Happy New Year!

As 2012 brings me into my 22^nd year of practice, I am full of gratitude for everyone who has made this journey possible. Running two offices has, at times, been challenging, but I enjoy the diversity of the two locations. The beautiful village of Homewood has been my main office location for over a decade and I am now entering my 4^th year at the Michigan Avenue location, just across from Millennium Park. During 2011, I was honored to have had several published manuscripts; a chapter published in a text book, and have been involved in federally funded research studies. I continued to teach Cox Technic seminars around the country as well as hands-on seminars at my office. My web site is continually updated and I try to provide relevant information through my email blasts and this blog. Here’s wishing you a happy and healthy 2012!

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Dr. Kruse's 2011 publications

During 2011, Dr. Kruse had the honor of being published four times. Two case reports were published in the peer reviewed Journal of Chiropractic Medicine. One study found a possible connection between low vitamin D levels and a loss of sense of smell. The other case documented the treatment of low back pain in a patient who previously had lumbar spine fusion surgery. A larger research study was also published in the peer reviewed Journal of Manipulative and Physiologic Therapeutics. This retrospective study documented the effective treatment of lower back pain in a group of 32 patients who previously had spinal surgery. Dr. Kruse also had a chapter discussing back pain and pregnancy published in the latest edition of Dr. James Cox's text book on low back pain.

Take a look at the publications page on my web site to read the articles.

Treating Sports Injuries

Treating Sports Injuries
Sports and exercise are important steps to maintaining health. Unfortunately, however, injuries during participation in sports are all too common. Often, these injuries occur in beginners or those who don’t use proper safety equipment or become overzealous about an exercise regimen.

Strains and Sprains
• An acute twisting or overextension of a joint can lead to tears of muscles and tendons, called “strains,” and tears of ligaments result in “sprains.”
• In mild injuries, just a few fibers are torn or stretched. Severe injuries, where there is a tear through the full thickness of the structure, frequently require surgical intervention.
• The intervertebral disc, a ligament between the vertebrae of the spine that works as a shock absorber, can also be torn, resulting in a disc bulge and/or herniation.
Tendinosis
• In those who are training too much, overuse of a particular joint or joints in the body can result in pain and dysfunction. There injuries are called “overuse syndromes.”
• A common overuse injury is tendinosis, a condition in which the tendon becomes inflamed from repetitive use.
Stress Fractures
• Some athletes may experience a stress fracture, which occurs when an abnormal amount of stress is placed on a normal bone, such as in a runner who rapidly increases the amount of mileage, rather than gradually progressing to longer distances.
• Shin splints are caused by microfractures on the front surface of the tibia (shin bone). This is most often seen in runners, although other athletes can be affected.
Diagnosis and Treatment
Sports injuries are most often diagnosed from the history of the activity which brought on the pain, along with a physical examination. In some cases, X-rays are necessary to rule out a fracture. Fractures require the application of some stabilizing device, such as a cast, after the bone is put back into position. Rarely, surgical intervention is required. Magnetic resonance imaging (MRI) and ultrasound may also be used.

There is a relatively standard treatment protocol for most types of sports injuries, which involves:
• Rest. Generally no more than 48 hours of rest and/or immobilization is needed, depending on the severity of the injury.
• Ice or heat can help with pain reduction and tissue healing.
• Compression of the area may reduce the amount of swelling from the injury.
• Elevation of the injured arm or leg above the level of the heart is thought to be helpful in reducing swelling.
• Joint manipulation. Recent research has shown that, in some cases, joint manipulation can help with pain reduction and more rapid recovery.
Prevention
In many cases, sports injuries can be prevented. Proper conditioning, warm-up and cool-down procedures, understanding proper techniques and using appropriate safety equipment can substantially reduce injuries.

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Massage Gift Certificates...Perfect!

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Food Allergy and Intolerance

Food allergies and intolerances are often misunderstood. Although many people have adverse reactions to certain foods, true food allergy—a reaction triggered by the immune system—is uncommon.

