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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Just Try Walking

Just Try Walking

While some fitness enthusiasts relentlessly seek out the latest, trendiest exercise crazes, many others are returning to good, old-fashioned walking to help them feel great and get into shape. Whether enjoying the wonder of nature, or simply the company of a friend, walking can be a healthy, invigorating experience. And thanks to its convenience and simplicity, walking just might be right for you, too.

Benefits of Walking

You don’t need to become a member of an expensive gym to go walking. And except for a good pair of walking shoes, it requires virtually no equipment.

A sedentary lifestyle has a debilitating influence on people’s health as they age, therefore exercise is imperative. Walking accomplishes all of the following and more:

• Improves cardiovascular endurance
• Tones muscles of the lower body
• Burns calories: about 80 if walking 2 miles per hour, and about 107 if walking 4.5 miles per hour
• Reduces risk of heart disease

Selecting Shoes

The first item of business when beginning your walking program is to select the right pair of shoes. Too many people choose fashion over function when purchasing running shoes, not realizing that poor-fitting shoes can do more than hurt their stride; they can also lead to pain throughout the body.

• Make sure the shoes you purchase fit properly. The balls of your feet should rest exactly at the point where the toe end of the shoe bends during walking.
• Select shoes with plenty of cushioning in the soles to absorb the impact.
• Shop for sneakers 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.
• When trying on shoes, be sure to wear them for at least 10 minutes at the store.
Once you have purchased a pair of shoes, don’t walk them into the ground. While estimates vary as to when is the best time to replace old shoes, most experts agree that between 300 and 500 miles is optimal.

Getting Started

Walking just 12 minutes every other day can offer important health benefits. But in order to increase your longevity, try to eventually work up to 30 minutes, five days per week. Experts generally agree that to be considered “active,” adults should try to take 10,000 steps each day. Wearing a pedometer is an easy way to track your progress.

The following tips can help you get started on your walking regimen:

• Move your arms freely, in coordination with the opposite leg.
• Don’t stoop your head or look down as you walk. This will challenge the normal forward curve of your neck, which, in turn, will cause you to carry your weight improperly.
• Don’t carry weights or dumbbells while walking. They’re better used as a separate part of your exercise regimen.
• Expect a little soreness in the thighs and calves for the first week or two. If you experience more than soreness, check with your doctor of chiropractic.
• Walk briskly, with “purpose.” Simply sauntering, while relaxing and enjoyable, is not an effective form of cardiovascular exercise.

Of course, be sure to consult your doctor before beginning any exercise program.

Walking Surfaces

Some walking surfaces are better than others on your musculoskeletal system.

• Walking on a cushioned or rubberized track is ideal, because the cushioning of this type of track absorbs most of the impact of your walking. Many recreation centers offer this type of track free of charge.
• Grass is another good surface, but watch out for hidden dips or holes in the ground.
• Walking on a surface with no give, such as concrete or a mall floor, is not your best choice, because this type of surface will not absorb much of the impact your body will experience. If you do choose to walk on such a surface, be extra careful to select highly cushioned shoes.

Pain and Injury

While you may experience pain or injury in a particular area, such as a knee or a hip, the root of the problem may lie somewhere else. Injuries of this nature are not regional, or isolated, but systemic. A problem in the foot or ankle can create an imbalance in every step, leading to discomfort or injury that moves to the knees, hips, low back, or elsewhere. If you suffer from pain beyond typical muscle soreness, your doctor of chiropractic can diagnose and treat your pain or injury and get you back into the swing of your walking routine. Your doctor of chiropractic can also help customize a wellness program that is right for you and has the expertise to help keep you in the mainstream of life.

If you have pain in your feet, heels or knees, you may benefit from a pair of custom fitted orthotics. Our offices offer digital foot scans to customize shoe orthotics to your condition and for your specific shoes.

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Dr. Oz Video - Back Pain

Back pain plagues as many as 80% of us – but guzzling pain killers isn’t the only way to get relief. A new report says that chiropractic therapy is just as effective as over-the-counter pain relievers for back pain. Dr. Oz explains how your spine gets misaligned and what this treatment could do for you.

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Quit Smoking...Why and How?

Quit Smoking: Why and How?

