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Nutrition and Exercise for Hypertension

Hypertension is usually a silent disease that leads to cardiovascular, cerebrovascular, and renal morbidity and mortality. This condition can seriously affect quality of life, reduce life expectancy, and place significant burdens on the healthcare system. Classic medications used to treat hypertension can involve side effects including headache, nausea, vomiting, stomach pain, constipation, diarrhea, weakness, fatigue, and erectile dysfunction. Hence, many patients with elevated blood pressure look for other means to help manage their condition with fewer, if any, side effects.

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In a previous post, we discussed a 2007 study in which patients who received a specific cervical chiropractic adjustment experienced a reduction in their blood pressure that persisted for at least eight weeks. Lead author Dr. George Bakris, “This procedure has the effect of not one, but two blood pressure medications given in combination. And it seems to be adverse-event free. We saw no side effects and no problems.”

Herbal and dietary supplements have been used by patients to help manage hypertension (HT) for many years. A series of literature reviews have found the following may provide better and safer substitutes to conventional drugs: cod liver oil, garlic, coenzyme Q-10, beta glucan, lipoic acid, whole grains, potassium, magnesium, sodium, vitamin E, vitamin B6, vitamin C, polyphenol, various botanicals/herbs, and vanadium (see Table 1, https://bit.ly/2QVpcY7 ).

Regarding exercise, a 2018 research review found that aerobic exercise can reduce blood pressure in hypertensive patients by 5-7 mmHg and that dynamic resistance exercises can lower blood pressure in adults with hypertension by 2-3 mmHg—which may rival the results achieved with first-line meds for hypertension.

While exercise, improving your nutrition, and getting regular chiropractic care are all part of living a healthier lifestyle, which can result in a healthier blood pressure reading, it’s important not to discontinue taking any medications unless instructed to by your treating physician.

What Is Frozen Shoulder?

Adhesive capsulitis (also known as “frozen shoulder”) is the end result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the humeral head or “ball” part of the ball and socket joint. Adhesive capsulitis dramatically reduces the range of motion of the affected joint, which can severely impact one’s ability to carry out their normal daily activities. A frozen shoulder may or may not be associated with shoulder pain and tenderness. Though all movements are affected, raising the arm to the side is often the most impaired movement of the shoulder.

Conditions such as tendinitis, bursitis, and rotator cuff injury can lead to adhesive frozen-shouldercapsulitis, especially if the person refuses to move the shoulder for an extended length of time. Diabetes, chronic inflammatory arthritis (such as rheumatoid) of the shoulder, and chest or breast surgery are known risk factors for adhesive capsulitis.

The condition is diagnosed following a review of the patient’s history for prior trauma caused by over reaching/lifting or from repetitive movements. The examination will look for severe loss of shoulder range of motion (ROM), both active and passive. X-ray, blood tests for underlying illnesses, and other imaging approaches may also be required to make a final determination for adhesive capsulitis.

Treatment for adhesive capsulitis has classically included an aggressive combination of anti-inflammatory medications, cortisone injections, manual therapies (such as joint manipulation, mobilization, and traction), exercise training, ice (if painful), heat (if no pain), and physiotherapy modalities such as ultrasound, electric stimulation, laser, etc.

Exercises performed by the patient are also highly important for achieving a satisfactory outcome. The patient can begin immediately with pendulum-type exercises, long-axis traction (while sitting, grip the chair seat and lean to the opposite direction while relaxing the shoulder muscles to open up the ball-and-socket joint), and eventually strengthening exercises (TheraTube, TheraBand, light weights, etc.).

A recent study involved 50 patients with frozen shoulder (20 males, 30 females, ages 40-70 years) who underwent chiropractic care for a median time frame of 28 days (range: 11-51 days). Researchers looked at patient-reported pain on a 1-10 scale and their ability to raise the arm sideways (abduction). Of the 50 cases, 16 resolved completely (100%), 25 showed 75-90% improvement, 8 showed 50-75% improvement, and 1 experienced less than 50% improvement.

