It has been an exciting week for me!!!
I was featured as a highly rated chiropractor on the 'page of happiness' in the September 2011 issue of the Angie's List magazine. My study on the Cox Chiropractic treatment of lower back pain which remained or developed after spinal surgery, was published in a leading chiropractic journal. This paper was also described as a 'paper of great clinical value' by Dr. James Cox and was the featured paper in the August edition of Dr. Cox's 'Clinical Pearls'. Chiropractic Care Millennium Park also won the 2011 CMUS Talk of the Town Award for Excellence in Customer Satisfaction.

And, from Angie's List

Chicago chiropractors give relief to many...

Date Published: August 19 2011
by Michael Schroeder

Angie's List member Garry Parks of Buffalo Grove couldn't find relief fast enough after badly straining his back last summer doing yardwork, and decided to visit highly rated chiropractor Ralph Kruse Jr. at Chiropractic Care in Chicago. He got in the same day and hasn't looked back since the first adjustment. "I haven't had any issues all year," Parks says. "I'm like, wow."

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Chiropractic Management Of Postsurgical Lumbar Spine Pain

Kruse, RA; Cambron, J: Chiropractic Management Of Postsurgical Lumbar Spine Pain: A Retrospective Study Of 32 Cases. Journal Of Manipulative And Physiological Therapeutics 2011;34(6):408‐412

Objective: Although chiropractic manipulation is commonly used for low back pain, applying this procedure to the patient with post lumbar spine surgery has not been adequately studied.

The purpose of this retrospective chart review is to report on the results of chiropractic management (including Cox flexion distraction technique) of patients with postsurgical lumbar spine pain to determine the change in reported pain based on surgical type.

Methods: Ten years of patient files from one chiropractic practice were electronically screened for lumbar spine surgery occurring before presenting for chiropractic care. Of the 58 patients with a postsurgical diagnosis, 32 files contained all pertinent components for this study including treatment with Cox flexion distraction manipulation (in addition to adjunct procedures) for at least 2 weeks and pretreatment and post‐treatment pain measures using the Numeric Pain Scale (NPS) that ranged from 0 (no pain) to 10 (worst pain imaginable).

Results: A change was observed in the mean pretreatment and post‐treatment NPS pain scores of 6.4 to 2.3, a reduction of 4.1 of 10. The mean number of treatments was 14, with a range of 6 to 31. When stratified by surgical type, the mean change in pain was most remarkable in patients who underwent a surgery that combined lumbar discectomy, fusion, and/or laminectomy, with an average NPS pain reduction of 5.7 of 10. No adverse events were reported for any of these postsurgical patients.

Conclusions: The results of this study showed improvement for patients with low back pain subsequent to lumbar spine surgery who were managed with chiropractic care.


32 CASES OF POST SURGICAL CONTINUED PAIN WERE TREATED WITH COX FLEXION DISTRACTION MANIPULATION (IN ADDITION TO ADJUNCT PROCEDURES) FOR AT LEAST 2 WEEKS. PRETREATMENT AND POST TREATMENT PAIN MEASURES USING THE NUMERIC PAIN SCALE (NPS) SHOWED A REDUCTION OF 4.1 OF 10 NPS VALUES WITH A MEAN NUMBER OF 14 TREATMENTS. THE RESULTS OF THIS STUDY SHOWED IMPROVEMENT FOR PATIENTS WITH LOW BACK PAIN SUBSEQUENT TO LUMBAR SPINE SURGERY WHO WERE MANAGED WITH COX FLEXION DISTRACTION CHIROPRACTIC CARE

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Tips for a Healthy Spine

Tips for a Healthy Spine

A healthy spine is an often overlooked and essential part of a healthy lifestyle. People who suffer from back pain, particularly if it is long-term, are generally less healthy than those who do not. In fact, back pain costs are staggering not only financially, but also in terms of lost time from work and because of psychosocial problems that arise during the healing process associated with long-term back pain.

Unfortunately, approximately 80-90% of the population suffers from spinal pain at some point. People who are overweight or obese, and who smoke, lift heavy objects, or had a previous episode of back pain, are more likely to experience back pain.

Because so many people suffer from spine pain, it’s important for you to try to keep your spine as healthy as possible. Following simple posture, lifting, and healthy lifestyle guidelines can help you keep your back in good shape.

The American Chiropractic Association recommends the following spinal health tips:

Standing

• When standing, keep one foot slightly in front of the other, with your knees slightly bent. This position helps to take the pressure off your low back.
• Do not stand bent forward at the waist for prolonged periods of time. The muscles in your low back become deconditioned in this position, which may lead to pain.

Lifting

• At all times, avoid twisting while lifting. Twisting is one of the most dangerous movements for your spine, especially while lifting.
• If the item is too heavy to lift, pushing it is easier on your back than pulling it. Whenever possible, use your legs, not your back or upper body, to push the item.
• If you must lift a heavy item, get someone to help you.

Sitting

• Keep your knees slightly higher than your hips, with your head up and back straight.
• Avoid rolling your shoulders forward (slouching).
• Try to maintain the natural curve in your low back.

Reaching and Bending

• When reaching for something above shoulder level, stand on a stool. Straining to reach such objects may not only hurt your mid-back and neck, but it can also bring on shoulder problems.
• Do NOT bend over at the waist to pick up items from the floor or a table.
• Instead, kneel down on one knee, as close as possible to the item you are lifting, with the other foot flat on the floor and pick the item up.
• Or bend at the knees, keep the item close to your body, and lift with your legs, not your back.