What is a food allergy?

Food allergies occur when the immune system has an abnormal response to an otherwise harmless food. Once the immune system mistakenly decides that a particular food is harmful, it creates specific antibodies to it. The next time you eat that food, the immune system releases neutralizing chemicals, including histamine, to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin and/or the cardiovascular system.

What is food intolerance?

A food intolerance is a digestive system response—not an immune system response. It occurs when something in a food irritates a person’s digestive system or when a person is unable to properly digest or break down the food—often due to a lack of a specific enzyme.

If you have a food allergy, eating even the smallest amount of the food may trigger a serious allergic reaction. But if you have a food intolerance, you can often eat small amounts of the food without a problem.

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Don't Take Arthritis Lying Down

Don't Take Arthritis Lying Down

Years ago, doctors hardly ever told rheumatoid arthritis patients to "go take a hike" or "go for a swim." Arthritis was considered an inherent part of the aging process and a signal to a patient that it's time to slow down. But not so anymore. Recent research and clinical findings show that there is much more to life for arthritis patients than the traditional recommendation of bed rest and drug therapy.

What Is Rheumatoid Arthritis?

The word "arthritis" means "joint inflammation" and is often used in reference to rheumatic diseases. Rheumatic diseases include more than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic arthritis, and many more. Rheumatoid arthritis is also a rheumatic diseases, affecting about 1 percent of the U.S. population (about 2.1 million people.)1 Although rheumatoid arthritis often begins in middle age and is more frequent in the older generation, it can also start at a young age.

Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints. Several features distinguish it from other kinds of arthritis:

• Tender, warm, and swollen joints.
• Fatigue, sometimes fever, and a general sense of not feeling well.
• Pain and stiffness lasts for more than 30 minutes after a long rest.
• The condition is symmetrical. If one hand is affected, the other one is, too.
• The wrist and finger joints closest to the hand are most frequently affected. Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected.
• The disease can last for years and can affect other parts of the body, not only the joints.2
Rheumatoid arthritis is highly individual. Some people suffer from mild arthritis that lasts from a few months to a few years and then goes away. Mild or moderate arthritis have periods of worsening symptoms (flares) and periods of remissions, when the patient feels better. People with severe arthritis feel pain most of the time. The pain lasts for many years and can cause serious joint damage and disability.

Should Arthritis Patients Exercise?

Exercise is critical in successful arthritis management. It helps maintain healthy and strong muscles, joint mobility, flexibility, endurance, and helps control weight. Rest, on the other hand, helps to decrease active joint inflammation, pain, and fatigue. For best results, arthritis patients need a good balance between the two: more rest during the active phase of arthritis, and more exercise during remission.2 During acute systematic flares or local joint flares, patients should put joints gently through their full range of motion once a day, with periods of rest. To see how much rest is best during flares, patients should talk to their health care providers.3

The following exercises are most frequently recommended for patients with arthritis:*

Type of Exercise Benefits Frequency of Exercise

Range-of-motion exercises, e.g. stretching and dance Help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day.

Strengthening exercises, e.g. weight lifting Help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe.

Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming Help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.


* Adapted from Questions and Answers about Arthritis and Exercise.3

If patients experience
• Unusual or persistent fatigue,
• Increased weakness,
• Decreased range of motion,
• Increased joint swelling, or
• Pain that lasts more than one hour after exercising, they need to talk to their health care provider.3 Doctors of chiropractic will help arthritis patients develop or adjust their exercise programs to achieve maximum health benefits with minimal discomfort and will identify the activities that are off limits for this particular arthritis patient.

Nutrition for the Rheumatoid Arthritis Patient

Arthritis medications help suppress the immune system and slow the progression of the disease. But for those who prefer an alternative approach, nutrition may provide complementary support. Some evidence shows that nutrition can play a role in controlling the inflammation, and possibly also in slowing the progression of rheumatoid arthritis.

