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If It’s Not Broke - Don’t Fix It ?

   Some people stop going to their chiropractor when their back pain stops because they think their problem is all gone and needs no more care.

Given the shoddy, limited coverage offered by most of the local hmo’s and managed care insurance plans to the people of the Hudson Valley - this is almost understandable.

The near-sighted thinking of insurance is: If it’s not broke, don’t fix it.

But, just because it’s not causing you to be in excruciating pain - doesn’t mean all is fine.

Consider this: Heart disease typically feels just fine... You'd never think there was a problem right about up to the point that the guy falls down dead...

What do you think? Do you suppose the guy was really "fine", in perfect health, up to that point? Or is there some small possibility that things were maybe going wrong for some time before that, or ...maybe for several years before that???

A man can have prostate cancer for a long, long time before it even has him getting up 10 times per night to pee, let alone causes him any discomfort.

Same thing for breast cancer. Too bad for way too many women to have absolutely no clue there’s something going wrong until it’s almost too late to help.

How many people are shocked to find out they have diabetes - because they have no pain?

An interesting analogy: If you broke your leg we can all agree - it will hurt (for a week to 10 days), then it starts to not hurt so much and then after 2-3 weeks it’s not hurting at all.

Are you gonna take the cast off then?

If you "buy" into the insurance thinking - it’s time to take it off.

If it’s not hurting... treatment is over, right?

So the thinking: "If It’s Not Broke - Don’t Fix It" worries me.

How do you KNOW it's not broke? What tests are you using to come to that conclusion?  

The "pain test" clearly has more holes in it than Swiss cheese. The presence or absence of pain is a totally unreliable indicator of whether or not you have a problem that needs care.

I think it's the precise recipe for the mess this country's general health care system is in right now. 

The Answer? Get checked and tested properly by a trained expert / someone with a degree in the field concerning your possible problems.

                 Hint: The Insurance claims "reps" are not experts in anything but denying claims.

 If the test is negative (ie.:normal) that’s great news and you can rest assured - you have a clean bill of health. If it is positive (meaning you have a problem), It’s not great news but at least you can take care of it early when it is manageable and inexpensive to do so.

 Are you concerned that your back problem may turn into arthritis? Let us check it and we can advise you what the proper steps are to prevent it from starting or getting worse if you already have it.

If you call before New Years and refer to this blog and say: "It’s not hurting but I want to find out if there is a problem"...you will qualify for ½ off of the initial consultation / examination fee.

What’s a Head Weigh?

Depending on who you talk to... the average head adult weighs anywhere from 10-12 lbs.

Try this - pick up and hold a 10 lb. weight in your hand at arm’s length for 5 minutes and see how this feels. After just a few minutes your arm will quickly begin to fatigue.

Now imagine what your neck muscles must go through all day long holding your head up.

In truth, your neck muscles should have an easier time doing this - That’s of course if your neck is in the right shape. If it’s not then you’ll understand why your neck is so sore at the end of the day.

So what is the right shape then?

Your neck, when viewed from the side, should describe a C-shaped curve of 45 degrees of arc. If it has that shape then the hole in your ear will be directly over your shoulder, inline with your hip. In the front view your neck should be perfectly straight - not leaning to either side.

Then all of the forces of gravity will be acting straight downward and you will feel no need to exert extra effort to hold your head up.

Here’s an example: Picture a perfectly straight broomstick sawed off perfectly square on one end. Stand that broom stick on it’s sawed-off end on a level surface. Will it fall over? Not a chance. The reason is that center of mass / weight is pushing straight downward and not to the side. No reason to fall.

Because of the normal shape and positioning of the head on the neck and the positioning of the neck on the rest of the body, that C-shaped curve places the center of gravity or weight of the head in a straight line - so the curve gives it its balance.

If you lose that curve, however, because of a strain or sprain injury (which typically straightens out the curve), it pushes the weight of the head forward.

Once this happens it puts increased demand on the muscles of the neck to keep it, in effect, from falling further forward, That’s when you start to feel the muscles begin to get sore.

Does this describe you?

