MONTHLY HEALTH UPDATE
Do Coffee Drinkers Live Longer?
Chad Abramson, D.C.
Whole Body Health
Are Probiotics Necessary? (PART 1)
We all know that bacteria can cause disease, so it makes sense to be at least a little
leery about taking a supplement that is loaded with bacteria. There is however, a growing
volume of scientific support that probiotics (PBs) can both treat as well as prevent quite a
Probiotics literally means "for life" (pro biota), which suggests these must be "good" bacteria and indeed, our digestive system's health depends on maintaining a balance between the good and bad flora. Since the 1990s, clinical studies have shown that PBs can effectively treat a number of condition such as irritable bowel syndrome (IBS), ulcerative colitis, Crohn's disease, H. pylori (causes ulcers), bladder cancer recurrence, C-Diff (Clostridium difficile)—a dangerous gut infection associated with antibiotics, pouchitis (post-surgical complication after colon removal), eczema in children, and more. Probiotics are not all the same, as different strains of bacteria have different functions and therefore, help us in different ways. For example, some organisms protect our teeth from getting cavities but can't survive in the highly acidic environment of the stomach.
Solid evidence exists for probiotic therapy in the treatment of diarrhea. Lacotbacillu GG can shorten the course of infectious diarrhea in infants and children (but not adults). The Harvard.edu website describes two large review studies that suggest PBs can reduce antibiotic-associated diarrhea by 60% when compared with a placebo.
Vaginal health is also improved by PB use, as it can reduce and/or eliminate recurring yeast infections. Lactobacilli can help treat bacterial vaginosis, which can potentially complicate pregnancies and lead to pelvic inflammatory disease (PID). This bacteria can also be used to treat UTIs, especially in women.
Come back next month for more much-needed information regarding probiotics...
Whiplash and Concussion - Important Nutritional Considerations
Mild traumatic brain injury (mTBI) is one of the many conditions that can accompany
a whiplash injury. The term is often used interchangeably with concussion, while "post-
concussion syndrome" and TBI (without the word "mild") refer to long-term residual
symptoms. Symptoms associated with mTBI initially include dizziness, nausea, and
headaches followed by slow cognition—difficulty processing thought, losing one's place
during discussions, difficulty with verbal expression, and more. Many mTBI sufferers
describe this as "mental fog."
Following mTBI, the brain releases various chemicals that help repair damaged neurons and reduce the risk of neurodegeneration. One such chemical is brain-derived neurotrophic factor (BDNF), and one of the best methods for increasing BDNF levels is intense exercise. However, because patients are advised to rest and slowly return to their normal activities following an mTBI, proper nutrition and supplements are necessary to boost BDNF levels. This can include consuming protein-rich foods such as a daily shake made of whey protein or pea and rice protein with added branched chain amino acids. Research has shown that combining this with 10 grams of creatine monohydrate is important for energy production in the brain. A recommended daily dose of 5000 IU of vitamin D can also assist in raising BDNF levels.
The research shows that a high-quality fish oil of up to 4000 mg/day in the first three weeks followed by 2000 to 4000 mg/day for three months can aid recovery. Omega-3 fatty acids (EPA and DHA) can help reduce inflammation from mTBI. The DHA in fish oil helps improve the strength and flexibility of the cell membranes of neurons, while EPA suppresses the production of pro-inflammatory chemicals such as prostaglandins and others. Studies also support administering glutathione (an antioxidant normally found in our cells), as it reportedly reduces brain tissue damage by an average of 70%. Other helpful options include vitamin C, selenium, niacinamide or B3, N-acetyl- L-cysteine (750-1000mg), broccoli extract, magnesium, curcumin (found in turmeric), and green tea extract. Your doctor of chiropractic can help guide you in managing your nutritional program following a concussion.
Neck Pain / Headaches
Are Neck Pain and Dizziness Related?
According to the Vestibular Disorders Association, there is a classification of
dizziness called "cervicogenic dizziness", or dizziness resulting from neck pain.
Published reports have linked the influence of head position on equilibrium as far back as
the mid-1800s, but it wasn't until 1955 when researchers coined the term "cervical
vertigo" to describe a clinical condition relating neck pain and/or injury to dizziness and
disequilibrium. These days, cervicogenic dizziness (CD) is considered the more accurate
diagnosis for this syndrome.
