Symptom Center

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Spinal Disc

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Temporomandibular Joint Disorder

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What is Causing the Asthma Epidemic?

Patient Information from the American Chiropractic Association In the United States, asthma cases have increased by more than 60  percent since the early 1980s, and asthma-related deaths have doubled  to 5,000 a year. What 

is causing the asthma epidemic and what can we do to stem the tide?

People in their 30s and older can remember that when they were  young, it was very unusual for even one child in school to have asthma.  Schoolchildren now often know several kids with asthma in a single  class. The rapid increase in the number of young people with asthma was  brought home to Dr. Scott Bautch, member of the American Chiropractic  Association's (ACA) Council on Occupational Health, when he went to a  football game with his 13-year-old son: "Someone on the field had a  breathing problem. It was hard to see whose son it was, and 15 parents  ran to the field with inhalers." 

What Causes Asthma?

So far, researchers don't know why cases of asthma are increasing  at such an alarming rate. They hypothesize that a combination of  genetics and some nonhereditary factors— such as increased environmental  exposure to potential allergens — plays a role. "Thirty years ago,  Windex was the only cleaning solvent used by a few people. Now, we have a  special cleaning solvent for every object," says Dr. Bautch. "In  addition, furniture and carpets are produced with formaldehyde as a  preservative, and people breathe it," he says. Decreased air quality is  coupled with the allergy-friendly modern house design, says Dr. William  E. Walsh, MD, FACC, an allergist practicing in Minnesota: "Fifty years  ago we lived in old, drafty houses, and the breeze dried and freshened  the air, and cleared out mold and other allergens. Nowadays, our  super-insulated houses don't breathe adequately. Making basements into a  living space increases mold exposure because mold grows in any  basement." Food has become another source of exposure to allergens. "Food  manufacturers put more preservatives in foods now to store them longer,"  says Dr. Bautch. Researchers hypothesize that an increase in  vaccinations, cesarean births, and antibiotic intake may be playing a  role, too.  

How Can Asthma Be Treated?

Asthma is a chronic disease; it can't be cured —only controlled.  For best treatment results, both the primary care physician and an  asthma specialist, such as an allergist or pulmonologist, should be  involved. According to experts interviewed for the article, the  treatment program, in addition to medication intake, should include  reducing exposure to the substances that induce acute episodes and  identifying specific allergens that affect the patient. 

Non-Allergen Causes of Asthma

Allergens aren't the only culprit of asthma attacks. Stress  factors — such as moving to a new home, or changing jobs — may induce or  aggravate asthma attacks. Even emotional expressions such as fear,  anger, frustration, hard crying, or laughing can cause an attack as  well. To reduce the patient's stress level and improve the patient's  quality of life, alternative treatments should be incorporated into the  treatment program. Various relaxation techniques, such as biofeedback,  meditation, yoga, and stress management, as well as massage,  chiropractic manipulation, breathing exercises, and acupuncture can be  helpful. 

Chiropractic Care Can Help

"Doctors of chiropractic can give a full-scale evaluation to  asthma patients; assess their physical and neurological status, their  lifestyle, diet, and stressors; and help the patients increase motor  coordination, and improve the work of respiratory and gut muscles to  increase the quality of life," says Dr. Gail Henry, a chiropractic  neurologist, who practices in Houston, Texas. "Doctors of chiropractic  can be a great addition to the healthcare team treating the asthma  patient." Talk to your doctor of chiropractic about other ways to improve  your quality of life. Doctors of chiropractic are trained and licensed  to examine and treat the entire body with emphasis on the nervous and  musculoskeletal systems. They also help people lead healthier lives by  focusing on wellness and prevention. 

Tips to Alleviate Asthma Symptoms

  • Use air filters to help clean air in your home.
  • Cover mattresses and pillows with dust covers and use hypoallergenic bed clothing to reduce exposure to dust mites.
  • Get checked for viral respiratory infections and different  medical conditions, such as flu, rhinitis, sinusitis, and  gastroesophageal reflux. Endocrine factors, such as menstruation,  pregnancy, and thyroid disease, may exacerbate asthma, as well.
  • Some medications—aspirin; beta-blockers, including eye drops;  nonsteroidal anti-inflammatory drugs, etc.—can also precipitate or  aggravate asthma symptoms.
  • If your asthma is exercise-induced, an individually prescribed  exercise program carefully chosen under the guidance of your primary  health care provider or doctor of chiropractic should be incorporated  into the treatment plan.
  • Avoid sulfites or monosodium glutamate (MSG) in foods. Since  both additives are used in a wide variety of foods, carefully read  processed food labels and choose MSG-free foods when eating out.
  • Choose a more vegetarian-type diet. Animal proteins found in meat include arachidonic acid—a precursor for inflammation. 
  • Include foods with omega-3 fatty acids in the diet—such as fish or fish oil.
  • Supplement with vitamin C, which helps reduce allergic reactions and wheezing.
  • To reduce stress in your children, spend quality time with them and limit their exposure to TV programs that include violence.