Not Sure? - Why not stop in and let us check it? It only takes a minute or two and it’s something we can do for no charge if you want to stop in on the fly and then you’ll know if you have something going on that needs to be checked and corrected before it starts causing real problems.

Speaking of head-way... Are we answering Your questions here?   Ask a question - Get an answer.

Trivia question: Get the right answer to this and get a free initial consultation and examination before the end of the year: Question - If you were to hold a 40 lbs. weight at arm’s length - what weight does this translate to (because of leverage), at the lowest disc in your lower back?

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Why Not Go for the Low Hanging Fruit... Instead?

   If you‘ve ever been walking in an apple orchard and suddenly wanted to eat a nice fresh apple right off the tree this will make sense to you.

Would you climb all the way to the tippy top of the tree to grab an apple off of the highest branch or would you at least go over and examine some of the lower hanging ones first, before choosing which one to eat?

Of course, unless you’re ten years old and up for the challenge of climbing the tree - the natural thing to do would be to look for a low hanging one first and then, perhaps not finding one to your liking....then start looking higher up the tree.

I see a similar thing happen in health care. Many people tend to think they need to look under some moon rock for the answer to many common health problems, including many neck and back problems, when a much simpler answer is staring them right in the face.

 

Take Carolyn’s story as an example: Carolyn has a complaint of neck, arm and shoulder pain that she has had for 7 months. An examination and x-ray evaluation would readily show that she has clearly been developing or building up to this problem for quite some time. Her neck is significantly out of alignment with loss of the normal curve ( refer to the previous post "Is it sudden tear or thread bare"), considerable arthritic decay and countless areas that could be causing irritation to the nerves of her neck which is a most likely cause of her symptoms.

In addition to that, she is 65 lbs over-weight, very out of shape, hasn’t been to the gym in over a year and she smokes a pack and a half per day.

She hasn’t "had the time" to deal with her pains, or she hasn’t wanted to spend the money to have it looked at, or, maybe her insurance doesn’t cover the care, or she was told chiropractic couldn’t help that problem, or she’s simply scared to death at what might be at the root of the problem.

Suffice to say - to this point, she hasn’t had any care at all for this problem yet.

Tomorrow she will see a neurologist who will send her for an MRI and then an EMG. Then it’s off to the orthopedist who will order more tests and then some blood work, and some more x-rays. Next week she will start with the physical therapist who will put hot packs on her followed by ultra-sound and maybe some massage - none of which is likely to do anything but run up a huge bill. Then it’s back to the neurologist who prescribes some muscle relaxers and sixteen other medications. Everybody, (doctors and patient alike) is grasping at straws avoiding looking at the elephant in the room.

All told she’s run up a substantial bill of several thousand bucks and she’s still hurting like mad.

One can’t help wondering if that apple at the tippy top of the tree still looks quite so shiny & red. There were so many to choose from that were so within reach, but she (and the docs too who are enabling her) chose to go for that one apple at the highest branch instead of one of the low hanging ones.

This might be a stretch Carolyn but how about, Go for the low hanging fruit instead:

 1) Stop smoking - Yes - seriously, just quit it. You know it’s killing you and there hasn’t ever been a single study to the contrary.

2) Next: lose weight and get into shape. It’s easier and cheaper than dirt to do.

Need help - Just ask

3) It’s a cinch that your hips and neck are dangerously out of alignment and this is better than 95 % of your problem. Chiropractors have been saying for 115 years that this causes symptoms just like you’re complaining about -

 See a chiropractor and Get Adjusted 2-3 times per week for (really), just a few weeks and you’ll feel like a new person.

Chiropractic is the true Low Hanging Fruit in health care - It’s easy to get. It’s simple and uncomplicated. It’s safe and low risk. It’s in-expensive and most often - It’s more effective when all else fails.

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Was It Sudden Tear or Thread-Bare?

We love our jeans when they’re really worn and thread bare in the knees and maybe even a few holes in the seat from when we suddenly got caught on something that snagged and tore them. You can always tell, though, which is a sudden tear and which is thread-bare. The thread-bare hole usually starts with an area that starts to get thin over time, many, many washes, a few knee scrapes and lots of wear & tear and then you start to see a little skin visible through it all but still numerous threads holding it together. The sudden tear will look like a clean rip, wide open, and you can tell - it just happened, no fraying there.

