Narrowing In On Stenosis

Stenosis is a spinal disease that’s more common as we age. What is it? Is surgery the answer? How can we manage it? Here are some facts and tips, courtesy of the Unified Virginia Chiropractic Association.  Stenosis means “narrowing.” Spinal stenosis exists when the space for nerves is less than optimal.

Mechanisms of spinal stenosis:
• Congenital stenosis. In this form of stenosis, you were born with smaller spaces for your nerves and/or spinal cord. Aging, or trauma (sports injury, car accident), can reveal symptoms suggesting the underlying predisposition.
• Acquired stenosis. Though trauma such as sports injuries or major accidents can cause stenosis, acquired stenosis occurs mostly due to degenerative changes associated with aging and physical stresses. Most commonly this happens when the discs of the spine desiccate (dry out), discs herniate (bulge), osteoarthritis causes bone spurs that narrow space for spinal nerves, or ligaments thicken due to mechanical stress or disease processes.
Locations where spinal stenosis occurs:
1. Central canal stenosis: Exists when the space for the spinal cord (the tube-like “canal” running up-and-down the spine’s length from neck to low back) becomes restricted or narrowed. This can easily affect all structures beyond, i.e. low back (lumbar) central canal stenosis can affect both legs.
2. Foraminal stenosis: Characterized by narrowing of the opening between the vertebrae, such as by bone spurs (osteophytes) or desiccated (dried out) discs causing decreased space between the vertebrae.
3. Lateral recess stenosis: Characterized by choking of the nerve and related structures after it has left the foramen (see above), such as by a herniated disc or (in some cases) a bone spur.
How do you know if you have spinal stenosis? First, the condition is most common in seniors1, especially if you have spinal arthritis/degeneration. Back or neck pain is a possible consequence. Common peripheral (arms/hands; legs/feet) symptoms include burning, radiating pain, numbness, loss of feeling/sensation, weakness, cramping pain, or shooting pain. Diagnosis begins with a thorough history and examination by a doctor trained in the spine (doctors of chiropractic are a prime example), and may proceed to include diagnostic imaging (x-ray, MRI, CAT scan) to determine what site(s) are narrowed, and how much.
Treatment options are numerous. Surgical options include making the spaces for the nerves larger via removing whatever tissues are causing the stenosis, possibly removing substantial bony elements and/or inserting metal or other synthetic spacers between bones. A Dartmouth-based study of surgery for lumbar (low back) stenosis showed good pain and functional outcomes for patients through 4 years post-surgery;2 however, surgery has its risks, and not all patients benefit. The federal government lists “a tear in the membrane covering the spinal cord at the site of the operation,” infection, or blood clot as the most common surgical complications.3 Risks also include more severe complications and death; which is why more frail and/or older patients may be poor candidates.
Non-surgical options exist, and are very promising. The goal of non-surgical management is to open space for the nerves and related vessels (blood vessels and lymphatics) to optimize nerve function, decrease pain and symptoms, and slow progression of the condition. Doctors of chiropractic use gentle hands-on methods (spinal adjustments) to optimize space between bones, and may also use soft-tissue manipulation to free up entrapped nerves beyond the spine. Published literature shows promise for the chiropractic approach in cases of cervical and lumbar spinal stenosis.4,5 NIAMS, a division of NIH (National Institutes of Health, United States Dept. of Health & Human Services) summarizes the research on chiropractic by stating it is as effective as any other form of noninvasive, non-operative treatment for back pain.6 In addition, NIAMS also notes that acupuncture has shown promise for these conditions.7
Doctors of chiropractic and their patients have a responsibility to be aware of and share safe, effective options for a variety of conditions. Please, share this information with someone who deserves to make an informed decision. And even if you don’t suffer from stenosis (yet?), remember that your doctor of chiropractic’s role is to help you feel and FUNCTION at your best—whether you are in pain, feeling better, or feeling great. For more information on ways to help your entire family live better, ask your chiropractor for guidance; or visit http://virginiachiropractic.org to find a highly-qualified chiropractor near you.