More than 50 million Americans smoke. People begin smoking for many reasons—stress, social status, and peer pressure—but the main reason they continue is addiction to nicotine. Smoking is, in fact, so addictive that some people consider giving up cigarettes harder than quitting an addictive illicit drug. People also continue to smoke for psychological reasons. For some, smoking seems to give the hands something to do. Others say it provides comfort.

Cigarette smoke, however, contains more than 4,000 chemicals, and, when inhaled, they merge into a tar-like substance that sticks to the tissues inside the mouth, throat, lungs, and stomach. The chemicals not only damage the tissues they contact directly, but they also harm the entire body by reducing the amount of well-oxygenated blood that reaches the organs.

Smoking affects nearly every organ in the body—heart, brain, stomach, bladder, kidneys, and even the skin. People who smoke also double or triple their risk of developing cataracts.

Why quit smoking?

Smoking affects not only your health. Second-hand smoke can cause damage to those around you—even family and friends who choose not to smoke. If you quit smoking:

• You’ll live longer and you and your family will live better.
• You won’t be winded when walking up a flight of stairs.
• You’ll be able to exercise and keep your heart healthier.
• You will reduce the risk of developing dementia, such as Alzheimer’s disease.
• Your baby will be at less risk of suffering from Sudden Infant Death Syndrome (SIDS).
• You’ll have less heartburn.
• For men, smoking increases the chances of impotence, so your love life will improve, as well.
• You’ll also be giving yourself money each month to spend on yourself and not on cigarettes.

How do I quit smoking?

• Make a serious mental commitment to quitting.
• Set a quit date.
• Refer to yourself as to a non-smoker in the present tense. For example, say, “I am a non-smoker.” Similar affirmations that fit your individual situation may also be helpful.
• Get rid of all cigarettes and smoking accessories (such as ashtrays) in your home, car, and other places where you might be tempted to smoke.
• Do not let people smoke in your home.
• Get support and encouragement from family, friends, co-workers and former smokers and consider joining a former smokers’ support group.
• When tempted, perform tasks that could help distract you: go for a walk, brush your teeth, exercise, or take a bath.
• Drink lots of fluids, preferably those with caffeine.
• Avoid drinking alcohol and avoid contact with smokers.
• You may want to try one of the many medications available to help smokers quit.

Quitting smoking is not easy. If it were, many more people would quit daily. You may find yourself suffering from irritability, nervousness, and sleeplessness. You may feel the need to have something in your mouth or hands. Chewing gum or mints can easily substitute for cigarettes, and rubber bands, paper clips, or other gadgets will help keep your hands busy. For most people, the side effects pass within a few days. It is critically important not to dwell on these adverse signs and to remain focused on the advantages of quitting.

Most smokers have to kick the habit more than once to finally quit. If you are unsuccessful the first or second time, try again. Don’t see the initial attempts as failures, but as opportunities to find out how not to quit. With a sincere commitment and perseverance, you will be able to quit. When you do, your family, friends, and most of all, your body will thank you for rising to the challenge.


For more information and research on this topic, go to http://www.coxchirocare.com/

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Does Your Bike “Fit” You?

Bike Fit Basics

Whether you ride on-road or off, pedal casually or competitively, it’s important to pay close attention to how your bicycle fits your body. A properly fitted bike will allow you to ride comfortably and safely, avoid injury, and produce more power, so you go faster with the same or less effort.

In general, when fitting a bicycle, there are five basic components to consider:
1. Frame size
2. Saddle (seat) height
3. Saddle position
4. Saddle tilt
5. Handlebar position
Frame Size
Frame size is perhaps the most important of all measurements because once you purchase the bike, there are very few—if any—minor adjustments that can affect the overall frame. Frame size is not necessarily dependent on your height; rather, it is more a matter of leg length. Simply, the frame should be easily straddled with both feet flat on the ground, and with perhaps an inch or two of clearance.

• For a road or hybrid bike, you should have an inch or two of clearance between your crotch and the top tube.
• For a mountain bike, clearance should be about four inches—especially if you plan to ride in rugged terrain where an unplanned dismount is likely.