In our jeans we love the look. It’s cool, a few choice, well-placed holes and bare spots adds character to them.      We also get similar thread-bare spots in our backs and that’s not so good.

Our back may seem to fail almost suddenly and we’ll think... "Gee, it was fine yesterday and today I can hardly move".

Was it a sudden tear or was it thread-bare?

What’s really happening here?

The ligaments and muscles that hold your back together and allow / make it move are made up of soft-tissue fibers that have an elastic limit. If we over-extend that elastic limit a little bit (even once in a while), some of those fibers are going to tear. And then some more tear, and later on, again - Some may say that’s ok, but is it?   Because it's a slow, usually painless process - no one pays much attention to it.

Think about your jeans again - Do you want the ligaments holding your back together to become thread-bare? What do you think will happen if too many of those fibers break?

One of the biggest causes of over-extending that elastic limit are all of those prolonged sedentary postures we take when sleeping, sitting at the computer, driving, watching TV, etc...which we do all of the time. Connect the dots here. These postures are repetitively over-stretching and over-extending the elastic limit of the soft tissue ligaments and muscles that hold your spine together. That’s why they are thread-bare.

There is another very insidious / quiet cause of thread-bare ligaments. When viewed from the side, a normal neck and lower back will have a concave arching curve to it. If there have been injuries or poor posture issues as stated above this curve is typically missing in most people. If the curve is missing or in-correct in the neck the person will appear to be looking slightly downward and if in the lower back he will appear to be stooped forward.

This over-extends the fibers of the discs and other ligaments of the spine and makes them become thread-bare.

Over time, with enough over-extending & "thread-baring" of those fibers - they will start to break through just as in your jeans.

Then one morning as you’re turning your head to back the car or you're putting on your socks or you bend over to pick up the tooth paste cap something (finally) lets go and you think... "sudden tear"?

Not likely - only the pain is sudden.

This scenario is avoidable with a check-up to find out if the shape of your spine and neck is such that it is causing your soft-tissue ligaments to become thread-bare.

Why not come let us check your neck and back for mis-alignments that could be making the ligaments there weak and thread-bare.

The check-up takes a few minutes and we’ll be able to tell you right then and there if you have a problem and different ways to handle it.

For the month of December there is no charge for this check-up if you bring us at least one can or box of dry food for us to donate to a family in need this holiday season.

Forward this to a thread-bare friend - There’s a lot of hungry people out there.

 

 

 

 

Why Do the Same Back Problems Keep Coming Back Over and Over Again?

When I first started the practice I thought every single case was completely different but after a while I started to see a pattern in types of back problems.

I realized that one could break down most back problems into two very different categories: The fast injuries and the slow ones -

Some people’s back problems were due to a sudden injury such as they wrecked a car. Maybe she pulled her back out making the bed. Maybe he lifted a large plank and herniated a disc. Maybe he slipped and fell on the ice. All are fast or "sudden onset". They heal just like a cut finger or a broken bone heals.

Then there is the much larger group of injuries which are slow or gradual in onset. These are the back injuries that occur as a result of sedentary postures - while simply sitting on the couch watching the ball game, sleeping on too soft of a bed - night in / night out for 30 years, sleeping in a fetal position or in a semi-crawl position with one leg extended straight and the other dragged up and to the side. Maybe it is the way she sits at the computer. These don’t heal completely because we keep doing the same sedentary postures over and over ...everyday.

The irony is most "slow" injuries do not hurt when they occur or you would stop doing it, right? BTW, most sudden injuries don’t hurt, when they occur either- you’re in shock and don’t feel much of anything.

The pain comes later... With slow injuries you could sit and watch the entire game and feel fine. Then, when you get up in the morning you don’t feel quite so fine anymore.

That’s when you feel the damage you caused sitting on that couch the night before.

Back problems do not attack you for no reason at all, but because of something you’re doing.

Clearly, most people don’t go around wrecking their car every day or making the bed wrong or even picking up heavy loads incorrectly every day - so the fast injuries are not the big issue here.

