Fibromyalgia: What Resources are Available?

Fibromyalgia (FM) is a chronic condition that impacts its victims in every aspect of their lives. The day has to be planned around how one might feel at certain times of the day and is always in the foreground of a Fibromyalgia  victim’s mind. Many patients who present for treatment of FM ask us about what resources are available for them and therefore, this is the subject of this month’s Health Update.

The National Fibromyalgia Association (NFA) was founded in 1997 in Orange, California and has become the largest nonprofit (501c3) FM specific organization. The initial goal was to help patients with FM find doctors who were willing to treat and manage FM patients as this was a BIG CHALLENGE and remains an important focus of the organization today. The mission of the NFA is to improve the quality of life for the FM patient and to find a team who embraces that premise by creating and offering many programs, high profile media campaigns, and providing training to support group leaders across the country. Their philosophy is to, “…empower patients and to provide them with a new level of hope for the future.” To that effect, the NFA evolved to include the development of an educational web site, the publication of an international magazine (“Fibromyalgia AWARE”), as well as developing medical education programs. The NFA website includes a “Resource” tab at their homepage that leads to a listing of many great options that can be accessed at the click of a button. URL:

http://fmaware.org/PageServer4a00.html?pagename=resources_directory

Here is an interesting place for health care providers and patients with FM to review research articles on FM from 1981 to 2002, with over 300 references available:

http://www.myalgia.com/refs%2081%20to%200302.htm

Another good resource for information on FM is the New York Times Health Guide:

http://health.nytimes.com/health/guides/disease/fibromyalgia/resources.html

There are many places one can acquire information about FM, including here at Advanced Wellness.  The list provided here barely scratches the surface.  Simply Google “fibromyalgia resources” to find almost anything you’ll need.

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services.  Feel free to call us for a free consultation to discuss your many  options here at Advanced Wellness.

Fibromyalgia: The Challenge of Treatment

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. Fibromyalgia 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 Fibromyalgia. 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.  If you would like to know how our multidisciplinary medical wellness center can  can help with your Fibromyalgia, call 732-984-9597 for a free consultation.

What has been your experience with Fibromyalgia?  What treatments have worked for you?  share your comments below or on our Advanced Wellness Facebook Page.

Maintenance Chiropractic for Chronic Low Back Pain

When people think of chiropractic, they immediately think of low back pain and are often surprised to find out that chiropractic can benefit many conditions such as carpal tunnel syndrome, tennis elbow, rotator cuff tears, as well as hip, knee, and ankle conditions.  There is also research support for manipulation (a key component of chiropractic) and its role in managing “somatovisceral” related conditions such as pneumonia, dizziness, stage 1 hypertension, PMS, asthma, colic, and bed wetting.

 

Research clearly shows that chiropractic manipulation out performs other forms of treatment for acute, subacute and chronic low back pain. But, the question remains, can “maintenance chiropractic” PREVENT problems down the road? Ironically, two medical doctors in August of 2011 published an article in a leading medical journal (SPINE) entitled, “Does maintained spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcome?” The study’s objective was to determine if treating chronic low back pain patients (pain >6 months) after a course of 12 treatments in the first month would do better, the same or worse if treatments were continued at 2-week intervals for an additional 9 months. They compared 3 groups of patients: 1.) 12 treatments of “sham” (placebo) manipulation over a 1-month period. 2.) 12 treatment of “real” spinal manipulative therapy (SMT) for 1 month but no treatments for the subsequent 9 months. 3.) The same as #2 but with treatments every 2 weeks over the next 9 months. To determine the differences between these 3 groups, the authors measured pain and disability scores (using questionnaires), generic health status (questionnaire), and back-specific patient satisfaction (questionnaire) at 1, 4, 7 and 10-month intervals.

 

The results showed that groups 2 (SMT for 1 month only) and 3 (SMT for 1 month + every 2 weeks for 9 months) had significantly lower pain and disability scores than the 1st group (sham/placebo group) at the end of the 1st month or, 12 visits. However, only group 3 (treatments were continued for 9 months at 2 week intervals) showed more improvement in pain and disability scores at 10 months. Equally important, the scores for the non-maintained group 2 patients returned to near their pre-treatment levels by month 10!