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Low Back Pain


Does Back Pain Go Away on Its Own?

Eighty percent of people suffer from back pain at some point in  their lives. Back pain is the second most common reason for visits to  the doctor's office, outnumbered only by upper-respiratory infections.  Most cases of back pain are mechanical or non-organic—not caused by  serious conditions, such as inflammatory arthritis, infection, fracture,  or cancer. 

What Causes Back Pain?

The back is a complicated structure of bones, joints, ligaments,  and muscles. You can sprain ligaments, strain muscles, rupture disks,  and irritate joints, all of which can lead to back pain. While sports  injuries or accidents can cause back pain, sometimes the simplest of  movements—for example, picking up a pencil from the floor— can have  painful results. In addition, arthritis, poor posture, obesity, and  psychological stress can cause or complicate back pain. Back pain can  also directly result from disease of the internal organs, such as kidney  stones, kidney infections, blood clots, or bone loss. Back injuries are a part of everyday life, and the spine is quite  good at dealing with these often "pulled" muscles. These very minor  injuries usually heal within 1 or 2 days. Some pain, however, continues.  What makes it last longer is not entirely understood, but researchers  suspect that the reasons may include stress, mood changes, and the fear  of further injury that may prevent patients from being active. In  addition, sometimes a painful injury or disease changes the way the pain  signals are sent through the body, and, even after the problem has gone  away or is inactive, the pain signals still reach the brain. It is as  if the pain develops a memory that keeps being replayed. 

Will Back Pain Go Away on Its Own?

Until recently, researchers believed that back pain would heal on  its own. We have learned, however, that this is not true. A recent  study showed that when back pain is not treated, it may go away  temporarily, but will most likely return. The study demonstrated that in  more than 33% of the people who experience low back pain, the pain  lasts for more than 30 days. Only 9% of the people who had low-back pain  for more than 30 days were pain free 5 years later. Another study looked at all of the available research on the  natural history of low-back pain. The results showed that when it is  ignored, back pain does not go away on its own, but continues to affect  people for long periods after it first begins 

What Can I Do to Prevent Long-Term Back Pain?

If your back pain is not resolving quickly, visit your doctor of  chiropractic. Your pain will often result from mechanical problems that  your doctor of chiropractic can address. Many chiropractic patients with  relatively long-lasting or recurring back pain feel improvement shortly  after starting chiropractic treatment. The relief is often greater  after a month of chiropractic treatment than after seeing a family  physician. Chiropractic spinal manipulation is a safe and effective spine  pain treatment. It reduces pain, decreases medication, rapidly advances  physical therapy, and requires very few passive forms of treatment, such  as bed rest.   

How Can I Prevent Back Pain?

  • Don't lift by bending over. Instead, bend your hips and knees  and then squat to pick up the object. Keep your back straight, and hold  the object close to your body. 
  • Don't twist your body while lifting.
  • Push, rather than pull, when you must move heavy objects.
  • If you must sit for long periods, take frequent breaks and stretch.
  • Wear flat shoes or shoes with low heels.
  • Exercise regularly. An inactive lifestyle contributes to lower-back pain.

What Should I Tell My Doctor of Chiropractic?

Before any treatment session, tell your doctor of chiropractic if you experience any of the following:  

  • Pain goes down your leg below your knee.
  • Your leg, foot, groin, or rectal area feels numb.
  • You have fever, nausea, vomiting, stomach ache, weakness, or sweating.
  • You lose bowel control.
  • Your pain is caused by an injury.
  • Your pain is so intense you can't move around.
  • Your pain doesn't seem to be getting better quickly.

