MONTHLY HEALTH UPDATE
Do Coffee Drinkers Live Longer?
Chad Abramson, D.C.
Whole Body Health
Can Diet Affect Acne?
Acne most commonly affects us during our adolescent years, but it can strike at any time
during our adult lives. Unfortunately, usual treatment seems restricted to taking oral antibiotics along
with some form of topical agent such as benzoyl peroxide, topical retinoids, or topical antibiotics.
This begs the question: Is there a safer and equally effective method to treat acne? Let’s take a
Though it’s not particularly well understood, researchers know that hormones (androgens), bacteria (P. acnes), and an overproduction of sebum (oil) all play important roles in acne causation. Recently, oxidative stress and inflammation have gained more attention, as some researchers report that inflammation may even start the acne process.
Opinions regarding the function that diet plays in acne care range between having no role at all to diet being a vitally important player. However, recent studies show that diet may be very important with regards to both cause and treatment. One such study placed subjects on a diet high in fiber, omega-3 fatty acids from fish and seafood, and total protein, and low in sugar and saturated fats. After twelve weeks, the researchers observed a clinically significant improvement in acne with an average of 22 fewer acne lesions in those consuming the special diet vs. participants who maintained their normal diet.
Similarly, in a one-year study, 87% of over 2,200 acne sufferers reported improvements in their acne after switching to the South Beach diet, which is similar to the findings from the study mentioned above. Of the total, over 80% reported that their acne improved within three months of starting the diet and 91% reported either discontinuing or reducing their acne medication use. What about milk? Harvard University-based researchers published three important studies involving over 60,000 individuals that concluded avoiding dairy products, with the exception of fermented yogurt, can help manage acne.
RECOMMENDATION SUMMARY (Please consult with your doctor before starting any diet): 1) No dairy; 2) Omega-3 (1-4g/d); 3) Anti-oxidants such as vitamins A and E (20mg/d), selenium (400mcg/d), and curcumin; 4) Zinc (oral 15mg/d and topical); and 5) Chromium (200- 400mcg). Many doctors of chiropractic can assist with nutritional counseling to help guide those with acne in deciding which dietary approach may work best for them.
Whiplash – Can We Predict Long-Term Problems?
Whiplash associated disorders (WAD) are most often associated with motor
vehicle collisions (MVC) but can occur from any form of trauma arising from slips and
falls, sports injuries, and more. A question patients suffering from WAD commonly ask
is, “How long will this take to get better?”
There are many factors in play with regards to how quickly one recovers from any injury: the type and degree of injury, the type of care, the “will” to get better, the patient’s education level, gender, emotional factors, and so much more. But what does the research say regarding risk factors for a prolonged recovery from WAD?
A Danish study found that WAD patients with immediate, high-intensity neck pain and stiffness were more likely to be disabled one year following their injury than those with a delayed onset of symptoms or those with low-grade pain. By combining scores for neck pain and stiffness along with other non-painful symptoms (such as blurred vision, nausea, and dizziness), the authors found that they could identify those at risk for long- term disability within a week of their accident.
Their study included 141 adults who contacted the ER within two days of the MVC complaining of neck pain or headaches arising from rear-end collisions without loss of consciousness or amnesia. None had prior neck or back pain or a history of severe headaches. The researchers found that 75% of patients with reduced neck motion still reported disability after one year.
Interestingly, the research team observed that patients involved in ongoing litigation (lawsuits) were at no greater or lesser risk of suffering long-term disability. In a recent large-scale study using an online survey completed by 127,959 respondents, researchers found that collision severity, poor expectations of recovery, victim mentality, dizziness, numbness or pain in the arms, and lower back pain each increased the risk of a poor recovery.
Neck Pain / Headaches
Slouching – Does It Really Matter?
Last month, we discussed how slouching can contribute to neck pain and headaches, but
we didn’t go into any detail about the other negative health ramifications of bad posture.
DIGESTION: Prolonged sitting is bad enough all by itself, but adding a slouched,
slumped posture can distort or compromise the space that houses internal organs and negatively
affect MANY vital functions, including digestion. This can lead to complaints including (but not
limited to) discomfort, constipation, and heart burn.
BREATHING: Slouching can also reduce the space occupied by the lungs, hindering the ability to take in a deep breath and/or force air out of the lungs. This is the reason why good conductors have their musicians sit up straight with both feet on the floor (it’s not just to “look good”)!
MOOD: Did you know that sitting for seven or more hours per day increases the risk of depression by 47% compared with sitting for four hours a day or less? Our energy levels also decrease with prolonged poor posture, further complicating this negative side effect.
WORK PERFORMANCE: Researchers have observed that sitting up straight increases alertness, reduces fatigue, and improves productivity. Moreover, co-workers may conclude that someone slumped over their desk is unmotivated, disinterested, or at the least, tired. Sit/stand workstations are gaining popularity, especially with the availability of low-cost options to transform a traditional desk into a standing desk. Studies show improved work performance when we have the option to change positions as needed during the day. Exercises you can perform at your desk, such as chin retractions, help strengthen the deep neck flexor muscles, which can help reduce poor neck posture. Stretching the chest muscles and keeping the “core” fit with pelvic stabilization exercises are also GREAT methods to improve our sitting posture!
VARICOSE VEINS: Prolonged sitting raises the risk for the formation of spider veins, especially in women, which can lead to varicose veins. Compression from sitting alters the flow of blood into the legs, and a proper fitting chair and sitting “correctly” can reduce the risk of developing circulatory dysfunction leading to varicosities or worse, blood clots.