Carrying

• When carrying objects, particularly if they are heavy, keep them as close to your body as possible.
• Carrying two small objects—one in each hand—is often easier to handle than one large one.

Healthy Diet and Exercise

• While the proverbial jury is still out, we suspect that extra weight puts undue strain on your spine. Keep within 10 lbs. of your ideal weight for a healthier back.
• “Beer belly” is likely the worst culprit, as it puts unwanted pressure on the muscles, ligaments and tendons in your low back.
• The most efficient and effective way to reduce weight is by eating a sensible diet and exercising regularly.
• Consult with your doctor before beginning any exercise program, particularly if you have a health condition.

Sleeping

• Sleeping on your back puts approximately 50 pounds of pressure on your spine. Other positions may be better.
• Placing a pillow under your knees while lying on your back cuts the pressure on your spine roughly in half.
• Lying on your side with a pillow between your knees may also reduce the pressure on your back.
• Never sleep in a position that causes a portion of your spine to hurt. Most often, your body will tell you what position is best.

Quit Smoking

Smokers have more spine pain than nonsmokers, and they also heal more slowly when they have an episode of back pain because the chemicals in tobacco smoke restrict the flow of blood to the tissues in and around your spine.

While following these instructions is no guarantee that you’ll be free from back pain for your entire life, it can certainly reduce your risk of developing it. These simple steps will help you keep your spine in good shape, making you a healthier, happier person.

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Tennis, Anyone?

Tennis is commonly considered an elite game, thanks to the country clubs that once provided the vast majority of tennis facilities. The combination of both high- and low-exertion levels of the game, however, can bring not only a unique exercise experience, but also tremendous health benefits, such as reducing the risk of heart attack. Follow these tips to avoid injury when serving up a game.

• Choosing a racquet - The grip of the racquet should be thick enough for your hand to fit around it without having your thumb and fingers overlap one another and the hitting area should be 105 square inches or smaller as an oversized racquet will tend to catch the ball on the extreme edge and this can twist your hands and wrists beyond their normal range of motion.
• Selecting a court – Find a tennis court with a surface that has some give, such as cushioned surfaces or even grass.
• Learn proper form – As a beginner take lessons to learn good tennis habits and proper form, which will help take the pressure off your wrists, spine and hips.
• Warm up – Before jumping right into your first serve, take a minute to rotate your legs, shoulders, hands and elbows in a slow, circular motion.
• Drink lots of water – When playing tennis, avoid drinking sodas because your body must use more water to push them out of your system than they put into your body.

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Stop Dreaming About Quality Sleep and Do Something!

Stop Dreaming About Quality Sleep and Do Something!

An old Chinese proverb states, "Only when one cannot sleep does one know how long the night is." Anyone who's ever experienced an occasional bout with insomnia—and that's most of us—can relate to this all too well.

In fact, surveys have shown that between 40 and 60 percent of the general population has trouble sleeping. Daily stress and worries, pressures from job and family, body aches and pains caused by uncomfortable beds or pillows, and a host of other issues can keep a person from getting enough quality sleep.

Sleep is critical to good health and functioning, so lack of it is a serious matter. "Sleep is one of the most important functions of the brain," says Frederick R. Carrick, DC, PhD, president of the American Chiropractic Association's Council on Neurology. Through it, our bodies recharge and renew for the next day's challenges.

As wellness experts, doctors of chiropractic can provide patients with a different approach to their sleeping problems— without the use of sleeping pills, which leave many people in a mental haze the next morning. To start, here are a few helpful tips they would recommend for the sleepless in Seattle (or any city, for that matter):

• Exercise regularly. Exercising in the morning is best, but if you must exercise in the evening, do so at least two or three hours before bedtime. Any later, and your increased heart rate can interfere with your sleep.
• Limit your intake of caffeinated beverages such as coffee, colas and tea—try to avoid them altogether late in the day and near bedtime. In addition, for each cup of caffeinated beverages you drink each day, drink an equal amount of water.
• If you have trouble sleeping and then get thirsty, drink tap water at room temperature (cold water may disturb the digestive system).
• Eat an early dinner. Eating after 6 p.m. may interfere with sleep as your body works to digest the food you’ve eaten.
• Go to bed at the same time each night and get up at the same time each morning. The routine will help your body know when it is time to rest.
• Keep your bedroom at a cool, comfortable temperature and try to make it as dark as possible when you’re ready for bed.
Creating a comfortable place to sleep by choosing the correct mattress and pillow is also essential to getting the quality sleep that your body needs to function at its best.
A mattress, for instance, should support the body’s weight evenly and allow the spine to stay in its natural alignment. Choosing the right one is a personal matter.

“There are a wide variety of comfort preferences. It’s very subjective,” says Brian Darcy, operations manager for Springwall, the manufacturer of premium-quality Chiropractic® sleep sets that ACA has endorsed for the past 38 years.

But regardless of whether you like your mattress firm or soft, give it a good trial run before you buy. Darcy recommends lying down on a mattress for a minimum of three to five minutes to get a good feel. Sitting on it simply won’t do.
Useful mattress facts...