Some foods and nutritional supplements can be helpful in managing arthritis:

• Fatty-acid supplements: eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and gamma linolenic acid (GLA). Several studies point to the effectiveness of these fatty acid supplements in reducing joint pain and swelling, and lessening reliance on corticosteroids.4,5
• Deep-sea fish, such as salmon, tuna, herring, and halibut, are sources of EPA and DHA. GLA is found in very few food sources, such as black currants and borage seed.
• Turmeric, a spice that's used to make curry dishes, may also be helpful. A 95 percent curcuminoid extract has been shown to significantly inhibit the inflammatory cascade and provide relief of joint inflammation and pain.
• Ginger extract has been shown to be beneficial in terms of inflammation.
• Nettle leaf extract may inhibit some inflammatory pathways.
• A vegetarian or low-allergen diet can help with the management of rheumatoid arthritis as well.

The benefits and risks of most of these agents are being researched. Before taking any dietary supplement, especially if you are using medication to control your condition, consult with your health care provider.

What Can Your Doctor of Chiropractic Do?

If you suffer from rheumatoid arthritis, your doctor of chiropractic can help you plan an individualized exercise program that will:

• Help you restore the lost range of motion to your joints.
• Improve your flexibility and endurance.
• Increase your muscle tone and strength.

Doctors of chiropractic can also give you nutrition and supplementation advice that can be helpful in controlling and reducing joint inflammation.
________________________________________

References
1. Questions and Answers about Arthritis and Rheumatic Diseases. National Institute of Arthritis and Musculoskeletal and Skin Diseases. February 2002. Available from http://www.niams.nih.gov/hi/topics/arthritis/artrheu.htm.
2. Handout on Health: Rheumatoid Arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Jan. 1998, revised Nov. 1999. Available from http://www.niams.nih.gov/hi/topics/arthritis/rahandout.htm.
3. Questions and Answers about Arthritis and Exercise. National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2001. Available from http://www.niams.nih.gov/hi/topics/arthritis/arthexfs.htm.
4. Fortin Paul R., et al. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. J Clin Epidemiol, Vol. 48, 1995, pp. 1379-90.
5. Navarro Elisabet, et al. Abnormal fatty acid pattern in rheumatoid arthritis - A rationale for treatment with marine and botanical lipids. J Rheum, Vol. 27, February 2000, pp. 298-303.

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Stability Balls

Stability balls, also known as exercise balls, Swiss balls, Physio balls, etc., are a low-cost versatile piece of equipment that can help improve core strength, facilitate flexibility exercises, and add variety to traditional fitness routines.

The exercise ball introduces an element of instability that isn’t available in a floor exercise. The body naturally and automatically responds to this instability by engaging the core muscles, both those in the abdominals and back and in the pelvic floor and hips. Over time, the core muscles strengthen, resulting in better posture, improved balance and enhanced athletic ability.

Choosing a stability ball
It’s important to buy the right size ball and maintain the proper air pressure. The firmer the ball, the more difficult the exercise will be. However, if you are overweight, an older adult, generally deconditioned, or just beginning a fitness routine, you may want to consider using a larger, softer ball. When sitting on the ball, make sure your hips are level—or just slightly higher than the knees.

Basic Exercises
Basic Abdominal Crunch: Lie on your back with your calves resting on the top of the ball. Curl your upper body, squeezing your abdominals and lifting your shoulders and upper back.

Body Ball Crunch: Lie on the ball with your back supported at the arch. Cross your arms behind your head or across your chest. Keep both feet on the floor. Curl your upper body, squeezing your abdominals and lifting your shoulders and upper back. Return to starting position. Do not pull on your head and neck.

Ball Pushups: Place the front of your knees and shins on the ball and your hands flat on the floor. Look down at the floor and lower your face to within a few inches of it, then push back up to the starting position. Increase the challenge by walking further out so that only your ankles are supported by the ball

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Our new Video!

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Key to Senior Fitness: Chiropractic Care and a Healthy Lifestyle

Over the hill at age 65? Ready for the rocker at 70? Not these days. Americans are living longer and making more of their later years. One key is exercise.