References:
1 Spinal stenosis prevalence and association with symptoms: the Framingham Study. Kalichman L, et al. Spine J. 2009 Jul;9(7):545-50.
2 Weinstein, J, et al. Surgical Versus Nonoperative Treatment for Lumbar Spinal Stenosis Four-Year Results of the Spine Patient Outcomes Research Trial. 2010: SPINE Volume 35, Number 14, pp 1329 –1338.
3 http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/default.asp#spine_b
4 Chiropractic treatment of lumbar spinal stenosis: a review of the literature. K Stuber, et al. J Chiropr Med. 2009 June; 8(2): 77–85. 5 Kruse RA, Gregerson D: Cervical Spinal stenosis resulting in radiculopathy treated with flexion-distraction manipulation: A case study. J of the Neuromusculoskeletal System 2002;10(4):141-7 6 http://www.niams.nih.gov/Health_Info/Spinal_Stenosis/default.asp#spine_i 7 Ibid.
Celebrate Wellness! is provided as a public service by the Unified Virginia Chiropractic Association, PO Box 15, Afton, VA 22920, phone 540-932-3100, e-mail vcacentral@hughes.net. Production and content courtesy of Trusted Voice. All rights reserved.

Pregnancy

Celebrate Wellness!
(Pregnancy)
Happy Birthday! Depending on your age, a birthday may be a time of introspection, celebration, or both. The “holiday” that marks a newborn’s first breath leads to many challenges and opportunities for mom and the family. How can you help mother and child embark on this adventure? Here are some facts and tips, courtesy of the Virginia Chiropractic Association.
As a pregnancy proceeds, mom’s body undergoes numerous changes. The most obvious changes involve body shape and posture, but a hormone called relaxin subtly makes ligaments a little looser. A good analogy is that the “rubber bands” (ligaments) that hold bones together become more easily stretched. Though this extra “play” between the bones will be useful upon delivery, it can also predispose mom to injury (knees, fallen arches, back pain). Since the feet are part of the shock-absorbing system that protects the knees, hips, and spine, and since chiropractic doctors are uniquely trained to help the human frame function at its best, its not surprising that some chiropractors will prescribe orthotics to support the feet to help limit pain during pregnancy and avoid permanent post-pregnancy fallen arches.
Here’s a self-care tip: Many pregnant women may benefit from certain forms of exercise. Though all people should consult a health care provider before embarking on an exercise program, and though pregnant women need to be especially cautious, water-based exercise may be a good aerobic outlet for the expectant mom. A 2006 study of 290 healthy, pregnant women indicated that a water-based exercise program was more effective than a land-based program for decreasing back and pelvic pain. Pregnant women can and should take steps to care for their changing bodies, and this and other studies suggest that the rewards of so doing may be significant. i
As the trimesters roll by, mom will tend to develop what’s known as a lordosis, an accentuated “dip” in her low back. Though the public and some doctors associate this posture with back pain, researchers suggest that lordosis alone may not cause low back pain.ii Another study suggests that imbalances in the joints at the base of the spine (sacroiliac joints) are highly correlated with pregnancy backache. iii Doctors of chiropractic commonly work with fixated or “stuck” joints in the spine, and since symmetry of sacroiliac joint motion is so important in pregnancy back pain, these unique doctors’ skills become especially relevant for moms-to-be.
Numerous studies show chiropractic care’s value in decreasing pregnancy back pain. iv When it comes time to deliver, a history of chiropractic care may be related to a smoother, less painful process — and that’s a valuable consideration. A published study showed decreased incidence of painful back labor in women who had received regular chiropractic care. v Though athletes, workers, and others appreciate the long-term benefits of regular trips to the chiropractor, there is no group more appreciative of those benefits than pregnant women.
Once mom has delivered, the family’s need for chiropractic care is over, right? Far from it. As with dental care, many choose chiropractic as part of healthy body maintenance; and there may be unexpected benefits. For parents of a child with colic, any relief is appreciated. A study out of Denmark showed vi a significant positive response of colicky babies to chiropractic care, in comparison to what CNN called “dimethicone drops, the standard (and generally ineffective) treatment.” vii Though some sources viii are very cautious when it comes to finding a chiropractor competent to adjust an infant or child’s spine, most agree that a gentle touch is essential to pediatric chiropractic care.
Doctors of chiropractic are trained to care for people of all ages. If you haven’t already done so, consider taking advantage of the full range of their skill and training. Your entire family will reap the rewards for generations to come.
For more information about health and well-being, ask your chiropractor, find a highly trained DC in your area at http://www.virginiachiropractic.org, or call the VCA at 540-932-3100.
i Granath, Aina et al. “Water Aerobics Reduces Sick Leave due to Low Back Pain During Pregnancy.” Journal of Obstetric, Gynecologic, & Neonatal Nursing 2006; Vol 35 Is 4, Pgs 465-471. ii Hansson T, Bigos S, Beecher P, Wortley M. The lumbar lordosis in acute and chronic low-back pain. Spine. 1985; 10:154-155. iii Damen. Léonie et al. “Pelvic pain during pregnancy… asymmetric laxity of the sacroiliac joints.” Acta Obstet Gynecol Scand, 2005. Vol 80 Is 11, Pgs 1019-1024. iv A. Lisi. “Chiropractic Spinal Manipulation for Low Back Pain of Pregnancy: A Retrospective Case Series.” Journal of Midwifery & Women’s Health, Vol 51, Is 1, Pgs e7-e10.iv xxx v Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. J Manipulative Physiol Ther. 1991 (Feb); 14 (2): 116-118. vi Jesper M. M. Wiberg, Jan Nordsteen, and Niels Nilsson. The Short-term Effect of Spinal Manipulation in the Treatment of Infantile Colic: A Randomized Controlled Clinical Trial…” JMPT 1999; 22 (8) Oct: 517–522 vii http://archives.cnn.com/2000/HEALTH/children/04/11/chiro.forcolic.wmd/index.html viii Ibid.
A Public Service of the Virginia Chiropractic Association

