MONTHLY HEALTH UPDATE
Do Coffee Drinkers Live Longer?
Chad Abramson, D.C.
Whole Body Health
If You Try a "Gluten-Free" Diet…
Gluten is found in wheat, oats, barley, and rye, and for those with Celiac Disease and
non-celiac gluten sensitivity (NCGS), gluten can be very dangerous, even lethal. But many
people opt to avoid foods containing gluten as part of an anti-inflammatory diet and there seems
to be little-to- no argument that anti-inflammatory diets are indeed a very healthy choice.
One study reported that a Mediterranean-style diet can reduce cardiovascular risk factors
and can help resolve both metabolic syndrome and non-alcoholic fatty liver disease.
Additionally, there are several published studies describing how an anti-inflammatory diet can
reduce pain associated with conditions such as rheumatoid arthritis. One such study reported a
striking reduction in pain, joint inflammation, and morning stiffness duration reduction utilizing
this type of diet—and these improvements persisted when researchers followed-up with
participants a year later!
Because low-grade inflammation has now been identified as the driver of most chronic degenerative diseases, it is important to understand that low-grade chronic inflammation manifests itself both locally and systemically through a variety of inflammatory mediators. Many of these can be measured in a blood test and are commonly found in patients with chronic diseases such as atherosclerosis (hardening of the arteries) and osteoarthritis. Individuals who do their best to cut gluten from their diet often seek out gluten-free versions of their favorite foods. Is there anything these people should know? Well, an article in the November 2017 issue of Consumer Reports notes that gluten-free foods made with rice flour may contain high levels of arsenic and other heavy metals. The article also points out that those who restrict foods containing gluten tend to eat fewer whole grains, which may result in increased heart disease risk due to lower fiber intake. What the authors of the article don’t point out is that consuming more fruits and vegetables can make up for this deficit, as these foods can also be high in fiber. The good news is that gluten-free whole grains such as amaranth, freekeh, quinoa, buckwheat, millet, teff, and sorghum are great, healthy substitutes.
Who Will Get Better?
Though most patients with a whiplash injury improve within a few months, about 25%
have long-term pain and disability that may persist for many months or years.
Now, a team of scientists from Northwestern Medicine Feinberg school of Medicine
reports that it may be possible to determine which whiplash patients will develop chronic pain,
disability, and/or post-traumatic stress disorder (PTSD) within one to two weeks of their
injury—leading to specialized treatment that may reduce their risk for developing a chronic
Using a specialized form of MRI that measures the fat and water ratio in the neck muscles, the researchers found that greater fat infiltration into these muscles indicated rapid muscle atrophy. The presence of fat in the muscle is not related to the person’s weight, size, or shape and is believed to represent an injury that is more severe or serious than what might be expected from a typical low-speed car crash.
However, though the lead investigator notes that the fat infiltration into the muscle appears to be a response to an injury, what has actually been injured—muscle, nerves/spinal cord, and/or more—remains a mystery.
Another study by the same research team found that chronic pain whiplash victims also exhibited a high level of muscle fat in their legs—indicating atrophy. The researchers hypothesize that these patients may have partially damaged their spinal cord, as this group of patients also reported feeling weak and clumsy when walking. Current research indicates that when managing whiplash cases, early return to activity, movement restoration, and exercises that specifically target the deep neck flexors lead to better outcomes than a “wait and watch” approach.
Doctors of chiropractic also utilize manipulation, mobilization, exercise training, diet, and nutrition, and encourage a return to a normal lifestyle as quickly as possible when treating patients with a whiplash injury.
Neck Pain / Headaches
Sick & Tired of Neck Pain?
For most of us, neck pain has reared its ugly head more than once. In fact, there are
estimates that anywhere from one-in- ten to one-in- five people will experience an episode of neck
pain in a given year. Though some studies report that between 33% and 65% of these people will
recover within twelve months, many individuals will experience either a relapse of their neck
pain or their neck pain will become a chronic health issue.