"Perhaps the most debilitating influence in people's health as they age is a sedentary life," said Dr. Richard Brassard, president of the American Chiropractic Association (ACA). "Exercise of some type is all but mandatory."

Otherwise, an individual may set him or herself up for broken bones, circulation problems caused by atrophying blood vessels, and a myriad of other physical problems associated with aging.

"Exercise, however, can improve a person's mobility, digestive processes and circulation. It can also reduce anxiety. Add proper nutrition and you have the makings of a naturally healthy lifestyle," said Dr. Brassard. "Following a healthy diet is another way of extending your golden years as long as possible."

Dr. Brassard and the ACA suggest the following tips to help seniors maintain a healthy lifestyle:

Walking

• Walking improves elasticity in blood vessels, which makes them less susceptible to formation of aneurysms or rupture.
• Start with one-third of a mile per day - one-sixth out and one-sixth back. (Measure the distance with your car.) Do that three days a week for a month, then double the distance, working gradually up to at least one mile a day, three days a week.
• Expect a little soreness in the thighs and calves for the first week or two. If you experience more than soreness, check with your chiropractor.

Stretching
• The average person should stretch to prevent the bowing or stoop caused by shortening of ligaments. A stoop can inhibit normal breathing.
• Stretch the groin muscles by sitting on the floor and bending one leg to the side and back as far as possible. Or sit Indian fashion on a cushion and watch television. A relaxed stretch is the goal.
• Stretch the back leg muscles by putting your hands on a wall, one foot flat on the floor behind you. Then lean into the wall. Or stand up straight and bend over. Or sit with one foot on an ottoman and bend forward.

Eating Right
• Make sure you have a properly balanced diet. If you take vitamins, take them with a meal. Drink 10 eight-ounce glasses of water a day to help keep the kidneys active, dilute and remove toxins from the body, and replace lost fluids. (Coffee, tea, soft drinks and alcohol are diuretics. Don't substitute them for water.)
Dr. Brassard suggests seeing your chiropractor regularly as well. "He or she has the expertise to help keep you in the mainstream of life."

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Proper Posture

We often hear that good posture is essential for good health, but very few people have a real grasp of the importance and necessity of good posture, or the position in which we hold our bodies while standing, sitting or lying down. Good posture is the correct alignment of body part supported by the right amount of muscle tension against gravity. Follow this advice for standing, sitting and lying properly:

• When sitting, keep your feet flat on the floor with a small gap between the back of your knees and the front of your seat. Your knees should be at or below the level of your hips.
• When standing, bear your weight primarily on the balls of your feet and keep your knees slightly bent. Your feet should be about shoulder-width apart and your earlobes should be in line with your shoulders to keep your head from jutting forward, backward or to the side.
• Avoid sitting or standing in the same position for long periods of time.
• Sleep with a pillow and avoid lying on your stomach. If you sleep on your side, place a pillow between your legs. If you sleep on your back, keep a pillow under your knees.

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Raking Leaves

Before you rev up the lawnmower or reach for your rake this fall, consider the possible consequences: upper or lower-back strain, neck strain and pain in the shoulders.

Just as playing football or golf can injure your body, the twisting, turning, bending, and reaching of mowing and raking can also cause injury if your body is not prepared. Like an athlete, if you leap into something without warming up or knowing how to do it, the chances of injury are greater.

What Can You Do?

