Tag Archive for: Car Accident Injuries

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

The Truth About Yoga & This Week’s 1-page Health News

This article ran in the NY Times, and ended up all over the internet. We thought it was important to give you our thoughts, since a lot of people are still asking us about it (it is amazing how much power the popular press has).

Levitt D. How Yoga Can Wreck Your Body. New York Times. Article adapted from “The Science of Yoga: The Risks and Rewards,” by William J. Broad, Published: January 5, 2012.

“According to Glen Black, a prominent yoga teacher of nearly 4 decades, a number of factors have converged to heighten the risk of practicing yoga. The biggest is the demographic shift in those who study it. Indian practitioners typically squatted & sat cross-legged in daily life, and yoga poses, were an outgrowth of these postures. Now urbanites who sit in chairs all day, walk into a studio a couple of times a week & strain to twist themselves into ever-more-difficult postures despite their lack of flexibility & other physical problems. Many come to yoga as a gentle alternative to vigorous sports or for rehabilitation for injuries. But yoga’s popularity — ~ 20 million practitioners in 2011 — means that there’s an abundance of teachers who lack the deeper training necessary to recognize when students are headed toward injury.

Black has come to believe that the vast majority of people should give up yoga altogether. It’s simply too likely to cause harm. Black notes that not just students but celebrated teachers too, injure themselves in droves because most have underlying physical weaknesses or problems that make serious injury all but inevitable. “Today many schools of yoga are just about pushing people,” Black said. Normally, the neck can extend 75◦, flex 40◦, laterally bend 45◦, & rotate ~50◦. Yoga practitioners typically move the vertebrae much farther. An intermediate students can easily turn their necks 90◦— nearly twice the normal rotation. In the shoulder stand, hyperflexion of the neck is encouraged. Iyengar emphasized in the shoulder stand tt the trunk & head should form a right angle with neck neck maximally flexed. In cobra pose, the head should extend as far back as possible. Extreme motions of the head and neck, can injure vertebral arteries, resulting in vertebrobasilar artery strokes & brain damage. A growing body of medical evidence supports the contention that, for many people, a number of commonly taught yoga poses are inherently risky.

Reports of yoga injuries have been published in some of the world’s most respected journals —Neurology, British Medical Journal, & JAMA. In 2009, Columbia University published a worldwide survey of yoga teachers, therapists & doctors. The survey’s central question — What are the most serious yoga-related injuries seen? —The largest number of injuries (231) centered on the low back. Other sites, in declining prevalence: shoulder (219), knee (174) & neck (110). Then came stroke.

Among devotees, yoga is described as a nearly miraculous agent of renewal and healing. They celebrate its abilities to calm, cure, energize & strengthen. And much of this appears to be true: yoga can lower blood pressure, make chemicals that act as antidepressants, even improve one’s sex life. But the yoga community long remained silent about its potential to inflict pain. Timothy McCall, MD & medical editor of Yoga Journal, called the headstand too dangerous for general yoga classes. He notes that the inversion may contribute to thoracic outlet syndrome, degenerative arthritis of the cervical spine & retinal tears.”

Commentary:

Here’s our take (Dr. Hyman & Dr. Stripling): In our combined 17 years of seeing patients, we have seen maybe 5 injuries from yoga, with most of those being strains of muscles. We’ve seen far more injuries from sneezing, sleeping and gardening. The truth is there is far more benefit to yoga than risk, especially if you take out the headstands. It’s annoying when the popular press finds some extreme position and warns us all that a popular activity is bad for you. Most of the time it’s just Chicken Little screaming that the sky is falling.

Here is our regularly scheduled Weekly1-Page Health News

Mental Attitude: No Emails? Being cut off from work email significantly reduces stress and improves focus. Heart rate monitors were attached to computer users in an office setting, while software sensors detected how often they switched windows. People who read email changed screens twice as often and were in a steady “high alert” state. Those removed from email for five days reported feeling better able to do their jobs and stay on task, with fewer stressful and time- wasting interruptions. UC Irvine and US Army, May 2012

Health Alert: Misusing Prescription Drugs At A Young Age! The peak risk for misusing prescription pain relievers occurs in mid-adolescence, specifically about 16 years old and earlier. Clinicians and public health professionals are prescribing more pain relievers, and research suggests an increased misuse of these drugs and increased rates of overdose deaths. Each year, 1 in 60 young people (between 12-21 years old) begin using prescription pain relievers outside the boundaries of what their doctor intended. Journal of the American Medical Association, May 2012

Diet: How Much Protein Do I Need? For healthy adults, an estimator used for MINIMUM daily protein intake is 0.36 grams per 1 pound of body weight. Formula = 0.36 grams/pound of body weight. For example, if you weigh 155 lbs, you should consume 56 grams of protein per day (155lbs x .36g/lbs = 56g). Institute of Medicine, 2002 (Note- those of you who train hard, plan on doubling that).

