This past week at Boulder Peak, and the latest edition of Denver Chiropractic Center’s 1-Page Health News

This past week the staff from Denver Chiropractic Centers all over the state. Dr. Hyman was up in Beaver Creek training for Xterra Beaver Creek on July 14. While biking, he ran into a bear under lift 11. There’s a little snippet of video posted on our blog: http://www.denverback.com/?p=861

Dr. Stripling and Keri were up working hard leading the Active Release treatment team at the Boulder Peak Triathlon this weekend. Here’s a picture from the brief window when Dr. Hyman stopped by:

And here’s the 1-Page Health News for You…

Mental Attitude: Immune Against Alzheimer’s? Researchers discovered the best marker associated with memory is a gene called CCR2. This gene showed immune system activity against beta-amyloid, thought to be the main substance that causes Alzheimer’s disease. According to Dr. Lorna Harries, “Identification of a key player in the interface between immune function and cognitive ability may help us to gain a better understanding of the disease processes involved in Alzheimer’s disease and related disorders.” National Institute on Aging, June 2012

Health Alert: Cancer Rates Expected To Increase! Cancer incidence is expected to increase more than 75% by the year 2030 in developed countries, and over 90% in developing nations. Countries must take action to combat the projected increases in cancer rates via primary prevention strategies such as healthier lifestyles, early detection, and effective treatment programs. Lancet Oncology, June 2012

Diet: Snacking On Raisins. Eating raisins as an after-school snack prevents excessive calorie intake and increases the feeling of fullness as compared to other commonly consumed snacks. Grapes, potato chips and cookies resulted in approximately 56%, 70% and 108% higher calorie intake compared to raisins, respectively. The cumulative calorie intake (breakfast + morning snack + lunch + after-school snack) was 10-19% lower in children who ate raisins as an after school snack when compared to children who consumed other snacks. Canadian Nutrition Society, May 2012

Exercise: Exercise and Cancer. Researchers are working toward proving that daily yoga or 20 minutes of walking will likely extend a cancer patient’s survival. In 15 years, doctors have gone from being afraid to recommend exercise to cancer patients to having enough data that shows it is safe and effective, particularly for relief of treatment side effects. American Society of Clinical Oncology Annual Meeting, June 2012

Active Release: A whole lot of nerve? Your nervous system runs and controls every aspect of your body. For example, there are 45 miles of nerves in your skin alone. Nerves throughout your body can become trapped in muscles, causing symptoms from headaches to carpal tunnel to sciatica to tingling in the toes. Active Release can take pressure off of nerves and fix problems. Gray’s Anatomy / Active Release Techniques

Wellness/Prevention: Early Stress? Children who experience intense and lasting stressful events in their lives score lower on tests of the spatial working memory and have more trouble on tests of short-term memory. Journal of Neuroscience, June 2012

Quote: “Remember to perform random acts of kindness.” ~ From the film Pay It Forward, released in 2000

This week’s 1-Page Health News

Mental Attitude: Sleep Tight? Children with excessive daytime sleepiness (EDS), despite little indication of short sleep from traditional measurements, were more likely to experience problems with learning, attention/hyperactivity and conduct than children without EDS. Obesity, symptoms of inattention, depression, anxiety, and asthma have been found to contribute to EDS. Penn State, May 2012

Health Alert: Obesity Projections! At current projections, 42% of the US population will be obese by 2030, with 11% categorized as severely obese. Severe obesity is defined as a body mass index over 40 or roughly 100 pounds overweight. $550 billion could be saved in the next 20 years just by keeping obesity rates at the current level! American Journal of Preventive Medicine, May 2012

Exercise: Cancer and Exercise. Physical activity is linked to lower rates of breast and colon cancer deaths. Exercise helps moderate insulin levels, reduce inflammation and possibly improve the immune response. Even though direct effects of physical activity on cancer are not definitely proven, given that physical activity is generally safe, improves quality of life for cancer patients, and has numerous other health benefits, adequate physical activity should be a standard part of cancer care. Journal of the National Cancer Institute, May 2012

Active Release: We frequently have patients referred to us from other chiropractors to treat some of the tougher problems that they can’t help. We’re always happy to work with other chiropractors’ patients, and respect the good work that these other docs do. Some of the more common conditions that other chiros refer include hip pain, sciatica, and rotator cuff problems. We use Active Release Techniques to treat the muscles, tendons, ligaments, and even the nerves that may be involved in these kinds of problems. Do you know someone who needs our help?

Wellness/Prevention: Commutes Risk Health. Individuals with the longest commutes are least likely to report frequently engaging in moderate to vigorous exercise, and most likely to show risk factors for poorer cardiovascular and metabolic health. Commuting more than 10 miles to work is linked with high blood pressure. American Journal of Preventive Medicine, June 2012

Quote: “Inaction, save as a measure of recuperation between bursts of activity, is painful and dangerous to the healthy organism. Only the dying can be really idle.” ~ H. L. Mencken

Low Back Pain or Hip Arthritis: Which One is it? How the Active Release doctors at Denver Chiropractic Center can help you

Low back pain (LBP) can have many causes. Our job is to identify the main pain generator(s) and manage the patient accordingly. This requires a careful history, examination, and a short trial of treatment with conservative methods, like Active Release Techniques Soft Tissue Treatment.