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Neck Pain

 Your neck, also called the cervical spine, begins at the base of  the skull and contains seven small vertebrae. Incredibly, the cervical  spine supports the full weight of your head, which is on average about  12 pounds. While the cervical spine can move your head in nearly every  direction, this flexibility makes the neck very susceptible to pain and  injury.  The neck's susceptibility to injury is due in part to  biomechanics. Activities and events that affect cervical biomechanics  include extended sitting, repetitive movement, accidents, falls and  blows to the body or head, normal aging, and everyday wear and tear.  Neck pain can be very bothersome, and it can have a variety of causes. Here are some of the most typical causes of neck pain: Injury and Accidents: A sudden forced movement  of the head or neck in any direction and the resulting "rebound" in the  opposite direction is known as whiplash. The sudden "whipping" motion  injures the surrounding and supporting tissues of the neck and head.  Muscles react by tightening and contracting, creating muscle fatigue,  which can result in pain and stiffness. Severe whiplash can also be  associated with injury to the intervertebral joints, discs, ligaments,  muscles, and nerve roots. Car accidents are the most common cause of  whiplash. Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.   

  • Osteoarthritis, a common joint disorder, causes progressive  deterioration of cartilage. The body reacts by forming bone spurs that  affect joint motion. 
  • Spinal stenosis causes the small nerve passageways in the  vertebrae to narrow, compressing and trapping nerve roots. Stenosis may  cause neck, shoulder, and arm pain, as well as numbness, when these  nerves are unable to function normally.
  • Degenerative disc disease can cause reduction in the elasticity  and height of intervertebral discs. Over time, a disc may bulge or  herniate, causing tingling, numbness, and pain that runs into the arm.

Daily Life: Poor posture, obesity, and weak  abdominal muscles often disrupt spinal balance, causing the neck to bend  forward to compensate. Stress and emotional tension can cause muscles  to tighten and contract, resulting in pain and stiffness. Postural  stress can contribute to chronic neck pain with symptoms extending into  the upper back and the arms. 

Chiropractic Care of Neck Pain

During your visit, your doctor of chiropractic will perform exams  to locate the source of your pain and will ask you questions about your  current symptoms and remedies you may have already tried. For example:  

  • When did the pain start?
  • What have you done for your neck pain?
  • Does the pain radiate or travel to other parts of your body?
  • Does anything reduce the pain or make it worse?

Your doctor of chiropractic will also do physical and  neurological exams. In the physical exam, your doctor will observe your  posture, range of motion, and physical condition, noting movement that  causes pain. Your doctor will feel your spine, note its curvature and  alignment, and feel for muscle spasm. A check of your shoulder area is  also in order. During the neurological exam, your doctor will test your  reflexes, muscle strength, other nerve changes, and pain spread. In some  instances, your chiropractor might order tests to help diagnose your  condition. An x-ray can show narrowed disc space, fractures, bone spurs,  or arthritis. A computerized axial tomography scan (a CT or CAT scan)  or a magnetic resonance imaging test (an MRI) can show bulging discs and  herniations. If nerve damage is suspected, your doctor may order a  special test called electromyography (an EMG) to measure how quickly  your nerves respond. Chiropractors are conservative care doctors; their scope of  practice does not include the use of drugs or surgery. If your  chiropractor diagnoses a condition outside of this conservative scope,  such as a neck fracture or an indication of an organic disease, he or  she will refer you to the appropriate medical physician or specialist.  He or she may also ask for permission to inform your family physician of  the care you are receiving to ensure that your chiropractic care and  medical care are properly coordinated. 

Neck Adjustments

A neck adjustment (also known as a cervical manipulation) is a  precise procedure applied to the joints of the neck, usually by hand. A  neck adjustment works to improve the mobility of the spine and to  restore range of motion; it can also increase movement of the adjoining  muscles. Patients typically notice an improved ability to turn and tilt  the head, and a reduction of pain, soreness, and stiffness. At Ash Chiropractic and Wellness, we will develop a program of  care that may combine more than one type of treatment, depending on your  personal needs. In addition to manipulation, the treatment plan may  include mobilization, massage or rehabilitative exercises, or something  else. 

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 For decades, osteoarthritis has been considered a part of aging.  But not anymore. Recent research points out that older people don't have  to suffer from osteoarthritic pain. And, surprisingly, people much  younger than 65 can develop osteoarthritis.  

What Is Osteoarthritis?

Osteoarthritis (OA), or degenerative joint disease, affects more  than 20 million Americans and is more common in women than in men. The  disease affects the cartilage—slippery tissue on the ends of bones that  meet in a joint. Normally, cartilage helps bones glide over one another.  In an OA patient, however, the cartilage is broken down and eventually  wears away. As a result, instead of gliding, bones rub against each  other, causing pain, swelling, and loss of motion. Although the majority of patients with OA are 65 and older,  recent research shows that osteoarthritis is not a by-product of aging.  Family history of OA, being overweight, lack of exercise, and prior  joint injuries are suggested as OA risk factors. 

