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Pain and self treatment: When pill-popping becomes dangerous.

A recent article in Fitness magazine touched on a trend that has become more and more common- over-the-counter (OTC) pain medications taken with the misconception they are risk free.  OTC pain relievers such as ibuprofin (advil or motrin), naproxen (aleve), and acetaminophen(tylenol) are taken by an estimated 175 million Americans yearly and can cause real damage when taken incorrectly.

Overuse of NSAIDS (nonsteroidal anti-inflammatory drugs) can cause bleeding ulcers, may increase blood pressure, and can cause kidney problems.  Acetaminophen may lead to liver failure.  Many individuals take these OTC drugs prior to a workout to mask pain, any may be unknowingly injuring themselves by pushing through pain caused by serious problems like muscle tears and ligament sprains.  Plus, NSAIDS like ibuprofen block the production of enzymes that repair tissue, and may delay healing following an injury.  It is also important to stress that OTC drugs have never shown scientific evidence of prophylactic (preventative) benefits.

While there are negative side effects associated with OTC drugs, they can be helpful in short-term situations when taken at the appropriate dosage.  You should always check with your doctor if you question the appropriate amounts, as your activity levels and other medications will influence the reactivity of the drugs. 

For those that choose to avoid pain medication at all costs, there are some natural ways to ease those aches and pains.

1. Fish oil supplements. Omega-3 fatty acids are one of the most effective supplements on the market today for a couple of reasons.  They have a natural anti-inflammatory property that may reduce pain and inflammation while supporting cardiovascular function.  A good quality fish oil supplement will improve your health and carries a low risk of adverse reactions.

2.  Glucosamine. This is a naturally occurring compound that helps prevent joint degeneration, and some studies have shown it to ease inflammation and joint swelling as well as ibuprofen.

3. Ice.  It may seem brainless, but ice is the best remedy for activity induced pain.  Applying ice immediately following activity will prevent inflammation from building in the area, and will almost always decrease pain after the fact.  You will initially feel the muscles tighten, but will likely wake with much less pain the next morning.

4. Heat.  It’s the most common question I get in my office.  “Which is better, ice or heat?”  My general rule is as follows: Ice 10 minutes on/20 minutes off 3-6 times per day for the first 72 hours post injury to decrease inflammation.  Once the initial injury has subsided, it is a good idea to alternate heat and ice to increase circulation to the injured area, always finishing with ice (think 4-6 times alternating 10-20 minute intervals).  If the injury is chronic and seems to be caused from tight muscles, heat will help increase blood flow to the area and may help with tension related pain.  A hot shower or bath followed by light stretching is a great way to use heat as a treatment.

5.  Sleep.  This is when your body repairs itself, and without it your body can stay in a chronic state of inflammation and pain. 

6.  Last but not least, do not forget the power of hydration.  Anytime you have an injury, whether minor or major, your body needs extra water to flush waste out as the body heals.  Aim to drink half your body weight in ounces as a baseline, adding more depending on your activity level or where you live (dry climates create a need for more water).

Circulation and chiropractic

You know how important it is to take care of your skin, especially here in Arizona.  Sunscreen, water, exercise, and good nutrition are a vital part of keeping your skin safe, but your circulation has the biggest job of all: delivery of nutrients and detoxification your body!  In order for your body’s circulation to remain un-interrupted, we need to look a little deeper at movement. 

We’ve all had that pins and needles feeling when we’ve slept on our arm a little funny, only to find that moving the arm restores all feeling and takes away the odd sensation within a few minutes.  Why does this happen?  You’ve restored circulation to the arm!  Now imagine a tight muscle or bony structure causing compression on a nerve leading to that arm.  Try as you might, shaking your arm probably won’t help much because the problem is compression in your neck or shoulder region.  It is likely you will feel a little restricted in the area as well, although nerve compression can occur independent of interrupted range of motion.

Chiropractic adjustments remove this interference, restoring nerve flow to the arm and allowing you to use it pain free.  The same is true for any part of your body that is supplied by a nerve…which is virtually all of you!  Keep your body working at 100% and PREVENT pain from occurring with chiropractic.