• A mattress should provide uniform support from head to toe. If there are gaps between your body and your mattress (such as at the waist), you're not getting the full support that you need.
• If you do have back pain and your mattress is too soft, you might want to firm up the support of your mattress by placing a board underneath it. But do this just until the pain goes away; such firmness is not good for "routine" sleeping.
• Every few months, turn your mattress clockwise, or upside down, so that body indentations are kept to a minimum. It's also good to rotate the mattress frame every so often to reduce wear and tear.
• If you're waking up uncomfortable, it may be time for a new mattress. There is no standard life span for a mattress; it all depends on the kind of usage it gets.
• Be aware that changes in your life can signal the need for a new mattress. For example, if you've lost or gained a lot of weight, if a medical condition has changed the way you sleep, or even if you have changed partners, it could mean that it's time to find a new mattress that will accommodate those changes and help you sleep more soundly.
• If you're not in the market for a new mattress, and your current mattress is too firm, you can soften it up by putting a 1- to 2-inch-thick padding on top of it - usually available at mattress and bedding stores.

Next, pillow talk...

After investing in a quality mattress, don't forget to choose an equally supportive pillow, advises Peter Mckay, DC, who is in private practice in San Diego and also works as a consultant for Innovative Choices, the maker of the Therapeutica Pillow-another ACA-endorsed product. "People will spend thousands of dollars on a mattress and then skimp on a pillow that doesn't support their head and neck properly," he observes. A good pillow will keep the cervical (neck) section of the spine aligned with the thoracic and lumbar (chest and lower back) sections. "[The sections] move together and should be supported together."

• When choosing a pillow, be selective. When lying on your side, your head and neck should remain level with your mid and lower spine. When lying on your back, your head and neck should remain level with your upper back and spine. In other words, your pillow should not be so thick that it causes your head and neck to be propped up or angled sharply away from your body.
• Be wary of pillows that are made out of mushy foam materials. The weight of your head can displace this kind of foam, leaving little support. Choose firmer foam and materials that press back and support the head.
• If you find yourself sleeping on your side with one hand propped under your pillow, that's a clue that you're not getting the support you need from that pillow.
• There is no such thing as a universal fit when it comes to pillows. Find one that is consistent with the shape and size of your body.

Chiropractic Care Can Help...

If you continue to experience pain and discomfort at night or have difficulty falling asleep, visit your doctor of chiropractic. Doctors of chiropractic are trained to treat spinal problems that can interfere with a restful night's sleep. They can also offer nutritional and ergonomic advice that can help improve the quality of your sleep.

Visit the ACA Site, click here

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or call our Chicago office: 312-269-5556
or our Homewood office 708.798.5556

Fibromyalgia

Fibromyalgia
If you or your loved ones have been diagnosed with fibromyalgia, you may be wondering what the disorder means for you. The condition still remains a mystery, although an estimated 3 to 6 percent of Americans, predominantly women, have fibromyalgia syndrome. Even diagnosing the condition can be complex: according to the National Fibromyalgia Association, it can take a patient up to 4 years to be accurately diagnosed.

Fibromyalgia is typically diagnosed in patients with:

• Widespread pain in all 4 quadrants of the body for a minimum of 3 months; and
• Tenderness or pain in at least 11 tender points when pressure is applied. These tender points cluster around the neck, shoulder, chest, hip, knee, and elbow regions.

Some fibromyalgia experts say, however, that many people may still have fibromyalgia with fewer than 11 tender points if they have widespread pain and several other common symptoms, including:

• Fatigue
• Sleep disorders
• Chronic headaches
• Dizziness or lightheadedness
• Cognitive or memory impairment
• Malaise and muscle pain after exertion
• Jaw pain
• Morning stiffness
• Menstrual cramping
• Irritable bowels
• Numbness and tingling sensations
• Skin and chemical sensitivities

Correct Diagnosis Is Key

Correct diagnosis of fibromyalgia is very elusive, so if you are diagnosed with the disorder—or suspect that you have it—seek the opinion of more than 1 health care provider. Other conditions may create fibromyalgia—like pain, fatigue, and other symptoms. Ruling other conditions out first is very important.
In addition to clinical evaluation that will assess possible causes of your pain, your doctor may need to order blood work to determine if you have:
• Anemia
• Hypothyroidism
• Lyme disease
• Other rheumatic diseases
• Hormonal imbalances
• Allergies and nutritional deficiencies
• Disorders that cause pain, fatigue, and other fibromyalgia-like symptoms.

If the tests show that you have 1 of these conditions, treatment will focus on addressing that problem first. If your pain is caused by a muscle or joint condition, chiropractic care may help relieve it more effectively than other therapies.

Treatment Alternatives


If no underlying cause for your symptoms can be identified, you may have classic fibromyalgia. The traditional allopathic approach includes a prescription of prednisone, anti-inflammatory agents, antidepressants, sleep medications, and muscle relaxants. These temporarily relieve the symptoms, but they do produce side effects. If you prefer a natural approach, the following suggestions may be helpful:
• Studies have shown that a combination of 300 to 600 mg of magnesium per day, along with malic acid, may significantly reduce may significantly reduce the number of tender points and the pain felt at those that remain. B vitamins may also be helpful.
• Eating more omega-3 fatty acids and fewer saturated fats has shown promise in fibromyalgia patients. Limit red meat and saturated fats and increase the amounts of omega-3 fatty acids by including fish, flax, and walnut oils in your diet. Fatty acid deficiencies can interfere with the nervous system and brain function, resulting in depression and poor memory and concentration.
• Improving the quality of sleep can help reduce fatigue. Watch your caffeine intake, especially before going to bed. Reduce TV and computer time. If you watch TV in the evening, choose relaxing, funny programs instead of programs with violent or disturbing content. Ask your doctor of chiropractic for other natural ways to help you sleep better.
• Stress-managing strategies can also help address anxiety or depression issues. Cognitive therapy has been shown helpful in relieving fibromyalgia patients’ negative emotions and depression by changing their perception of themselves and attitudes toward others.
• A traditional gym-based or aerobic exercise program may exacerbate fibromyalgia symptoms and is not recommended. Instead, yoga, Pilates, or tai chi—which offer mild stretching, relaxation, and breathing techniques—may work better than vigorous exercise.
• Chiropractic care has consistently ranked as one of the therapeutic approaches that offer the most relief for the fibromyalgia patient. Your doctor of chiropractic can also include massage therapy, ultrasound, and electrical stimulation in the treatment program, which may help relieve stress, pain, and other symptoms.
Your doctor of chiropractic has the knowledge, training, and expertise to help you understand your problem and, in many cases, to manage it successfully. Remember, however, that the treatment program can be successful only with your active participation. If your doctor of chiropractic feels that he or she cannot help you, you will be directed to another health care provider.

