The Pregnant Patient!

During pregnancy, a number of body changes occur to the expectant mother, some physiological (changes in body chemistry and loosening of the ligaments) and endocrinological (hormonal). These changes occur for the purpose of creating an optimal environment for developing the baby and well being for the mother. During pregnancy, most women experience a number of biomechanical and neuromuscular problems which respond favorably to gentle safe chiropractic treatment, along with massage and exercise instruction.

Approximately 90% of pregnant women experience back pain. Although the majority experience back pain in their last trimester, studies have showed that symptoms often begin by the twelfth week.

Risk factors for low back pain during pregnancy include previous back problems, increased weight gain, age, and multiparty (having had more than one child). Neck and back pain primarily occur as a result of increased weight gain, change in the distribution of weight thereby causing an increased demand on the spinal and pelvic muscles. These stresses also alter the normal spinal curves and related biomechanics. The result is increased physical stress to the body leading to pain and discomfort. 

 Chiropractic is a primary health care profession that deals with a wide variety of these types of musculoskeletal disorders. All functions of the body are controlled by the nervous system. This system consists of the brain, spinal cord, nerve roots and all nerves in your body. These delicate structures are protected by the spinal column and pelvis. Any of these bones can lose their normal alignment and may contribute to the above symptoms. Additional symptoms include headaches, nausea or insomnia.

There is a large amount of research supporting the efficacy of chiropractic during pregnancy. The results of some of these studies are summarised below:

• Women who receive chiropractic adjustments in the 3rd trimester of pregnancy were able to carry and deliver children with more comfort. (1)
• The need for pain killers during delivery is reduced by up to a half. (2)
• Approximately 91% of pregnant women with sacroiliac joint pain achieved relief with manipulation. (3)
• Almost 3 times less back pain was experienced during labor when 
  manipulation was administered during pregnancy. (4)
• Women had a positive response to chiropractic treatment for pre and post partum symphysis pubis dysfunction. (5)

(1) American Medicine Association records released in 1987 during the trial in US District Court Northern Illinois Eastern Division, NO. 76C3777.

(2) Freitag, Per: - Expert testimony of Pertag M.D., Ph.D. Comparing the results of two neighbouring hospitals, U.S District Court Northern Illinois Eastern Division, No.76C3777, May 1987.

(3) Daley et al, (1991) Sacroiliac Subluxation: a common treatable cause of low back pain in pregnancy. Fam Prac ResJ, 11 (2) 149-159.

(4) Diakow, PR. Et al (1991) Back Pain during pregnancy and labour. JMPT 14 (2): 116-8

(5) Andrew & Pedersen (2003) A study into the effectiveness of Chiropractic treatment for pre and postpartum women with symphysis pubis dysfunction, Eur J of Chiropractic 48, 77-95.

If you are pregnant and live in Durham or the surrounding areas of Raleigh, Morrisville, Brier Creek, RTP,  NC, contact Chiropractic Wellness at Brier Creek to get on the road to recovery as soon as possible.

Chiropractic Facts and Myths!!

Unlike standard medical doctors whom you visit when you have a symptom to be treated, chiropractors offer adjustments to improve spinal alignment and overall well-being before symptoms develop.

As successful as chiropractic has become, there are a lot of myths circulating among the general public. Times have definitely changed for the better, but the fact is that many people still do not understand what chiropractors do. Let's talk about a few of the more common myths about chiropractic.

Myth #1 - Chiropractors are not real doctors.

A chiropractic college grants a D.C. or Doctorate of Chiropractic degree. Chiropractors are licensed as health care providers in every U.S. state and dozens of countries around the world. While the competition for acceptance in chiropractic school is not as fierce as medical school, the chiropractic and medical school curricula are extremely 

rigorous and virtually identical. In fact, chiropractors have more hours of classroom education than their medical counterparts. As part of their education, chiropractic students also complete a residency working with real patients in a clinical setting, supervised by licensed doctors of chiropractic. Once chiropractic students graduate, they have to pass four sets of national board exams as well as state board exams in the states where they want to practice.

