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.
Migraines are a common head that effects, about 6% of men and 18% of women get a migraine in a given year, in the united states.
1. Manual Therapy
Spinal manipulation is a useful tool in migraine prophylaxis. One study demonstrated a “significant reduction” of migraine intensity in almost half of those patients receiving spinal manipulation. Nearly ¼ of migraine patients reported greater than 90% fewer attacks. Spinal manipulation has demonstrated similar effectiveness but longer-lasting benefit with fewer side effects when compared to a well-known and efficacious medical treatment (amitriptyline).
Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impactof Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link
Chaibi A, Benth JŠ, Tuchin PJ, Russell MB. Adverse events in a chiropractic spinal manipulative therapy single-blinded, placebo, randomized controlled trial for migraineurs. Musculoskeletal Science and Practice. 2017 Jun 1;29:66-71. Link
A Harvard study found that SMT significantly reduced migraine days as well as pain intensity. And SMT is safe; a study to define adverse events following chiropractic spinal manipulation for migraines found that “adverse events were mild and transient, and severe or serious adverse events were not observed.”
1. Acupuncture
Several recent studies have shown that acupuncture is another viable tool for managing migraines.
Vázquez-Justes D, Yarzábal-Rodríguez R, Doménech-García V, Herrero P, Bellosta-López P. Analysis of the effectiveness of the dry puncture technique in headaches: systematic review. Neurology. 2020 Jan 13. Link
Xu S, Yu L, Luo X, Wang M, Chen G, Zhang Q, Liu W, Zhou Z, Song J, Jing H, Huang G. Manual acupuncture versus sham acupuncture and usual care for prophylaxis of episodic migraine without aura: multicentre, randomised clinical trial. BMJ. 2020 Mar 25;368. Link
Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2019 Apr;59(4):532-42. Link
2. Eat Smart & Maintain an Ideal Weight
Dietary fats trigger the synthesis of prostaglandins which are known migraine triggers (19). Low-fat diets have been shown to play a role in migraine prophylaxis. (20,21) Weight loss may decrease the frequency of migraine and other primary headaches (tension, cluster). (16-18) Patients on a low sodium (DASH) diet report a decrease in headache frequency vs those on a high sodium diet. (23) One new study showed that “adherence to the Harvard Healthy Eating Plate advice, particularly the reduction in carb, red and processed meat consumption, is useful in migraine management, reducing migraine frequency and disability.” (47)
3. Drink Water
Drinking more water and drinking less soda and sugar beveragesis all ways a good idea. . A study published earlier this month, showed “The results showed that the severity of migraine disability pain severity headaches frequency and duration of headaches were significantly lower in those who consumed more total water.” (Khorsha F, Mirzababaei A, Togha M, Mirzaei K. Association of drinking water and migraine headache severity. Journal of Clinical Neuroscience. 2020 May 20. Link)
4. Vitamin D
Vitamin D is important hormone in the body. that right its a hormone and is involved in many different processing the body. Vitamin D deficiency is associated with migraine attacks. Vitamin D supplementation in a dose of 1000-4000 IU/d has been shown to reduce the frequency of migraine attacks.
owaczewska M, Wiciski M, Osi?ski S, Kamierczak H. The Role of Vitamin D in Primary Headache–from Potential Mechanism to Treatment. Nutrients. 2020 Jan;12(1):243.
Ghorbani Z, Togha M, Rafiee P, Ahmadi ZS, Magham RR, Djalali M, Shahemi S, Martami F, Zareei M, Jahromi SR, Ariyanfar S. Vitamin D3 might improve headache characteristics and protect against inflammation in migraine: a randomized clinical trial. Neurological Sciences. 2020 Jan 2:1-0.
5. B Vitamins
Riboflavin (Vit B2) may help prevent migraines. (26, 29-38) Dosage recommendations vary, however, the average dose used in the studies was 400mg/day. Vitamin B6 supplementation (with or without concurrent B9 and B12) has also demonstrated prophylactic benefit.
Maizels M, Blumenfeld A and Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: A randomized trial. Headache 2004; 44: 885–890.
Smith C. The role of riboflavin in migraine. Can Med Assoc J 1946; 54: 589–591.