Exercise: Jogging For Life. Jogging 1-2.5 hr/week increases the life expectancy of men by 6.2 years and women by 5.6 years. Jogging improves oxygen uptake, increases insulin sensitivity, improves lipid profiles (raising HDL and lowering triglycerides), lowers blood pressure, reduces platelet aggregation, increases fibrinolytic activity, improves cardiac function, bone density, immune function, reduces inflammation markers, prevents obesity, and improves psychological function. EuroPRevent2012 Meeting, May 2012

Wellness/Prevention: Zinc About It! People regularly taking oral zinc may experience shorter common cold symptoms than those who do not. Higher doses appeared to have a better effect, but taking zinc for just 2-3 days seemed to have no impact at all. Common adverse events associated with zinc supplements are nausea and a bad taste.

Canadian Medical Association Journal, May 2012

Quote: “Everything comes to him who hustles while he waits.” ~ Thomas A. Edison

How’d the staff do at Elephant Rock? & this week’s 1-Page Health News.

First off, I (Glenn) want to start by wishing my parents a happy 45th wedding anniversary. 45 years!?! That’s incredible.

And yes- Miss Keri & Dr. Stripling both did the Elephant Rock ride yesterday…

Miss Keri: 34 miles in 2:30.

Dr. Stripling: 100 miles in 7:49.

Me? I set the record for eating Bon Bons and watching paint dry in my back yard. 3 boxes in under 10 minutes. Just kidding. I’m cramming for Xterra Curt Gowdy on June 24th (off road triathlon). I rode, ran and swam yesterday. Then I mowed the lawn.

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

Mental Attitude: Facebook Addiction? According to Dr. Cecilie Schou Andreassen, some users of Facebook have developed a dependency to the social networking site. “Facebook Addiction” is more common among young people who are anxious and socially insecure, probably because those who are anxious find it easier to communicate via social media than face-to-face. Psychological Reports, May 2012 Health Alert: Infection and Cancer. Each year, 16.1% of the 12.7 million total new cancer cases in the world are due to infections that are largely preventable or treatable. Most of these cancer-causing infections were of the gut, liver, cervix and uterus. The Lancet Oncology, May 2012

Diet: Black Pepper and Fat. Black pepper has been used for centuries in traditional Eastern medicine to treat gastrointestinal distress, pain, inflammation and other disorders. A new study found that Piperin, the pungent-tasting substance that gives black pepper its characteristic taste, can block the formation of new fat cells. Journal of Agricultural and Food Chemistry, May 2012

Exercise: Strong Bones! Osteoporosis affects more than 200 million people worldwide, yet many are unaware they are at risk. The disease has been called the silent epidemic because bone loss occurs without symptoms and the disease is often first diagnosed after a fracture. Osteoporosis is more common in women, but men also develop it, usually after age 65. Young men who play volleyball, basketball or other load-bearing sports for 4 hours a week or more may gain protection from developing osteoporosis later in life. Men who increased their load-bearing activity from age 19-24 not only developed more bone, but also had larger bones compared to men who were sedentary during the same period. Bigger bones with more mass are thought to offer a shield against osteoporosis. Journal of Bone and Mineral Research, May 2012

Chiropractic: “I came to the point where I wanted an adjustment every day. I believe in Chiropractic.” ~ Evander Holyfield, 4x World Heavyweight Boxing Champion Wellness/Prevention: Ancient Remedy Slows Prostate Problems. Caffeic acid phenethyl ester, or CAPE, is a compound isolated from honeybee hive propolis, the resin used by bees to patch up holes in hives. If you feed CAPE to mice with prostate tumors, their tumors will stop growing. After several weeks, if you stop the treatment, the tumors will begin to grow again at their original pace. Cancer Prevention Research, May 2012

Quote: “Earth provides enough to satisfy every man’s need, but not every man’s greed.” ~ Gandhi

Neck Pain – which treatment works best?

Neck Pain:  Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint using various methods such as figure 8, side to side, front to back and /or combinations of any of these movements. In the neck, gentle to firm manual traction or pulling, when applied to the cervical spine, stretches the joint and disk spaces and can be included during MOB.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide).

Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.

As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.

Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function!

