Another study showing that obese patients who got COVID-19 had a worse outcome . COVID-19 has brought to light that the more unhealthy you are the, the worse the outcome will be for you.
Now is the time to get healthy. Start exercising! No matter what you do, it’s better than nothing. Make small changes to our diet and finally start to sleep more. These simple things can help change your life and put you on the road to health. It might not stop you from getting COVID-19 but you’ll be better able to fight off the infection.
American Heart Association analyzed data from patients hospitalized with COVID-19 at 88 US hospitals enrolled in the American Heart Association’s COVID-19 Cardiovascular Disease Registry with data collection through July 22, 2020. BMI was stratified by World Health Organization obesity class, with normal weight prespecified as the reference group. They found:
“Obese patients are more likely to be hospitalized with COVID-19, and are at higher risk of in-hospital death or mechanical ventilation, in particular, if young (age ≤50 years).” say the study authors. “Obese patients are also at higher risk for venous thromboembolism and dialysis.”
If you need any help with your quest for health, call the office to make an appointment and together we can make a plan to improve your health. Now is the time to start so what’s holding you back? Pain? I can help with that as well!
Chiropractic is the best choice for drug free health care. The United States opioid epidemic is well documented. (1) Seeing a chiropractor is a great way to treat pain without pain medicine. Chiropractic care with a good home exercise program is a great way to treat most conditions. Throw in some movement correction and ergonomics now we’re talking about great care.
“Patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription.” Pain Medicine (2)
“Offering (chiropractic) services in primary care may help to address pain and disability, and hopefully limit external referrals, advanced imaging, and opioid prescriptions.” Journal of Primary Care & Community Health (3)
“Compared to patients with neck pain who saw a primary health care provider, patients with neck pain who initially saw a conservative therapist were 72%-91% less likely to fill an opioid prescription” Archives of Physical Medicine and Rehabilitation (4)
Here at Sikorsky Chiropractic we use adjustments, exercises, ergonomics, movement corrections to help patients become pain free.
Chiropractic first, medicine second , surgery last resort. We are always putting the patient first.
Whedon JM, Toler AW, Kazal LA, Bezdjian S, Goehl JM, Greenstein J. Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain. Pain Medicine. 2020 Mar 6. Link
Prater C, Tepe M, Battaglia P. Integrating a Multidisciplinary Pain Team and Chiropractic Care in a Community Health Center: An Observational Study of Managing Chronic Spinal Pain. J Prim Care Community Health. 2020;11:2150132720953680. doi:10.1177/2150132720953680 Link
Louis CJ, Herrera CN, Garrity BM, McDonough CM, Cabral H, Saper RB, Kazis LE. The association of initial provider type on opioid fills for individuals with neck pain. Archives of Physical Medicine and Rehabilitation. 2020 May 11. Link
Sitting all day in front of a computer can negatively effect your health. We sit much more than we have ever done. Sitting can effect your spine by placing pressure on the muscle, tendons, and disc. I see many patients who have pain from sitting in a bad position ( poor posture) all day.
Another way sitting effects our health is through muscle activity. When we sit our muscles turn off because the body is at rest. This leads to reduced muscle metabolism. This effects lipid (fats) and glucose metabolism and blood flow. Muscle required glucose and lipids to work.
Human physiology is not well adapted to prolonged periods of inactivity, with time spent sitting increasing cardiovascular disease and mortality risk. Health risks from sitting are generally linked with reduced levels of muscle contractions.
Standing some part of the day will help improve our health. When you stand it requires some muscle activation(contraction). Higher levels of muscle activation can improve your health.
In short, sitting all day can cause you to have poor posture and increase your risk of diabetes and heart disease.
A new study that looked at 216 people with COVID-19 found that 80 percent didn’t have adequate levels of vitamin D in their blood.
The study also found that people who had both COVID-19 and lower vitamin D levels also had a higher number of inflammatory markers such as ferritin and D-dimer, which have been linked to poor COVID-19 outcomes.
A different study found that COVID-19 patients who had adequate vitamin D levels had a 51.5 percent lower risk of dying from the disease and a significant reduced risk for complications.