Saddle Height
A saddle (seat) set too high or too low can cause pain and lead to injuries of the back and knees, and it will also affect the efficiency of each pedal stroke. As a starting point, set the saddle height so that your knee is slightly bent when the pedal is at its lowest position and the ball of your foot is on the pedal. It is recommended to make adjustments in very small increments and, if applicable, to wear your cycling shoes during the adjustment process.
Saddle Position
To check the saddle position, sit on your bicycle—using a friend or a stationary object to keep yourself balanced— and rotate your pedals until they are horizontal (at the 3 o’clock and 9 o’clock positions). If your saddle is positioned properly, your forward knee should be directly over the respective pedal axle (with the ball of your foot on the pedal). For precise measurement, use a plumb-bob to help you visualize the alignment. If adjustments are needed, loosen the seat post and slide the saddle forward or backward, keeping the seat level.
Saddle Tilt and Design
Generally speaking, your saddle should be level. Check this adjustment by using a carpenter’s level balanced on the saddle while the bike is on level ground. If your saddle tips too much in either direction, pressure will be placed on your arms, shoulders, and lower back.
Handlebar Position and Distance
Handlebar setup is a matter of personal preference because it will affect shoulder, neck, and back comfort. Generally, handlebars are positioned higher for comfort (a more upright riding position) and lower for improved aerodynamics.
Always Wear a Helmet!
A bicycle crash can happen at any time; however, according to the National Highway Safety Traffic Administration, a properly fitted bicycle helmet reduces the risk of head injury by as much as 85 percent and the risk of brain injury by as much as 88 percent. The following are tips to help ensure the correct helmet fit:
• The helmet should be level on the head, and it must cover the forehead.
• The Y of the side straps should meet just below the ear.
• The chin strap should be snug against the chin so that when you open the mouth very wide, the helmet pulls down a little.
• Put your palm on the front of the helmet, and push up and back. If it moves more than an inch, more fitting is required.
• Shake your head around. If the helmet dislodges, work on the strap adjustments.
• Do not wear a hat under the helmet.
• All helmets sold in bike shops must be approved by the U.S. Consumer Product Safety Commission (CPSC) and should carry a CPSC sticker.

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Enjoying the Outdoors with Baby!

From biking and hiking to walking and jogging, today's parents are keeping fit and bonding with their babies in the process. With an array of products unheard of a generation ago - like baby carriers, joggers and trailers - even the tiniest among us are enjoying the great outdoors. But while these items can make life easier and more enjoyable for both parent and child, they can be the cause of pain and injury if not used properly. The American Chiropractic Association (ACA) urges you to exercise caution and good judgment while exercising with your baby.

Biking
When biking with a child on board, use a trailer, a rolling ride-along that hitches to the back end of a bike. It is a much safer option than a carrier, a "passenger" seat that sits directly on the bike, according to Dr. Scott Bautch, a member of ACA's Council on Occupational Health. Dr. Bautch prefers trailers because of their added stability. He cautions that carriers can decrease a bike's stability, possibly causing it to topple and injure both the parent and child.

To further ensure the child's safety while biking, keep the following tips in mind:
• The trailer must be equipped with a harness that can be placed over the child's body. The harness should be complicated enough that the child cannot unhook it or wiggle out of it.
• A screen that covers the front of the trailer will add an extra line of protection against stray pebbles and other flying objects.
• Be sure to select a trailer that has large, bicycle-style tires, which will add stability and ease to your ride.
• Protect your child's head with a sturdy, adjustable helmet that can be sized to fit properly. If the helmet rests too high, it will expose part of the child's head, leaving it susceptible to injury.
• Bike only on smooth surfaces for optimal control.
• Only an experienced rider should attempt to bike with a child on board at all. And even then, the rider should practice with a ride-along trailer for two weeks before riding with a real child - in an effort to get a feel for the strength and coordination necessary to maneuver the bike.
Jogging
If you wish to go for a jog and bring your child along for the ride, the baby jogger is your best option. A baby jogger is a rolling pushcart that a parent can jog behind, using handlebars to maneuver. Here are some rules of thumb to consider:
• Make sure the handlebars of the jogger are both large and adjustable, so that they fit comfortably into your hands for complete control. The handlebars should be kept as upright as possible.
• Handbrakes and a locking mechanism are a necessity.
• Look for a jogger with a good shoulder harness to keep the child secure.
• Large, bicycle-style tires offer more control and stability.
• A screen over the front of the jogger adds to its safety by deflecting stray flying objects.
• Jog only on smooth surfaces.
Backpack-Style and Front-Side Baby Carriers
For parents who prefer walking or hiking with their little ones, a backpack-style or front-side baby carrier could be for you. Dr. Bautch cautions, however, that there are risks involved with carrying an infant on your back in a backpack-style carrier. "The cervical spine of a child less than one year old is not fully developed. It is important at that age that the head does not bob around. The backpack-type carrier is not ideal because the parent cannot watch to make sure the child's head is stable. A front-side carrier is better for a very young child," explains Dr. Bautch.