In our clinic (Denver Chiropractic Center) we’ve found that the best approach uses BOTH. Mobilization in the form of Active Release Technique combined with safe and gentle (never forced) adjustments – also known as spinal manipulation – get better results in a shorter time frame.

Call us at 303.300.0424 if you want to get rid of your neck pain. We’re here to help.

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

Whiplash: Where’s the Pain Coming From?

Whiplash commonly occurs as a result of a motor vehicle collision when, typically, there is hyper-motion in one direction followed by motion in the opposite direction in a “crack the whip” like manner.

The direction of the strike typically dictates the direction of movement of the head so in a rear end collision, the strike is from behind, whipping the head forwards and then backwards. In a side-on collision, a side-to-side motion results. Pain can occur anywhere around the neck, upper back, arms, chest and/or head, depending on the tissues that are injured.

Soft tissues including the muscles, their tendon insertions, ligaments that securely tie bone to bone, the shock absorbing disk in the front of the vertebral column, and/or the nerves that pass through the holes of the spine that innervate the arms and hands can be affected by these injuries.

The injuries associated with whiplash can lead to disruption of normal daily activity, depression and anxiety. There can be immediate symptoms or a delay in the onset and pain with its associated disability can last for days, weeks, months, or longer, depending on each case.

Last month, we discussed the grades 1, 2, and 3 or, mild, moderate, severe sprains (ligament injuries) and strains (muscle injuries). Previously, we discussed methods of prognosing the lasting effects of the injury in a reported classification system called “whiplash associated disorders” or WAD I, II, III. & IV.

Here, the differentiating feature is pain with no objective exam findings (WAD I), the presence of objective loss of motion but negative neurological findings (WADII) or, the presence of measurable neurological dysfunction (WAD III). Studies have shown that the likelihood of prolonged injury increases with each WAD grade.

A side-to-side or front-to-back mechanism of injury can result in damage to the ligaments in the back of the spine called the supra- and inter- spinous ligaments, the disk and/or nerve root that exits the spine allowing the arm and hand to sense and be strong (when it’s not pinched or damaged like in a WAD III) and/or, the bone which can compress when the force is hard enough (WAD IV).  A concussion can occur when the brain bounces against the inside of the skull.

In our opinion, after careful exam to rule out more significant injuries, and advanced soft tissue treatment system like Active Release Techniques is the best way to deal with the soft tissue injuries that result from a car accident (or bike crash, etc). By managing the scar tissue your body lays down in soft tissue injuries, we can usually improve your ranges of motion and reduce pain. While gentle (never forced) chiropractic adjustments can help as well, in our experience they are secondary to the soft tissue treatment.

To se if you’re a candidate for our care, call the office at 303.300.0424. We work with all major insurance companies and we accept Med Pay.

An update on Miss Keri (after the bike crash) and this week’s 1-Page Health News from your Denver Active Release Providers at Denver Chiropractic Center

Miss Keri here at the office wanted to say thanks to everyone for the concern after her “meeting” with the concrete wall while on her bike last week. Her nasty injury required a little attention from a wound care nurse to make sure it doesn’t leave a scar, but she’s on the mend. Once again thanks for your concern.

That last email about her bike crash received the highest open response of any email we’ve ever sent. And here’s this week’s 1-page health news.

Mental Attitude: Meditation. Adults with memory impairment and memory loss may benefit from mantra-based meditation (12 minutes of meditation per day for 8 weeks). Mantra-based meditation has demonstrated a positive effect on patients’ emotional responses to stress, fatigue and anxiety. Findings revealed a substantial increase in cerebral blood flow in the patients’ prefrontal, superior frontal, and superior parietal cortices, and also better cognitive function. Journal of Alternative and Complementary Medicine, March 2012

Health Alert: Diabetics And Stroke. 26 million Americans have diabetes, and more than half are younger than 65. The longer you have diabetes, the higher your risk for stroke. Compared to people without diabetes (after considering other factors such as age, smoking history, physical activity, history of heart disease, blood pressure and cholesterol), the risk of stroke increased 70% in people with diabetes for less than 5 years, 80% in people with diabetes for 5-10 years and three-fold in people with diabetes for 10 years or more. American Heart Association, March 2012

Diet: Seeing Things? Hungry people see food-related words more clearly than people who’ve just eaten. This change in vision happens at the earliest perceptual stages, before higher parts of the brain have a chance to change the messages coming from the eyes. Psychological Science, March 2012 Exercise: Good Reasons. Exercise helps to alleviate low-back pain, helps to reduce the amount of insulin required to control blood sugar levels in Type I (insulin-dependent) diabetics and improves mental alertness. Surgeon General’s Report on Physical Activity and Health, 1996

