MONTHLY HEALTH UPDATE
Do Coffee Drinkers Live Longer?
Chad Abramson, D.C.
Whole Body Health
Chiropractic and Hypertension
In a blood pressure reading, the higher number (“systolic”) represents the pressure that blood
exerts against the arterial walls when the heart beats. The lower number (“diastolic”) represents the
pressure blood exerts against the arterial walls when the heart rests between beats (measured in
millimeters of mercury or mmHg). The definition of hypertension (HT), like so many other aspects of
health, has been defined and redefined over the years. Let’s take a look at the current definition and what
(if anything) chiropractic provides to help this VERY common condition.
The American Heart Association defines (as of November 2017) “NORMAL” as being <120/ and <80; "ELEVATED" as 120-129/ and <80; STAGE 1 HT: 130-139/ or 80-89; STAGE 2 HT: >140/ or, >90; HYPERTENSIVE CRISIS: >180/ and/or >120. Between the two numbers, the systolic blood pressure (BP) is generally given the most attention as a major risk factor for cardiovascular disease for people over age 50. A gradual increase in systolic BP normally occurs with increasing age as arteries gradually stiffen due to plaque build-up. Recent studies report that the risk of death from ischemic heart disease and stroke DOUBLES with every 20mmHg systolic or 10mm Hg diastolic BP increase in people from age 40-89.
So, CAN chiropractic help patients with hypertension? The answer is YES... at least in some cases. A placebo-controlled study published in 2007 (and spotlighted on "WebMD") reported a specific type of chiropractic adjustment applied to the Atlas (C1) vertebra that SIGNIFICANTLY lowered both systolic (by 14 mm Hg) and diastolic BP (by 8 mm Hg) in 25 patients with early-stage HT. This improvement did not occur in 25 control patients who received a sham procedure. This beneficial effect persisted for eight weeks during which time the patients took no medication for their condition. Dr. George Bakris, the director of the University of Chicago hypertension center and lead author of the 2007 study wrote, “This procedure has the effect of not one, but two blood pressure medications given in combination. And it seems to be adverse-event free. We saw no side effects and no problems." Case studies of chiropractic treatment lowering BP date back to the 1980s, and higher quality, larger scaled studies have been published in the last decade. One explanation on how chiropractic adjustments help to lower BP is that adjustments applied to C1 (the Atlas) affect the parasympathetic nervous system, which tends to lower the diastolic BP (lower number), while mid-thoracic manipulation—which stimulates the sympathetic nervous system—tends to lower the systolic BP (upper number) to a larger degree. Chiropractic care includes not only spinal manipulation, but also dietary counseling, and more—all WITHOUT the potential for the sometimes significant side-effects associated with medications.
Concussion and Whiplash – Is There a Connection?
Whiplash or whiplash associated disorders (WAD) represent a constellation of symptoms that are
very similar to those reported by patients who have sustained a concussion or minor-traumatic brain
injury (mTBI). These shared symptoms include (but are not limited to): headache; neck pain;
nausea/vomiting; dizziness; balance issues; vision problems; and difficulty concentrating. Chiropractic care focused on the cervical spine has been demonstrated to benefit patients with WAD. Is it possible that the same form of treatment can help the mTBI patient as well?
In the March 2015 issue of the journal The Physician and Sportsmedicine, researchers looked at case studies involving five patients with concussion symptoms that did not resolve within 30 days and had become chronic. The mechanism of injury in three of the cases was sport-related, while the other two stemmed from a slip and fall and a motor vehicle collision. Treatment focused on the cervical spine and included the use of either spinal manipulative therapy (SMT) or mobilization; active release technique (ART) to stretch tight neck muscles; and exercises aimed at strengthening the deep neck flexor muscles and/or other surrounding neck musculature.
Case 1: A 25-year-old professional mixed martial arts male injured from sparring presented four months after the injury. After three treatments, he reported a significant reduction in symptoms, with full resolution after eight treatments.
Case 2: A 59-year-old female who hit the back of her head on the ground after a fall presented with 31-month duration of symptoms that reportedly improved significantly within three months of twice-per-week treatments.
Case 3: A 19-year-old male junior hockey player presented two years after the initial injury and reportedly experienced an 80% improvement in his symptom after four treatments spread out over a three-week timeframe.
Case 4: A 19-year-old male injured in a car accident presented 14 weeks after the injury and reported a nearly 50% reduction in symptoms after one treatment and full resolution after eight treatments.
Case 5: A 51-year-old female hockey player who was struck on the left side of the head presented five weeks post-injury and reported a full resolution of symptoms after three treatments per week for six weeks.
The important point here is that treatment was aimed ONLY at the cervical spine, not the concussion, with excellent results in each case. These findings indicate the need for larger studies concerning the use of conservative chiropractic care for cases of mTBI that do not resolve within a month’s time.
Neck Pain / Headaches
What Exercises Are Best for Neck Pain?
Past research has demonstrated that combining spinal manipulative therapy (SMT) with
exercise yields the best long-term results for individuals with neck pain. So what exercises
should we consider when neck pain rears its ugly head?