The American Chiropractic Association (ACA) offers the following tips to help prevent the needless pain yard work may cause.
• Do stretching exercises, without bouncing, for a total of 10 to 15 minutes spread over the course of your work. Do knee-to-chest pulls, trunk rotations, and side bends with hands above your head and fingers locked. Take a short walk to stimulate circulation. When finished with the yard work, repeat the stretching exercises.
• Stand as straight as possible, and keep your head up as you rake or mow.
• When it's still warm outside, avoid the heat. If you're a morning person, get the work done before 10 a.m. Otherwise, do your chores after 6 p.m.
• When raking, use a "scissors" stance: right foot forward and left foot back for a few minutes, then reverse, putting your left foot forward and right foot back.
• Bend at the knees, not the waist, as you pick up piles of leaves or grass from the grass catcher. Make the piles small to decrease the possibility of back strain.
• When mowing, use your whole bodyweight to push the mower, rather than just your arms and back.
• If your mower has a pull cord, don't twist at the waist or yank the cord. Instead, bend at the knees and pull in one smooth motion.
• Drink lots of water, wear a hat, shoes and protective glasses. And, to avoid blisters, try wearing gloves. If your equipment is loud, wear hearing protection. If you have asthma or allergies, wear a mask.
• Try ergonomic tools, too. They're engineered to protect you when used properly.
• If you do feel soreness or stiffness in your back, use ice to soothe the discomfort. If there's no improvement in two or three days, see your local doctor of chiropractic.

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Beware... text neck from too much gadget use!

First, too much texting caused some people to come down with painful Blackberry Thumb. Now today’s technology is being blamed for another malady: text neck.

Doctors and chiropractors say people hunched over their mobile gadgets are developing neck strain, headaches and pain in the shoulders and, sometimes, in arms and hands. What’s more, all that curving of the body to text, type, watch videos and play games could cause debilitating pain that lasts a lifetime, they warn.

“This is a global epidemic,” says Dean L. Fishman, a chiropractor who practices at the Text Neck Institute in Fort Lauderdale, Fla. He trademarked Text Neck and changed the name of his practice after noticing 90 percent of his patients coming in with the same complaint. His youngest patient is a 3-year-old, who’s in love with playing games on an electronic device.

“It’s starting younger and younger. There are more than six billion phones connected, and that’s not counting the Kindles, iPads, tablets and all these devices we rely on daily,” Fishman says. “Go outside, to a restaurant, the supermarket, a gym, the airport and notice the posture of almost everyone around you. You will see this everywhere, and now multiply that by every city in the world.”

American sent 110 billion text messages in December 2008, the U.S. Census Bureau reported, and that number can only be increasing.

Fishman says text neck is actually not a new condition, but it’s getting more attention because so many people are suffering from it. Doctors used to call it forward head posture, but Fishman noticed his patients better understood what he was talking about when he used the term text neck.

Richard Wells, professor of applied sciences at the University of Waterloo, in Waterloo, Ontario, Canada, wondered about the effects of technology on our bodies and conducted what is believed to be the world’s first research study on text neck.
He found that among 140 students who participated in an online survey, twice as many experienced pain in their shoulders, neck and other areas when they used their devices three hours or more a day compared to those who used their devices for less time. The study was published in the January 2011 edition in the Journal of Applied Ergonomics.

“We learned the longer people use mobile devices, cell phones, PDAs — all the things we use to communicate with that have little keyboards — the more they have pain in their necks, shoulders and thumbs,” he says.

Texas chiropractor Cynthia Vaughn and spokesperson for the American Chiropractic Association says text neck is affecting tens of thousands of people here in the United States because nearly everyone has a cell phone. “It’s a known phenomenon and that’s increasing and doctors need to educate their patients on the proper ergonomics of this.”

Preventing text neck

Learning to hold your arms out and look straight ahead may initially seem awkward, but it can save your neck and spine, she says. Taking frequent breaks every 15 minutes and holding your head back also helps alleviate symptoms. The American Chiropractic Association also warns people to tuck their chins down to their chest, if you must look down rather than holding your arms out. Stretch your hands; squeeze a stress ball and stretch your chest by standing up straight with arms down at your side. Turn your forearms until your thumbs are pointing at the wall behind you.

“I tell my patients the easiest thing to do is pick up the phone and call people,” Vaughn says. “Phones still call out. If you’re not going to call people, take the time to drop your head back every few minutes.”

For those who already have neck and shoulder pain, Fishman says his patients have found relief by coming in for adjustments. Chiropractors and orthopedic specialists most often treat the issue.