So what can a doctor of chiropractic do about it? The answer is simple: spinal manipulation (SM) and exercise. Spinal manipulation is the most common form of treatment delivered in a chiropractic setting, and many studies note that neck pain is the second most common reason patients seek chiropractic care (back pain is number one). Regarding exercise, patients may be advised to engage in stretching exercise, strengthening exercises, or both.
For example, after an hour of seated computer work, one might experience muscle fatigue from prolonged static postures, especially for those outside of a neutral position. For this scenario, here’s a great STRETCH option to do every 30-60 minutes (yes, SET A TIMER): 1) Tuck the chin (and keep it tucked); 2) reach with the right hand over the top of the head and gently pull the right ear toward the shoulder while the left hand reaches down to the floor (as if to pick up a dollar bill); 3) next, nod the head (as if gesturing “yes”) multiple times; 4) follow this by shaking the head left to right (as if gesturing “no”); 5) repeat steps one through four with the head/neck flexed forward and backwards, “searching” for the tightest spots and “work” them until they loosen up. Repeat on the opposite side.
Here is an exercise to STREGTHEN the neck muscles. 1) Tuck in the chin while looking straight ahead; 2) place the back of your second and third fingers under your chin and nod (up/down) against mild resistance; 3) repeat five to ten times SLOWLY; 4) repeat steps one through three with head/neck flexed forward and then again backwards (looking towards the ceiling). Repeat multiple times each day. The KEY is to set the timer to remind you to do these! If you have significant forward head carriage and rounded shoulders, your doctor of chiropractic can show you addition important exercises, but this will be a great start for you to gain control over that chronic, recurring neck pain that you’ve been putting up with for far too long!
Why Is Shoulder Pain So Common?
Shoulder pain is common. If fact, it’s highly likely that many of you reading this currently have or have had a shoulder injury, as studies suggest that about 90% of us will tear our rotator cuff, labrum, and/or capsule at some point in time during our lives. So why is this so common? More importantly, what can be done about this? The reason for the high prevalence of shoulder pain is due to the anatomy of the shoulder. The shallow “socket” allows for the shoulder’s great range of motion, but with this excellent mobility comes a decrease in stability, as a joint can’t be BOTH stable AND highly mobile. So from a prevention standpoint, consider the following: 1) Don’t reach into the back seat to lift your heavy briefcase or purse to the front seat. 2) Take “mini-breaks” when working overhead. 3) Follow an exercise program that maintains strength in your shoulders. 4) Get help when you know the task you’re about to attempt is going to be a challenge. This list could go on and on but the last point is crucial: don’t feel insecure about asking for help with difficult tasks! As the saying goes, "An ounce of prevention is worth a pound of cure." An important goal regarding recovery from a shoulder injury involves restoring the joint space between the ball and socket joint and the “roof” of the shoulder or acromion process (or "acromiohumeral distance", or AHD). A shoulder impingement injury typically occurs when this space is reduced, resulting in a tighter fit that pinches pain-sensitive structures when one attempts to raise their arm up over their head. To reduce impingement, try the popular “pendular exercise” by holding a 5-15 lbs (2.26-6.80 kg) weight so that the arm swings loosely like the pendulum of a clock. The weight pulls the shoulder joint open, reducing impingement. Another exercise is gripping the seat of a chair while leaning to the opposite side (focus on relaxing the shoulder while leaning) to open or separate the joint. The joint can also be opened using elastic therapeutic tape. A 2017 study found that taping over the front and back deltoid muscle from insertion to origin worked best to open the AHD to reduce impingement. Doctors of chiropractic can also utilize manipulation and mobilization to open the AHD.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome – OVERVIEW (Part 1)
Carpal tunnel syndrome (CTS) represents a collection of signs and symptoms resulting from the
compression or pinching of the median nerve as it passes through the carpal tunnel at the wrist. In this
overview, you will see why CTS can be a challenging ailment to diagnose and treat.