In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM). The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!
You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.
Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.
Studies also show that weakness of the deep neck flexor muscles is very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.
Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.
Can Chiropractic Help Prevent a Hamstring Injury?
Sports that require rapid acceleration and deceleration, cutting left and right,
agility, jumping, and bending pose a unique risk for injury to the lower limbs.
Hamstring injuries are the most prevalent injury in Australian rules football, afflicting
16% of players, causing an average of 3.4 missed matches per injury, accounting for
the most time lost due to injury, and having the highest recurrence rate once players
return to the active roster. Moreover, a player’s performance can be highly diminished
by hamstring injuries.
In a 2010 study, researchers randomly assigned 57 male Australian football players to either a control group that received the current best practice medical and sports science management or an intervention group that received the same care with the addition of a sports chiropractic manual therapy injury prevention program that included manipulation/mobilization and/or soft tissue therapies to the spine and lower extremities. Both groups received a minimum of one treatment per week for six weeks, one treatment every two weeks for three months, and one treatment per month for the remainder of the season (three months).
At the close of the season, the researchers found that the group receiving the chiropractic injury intervention program reported significantly fewer primary lower- limb muscle strains and weeks missed due to no-contact knee injury than the other group. Though lower-limb injury prevention was the primary focus of this study, the players in the chiropractic group also experienced fewer episodes of back pain. Because dysfunction in one area of the body can place added stress elsewhere, it’s important to examine the whole patient in order to identify other issues that may either be the cause or contribute to the patient’s chief complaint. Likewise, preventative care focused on maintaining proper motion in the joints throughout the body can lead to a reduced risk for injury, as was demonstrated by this study.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome and Sports
Carpal tunnel syndrome (CTS) is the most common and well-known entrapment
neuropathy, or pinched nerve in the extremities. Many people think that carpal tunnel syndrome
(CTS) affects only computer workers or assembly-line workers, but that is far from the truth.
Though CTS can affect anyone, it’s quite common in athletes. Surprised? Let’s take a closer
Many sports—including golf, tennis, cycling, and baseball—require a firm grip, high repetition, and little to no rest time, which can exceed the capacity of the soft tissues in the wrist. Over time, this stress can build and place pressure on the median nerve, resulting in the symptoms of pain, numbness, and tingling that are often associated with CTS. Additionally, trauma to the wrist from a sports collision can lead to the rapid development of CTS symptoms. The diagnosis of CTS is typically made by combining a group of findings rather than by one definitive test. The patient’s history and symptoms coupled with the results from several provocative tests, which are easily performed in the office, are typically needed to arrive at an accurate diagnosis. Because CTS can co-exist with other conditions, of which several mimic similar signs and symptoms of CTS, an electromyography and/or nerve conduction velocity test can be extremely helpful.
In addition to therapies such as mobilization and manipulation to the wrist and other anatomical locations along the course of the median nerve (the elbow, shoulder, neck, for example), treatment by a doctor of chiropractic often includes the following non-surgical methods: wearing a wrist splint, primarily at night; using anti-inflammatories such as ginger, turmeric, and bioflavonoids; making modifications to the sport (if possible); managing vocational and avocational factors that place stress on the wrist; working with other healthcare providers to manage conditions like diabetes, hypothyroid, or certain types of arthritis that can cause or contribute to CTS; and training the patient in specific exercises that can be interspersed throughout the day.
It is very important to stress that EARLY INTERVENTION for CTS typically yields the best outcomes. So please, DO NOT WAIT before seeking care when you experience pain, numbness, or tingling in the wrist, hands, or fingers!
Low Back Pain
Low Back Pain: Spinal Manipulation vs. NSAIDs
Low back pain (LBP) is the single greatest cause of disability worldwide and
the second most common reason for doctor visits. Overall, LBP costs society more
than $100 billion annually when factoring in lost wages, reduced productivity, and
legal and insurance overhead expenses.
Studies regarding the use of spinal manipulation(SM)—a form of treatment offered by doctors of chiropractic—for LBP are plentiful and have led to the strong recommendation that SM should be considered as a FIRST course of care for LBP. The American College of Physicians and the American Pain Society both recommend SM for patients with LBP who don’t improve with self-care. In 2010, the Agency for Healthcare Research and Quality (AHRQ) reported that SM is an effective treatment option for LBP – EQUALLY effective as medication in reducing LBP and neck pain.
A 2013 study compared SM and non-steroidal anti-inflammatory drugs (NSAIDs) and found that SM was MORE effective than diclofenac, a commonly prescribed NSAID, for the treatment of LBP. Patients in the SM group also reported NO adverse side effects. More importantly, a 2015 study found that NSAID use can actually slow the healing process and even accelerate osteoarthritis and joint deterioration!
Doctors of chiropractic utilize SM as many conditions, including LBP— more than any other healthcare profession including osteopathy, physical therapy, medical doctors, and others. Chiropractors also combine other synergistic forms of care, such as patient-specific exercise training, to help patients learn how to self- manage their LBP, as recurrence is such a common issue.
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.