Discover a Healthier You!
Dr. Bobbie
BodyWise Chiropractic

Chiropractic-it’s not just for spines!

When I speak to people about chiropractic, a common remark is “Well, I don’t have any back pain, so I don’t need chiropractic!”.  While most people initially present to my office for a pain of some sort….neck pain, back pain, or headaches, they are surprised to find that chiropractic can benefit you in many more ways.

1. Chiropractic care is not just for your spine.  I commonly work on shoulders, elbows, wrists, hips, knees, and ankles, and find that not only does it help decrease tension in your back, it also makes you more efficient during your activities of daily living.  Increased range of motion means less discomfort when working, exercising, or relaxing.

2. It’s not about a “quick crack”.  When you get an adjustment, the joint may release a gas that makes a popping noise when making contact with the rest of your bodily tissues.  I recently had a patient that claimed to be afraid of chiropractic because of the noise, but once she found out it is just a gas release was much more comfortable with the idea.  The purpose of a chiropractic adjustment is to restore motion to a joint that isn’t moving correctly, thus restoring nervous input to the entire body.  The sound is just a side effect that may or may not occur with the adjustment.

3. Many times an adjustment isn’t enough.  I find this to be especially true when working with the extremities, thus generally do some soft tissue therapy along with the adjustment.  This soft tissue treatment is different than a massage in that it is very specific to the area in need.  Many times stretching the area also helps to enhance the benefit from a chiropractic adjustment.

4. Chiropractic is a great tool to have in your wellness plan.  By combing exercise, healthy eating, chiropractic care, and plenty of rest, you’ll find you feel and look your best!

The rotator cuff-part II

A rotator cuff injury includes any type of irritation or damage to your rotator cuff muscles or tendons. Many times the cause of a rotator cuff injury includes lifting or repetitive arm activities — especially those done overhead, such as throwing a baseball or placing items on overhead shelves. While these activities many times see more immediate pain, patients more commonly present to my office with shoulder pain that came on slowly. Many times the particular activity that aggravated the shoulder isn’t obvious. Because of this, these injuries are harder to treat as the patient doesn’t know which activity to stop during treatment. Here are some activities that commonly lead to a repetitive injury. 1. Working with a mouse. While most assume carpel tunnel is the only injury related to mouse work, this couldn’t be further from the truth. The right shoulder is forced to round forward if your workstation isn’t set up to accommodate for your size. I find that employees are placed in cubicles that are termed “one-size fits all”, and either can’t reach the floor or can’t rest their lower back on the chair while typing or using the mouse. Due to this increased stress is placed on the shoulders and upper back and over time can lead to overuse injuries such as tendonitis or bursitis, commonly known as inflammation of the tendons or bursa in the shoulder. Muscles attach to bones via tendons, so increased tension in the muscles is a common predecessor to tendonitis. This can be avoided by taking time to stretch throughout the day. If you work in a large company, they may have an ergonomics expert available to come evaluate you in your workstation. 2. Heavy lifting. Most people are aware of proper lifting techniques to avoid a lower back injury, but may not realize that safe practice for the shoulders is also essential. Carrying a box closer to your core places less stress on your shoulders. Getting assistance from a coworker when lifting something high decreases your chance of injury. This also decreases the chances you will injure your neck due to increased strain. A strain or tear may be the result of lifting something too heavy. 3. “Weekend warrior syndrome” While I support all attempts at fitness and improving health, there are some restrictions that need to be kept in mind when it comes to working out. If you are extremely busy during the week and can only fit workouts in on the weekend, don’t attempt to fit a week’s worth of exercise into 2 days unless you want to risk injury. A simple solution is to squeeze in some pushups or simple exercise moves such as squats or lunges into your routine during the week. Squats while brushing your teeth, lunges when picking up the house, or abdominal exercises while watching television all take no extra time, but can help you improve your strength and decrease the chances of injury when you do have time to get to the gym. So what else can you do when stretching or icing isn’t enough? Check back next week for the treatments that see the best results in my office when it comes to shoulder pain.

