Schumacher Chiropractic Clinics

The first tip in managing stress is to recognize your stressors. The next step is to put each of them in their place. The following stress management tips, based on some old and some new adages, can help you do just that!

Take a Deep Breath and Count to Ten—
Taking a deep breath or two adds oxygen to your system, which almost instantly helps you relax. In addition, taking a moment to step back can help you maintain your composure, which in the long run, is what you need to work rationally through a stressful situation.

Start with “take a deep breath” and…

1. Count to ten (or more or less as the situation warrants!)
2. Stand up and stretch. Remember relaxation is the opposite of stress.
3. Stand up and smile. Try it! You’ll feel better!
4. Take a short walk. If you’re at work, take a bathroom break or get a glass of water. Do something that changes your focus. When you come back to the problem, chances are it won’t seem nearly as insurmountable.
5. In the book Gone With the Wind, Scarlett O’hara says, “I can't think about that right now. If I do, I'll go crazy. I'll think about that tomorrow.” Good advice!

1. Take the time. Too often we put the pleasantries of life on the back burner, telling ourselves we don’t “have time” or can’t “make time” for them. However, actually, time is the only thing we do completely own. While we can’t “make” a day that’s longer than 24 hours, each of us starts the day with exactly that amount of time. Take a part of your time to recognize the good things in your life.
2. Sleep on it. Every coin has two sides and every issue has both pros and cons. List them both then put the list away and take a second look tomorrow. Sometimes “sleeping on” a situation changes the minuses to pluses.
3. Every cloud has a silver lining. After all, rain makes things grow! Ben Franklin found good in a bolt of lightning. Find the good in your stressful situation by listing the negative surges and determining what it will take to make them into positive charges!

1. Dare to say no. One more little thing may be the “straw that breaks the camel’s back”. It’s okay to say “No”, “I can’t”, or “Later”.
2. Acquit yourself. Sometimes events really are out of control and you really are “Not Guilty”. Quit blaming yourself.
3. Be pro-active in finding peace. Those who unsuccessfully use the crutches of drugs and/or alcohol to alleviate stress often find themselves in a twelve-step program like A.A. where one of the mainstays is the Serenity Prayer:

   “God grant me the Serenity to accept the things I cannot change; The Courage to change the things I can; and the Wisdom to know the difference.”

4. When you need help, get help. Even Atlas couldn’t bear the weight of the world on his shoulders forever. Whether you need help from kids or spouse in hauling groceries into the house, help from a colleague to solve a work-related problem, or professional help to find the causes of and effectively manage your stress, getting the help you need is in itself a major stress management tip!

• Get a good night's rest.
• Eat healthily.
• Listen to your favorite music.
• Exercise, participate in a sport or engage in fun activity.
• Plan out your time and prioritize.
• Talk to a friend about your problems, don't hold it in.
• Get a massage.
• Take a nap.
• Take a warm bath.
• Read a book or watch TV.

I found an interesting article in Experience Life magazine about cell phones and the possible side effects of EMF's. I hope you find it interesting. 

The electromagnetic radiation surrounding us – especially from cell phones – may pose unseen dangers to our health. Learn what you can do to reduce your exposure to EMFs.

By Pamela Weintraub / December 2011

My Brooklyn neighborhood is one of the most historic in New York. Up the block, the F. G. Guido Funeral Home, built circa 1840, was a destination of choice for many a Mafia send-off. The Gothic arches of St. Paul’s Church, across the street, have welcomed Episcopalians and music lovers since 1849. Along with hundred-year-old brownstones graced by deep front gardens, these national landmarks are assiduously protected from change. But, one modern feature has silently infiltrated this vintage section of Brooklyn: electromagnetic frequencies, or EMFs for short.

Invisible to the eye, EMFs are powering an ever-expanding thicket of appliances and electric lights, and more recently, a burgeoning network of cell towers, wireless routers and the ever-present cell phones that gird our lives.

Life without cell phones and other wireless conduits has become nearly unthinkable, but a growing chorus of experts now worries that our near constant immersion in these force fields could be endangering our health.