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Stroke

What Is Stroke?

Stroke is caused by a lack of blood supply to a portion of the brain, which causes that portion to die within just a few minutes. This lack of blood supply, also known as ischemia, results in long-term neurological effects because the cells in the brain do not regenerate.

The outcome of stroke depends on the person’s age, general health, the region of the brain affected by the stroke, the type of stroke, and the extent of the brain damage. Common long-term effects include difficulty speaking, poor memory, altered emotions, poor recognition of previously familiar objects and people, amnesia, deformities of the extremities, and difficulty with movement, including weakness and paralysis. The weakness and paralysis often affect one side of the body—usually opposite the stroke location. Some of the effects can be permanent, while others may resolve with time and treatment.

What Are the Warning Signs of Stroke?

Sometimes people experience a “pre-stroke”—a short term lack of blood supply to the brain, also called a transient ischemic attack. The loss of blood supply lasts from seconds to just a few minutes and does not result in permanent damage. This condition is often a precursor to a full-scale stroke, so any symptoms associated with it should be investigated immediately.

What Should I Do If I Have Any of the Symptoms?

If you, your friend, or a family member is having any symptoms, seek medical care immediately:

• Dial 911 or have someone take you or your friend to the nearest emergency room. Do NOT let the person with the symptoms drive or stay home.
• Try to remember the time of onset of your symptoms and what symptoms you’re having. This information will help the treating doctors provide the best possible care for you.

Remember: The sooner you seek emergency medical assistance, the better the chances of minimizing the damage from a stroke. The person with the symptoms should seek medical care even if:

• Not all symptoms are present.
• The symptoms go away after a short time.
• He or she has the symptoms with no real pain.
• He or she denies the symptoms,

What Is the Treatment for Stroke?

There are generally three separate stages of treatment for stroke: prevention, therapy immediately after stroke, and post-stroke rehabilitation.

Stroke prevention is based on treating underlying risk factors (see tips below). Acute stroke therapies try to stop a stroke while it is happening. These include anticoagulants that help break up or prevent further formation of blood clots and efforts to support the person’s vital functions, such as breathing. Post-stroke rehabilitation helps overcome some of the disabilities that result from the brain damage. For most stroke patients, physical therapy, occupational therapy, and speech therapy form the base of a rehabilitation program.

How Can I Reduce My Risk of a Stroke?

1. Stop smoking. In some people, smoking cessation can reduce the risk of a stroke to that of a non-smoker. Smoking causes damage to the blood vessels throughout the body. Some of the chemicals in tobacco smoke take the place of oxygen in the blood, increasing the likelihood of loss of blood supply to the brain.
2. Eat a healthy diet. Eat only sensible portions of foods. Avoid foods high in saturated and trans fats.
3. Keep your blood pressure under control.
4. Get regular physical examinations and follow your doctor’s orders.

Is There Risk of Stroke from Neck Manipulation?

Neck manipulation is a remarkably safe procedure. Although some reports have associated upper high velocity neck manipulation with a certain kind of stroke, or vertebral artery dissection, there is not yet a clear understanding of the connection. While we don’t know the actual incidence of stroke associated with high velocity upper neck manipulation, the occurrence does appear to be rare, based upon the clinical reports and scientific studies to date. The chiropractic profession is actively researching stroke and neck manipulation and available safe alternative conservative therapies.
It has also been suggested, for example, that sudden severe upper-neck pain and/or headache, which may indicate a pre-stroke condition, could cause someone to visit a doctor of chiropractic. In addition, some regular everyday activities, such as stargazing, rapidly turning the head while driving, and even having a shampoo in a hair salon may cause aneurysm—a widening of an artery resulting from the weakening of the artery walls—of the neck arteries, resulting in stroke. These events remain very difficult to predict.

If you are visiting your doctor of chiropractic with upper-neck pain or headache, be very specific about your symptoms, so that he or she can provide the safest and most effective treatment, even if it involves referral to another health care provider. There are various head and neck positions and forms of joint movement. Depending on your clinical condition, joint mobilization, therapeutic exercise, soft-tissue techniques, and other therapies can also be recommended. If the issue of stroke concerns you, do not hesitate to discuss it with your doctor of chiropractic.

