Posted on July 31, 2013
Most people visit a chiropractor because they are in pain. It is the chiropractor’s job to determine what is causing the pain and then take steps to fix the problem. In some cases, this can be quite tricky because of something called referred pain, meaning that the pain is felt in a different area than the actual problem. There are a few different types of referred pain:
Radicular: This type of pain is caused by a nerve that is being irritated or compressed. One example is shooting pain down the leg (aka sciatica) caused by a disc herniation in the lumbar spine. This type of pain is typically described as sharp and shooting like an electric shock, and it is often accompanied by numbness or tingling. True radicular pain is not very common; most people who come to see me complaining of sciatica actually have deep referred pain.
Deep referred pain: This type of pain is caused by inflammation and in the joints or ligaments or trigger points (“knots”) in the muscles or tendons. It occurs because of the way the body is wired. For example, nerves coming from your buttock and thigh connect to the spinal cord in the same area as nerves coming from the sacroiliac (pelvic) joint. Sometimes the brain has difficulty telling where the signal is coming from, and you will perceive pain in both areas. Therefore, if you have a sprain or misalignment of the sacroiliac joint, you might feel pain in the buttock and thigh even though there is nothing wrong in that area. Many people who think they have sciatica are actually suffering from deep referred pain from the lumbar spine, pelvis, and gluteal muscles.
Deep referred pain is by far the most common type of musculoskeletal pain; I can pretty much guarantee you have experienced it in some form before. It can be quite a good mimic; people will often come to my office with what they think is sciatica, plantar fasciitis, carpal tunnel syndrome, or a “pinched nerve”, only to find out the cause of their pain is being referred from adjacent joints or muscles.
Somatovisceral pain: Signals from the internal organs and musculoskeletal system can also be confused by the brain, causing organic diseases to refer to the musculoskeletal system and vice versa. One example that you are probably familiar with is the pain that sometimes radiates into the neck, jaw, and down the arm during a heart attack. Fortunately I rarely see this type of pain in my office!
Whatever type of pain you have, don’t ignore it. Pain is your body’s way of telling you something is wrong. Come in and get checked out. If caught early, most problems are fairly simple and can be taken care of easily.
Posted on April 30, 2013
If you watch Dr.Oz, you may have heard some of the recent hype about tart cherry juice and its amazing anti-inflammatory properties. Tart cherries contain a large amount of a powerful antioxidant called anthocyanin. This antioxidant is thought to inhibit the same enzyme as aspirin (cyclooxygenase), which would explain why it would decrease inflammation and pain. In a small study done at Oregon Health & Science University, women drinking tart cherry juice for 3 weeks had a significant reduction in inflammatory markers and arthritis pain.
I am always looking for new things to help my patients, but also wary of new “miracle cures” that are being hyped up by the media, so I decided to do a little experiment myself. Since I do not have arthritis, I decided to use my parents as guinea pigs. They both have chronic pain due to severe osteoarthritis of the spine and knees. After tasting the tart cherry juice, I decided to use tart cherry capsules instead. The juice is very, well, tart, and I think it would be difficult to drink two whole glasses of it each day. There is also a lot of sugar and calories in that much juice. I bought the Solaray brand Tart Cherry Juice capsules on Amazon.com. I had my parents track their pain levels for a week before starting the capsules in order to get a baseline. Then I had them take 2 capsules twice per day with breakfast and dinner for the next week and again record their pain levels.
Both of my parents reported a modest reduction in their arthritis pain. My mother’s average pain level went from 5.71 to 5, and my father’s went from 7.71 to 4.57. I could tell when I saw my mother for her weekly chiropractic treatment that she was much less inflamed than usual. They also both reported increased pain when they stopped taking the capsules, and thus they have gone on Amazon.com themselves now and bought another two bottles. I am encouraging them to try 3 capsules twice per day to see if it further reduces their symptoms.
Neither of my parents reported any adverse side effects. Both of them have a history of GERD and stomach ulcers, but the capsules did not seem to bother them.
Of course this was only a tiny study with no placebo controls, but I think the results are promising. Is tart cherry juice a miracle cure for arthritis? No, but it may help “take the edge off” and be an important part of managing osteoarthritis, along with a healthy diet, regular low-impact exercise, chiropractic & massage, etc. Because it is an antioxidant, it also has many other health benefits such as maintaining cardiovascular health and preventing free radical damage to cells. If you have chronic osteoarthritis pain, it may be worth trying. One word of caution: Check with your PCP first if you are taking blood thinners. Since tart cherry juice acts similar to aspirin, it may have some blood thinning properties.
Click here to see Dr.Oz’s segment on tart cherry juice.
Posted on January 15, 2013
While chiropractic as an actual organized profession did not come about until the early 1900’s, there is evidence of spinal and joint manipulation for the relief of back pain as far back as 2700 B.C. in ancient Chinese and Greek literature. Good old Hippocrates himself recommended: “Get knowledge of the spine, for this is the requisite of many diseases.”
The chiropractic profession has a very colorful and controversial history. It was founded by spiritualist and magnetic healer D.D. Palmer in Davenport, Iowa in 1895. He got the idea when he supposedly restored a man’s hearing by manipulating a vertebra in his neck. Based on this event and his knowledge of human anatomy, D.D. devised a theory that went something like this:
1. The brain and spinal cord controls all the functions of the body.
2. The spinal column surrounds and protects the spinal cord.
3. Small misalignments, or “subluxations”, can irritate or compromise the spinal nerves that go from the spine to the muscles and organs.
4. These subluxations lead to dysfunction and “dis-ease” in the body.
Early chiropractors adhered very strictly to this theory, claiming that subluxations were the root cause of almost all health problems. The early chiropractic profession was more akin to a religious cult than a form of healthcare. As a result, many early chiropractors were thrown in jail for “practicing medicine without a license”. Some modern chiropractors (“straight” or traditional chiropractors) still follow this dogma religiously, but most realize that well-being depends on several factors, such as genes, diet, lifestyle, and germs.
Despite these setbacks, the chiropractic profession gained popularity and acceptance during the 20th century, eventually being recognized as a true profession in all fifty states. There is ample evidence now for the effectiveness of chiropractic care for several musculoskeletal problems, although chiropractic manipulation’s effect on other diseases is still somewhat controversial. There are now 18 accredited four-year postgraduate chiropractic colleges in the U.S., and several more abroad. Chiropractors have to pass both state and national boards in order to be licensed and must complete 12 hours of continuing education every year to keep a license.
In case you are wondering where I stand in regards to chiropractic theory:
My undergraduate training was in biotechnology, and I have always tended to have more faith in science and reason than religion. Based on the scientific literature and my own experience, I believe that chiropractic manipulation, in addition to soft-tissue work and exercises, is the most effective treatment for many musculoskeletal conditions. I also believe that a spinal nerve that is being irritated may cause dysfunction of the organs as well. How else can I explain how some patients tell me that their constipation or asthma is relieved after getting adjusted? However, I certainly do not believe that subluxations are the cause of all disease. The human body is very complex and there are usually many causitive factors in each disease. But I do believe that for optimal health, one should get adjusted regularly in addition to eating healthy, exercising, taking vitamins, managing stress, and getting enough sleep.