The authors concluded that not only is spinal manipulative therapy effective for chronic low back pain, but more importantly, REGULAR ADJUSTMENTS EVERY 2 WEEKS after the initial course of concentrated care (3x/week for 4 weeks) was needed, “…to obtain long-term benefit,” suggesting that, “…maintenance SM after the initial intensive manipulative therapy,” is appropriate care to obtain long-term results.

 

This study FINALLY supports the recommendations made by chiropractors for many years –regular adjustments are beneficial to obtain a higher quality of life, less pain and less disability!

 

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.   If you would like to know how chiropractic care can help with your low back pain, call 732-984-9597 for a free consultation

The Neck & Shoulder Pain Relationship

Given the close anatomical proximity between the neck and shoulder, it’s no wonder the two are intimately related. In our hectic lifestyles of driving, hunching over computers, talking on the phone, not to mention stress arising from multiple sources, the muscles in the neck, upper back and shoulders seem to tighten up and hurt at the same time. The question is, between the neck and the shoulder, which one is the “chicken” and which is the “egg?”

The neck gives rise to the nerves that innervate the head (C1-3 nerve roots), the shoulders (C4-5), and the arms (C5-T2). Hence, there are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), and 6 sets in the lumbar or low back region and 5 sets in the sacrum, all of which travel to a specific destination allowing us to move our muscles and to feel hot, cold, sharp, dull, vibration and position sense. When these nerves get pinched or irritated, they lose their function and the ability to feel, making it challenging to button a shirt, thread a needle, or pick up small objects.  It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, the nerves arising from the neck, when pinched, can have a dramatic effect on our ability to carry out our desired activities in which the shoulder, arm and hand use is required.

On the other hand, when the shoulder is injured (such as a rotator cuff tear), this can also result in neck problems. There are several ways pain from the neck affects the shoulder and vice versa. When the shoulder is injured, pain “information” is relayed to the brain starting at the nerve endings located in the area of the shoulder injury, transmitting impulses between the shoulder and the neck, and finally from the neck to the sensory cortex of the brain. That information is processed and communication to the motor cortex prompts nerve signals to be sent back to the shoulder through the neck and to the injured area (in this case, the shoulder). A reflex muscle spasm often occurs as a result, serving as kind of an “internal cast” as the muscle spasm tries to protect the injured shoulder.

This can become a “vicious cycle” or never-ending “loop” until the reflex is interrupted (perhaps by a chiropractic adjustment). Another means by which both areas become injured has to do with modifications in function. We tend to change the way we go about our daily chores when an injury occurs to the shoulder, such as putting on a coat differently by leaning over to the opposite side. These functional changes can also give rise to neck pain. Because of this reflex cycle, as well as the close anatomic relationship between the neck and shoulder, not to mention the “domino effect” of soft-tissue injuries which seem to change the function at the next joint level, it’s not surprising that both the neck AND the shoulder require simultaneous treatment for optimal treatment benefit. However, the good news is, regardless which one is the “chicken or the egg,” chiropractic treatments of shoulder injuries will almost always include the neck and vice versa.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

If you would like to know how chiropractic care can help with your neck pain or shoulder pain, call 732-984-9597 for a free consultation call.

Fibromyalgia: The Challenges of Diagnosis

Fibromyalgia (FM) is a chronic condition where the diagnosis is made by elimination since there are no specific lab tests for diagnosing FM. In the past, we’ve discussed the different types of FM, the lack of good diagnostic tests, many management recommendations derived from interviews with FM patients, and more.