What Can Be Done for Kneecap Pain?
Patellofemoral (PF) pain (or pain in the area of the knee cap) is a very common
problem, especially in women because they naturally have a wider pelvis. A wider pelvis
can cause a “knock-knee” effect, which can be exacerbated by flat feet and ankle
pronation (rolling in at the ankles). The net result is that outward pressure increases on
the patella, which can be quite disabling and interfere with weight bearing activities. So,
what can be done for individuals with patellofemoral pain?
Because we cannot change the width of the pelvis, the focus must shift to the foot/ankle and hip/knee muscle balance. A 2014 study set out to prove (or disprove) that exercises that target BOTH the hip and knee vs. the knee only would yield better long- term outcomes.
Here, researchers randomly assigned 31 women with PF pain to one of two treatment groups: Group A participated in BOTH hip & knee exercises for eight weeks and Group B engaged in ONLY knee exercises for eight weeks. Following the completion of each eight-week exercise program, the researchers examined each participant, followed by a re-examination three months later. The investigators found that patients in Group A experienced greater improvements with regards to pain and function. The authors of the study concluded, “An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain, physical function, kinematics, and muscle strength compared to a program of quadriceps-strengthening exercises alone.”
The “take-home” message here is that patients obtain the best results when treatment—in this case, exercise—is applied to more than just the area of complaint. Chiropractic care includes assessment of the whole person, not just a localized area where the patient feels pain. Perhaps this is why chiropractic almost always scores highest in “patient satisfaction” surveys when compared with other healthcare delivery systems.
Carpal Tunnel Syndrome
CTS and Other Causes of Hand Numbness
Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed at the
wrist. However, there are other anatomical locations in which the median nerve can
experience interference, and the median nerve is not the only nerve that ventures into the
hand. So if you experience a symptom like hand numbness, CTS may not be the culprit…
After CTS, the next most common nerve pinch is the ulnar nerve at the inner
elbow, which is technically called “cubital tunnel syndrome” (CuTS). This is often
caused from over-use of the arm such as lifting and/or gripping with the palm up. The
unique difference between CuTS and CTS is that the pinky and ring finger are affected
but NOT the index, middle, and thumb-side ring finger, which are the median nerve-
innervated fingers affected by CTS. Because over-use is also a common cause of CTS,
these two conditions can co-exist, in which case all five fingers may be affected but not
necessary all at the same time.
The shoulder is yet another fairly common location for a pinched nerve and is referred to as “thoracic outlet syndrome” (TOS). The most common nerve pinched here affects the fourth and fifth fingers, similar to CuTS; however, with TOS the upper arm is also affected, not just the elbow to the inner hand.
Another relatively common location for a pinched nerve affecting the arm is at the neck, often from a herniated disk and/or an arthritic spur where the nerve exits the spine. Depending on which nerve is compressed and the amount of compression, the numbness/tingling can affect different parts of the arm and/or hand.
Doctors of chiropractic are trained to differentiate between these various “syndromes” and to safely deliver treatment to the affected joints, muscles, and other soft tissues to reduce pain and restore proper motion so patients can return to their normal activities of daily living.
Low Back Pain
What Causes Low Back Pain?
Low back pain (LBP) is VERY common condition, and research shows that up to 50% of the adult
population in the United States will experience LBP in any three-month timeframe over the course of a year.
Worse, low back pain can persist for months, years, and even longer, significantly reducing one’s ability to
work, play, and enjoy life. So, let’s take a look at where LBP can come from…
ANATOMY: There are five lumbar vertebrae located just below the last rib and extending down to the sacrum. The FRONT of the vertebral column is made up of large box-shaped “vertebral bodies” that are strong and made to bear heavy weight. Between the vertebral bodies are shock-absorbing “intervertebral disks” that have a tough outer layer that surrounds a liquid-like center, giving it the ability to absorb vertical loaded pressure.
The spinal cord runs through the MIDDLE of the vertebra through the spinal canal. Nerves also exit the spine at each spinal level.
The BACK of the vertebra is made to protect the spinal cord. There are two gliding joints on the either side (called facet joints) of the vertebrae, which allow us to bend sideways, backwards, forward, or a combination of movements.
Below the lumbar spine sits the sacrum. The sacrum is wedged between the left and right wings of the pelvis, the ilia, forming the sacroiliac joint (SIJ). For many years, anatomists didn’t believe the SIJ could move and thus, could not be a pain generator. More recent research has concluded that not only is there movement in the SIJ but it may be the primary pain generator in up to 30% of lower back pain cases.
CASE STUDIES: Each of the above anatomical structures can be potential causes of LBP, and the presenting patient’s symptoms and clinical signs can help a doctor of chiropractic figure out what’s going on. For example, when a patient states, “My back kills me and the pain shoots down my leg when I bend over and feels better when I bend backwards and leg pain disappears,” this is most often caused by a herniated disk pinching a nerve in the low back.
In the above case, it’s important to examine the nerves that run down the leg, as the nerve can become damaged if too much pressure is exerted on the nerve for too long. Here, your doctor will ask you to walk on your toes and heels, check your reflexes at your knee and heel, and test your ability to feel sensations on the skin. If any of these tests reveal loss of function, the first goal of care will be to remove the pinch on the nerve to restore leg feeling and strength. On the other hand, when a patient feels better bending over and worse bending backwards, the facet joints and/or the SIJ may be the culprit.
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Abramson Family Chiropractic
10222 19 th Ave SE, Suite 103, Everett, WA 98208
This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.