// BLOG
Fibromyalgia: The Challenge of Treatment
March 5, 2012
Fibromyalgia (FM) is a disorder involving chronic pain that has no known cause. It is characterized by widespread musculoskeletal pain, sleep disturbance, fatigue and mood disorders. FM affects about 2% of the US population and ranges between 1% and 11% in other countries. It is more prevalent in adult women than men (3.4% vs. 0.5%) and is most common with increasing age with the highest occurrence between 60-79 years of age. The criteria for the diagnosis of FM was established in 1990 by the American College of Rheumatology as widespread pain of at least 3 month duration and pain on palpation (pushing with the fingers) of at least 11 of 18 specific tender sites on the body. Pain, fatigue and sleep disturbance are observed in all patients with FM. Additional features can include: stiffness, skin tenderness, post-exertional pain, irritable bowel syndrome, cognitive disturbances, overactive bladder syndrome or interstitial cystitis, tension or migraine headaches, dizziness, fluid retention, paresthesias (numbness), restless legs, Reynaud’s phenomenon (white finger disease), and mood disturbances. FM is also strongly associated with anxiety, depression, chronic fatigue syndrome, myofascial pain syndrome, hypothyroidism, and many of the inflammatory arthritic diseases. Though there are no specific tests for FM, neurotransmitter deregulation including serotonin, norepinephrine, and substance P, result in an abnormal sensory processing in the brain and spinal cord. This results in a lower pain threshold commonly seen in FM.
The treatment of FM may be best looked at from 3 specific goals which include: 1. Alleviate pain; 2. Restore sleep; and 3. Improve physical function. Thus the most successful approach to the treatment of FM has been reported to be multidisciplinary or, involving several different types of health care providers. Clinical tools often used by doctors to monitor symptom change include a 0-10 pain scale, a body function scale called the Fibromyalgia Impact Questionnaire (FIQ) which measures physical function, common FM symptoms and general well-being; and, for measuring the physical and emotional side of FM, the SF-12 or SF-36 (SF = “short form” and either a 12 or a 36 item tool). The use of these tools helps monitor the success of the treatment that is being applied to the patient.
Though medications are reported as an important treatment option (such as an anti-inflammatory, analgesic, anticonvulsant, hypnotic, corticosteroids, opiates, various injections and more), the focus of this discussion is aimed at the alternative or complementary treatment approaches, as many FM patients cannot tolerate the side effects of the many different medications. Alternative approaches include cognitive behavioral therapy (counseling), exercise (strength & flexibility), acupuncture, and chiropractic treatment approaches, particularly manipulation but also soft tissue therapies and guided exercise training. Physiological therapeutic approaches frequently used in chiropractic clinics include low-power laser therapy, hydrotherapy such as whirlpool, Balneotherapy – using minerals and oils in the moving water, pulsed electromagnetic field, traction and massage therapy. Another exercise approach that can have great value in managing stress and facilitating sleep is Yoga. The key to a successful treatment outcome requires finding a “team” of health care providers that are willing to listen to the patient and work together to improve the patient’s quality of life. Through this concerted team approach, in addition to the patient taking responsibility by performing exercises on a regular basis, following a proper diet, and getting adequate restful or restorative sleep, FM can be quite well “controllable” and, a relatively “normal” lifestyle can be enjoyed.
If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!
When considering additional treatment for muscle pain, our chiropractic and physical therapy clinics in Bayonne and Scotch Plains NJ offer state-of-the art technologies to offer relief from muscle pain. Our physicians come highly recommended by numerous physicians in Hudson and Union Counties. Feel free to contact us for a Free, In-Office Evaluation. If you are looking for faster service, give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location, call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $145 value).
“I Keep Taking Ibuprofen and Acetaminophen and My Migraines Are Getting Worse Not Better?”
February 29, 2012
It is difficult to not know someone who suffers from chronic headaches or migraines.
In 2004, the percentage of adults who experienced a severe headache or migraine during the preceding 3 months was 18%. Migraine headaches, which are characterized by painful, disabling, and recurring symptoms, have no known proven cause, treatment, or cure. They occur more often in women than men and in one ten year period, the proportion of adults with migraine increased 64-77%.
