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Headaches and Chiropractic

Headaches


If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea. What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative. Research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck. A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication. Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems. Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern. “The greatest majority of primary headaches are associated with muscle tension in the neck,” says Dr. George B. McClelland, a doctor of chiropractic from Christiansburg, VA. “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

What Can You Do?

The ACA suggests the following:
• If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.
• Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.
• Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.
• Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

Dr. McClelland says your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:
• Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.
• Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.
• Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Information found at: https://www.acatoday.org/content_css.cfm?CID=2186

Understanding Whiplash Injuries

Whiplash
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There have been many statements made about whiplash that are either totally or partially false. Let’s take a look at some of the “FACTS.”

1. Pain is NOT the only symptom: Although neck and/or shoulder area pain is the most common symptom associated with a whiplash injury, look for other symptoms such as (but not limited to) headache, numbness/tingling in the arms, nausea, difficulty swallowing, dizziness, poor concentration, jaw pain, blurred vision, ringing in the ears, and more. Many of these symptoms may not manifest until days, weeks, or months after your collision.

2. Cervical spine injury can occur at low speeds: It doesn’t take a lot of force to inflict injury to the neck. In fact, speeds of only 5-10 mph (~8-16 km/h) can generate significant G-forces to injure the soft tissues (muscles, tendons, ligaments, and disks) in the neck. Factors influencing injury include (but are NOT limited to) vehicles size/weight and speed differential, location of impact direction, head restraint location, seat failure, seat back angle and “spring,” seat back height, surface slipperiness, and more.

3. No vehicular damage does NOT mean no injury: As stated in #2, low speed collisions can generate enough force to cause injury to the neck. It is important to know that an 8 mph (~13 km/h) rear-end collision may result in a 2 g force acceleration of the impacted vehicle, a 5 g force acceleration acting on the occupant’s head, and all within 250-300 msec. after impact. (FYI: 1 g = an acceleration of approximately 32 ft/sec or 10 m/sec.). IF the metal of the car crushes (“plastic deformity”), energy is absorbed and LESS is transferred to the occupants and VICE VERSA! So, to avoid injury, it’s BETTER to have vehicular damage (the opposite of what you’d think)! Studies show a 10 mph (~16 km/h) impact can produce a total collapse of only 2.5 inches or 6.35 cm (mostly to the back bumper). Often, you have to crawl underneath the vehicle to see the damage.

4. An unusual S-shaped curve has been identified during the rear-end impact: There are seven cervical or neck vertebrae which form a 35-40° curve called a lordosis, which is “C-shaped.” In the initial 50-75 milliseconds after impact during a rear end collision, the head remains stationary while the seat moves the torso and rest of the body forwards and for an instance, an “S-shaped” curve is created (flexion in the upper half and extension in the lower half). This abnormal curve occurs BEFORE the head hyperextends backwards POSSIBLY hitting the headrest and then springing forwards (like “cracking a whip”).

5. X-ray CAN prove soft tissue damage: X-rays are often used to “rule-out” a fracture and as a result, they are often initially read as “normal” as radiologists (the specialists who read x-rays) don’t often report on the subtle findings found on the x-ray that may support the presence of a soft tissue injury. As chiropractors, we OFTEN take “stress views,” or flexion and extension x-rays after the initial painful symptoms improve. Stress x-rays can yield a much better image of how well the ligaments are holding the vertebra together. When ligaments are stretched or torn (just like in a sprained ankle), excessive movement and/or angles can form between the bones, which are often only be seen at the extreme end-points of movement. We can measure the angle formed between the vertebrae and the amount of translation or “slip” that occurs to determine if there is a loss of ligament control which results in excessive motion, increasing the likelihood of future problems.

6. “Rest = rust” when it comes to whiplash: When we hurt, we often instinctively choose rest over activity, as we may be afraid that any activity will make the pain worse. But after just a few days of rest, both our injured ANDhealthy muscles become stiff and weak, which prolongs the healing process. Most studies show that returning to normal activity as soon as possible results in faster healing and resolution of pain. Also, the longer you remain inactive, the greater the chance for chronic pain to develop, which can result in permanent problems. We will guide you GRADUALLY back into normal, desired activities. DON’T LET PAIN OR THE FEAR OF PAIN keep you from getting on with life! This is both physically and mentally harmful!

7. You don’t have to be in a car to get whiplash: Even though car crashes account for the majority of whiplash injuries, a slip and fall or participating in a high-impact sport such as football, snowboarding, skiing, boxing, soccer, or gymnastics can result in head/neck trauma, which is more common than you think! With this said, other conditions, such as concussion, can occur in car crashes even if you don’t hit your head! The term, “mild traumatic brain injury” or MTBI is frequently used when it pertains to car crashes. Here, common symptoms include difficulty finding words to express yourself, losing your place when talking, and difficulty concentrating, focusing, and communicating. Many people are self-conscious about these types of problems and often do not discuss them with their doctor!