Warning signs of stroke include ANY of the following:

• Sudden difficulty speaking (slurred speech) or understanding what people are saying
• Sudden onset of confusion or altered mental status, such as loss of consciousness, or not recognizing people who should be familiar
• Sudden numbness or tingling on one side of the face or body, or both
• Sudden onset of dizziness or unsteadiness, loss of balance or coordination, or both
• Sudden difficulty walking or standing upright
• Sudden severe headache
• Sudden severe unexplained upper-neck pain
• Sudden trouble with vision or sight.

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Back in the Swing

Golf is a common summer-time activity that those of us who live in the northern parts of the country don’t participate in year-round. The physical demands of golf are much different from what most people experience in their daily lives and therefore, we should prepare our bodies for the specific physical stresses of golf so we can enjoy the game. Below are some exercises that can be done to prepare your body for tee time.

• Endurance training – The game of golf is usually played over a three- to five-hour time period, requiring a certain level of endurance. Deadlifts and anterior reaches are good for working on endurance.
• Joint mobility and stability – The explosive golf swing requires a high level of execution, coordination and power. Try standing with arms hanging at your sides (with or without weights) and gently leaning to one side. Repeat on the other side.
• Working on the trunk and shoulders – Golfers’ ability to turn their shoulders will be determined by the coordinated strength of their core and their ability to rotate through the spine. Various chopping and lifting exercises will help.
• Training pelvic tilt – If golfers are not conditioned properly, they will begin flexing their spine in order to address the ball, as opposed to hinging at the hip. On all fours, gently arch your back up toward the ceiling as you breathe in. On the exhale, gently push your bellybutton toward the floor and curve your back in the opposite direction, looking up toward the ceiling.

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Temporomandibular Joint Disorder

Temporomandibular Joint Disorder

Does it hurt when you chew, open wide to yawn or use your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it?

If you answered “yes” to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.

Signs may include:

• Radiating pain in the face, neck, or shoulders;
• Limited movement or locking of the jaw;
• Painful clicking or grating when opening or closing the mouth;
• A significant change in the way the upper and lower teeth fit together;
• Headaches, earaches, dizziness, hearing problems and difficulty swallowing.
For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.
What Causes TMD?
Researchers agree that TMD falls into three categories:
• Myofascial pain—discomfort or pain in the muscles of the jaw, neck, and shoulders;
• A dislocated jaw or displaced disc;
• Degenerative joint disease—rheumatoid arthritis or osteoarthritis in the jaw joint.

Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD.

Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist's chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, today’s dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment. In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.

While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.
Some conditions once accepted as causes of TMD have been dismissed—moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes.

Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, posture and higher heels.

TMD Diagnosis and Treatment

To help diagnose or rule out TMD, your doctor of chiropractic (DC) may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the balance of the muscles. If you have no problems while doing these things, then the problem is not likely to be TMD. Your DC can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis.

If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, your doctor’s first goal is to relieve symptoms, particularly pain. If your doctor of chiropractic feels that you need special appliances or splints (with the exception of the “waterpack” and other guards against teeth grinding), he or she will refer you to a dentist or orthodontist for co-management.

In addition to treatment, your doctor of chiropractic can teach you how to:

• Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.
• Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (some hard candies are even called “jawbreakers”—for good reason). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.
• Perform TMD-specific exercises. Depending on your condition, your DC may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.


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How to Select Athletic Shoes

How to Select Athletic Shoes

Too many people choose fashion over function when purchasing athletic shoes, not realizing that poor-fitting shoes can lead to pain throughout the body. Because footwear plays such an important role in the function of bones and joints—especially for runners and other athletes—choosing the right shoe can help prevent pain in your back, hips, knees, and feet.

Unfortunately, there is no such thing as the very best athletic shoe—every pair of feet is different, every shoe has different features, and overall comfort is a very personal decision. For this reason, it is recommended that you first determine your foot type: normal, flat, or high-arched.

The Normal Foot

Normal feet have a normal-sized arch and will leave a wet footprint that has a flare, but shows the forefoot and heel connected by a broad band. A normal foot lands on the outside of the heel and rolls slightly inward to absorb shock.
Best shoes: Stability shoes with a slightly curved shape.

The Flat Foot

This type of foot has a low arch and leaves a print that looks like the whole sole of the foot. It usually indicates an over-pronated foot—one that strikes on the outside of the heel and rolls excessively inward (pronates). Over time, this can cause overuse injuries.
Best shoes: Motion-control shoes or high-stability shoes with firm midsoles. These shoes should be fairly resistant to twisting or bending. Stay away from highly cushioned, highly curved shoes, which lack stability features.

The High-Arched Foot

The high-arched foot leaves a print showing a very narrow band—or no band at all—between the forefoot and the heel. A curved, highly arched foot is generally supinated or under-pronated. Because the foot doesn’t pronate enough, usually it’s not an effective shock absorber.
Best shoes: Cushioned shoes with plenty of flexibility to encourage foot motion. Stay away from motion-control or stability shoes, which reduce foot mobility.

When determining your foot type, consult with your doctor of chiropractic. He or she can help determine your specific foot type, assess your gait, and then suggest the best shoe match.