Dr. Bautch also urges you to think about the following:
• A backpack-style or front-side carrier decreases a parent's stability when walking or hiking. It is critical that a parent gets into shape before attempting to use one of these products.
• Since these carriers will change the feel of walking or hiking quite a bit, they should not be used by beginning walkers or hikers.
• If using a backpack-style or front-side baby carrier, make sure to select one with wide straps for your shoulders and waist. This will help distribute the carrier's weight evenly. The shoulder straps should fit comfortably over the center of your collarbone.
• The carrier should include a harness to keep the child stable.
• Once you place the child in the carrier, check to make sure there is no bunching of material against the child's body, particularly on the back, buttocks and spine. Isolated, uneven pressure like this can produce pain.
Baby Slings
The "baby sling" is becoming more and more popular for its versatility of positions and comfort. But if you wish to use a baby sling, keep in mind that it is intended only for very young infants and follows these tips:
• A baby can become very hot inside the sling, so be mindful of the temperature around you. Also, make certain the baby's breathing is clear and unobstructed by the sling's material.
• Never run or jog while carrying a baby in any backpack-style carrier, front-side carrier or baby sling. A baby's body is not adjusted to the cyclic pattern that is a part of running and jogging. This motion can do damage to the baby's neck, spine and/or brain.
Take Care of Yourself
Finally, don't forget about your own health and comfort. When lifting a child to place him or her into a trailer or jogger, exercise caution. Don't bend from the waist, but begin in a 3-point squat and implement a two-stage lift that consists of a) pulling the child up to your chest and then b) lifting straight up with your leg muscles. Stay as close to the car seat or trailer as possible and place the child into it without reaching, stretching or twisting. The further the child is from your body, the more strain you will place on your spine and musculoskeletal system.

Chiropractic Care Can Help
If you or your child experiences any pain or discomfort resulting from these or other outdoor activities, call your doctor of chiropractic. Doctors of chiropractic are licensed and trained to diagnose and treat patients of all ages, and can provide health tips for you and your children that will make enjoying outdoor activities safer and more enjoyable.

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Osteoporosis: Not Just An Elderly Disease

It used to be that osteoporosis was considered a disease that affected only the elderly. We particularly associated osteoporosis with older women whose backs were slightly hunched over or those who could no longer stand up straight. Today, the truth is that an estimated 20 million American women suffer from osteoporosis, and 80 percent of them don't even know it.

Osteoporosis is a chronic, progressive condition that steals bone from the body, leading to fractures of the hip, spine and wrist. Older people can suffer disability and even death from osteoporosis-related fractures. Alarmingly, one in two women and one in eight men will suffer from an osteoporosis-related fracture in his or her lifetime.

Many people confuse osteoporosis with arthritis, and wait for swollen joints and discomfort before being tested. Even though osteoporosis is painless until a bone fracture occurs, it is important to find out how healthy your bones are now and if need be, adjust your lifestyle to avoid this brittle bone disease. The American Chiropractic Association recommends the following tips to maintain healthy bones:

• Start a regular exercise program. Walking, skipping rope, jogging, playing racquet sports, swimming and aerobics are all helpful in reducing the risk of osteoporosis. Exercising for 20 minutes, three times a week, is helpful.
• Although weight lifting exercises are generally recommended, the National Osteoporosis Foundation says those suffering from osteoporosis should consult their health care practitioner before beginning a weight lifting program because excessive strain on the bones could result.
• Those with severe osteoporosis and who have suffered from fractures may find Tai Chi, a form of martial arts, to be a beneficial strength training exercise system.
• People suffering from osteoporosis should be careful when bending and lifting heavy objects, including grandchildren. Bend from the knees, not the waist, when lifting, and try to avoid hunching while sitting or standing.
• Be sure to include calcium in your daily diet. The National Institutes of Health's recommendations are 1,000 mg/day for post-menopausal women taking estrogen; 1,500 mg/day for postmenopausal women not taking estrogen, and 1,500 mg/day for men and women over 65 years of age.
• If you are looking for a calcium supplement, try one that's highly absorbable, such as microcrystalline hydroxyapatite concentrate (MCHC), or one of the malates, fumarates, succinates, glutarates, or citrates. But don't overdo it. Taking more than the recommended amount of calcium may cause kidney stones.
• Consider taking additional nutritional supplements, such as vitamin D, C, magnesium, zinc and silica after consulting with your doctor of chiropractic.
• Eat a healthy, balanced diet, including fresh vegetables, fruit, nuts and seeds. Try broccoli, kale, collard greens, cabbage and turnip greens. Experiment with tofu, salmon, sardines and grains. Low-fat milk and/or yogurt are good sources of calcium. (A glass of low-fat milk and a cup of yogurt add 600 mg of calcium to your daily diet.)
• Drink 8 eight-ounce glasses of water a day (herb teas, juices and coffee are not a substitute for water.) Avoid caffeine, carbonated sodas, alcohol, baked goods and junk food.
• Watch your animal protein intake.

Chiropractic Care Can Help...
Talk to your doctor of chiropractic about ways to improve the health of your bones. Doctors of chiropractic are licensed and trained to treat patients of all ages and can help people suffering from osteoporosis lead healthier lives.

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Scoliosis

Scoliosis affects 5 to 7 million people in the United States. More than a half million visits are made to doctors’ offices each year for evaluation and treatment of scoliosis. Although scoliosis can begin at any age, it most often develops in adolescents between the ages of 10 and 15. Girls are more commonly affected than boys. Because scoliosis can be inherited, children whose parents or siblings are affected by it should definitely be evaluated by a trained professional.

What is scoliosis?

Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated.

In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, or affecting heart function. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers.

Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, provided there are no signs of further progression. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.

How is scoliosis evaluated?

Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.

Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis. In addition, x-rays of the wrist are often performed. These films help determine the skeletal age of the person, to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression. Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.

Other tests, including evaluation by a Scoliometer™, might also be ordered by the doctor. This device measures the size, by angle, of the rib hump associated with the scoliosis. It is non-invasive, painless, and requires no special procedures. A Scoliometer™ is best used as a guide concerning progression in a person with a known scoliosis—not as a screening device.

Is scoliosis always progressive?

Generally, it is not. In fact, the vast majority of scolioses remains mild, is not progressive, and requires little treatment, if any.

In one group of patients, however, scoliosis is often more progressive. This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period. Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly. In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.

What is the treatment for scoliosis?

There are generally three treatment options for scoliosis—careful observation, bracing, and surgery. Careful observation is the most common “treatment,” as most mild scolioses do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.

Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.

Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases

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Post-Surgery Back Pain

One of our goals at Chiropractic Care is to prevent as many spinal surgeries as possible. We understand that surgery is necessary for certain conditions, but we also feel that many surgeries can be prevented with conservative chiropractic care. Patients who have already undergone surgery require special consideration when determining the appropriate treatment plan. Cox Flexion Distraction manipulation is an effective therapy that gently relieves pressure on spinal nerves and is frequently utilized in our offices to treat post-spinal surgery patients.

The rate of spinal surgery in the United States and the associated costs continues to rise even though there is little evidence in favor of surgical spinal fusion for back conditions. In some cases, the spinal surgery is ineffective, a condition called failed back surgery syndrome (FBSS). Other patients will develop pain months or even years after surgery. A typical reason for this developing pain is called Adjacent Segment Disease (ASD). One common type of surgery is a spinal fusion. This surgery alters the normal biomechanics of the spine limiting motion at the fused levels. This loss of motion is compensated for by an increase in motion at spinal levels above and below the fused site resulting in a significant amount of additional forces being placed on those facet joints  and discs. These additional forces may result in vertebral degeneration, disc herniation, spinal instability and spondylolisthesis which can result in pain and spinal stenosis.

One form of therapy that is beneficial to post-surgical pain cases is Cox decompression manipulation. Decompression manipulation is considered a low velocity, low amplitude adjusting procedure and has been shown to create a decrease in intradiscal pressure, an increase in posterior disc height while opening the vertebral canal and intervertebral foramen thus relieving pressure on pain sensitive nerves.

Dr. Kruse, along with Dr. Jerrilyn Cambron have recently had a paper accepted for publication demonstrating that Cox manipulation may also benefit post-surgical patients who suffer from adjacent segment disease.