We are exposed “to as much as 100 million times more electromagnetic radiation than our grandparents were,” notes Ann Louise Gittleman, PhD, author of Zapped: Why Your Cell Phone Shouldn’t Be Your Alarm Clock and 1,268 Ways to Outsmart the Hazards of Electronic Pollution (HarperOne, 2010).

Worry intensified this year after the World Health Organization (WHO) analyzed the data and called cell phones a possible carcinogen. The jury is still out on the range of possible effects, but a raft of studies now links EMFs — especially those from cell phones carried close to our bodies — to brain tumors, damaged DNA, fertility problems and autism.

With cell-phone usage surging from a hundred million people worldwide in 1997 to some 5 billion today, even small increases in risk could pose a serious global threat. A Council of Europe committee has even warned that EMFs might bring about a health crisis comparable to those once spawned by smoking and asbestos.

In an effort to lower risk, some communities are taking action to reduce EMF exposures. The National Library of France, for example, has dismantled its wireless system. Germany has advised against wireless technologies in residential neighborhoods.

But when it comes to cell phones, initial change might have to come one person at a time.

“Studies show people would rather leave home without their wallet than their cell phone. The cell phone has become an extension of the body,” says Devra Davis, PhD, former researcher for the National Academies of Sciences and president and founder of the Environmental Health Trust, an organization devoted to educating the public about controllable environmental health risks and policy changes needed to reduce them.

Read on to learn more about EMFs and the best ways to reduce your own exposure risks.

EMFs are Everywhere

What is all the fuss about, anyway? Electromagnetic frequencies — essentially different forms of radiation that vary along what physicists call the “electromagnetic spectrum” (see illustration below) — abound in nature. They build up after thunderstorms and travel through the planet from pole to pole. Light is the most familiar EMF, but modern technology also generates EMFs: x-rays, radio waves and microwaves, to name a few.

What makes one form of electromagnetic radiation fundamentally different from another? In a nutshell: Its wavelength and frequency. Shorter waves have to cycle up and down more frequently to travel a given distance, so they are more energy intensive; some, like x-rays and gamma rays, emit so much energy they can break living tissue apart, a characteristic that has caused experts to label them “ionizing.” By contrast, longer waves, like TV waves, radio waves and microwaves, have to cycle up and down less frequently to travel a given distance. That means they emit less energy; they don’t ionize living tissue and have been widely embraced as safe.

It wasn’t until January 1993, when TV talk-show host Larry King did an interview with a Florida man, that confidence began to erode. King’s guest, David Reynard, had filed a claim against the cell-phone manufacturer NEC and the carrier GTE Mobilenet. According to Reynard, in 1988 he’d given his wife, Susan, a cell phone for her birthday. Seven months later, he told King, she was diagnosed with a malignant brain tumor that closely resembled the size and shape of the phone’s antenna. A month after Reynard filed the lawsuit, Susan was dead.

Could the cell phone really have been the culprit? Experts like Davis hypothesize that it could have been. The effect on the brain and other vulnerable tissue is much like snapping a rubber band, she explains. “Snap it once, and it stays intact, but snap it constantly and irregularly, and the rubber band falls apart.”

Given how widespread cell-phone usage is, and how quickly Susan Reynard’s cancer (a rare, malignant astrocytoma) developed, lawyers couldn’t prove that her cell phone was to blame. Yet studies and counter-studies have cast an increasingly disturbing — though uncertain — light on the damage that non­ionizing wavelengths might cause.

In 1994 University of Washington scientists exposed live rats to cell-phone-like radiation and then examined their brains. DNA from brains of exposed rats was damaged, while DNA from unexposed rat brains remained intact.

Many consider a series of studies from Lund University in Sweden to be the pivotal evidence to date. By 2003 the Swedish researchers were reporting that cell-phone radiation breached the blood-brain barrier, the vascular and immune barricade keeping toxins out of the brain. In one study, the Swedish scientists exposed 32 rats to cell-phone radiation for just two hours, varying intensity among the rats in order to reflect the types of exposures human cell-phone users might receive. When the rats were euthanized roughly 50 days after exposure, and their brains studied, scientists found significant blood-vessel leakage and shrunken, damaged neurons. The higher the level of radiation, the more damage was done.