It’s the sedentary posture habits that cause the problems that keep coming back over and over again. Poor sedentary posture habits weaken and de-stabilize one joint or another and once that happens - it will always be lying there dormant and "quiet" - and waiting to ruin your day - ...because it can.

It can because it has lost it’s structural integrity and stability.

There’s plenty you can do to strengthen and re-stabilize your back so this doesn’t happen. And it’s not expensive or even time consuming.

If one were to take a pro-active approach and engage in a maintenance program of care, your back would more than likely never let you know it’s there.

A simple maintenance program might consist of 1, maybe 2 times per month - You come in, get checked for any imbalances, you get adjusted;

1 -2 -3 and you’re done

Do that and you will likely never feel your back problem.

One hidden perk to it all: You will also likely go thru the entire winter without getting a cold or anything else going around town.

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Print this blog entry and bring it with you for a

Free Check-Up & Adjustment

Bring another friend or family who is not already a patient here who comes under care for at least 6 visits...( She or he must mention your name for you to qualify), and you get one more Free visit here after his 6th visit... and if s(he)brings someone else who then comes under care also for 6 visits you will get one more free visit.

(This e-coupon is valid for one visit until and including December 31, 2010. No promise or guarantee of a cure of any kind is implied. It is not redeemable for any cash value )

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So, it pays to read these blogs and it also pays to pass it around

How...or When Did That Cold Really Start?

Often, when someone comes down with the flu or a bad cold or they have a heart attack or develop cancer - they will say that they were fine just before it started.

How many think their disease is an isolated thing or entity, that just started... this morning?

           Many also think they caught it from so & so who used their phone or coughed in her direction...

 Here’s a crazy idea - nothing started this morning except breakfast.

And nobody gives you a cold - you catch a cold because you’re receptive to it.

When you first begin to notice you’re getting a cold....you’ve actually been "starting" to get it for about 3 weeks. And that’s one of the fastest things you can catch.

If you have a heart attack this morning you‘ve been working on it for years.

If you are diagnosed with cancer this afternoon - it didn’t start with at that one cigarette you had this morning with your coffee.

Try to view the "cold", the illness or disease as the culmination of events. It is the end result of a cascade of events in which you are actually losing your balance.

Just as when you fall off a ledge, you aren’t "suffering" from any "loss" of balance...well, not until you (stop), ie.: hit the bottom. Notice - there are no symptoms in midair...

While you are actually going through the experience of losing your balance - you don’t feel it until you hit the bottom.

And, likewise, you don’t feel the result of losing your balance in health until you begin to have symptoms.

You don't catch things (and get the symptoms of it ) until you have already lost your balance. And it's only when you lose your balance that you’re receptive to whatever is going around.

If you’re in balance it is much, much harder to catch anything.

So you can't blame someone else who coughed on you for giving you their cold. If you didn't lose or balance...it wouldn't matter even if she kissed you   

Some key ways to maintain your balance:

* Have your spine checked and adjusted to maintain proper spinal alignment & balance / good nerve function - without proper nerve function no organ, gland or muscle can work properly

* Reduce your stress levels. Stress exhausts your body's ability to maintain its balance. Getting your       spine adjusted greatly reduces the effect stress has on your body and your health in general    

* Maintain proper hydration - The body cannot work properly without proper hydration

* Maintain a well-proportioned nutritional diet - The body needs the right kind of fuel to operate

* Maintain proper body temperature. We are warm-blooded creatures which means we can keep ourselves warm - but not indefinitely. After a period of time at low temperatures we become hypothermic and this will exhaust the body’s ability to maintain itself. In other words - it will lose its balance

* The body requires sufficient rest . Without rest, in time, it will lose its balance.

* Clean, un-polluted air - without clean air to breathe the body will soon lose its balance.

Tip of the week - Take a Break

It's a bit of a no-brainer but if you keep sitting at your computer all afternoon without getting up and stretching out a bit - you're going to turn to cement.