When first presenting for care, the patient tells us about their complaint in the history portion of our evaluation. Here, we not only ask about the main reason for their appointment or, what’s bothering them now but also their past history. We also discuss old injuries such as slips and falls, sports injuries that date back to high school, motor vehicle induced injuries, as well as family history (we ask if family members have or have had low back trouble since it’s been reported that there is a genetic link identified for osteoarthritis).

We also inquire about the patient’s current activity level and how well those activates are tolerated, often using tools completed by the patient that can be scored and compared periodically during care to track the benefits of treatment. When we finally return to the primary complaint history, we ask about the location, mechanism of injury, notable changes in the course of the condition, the onset date, pain related activities that increase or decrease pain, the quality of pain, radiation patterns, severity levels (such as a 0-10 scale), and timing issues such as, worse in the mornings vs. evenings.

When patients say, “…I have low back pain,” they may point to anywhere between the lower rib cage and their hip area. In other words, everyone interprets where their low back is located differently. So, when differentiating between low back pain and hip pain, one would think that the patient would either point to their low back or their hip, right? Well, where does hip osteoarthritis usually hurt? That’s what makes it so hard! The pain location can vary and move around in the same patient anywhere in the pelvic region including the groin (which is common), to the side of the pelvis, to the buttocks, the sacrum and in the low back.

To make it even more challenging, degenerative or injured disks in the lower lumbar spine can refer pain directly into the hip area and also create localized low back pain. In fact, patients often have BOTH conditions simultaneously. Usually, during examination, we move the hip in the socket and feel for reduced motion and watch for pain patterns in certain positions. When comparing the two sides, we both can feel, “…a difference between the two.”

The osteoarthritic (OA) hip is comparably more tight and painful with rotation movements. For example, the patient is seated with their leg crossed, trying to touch their knee to their opposite shoulder. In the OA hip patient, they may only be able to get it half way there compared to the other side and often complain of groin pain. The “ultimate test” is the x-ray that reveals the loss of the joint space – the “cartilage interval” – which narrows on the OA hip side.

How often is hip OA found? In a recent article, after reviewing 2000 patient files and 1000 x-rays of patients 40 years or older, 19% (~1 out of 5) demonstrated x-ray findings of hip OA. THAT’S A LOT!  At Denver Chiropractic Center, management of hip OA includes mobilization, manipulation, stretching the muscles surrounding the hip joint with Active Release Techniques, exercise/stretch instruction, nutritional strategies and others. If/when the time comes, we will help set up a referral to the orthopedic surgeon for joint replacement, as any “quarterback” of your care should.

In our experience, using Active Release Techniques to manages the soft tissues (muscles, tendons) that are associated with the hip joint –and there are a lot of them – is the best option to both manage the pain and stiffness in the hip joint.

It all starts with the initial exam. To schedule yours (or schedule one for someone that you care about), call us at 303.300.0424.

Our 14th Anniversary and This Week’s 1-Page Health News

Those of you who want these weekly 1-Page Health News emails sent directly to your email can go to denverback.com and fill out the little form on the upper left part of the page.

May marks another year for Denver Chiropractic Center. For those of you keeping score, that’s 14 years down, and now in our 15th year.

Last week was the busiest week we’ve ever had. Ever. And we’d like to thank you. Your trust, support and referrals are what make our existence and growth as a business possible. We look forward to being here to help you for a few more decades. Once again, thanks.

We’d also like to wish all the moms out there a Happy Mothers Day.

Here’s this week’s 1-Page Health News:

Mental Attitude: Berry Good News. Men who regularly consume foods rich in flavonoids (such as berries, apples, certain vegetables, tea and red wine) may significantly reduce their risk for developing Parkinson’s disease. Flavonoids are naturally occurring, bioactive compounds present in many plant-based foods and drinks. Neurology, April 2012

Health Alert: Stressed? The risk for coronary heart disease and stroke increases by 30% in a person whose partner has cancer. The cause is probably the negative stress to which the cancer patient’s partner is exposed. Previous studies show that stress can affect the nervous system, blood pressure, and inflammation, increasing the risk of developing coronary heart disease and stroke. Centre for Primary Healthcare Research in Malmö, April 2012

Diet: Pain Relief. The supplement Methylsulfonylmethane gave osteoarthritis patients relief from symptoms of pain and physical dysfunction. Osteoarthritis Cartilage, 2008 Exercise: Being Fit. Improving or maintaining physical fitness appears to help obese and overweight children reach a healthy weight. During a four-year study, obese and overweight girls and boys who achieved fitness were 2.5 to 5 times more likely to reach a healthy weight than those who stayed underfit. Obesity, April 2012

Active Release Techniques: Sciatica. Many people with sciatica are worried that it’s coming from a ruptured disc. While this is sometimes true, in most cases, muscles are pressuring the sciatic nerve and causing symptoms down the back of the leg. The piriformis is a likely suspect, as are the hamstrings. Using Active Release Techniques to relieve the tension in these muscles can take the pressure off of the nerve and fix the problem.