The Red Flags of Low Back Pain

Treatment guidelines published around the world note that ruling out “red flags” is a healthcare provider’s number one responsibility, which is in line with the decree exhorted by all healthcare professionals when first entering practice to do no harm. When detected, red flags prompt a doctor to stop and immediately send the patient to the appropriate healthcare provider or emergency department to avoid a catastrophic outcome, which may include death.how-to-tell-if-your-back-pain-is-serious

The four main red flags cited for low back pain include: cancer, fracture, cauda equine syndrome, and infection. In 1992, Dr. Richard Deyo reported that the patient’s history is more important for identifying red flags than a routine physical exam, especially in the early stages of these conditions. This is partially why new patients need to fill out so much paperwork on their initial visit. These are the factors that suggest red flags when it comes to low back pain:

Cancer: a past history of cancer, unexplained weight loss, failure to improve with a month of therapy, no relief with bed rest, and duration of pain over one month. However, when the combination of age over 50 years, past history of cancer, unexplained weight loss, and failure to improve with one month of therapy exists, the sensitivity or “true-positive” reaches 100%—in other words, IT IS CANCER until proven otherwise!

Cauda equine syndrome: acute onset of urinary retention or overflow incontinence, loss of anal sphincter tone or fecal incontinence, “saddle” anesthesia, and global or progressive motor weakness in the lower limbs.

Infection: prolonged use of corticosteroids (such as organ transplant recipients); intravenous drug use; urinary tract, respiratory tract, or other infection; and immunosuppressant medication and/or condition.

Spinal fracture: history of significant trauma at any age; minor trauma in persons over 50 years of age; patient over 70 years of age with a history of osteoporosis (with or without trauma); and prolonged use of corticosteroids. A checklist that includes these important historical questions can be easily applied in any practice, which is highly recommended.

All healthcare providers—including chiropractors—managing patients in a primary care setting are obligated to rule out red flags in order to ensure patient safely when rendering treatment for LBP. The good news is that most cases of low back pain aren’t caused by these red flags and respond well to conservative chiropractic care!

The Role of Diet in ADHD…

Due to concern about the side effects and the long-term use of medications typically prescribed to treat attention-deficit/hyperactivity disorder (ADHD), there is an increasing demand for alternative forms of treatment for patients with the condition, with dietary medications and supplementation showing promise.

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Research has shown that deficiencies in zinc, iron, calcium, magnesium, selenium, glutathione, and/or omega-3 fatty acids can contribute to oxidative stress and altered neural plasticity needed for brain development and healing. For children with ADHD, this can manifest as poor concentration and memory and learning challenges.

Hypersensitivity to foods and/or additives can increase inflammation in the blood, which presents in children as atopy (hereditary allergy like asthma, hay fever, or hives), irritability, sleep issues, and prominent hyperactive-impulsive symptoms. Studies have demonstrated that taking a probiotic can help manage inflammation, which may benefit children with ADHD as well.

The link between ADHD and food additives including (but not limited to) preservatives, artificial flavorings, and colorings has been debated for decades. A 2007 Lancet publication reported that sodium benzoate and commonly used food colorings may exacerbate hyperactive behavior in children under the age of nine. A 2010 follow-up study concluded that children affected by these types of additives may share common genetic factors.

Essential fatty acids (EFAs) and phospholipids are both essential for normal neuronal structure and function, of which diet is the only source of these important nutrients, especially during critical periods of development (childhood). Dietary deficiency early in life has been reported to increase the risk of developing ADHD signs and symptoms.

Past studies have established the importance of maintaining a healthy balance between the omega-3 vs. omega-6 fatty acids in one’s diet to reduce systemic inflammation. When the ratio of omega-6 to omega-3 becomes too high (3:1 is favorable), it’s considered a risk factor for ADHD.

Diets low in protein and high in carbohydrates (refined carbs/sugar) are also a well-known risk factor for developing ADHD because the amino acids that make up proteins are essential for our body to manufacture neurotransmitters.