One of the many causes of FM involves the autoimmune system, thus suggesting that FM may be an autoimmune disease. In summary, the autoimmune system is very important system for all of us, as it controls the means by which our body fights off unwanted foreign particles like viruses, bacteria, and a host of other triggers that can negatively affect our body. The autoimmune process is best explained by example: Let’s say a certain type of food is eaten to which the person has an allergy. As particles from that food are absorbed into the blood stream, the body senses that something is wrong –foreign particles are there that shouldn’t be there. As a result, our body produces antibodies, which function like an army trained to “fight” the foreign particles. If the body’s autoimmune system handles it without a problem, the person may not even know anything is “wrong” or that this process is going on. However, if the foreign particle is not handled easily or properly, all kinds of symptoms can occur. In this food allergy example, stomach pain, nausea, cramping, diarrhea and perhaps hives on the skin may even occur. Another common autoimmune example occurs in the spring when flowers bloom, grass grows, trees bud, and so on. Many of us suffer from what is commonly referred to as “hay fever” and possible symptoms include a runny nose, itchy watery eyes, and sneezing (lots of it).

FM is sometimes thought to be associated with rheumatoid arthritis but the scientific evidence is not in full agreement with this theory either. More consistent evidence for causation seems to support the following possibilities: 1. Following trauma or injury. 2. A central nervous system origin. 3. Changes in muscle metabolism. 4. A decrease in muscle blood flow.

However, there are still those who support the cause of FM being triggered by an infectious agent like a virus in susceptible people, even though no specific agent has yet to be identified. For those who state that FM is not an autoimmune disease, they do admit FM may have an “autoimmune component” to it. One study reported, “…that scientists have discovered a new antibody in the blood of many FM patients,” which was reported in the Journal of Rheumatology. Subsequently, a new test was developed for detection of the “Anti-Polymer Antibody” (APA) that was reportedly found in more than 60% of FM patients with severe symptoms. The idea of a specific blood test for FM is certainly welcomed by all experts and clinicians who manage FM as a reported $16 billion/year in direct medical costs are associated with FM. Unfortunately, when comparing the APA levels in FM patients to those with rheumatoid arthritis and controls with neither, the APA levels were not able to distinguish between the groups.  Unfortunately, until better testing methods are developed, doctors and researchers will continue to look for the “gold standard” FM test.

If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

If you would like to know how chiropractic care can help with your Fibromyalgia, call 732-984-9597 for a free consultation call.

 

 

Low Back Pain & Spinal Manipulation: How Does It Work?

Health Update: Low Back Pain

 For many years, Chiropractic has been at the forefront of treating low back pain (LBP) with both greater patient satisfaction and less lost time at work when compared to other non-surgical treatment approaches. There have been many explanations as to why chiropractic manipulation therapy (CMT) works but many of these studies include other treatment modalities or methods and the benefits are, therefore, not clearly derived only from CMT.  A recent study has tried to clear this up and the results are very interesting!

 

This study included two chiropractors and two a physical therapists (PT) from Canada and the US. What is unique about this study is that they measured clinical or symptomatic improvement by tracking improvement in activity tolerance using a standard questionnaire commonly used by chiropractors and PTs all over the world, as well as changes in the spinal stiffness using a valid/reliable instrument before and after CMT was utilized. The importance of these findings is that only CMT was utilized and hence, other forms of treatment commonly utilized by chiropractors did not cloud the findings. There were 48 patients included in the study and the initial 2 treatments were administered 3-4 days apart, followed by an assessment 3-4 days after the 2nd treatment. Assessments were also performed before and after each treatment. The assessments included use of the questionnaire and a stiffness measurement using the special instrument. Also, “recruitment of the lumbar multifidus muscle” (a muscle in the low back that helps stabilize the trunk or core) was measured by ultrasound. After each treatment, significant improvement was found in the overall pain level and in reduced spinal stiffness (which remained improved 3-4 days after the last/second treatment).

 

The study conclusions revealed less pain, more activity tolerance and less spinal stiffness after the administration of the 2 treatments. The greatest clinical improvement was found in those who had the most dramatic reduction in stiffness after each treatment. They found that the level of muscle recruitment was directly related to the degree of spinal stiffness.  They also found that patients who received thrust manipulation (CMT) had immediate improvements with reduced pain, stiffness and improved muscle recruitment measurements. However, this same effect was NOT obtained when non-thrust mobilization techniques were used. This means many non-thrust manual techniques such as mobilization, massage, and other soft tissue release methods do not create the immediate benefits that were produced by thrust manipulation.