Cox Decompression Chiropractic Manipulation of a Patient with Post-surgical Lumbar Fusion: A Case Report.  Accepted for publication in the Journal of Chiropractic Medicine (JCM), 2011. 

Drs. Kruse and Cambron have also had a study accepted for publication demonstrating the positive outcomes of Cox Decompression Manipulation performed to a larger population of patients who previously underwent lower back spinal surgery.

Post-Surgical Lumbar Spine pain treated with Cox Chiropractic Flexion Distraction manipulation: A retrospective study in a private practice setting. Accepted for publication in the Journal of Manipulative and Physiological Therapeutics (JMPT), 2011.

For more information and research on this topic, go to http://www.coxchirocare.com/ and look for post-surgery back pain.

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Mom, these books weigh more than I do!

Jacey Merkle weighs just 90 pounds. Add her backpack, and her weight shoots up to 110.

On any given school day, Jacey, a seventh-grader at Southwest Middle School, will lug around 20 pounds of books and school supplies on her back.

And she’s not alone.

The American Chiropractic Association has been sounding the alarm for years over heavy backpacks and the back issues they cause in young students.

In a recent study, researchers found that the average child carries a backpack “that would be the equivalent of a 39-pound burden for a 176-pound man, or a 29-pound load for a 132-pound woman.”

In the study, 60 percent of those carrying heavy backpacks had already reported back pain.

A second study done showed that the longer a child wears an oversized backpack, the longer it takes for a “curvature or deformity of the spine to correct itself,” according to the ACA.

Rapid City chiropractor James Schwietert said he treats plenty of students who have back and neck pain caused by carrying heavy backpacks.

“Some of these backpacks weigh half as much as the child,”Schwietert said. “Over the long term, what you’re doing is loading the spine with unnecessary weight at too young of an age.”

An overly heavy backpack will cause a child to bend forward to support the weight on his back, rather than on the shoulders.

Schwietert said that while children may have only minor back and neck complaints now, they will likely see graver complaints later in life. “They’re going to carry that issue.”

Karin Merkle, Jacey’s mother, said her daughter’s heavy backpack has been an issue in their house, especially since Jacey walks a mile to and from school each day.

Merkle tried to find alternatives for her daughter, even buying a rolling suitcase. It didn’t work well, so Jacey went back to her backpack.

Stan Evans, principal at Dakota Middle School, said the heavy backpacks haven’t been a huge issue at his schools, but said, “I know that some students do overload them.”

Evans thinks that while there will always be a place for textbooks in education, teachers will continue to use other resources such as online curriculum.

That shift should lessen the burden of heavy backpacks.

Schwietert also expects a day when students will carry all of their schoolwork on lightweight electronic devices.

Until that happens, he urges parents to pay attention to the weight in their kids’ backpacks and look for alternatives whenever possible.

He also encourages parents to spend a little more to get ergonomically correct backpacks that shift the weight lower on the body.

It may be an extra expense now, but it will pay off in the end, he said.

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Pull Your Weeds, Not Your Back, When Gardening

 

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As springtime approaches, weather warms up and leaves turn green, many people will spend more time outside planting bulbs, mowing the lawn and pulling weeds. Gardening can provide a great workout, but with all the bending, twisting, reaching and pulling, your body may not be ready for exercise of the garden variety.

Gardening can be enjoyable, but it is important to stretch your muscles before reaching for your gardening tools. The back, upper legs, shoulders, and wrists are all major muscle groups affected when using your green thumb.

A warm-up and cool-down period is as important in gardening as it is for any other physical activity," said Dr. Scott Bautch of the American Chiropractic Association's (ACA) Council on Occupational Health. "Performing simple stretches during these periods will help alleviate injuries, pain and stiffness."

To make gardening as fun and enjoyable as possible, it is important to prepare your body for this type of physical activity. The following stretches will help to alleviate muscle pain after a day spent in your garden.

Garden Fitness Stretches

Before stretching for any activity, breathe in and out, slowly and rythmically; do not bounce or jerk your body, and stretch as far and as comfortably as you can. Do not follow the no pain, no gain rule. Stretching should not be painful. o While sitting, prop your heel on a stool or step, keeping the knees straight. Lean forward until you feel a stretch in the back of the thigh, or the hamstring muscle. Hold this position for 15 seconds. Do this once more and repeat with the other leg.