Medical experts theorize that maintaining adequate vitamin D levels may help lower risk or aid recovery from severe COVID-19 for some people, though more testing is needed.
A Little Information about Vitamin D.
The major natural source of the vitamin D is synthesis of cholecalciferol (precursor to Vitamin D) in the lower layers of skin epidermis through a chemical reaction that is dependent on the SUN. Cholecalciferol is then convert to the active form of Vitamin D.
Did you know that Vitamin D is a hormone and not a vitamin. Hormones are chemicals that the body produces to control how the body is functioning. Hormone are signaling molecules that can turn on and off cells and organs .
Vitamin D is a hormone that controls blood calcium concentration and impacts the immune system. Many studies point to the beneficial effect of vitamin D on the immune system, especially regarding protection against infections.
Robust evidence suggests that vitamin D is protective against respiratory tract infections. Data from 25 randomized controlled trials from around the world demonstrate that daily or weekly supplementation of vitamin D reduced the risk of acute respiratory infection by more than 50 percent in people with low baseline vitamin D levels.
Low vitamin D levels have been associated with an increase in inflammation and can increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in COVID-19.
Having your Vitamin D levels tested is not a bad Idea. This way you wont be guessing on your levels. Once you know your levels it will give you a better understanding if you need to supplement with Vitamin D.
Ibuprofen is a common over the counter nonsteroidal anti-inflammatory drug (NSAID). It works by reducing hormones that cause inflammation and pain in the body.
Ibuprofen has many side effects such as stomach bleeding, and even increase your risk of fatal heart attack or stroke, especially if you use it long term or take high doses, or if you have heart disease.
These side effects and others are the reason someone should not take more than your recommended dose.
Here’s another reason not to take Ibuprofen. A study showed that ibuprofen use in men led to (i) elevation of LH; (ii) a decreased testosterone/LH ratio and, to a lesser degree, a decreased inhibin B/FSH ratio; and (iii) a reduction in the levels of the Sertoli cell hormone AMH. The decrease in the free testosterone/LH ratio resulted primarily from the increased LH levels, revealing that testicular responsiveness to gonadotropins likely declined during the ibuprofen exposure.
That sound pretty scary. A over the counter can effect a males sex hormones. What man wants lower testosterone?
If you have pain that requires taking over the counter medication pain killers for a long time , you might want to try so else. Chiropractic is a safe drug free approach. Call our office and make an appointment .
Decreased sleep duration is associated with obesity, diabetes and cardiovascular disease
Controlled laboratory studies have shown that decreased quantity and quality of sleep negatively affects glucose regulation and alters food intake and energy balance.
Experimental sleep restriction alone or in combination with misalignment, and decreases in sleep quality negatively affect glucose regulation. Sleep curtailment alters energy expenditure, weight regulation, gene-expression, and inflammatory cytokine levels.
Below is a cool chart from the study. It’s amazing what a lack of sleep can effect.
this image is from the study.
Besides eating right, exercising and chiropractic care, getting 7-9 hours of sleep a night is necessary for a healthy life style.
Wrist pain. Hand pain. Maybe you’ve felt this condition while sitting at the computer typing out work assessments, during a long session of playing video games, or swiping left or right on a phone or tablet screen repeatedly. Perhaps you lift weights and experience it in the middle of an intense workout, or while holding heavy construction tools. Whatever the cause may be, whether it’s from typing for long periods of time, holding a phone for a long time, or holding a jackhammer, the immediate conclusion people think of is a condition known as carpal tunnel syndrome.
But what is this syndrome? Is all wrist pain automatically carpal tunnel syndrome, or is it possibly something else?
Carpal tunnel syndrome (CTS) is an entrapment neuropathy.1 Think of a pinch in a hose line caused by stepping on it, and you can visualize a similar compression of the nerve as it travels down through the wrist and into the hand. The nerve, in particular, known as the median nerve, travels through a bony area in the wrist called – you guessed it – the carpal tunnel.