Shoe Purchasing Tips
Consider the following tips before you purchase your next pair of athletic shoes:

• Match the shoe to the activity. Select a shoe specific for the sport in which you will participate. Running shoes are primarily made to absorb shock as the heel strikes the ground. In contrast, tennis shoes provide more side-to-side stability. Walking shoes allow the foot to roll and push off naturally during walking, and they usually have a fairly rigid arch, a well-cushioned sole, and a stiff heel support for stability.
• If possible, shop at a specialty store. It’s best to shop at a store that specializes in athletic shoes. Employees at these stores are often trained to recommend a shoe that best matches your foot type (shown above) and stride pattern.
• Shop late in the day. If possible, shop for shoes at the end of the day or after a workout when your feet are generally at their largest. Wear the type of socks you usually wear during exercise, and if you use orthotic devices for postural support, make sure you wear them when trying on shoes.
• Have your feet measured every time. It’s important to have the length and width of both feet measured every time you shop for shoes, since foot size often changes with age and most people have 1 foot that is larger than the other. Also, many podiatrists suggest that you measure your foot while standing in a weight bearing position because the foot elongates and flattens when you stand, affecting the measurement and the fit of the shoe.
• Make sure the shoe fits correctly. Choose shoes for their fit, not by the size you’ve worn in the past. The shoe should fit with an index finger’s width between the end of the shoe and the longest toe. The toe box should have adequate room and not feel tight. The heel of your foot should fit snugly against the back of the shoe without sliding up or down as you walk or run. If possible, keep the shoe on for 10 minutes to make sure it remains comfortable.

How Long Do Shoes Last?

Once you have purchased a pair of athletic shoes, don’t run them into the ground. While estimates vary as to when the best time to replace old shoes is, most experts agree that between 300 and 500 miles is optimal. In fact, most shoes should be replaced even before they begin to show signs of moderate wear. Once shoes show wear, especially in the cushioning layer called the midsole, they also begin to lose their shock absorption. Failure to replace worn shoes is a common cause of injuries like shin splints, heel spurs, and plantar fasciitis.

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Stress on the Job

Stress on the Job

Stress has been called the spice of life, the common cold of the psyche, and even a socially acceptable form of mental illness. No doubt, stress can be beneficial—for example, a deadline can help us focus and become more alert and efficient. Persistent or excessive stress, however, can undermine performance and make us vulnerable to health problems, from cancer and heart disease to substance abuse and obesity.

Stress is a physical and mental response to the difference between our expectations and our personal experience, real or imaginary. While reacting to stress, the body goes through alarm, resistance, and exhaustion. Released hormone epinephrine, or adrenaline, prepares the body for physical action (“fight or flight”) by increasing heart rate, blood pressure, and blood glucose levels. Then, the body releases glucocorticoid cortisol, or hydrocortisone, producing anti-inflammatory and immunosuppressing effects.

Consequences of Chronic Stress
Although occasional stress can be of benefit, too much stress is taxing on the body. Excessive levels of glucocorticoids can hinder growth, delay wound healing, and increase risk of infection. Chronic stressors—or their constant anticipation—can make us believe that we must always be on guard, leading to anxiety. Feelings of hopelessness or avoiding solving our problems can spark depression.

Past or present psychological distress can also lead to pain, particularly low-back pain, which often comes with leg pain, headaches, sleep problems, anxiety, and depression. Stress may even be a more powerful pain generator than strenuous physical activity or repetitive motion. Research shows, for example, that pain in adolescents is associated with depression and stress, but not with computer use or physical activity.

Stress is highly individual and depends on our circumstances. For example, we react to stress better if we can vent our frustrations, feel in control, hope that things will change for the better, and get social support.

Gender also determines how we handle stress. Women are easily stressed by household problems, conflicts with people, or illness in people they know. Men get more significantly affected by job loss, legal problems, and work-related issues. Men are also more likely to get depressed over divorce or separation and work problems. Depression in women, however, is more likely to spring from interpersonal conflicts or low social support, particularly from family.

Stress on the Job

The workplace has become a major stressor, contributing to the risk of hypertension and heart disease. Recent studies have shown, however, that what stresses us out is not so much the job demands, but our attitude toward them. For example, people who react with anger to their high job strain or who are worried about their chronic work overload have much higher morning corsisol levels. Lack of a sense of control over a job is also associated with higher blood pressure, especially in women and in people with higher socioeconomic status.

Stress Relief Is Important

No matter what stresses you out, consider taking active steps to change your attitude toward stress and to reduce stress in your life. For suggestions on stress relief, please call Chiropractic Care

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Stress Relief

Stress Relief

Stress has become a fact of life, and for some, the daily norm. Although occasional stress can help improve our focus and performance, living with chronic stress can backfire by causing anxiety, depression, and serious health problems.

Understanding who we are, knowing our major struggles, putting them in perspective, and taking action can help us deal with stress. The following strategies can also improve stress tolerance and help lessen the effects of stress on our health.

Think Positively

“Adopting the right attitude can convert a negative stress into positive,” said Hans Selye, author of the groundbreaking work around stress theory. When optimism is hard to muster, cognitive-behavioral therapy, which trains people to recognize negative thinking patterns and replace them with more constructive ones, can also help reduce the risk of chronic stress and depression.

Get Out and Enjoy Nature

While modern civilization has made our lives more convenient, it has deprived us of an essential source of stress relief—connection with nature. Studies show that interacting with nature can help lessen the effects of stress on the nervous system, reduce attention deficits, decrease aggression, and enhance spiritual well-being.

“Smell the Roses” for Better Mood

Aromatherapy, or smelling essential plant oils, recognized worldwide as a complementary therapy for managing chronic pain, depression, anxiety, insomnia, and stress-related disorders, can help you unwind. Orange and lavender scents, in particular, have been shown to enhance relaxation and reduce anxiety.

Relax with a Cup of Tea

During stressful times, coffee helps us keep going. To give yourself a break, however, consider drinking tea. Research shows that drinking tea for 6 weeks helps lower post-stress cortisol and increase relaxation. Habitual tea drinking may also reduce inflammation, potentially benefiting your heart health.