Knee Pain – Do I Need a Replacement?

About a quarter of adults experience frequent knee pain, which results in limited function, reduced mobility, and impaired quality of life. Osteoarthritis (OA) is the most common cause of knee pain in those over 50 years of age, and it is the #1 reason for total knee replacement (TKR). The rate of TKR in the United States and the United Kingdom has increased substantially in recent decades, which many have written off as a consequence of our aging populations. But is that really the case?

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One study reviewed long-term data from the National Health and Nutrition Examination Surveys (NHANES) and the Framingham Osteoarthritis (FOA) study. The research team concluded that advancing age is indeed a factor behind the increase in TKR since the 1970s, but it doesn’t tell the whole story. The researchers also found that obesity is a risk factor for symptomatic osteoarthritis of the knee, and as you know, obesity rates have skyrocketed in the last four decades.

So, what can be done to reduce your risk for a total knee replacement? There isn’t anything you can do about getting older, but there’s a lot you can do to maintain a healthy weight. Begin by switching to a more anti-inflammatory diet such as the Mediterranean diet or the Paleo diet. You don’t have to change everything you eat all at once. Start by eating an extra serving of vegetables and one less serving of processed food a day. As you notice yourself starting to feel better, it will give you the confidence to make further dietary modifications.

Because the primary way for the cartilage in your joints to get nutrients is through movement, you’ll need to become more active. Increase the number of steps you take per day and raise the intensity over time. You should also engage in balance and strength training exercises.

Of course, you’ll also need to ensure your knee isn’t subjected to abnormal movements both above and below that can compromise the tissues that make up the joint. For example, ankle pronation can overload the medial compartment of the knee. Similarly, a problem in the hip, pelvis, or lower back can also place stress on the knee, which can impair its function. That’s why doctors of chiropractic evaluate the whole patient to identify any and all contributing factors to a patient’s chief complaint. Otherwise, the patient may not experience a satisfactory outcome.

 

This information should not be substituted for medical or chiropractic advice. Any and all health care concerns, decisions, and actions must be done through the advice and counsel of a health care professional who is familiar with your updated medical history.

Different Headaches and Chiropractic Care

Adults may experience many different kinds of headaches. A primary headache is a headache that is not a part of another disease process. Secondary headaches can come from a poor eyeglass prescription, diabetes, the flu, or even a brain tumor. The most common primary headaches are tension-type, migraine, and cervicogenic (from the neck).

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In cervicogenic headache, neck function is prominently disturbed. In addition to neck pain, there are usually tight neck and shoulder muscles, and a limited range of motion.

Tension type headaches feel like a tight band around your head. Stress seems to aggravate them and women tend to get this type of headache more frequently.

Females are also more affected by migraine headaches.

There are two types of migraine: classical and common.

The classical migraine headache may start with nausea or sickness in the stomach and proceed to an intense throbbing pain on one side of the head.

The common migraine lacks this nausea and is more common than the classical type.

Research has shown that the three above described headaches can also overlap with one another. In chiropractic, we look to the spine as an often-overlooked factor in headache treatment. By objectively analyzing spine function, the doctor will identify the joints that are restricted in their range of motion or show abnormal posture and alignment. Many patients on x-ray, or through external postural analysis from the side, can show forward head posture. This is where the neck seems to arise from the front of the chest rather than back over your shoulders. The head is very heavy and with this poor posture, the muscles at the back of the neck must contract to restrain this heavy load.

There isn’t one particular bone that is treated for these different types of headaches, the premise being that the headache is a symptom of another problem in the spine.

Chiropractic care has an excellent safety profile and several studies have shown that patients with headaches positively respond to chiropractic care without the side effects often seen with drug treatments. Chiropractic care is one of the most researched non-drug options available for patients. Unfortunately, many patients choose over-the-counter and prescription medications and don’t consider more natural approaches that may get at the cause of the condition rather than just its effects.