The Rotator Cuff-Part 1

You know where it’s located, but do you really know what your rotator cuff does? In this 3 part blog, I’m going to explain the makeup of the shoulder joint, talk about some common ailments seen in my office concerning the shoulder, and finally inform you on different treatment modalities available if you or someone you know has shoulder dysfunction.

The rotator cuff is comprised of 4 different muscles that work to stabilize the humerous (your upper arm) inside the glenohumoral joint (shoulder). Picture the glenoumoral joint as a golf ball sitting on a tee, as it depends on muscles rather than ligaments and bones for stability and movement. These muscles all have their origin on the scapulae (shoulder blade) and insert, or attach, on the humerous. In addition to stabilizing your shoulder joint, they also help elevate and externally rotate it. The muscles and their tendons form a “cuff” over the upper end of the arm.

Symptoms of a rotator cuff injury or overuse may develop immediately after trauma, such as a fall on an outstretched arm or a lifting injury. Many times a sudden acute pain and snapping sensation accompany the injury, and are followed by muscle weakness. Symptoms may also develop gradually with long-term wear or repetitive activity. The pain will generally begin with overhead activities, but may become more noticeable at rest as time goes on. Sleeping on the affected side often becomes uncomfortable.
Individuals that are at a higher risk of getting an overuse injury of the rotator cuff may be involved with baseball, tennis, or weight lifting as these activities utilize repetitive overhead motions.

Next week’s blog will go into more detail on the more common repetitive or acute injuries of the shoulder seen in my office.

Costochondritis-a benign cause of chest pain

To explore the topic of heart health this month, I’d like to touch on a topic that isn’t well known among the general population. Costochondritis is a benign cause of chest pain, and is more common than you think. In fact, it is one of the most common reasons for chest pain in both men and women. Costochondritis is defined as inflammation of the cartilage connecting the ribs to the sternum, or breastbone. It can cause sharp pain on either side of the chest, and may radiate into the shoulder or arm on the same side. You may also notice a discomfort when taking a deep breath or coughing. While the symptoms can be quite frightening, the reason costochondritis comes on is less clear. A physical injury or fall on the area, a recent infection, or excessive coughing or sneezing may be to blame. Many times the rib itself is out of alignment (a rib subluxation) causing increased inflammation with each breath in and out.

The treatment for costochondritis can vary from icing the area to getting a chiropractic adjustment to the rib and accompaning vertebra that is out of alignment. The adjustment can be a bit uncomfotable, but the relief is generally instantaneous if this is the cause of the irritation. The treatment of ice will calm down the inflammation and allow you to heal with less pain.

Disclaimer: Chest pain is an emergency. All chest pains and concerns should be reported to and checked out by your physician. This article is meant to be purely educational and does not replace a visit to your physician.

Stress and your body

Stress is a dangerous thing.  While you all agree that stress isn’t optimal, most of you wouldn’t suggest it to be dangerous.  According to Merriam-Webster, the definition of dangerous is: 1 : exposing to or involving danger 2 : able or likely to inflict injury or harm.  As a chiropractor, I see injury caused by stress daily.  Headaches, neck tension, lower back discomfort, and arm pain are only a few things that we can trace back to stress when searching for their cause.  Stress has been declared a hazard of the workplace by Occupational Safety and Health Administration (OSHA). Why? Stress costs American industry more than $300 billion annually.  Yikes.  So what can you do to decrease the stress in your life?

One way is to try chiropractic.  Chiropractic, you ask?  But I wasn’t in an accident!  This misnomer is one reason chiropractic isn’t sought after for common stress causing ailments.  Chiropractors work primarily with the spine, the root of the nervous system through which nerve impulses travel from the brain to the rest of the body. One effect of chronic stress is prolonged muscle tension and contraction. This muscle tension creates uneven pressures on the bony structures of the body, often leading the misalignment of the spinal column, known as subluxations in the tradition of chiropractic.