Ever since the Swedish study, increasing numbers of people have been claiming a link between their brain tumors and their cell phones. Countless studies, most of them small, have shown evidence of harm. But these studies have been countered by just as many studies finding no risk at all.

To help get to the truth, a multinational study called INTERPHONE compared cell-phone usage in brain-tumor patients with usage in a healthy control group without brain tumors. Results, reported in 2010 in the International Journal of Epidemiology, were mixed. According to researchers, risk of getting a brain tumor was higher for those using cell phones the most — 30 minutes a day or more for at least 10 years. On the other hand, people using cell phones for shorter periods of time were reported to have less risk than those using only landlines; for these moderate users, the study implied, cell phones had a protective effect.

Writing an editorial on the study in the same issue of the journal, Rodolfo Saracci, MD, of the National Research Council in Pisa, Italy, and Jonathan Samet, MD, of the University of Southern California in Los Angeles, tried to shed some light. Addressing the tepid findings on risk for heavy users only, they commented that, in contrast, “none of today’s established carcinogens, including tobacco, could have been firmly identified as increasing risk in the first 10 years or so since first exposure.”

As for the so-called protective effect, they found no biological mechanism to explain it. Given that, most experts say it probably reflects a flaw in the design of the study — and not a benefit
from EMFs.

This year’s critical WHO report labeling EMFs a “possible” carcinogen followed fast on the heels of the INTERPHONE study. According to Samet, who led the WHO working group that reviewed the evidence, the cancer–cell-phone link cannot be dismissed.

“The evidence is credible,” he comments. But Samet also points out that without a known mechanism for how cancer is induced, it’s impossible to elevate the risk label to its next level of concern: from “possible” to “probable.” More research will be required.

Young Brains and Cell Phones

Could there be too much of an emphasis being put on brain cancer, which is still a rare diagnosis? “A much larger concern is damage to neural connections in the developing brain and to the reproductive health of men and women,” says Davis.

When it comes to reducing EMF-exposure risks, every millimeter of separation between a cell phone and the brain is protective. With thinner skulls and smaller ears, children are closer to the radiation source. In fact, researchers have long reported significantly higher absorption rates of radiation for children — about twice as much for those under age 8.

When it comes to disruption of neural connections, compelling research published in the Journal of the American Medical Association this year shows that 50-minute cell-phone calls increase glucose metabolism in the area of the brain closest to the phone antenna — specifically, the orbitofrontal cortex and temporal pole, regions involved in sensory integration, language, decision making, and social and emotional processing.

Although the study’s lead author, psychiatrist Nora D. Volkow, MD, of the National Institute of Drug Abuse at the National Institutes of Health, does not know whether the metabolic increases can cause damage over time, she does say that, if they do, children and adolescents (because they have the most neuroplastic brains) would be at greatest risk. “As of right now, we don’t know what happens when you get repeated exposures. What happens over the course of 10 or 15 years?” she wonders.

Research presented at a conference held in Istanbul this May underscores Volkow’s concerns. After Turkish researchers exposed adult rats to mobile-phone-like emissions, they found damage to the cerebellum, a part of the brain important for language, attention and motor control. After exposing pregnant rats to similar radiation during gestation, the researchers documented cell loss in the newborn rats’ hippocampus, a part of the brain pivotal to memory formation.

It appears that cell phones can also threaten fertility. Research from the University of Athens showed that cell-phone radiation could cause DNA fragmentation in the ovarian cells of insects, drastically reducing reproductive capacity.

At the same conference, research was presented from Jawaharlal Nehru University in New Delhi, where researchers exposed rats to two hours of cell-phone radiation a day for 35 days. At the end of that period, exposed rats had high levels of free radicals that resulted in an increased risk of infertility and cancer.