Back To School

Celebrate Wellness!   (courtesy of United VCA)

BACK TO SCHOOL!
A new school year is dawning. It’s a time of joy, new beginnings, and new injury risks. Here are some tips to stack the odds in your family’s favor, courtesy of the Virginia Chiropractic Association.
Healthy school lunches and healthy exercise together are an opportunity to protect your child’s heart, decrease future diabetes and arthritis risks, and create positive self-esteem. Healthy exercise can be as simple as a daily walk, and innovative communities have established safe walking routes to and from school.i Children should travel in groups, and need to be aware of traffic and potential human hazards. Should your child choose more intense forms of exercise such as recreational or organized sports, be sure they do so safely. Soccer goals need to be anchored properly. The U.S. Consumer Product Safety Commission notes 28 deaths between 1997 & 2007 caused by movable soccer goals that fell on children who climbed on them or hung on their crossbars.ii If your child is involved in collision sports like football or even skateboarding, a proper-fitting helmet can literally be life-saving. And if your child gets his or her joy on the playground, be sure it’s a safe one. The U.S. Consumer Product Safety Commission recommends a minimum of 9 inches of shock-absorbing material in the event of a fall from playground equipment. iii
Clothing can itself be life-saving. Reflectors on shoes or garments can make a child more visible in the dark. Also, remove drawstrings from young children’s sweatshirts and jackets– you may be removing a potential choking hazard.
Can words make a difference? Absolutely. Peer pressure is as powerful today as it was in prior generations. Have age-appropriate talks with your children about drugs, tobacco, alcohol, and sexual activity. Frame the conversation in terms that your child can relate to, using an ethical framework that is consistent with your world view.
For teens, the car is both a powerful tool and risk. Be sure your children understand the risks associated with distracting activities like texting while driving; and outline clear consequences for violations. In Virginia, drivers 18 and younger may not use a cell phone while the vehicle is in motion. iv Be sure that your child understands that violations of state law may mean consequences that are beyond your ability as a parent to mitigate.
Another major risk to your children’s safety is right behind them: their backpacks. Heavy backpacks can cause growing frames to experience temporary backaches, joint pain, even muscle strains and headaches; and some children may begin a lifetime of these problems. Here’s a simple tip: Weigh your child, and then weigh his or her backpack. Only 4% of parents do this simple test, yet the children of those “4 percenters” carry the lighter backpacks (Archives of Disease and Childhood. 2003;88:18-19). If you care about your child’s health and well-being — and you know you do — pull out the scale, and use it. A child’s daily backpack shouldn’t weigh more than 10% of total body weight, and some sources suggest a maximum of 5-10%. v Simply put, your 100 pound child’s backpack should weigh under 10 pounds. For a 150 pound child, 15 pounds is the recommended maximum. For a 75 pound child, 7 1/2 pounds is the most he or she may be able to safely carry on their back.
In addition to stressing young frames and growing structures, heavy backpacks cause acute injuries. In fact, a study in Pediatrics showed that emergency room visits associated with backpacks are most highly correlated with tripping, with the head and face being the most commonly seriously injured body parts. vi Why not protect your kids with a simple device that most of us already own– specifically, the bathroom scale?
For more information about health and well-being, ask your chiropractor, find a highly trained DC in your area at http://www.virginiachiropractic.org, or call the VCA at 540-932-3100.
i http://www.saferoutesinfo.org/ ii http://www.cpsc.gov/cpscpub/prerel/prhtml07/07277.html
iii Ibid. iv http://www.dmv.state.va.us/webdoc/pdf/dmv16.pdf v http://www.amerchiro.org/content_css.cfm?CID=65 vi Wiersema, Brent M., DO, Eric J. Wall, MD, and Susan L. Foad, MPH. Acute backpack injuries in children. Pediatrics. Jan. 2003;111(1):163-166
A Public Service of the Virginia Chiropractic Association
Child’s weight (pounds)5% of body weight10% of body weight502 1/256036703 1/278048904 1/291005101105 1/2111206121306 1/2131407141507 1/2151608161708 1/2171809181909 1/2192001020