The carpal tunnel itself is a narrow passageway inside your wrist surrounded by bones and ligaments. Compression, or pinching, of the median nerve, can create symptoms including numbness, tingling, and weakness in the hand, wrist, and arm.2
Carpal tunnel is the most common of neuropathies, or nerve conditions, with over 90% of neuropathic cases being from carpal tunnel compression.1
Typing with poor wrist position is a cause of wrist pain.
Carpal tunnel can be caused by a variety of circumstances and conditions as well. CTS is more likely to occur in people who hold vibrating tools or work in an assembly line, engage in work that requires repetitive flexing of the wrist such as typing, take certain medications, have inflammatory conditions, or have poor wrist and hand ergonomics.2
The most common causes of carpal tunnel syndrome include genetic predisposition, history of repetitive wrist movements such as typing, or machine work as well as obesity, autoimmune disorders such as rheumatoid arthritis, and pregnancy.1 However, repetitive motions are a high-risk factor in developing carpal tunnel symptoms due to the repetitive activities inflaming the tendons that run through the carpal tunnel. This inflammation can lead to compression of the median nerve.3
Symptoms usually start gradually, in one or both hands during the night, with frequent numbness or tingling in the fingers.4 Some people report their hands and fingers even feel useless, clumsy, and unresponsive or even feel swollen, although little or no swelling is apparent!
Unfortunately, many cases of the wrist and forearm pain are automatically diagnosed as CTS without truly examining all possible causes of the pain, or even confirming if the painful condition is truly CTS.
The million-dollar question: Is every hand and wrist issue created by an issue with the nerve inside the carpal tunnel? The short answer: no!
Another condition, called Pronator Teres Syndrome (PTS), is very similar to CTS in the way it manifests. PTS causes similar sensations to carpal tunnel syndrome, including weakness, tingling, pain, and numbness.
However, Pronator Teres Syndrome is caused by a muscle in the forearm – it has nothing to do with the carpal tunnel in the wrist and hand!
Pronator Teres Syndrome describes a condition where the median nerve is also compressed, but the cause is distinctly muscular.5 The Pronator Teres muscle in the forearm becomes over-used: think of excessive repetitive motions involved in our usual activities of daily living. Maybe the repetitive motion is from an aspiring college tennis player perfecting her swing daily or someone who works in a kitchen, ladling soup, and washing dishes. Maybe it’s the guy who wants to Do-It-Yourself a new kitchen in his home, and he’s swinging a hammer to break up old kitchen fixtures. Whatever the repetitive cause, the same motions cause scar tissue, adhesions, or muscular restrictions to set up housekeeping inside the muscle and entrap the Median Nerve, causing forearm, wrist, and hand symptoms – much like CTS.
Both syndromes cause similar pain but must be treated differently to achieve the desired results. Imagine being treated for one condition with no change in pain and no results – when you actually have the other and need a different treatment altogether!
What can you do if you have wrist and hand pain? Your first line of defense is a physical examination of the hands, arms, shoulders, and neck by your trained chiropractic physician. He or she can help determine if the person’s complaints are related to daily activities, such as overuse or poor ergonomics, or due to an underlying disorder such as carpal tunnel or pronator teres syndrome.
Many cases of carpal tunnel can be treated conservatively or without surgical intervention. Splinting, changing your daily routine, chiropractic care, soft tissue work, and other forms of treatment exist that safely improve and resolve a painful wrist condition.4
In the meantime, if you’re suffering from wrist and hand pain and you’re waiting for your next doctor’s appointment, here are some basic, easy stretches you can do on your own. Remember, these are a method of prevention, not treatment for any wrist or forearm condition.
Perform each stretch to tolerance (meaning, don’t hurt yourself!) for two sets, with 15-second holds on each arm.
Wrist Flexor Stretch
Begin standing with your arm straightened in front of you at chest level, palm facing down.
Flex arm and stretch fingers down and back with the opposite hand.
Straighten arm while keeping tension on fingers.
Rotate arm by twisting fingers inward.
Thumb Flexor Stretch
Flex the arm.
Extend wrist back, allowing fingers to curl inward.