The news is disturbing for humans as well: Research from the Cleveland Clinic in Ohio recently suggested that cell phones may lower sperm count in men — especially those who kept the phone on “talk” mode, and carried it on their body, most often in their pants pocket.

Communities React

The most specific findings come from studies of rodents, hardly the highest level of evidence. But right now, that is the best evidence available. Cell-phone technology is new, and definitive human evidence won’t emerge until decades of use enable long-term follow-up and the kind of epidemiological evidence true proof demands.

Some communities aren’t content to wait those decades for consensus when they can do something now. The San Francisco Commission on the Environment called for a review of cell-phone safety standards, safety warnings at the state and federal levels, and safety information at the point of sale. The mayor and town council of Jackson Hole, Wyo., have voted for a cell-phone safety-awareness campaign for the city and the public schools.

For its part, the cell-phone industry insists on more research before it issues warnings or changes its products in any way. Some compare this to the tobacco industry’s resistance to conceding risk and issuing warnings that smoking can cause cancer. “Whilst the vast majority of scientific studies have not shown any adverse health risks, there are some studies that have raised questions that need to be addressed by further research,” according to the Mobile Manufacturers Forum, an international association of telecommunications-equipment manufacturers established in 1998.

Most cancer advocacy organizations insist on better evidence as well. “Studies thus far have not shown a consistent link between cell-phone use and cancers of the brain, nerves, or other tissues of the head or neck. More research is needed because cell-phone technology and how people use cell phones have been changing rapidly,” according to the National Cancer Institute in Washington, D.C.

The furious yin and yang of the debate continues as this article goes to press. In July the Journal of the National Cancer Institute published a study comparing 352 Western European children who had brain tumors with 646 without tumors; cell-phone use, the researchers reported, created no increased risk for the disease.

Still, Davis calls those conclusions “astonishing and deeply disturbing.” The research, conducted from 2004 to 2008, couldn’t possibly capture the quadrupling of cell-phone use over the last few years, she says. “And how,” she wants to know, “can a study lasting just four years answer questions about tumors that can take a decade to form?”

Although Davis agrees that we have not yet proven harm to the standards that science demands, she says that shouldn’t stop us from taking cautionary measures now. “The need for research should not be allowed to become an excuse to carry on as though everything is fine, until we have incontrovertible proof that it is not,” she writes in her book, Disconnect: The Truth About Cell Phone Radiation, What the Industry Has Done to Hide It, and How to Protect Your Family (Dutton Adult, 2010). We may not yet have an epidemic of brain tumors in countries that have used cell phones for little over a decade, she points out. “But 10 years after cigarettes began to be heavily smoked, we also did not have an epidemic of lung cancer. Years from now our grandchildren will look back and ask: Did we do the right thing and act to protect them, or did we harm them needlessly, irresponsibly, and permanently, blinded by the addictive delights of our technological age?

I found this article in one of my professional journals. I hope you find it interesting.

By Mark Studin, DC, FASBE(C), DAAPM, DAAMLP

It was reported by Doheny in 2006 that migraine headaches cost U.S. employers more than $24 billion annually, including direct health care costs and indirect expenses such as absenteeism

Doheny went on to report that according to Michael Staufacker, director of program development for StayWell Health Management in St. Paul, Minn., "The programs are so few and far between because many companies 'don't perceive it as a priority.'"¹

Much of the public perceive headaches and migraines as normal occurrences. For example, a patient will enter a doctor's office and report that they experience "normal" headaches, not realizing that pain is never a normal occurrence. Symons, Shinde and Gilles emphasized the nature of pain, quoting this statement from the International Association for the Study of Pain: Pain is "'an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."² As a result of the public not taking many types of headaches as potential serious problems, they let the condition linger, leading to negative sequella.