8. Magnesium (400-600mg)
Magnesium a mineral that can help with headaches. Magnesium play a role in energy production , bone formation, nerve function and blood vessel function. An umbrella review found strong evidence that “Magnesium supplementation can reduce the intensity/frequency of migraine.” Dosage recommendations vary, however, the average dose used in the studies is 400-600mg/ day for the prevention of migraine in non-pregnant patients.
Ko¨seoglu E, Talaslioglu A, Go¨nu¨l AS, et al. The effects of magnesium prophylaxis in migraine without aura. Magnes Res 2008; 21: 101–108.
Esfanjani A, Mahdavi R, Ebrahimi Mameghani M, et al. The effects of magnesium, L-carnitine, and concurrent magnesium-L-carnitine supplementation in migraine prophylaxis. Biol Trace Elem Res 2012; 150: 42048.
Peikert A, Wilimzig C and Ko¨hne-Volland R. Prophylaxis of migraine with oral magnesium: Results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia 1996; 16: 257–263.
10. Melatonin (2-3mg)
Melatonin is a important hormone release by the brain during sleep. Melatonin should be taken 30 minutes before bed. One systematic review and meta-analysis concluded: “Melatonin may be of potential benefit in the treatment‐prevention of migraine in adults.” Study doses varied widely (0.05-50mg), however, the typical dose used in the studies was 2-3mg, taken before bedtime. Liampas I, Siokas V, Brotis A, Vikelis M, Dardiotis E. Endogenous Melatonin Levels and Therapeutic Use of Exogenous Melatonin in Migraine: Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain. 2020 Apr 30.
Suffering from migraines? Make an appointment to get started on the road to relief!
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.
A new study found that diabetes was associated with a 51% increased risk of dementia but exercise was associated with a dose-dependent decrease.
Exercise 3‐5 days/week was associated with a 37% lower dementia risk and >5 days/week was linked to a 59% lower risk of dementia (compared to on exercise).
This was an observational study which means causation cannot be established. However, meta-analyses of randomized controlled trials have found the benefits of regular exercise on cognitive function. The dose-dependent effect on lower dementia risk also strengthens the data.
Upper Cross Syndrome describes a type of common muscle imbalance.
This occurs when the neck flexors and the middle back become weak while the pectoral muscles and the muscles at the base of the skull become tight. This produces a familiar pain pattern at the base of the neck and the shoulders, as well as joint dysfunction at the base of the skull and shoulders.
Upper Cross Syndrome can lead to neck pain.
The main physical causes of this condition are:
Desk job
Too much sitting
Driving long hours
Poor posture
Working out incorrectly
How many hours a day do you sit in front? Photo by subham saha
However, with the proper education, you can protect yourself from many of these causes. The primary sufferers of this condition, especially chronic cases, often have poor posture while sitting at a desk for most of the day. A co-morbid factor is a sedentary lifestyle with little physical activity. This poor sitting posture leads to a re-enforcement of the Upper Crossed Syndrome, and it is crucial that you arrange your workstation to facilitate a proper posture as best as possible.
The best way to combat this problem is, of course, to prevent it before it starts.
If possible, minimize sitting for long periods of time and take frequent work breaks to take short walks around the office to reset your posture.
There are methods of rehabilitative exercise that can be taught to you to reverse any damage already done and prevent a progression of this condition, as well as instill healthy habits for you to employ for the rest of your life.
What You Can Do About It
If you are currently experiencing neck pain that you may believe is related to Upper Cross Syndrome, this condition can be conservatively managed relatively quickly. Make an appointment today and get on the road to recovery.
Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? The short answer is YES.
Anyone with Osteoarthritis in their knees knows how it can limit their life. For one example walking could become difficult and painful.
A study from the British journal of sports medicine has found strengthening the hips muscle can help with knee osteoarthritis.
Walking improved after the addition of hip strengthening to quadriceps strengthening in people with knee Osteoarthritis. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function
simple but effective hip exercise
Key points
Land-based exercise reduces pain and improves function in people with knee osteoarthritis (KOA) over the short to medium term.
People with KOA have weakness in hip abduction is (7%–24% weaker than control patients).
Hip abduction strength is positively related to function in people with KOA.