But whatever your job is it's a good idea to stop periodically throughout the day and loosen up

The Japanese automobile manufacturers have been doing this for years. They blow a horn and the whole entire assembly line stops and shuts down for 10 -15 minutes and the whole entire company does callestenics and then they all go back to work again. Do you think that is why  the average Japanese worker reports higher job-satisfaction than is in this country or why Japanese cars have a reputation of being better built?

                      In this country we take a cigarette or coffee break...Go figure!

But, really, why should you take a break?

Well, for a number of reasons: from a purely mechanical standpoint, your joints lubricate themselves and maintain their own internal health all by themselves...but only when they are moving. So, if you want to keep them loose and mobile so you can play golf this saturday you have to work at keeping them moving all during the week as well.

Your lymphatic system which is an integral part of your immune system only moves lymphatic fluid along its vessels because of muscular contraction throughout the rest of the body. So, if you don't move and contract your muscles ...you don't move your lymphatic fluid - can you guess how that will not help your immune system?  

When you breathe - inhale and exhale,  you generally do not completely change ALL of the air in your lungs. The result is there is always a bit of stagnant residual air left behind in your lungs. Much of this is full of carbon monoxide, nitric oxide and other garbage that isn't all that good for you. If you exercise and force yourself to take really deeeeeep breaths you will clean this garbage air out and you can start over with lungs full of good clean air. Your muscles, your brain and all of the rest of will really feel the difference quickly.

If you stimulate better circulation ( think increased oxygen to the brain...),  by doing this do you think it might make you feel a little more alert and able to focus on your work

People frequently come in to see me with neck and back complaints that stem, in large part, from being too sedentary and if we could just get them moving a little bit more everyday - they'd feel lots better.

Try it - get off your butt, stand up and do a few jumping jacks (how about 25?), do a push up or two,...(think 30 -50) do a few squats, shadow box a bit, run in place a for a minute or two (how about run up 10 flights of stairs real quick instead?), and get back to work

Do it NOW - This shouldn't take more than a couple of minutes.  

Now it only becomes helpful if you do it all of the time. You have to make it a habit to do it several times per day. So write yourself a reminder on a sticky post it pad and put it on your computer screen or someother place where you're sure to see it.

Habits take 2 weeks to form  so yo'll have to work at reminding yourself to do this but once it's in-grained in you you'll never look back and ask yourself "Why the heck am I doing this nonsense?"  

Here's a crazy idea - start a thing in your office and get everybody else doing it too

Need help? Share this blog by copy / pasting & emailing it anonomously to everybody in the office - especially Mr. Boss Man

Is My Back Condition Getting Any Better?

On the surface of it all - That might sound like a pretty dumb question.

I mean... can't you tell if it feels better or not ?

Well, it might be feeling better and not be improving or it might be improving and it's not feeling any better today than it did a week ago.

Which is it?

Here's how you can tell:

Pick a task or activity such as walking or (running?), typing, cooking, getting yourself dressed, making the bed? etc, that you typically do every day that you haven't been able to do or haven't been able to do as well because you hurt your back.

Try to do it the same way you always used to do it before you got hurt. Write down how long it takes to do it and make a note, also (yea - you have to write it down...),  how you felt doing it. Maybe make a grading scale of  0 -10 where 0 is feeling fine / no pain and 10 is absolute agony doing it. If it's simply walking - write down how far you can walk before the pain gets to say 5 or whatever number you decide is your limit of tolerance.

Put yourself through this task one time and make these notes about it. This is your bench mark / base line reference point. 

Now, everyday - do it again and make the same notations about it.

If you're really improving your numbers will show it.

Here's a little Gee -Whiz psychology for you - As you start to see your numbers improving your sub-conscious brain will tell you that you can stop hurting as much and your pain will start to decrease as well.

Your back problem is NOT in your head but much of your perception of it and reaction to it often is... 

Any questions? email me at dchealth99@aol.com

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The Best Kind of Back Pain Patient

In this current economy in any type of business one is supposed to have the attitude: I will take any customer that walks in my door..."

Is this really a good idea?

If I were asked, however who is the IDEAL customer / patient - I would say, without reservation, that he or she would be something of a gym-rat, someone who took an active role in her health and conditioning, didn't smoke, drank alcohol minimally, was not over weight, exercised regularly and simply - sought to enjoy life, better health, enhanced performance, and maintain her youth and flexibility into her senior years.