According to Munakata, Hazard, Serrano, Klingman, et al., "neuroimaging studies have provided compelling evidence that suggests progressive brain changes in persons with migraines ... migraine frequency is associated with posterior circulation infarcts and diffuse white-matter lesions ... Welch, et al., showed that impairments in iron homeostasis in periaqueductal grey areas that were associated with migraine duration and chronic daily headache."³

Munakata, et al., also reported that the economic impact of migraines in both direct health care costs and indirect costs of absenteeism is a huge economic burden.³ The direct cost of migraines ranges from $127 to $7,089 per victim, and the indirect cost due to absenteeism $709 to $4,453 per victim, making migraines an economic burden to the individual, the insurer, the employer, as well as local, state and federal entities who experience a lowered tax base from lost wages. It was also reported that between 2005 and 2006, there were 1,729,555 physician office visits, 186,603 advanced imaging procedures, 59,589 other diagnostic procedures, and 22,168 hospital days with a primary diagnosis of migraine or headache; all of which are paid by private or public insurers, or out of the pockets of individuals. In short, the costs are staggering and a burden to the economy.

Friedman, Feldon, Holloway et al., reported that acute headaches account for 5 percent of emergency department (ED) visits in hospitals. They also reported: "[T]he ED environment that may also contribute to unsatisfactory treatment response include limited physician contact time that may preclude a detailed history, overuse of ED by patients with substance abuse problems, the need for rapid triage, the competing distraction of patients with life-threatening conditions, and directives (or lack thereof) for care dictated by the referring physician. ...Thus, the treatment of migraine patients in the ED appears to be suboptimal and the high rate of recurrent headache may be attributed to underutilization of relatively 'migraine specific' treatment."⁴

Nelson, Suter, Casha, et al., reported on randomized clinical trials that took place over an eight-week course of treatment. The results showed there was minor statistical differences in outcomes for improvement during the trial period for chiropractic care, amatriptyline or over-the-counter medications for treating migraine headaches. It was also reported that there was no statistical benefit in combining therapies. However, the major factor to consider is that in the post-treatment, follow-up period, chiropractic was 57 percent more effective in the reduction of headaches than drug therapy. In addition, it was reported that, with the drug group, "58% experienced medication side effects important enough to report them. In the amatriptyline group, 10% of the subjects had to withdraw from the study because of intolerable side effects. Side effects in the SMT (Spinal Manipulative Therapy) group were much more benign, infrequent, mild and transitory. None required withdrawal from the study."⁵

Although this study was conducted 13 years ago, a more current study by Chaibi, Tuchin and Russell reported that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be equally as effective as propranolol and topiramate in the prophylactic management of migraine,⁶ supporting the previous findings. Although more research is desperately needed, the above conclusions suggest a clear direction when it comes to managing migraines and headaches.

Using the 57 percent increased effectiveness that chiropractic has over drug therapy (leaving out the overlap that chiropractic could help without drugs) and the $24 billion U.S. employers pay for headaches and migraines annually, the savings from chiropractic care would approach $13.7 billion annually. Now imagine the reduction in the staggering costs currently incurred by the public, government and other entities for headache/migraine if that same percentage (57 percent) were applied. In addition, if chiropractic reduced the necessity for emergency room visits by 57 percent, ED doctors could focus on what their primary purpose is, to save lives in urgent scenarios.

With these cost savings, chiropractic benefits the federal government, local government, employers, private and public insurers and the public. It eases the burden on emergency rooms and prevents unnecessary side effects of drugs that are not clinically indicated, with a more viable and proven drugless solution. Although much more research is desperately needed to explore the benefits of chiropractic for migraines and headaches, the available research suggests chiropractic offers immediate solutions.

References

1. Doheny K. Recognizing the financial pain of migraines. Workforce Management, 2006;85(16):10-12.
2. Symons FJ, Shinde SK, Gilles E. Perspectives on pain and intellectual disability. Journal of Intellectual Disability Research, 2009;52(Pt 4):275-286.
3. Munakata J, Hazard E, Serrano D, Klingman D, Rupnow MFT, Tierce J, Reed M, Lipton R. Economic burden of transformed migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study. Headache, 2009;49(4):498-508.
4. Friedman D, Feldon S, Holloway R, Fisher, S. Utilization, diagnosis, treatment and cost of migraine treatment in the emergency department. Headache, 2009;49(8):1163-1173.
5. Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 1998;21(8):511-519.
6. Chaibi A, Tuchin PJ, Russell MB. Manual therapies for migraine: a systematic review. The Journal of Headache and Pain, 2011;12(2):127-133.