Just like medical doctors, chiropractors are professionals that are subject to the same type of testing procedures, licensing and monitoring by state and national peer-reviewed boards. Federal and state programs, such as Medicare, Medicaid, and Workers' Compensations programs cover chiropractic care, and all federal agencies accept sick-leave certificates signed by doctors of chiropractic. Chiropractors are also commissioned as officers in the military.

The biggest difference between chiropractors and medical doctors lies not in their level of education, but in their preferred method of caring for people. Medical doctors are trained in the use of medicines (chemicals that affect your internal biochemistry) and surgery. Consequently, if you have a chemical problem, such as diabetes, hypothyroidism, or an infection, medical doctors can be very helpful. However, if your problem is that your spine is mis-aligned or you have soft tissue damage causing pain, there is no chemical in existence that can fix it. You need a physical solution to correct a physical problem. That is where chiropractic really shines. Chiropractors provide physical solutions -- adjustments, exercises, stretches, muscle therapy -- to help the body heal from conditions that are physical in origin, such as back pain, muscle spasms, headaches, and poor posture. Another distinction is the fact that it is completely appropriate to receive chiropractic care even if you do not have symptoms. Unlike standard medical doctors, whom you visit when you have a symptom to be treated, chiropractors offer adjustments to improve spinal alignment and overall well-being before symptoms develop.

Myth #2 - Medical doctors don't like chiropractors.

The American Medical Association's opposition to chiropractic was at its strongest in the 1940s under the leadership of Morris Fishbein. Fishbein called chiropractors "rabid dogs" and referred to them as "playful and cute, but killers" He tried to portray chiropractors as members of an unscientific cult who cared about nothing but taking their patients' money. Up to the late 1970s and early 1980s, the medical establishment purposely conspired to try to destroy the profession of chiropractic. In fact, a landmark lawsuit in the Supreme Court of Illinois in the 1980s found that the American Medical Association was guilty of conspiracy and was ordered to pay restitution to the chiropractic profession.

In the 20 years since, the opinion of most medical doctors has changed: several major studies have shown the superiority of chiropractic in helping people with a host of conditions, and medical doctors developed a better understanding as to what chiropractors actually do. Many people have returned to their medical doctors and told them about the great results they experienced at their chiropractors office. Hospitals across the country now have chiropractors on staff, and many chiropractic offices have medical doctors on staff. Chiropractors and medical doctors are now much more comfortable working together in cases where medical care is necessary as an adjunct to chiropractic care.

Myth #3 - Once you start going to a chiropractor, you have to keep going for the rest of your life.

This statement comes up frequently when the topic of chiropractic is discussed. It is only partially true. You only have to continue going to the chiropractor as long as you wish to maintain the health of your neuromusculoskeletal system. Going to a chiropractor is much like going to the dentist, exercising at a gym, or eating a healthy diet: As long as you keep it up, you continue to enjoy the benefits.

Many years ago, dentists convinced everyone that the best time to go to the dentist is before your teeth hurt, that routine dental care will help your teeth remain healthy for a long time. The same is true of chiropractic care for your spine. It is important to remember that, just like your teeth, your spine experiences normal wear and tear as you walk, drive, sit, lift, sleep, and bend. Routine chiropractic care can help you feel better, move with more freedom, and stay healthier throughout your lifetime. Although you can enjoy the benefits of chiropractic care even if you receive care for a short time, the real benefits come into play when you make chiropractic care a part of your wellness lifestyle.

Mobility!!

Imagine waking up one morning with a frozen shoulder where you couldn’t move your upper arm more than a few inches in any direction. How much would that impact your ability to do your job? How much would that affect your ability to drive your car or even to dress yourself? How much would that affect your ability to concentrate on anything other than your shoulder? Obviously, if your shoulder did not move correctly, it would have a dramatic impact on your life. Well, the same is true with movement in every part of your body. If things aren’t moving the way they are supposed to move, it will have a negative impact on your ability to function at work, take care of the demands of everyday life, and even your ability to concentrate.

Many patients with severe low back pain report that their pain came on suddenly when they did something as simple as bend down to pet their cat, put on their socks, or pick up the newspaper. Just about everyone would agree that a person’s body should be able to handle such simple movements. So what has happened?