Stretch thumb back toward the arm.
Did you have fun with those stretches? Did they cause any discomfort, or did it feel good to stretch those hand and forearm muscles?
Keep in mind, there are other conditions that can affect the wrist, forearm, and elbow, and if you are having pain besides carpal tunnel and pronator teres muscles. We only addressed two common causes here. Your local chiropractor is well-versed in extremity conditions that can create discomfort and affect your ability to work and play.
References
Sevy, J.O., and Varacallo, M. (2020). Carpal tunnel syndrome. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Mar.
Far too often in today’s healthcare system, patients are being let down by their healthcare providers. As the patient, you deserve to be guided back to health appropriately and efficiently. Too many injured and ailing people are not being thoroughly evaluated, therefore not receiving appropriate conservative care, nor are they given a game plan to prevent the pain or injury from returning in the future. There are many types of ailments and illnesses, but for the purpose of this article we will be discussing musculoskeletal pain and injuries.
There are 3 fundamental aspects of care you deserve as the patient
Comprehensive Evaluation and Assessment
Conservative Treatment Options
Prevention Training
Comprehensive Evaluation and Assessment
Too often a patient presents to their primary care physician or specialist and they are given a proper history and consultation, but a very low-level musculoskeletal exam. Many times, the doctor doesn’t even assess the muscle tissue, joint function and/or the movement of the patient. In many cases they perform a few orthopedic tests, may refer you for some diagnostic imaging, before concluding that you must rest for 6 weeks and finally prescribe you some medication to help “manage” your condition.
As a patient it is important to understand what you should expect from a comprehensive evaluation and assessment. Your evaluation and assessment should provide you with a working diagnosis and the potential indirect causes of the pain or injury. The diagnosis should be specific and clearly communicated.
In order to determine an appropriate working diagnosis a comprehensive evaluation should include, but is not limited to:
A thorough History & Consultation
Functional Assessment: Assessing weakness, tightness, faulty movement patterns.
Orthopedic Exams, Range Of Motion, Neurological testing as needed.
Muscle and Joint Palpation/Testing.
Gait Analysis (if deemed necessary)
When a thorough evaluation and assessment is performed it provides the healthcare provider with the information required to determine the appropriate course of care. This allows for an informed decision regarding which conservative treatment options would be best suited for your individual case.
Conservative Treatment Options
In my opinion, you deserve to have a comprehensive hands-on approach to your pain or injury. Most patient presentations respond best to a specific combination of therapies. This may include muscle therapy, joint restriction chiropractic adjustments, rehab exercises, and advice on how to train and prevent further exacerbations of the injury. You may not need both the muscle therapy and chiropractic adjustment for all pain or injuries, but many will optimally benefit from all four approaches above.
Conservative treatment should not be a “one size fits all” approach. With multiple therapies available, each which targets different tissues it is important that your care plan is individualized based on the findings from your comprehensive assessment.
Prevention Training
There are few things more frustrating from both the patient’s or doctor’s perspective than the return of the pain or injury. There are many potential factors that can contribute to re-aggravation of your injury or symptoms. These include over-use strain from work, life or sport, not following the prescribed exercises, or the lack of injury prevention training from your healthcare provider. As an informed patient, these are a sample of some prevention options you should expect instructions on.
Activities of Daily Living Training: Many activities we do in our daily life cause physical strain when performed improperly.
Return to Work/Sport Advice: Proper time frame for return and potential modifications.
Body Awareness and Preparation: Proper lifting, bending, posture, etc.
Corrective Exercises: Core stability exercises.
Desk Ergonomics Tips: Desk sitting is causing many of your conditions.
Proper Equipment recommendations: Proper running shoes for a runner.
Skills/Technique Training: Golf swing technique from a teaching professional.
To summarize, there are many potential shortcomings that you may experience when you see any healthcare provider for your musculoskeletal pain or injury. The first step is being an informed patient, and understanding what quality care entails. I have outlined some key points that you as an informed patient should come to expect from your provider when you seek treatment for any musculoskeletal condition.