Dr. Mark Studin is a 1981 graduate of New York Chiropractic College. He is the co-founder and former executive director of the New York Chiropractic Council. Currently, he is president of CMCS Management. Contact Dr. Studin with questions and comments regarding this article at drmarks380@aol.com .

$15,897,840,000 and Adds $692,160,000

in Wages to Americans

by Mark Studin DC, FASBE(C), DAAPM, DAAMLP

It was reported by Zigler in 2011 that 200,000 spinal fusion surgeries are performed each year, just in the United States alone. An equal number of microdiscectomies are performed as reported by Mayer (2006), which is considered by many to be a conservative number. Let's consider the chiropractic impact of exposing the public to treatment that could avoid needless surgeries, using the 400,000 disc surgeries as a conservative number, not to mention how this could change the unnecessary cost to government and private insurers and lost revenue to both governmental agencies and workers from absenteeism. Allen and Garfin (2010) reported that spine-related health care expenditures totalled over $97.5 billion (2011 inflation adjusted), a 65% increase from 1997. With an aging population, this trend, based on the biomechanics of the aged, will continue.

It was reported by McMorland, Suter, Casha, du Plessis, and Hurlbert in 2010 that over 250,000 patients a year undergo elective lumbar discectomy (spinal surgery) for the treatment of low back disc issues in the United States. The researchers did a comparative randomized clinical study comparing spinal microdiscectomy (surgery) performed by neurosurgeons to non-operative manipulative treatments (chiropractic adjustments) performed by chiropractors. They compared quality of life and disabilities of the patients in the study.

The study was limited to patients with distinct one-sided lumbar disc herniations as diagnosed via MRI and had associated radicular (nerve root) symptoms. Based upon the authors’ review of available MRI studies, the patients participating in the study were all initially considered surgical candidates. Both the surgical and chiropractic groups reported no new neurological problems and had only minor post-treatment soreness. 60% of the patients who underwent chiropractic care reported a successful outcome while 40% required surgery and of those 40%, all reported successful outcomes. This study concluded that 60% of the potential surgical candidates had positive outcomes utilizing chiropractic as the alternative to surgery.

Let's do the math. If we take the 400,000 disc surgeries (adding cervical surgeries to the equation) done each year as discussed in the opening paragraph and apply McMorland et al.'s (2010) findings that 60% of surgical candidates had successful outcomes with chiropractic as an alternative to surgery, 240,000 patients yearly could avoid needless surgery if they sought chiropractic care.

According to Sherman, Cauthen, Schoenberg, Burns, Reaven and Griffith in 2010, the 2010 inflation adjusted amount per case in Medicare dollars is $13,243.82 per patient once you take into consideration the complications, but exclude many other variables such as repeated MRI's, myelograms, and many hospital charges. Allen and Garfin (2010), taking into account total charges, including mean hospital charges for a single level, uncomplicated, minimally invasive surgery, reported the cost to be $70,159 for all payors. They also went on to report that for 2-level disc surgeries the complication rate increased by 25% with significantly more costs.

If you consider 240,000 preventable surgeries at $70,159 per patient, that equates to $16,838,160,000 healthcare dollars that did not have to be spent. MEDSTAT, as reported by Chiropractic Lifecare of America (2009), estimated that the average cost of chiropractic care per patient per case is $3,918 (2011 inflation adjusted dollars.) If you take this amount and apply it to the 240,000 unnecessary surgeries, you have a net savings of $66,241 per patient. The net savings to the Medicare system and private insurers is $15,897,840,000.

According to Fayssoux, Goldfarb, Vaccaro, James (2010) who studied the indirect costs associated with surgery for low back pain, the average lost productivity related to absenteeism resulted in lost wages of $2,884 per patient for the first postoperative year. "The findings demonstrate the significant, though not surprising, impact of spinal disability on productivity, and the importance of including measurement of lost productivity and return to work..." (Fayssoux et al., 2010, p. 9). This equals an additional $692,160,000 in wages to Americans per year by taking the necessity of absenteeism out of the equation with no surgeries to recover from.