Why See The Doctor If I’m Not Sick?

Celebrate Wellness!

 

Doctors treat sickness, and these days there’s a specialist for each disease, so why see a doctor if I’m not sick? It sounds like sound reasoning… yet a rising tide of preventative, wellness-oriented living is here. Here are some facts and tips, courtesy of the Unified Virginia Chiropractic Association.

In America, our “last-year-of-life expenditures” total 22% of total healthcare dollars spent.1 Medicare payments for Americans’ final 2 months of life exceed the total budget for the Department of Homeland Security. 2 Investing in wellness makes good sense, and good cents that add up to tens of thousands of dollars. Here’s are a few simple ways to change your “Wellness Investing Profile” :

• Seek doctors who model good health. “Healthy behavior modeling” is a powerful phenomenon. Our kids model what we do, yet we too have our models. Published studies show that health-conscious doctors who “practice what they preach” are more effective in getting patients to adopt positive behaviors. 3 This is true for everything from healthy exercise habits, to regular chiropractic checkups, to seat belt use. Doctors of chiropractic have long been models for healthy living, for their patients and their communities. A “Community of Wellness” really is a family affair.

• Quit Smoking. Smoking isn’t just bad for you… it’s expensive, far beyond the roughly $1500 per year a smoker may spend on cigarettes. A group of Duke University professors estimate the lifetime cost of smoking for a 24 year-old to be $86,000 (female), and $183,000 (male). 4 The Chief Medical Officer of the Blue Cross & Blue Shield association recommended a particular type of doctor to help patients to exercise, lose weight, quit smoking, and engage in a variety of positive behaviors. What type of doctor was he speaking of? Doctors of chiropractic.5

• Get regular health checkups… but choose wisely. In some models of “health” care, healthy checkups are actually disease-screening checkups. Some of these disease-screening tests are not as effective as once promised. False positives, invasive diagnostics, mis-spent financial resources, and wasted emotional energy and anxiety can be the result of random, non-targeted screening tests. Some published literature suggests that some forms of non-targeted, presumably preventative screening may actually increase mortality! Doctors of chiropractic focus on health, not just sickness. Millions of Americans regularly see these highly-trained professionals to improve their function for sport, leisure, and life… and to live, well. On a larger scale, chiropractic doctors have been studied for cost effectiveness, patient satisfaction, outcomes, and patients’ use of medications (prescription and nonprescription) and/or surgery. Consistently, doctors of chiropractic have come out on top.