 

With this new information, we are now able to explain with confidence to patients the reasons why they typically feel better after the spinal adjustment. The patient can then appreciate receiving an answer that makes clear sense and has been “proven.” It’s important to realize that the “bonus” of receiving chiropractic care for low back pain includes not only just pain reduction, but more importantly, improvement in tolerating activities such as vacuuming, washing dishes, golfing, walking and of course, working.

 

We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

If you would like to know how chiropractic care can help your low back pain, call 732-984-9597 for a free consultation call.

The Neck and Headache Connection

When we hear the term headache, we don’t usually think about the neck. Rather, we focus on the head, more specifically, “…what part of the head hurts?” But, upon careful questioning of patients, we usually find some connection or correlation between neck pain and headaches.

The Neck Anatomy

The key to this connection can be found in looking at the anatomy of the neck. There are 7 vertebrae that make up the cervical spine and 8 sets of nerves that exit this part of the spine and innervate various parts of the head, neck, shoulders and arms, all the way to the fingers. Think of the nerves as electric wires that stretch between a switch and a light bulb. When you flip on the switch, the light illuminates. Each nerve, as it exits the spine, is like a switch and the target it travels to represents the light bulb. So, if one were to stimulate each of the nerves as they exit the spine, we could “map” exactly where each nerve travels (of course, this has been done).

When we look specifically at the upper 3 sets of nerves that exit the spine (C1, C2, and C3), we see that as soon as they exit the spine, they immediately travel upwards into the head (the scalp). Like any nerve, if enough pressure is applied to the nerve, some alteration in nerve function occurs and usually a sensory change is noted (numbness, tingling, pain, burning, etc.). If the pressure continues, these symptoms can last for a long time. These types of headaches are often called “cervicogenic headaches” (literally meaning headaches that are caused by the neck). These can be caused by the nerves getting pinched by tight muscles through which they travel as they make their way to the scalp.

Neck and Headache Connection

Another connection between the neck and headaches includes the relationship between 2 of the 12 cranial nerves and the first three nerves in the neck described above. These types of headaches usually only affect one half of the head – the left or right side. One of the cranial nerves is called the trigeminal nerve (cranial nerve V). Because the trigeminal nerve innervates parts of the face and head, pain can also involve the face. Another cranial nerve (spinal accessory, cranial nerve IX) can also interact with the upper 3 cervical nerve roots, resulting in cervicogenic headaches. People with cervicogenic headaches will often present with an altered neck posture, restricted neck movement, and pain when pressure is applied to the base of the skull or to the upper vertebrae. Other than a possible numbness, there are no clinical tests that we can run to “show” this condition, though some patients may report scalp numbness or, it may be found during examination.

Though medication, injections, and even surgical options exist, manipulation applied to the small joints of the neck, especially in the upper part where C1-3 exit, works really well so why not try that first as it’s the least invasive and, VERY EFFECTIVE! In some cases, a combination of approaches may be needed but many times, chiropractic treatment is all the patient needs for a successful outcome.

We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

 

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR NECK PAIN!  FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Fibromyalgia: What Water Exercises Can I Do?

Fibromyalgia (FM) is a condition associated with tight, sore muscles with generalized, whole body pain, which can dramatically affect a person’s lifestyle.  However, there are ways to fight back!  Previously, we discussed the benefits of water exercises and this time, we’re going to illustrate some specific exercises that can be performed in water.

Remember to start slow and gradually introduce more exercises (as well as repetitions and the length of exercise time) AFTER you have proven to yourself that the previous exercises are well tolerated. MOST IMPORTANT, have fun with these, and modify them as needed to make them “yours.”

 

Diving Forward

Prep: Arms straight, stretched out from sides, palms forward.

Action: Push hands together, then outward.

 

Diving Downward

Prep: Arms straight, stretched out from sides, palms down.

Action: Swing hands down and inward across front, then outward; repeat down and inward behind back, then outward.