Chronic migraine headaches are classified either as “common” or “classical.” Symptoms of the common migraine headache include nausea, dizziness, fever, and general malaise. The classical migraine headache is most noted for an aura that immediately precedes the headache. This aura could be visual or auditory. In addition, the classical migraine headache is characterized by a relatively short duration (less than or equal to 12 hours) compared with the common migraine headache (up to 4 days).
Although clinical studies have not clearly defined the cause of chronic migraine headaches, potential risk factors include diet, allergy, air quality, and stress. Many patients use complementary treatments such as chiropractic care. Recent studies have shown that patients who have had neck trauma such as whiplash are at greater risk for headache. Cervicogenic headache is a term for when the neck or cervical spine causes pain to be experienced in the head. Usually the neck or upper back region has muscle tightness and limited mobility.
In tension-type headache there is a great deal of muscle tension in the neck, and the headache begins as a band of tension around the head, rather than a severe pulsating pain on one side as seen in migraine.
Whatever ever the type of headache, most patients have suffered for years and have been taking many pain pills such as ibuprofen and aspirin with few results. Recent research has shown that when these medications are consumed for long periods, they can actually cause a rebound effect and increase headache frequency. The headache can initially get worse as the patient has the medication withdrawn. In addition to actually increasing the severity of the headache, long-term use of these medications can cause organ damage to the stomach, liver, or kidney.
It is important to remember that a headache is a symptom that tells you something is wrong. Covering up the symptom will not solve the problem. Physical approaches involving spine posture are important to consider and are generally preferred to injections, sprays, and medications. A seeming endless diet of pain medications with unknown safety is not the answer for patients with headache.
When considering treatment for headaches, our chiropractic and physical therapy clinics in Bayonne and Scotch Plains NJ offer state-of-the art technologies to offer relief from headaches. Our physicians come highly recommended by numerous physicians in Hudson and Union Counties. Feel free to contact us for a Free, In-Office Evaluation. If you are looking for faster service, give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location, call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $145 value).
“Walking For A Healthy Back?”
February 20, 2012
Scientists who have the studied the architecture of the spine have concluded it is meant for walking. That may come as a surprise since we humans do very little walking these days. Our lives, over thousands and millions of years have gone from a day filled with walking and searching for food, to one that is largely sedentary. Many of us spend the bulk of our day working at a desk, and inactivity has become a major problem to our spinal health. It has been shown prolonged sitting increases the pressures in the disk and leads to decreased strength of the spinal and leg muscles.
Many of us do not sit all day, but instead engage in heavy and repetitive lifting tasks. The heavier the loads we lift, the greater is the risk for spinal degeneration. Whether it is heavy lifting or sedentary life, the effects are the same: low back pain. Low back pain has now become an epidemic in society. Depending on which study you look at up to 90% of us will experience low back pain at some point in our lives.
A study of adolescents inNorwayshowed about 57% had back pain in the past year. We tend to think of our children as immune to back troubles, but the statistics show otherwise. Back pain seems to start in adolescence, and follows us into adult life.
When LBP was compared to activity levels, an inverse relationship was shown. This means that the less time children spent at the computer or watching television, the less likely they were to report back pain. Walking decreased the occurrence of back pain.
In a study of adults who engaged in regular, low to moderate exercise, such as walking, significant differences were noted when these people were compared to those with a more sedentary lifestyle. The group of patients who exercised, had improved mood, reduced need for physical therapy, and used less pain medication. They also tended to have less work disability.
The positive effects of walking continue into old age. Those who walk regularly show less lower body disability.
There was a time when medical doctors thought bed rest for two weeks was a good treatment for patients with low back pain. However, over the past two decades, multiple research studies have shown this prescription will actually increase your low back pain.
Whether you have back trouble or not, it is important to stay active and walking is one of the best ways to keep you pain free. You don’t need a gym membership to do it-just some comfortable shoes. It lowers your risk for back trouble, and is also the best activity to engage in during rehabilitation following an injury.
Back pain is one of the most common problems we treat in our office. You can always schedule a complimentary consultation to discuss your health concerns, and the different techniques we use in our office to help get you well again. Just call (201) 339-8889 for an appointment at our Bayonne office and (908) 490-1800 for an appointment at our Scotch Plains office.