SYMPTOMS: Numbness, tingling, and pain. Less commonly, burning and/or sharp pain in the
index to the thumb-side half of the fourth finger, palm-side only. Loss of grip strength (such as
unscrewing a jar) may occur but usually later in the course of the condition.
PATHOPHYSIOLOGY: Compression of the median nerve inside the bony carpal tunnel occurs when the pressure inside the tunnel increases, often due to overuse with subsequent swelling. There are multiple epidemiologic factors including genetic, medical, social, vocational, avocational, and demographic with a complex interplay between some or all these factors. However, definitive causative factors remain obscure and unclear in many cases.
EPIDEMIOLOGY: About one to three people per every 1,000 will develop CTS in a given year, and estimates show about 50 people per 1,000 currently live with CTS in the general population. However, the incidence may rise as high as 150 cases per 1,000 subjects per year, with prevalence rates greater than 500 cases per 1,000 subjects in certain high-risk groups. The incidence and prevalence is similar in developed countries like the United States, the United Kingdom, and the Netherlands, but CTS is almost unheard of in some developing countries. The female-to- male ratio for CTS is three-to- ten females to one male. Carpal tunnel syndrome seems to peak at age 45-60 years old with only 10% of CTS patients under the age of 31. The condition is not fatal, but if left untreated, severe cases can lead to complete, irreversible median nerve damage and a loss of much hand function.
CLINICAL PRESENTATION: A patient’s history is often more valuable than the physical examination when it comes to CTS. Patients may report the above-listed symptoms, which may worsen at night and interrupt sleep. Symptoms may also increase in intensity during activities like driving, crocheting, and painting. Frequently, CTS affects both hands, but it’s usually worse in the dominant hand. Patients may have difficulty "mapping" their symptoms well and may feel numbness, tingling, pain, and/or weakness in the whole arm and/or forearm. It’s often prudent to look for additional compression elsewhere in the course of the median nerve in the neck, shoulder, and/or elbow. Less commonly, the patient may experience whole hand hot/cold sensitivity with color changes and/or sweating, which may indicate autonomic nervous system involvement. The use of CTS questionnaires can help diagnose and track progress during care. This discussion will continue next month – stay tuned!
Low Back Pain
The Elderly & Back Pain – Is Chiropractic Effective?
Around the world, low back pain (LBP) is a leading cause of disability and ranks sixth in terms of “overall disease burden.” Chronic low back pain (cLBP) has a profound socioeconomic impact on individuals, families, and communities—so much so that the World Health Organization has identified LBP as a major disabling condition. Older people tend to have greater physical disability caused by LBP compared with younger individuals, and old age is often associated with non-recovery and poor outcomes. One study found that more than a quarter of older people in the United States had cLBP upon entering retirement and that baby-boomers (those born between 1946 and 1964) account for 51% of all costs (over $10 billion) associated with cLBP. So the question of the month is: how safe and effective is chiropractic care for older patients with cLBP? To help answer this question, researchers searched multiple sources for studies that included patients over 55 years of age with cLBP (more than three months of LBP), that utilized some form of manual therapy, that included tools that measured pain and disability, and that utilized a randomized control trial design. Researchers excluded data from experiments in which subjects had prior back surgeries, had pelvis-only pain (e.g. tail bone pain), or had received only a single treatment without follow-up. Though only four studies met these stringent criteria, the authors did conclude that manual therapies, which include spinal manipulation delivered by doctors of chiropractic, can improve pain and function in older patients with chronic low back pain with very few adverse side effects. This study supports the benefits of chiropractic care for the aging population and emphasizes the need for effective treatment options for cLBP with a low risk for serious adverse effects. With the size of the senior population expected to double over the next several decades, Chiropractic care will surely continue to play an important role in improving the quality of life of the elderly.
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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.