide the highest quality care and follow “best practice” approaches. We look forward to helping our patients and appreciate the confidence shown by our patients for choosing our practice to help manage their health related issues.
YOU MAY BE A CANDIDATE FOR LOW BACK PAIN TREATMENT!
FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288
Or Visit www.backsmarthealth.com
Another cause of low back pain can arise from certain medications. In a July 2009 journal article, muscle fiber damage was found in 57% of patients taking drugs associated with lowering cholesterol, referred to as statins. Typically, health care providers rely on a blood test that is suppose to detect the breakdown of muscle tissue called CPK (creatine phosphokinase) when statin-related muscle damage is suspect. However, in their study, only one in 44 patients with muscle damage caused by statin drugs was abnormal! According to the researchers, muscle pain associated with statin drug treatment has been dismissed as a “minor” side effect by both doctors and patients. In fact, the American College of Cardiology and the American Heart Association have published guidelines recommending continuing statin therapy, “…as long as circulating levels of CPK do not exceed 10 times the upper limit of normal (1,950U/L).” To see if that is was a good recommendation, CPK was tested in 10 healthy volunteers who had never taken statins, 10 control subjects matched by age, 15 patients with clinically diagnosed myopathy from statins but had stopped the statin therapy at least 5 weeks prior to the study, 29 patients with a history of statin-associated myopathy who remained on statin therapy and 19 patients with long-term statin therapy but no muscle complaints. Significant muscle damage (>2% of the biopsied muscle sample) was NOT seen in any of the control patients not taking statins. However, it was seen in 1 of the 19 patients on long-term statin therapy who reported no muscle symptoms as well as 25 of the 44 with myopathy (57%). More importantly, all but 3 patients who quit statin therapy because of related muscle pain reported their symptoms disappeared within days of quitting the statin medication. Also, the rate of significant muscle damage was about equal in those with myopathy still taking the statin meds (55%), and those who had quit the medication 60%. The severity of muscle damage was not related to the length of time the statin med was used or, with higher doses of statins.
The point of this discussion is that low back pain may be related to causes other than an injury or trauma to the back and that a thorough history from the patient must be obtained, especially when the patient is non-responsive to typical care for low back pain.
At this clinic we strive to provide the highest quality care and follow “best practice” approaches. We look forward to helping our patients and appreciate the confidence shown by our patients for choosing our practice to help manage their health related issues.
YOU MAY BE A CANDIDATE FOR LOW BACK PAIN TREATMENT!
FOR A FREE NO-OBLIGATION CONSULTATION CALL 770-888-4288
Or Visit www.backsmarthealth.com
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