8. Aging increases the risk of whiplash injuries: The elderly are more likely to suffer from a whiplash injury compared with younger individuals. This is because as we age, we lose flexibility in the joints, muscles, and tendons in the neck. This REDUCES the ability for these tissues to stretch, making them MORE likely to be injured during the whiplash process. Also, the shock-absorbing cushions between our vertebrae (the intervertebral disks) lose their water content and literally dry up and crack as we age. This, along with the gradual onset of osteoarthritis in our joints, results in a reduced cervical range of motion.

9. Females are at greater risk of injury than males: This is because there is simply less neck muscle mass and strength among medium built females vs. males. This difference is even more dramatic in slender-necked females. Add the age component to this and the older slender female neck is particularly vulnerable to a cervical spine injury due to whiplash.

10. DO NOT ignore symptoms: Although most neck-injured crash victims experience immediate pain, some do not. This delay in symptom onset can be hours, days, and even sometimes weeks! Although it’s “human nature” to procrastinate and NOT seek immediate chiropractic care, you should! Studies show that the longer you wait, the longer it may take to help you! Also, in most cases, neck pain should gradually improve within the first month or two, but this does not always happen. The longer pain persists, the lower the odds for resolution, especially if the pain has lasted more than six months. Persisting symptoms may include (but are not limited to) headache, fatigue, shoulder pain, blurred vision, dizziness, difficulty concentrating, communicating, sleeping and/or swallowing. BOTTOM LINE: COME IN ASAP after the crash as prompt care yields the best results!

This article was from Chiro-Trust.org and can be found at http://chiro-trust.org/whiplash/10-facts-know-whiplash-part-1/.

Chiropractic Care for Safer, Easier Births

Prenatal Chiropractic

Chiropractors and midwives have been working together more frequently since the utilization of complementary and alternative approaches in birth. Research has been done previously and has determined that chiropractic can be very effective in helping a woman who is experiencing “dystocia,” which can be defined as being abnormally long, painful, or nonprogressive births. There has been a call for more research in how chiropractors and midwives can aid pregnant mothers, and the following report is a case in which a chiropractor and 3 midwives were helpful in aiding a woman who was having a difficult birth.

A 26 year old woman chose to give birth to her first child at home. Initially, the birth process was proceeding well, but after 22 long hours, progress had stalled. Due to the fact that her contractions had become less frequent, since there was a stalling in the descent of the baby, and cervical dilation ceased at 7 cm, it was determined that the mother was experiencing dystocia. After an additional hour, it was deduced that the baby was “asynclitic,” which means that the baby’s head position was not optimal for birth and was causing restrictions in movement and a decreased heart rate of the baby. At this time, it was decided that the chiropractor would become involved, and would utilize the Webster Technique.

The Webster technique is a specific chiropractic analysis and adjustment designed to locate and remove any pelvic subluxations (misalignments) that are causing interference to the normal function of the pelvic neuromusculoskeletal system. Immediately after completing the first adjustment utilizing the Webster technique, which included the “psoas muscles release” and “round ligament contact release”, the mother began to feel the baby “move.” The midwives immediately noted significant progress, with increased contraction timing, and improved fetal heart rate. However, at 28 hours, the baby was determined to be asynclitic once again. An additional psoas release was performed at 34 hours after the midwives had attempted different patient position changes and surgically ruptured the mother’s membrane. Thirty minutes later, a normal heathy eight and a half pound baby girl was born without complications.

Many causes of dystocia have been theorized. They include muscle weakness, poor baby positioning, soft tissue abnormalities, or bony abnormalities of the mother’s pelvis. It is not uncommon for a first time mother to be diagnosed with dystocia. In fact, the rate of cesarean section surgeries increased to above 20% in 2004, with 50% of those being due to dystocia.

Medical treatment for dystocia can include observation, manually moving the baby during contractions, rupturing of the mother’s membranes, and/or changing of the mother’s positioning. The decision to move to operative vaginal delivery or cesarean section surgery only comes after there is a sustained drop of fetal heart rate, indicating fetal distress.

Chiropractic asserts that chiropractors and birth care providers should collaborate during pregnancy. Within the scope of “Integrative Medicine,” multiple approaches are used to give the best possible care to the patient. Reducing the effects of subluxations (spinal misalignment) to the mother during pregnancy is well within the chiropractic scope of practice.

Additional research regarding chiropractic, midwifery, and resolution of dystocia is underway. To date, experience and clinical evidence have shown that cooperation between these professions may greatly aid pregnant mothers and their births.
-Joel Alcantara, Justin Ohm, & Jeanne Ohm. “Chiropractic Care of a Patient with Dystocia & Pelvic Subluxation.” Journal of Pediatric, Maternal, & Family Health.

This article was from the International Chiropractic Pediatric Association and can be found at http://icpa4kids.com/fwf/2016%20Newsletters/Research_July2016.pdf.