How Is Osteoarthritis Diagnosed?

OA is diagnosed through a combination of clinical history,  patient examination, and x-rays. Other tests, such as drawing fluid from  the joint, are sometimes used.  The signs of OA include:  

  • Steady or intermittent joint pain 
  • Joint stiffness after sitting, sleeping, or otherwise not moving for a long time
  • Swelling or tenderness in the joints
  • A crunching feeling or the sound of bones rubbing against each other.

If you experience any of these signs, consult your health care  provider. While the diagnosis is relatively easy to make, it is often  harder to establish whether or not OA causes the patient's symptoms.  That's why the treating doctor needs to not only make the diagnosis, but  also rule out other disorders and conditions that can make the symptoms  worse.1 Timely diagnosis and treatment can help manage pain, improve  function, and slow the degeneration. 

Should Osteoarthritis Patients Exercise?

Exercise is one of the best forms of OA treatment—and prevention.  It strengthens the muscular support around the joints and improves and  maintains joint mobility and function. In addition, exercise helps  control weight and improves the patient's mood and outlook—important  factors influencing the severity of the symptoms. If you suffer from OA, consider the following exercise tips:  

  • Low-impact or non-weight-bearing activities, such as walking,  stationary training, and light weight training work best for OA  patients. 
  • Use strengthening exercises if the key muscle groups that  relate to the function of the joints are weakened by the degeneration. 
  • If you are overweight, start exercising carefully, so as not to put too much stress on the knee and ankle joints.
  • Stair climbing, water aerobics, Theraband workouts, and similar  exercises will help to keep the joints mobile without straining them.
  • Learn to read the body's signals and know when to stop, slow down, or rest.

How Can Your Chiropractor Help?

Doctors of chiropractic, by the nature of their work, can detect  the earliest degenerative changes in the joints. They see the impact of  degenerative changes in the spine, as well as in the hips, knees, and  other weight-bearing joints. Doctors of chiropractic are also trained to  relieve the pain and improve joint function through natural therapies,  such as chiropractic manipulation, trigger-point therapy, or some  massage techniques. Doctors of chiropractic can provide exercise counseling, helping  you choose exercises that are best for you. If a sore or swollen joint  prevents you from exercising, talk to your doctor of chiropractic about  other drug-free pain-relief options, such as applying heat or cold to  the affected area. In addition, your doctor of chiropractic can help you  choose proper supplements that play important roles in OA prevention  and treatment. 

Nutritional and Supplemental Approach to Treating Osteoarthritis

For those who would like to try supplements and nutrition as well, they are often found effective. Glucosamine and chondroitin sulfate are the two most popular and  most researched OA supplements. When taken over a period of time, they  tend to reduce pain and increase function especially with knee OA. These  supplements may also slow progression of the disease. When taking supplements, remember:  

  • As with medications, take the right amount. Studies used 1,500  mg per day of glucosamine and 1,200 mg per day of chondroitin sulfate.  If you use a different dosage, the effect will be different.
  • Different products may contain a different amount of the  supplement--sometimes not corresponding to what's on the label. To  choose the proper supplement, consult a health care provider trained in  nutrition.
  • Unlike the quick effect of medications, it usually takes  several weeks before you feel pain relief or improvement in function  when taking a supplement. 
  • Supplements may not be for everyone. Chondroitin sulfate may  interfere with anticoagulant medications, so if you take anticoagulants,  talk to your prescribing physician before taking glucosamine and  chondroitin. In addition, the supplements haven't been studied in  pregnant women, so they should not take glucosamine and chondroitin. 

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Sciatica describes persistent pain felt along the sciatic nerve,  which runs from the lower back, down through the buttock, and into the  lower leg. The sciatic nerve is the longest and widest nerve in the  body, running from the lower back through the buttocks and down the back  of each leg. It controls the muscles of the lower leg and provides  sensation to the thighs, legs, and the soles of the feet. Although sciatica is a relatively common form of low back and leg  pain, the true meaning of the term is often misunderstood. Sciatica is  actually a set of symptoms— not a diagnosis for what is irritating the  nerve root and causing the pain.  Sciatica occurs most frequently in people between the ages of 30  and 50 years old. Most often, it tends to develop as a result of general  wear and tear on the structures of the lower spine, not as a result of  injury. 