A comprehensive assessment including but not limited to a thorough history, a functional movement assessment, palpation (assessing by hand) of the joints, muscles, tendons and ligaments
An exam that assesses the body as a whole in order to determine the root cause, and does not only focus on the point of pain. For example, many times a patient with low back pain has hip range-of-motion and mid-back mobility issues that have led to the low back being over-worked.
A specific working diagnosis based off of the comprehensive exam.
All your conservative treatment options should be explained and discussed, offering you a chance to ask any questions you might have and provide clarity regarding our plan.
You should expect to receive advice regarding preventative care for your injury, so once you are out of pain, you can avoid re-injury or aggravations.
Neck pain and Headaches are a very common issue in our
society, and understanding the causes and prevention of them will go a long way
to leading a healthy and pain free life. In this educational summary, we
discuss some of the most common conditions we see in our office. Below we will
discuss the following neck-related pain conditions.
Upper Crossed Syndrome
Headaches
Neck Sprain/Strain
Disc Pain
Cervical Radiculopathy
TMJ Dysfunction
Potential causes of
Cervical Discogenic Pain Syndrome
Direct trauma – falls, motor vehicle accident, whiplash, sports injury
Overuse, fatigue, repetitive microtrauma – over hours, days, months of the same position
Postural – can be either an intrinsic postural problem (e.g. loss of cervical curvature) or an extrinsic postural problem (e.g. prolonged stressful position, protruded head posture).
Sudden unguarded movement.
Degenerative disc disease.
Photo by cody berg This workstation is not set up correctly
Symptoms of Cervical Discogenic Pain Syndrome
The symptoms will vary
depending on whether the condition is caused by a herniated disc or by a
degenerative disc. With a herniated disc, some people will not experience pain
in the neck but will have radiating pain, tingling, and numbness down the arm or
around the shoulder blade due to pressure put on the nerve root. Discogenic
pain due to an injury can result in immediate pain or pain shortly after the
injury. Headaches (usually cervicogenic)
can also result from cervical disc pain.
Treatment of Cervical
Discogenic Pain Syndrome
Treatment for cervical discogenic pain will depend on the clinical
presentation. Conservative treatment can successfully manage many cervical disc
herniations. Initial treatment will focus on controlling pain and inflammation.
Once pain and inflammation have
decreased, early rehabilitation will help prevent chronic pain and disability. This will consist of osseous manipulation, soft
tissue therapy, activity as tolerated, and pain-free
range of motion exercises. Late rehabilitation will be administered as the condition improves and will include
stabilization exercises, patient education, and postural training. Education in
proper training, biomechanics, and a home exercise program will help strengthen
the spine and decreases the likelihood of future injury. If you fail to respond
to conservative treatment, or in cases of severe pain, diagnostic imaging
(x-ray, MRI) will be warranted, and an
orthopedic consult may be necessary.
Cervical Radiculopathy
Cervical Radiculopathy is a
dysfunction of the cervical nerve roots resulting in various neurologic
findings. The cervical spine consists of seven cervical vertebrae and eight
cervical nerve roots. Cervical radiculopathy can result in pain, numbness, or
weakness and though the problem occurs at the nerve root of the cervical spine,
these symptoms will often radiate to parts of the body controlled by that
nerve. The seventh (C7) and sixth (C6) cervical nerve roots are most commonly
affected.
In younger patients,
cervical radiculopathy is usually the result of a disc herniation or an acute
injury causing foraminal impingement of the exiting nerve. In the older
population, cervical radiculopathy is usually due to foraminal narrowing from
osteophyte formation, decreased disc height, or degenerative changes. In
elderly patients with osteophyte formation, repetitive neck movements may
result in a more insidious injury. Cervical radiculopathy due to sports
injuries can result from several mechanisms. Typical these injuries occur from
forced extension, lateral bending, or a rotation mechanism, which closes the
foramen and results in the exiting nerve root being
injured.