• Take responsibility for your own health. Eat well, be active (ask your doctor for guidance), nurture a positive mental outlook, seek proper recovery and sleep, and enlist your chiropractor’s help as you seek optimal neurological and structural function.

Regardless of how you choose to invest in your health, your doctor of chiropractic’s role is to help you feel and FUNCTION at your best — whether you are in pain, feeling better, or feeling great. For more information on ways to help your entire family live better, ask your chiropractor for guidance; or visit http://virginiachiropractic.org to find a highly-qualified chiropractor near you.

References:

1 Medical Expenditures during the Last Year of Life: Findings from the 1992–1996 Medicare Current Beneficiary Survey, Donald R Hoover, Stephen Crystal, Rizie Kumar, Usha Sambamoorthi, and Joel C Cantor. Health Serv Res. 2002 December; 37(6): 1625–1642.

2 http://www.cbsnews.com/2100-18560_162-6747002.html

3 Hash, R.B., Munna, R.K., Vogel, R.L. & Bason, J.J. (2003). Does physician weight affect perception of health advice? Preventative Medicine, 36, 41-44.

4 The Price of Smoking. Frank A. Sloan, Jan Ostermann, Christopher Conover, Donald H. Taylor, Jr. and Gabriel Picone. 2004.

5 WHITE HOUSE COMMISSION, COMPLEMENTARY & ALTERNATIVE MEDICINE POLICY. Testimony delivered Monday, May 14 2001, 8:00 a.m. by Allan Korn, M.D., Chief Medical Officer and Senior Vice President for Clinical Affairs for the Blue Cross and Blue Shield Association (BCBSA).

Celebrate Wellness! is provided as a public service by the Unified Virginia Chiropractic Association, PO Box 15, Afton, VA 22920, phone 540-932-3100, e-mail vcacentral@hughes.net. Production and content courtesy of Trusted Voice. All rights reserved.

Chronic Headaches Helped by Chiropractic

Photo from http://www.warwickphysio.com

by Betty J. Humphrey

It is a little known fact that chiropractic adjustments can have a huge impact on the quality of life for chronic headache sufferers.  Research is showing that those who suffer with headaches on a regular basis are finding benefits to regular chiropractic visits.  Besides lessening the severity and number of headaches experienced, chiropractic adjustments have been found to provide individuals with relief from headache pain that they are suffering at the time of the adjustment, as well.

Most people associate migraine headaches with large doses of pain medications and ongoing treatment by the use of preventative drugs.  While these measures often make life more normal for these individuals it rarely, if ever truly cures the headaches.  When the drugs are stopped the symptoms return.  Chiropractic is different.  With regular spinal adjustments symptomatic relief is experienced while ongoing reduction of pressure on nerves helps to return the body to a normally functioning state.  In many cases we see people gradually stop the medications entirely and instead are able to control their headaches through regular chiropractic adjustments.

Chiropractic isn’t a one stop cure for headaches but it is an investment that can yield big dividends in your health.  Drugs are damaging to the kidneys, liver and other organs of the body.  Chiropractic is a natural approach to creating balance and health.  We encourage anyone who is a headache sufferer to come in today for a free consultation.  Let us help you feel better.  Call the office to set up your free headache consultation today.   (540) 433-6909

The History of Chiropractic

by Betty J. Humphrey

In 1895 D.D. Palmer performed the very first chiropractic adjustment on Harvey Lillard which successfully restored his hearing.  Since that time chiropractic has grown to become a respected, effective and affordable treatment alternative for many physical conditions ranging from migraine headaches to sciatica.

In our office we feel it is our responsibility to educate individuals about how their body works and how it heals.  In many cases we find that by helping patients understand what is happening to cause the issues that bring them to us they are empowered to protect and enhance their health on a much higher level.  If you are one of the many individuals who suffer with chronic pain or onsets of sudden, debilitating pain and you would like to learn how to live with less pain, please fill out the form below.  Thanks!