There are a number of neck-related diagnoses that can cause dizziness or disorientation including cervical spondylosis (spurs), cervical trauma (like whiplash), and cervical arthritis (osteoarthritis being the most common).
Unfortunately, there is no "gold-standard" test to confirm or rule out that the neck is the cause of one's dizziness. A physical examination in a chiropractic clinic will seek to eliminate other causes of dizziness such as inner ear dysfunction (labyrinthitis or vestibular dysfunction) and/or other nervous system problems. Your doctor of chiropractic will also examine the eyes by carefully looking for oscillating eye motion (called nystagmus) in six different positions of end-range gaze. A diagnosis of CD is then made once all other causes of dizziness have been ruled out.
Symptoms of CD usually occur after the onset of neck pain. They're often described as a sensation of movement that worsens with head movement or after prolonged time in one position. Such dizziness can last minutes to hours. A general sensation of imbalance occurs with head movement and/or with movement in the environment (like looking out of window of a fast-moving train, plane, or vehicle). Headache may accompany the dizziness and neck pain. Generally, as neck pain reduces so does the dizziness.
Because CD can result from trauma such as whiplash or head injury, treatment aimed at resolving the patient's neck pain will usually resolve their symptoms of dizziness as well.
Shoulder Pain - What Are My Treatment Options?
The shoulder is not just one joint but rather four: the sternoclavicular (collar bone/breast bone),
acromioclavicular (the "roof" of the ball & socket joint), glenohumeral (the ball & socket joint), and
scapulothoracic joints (shoulder blade/rib cage joint). There are also many structures in the vicinity that
can mimic shoulder pain-namely, the cervical spine (neck), the upper half of the thoracic spine (upper
back), and the rib cage.
The most common area that most shoulder pain sufferers point to is the top of the shoulder—between the neck and upper arm/shoulder joint. This may indicate dysfunction in the neck, since it can refer pain to this area. When patients point to their upper arm, the shoulder "could be" the pain generator, but more information is necessary before their doctor can make a firm diagnosis. If raising the arm above the horizontal plane (90°) hurts, it could be an impingement caused by a swollen bursa ("bursitis"), tendon ("tendinitis"), and/or a tear of the rim of the socket ("glenoid labrum tear"). Specific orthopedic tests exist that help to differentiate between the possible causes or diagnoses but often, an MRI may be necessary to nail down a diagnosis. Unfortunately, an MRI can also show too much information, such as normal age-related changes, "silent" abnormal findings (like tears and frayed tissue that are not pain generators), which can actually make it more difficult to be sure what is causing the patient's current shoulder pain.
When it comes to treatment, there is evidence to suggest conservative approaches, like exercises, are just as effective as surgical approaches. One review found the following:
- Subacromial impingement syndrome: Exercise is as effective as surgery at one, two-, four-, and five-year follow-ups (at a fraction of the cost of surgery).
- Rotator cuff partial thickness tears (<75%): Exercise is as effective as surgery (at a fraction of the cost).
- Atraumatic full thickness rotator cuff tears: Exercise significantly reduces the need for surgery (75%).
- Subacromial impingement syndrome: Exercise significantly reduces the need for surgery (up to 80%).
So if you suffer from shoulder pain, don't jump to surgery as your first treatment option. Conservative treatments offered by doctors of chiropractic—such as manual therapies, exercise training, and the use of modalities—can help improve motion in the shoulder and the surrounding structures at a much lower cost and without the risks that come with more invasive procedures. Also, regardless of the treatment option you choose, keep in mind that it can take three, six, nine, or even twelve months to reach a satisfying end-point in treatment for these types of injuries.
Carpal Tunnel Syndrome
Can Carpal Tunnel Syndrome Be Prevented?
Let's say you've applied for a job that requires frequent gripping and handling of products and
you heard that carpal tunnel syndrome (CTS) is a problem at this particular manufacturing plant. You
really need the job, but you are leery of the possibilities of developing CTS. Is there anything you can do
to PREVENT it?
Though there are no "guarantees" that CTS won't occur despite our best efforts at prevention, here are some practical approaches that can make a big difference:
1. LIGHTEN IT UP: CTS risk increases as a result of three things: Force + Speed + No Rest. First, try using less force or lighten up on your grip whenever possible. Though it's hard to change habits, try gripping tools less tightly (use higher quality tools if they reduce the need to squeeze hard), don't "pound" the keys of your keyboard, don't squeeze your computer mouse, kitchen utensils, etc. and don't strangle your golf club, tennis racquet, garden tools, or steering wheel. Use lighter-weight tools/utensils at home or work.