Fishman also created a new Android app, called Text Neck, which gives users a green light when they are properly holding their phones and a red light when they are holding their heads down and rounding their shoulders. The application also can send reports to parents who can monitor their children’s posture while using their phones.

“We teach our patients to pull the shoulder blades back and down,” he says. “In our research, we found the people who made the most improvement in the restoration in the curve of their neck came from people who made the biggest change and stopped hanging down low.”

http://www.msnbc.msn.com/id/44820101/ns/health-health_care/t/beware-text-neck-too-much-gadget-use/#.Tprx-o6kdBk

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Tips for Healthy Aging

Tips for Healthy Aging

The number of people living longer is increasing dramatically. An estimated 4.2 million U.S. residents now fall into the age group of the “oldest old”—85 years and older—with more than 40,000 having reached the age of 100. In fact, centenarians (those 100 and older) are the fastest-growing subpopulation of the elderly, and by 2050, according to census projections, 1 million Americans will celebrate their 100th birthdays.

At the same time, a growing body of evidence suggests that good genes are only a small part of the longevity puzzle. In fact, researchers now believe that chronic illness is not an inevitable consequence of aging, but it results more often from lifestyle choices that we’re perfectly free to reject.

So what are centenarians’ secrets to healthy old age? Experts recommend the following:

Embrace a Positive Attitude

Centenarians tend be very optimistic and always hope for the best. According to research, having a positive attitude is key to the ability to live longer and can lead to a healthier, higher quality of life. Researchers speculate that positive emotions may directly affect overall health, perhaps through direct mechanisms, such as immune function, or indirectly, for example, by strengthening social support networks.

Stimulate Your Mind

Research shows the more educated we are, the longer we live. And the benefits of education are even more pronounced when learning continues throughout our lives. Most centenarians take advantage of opportunities and possibilities that have not been available to them earlier in their lives, such as second careers, volunteer activities, musical instruction, writing, various classes in areas of interest or travel. In addition, you may want to consider mentally challenging activities such as crossword puzzles or learning a new language.

Limit Stress and Stay Connected

Protect your mental and physical health by managing your stress at work and at home. Humor, meditation, exercise and optimism are good ways to naturally reduce stress and relieve tension.

Stay in touch with family and friends. Those who maintain a close network of social support do best. Social contacts may encourage us to take better care of ourselves—by cutting down on smoking and drinking, for example, or seeking medical treatment earlier for symptoms that may indicate serious problems. Friends may also help us get through difficult times by offering coping mechanisms and having a positive effect on mood and self-esteem.

Take Advantage of Your Genes

Good health practices will help you make up for at least some of the genetic difference between you and centenarians. Essentially, you can compensate for bad genes by healthy living—or ruin perfectly good genes with poor habits. Smoking and excessive alcohol intake, for example, increases the risk of many chronic diseases. As you age, be sure to get regular health screenings.

Support Your Body with Exercise

Find fun ways to stay in shape, such as dancing, gardening, swimming, walking or jogging. Include strength training, as directed by a personal trainer or health care provider, to maintain muscle mass. Increased muscle tissue burns fat more efficiently, reduces your heart disease risk, and lessens your chance of a broken hip from falling. For adults, a minimum of 30 minutes of moderate physical activity on most days of the week is recommended.

Make Healthy Diet Choices

What you eat and drink—and what you don't eat and drink—can make a big difference to your health. To prevent weight gain and maintain good health, pay special attention to eating efficiently. Choose foods that maximize nutritional value and minimize calories.

Overly processed foods often contain more calories and fewer nutrients. Choose, instead, whole, natural foods like fruits and vegetables, whole grains, good (unsaturated) fats, nuts, legumes and healthy sources of protein (white meat, fish and eggs).

Choose a Good Health Care Provider

Even if you are healthy and make good preventative choices, it is essential to have access to a good, trustworthy health care provider.