Wellness/Prevention: Obesity and Watching TV. In a study of obesity among European children, Dr. Yannis Manios, Assistant Professor at Harokopio University in Athens, writes, “We found that many countries are lacking clear guidelines on healthy eating and active play. However, there is good evidence linking sedentary behavior (like TV watching) with subsequent obesity. Obesity Reviews, March 2012 (Um, this is not brilliant work.)

Quote: “Simple diet is best; for many dishes bring many diseases; and rich sauces are worse than heaping several meats upon each other.” ~ Pliny

Low Back Pain & Spinal Manipulation: How Does It Work?

For many years, Chiropractic has been at the forefront of treating low back pain (LBP) with both greater patient satisfaction and less lost time at work when compared to other non-surgical treatment approaches. There have been many explanations as to why chiropractic manipulation therapy (CMT) works but many of these studies include other treatment modalities or methods and the benefits are ,therefore, not clearly derived only from CMT.  A recent study has tried to clear this up and the results are very interesting!

This study included two chiropractors and two a physical therapists (PT) from Canada and the US. What is unique about this study is that they measured clinical or symptomatic improvement by tracking improvement in activity tolerance using a standard questionnaire commonly used by chiropractors and PTs all over the world, as well as changes in the spinal stiffness using a valid/reliable instrument before and after CMT was utilized. The importance of these findings is that only CMT was utilized and hence, other forms of treatment commonly utilized by chiropractors did not cloud the findings. There were 48 patients included in the study and the initial 2 treatments were administered 3-4 days apart, followed by an assessment 3-4 days after the 2nd treatment. Assessments were also performed before and after each treatment. The assessments included use of the questionnaire and a stiffness measurement using the special instrument. Also, “recruitment of the lumbar multifidus muscle” (a muscle in the low back that helps stabilize the trunk or core) was measured by ultrasound. After each treatment, significant improvement was found in the overall pain level and in reduced spinal stiffness (which remained improved 3-4 days after the last/second treatment).

The study conclusions revealed less pain, more activity tolerance and less spinal stiffness after the administration of the 2 treatments. The greatest clinical improvement was found in those who had the most dramatic reduction in stiffness after each treatment. They found that the level of muscle recruitment was directly related to the degree of spinal stiffness.  They also found that patients who received thrust manipulation (CMT) had immediate improvements with reduced pain, stiffness and improved muscle recruitment measurements. However, this same effect was NOT obtained when non-thrust mobilization techniques were used. This means many non-thrust manual techniques such as mobilization, massage, and other soft tissue release methods do not create the immediate benefits that were produced by thrust manipulation.

With this new information, we are now able to explain with confidence to patients the reasons why they typically feel better after the spinal adjustment. The patient can then appreciate receiving an answer that makes clear sense and has been “proven.” It’s important to realize that the “bonus” of receiving chiropractic care for low back pain includes not only just pain reduction, but more importantly, improvement in tolerating activities such as vacuuming, washing dishes, golfing, walking and of course, working.

We realize you have a choice in where you get your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. Call us at 303.300.0424

A patient’s question about sciatica

Dear Glenn,

Here’s another question from a patient:

Hello Dr. Hyman,

I’ve been experiencing an annoying pain that originates
in my glute and goes down the back of my leg. You treated
a friend of mine for sciatica (I’m assuming that’s what
this is). Can you help me and how?

The answer:

“Sciatica” refers to pain in the sciatic nerve’s
distribution, down the back of the leg. It’s caused
most commonly by one of two problems:

Pressure on the nerve from a bulging disc.
Pressure on the nerve from the muscles in the area.

The muscular cause is way more common.

The first step is to perform a thorough examination
and make sure your problem is not caused by a
herniated disc. If it is, that can be treated,
but treatment is different.

If I determine that the pain comes from the muscles,
I will identify the muscles involved and release them.
I do this by applying gentle tension to the muscle and
combining that with specific movements. This is
known as Active Release Technique®, which I am
certified to provide (I’m also an ART instructor).

If the joints in your low back and pelvis
are stiff and contributing to the problem,
they may be adjusted. Adjustments are a
gentle way to loosen joints. Very little
force is used with adjustments and they
usually feel great.

The first step is to make an appointment and let
me determine what’s causing your sciatica, then
we can determine the correct treatment plan.

On average, 4-8 visits are required.
……….

If anyone that you know is suffering from
sciatica, tell him or her to call us at
303.300.0424. We can help.

Glenn Hyman
http://www.denverback.com