2. TAKE BREAKS: Take 30-60 second stretch breaks every 15 minutes to allow the soft tissues in the hands and wrists to recover.
3. STRETCH 1: Place your palm on the wall/desk pointing your fingers downward and stretch your wrist as far back as possible (elbow straight) until you feel the "pull" in the forearm muscles. HOLD for five to ten seconds and repeat on the other side. STRETCH 2: Make a fist for three seconds, then straighten out the big knuckle joints of the fingers (make a "bear claw"), followed by opening the hands and fanning out the fingers as far as possible. Hold each position for five to ten seconds and repeat as time allows.
4. KEEP THE WRISTS NEUTRAL: When possible (driving a car, sleeping, etc.), keep your wrists straight/avoid bending. Use a wrist splint at times to help remind you (especially at night).
5. CHANGE YOUR ROUTINE: Instead of staying at a risky task until you're done, switch to a task that doesn't require extreme gripping and force and/or switch between the left and right hand.
6. CHECK YOUR POSTURE: Keep the chin tucked in (retracted) and head back. Avoid forward head posture and sit up "tall." At a desk, keep knees, hips, elbows at 90°, and arch the lower back—in other words, don't slouch!
7. AVOID COLD HANDS: Try to avoid letting your hands and fingers get cold. Wear gloves (if possible), have a small space heater nearby, or rub your hands together. Even fingerless gloves can help a lot.
8. ROTATE BETWEEN TASKS: Discuss rotating between job tasks with co-workers and your boss to avoid the same repetitive movements during your shift. This can really help in assembly line work.
9. SEEK HELP SOONER RATHER THAN LATER: Heed the early warning signs of CTS. Do NOT let CTS advance without seeing a chiropractor, as studies show that waiting too long reduces the success rate of treating CTS! Your doctor of chiropractic can teach you exercises, retrain your posture, suggest ergonomic (work) improvements, and treat your overused muscles and joints.
Low Back Pain
Low Back and Dysmenorrhea - Are They Related?
Dysmenorrhea, also known as painful periods, is a common gynecological condition that
affects up to 70% of menstruating women. About 15% of individuals with the condition report that it
significantly interferes with their activities of daily living (ADLs) and in some cases, results in
absence from school and/or work. Studies have found that dysmenorrhea is related to early menarche
(the onset of menstruation), nulliparity (not having children), and stress. But is it possible there's an
anatomical component to the condition?
The lumbar spine, or low back, consists of five vertebrae that rest on top of the sacrum, or tail bone, which is wedged between the "wings" of the pelvis (the ilia) making up the sacroiliac joints (SIJs). This close anatomical relationship with the pelvic organs suggests that the musculoskeletal dysfunction may play some role in dysmenorrhea. But is this truly an important relationship and if so, can spinal manipulation to the low back and pelvis/SIJs help reduce the pain associated with dysmenorrhea?
One study looked at the relationship between pelvic alignment and dysmenorrhea in 102 females divided into groups of those with and those without the condition. The researchers observed there were differences in pelvic alignment between members of both groups. Another group studied the lumbo-pelvic alignment and abdominal muscle thickness in 28 women with primary dysmenorrhea and 22 women without the condition and found greater misalignment and smaller diameter abdominal muscles in the dysmenorrhea group.
To determine if there is a change in pain perception after pelvis manipulation in women with primary dysmenorrhea, a randomized controlled trial of 40 women (20 in two different groups) received a "global pelvic manipulation" (GPM) while the other group received a sham or placebo intervention. The participants in the GPM treatment group reported significant improvements in overall pain and sensitivity when compared with the sham treatment group, supporting manipulation as an effective tool in the management of dysmenorrhea.
Though further research is warranted, this study shows there is scientific support for the use of spinal adjustments in women suffering from dysmenorrhea. Therefore, chiropractic may offer an effective, safe, and often fast remedy for those who choose to not risk the side effects of various medications commonly used to treat dysmenorrhea.
FOR YOUR FREE NO-OBLIGATION CONSULTATION CALL
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.