Hip strengthening is beneficial compared with non-exercise interventions in people with KOA.
Hislop AC, Collins NJ, Tucker K, Deasy M, Semciw AI. Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine. 2020 Mar 1;54(5):263-71. Link
Running has become one of the most common forms of physical activity in today’s society. It can be a community building activity, a personal challenge and most importantly a great work out. It is a sport that everyone can participate in; all you need is a good pair of shoes and a little motivation. That being said running can be extremely hard on your body, especially when you are just starting. We are finding that injuries among runners are very common. From shin splints to rolled ankles, no one is immune from getting hurt; however, here are some tips to keep you healthy and on pace.
Photo by RUN 4 FFWPU
Do not do too much, too fast
When runners are just starting and begin to make progress, they tend to push their limits. Although this is a great way to challenge yourself, it is important that you understand your body has a threshold that when exceeded results in injury. Your mileage should be tracked on both a daily and weekly basis. If you have never done much long-distance running, then your weekly mileage should begin quite low. It is important that as you improve your mileage increases gradually. A consensus among the running community is the rule of 10%. Do not increase your mileage by any more than 10% on a week to week basis. For many runners and new runners specifically, 10% may even be too much of a jump. This is why when preparing for a distance race, whether it is a 10k, half marathon or a marathon it is recommended you start as early as possible. Could you train and complete a half marathon in 6 weeks? Maybe, but the toll it could take on your body and the injury risk you are exposing yourself to are likely not worth it. A recent study showed that runners who only increased their mileage by 3% a week had a much higher rate of success in their upcoming races than runners who ramped up their mileage quicker.
So how do you know where to start? First, start with walking. If you can walk an hour a day with out any injury you may start running. As a new runner, start with short runs and accumulate miles over the week. It is important to understand how far you have been running, so I recommend using an app on your phone such as “Map My Run” to help track each run. Personally I have a Garmin GPS watch , that links to Garmin connect. Garmin connect is an app. Most GPS watches can be linked to an app.
Photo by Mateusz Dach
Do not run through significant pain
As runners, we all understand some discomfort is a part of the sport. Your legs and feet will likely be sore after a long run; however, if you begin to notice significant pain or discomfort while running consider taking a break. Breaks are one of the hardest things to convince a runner of doing, but it could save you from more severe injury. Aside from the odd rolled ankle, very few running injuries are acute and traumatic. Far more commonly runners ignore the pain and “tough it out” when they begin to feel discomfort.
This can result in a cumulative injury cycle. What is that you might ask? It means if you continue to stress an injury by running, you will continue to make it worse and it can become a much more significant issue. Sometimes all it takes is an extra day off when symptoms are minor to allow your body to recover. This is important because if you have an injury, it is very common for your body to adapt by altering your gait (running pattern).
This may lead you to be less efficient, develop bad habits or in a worst-case scenario cause an injury elsewhere in your body. Remember, everything is connected, so if you are running with a limp the biomechanical stresses will be placed on a different part of your body. Give your body a chance to recover and if you think that an injury is nagging have a medical professional look at it. It is much more beneficial to have an injury taken care with a couple of sessions of treatment rather than letting it persist and having to deal with it when it is much more serious, and your recovery time is extended.
Photo by RUN 4 FFWPU
Call the office if you’re having pain. Do not tough it out! It could only get worse. We work with a lot of athletes and help them return to activity. Athletes looking to prevent injuries or perform better see us.
Move in every aspect of your life, at home and work
Set the alarm every hour to perform some movement. 3-5 minutes in length.
Place a Lacrosse Ball under your legs, top of legs, between shoulder blades while at the desk.
Light dumbbells at your desk for fitness snacking throughout the day.
Park at the farthest spot away to get more walking throughout the day.
Walking meetings are a great way to get movement and productivity.
Seated Exercise throughout the day three times per work day minimum.
Seated Cat and Cows
Seated Twists
Neck Ranges of Motion
Shoulder Rolls
Find an accountability buddy.
Strategically plan your traveling to take your workouts with you.
More people are working from home now more than ever. If you are experiencing pain since this big change please give our office a call. We are here and ready to help!
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.
Dr. Steve Sikorsky | Chiropractic Care Elgin, Illinois