Chiropractic: Hold Your Head Up! “Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can pull the entire spine out of alignment. Forward head posture (FHP) may result in the loss of 30% of vital lung capacity. These breath-related effects are primarily due to the loss of the cervical lordosis, which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping lift the first rib during inhalation.” ~Rene Cailliet M.D., famous medical author and former Director of the Department of Physical Medicine and Rehabilitation at the University of Southern California

Wellness/Prevention: Avoid Absenteeism. The US is losing $226 billion per year due to employee absenteeism. A worker is less likely to take sick leave if their supervisor offers support (lightened work load or stress management training) when an employee is experiencing psychosomatic stress symptoms. The worker feels inclined to reciprocate the supportive treatment by keeping their work effort high. European Journal of Work and Organizational Psychology, January 2012

Quote: “Anything is possible. You can be told that you have a 90% chance or a 50% chance or a 1% chance, but you have to believe, and you have to fight.” ~ Lance Armstrong

Is it sciatica or Low Back Pain? How can Denver Chiropractic Center help you with Active Release Techniques?

Low back pain (LBP) can be localized and contained to only the low back area or, it can radiate pain down the leg. This distinction is important as LBP is often less complicated and carries a more favorable prognosis for complete recovery. In fact, a large part of our history and examination is focused on this differentiation. This month’s Health Update is going to look at the different types of leg pain that can occur with different LBP conditions.

We’ve all heard of the word “sciatica” and it (usually) is loosely used to describe everything from LBP arising from the joints in the back, the sacroiliac joint, from the muscles of the low back as well as a pinched nerve from a ruptured disk. Strictly speaking, the term “sciatica” should ONLY be used when the sciatic nerve is pinched; causing pain that radiates down the leg.

The sciatic nerve is made up of five smaller nerves (L4, 5, S1, 2, 3) that arise from the spine and join together to form one large nerve (about the size of our pinky) called the sciatic nerve – like five small rivers merging into one BIG river. Sciatica occurs when any one of the small nerves (L4-S3) or, when the sciatic nerve itself, gets compressed or irritated.

This can be, and often is caused from a lumbar disk herniation (the “ruptured disk”).  A term called “pseudosciatica” (a non-disk cause) includes a pinch from the piriformis muscle where the nerve passes through the pelvis (in the “cheek” or, the buttocks), which has been commonly referred to as “wallet sciatica” as sitting on the wallet in the back pocket is often the cause.

When this occurs, the term “peripheral neuropathy” or “ peripheral nerve entrapment” is the most accurate term to use. Direct trauma like a bruise to the buttocks from falling or hitting the nerve during an injection into the buttocks can also trigger “sciatica.”

The symptoms of sciatica include low back pain, buttocks pain, back of the thigh, calf and/or foot pain and/or numbness-tingling. If the nerve is compressed hard enough, muscle weakness can occur making it hard to stand up on the tip toes creating a limp when walking. In the clinic, we will raise the straight leg and if pinched, sharp pain can occur with as little as 20-30° due to the nerve being stretched as the leg is raised.

If pain occurs anywhere between 30 and 70° of elevation of either the same side leg and/or the opposite leg, this constitutes a positive test for sciatica (better termed, “nerve root tension”). When a disk is herniated into the nerve, bending the spine backwards can move the disk away and off the nerve resulting in relief, which is very diagnostic of a herniated disk. Having a patient walk on their toes and then heels and watching for foot drop as well as testing the reflexes, the sensation with a sharp object, and testing the reflexes at the knee and Achilles tendon can give us clues if there is nerve damage.

At our clinic we’ve gone beyond simple traditional chiropractic adjustments to “align the spine.” We use more advanced techniques, like Active Release Techniques to address the pressure that the muscles can exert on the sciatic nerve. We will also use motion-restoring spinal adjustments to restore healthy mobility to the spine. By utilizing these advanced techniques, we are usually able to get excellent results for our patients with low back pain and sciatica in a relatively short period of time.

It all starts with the initial exam. Call us to schedule yours 303.300.0424. We’re here to help you!

Neck Pain: Manipulation vs. Mobilization – What’s Better?

Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches.

Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint or muscle using various methods such as stretching.

Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide).

Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.

As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.

Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures.

Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function!

In our clinic (Denver Chiropractic Center) we’ve found that the best approach uses BOTH. Mobilization in the form of Active Release Technique combined with safe and gentle (never forced) adjustments get better results in a shorter time frame. It all starts with the initial exam, so call us to schedule yours – 303.300.0424.