He or she would keep her appointments, treating them as something important to her health and goal of remaining young.

Her level of conditioning makes care for her relatively easy. In other words her problem typically responds to care much more quickly than if she were to weigh 50-100 lbs over-weight, have a huge pendulous abdomen, never go to the gym / not be in condition, smoke 1- 1/2 packs per day, etc., etc.  

Her first question to me when she calls for an appointment or in taking her case history would NOT be if I accepted her insurance or was "in her plan."

That might not even come up in the conversation as, what chiropractic care can do for her and her injured back so surpasses the relatively minor expense of it when compared to the dismal results achievable through other more expensive means, that it makes the issue of money utterly ridiculous to discuss.

She would generally tend to follow recommendations for care.    

As a practice grows, one tends to become more selective in who is accepted for care. We want to help everybody of course, but face it, you can't.

The person who is overweight, never works out, smokes and is in generally worn-out condition...didn't get that way over-night and they're not going to get better anytime soon. Their lack of conditioning / healthy muscle tone will prevent him or her from responding quickly to care and it will generally cost more in time and money to help him or her.

Excuse me... do you own a mirror? Did you get that over weight this week?

Is somebody forcing you with a gun to your head to smoke (at $7 per pack x 2 packs per day x 7 days per week - so you can't afford my care and now you're asking me to accept your shodddy insurance and / or cut my fee and give you a break?

With the level of self disicpline and life style you demonstrate what kind of a patient will you actually be?

Are you going to be calling me at 11 PM with a meltdown because you're so out of shape that your back is responding poorly to care?

Judging by your being over-weight, your smoking and lack of conditioning...It is more likely the doctor will be assuming more of the responsibility for the outcome than the patient is.

This person is not a good risk to take as a case and will likely have a less than optimum outcome.

  

How Long Does It Take To Fix a Bad Back?

That could be a very loaded question -

and it depends on who is answering the question and who is paying the bill.

If you ask Blue Cross / Blue Shield or just about any of the other "HMO / Managed Care Plans" they’ll tell you that you can have all the care you need....

but - Guess what? They’re the ones who determine how much you need.

It’s amazing - they can tell without doing an examination on you and even with the results of the examination provided to them by your doctor - they can still figure out that you will only need

5 - 8 or maybe, (in a worst case scenario),10 treatments at a chiropractor to fix your injured back.

After that you’re either "fixed" or, in the their opinion, you’ve reached MMI or maximum medical improvement and no further care is going to make it any better so there’s no point in continuing.

In NY the Workers’s Compensation rules for treating an injured back is going to be changing.

You will be allowed to be treated 3 times per week for 4 weeks and then twice per week for 4 weeks. If you’re not "better", whatever that means, by then ...you’re on your own.

Now - If you ask your doctor: "How long is it going to take?"...

The answer will sound much different and it will be answered with a series of questions back at you:

What actually happened that you are in pain? If you tore something lifting something incorrectly - expect to take at least 6-8 weeks to heal that torn ligament or muscle. That isn’t "chiropracticese" but based upon tissue embyology and how long it takes for muscle and ligament tissue cells to replace themselves - which is how we actually heal.

If your back is simply hurting you all of the time because of postural habits such as how you sleep every night or sit at your computer - you should stop hurting within a few to several days...if you change your postural habits.

But there are other issues that will automatically vary the answer:

How long have you had the problem?

If you’ve had the problem a long time - expect it take longer to correct the problem.

How over weight are you? - If you’re substantially over your normal weight for your height - expect it to take longer to correct the problem and it probably won’t fully correct until you do reduce your weight.

How out of condition are you? If you never exercise - expect it to take longer to correct your problem because "weak / de-conditioned" muscles don’t do as well holding you all together and holding your alignment.

Are you a smoker and / or how much do you actually smoke? Nicotine destroys collagen - the fabric of your muscles and ligaments. If you smoke it will naturally weaken those parts held together by muscles and ligaments and lengthen the repair time.