Chiropractic offers solutions to the federal government, local government, and public and private insurance companies by avoiding unnecessary surgeries. Chiropractic offers solutions to the economy of local, state and federal governments by increasing the tax base and productivity in the marketplace as a result of keeping workers at work and circulating money into local economies with increased paychecks at the end of the year. The research is conclusive and chiropractic has solutions to many of the economic and societal problems in the United States and worldwide.

References:

1. Zigler, J. (2002). Lumbar artificial disc surgery for chronic back pain. spine-health. Retrieved fromhttp://www.spine-health.com/treatment/artificial-disc-replacement/lumbar-artificial-disc-surgery-chronic-back-pain

2. Allen, R. T., & Garfin, S. R. (2010). The economics of minimally invasive spine surgery: The value perspective. Spine, 35(Suppl. 26), 375-382.

3. Mayer, H. M. (Ed.). (2006). Minimally invasive spine surgery: A surgical manual. Germany: Springer.

3. McMorland, G., Suter, E., Casha, S., du Plessis, S. J., & Hurlbert, R. J. (2010). Manipulation or microdiskectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics, 33(8), 576-584.

4. Sherman, J., Cauthen, J., Schoenberg, D., Burns, M., Reaven, N. L., & Griffith, S. L. (2010). Economic impact of improving outcomes of lumbar discectomy. The Spine Journal, 10(2), 108–116.

5. Chiropractic Lifecare of America. (2009). The MESTAT Project. Learning. Retrieved from http://www.clahealthcare.com/learning/index.html

6. Fayssoux, R., Goldfarb, N. I., Vaccaro, A. R., & Harrop, J. (2010). Indirect costs associated with surgery for low back pain—A secondary analysis of clinical trial data. Population Health Management, 13(1), 9-13.

One of the most common questions I get is whether ice or heat is best for pain and injuries. Well, it depends. Both can be beneficial at different times. The following are some guidelines on when to utilize each.

The safest choice for treatment of injuries is ice. This method is best for injuries or pain that is less than 24 hours old, or any injury that continues to produce swelling.  Ice decreases pain and provides vasoconstriction (closing of small blood vessels). This helps limit the amount of swelling that occurs immediately after the injury. It also has a calming effect on nerves, which can decrease pain. Ice or cold packs should never be put directly on the skin due to the risk of frostbite. In fact, cold packs can be even colder than natural ice. Neither ice nor cold packs should be used for longer than 30 minutes. To get added results for treatment of swelling, elevate the area being iced.

Ice Tips:

• Rub the ice cube over the affected area until it melts completely.
• Soak a thin washcloth in cold water. Wring it out and place over the affected area. Place a bag of frozen vegetables or bagged ice on top. If you want, use an Ace wrap to hold it in place.
• For hands or feet, soak in a bucket or bowl of icy water for 10-15 minutes.

Heat promotes muscle relaxation, and is best used on postural muscles like those along the lower back, mid-back and neck. Muscle soreness and spasms are the most common symptoms treated with heat. This method can also help with osteoarthritis to increase range of motion and, therefore, decrease pain. Heat should also be applied for only 30-minute intervals.

Know that, when heat it is applied over an area of acute injury, active inflammation or swelling can get worse, as heat causes vasodilatation (opening of the small blood vessels), the opposite of ice. Another danger of using a heating pad is burning the skin. Commonly, a person will fall asleep on the heating pad or simply leave it on too long.

Moist heat is the most effective form. Chiropractors  use a machine called a hydrocollator that keeps the hot pack in 160 degree water. Several layers of towels are used between the hot pack and the skin.

Heat Tips:

• Use an electric heating pad.
• Apply for no more than 30 minutes.
• Place a cloth layer between the heating pad and the skin. The first few times the heating pad is used, check the skin every 5 minutes to make sure there is no burning.
• The setting on the heating device should be at the minimum level where you still feel heat. A higher setting is not better, just more likely to burn.