 

Squats

Prep: Legs straight.

Action: Bend at knees to lower body down, then up.

 

High Kick

Prep: Legs straight, pointing forward

Action: Swing one leg forward to backward; repeat with other leg.

 

Backward Kick

Prep: Legs straight, hold onto support.

Action: Ben one knee to raise foot backward, then down; repeat with other knee.

 

Deep-water Walking

Prep: Start in a dog-paddling position

Action: Climbing motions with both arms and legs.

 

Horizontal Walking

Prep: Legs straight, floating face down holding stairs.

Action: Bend one knee forward and back, then other knee.

 

Of course, there are many other maneuvers that can be done in water.  Simply walking in water at various depths works well.  Another good/easy exercise is taking empty 1 gallon milk jugs with the caps on and squat down in the shallow end of a pool so only your neck is exposed and move your arms underwater back and forth in different directions, at different speeds, gradually increasing the speed of the movement.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Learn How To Improve Your Brain

How would you like to have a bigger, more powerful brain?

powerful-human-brain-diagramSadly, the hippocampus, a part of the brain key to memory and special navigation, is known to shrink as we age.    This shrinkage starts in late adulthood and is responsible for memory loss and impairment.

Now, There Is New Hope

According to the Los Angeles Times, a new study published by the Journal Proceedings of the National Academy of Sciences has revealed “a program of aerobic exercise, over the course of a year, can increase the size of the hippocampus… in adults ages 55-80.”    In the study, 120 people from ages 55-80 who did not exercise previously were split into 2 groups; 60 were put into an aerobic exercise program that consisted of walking around a track 3 days a week for 40 minutes per session; and the other 60 did a program consisting of stretching and weights.

Results

According to the Los Angeles Times article, “The group doing aerobic exercise had increases in hippocampus volume: up 2.12 % in the left hippocampus, and 1.97% in the right hippocampus.  The stretching group, on the other hand, had decreased hippocampus volume:  down 1.40% on the left and 1.43% on the right.”    What’s important to note is the article said it is never too late to start and it suggested that some very simple exercise programs may be a cost-effective way to treat a widespread health problem, without the side effects of medication.

Natural Ways To Treat Infection

Did You Know?

 

tea-tree-plantAmong the many natural ways to treat infection, tea tree oil is one of the very best. Tea tree oil is an essential oil taken from the leaves of the melaleuca alternifolia, a plant native to Australia. It has a wide variety of uses with strong antiseptic, antibacterial, antiviral, and antifungal properties. The aborigines in Australia used tea tree leaves to heal skin infections, wounds, and burns by crushing the leaves and holding them in place with a mud pack. Tea tree oil effectively treats a variety of conditions. If you choose to try tea tree oil, it is good practice to do a patch test on your skin first, as undiluted tea tree oil can irritate the skin. If the skin is sensitive, then it is necessary to dilute it. A good tea tree oil solution can be made by mixing 5 parts of tea tree oil with 95 parts of water.

Please note: tea tree oil should never be taken internally, even in small amounts.  

          Here are just some of the many ways to effectively use tea tree oil: 

  • Acne – Tea tree oil kills the skin dwelling bacteria that cause acne. Dilute the tea tree oil as directed above and apply to lesions. Another way to apply it is by diluting it with aloe vera gel. To begin with, mix one or two drops to one ounce of the gel. 
  • Athlete’s Foot – Every morning and evening, saturate a cotton ball with tea tree oil (you may need to dilute it) and apply to the affected and surrounding areas. Also, you may want to apply a tea tree oil enriched moisturizer. Tea tree oil is also very effective when treating nail fungal infections.
  • Insect Bites – Apply full strength to the bite area. Tea tree oil is also an effective insect repellent.
  • Wound Healing – Moderately apply tea tree oil (at a strength of 70% to 100%) on the wound at least twice daily.

                Lastly, putting a few drops of tea tree oil in bathwater has a relaxing and rejuvenating effect. It will also soothe sore muscles and eliminate persistent body odor.

 

Quick Video: Tea Tree Oil


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