Is your neck causing your low back pain?
February 13, 2012
In most of us when we hurt the low back from lifting, the pain starts at the lower spine.
It’s usually not a difficult connection to make, that if it’s the low back that is strained, it is the low back that is injured. But in some cases the back pain seems to creep up, or come out of nowhere. Sometimes you wake up with the pain, and there was no trauma at all. In these cases it is even more important to examine the entire spine for the cause of the problem.
The nervous system is enclosed within the bony spinal column and skull. Nerve signals travel from the brain to all distant areas of the body; to organs, muscles, etc. All of these nerves pass through the neck region, even nerves to the legs. This is why an injury that affects the neck can have ramifications in the areas below. The nerve system is a communication link from brain to tissue, and when the nerve is pinched or irritated, there’s a break or miscommunication in the signal.
Most of us are aware that a person can become paralyzed from a bad neck injury such as a fracture. But what is less well known is that minor sprains of the neck can have an effect on muscle tension and pain in the low back. Some chiropractic techniques specialize in only adjusting the upper portion of the neck because this area can have a profound effect on the entire body.
How neck problems can affect low back is not well understood and is being researched. Some theories are that neck problems tend to cause changes in balance. People tend to sway a bit more when neck problems such as whiplash are present. Perhaps this in-coordination of muscles leads to poor recruitment of muscles when we lift?
Another theory is that if nerves are initially irritated at the top of the neck, they become more susceptible to pinch or irritation at other more distant regions of the spine. The spinal cord is also attached to the upper neck vertebrae. If twisting of the upper neck bones occurs, this can pull on the attachments which link to the cord. Disk protrusions in the neck can also compress the front of the cord, sometimes causing symptoms into the arms or legs.
A thorough examination by a doctor of chiropractic will determine if your low back condition is coming from a neck injury.
When considering treatment for back pain, our chiropractic and physical therapy clinics in Bayonne and Scotch Plains NJ come highly recommended by numerous physicians in Hudson and Union Counties. Feel free to contact us for a Free, In-Office Evaluation. If you are looking for faster service, give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location, call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $145 value).
Headaches and Posture
February 6, 2012
Have you ever glanced at your reflection in a storefront window or mirror as you walked by and noticed your posture? Scary, isn’t it? We all know that we should stand up straight but we soon forget when we get busy and stop thinking about it.
Poor posture is often due to years of standing slouched and this bad “habit” usually starts at a young age. Just look around when you’re in an airport or shopping mall and notice the many people have poor posture. In fact, people’s posture may reflect their attitude – if they’re happy, sad or depressed. Poor posture may be related to self-consciousness, especially during adolescence. It is also genetic as we frequently see a “trait” throughout family members with similar postural tendencies.
The most common postural fault associated with headaches is the forward based head and shoulders. From the side, it appears that the head is significantly forward relative to the shoulders, the upper back is rounded forward and the shoulders are rolled forwards and rotated inward. One exercise that helps reduce this postural bad habit is tucking in the chin and pretending a book is balancing on top of the head. The objective is to not allow the book to slide forward off your head and land on your toes!
It takes approximately 3 months of CONSTANT self-reminding before the new “good habit” posture becomes automatic, so be patient. Soon you’ll “catch yourself doing it right” without thinking about it.
Frequently, posture is faulty lower down the “kinetic chain.” The first link of the chain is the feet and the last link is the head. Since we stand on two feet, any change in that first link or the feet, can alter the rest of the chain, especially areas furthest away – the head, resulting in headaches. For example, if one leg is short, the pelvis drops, the spine shifts (scoliosis), the shoulder drops and the head shifts trying to keep the eyes level. A short leg usually needs to be managed with a heel lift, an arch support or combination of both to properly treat the headache patient.
Most health care providers EXCEPT Chiropractic Physicians typically ignore these issues. Chiropractic Doctors are specifically trained to analyze posture and correct it. You can depend on our clinic for up-to-date treatment approaches such as these.
When considering treatment to correct bad posture that may be causing your headaches, our chiropractors and physical therapists come highly recommended by numerous physicians in Hudson and Union Counties. Feel free to contact us for a Free, In-Office Evaluation. If you are looking for faster service, give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location, call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $145 value).
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