Risk Factors for Cervical
Radiculopathy
Heavy manual labor requiring lifting more than 25 pounds (especially repetitive activity)
The condition may follow a neck injury or be of insidious onset, and there may be a history of multiple episodes of previous neck pain or arthritis of the cervical spine. The pain may range from deep aching to severe burning neck pain. Usually, the pain will be referred to the shoulder blade, which might be described as shoulder pain. If the radiculopathy progresses, radicular arm pain (“sharp, shooting, electrical”) or sensory changes (“numbness, tingling, loss of sensation”) may develop down the arm and into the hand. Arm symptoms will depend on which nerve root is involved. Occasionally, a motor weakness may develop of the shoulder or arm. Certain neck positions which cause increased foraminal narrowing may increase the pain. The symptoms may be relieved by lifting the arm over the head which decreases the tension at the nerve root.
Treatment of Cervical
Radiculopathy
Initial treatment will
focus on reducing pain and inflammation and prevention of further neurological
loss. The focus will also be on centralizing (reducing) any radicular symptoms
by decreasing nerve root compression and pressure within the herniated discs. This will consist of manual traction and pain-free active non-resisted ranges of motion
while avoiding positions that increase neck and
arm symptoms. A cervical pillow at night can be helpful in maintaining the neck
in a neutral position and limiting head positions that cause foraminal
narrowing. Electrotherapy modalities may be used to help reduce any associated
muscle pain and muscle spasms. Once pain and inflammation have decreased, therapy will progress to
restore full range of motion and mobility of the neck and shoulder. This will include muscle stretching,
strengthening and proprioceptive training, and corrective exercises as
tolerated. Cervical manipulation and soft tissue therapy may be administered as tolerated and as long as it
does not cause an increase in symptoms. If you fail to respond to conservative
treatment, or in cases of severe neurological loss, a secondary consultation
with a neurologist or neurosurgeon will be
recommended.
TMJ Dysfunction
“I’ve got TMJ” It’s a pretty common statement which is a bit of a misnomer. Everyone has TMJ. Why? The TMJ is the tempo-mandibular joint(TMJ). We all have it. What people are probably trying to say is that they have TMJ disorder, aka pain and dysfunction of the jaw while opening or closing your mouth.
What happens is the mandible (your jaw) connects to the rest of your head at the temporal bone. It’s a hinge joint that pivots through a cartilage disc called a meniscus in between the two bones of this joint. Unfortunately, it’s a common place for the TMJ to become subluxated or in other words, a little bit dislodged. After that, you can get overuse and degeneration of that joint. One way to tell if you have this disorder is to open your mouth and measure, can you open your mouth the height of 3 fingers for your hand? If not, you might have TMJ disorder.
The
main physical causes of this condition are:
trauma
overuse
from a commonly chewing on one side of
your mouth
keeping
the mouth open for extended periods of time (like at the dentist)
improper
bite
grinding
From a physical standpoint, the best way to prevent TMJ disorder is to wear proper mouthpieces while playing sports, wearing mouth guards while sleeping, making sure to chew food evenly on both sides of your mouth, cutting tough meats and other foods into small pieces and minimizing gum chewing. Having better posture also improve the alignment of the TMJ.
Is forward head posture relevant to autonomic nervous system function and cervical sensorimotor control?
Forward head posture can lead to many things! Besides looking bad it can cause such things as headaches, neck pain, shoulder pain as well as TMJ problems.
Highlights from the study show:
Forward head posture negatively affects cervical sensorimotor control.
Forward head posture negatively affects the autonomic nervous system.
There is strong correlation between the Craniovertebral angle (CVA) and cervical sensorimotor outcomes.
There is strong correlation between the Craniovertebral angle (CVA) and cervical sensorimotor outcomes.
There is strong correlation between the Craniovertebral angle(CVA) and skin sympathetic outcomes.
Here’s a picture of forward head posture or a poor CVA. The picture to the left is the worse CVA. The one on the right is very good posture.
the picture
CONCLUSION:
“We have identified a forward head posture is associated with abnormal autonomic nervous system function and disturbances of cervical sensorimotor control. This finding has important implications for the assessment and rehabilitation of these subjects.”
If you need help with your posture contact the office! We can help!