Stand up, balance yourself, and grab the front of your ankle from behind. Pull your heel towards your buttocks and hold the position for 15 seconds. Do this again and repeat with the other leg.

While standing, weave your fingers together above your head with the palms up. Lean to one side for 10 seconds, then to the other. Repeat this stretch three times.

Do the "Hug your best friend." Wrap your arms around yourself and rotate to one side, stretching as far as you can comfortably go. Hold for 10 seconds and reverse. Repeat two or three times.

Finally, be aware of your body technique, body form and correct posture while gardening. Kneel, don't bend, and alternate your stance and movements as often as possible to keep the muscles and body balanced.

When the Bulbs Are Planted...
If you already feel muscle aches and pains and did not complete the warm-up and cool-down stretches, there are ways to alleviate the discomfort. Apply a cold pack on the area of pain for the first 48 hours or apply a heat pack after 48 hours, and consider chiropractic care.

Ready for Spring... Yard Work!

The state-of-the-art equipment available today for lawn and leaf management can help turn the average homeowner into a lawn specialist overnight. But the use of weed trimmers, leaf blowers and hedge clippers has also been sending many aspiring landscapers to the office of their local doctor of chiropractic.

The American Chiropractic Association (ACA) warns that using this equipment can result in back and neck pain, as well as more serious muscular strains and tears if not used properly.

"The repetitive motion that your body undergoes when using such equipment can bring on a whole host of mechanical problems within the body," says ACA President Dr. Richard Brassard. "It is essential to operate your equipment properly. If you do not, the pounding your body endures may be multiplied."

Tips On Safely Using Your Outdoor Equipment
Dr. Brassard offers the following tips to help you safely enjoy a productive day in the yard:

Regardless of what piece of equipment you are using, make sure it has a strap-and that you use it. Place the strap over your head on the shoulder on the opposite side of your body from the device. This will help normalize your center of gravity.

Be sure to switch the side on which you are operating the equipment as often as possible, and to balance the muscles being used, alternate your stance and motion frequently.

Take frequent breaks from the activity of the day. Muscle fatigue may be felt when using any of these devices for an extended period of time.

Consider electric-powered items, especially if you experience back or neck pain, as they tend to be much lighter than their engine-powered counterparts.

When picking up or putting down your equipment, be sure to bend from the knees, not at the waist. Keep the object close to your body as you lift, not at arm's length.

"While it is critical that you operate your yard equipment safely, it is equally important that you prepare your body for the work you are about to do," explains Dr. Brassard. "Be sure to include a warm-up/cool-down period that involves stretching to help avoid injury."

Simple Stretches For Everybody
Before stretching, there are a few tips to keep in mind. Breathe in and out slowly throughout each stretching exercise until the muscle is stretched to its furthest point. At that point, hold your breath in. When you relax, breathe out. Stretch gently and smoothly. Do not bounce or jerk your body in any way and stretch as far as you can comfortably. You should not feel pain.

Following are a few easy stretches Dr. Brassard recommends for getting the most out of the time you spend in the yard:

Stand up and prop your heel on a back door step or stool with your knee slightly bent. Bend forward until you feel a slight pull at the back of the thigh, called the hamstring. You may need to stabilize yourself by holding onto a garage door handle or sturdy tree branch. Hold the position for 20 seconds, then relax. Do it once more, then repeat with the other leg.

Stand up and put your right hand against a wall or other stable surface. Bend your left knee and grab your ankle with your left hand. Pull your heel toward your buttocks to stretch the quadricep muscle at the front of your thigh. Hold that position for 20 seconds, relax and do it again. Repeat with the other leg.

Weave your fingers together above your head with your palms up. Lean to one side for 10 seconds to stretch the side of your upper body, then reverse. Repeat two or three times.

"Hug your best friend": Wrap your arms around yourself after letting your breath out and rotate to one side, as far as you can go. Hold it for 10 seconds. Then reverse. Repeat two or three times.

Chiropractic Care Can Help
If you experience pain or discomfort resulting from outdoor equipment misuse, call your doctor of chiropractic. Doctors of chiropractic are trained and licensed to treat the entire neuromusculoskeletal system, and can help people lead healthier lives by focusing on wellness and prevention.

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or call our Chicago office:  312-269-5556
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