INFORMATION FROM DISCOVERY HEALTH

My brother Dr Dan, found this great article on the American Chiropractic Associations website about wellness that I wanted to share with you. Enjoy!

“Wellness” has become a buzzword among the public, health care practitioners and legislators alike. But what exactly does it mean, and how can people benefit from it? The American Chiropractic Association (ACA) defines wellness as “an active process that promotes health and enhances quality of life.”

“With the enactment of health care reform legislation earlier this year, the public is going to hear more and more about the importance of wellness, staying healthy and ultimately reducing health care costs caused by chronic diseases such as heart disease and diabetes,” says ACA President Dr. Rick McMichael. “It’s time for people to understand that they have the power to take charge of their health and be well enough to do the activities they enjoy."

Dr. Scott Bautch, a doctor of chiropractic from Wausau, Wis., explains wellness further. “We consider wellness the act of adding potential to people’s lives,” he says. “Whether that potential is the ability to avoid cholesterol problems, quit smoking, or exercise more — it’s all individual to each person. In other words, wellness is about giving people specific skills that will help them flourish in life.”

Finding a wellness coach

“If you’re interested in health and wellness, a good place to begin is by talking about it with a doctor of chiropractic,” notes Dr. McMichael. “Our doctors are well known for their expert care of back pain, neck pain and headaches, but they also offer patients a variety of conservative recommendations and counseling on general health and wellness." (link to: http://www.acatoday.org/healthtips)

You may ask, “What can a doctor of chiropractic offer that is different from a medical doctor?” The answer lies in the way the two professions approach wellness. To achieve “wellness” in traditional terms, a medical doctor will simply screen you for diseases, explains Dr. Bautch. “You might be examined or have lab tests. For medical doctors, wellness is about staying ahead of diseases.”

A doctor of chiropractic (DC), on the other hand, will screen you for diseases, but he or she also will talk to you about your lifestyle and behaviors that may put you at risk for injury or illness. It’s important to note that chiropractic’s approach is drug-free; instead of writing a prescription, a DC offers spinal adjustments, rehabilitative exercises, nutritional counseling and lifestyle modifications to move patients toward optimum function and wellness.

Typically, when a new patient visits a DC, one of the first things the doctor will assess is functional capacity. The DC will focus on decreasing pain and returning the patient to normal daily activities, including exercise. In the intermediate stage, a chiropractor will continue therapeutic care, but also begin to address factors that may have led to the patient’s pain by recommending lifestyle modifications. An example of intermediate care might include managing the patient’s obesity with counseling on diet and exercise. In the final stage of wellness care, a DC will help the patient take responsibility for his or her own health through patient education, enabling the person to independently maintain and even advance the level of wellness achieved.

Adjust your attitude

“The first thing I work on with a patient who is interested in living well is life skills in terms of thinking and dealing with life’s ups and downs,” says Dr. Bautch. “Research shows that coping skills and the ways that people deal with stress can be huge factors in whether or not someone is well.” 

You can boost your attitude in a variety of ways: enjoying nature, looking for humor in life’s mishaps, listening to relaxing music and creating a support system of people who you can turn to in times of trouble or stress. 

Start moving

Next, Dr. Bautch works with patients to increase their daily movements. “Americans today take significantly fewer steps than previous generations, and they spend a great deal more time in sedentary positions,” he says. “Adding more motion to your life can be a huge step toward living well.”

Simply taking a 30 minute walk each day is a great way to recoup the steps that are missing from your day. Experts generally agree that to be considered “active,” adults should take about 10,000 steps each day. Wearing a pedometer is an easy way to track your progress.

Food for fuel

Once the first two components of wellness are addressed, Dr. Bautch will address a patient’s diet. It’s surprising for some to learn that making even a few simple changes, such as eating more raw or organically grown foods, drinking more water and consuming 25 to 30 grams of fiber per day, can positively impact your health and help prevent a variety of adverse health issues in the future.