Healthy Joints

From The Unified VCA’s Celebrating Wellness!

Healthy Hips, Knees and Other Joints
Have you, a friend, or a family member had a joint replacement? How can you maximize the quantity and quality of your life, while minimizing the need for joint replacement, and re-replacement procedures? Here are some facts and tips, courtesy of the Virginia Chiropractic Association.
During 1979-2002, hip replacement rates for American seniors increased approximately 800%. i During that timeframe, the rate of knee replacement increased roughly 400%; and the largest increase was among those under age 50.ii According to the American Academy of Orthopedic Surgeons, Americans now receive approximately 193,000 total hip replacementsiii and 581,000 knee replacementsiv per year. Those 581,000 knee replacements are projected to balloon to 3.48 million by the year 2030.v We are clearly facing an epidemic of arthritis and joint replacement.
One of the best approaches to health is prevention. Most joint surfaces are covered in hyaline, a very smooth cartilage that is mostly water. By maintaining proper hydration levels and functional joint strength around your major weight-bearing joints, you’ll have taken some strong positive steps towards joint longevity. Who’d have thought that a simple glass of water could have such power to protect your body’s frame?
The knee joints are, loosely speaking, hinge joints. They do rotate some, but not with the greater range of motion that you expect from a forearm where it rotates at the elbow. If the inside of the foot collapses too much (pronation) during walking, running, or standing, the knee will be stressed to turn or twist. The long-term consequence is stress and wear on the inside of the knee. Also, the muscles in the front of the thigh tend to pull on the knee in ways that are stressful to the knee — especially if you have wide hips (a large “Q Angle,” as your doctor will refer to it). No, you can’t get a new body; but with the help of a professional, you can decrease damaging stresses and help your knees move (or “track”) their best. This is where your chiropractic doctor comes in.
Just like alignment issues are important for your knees, they also affect the hips and back. Some people’s hip bones are different from one side to the other, and some people have a short leg on one side. The muscles around the pelvis connect to the spine, the ribs, the hips, even the knees. Helping them all relate in a healthy way is one of the services a doctor of chiropractic can provide.
Hydration and maintaining joint strength and stability requires daily attention. Preventing premature joint wear is, in no small part, your job; but your partner in this process is your doctor of chiropractic. Alignment might refer to your auto tires wear; it also refers to how your foot relates to the ground, how your knees relate to your hips, how your hips relate to your spine… and the other way around. Every joint in the body affects other joints, just as a disturbance in the nervous system in one area (for example, the pain of an ankle sprain) can affect other areas (for example, back pain from limping around on the aforementioned ankle). We’ve all fallen as children, and many of us have had other mishaps, accidents, and traumas in life. Even though some or even all of the pain from an injury might fade, unless movement and related neurological patterns are normalized, the old and forgotten injuries of life may come to haunt us in the form of subtle misalignments… and the not-so-subtle result of pain, joint failure, and need for joint replacement. Doctors of chiropractic focus on the human frame and its neurological and structural balance, to help you get plenty of mileage out of your body.
Even if you’ve already had replacements in a knee, hips, the spine, shoulders, elbows, or other joints, chiropractic is still an important part of living well. Chiropractic doctors see artificial joints every day on x-rays, so you’ll have plenty of company in our office. Some doctors of chiropractic have special training in sports and rehabilitation, and all doctors of chiropractic are trained in the function of the nervous system and every — yes, every — joint in the human body. Doctors of chiropractic can serve as the “body shop” when you have a serious injury, but they also shine in the area of rehabilitation and — just like the auto shop — functional alignment to keep your joints working to their full and optimal capacity. That’s something you’ll appreciate whether your goal is to attain peak performance, or to maximize the life of your real and already-replaced joints.
Doctors of chiropractic are trained to care for people of all ages, and they focus not just on avoiding pain but on helping you maximize your quality of life. If you haven’t already done so, consider taking advantage of the full range of their skill and training. Your entire family will reap the rewards for many years, and many generations, to come.