A health care provider should:

• Know and support all forms of healing and various approaches to health care to present patients with the most effective, safest preventative or treatment options available.
• Emphasize prevention and whole-person wellness.
• Teach healthy living practices.
• Involve patients in decisions regarding their care—except for acute, potentially life-threatening emergencies.
• Encourage patients to be responsible for their health.

Chiropractic Care Can Help

Talk to your doctor of chiropractic about other ways to improve your quality of life. Doctors of chiropractic are trained and licensed to examine and treat the entire body with specific emphasis on the nervous and musculoskeletal systems, wellness and prevention.

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Blackberry Thumb

Together with several other repetitive stress injuries that are showing up in this fast-paced, technology-focused era is a condition known in popular culture as BlackBerry® thumb. Blackberry thumb is the joint and wrist pain and inflammation caused by the overuse of any personal digital assistant (PDA) or Smartphone. Red flags that signal a need to change how we use PDAs, and possibly the need to consult with a qualified health care professional, are occasional aches in any or all of those areas. Left untreated, BlackBerry thumb can develop into severe pain, weakness, and even disability.

What Causes It?
BlackBerry thumb occurs as the result of asking the thumb joints to repeatedly perform the same action too often. Excessive tapping, flicking, and clicking do our thumbs no favors. X-ray and exam findings can determine if a patient has BlackBerry thumb.
Some sports enthusiasts like to “work through pain.” They believe that by pushing the body beyond its current limits, it will gradually become accustomed to new demands placed on it. That approach does not work with joints. And since BlackBerry thumb is a joint problem, forcing thumbs to go above and beyond will only lead to further trouble.

Typical Treatments
Patients will often be asked to rest the thumbs as part of treatment. Medical treatment typically consists of resting or splinting the thumb, anti-inflammatory medicines, cortisone injections and, as a last resort, surgery.

What Might a DC Suggest?
Doctors of chiropractic (DCs) are educated to use a variety of non-drug, non-surgical
approaches to BlackBerry thumb. Giving your thumbs a chance to start the healing process may include a program of rest, thumb strapping, and gentle stretches or targeted massage. A DC may decide to use Instrument-Assisted Soft-Tissue Mobilization (IASTM) to help alleviate the problem. One of the better-known of such techniques is Graston Technique®, which utilizes stainless steel instruments in the hands of practitioners skilled at treating damaged soft tissues.

What Can I Do To Help Myself?
Whatever we might wish them to do, doctors cannot simply make BlackBerry thumb “go
away” without the cooperation of the patient. Moderation and flexibility in how we use PDAs are key. When it comes to BlackBerry thumb, the following tips can make our PDAs do what they were designed to do—serve us, not hurt us:

• Avoid typing for more than three minutes without a break.
• Hold the PDA comfortably and close to the body.
• Insert it into a holder and set it on a desk or a briefcase.
• Turn the device off on the weekend—or at least on Sundays.
• Decide that you will check emails and text messages just four times a day.
• Cut back on the number of keystrokes and keep messages short and simple.
• Abbreviate.
• Consider using the AutoText feature.
• If a message must be longer, use your computer keyboard, not your PDA.
• Practice using other fingers for typing—especially when thumbs hurt.
• If thumbs are in pain, use a thumb or wrist support.
• Pay attention to your grip. Keep wrists upright and straight.
• Don’t slouch while texting. Slouchers often develop neck pain, in addition to thumb
pain.

For more information from the American Chiropractic Association on how to getTechno Healthy, visit www.TechnoHealthy.com.

October 2011
For more information on injury prevention and wellness, or to find a doctor of chiropractic near you, go to the patient information section on ACA’s Web site at www.acatoday.org/Patients or call 800-986-4636.
This patient information page is a public service of the Journal of the American Chiropractic Association. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for a diagnosis by a specialist. For specific information concerning your health condition, consult your doctor of chiropractic. This page may be reproduced noncommercially by doctors of chiropractic and other healthcare professionals to educate patients. Any other reproduction is subject to ACA approval.

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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.

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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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