Chronic stress also leads to nerve irritation. The adjustments of a chiropractor release muscle tension, and that helps the body return to a more balanced, relaxed state. Adjustments also reduce spinal nerve irritation, and improve blood circulation. These changes may be enough, in many cases, to convince the brain to turn off the fight or flight response, beginning the process of healing. A healthy and balanced spine is one key to effectively managing stress.

While chiropractic cannot make a job less stressful, or create a quieter, calmer world, a chiropractic treatment can help you develop healthy responses to stress, reducing potential physical damage.

Chiropractic is based on the concept that given the opportunity, the mind and body can heal itself. In relieving some of the effects of chronic stress, chiropractic care provides just such an opportunity.

Every runners nemesis: ITB Syndrome

If you’re a runner, you may have experienced these familiar symptoms:  a few miles into a run the lateral hip or knee begins to hurt, many times forcing you to cut the run short.  You stretch, and stretch, and stretch…but nonetheless the pain comes back your next trip out to pound the pavement.  What gives?  The iliotibial band, or ITB, is a band of connective tissue that starts at the ileum (top) of the pelvis and travels the outside of the leg, inserting just below the knee in the tibia (shin bone). If it is tight it rubs on bony prominences, either at the knee or at the hip area. Treatment is easy on paper: stretching with use of a foam roller or the stick and this gets better. Sometimes overpronation stretches the ITB during the swing phase of running gait and then it contracts tighter when you land. (Think of a rubber band when you stretch it then let go: it becomes shorter.) In this case an orthotic can be useful, decreasing the pain by correcting for over pronation.

So why doesn’t stretching in itself take care of the problem?  The problem lies in the makeup of the ITB.  Connective tissue has a different function than muscle in your body, primarily present to cover muscles to allow gliding over one another with movement.  The ITB is actually an extension of a muscle, the tensor fascia latae (TFL), and many times is not actually stretched in itself.  While stretching the gluteal and TFL muscles can help, many times manual soft tissue treatments (ART, massage, foam rolling, the stick) are necessary in conjunction.

If the pain is persistent regardless of your self-treatment, it may be time to see a sports physician, such as a chiropractor or physical therapist.  Active Release Technique has proven to be an effective treatment for ITB syndrome in conjunction with self-treatment, and many times will speed up treatment time.  As with many running injuries, it is always a good idea to consider the shoes you are running in.  It is recommended that you replace running shoes between 350-550 miles depending on your running style, body weight, and the surface on which you run. Lighter runners can get closer to the upper end of the recommendation, while heavier runners are harder on shoes and should consider replacement shoes closer to 350 miles.

The most difficult part of treating ITB syndrome is the obvious: in order for the pain to decrease you may need to take a short break in your running schedule.  In most cases, treatment can be done while you continue training.  Always seek the advice of a professional if self-treatment does not bring relief in 7-10 days.

Dr. Bobbie is a full body ART practitioner and practicing chiropractic physician in Tempe, AZ, and has personally dealt with most running injuries in the book over her 15 year running career.

Stretching and your aching back

You all know stretching is good for you…but do you know why? Consider the benefits of stretching: increased flexibility, increased circulation, and…decreased back pain? Absolutely! Read on to find out how.

Consider the following scenario: You pound out a few miles on the treadmill and follow it with a series of strength training exercises. Or maybe you commonly sneak out of work for a noon step class. Following the workout you smile with satisfaction and hit the showers. Not so fast! Did you consider stretching those muscles that pulled you through your invigorating workout? Understand why stretching matters-and how to stretch correctly.

Flexible muscles can improve your daily performance. Tasks such as lifting packages, bending to tie your shoes or hurrying to catch a bus home become easier and less tiring.

Many times tight muscles contribute to lower back pain, because they do not allow the joints to move in their full range of motion. By simply removing the strain of the tight muscle, the joint is able to move more freely, and combined with a chiropractic adjustment may be restored to normal range of motion. Good range of motion keeps you in better balance, which will help keep you mobile and less prone to injuries. Better circulation results in increased blood flow to your muscles, and can speed recovery following muscle injuries.

Lastly, stretching can relieve stress by releasing the tension that many times leads to neck discomfort and headaches. So take those extra five minutes to stretch…your body will thank you!