Laugh It Off

Humor relieves stress and anxiety and prevents depression, helping put our troubles in perspective. Laughter can help boost the immune system, increase pain tolerance, enhance mood and creativity, and lower blood pressure, potentially improving treatment outcomes for many health problems, including cancer and HIV. Humor may also be related to happiness, which has been linked to high self-esteem, extroversion, and feeling in control.

Build a Support System

Relationships are also key to health and happiness, especially for women. Women with low social support, for example, are more likely to increase blood pressure under stress. Loneliness may also contribute to stress in both men and women, also leading to poorer outcomes after a stroke or congestive heart failure. On the other hand, active and socially involved seniors are at lower risk for dementia and Alzheimer’s disease. Social support also helps cancer patients to boost the immune system and maintain a higher quality of life.

Employ the Relaxing Power of Music

Music, especially classical, can also serve as a powerful stress-relief tool. Listening to Pachelbel’s famous Canon in D major while preparing a public speech helps avoid anxiety, heart rate, and blood pressure, which usually accompany public speaking.

Singing and listening to music can also relieve pain and reduce anxiety and depression caused by lowback pain. Group drumming also showed positive effects on stress relief and the immune system. Music therapy can also elevate mood and positively affect the immune system in cancer patients and reduce fatigue and improve self-acceptance in people with multiple sclerosis.

To help people deal with stressful medical procedures, music can help reduce anxiety before surgery. When played during surgery, it can decrease the patient’s post-operative pain. Aiding recovery, a dose of calming music may lower anxiety, pain, and the need for painkillers.

Calm Your Mind

In recent decades, many forms of meditation have gained popularity as relaxation and pain relief tools. Focusing on our breath, looking at a candle, or practicing a non-judgmental awareness of our thoughts and actions can help tune out distractions, reduce anxiety and depression, and accept our circumstances. In cancer patients, meditation-based stress reduction enhances quality of life, lowers stress symptoms, and potentially benefits the immune system.

Guided imagery, such as visualizing pictures prompted by an audiotape recording, also shows promise in stress relief and pain reduction. Based on the idea that the mind can affect the body, guided imagery can be a useful adjunct to cancer therapy, focusing patients on positive images to help heal their bodies.

Enjoy the Warmth of Human Touch

Just as the mind can affect the body, the body can influence the mind. Virginia Satir, a famous American psychotherapist, once said that people need 4 hugs a day to help prevent depression, 8 for psychological stability, and 12 for growth. While asking for hugs may not work for some, massage can help us relieve stress and reduce anxiety and depression. Massage has also been shown to reduce aggression and hostility in violent adolescents, to improve mood and behavior in students with ADHD, and to lead to better sleep and behavior in children with autism.

Massage has other therapeutic properties, as well. Regular massage may reduce blood pressure in people with hypertension and may lead to less pain, depression, and anxiety and better sleep in patients with chronic low-back pain. Compared to relaxation, massage therapy also causes greater reduction in depression and anger, and more significant effects on the immune system in breast cancer patients.

Give Exercise a Shot

To get the best of both worlds, affecting the mind through the body while getting into good physical shape, try exercise. In one study, a group of lung cancer patients increased their hope due to exercise. Exercise can also reduce depression and improve wound healing in the elderly. Tai chi, which works for people of all ages, may enhance heart and lung function, improve balance and posture, and prevent falls, while reducing stress.

No matter what stress-relief methods you choose, make it a habit to use them—especially if you feel too stressed out to do it. As someone once said, the time to relax is when you don’t have time for it.

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Chronic Pain and Depression

Pain serves an important function in our lives. When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and tells you to take care of the affected body part.

Chronic pain, on the other hand, persists for weeks, months, or even years. Some people, often older adults, suffer from chronic pain without any definable past injury or signs of body damage. Common chronic pain can be caused by headaches, the low back, and arthritis. Unfortunately, there is scant objective evidence or physical findings to explain such pain.

Until recently, some doctors who could not find a physical cause for a person’s pain simply suggested that it was imaginary— “all in your head.” This is unfortunate because we know that all pain is real and not imagined, except in the most extreme cases of psychosis. Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain undergo structural changes.

Psychological and social issues often amplify the effects of chronic pain. For example, people with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, take care of children, or engage in leisure activities. In turn, spouses, children, and co-workers often have to take over these responsibilities. Such changes often lead to depression, agitation, resentment, and anger for the pain patient and to stress and strain in family and other social relationships.

How is depression involved with chronic pain?

Depression is the most common emotion associated with chronic pain. It is thought to be 3 to 4 times more common in people with chronic pain than in the general population. In addition, 30 to 80% of people with chronic pain will have some type of depression. The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.
People with chronic pain and depression suffer dramatic changes in their physical, mental, and social well-being—and in their quality of life. Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work. This constellation of disabilities starts a vicious cycle—pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.
Until recently, we believed that bed rest after an injury was important for recovery. This has likely resulted in many chronic pain syndromes. Avoiding performing activities that a person believes will cause pain only makes his or her condition worse in many cases.