In every one of these cases, the joints of the patient’s body were “all locked up” -- they were barely moving at all. When the joints in one area of the body do not move the way they should, other areas of the body are forced to move more in order to compensate. This creates a significant stress on those areas that have to pick up the slack, and it soon leads to pain and inflammation. At the same time, the areas that don’t have normal movement will slowly worsen as the muscles continue to tighten, the joints stick together, and the ligaments and tendons shorten. This leaves the body in a very unstable condition; if left unchecked, this process will continue until the body can hardly move at all. That is how a person comes to suffer flare-ups of pain at the slightest provocation.

Most of us have seen people who have lost most of their normal mobility: they look like bodies have been starched stiff whenever they try to move around. This is especially prevalent among the elderly. Contrary to popular belief, however, this is not an inevitable effect of aging; rather it is the inevitable effect of not maintaining the body’s mobility through exercise, healthy alignment, and body mechanics. There are people in their 60s, 70s, or even older, who are stronger and more flexible than the average person in their 30s, simply because they keep themselves exercising.

Maintaining mobility is critical in order to live free from pain and disability. Maintaining good mobility is not difficult, but it does not happen on its own. Just as in developing a good posture, it is necessary that you perform specific exercises and stretches to keep your muscles, ligaments, and tendons flexible and healthy. In addition, it is necessary that all of the joints in your body are kept moving correctly as well. Although this can be achieved to a great degree through stretching, most people also find routine chiropractic adjustments to be very beneficial.

Rotator Cuff Injuries and Impingement Syndrome

Chiropractic, Rotator Cuff Injury and Impingement syndrome

What is Impingement syndrome?

Chiropractic treatment for sub-acromial bursitis (or shoulder bursitis) and rotator cuff tendonitis is very effective. These are two conditions that often occur simultaneously. There is inflammation of a particular area within the shoulder joint that is causing a common set of symptoms. The best terminology for these symptoms is 'impingement syndrome.' Impingement syndrome occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons.

Where is the problem that causes shoulder bursitis?

Impingement syndrome, or shoulder bursitis, occurs when there is inflammation between the top of the humerus (arm bone) and the acromion (tip of the shoulder). Between these bones lies the tendons of the rotator cuff muscles, and the bursa that protects these tendons. The muscles affected are the teres minor, infra spinatus and supra spinatus. Normally, these tendons slide effortlessly within this space.

What causes this problem?

The most common cause is a combination of overuse and faulty mechanics of the shoulder, which is often caused by a muscle imbalance. If the upper trapezius muscle is hyperactive and the scapular stabilizing muscles and the rotator cuff are weak, it prevents the shoulder from moving normally and causes impingement. The postural changes often seen in association with this muscle imbalance would be rounded and forward drawn shoulders, and a head-forward posture.

The problem can be exacerbated by wear and tear of the A/C joint and thickening of the rotator cuff tendon. In some individuals with this problem, the shape of their bones is such that they have less space than normal. Therefore, only slight thickenings of the tendons or bursa can cause symptoms. Often there is an initial injury, either due to trauma or overuse that sets off the process of inflammation. Thereafter, the problem can be self-exacerbating. Once there is an initial injury, the tendons and bursa become inflamed. This inflammation causes a thickening of these structures due to fibrosis and scar-tissue build-up. The thickening then takes up more space, and therefore the tendons and bursa are pinched upon even more - this is the impingement. This causes more inflammation, and more thickening of the tendons and bursa, and so on. This can lead to a chronic condition; therefore early treatment is very important.

What are the symptoms of shoulder bursitis / impingement syndrome?

Common symptoms include:

                           

Pain with lifting the arm out away from your body and up (abduction), activities above shoulder height. 

The painful arc is between 80-120°.

                                           Pain over the outside of the shoulder/upper arm

 Pain while sleeping at night 

Impingement syndrome and a rotator cuff tear are different problems, and although they are related, the treatment is different. Impingement syndrome is a problem of inflammation around the rotator cuff tendons. A rotator cuff tear is an actual tear within the tendons. The best sign that differentiate these problems is the strength of the rotator cuff muscles. 

Your Chiropractor will be able to specifically isolate these muscles to better determine if a rotator cuff tear is present. Once the problem has been diagnosed the chiropractor can start to give advice and start the treatment.