Signs and Symptoms

Some of the common signs and symptoms of chronic pain include:
• Pain beyond 6 months after an injury
• Allodynia—pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
• Hyperpathia—increased pain from stimuli that are normally painful
• Hypersensation—being overly sensitive to pain
Signs of major clinical depression will occur daily for 2 weeks or more, and often include many of the following:
• A predominant feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
• Changes in appetite or weight (loss or gain) and/or sleep (too much or too little
• Poor concentration or memory
• Feeling restless or fatigued
• Loss of interest or pleasure in usual activities, including sex
• Feeling of worthlessness and/or guilt

What is the treatment for chronic pain and depression?

The first step in coping with chronic pain is to determine its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.
• Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
• Relaxation training, hypnosis, biofeedback, and guided imagery, can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.
• Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.
• Involving your family with your recovery may be quite helpful, according to recent scientific evidence.

Feel free to discuss these or other techniques with your doctor of chiropractic. He or she may suggest some simple techniques that may work for you or may refer you to another health care provider for more in-depth training in these techniques.

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Whiplash

Whiplash

Whiplash is a generic term applied to injuries of the neck caused when the neck is suddenly and/or violently jolted in one direction and then another, creating a whip-like movement. Whiplash is most commonly seen in people involved in motor vehicle accidents, but it can also occur from falls, sports injuries, work injuries, and other incidents.

What structures are injured in a whiplash?

Whiplash injuries most often result in sprain-strain of the neck. The ligaments that help support, protect, and restrict excessive movement of the vertebrae are torn, which is called a sprain. The joints in the back of the spine, called the facet joints, are covered by ligaments called facet capsules, which seem to be particularly susceptible to whiplash injury.

In addition, the muscles and tendons are strained—stretched beyond their normal limits. The discs between the vertebrae, which are essentially ligaments, can be torn, potentially causing a disc herniation. The nerve roots between the vertebrae may also be stretched and become inflamed. Even though it is very rare, vertebrae can be fractured and/or dislocated in a whiplash injury.

What are the common signs and symptoms of whiplash?

The most common symptoms of whiplash are pain and stiffness in the neck. These symptoms are generally found in the areas that are “whiplashed.” For example, during a whiplash, first the head is lifted up from the upper-cervical spine. This creates a sprain/strain in the region just below the skull, where symptoms usually occur. Symptoms may also commonly be seen in the front and back of the neck. Turning the head often makes the pain and discomfort worse.

Headache, especially at the base of the skull, is also a common symptom, seen in more than two thirds of patients. These headaches may be one-sided (unilateral) or experienced on both sides (bilateral). In addition, the pain and stiffness may extend down into the shoulders and arms, upper back, and even the upper chest.

In addition to the musculoskeletal symptoms, some patients also experience dizziness, difficulty swallowing, nausea, and even blurred vision after a whiplash injury. While these symptoms are disconcerting, in most cases, they disappear within a relatively short time. If they persist, it is very important to inform your doctor that they are not resolving. Vertigo (the sensation of the room spinning) and ringing in the ears may also be seen. In addition, some patients may feel pain in the jaw. Others will even complain of irritability, fatigue, and difficulty concentrating. These symptoms also resolve quickly in most cases. In rare cases, symptoms can persist for weeks, months, or even years.

Another important and interesting aspect of whiplash is that the signs and symptoms often do not develop until 2 to 48 hours after the injury. This scenario is relatively common but not completely understood. Some speculate that it may be due to delayed muscle soreness, a condition seen in other circumstances.
How is whiplash treated?

Staying active

One of the most important aspects of whiplash management is for the patient to stay active, unless there is some serious injury that requires immobilization. Patients should not be afraid to move and be active, within reason. In addition, your doctor will often prescribe an exercise or stretching program. It is particularly important to follow this program as prescribed, so that you can achieve the best long-term benefits.

Chiropractic manipulation and physical therapy

Ice and/or heat are often used to help control pain and reduce the muscle spasm that results from whiplash injuries. Other physical therapy modalities, such as electrical stimulation and/or ultrasound, may provide some short-term relief. They should not, however, replace an active-care program of exercise and stretching. Spinal manipulation and/or mobilization provided by a chiropractor can also give relief in many cases of neck pain.

Can whiplash be prevented?

Generally speaking, whiplash cannot be “prevented,” but there are some things that you can do while in a motor vehicle that may reduce the chances of a more severe injury. Always wear restraints (lap or shoulder belt), and ensure that the headrest in your vehicle is adjusted to the appropriate height.

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Dr. Christopher Calarco - Chiropractic Care, Ltd.

Dr. Christopher Calarco

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Dr. Christopher Calarco completed his undergraduate studies at the University of Nevada Las Vegas, where he received a Bachelor in Biological Sciences with an emphasis in biochemistry. He then attended the National University of Health Sciences where he earned his Doctorate in Chiropractic Medicine and currently holds certificates in acupuncture, rehabilitation and physiotherapy. He previously studied Cox-Flexion Distraction under Dr. Jedlicka, and is currently working towards certification under the guidance of Dr. Ralph Kruse. Dr. Calarco takes a multidisciplinary approach to health care with the belief that his patients can benefit from integrating chiropractic care with conventional medicine as well as physical therapy and massage therapy. He is dedicated to a lifetime of continuing education on his particular interests in spinal biomechanics and musculoskeletal pathology. His goal is to educate patients and provide them with the tools for life-long health.

Educational Background
University of Nevada Las Vegas (B.S.) Las Vegas, NV
National University of Health Sciences (D.C.) Lombard, IL

Associations/Organizations
American Chiropractic Association
Illinois Chiropractic Society
Greater North Michigan Avenue Association

Special Honors, Degrees, Certifications

Certified Chiropractic Physician
Certified Acupuncturist

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