What are the symptoms of sciatica?

The most common symptom associated with sciatica is pain that  radiates along the path of the sciatic nerve, from the lower back and  down one leg; however, symptoms can vary widely depending on where the  sciatic nerve is affected. Some may experience a mild tingling, a dull  ache, or even a burning sensation, typically on one side of the body.  Some patients also report:  

  • A pins-and-needles sensation, most often in the toes or foot
  • Numbness or muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying  over time. In addition, the pain can worsen after prolonged sitting,  sneezing, coughing, bending, or other sudden movements. 

What causes sciatica?

The most common cause of sciatica is irritation of the sciatic  nerve in the lower back (lumbar region) due to a herniated or ruptured  disc. Spinal discs are shock absorbing cushions between each vertebra  that keep your spine flexible. Discs have a stronger outer ring and a  soft jelly-like center, but as we age, spinal discs can deteriorate,  becoming drier, flatter, and more brittle. Frequently, the tough outer covering may develop tiny tears,  which allow the jelly-like substance to seep out (rupture or  herniation). The herniated disc may then press on the nerve root,  causing sciatic symptoms such as pain, tingling, and weakness in the  legs and feet. Nerve roots may also be irritated by the chemicals found  in the discs' nucleus. Other conditions can also put pressure on the nerve, including:  

  • Spinal stenosis – narrowing of the spinal canal, which places pressure on the spinal cord or the nerve roots 
  • Degenerative disc disease – a common part of the aging process,  leading to a change in the disc shape and function, which can result in  disc herniation or pain
  • Pregnancy – extra weight and pressure on the spine can compress the sciatic nerve
  • Trauma – a fall, car accident, or other trauma can injure the nerve roots
  • Piriformis syndrome – spasm of the piriformis muscle can compress the sciatic nerve
  • Spondylolisthesis – when a vertebra slips forward over another vertebra, the slip can pinch the nerve root
  • Spinal tumors or infections – very rare; both can compress the sciatic nerve

In rare cases, a herniated disc may press on nerves that cause  you to lose control of bladder or bowel functions. This is an emergency  situation and requires an immediate call to your doctor. 

How is sciatica diagnosed?

Your doctor of chiropractic will begin by taking a complete  patient history. You'll be asked to describe your pain and to explain  when the pain began, and what activities lessen or intensify the pain.  Forming a diagnosis will also require a physical and neurological exam,  in which the doctor will pay special attention to your spine and legs.  You may be asked to perform some basic activities that will test your  sensory and muscle strength, as well as your reflexes. For example, you  may be asked to lie on an examination table and lift your legs straight  in the air, one at a time. In some cases, your doctor of chiropractic may recommend  diagnostic imaging, such as x-ray, MRI, or CT scan. Diagnostic imaging  may be used to rule out a more serious condition, such as a tumor or  infection, and can be used when patients with severe symptoms fail to  respond to six to eight weeks of conservative treatment. 

What are my treatment options?

For most people, sciatica responds very well to conservative  care, including chiropractic. Keeping in mind that sciatica is a symptom  and not a stand-alone medical condition, treatment plans will often  vary depending on the underlying cause of the problem.  Chiropractic offers a non-invasive (non-surgical), drug free  treatment option. The goal of chiropractic care is to restore spinal  movement, thereby improving function while decreasing pain and  inflammation. Depending on the cause of the sciatica, a chiropractic  treatment plan may cover several different treatment methods, including  but not limited to spinal adjustments, ice/heat therapy, ultrasound,  TENS, and rehabilitative exercises.  Chiropractic spinal manipulation is proven to be effective and  has minimal side effects. Recently released practice guidelines  published in the Annals of Internal Medicine (2007) stress a  conservative approach to treating low-back pain and recommended spinal  manipulation as one treatment with proven benefits. Unless advised otherwise by your doctor of chiropractic, remain  active and avoid prolonged bed rest. In the long run, inactivity can  make your symptoms worse, whereas regular exercise has been shown to  reduce the intensity of pain associated with sciatica. Fortunately, 80 to 90 percent of patients with sciatica will  recover without surgery. If surgery is warranted or your doctor of  chiropractic feels it would be best to co-manage your condition with  another provider, however, he or she will refer you to a local  specialist. 

An Ounce of Prevention Is Worth a Pound of Cure

While it's not always possible to prevent sciatica, consider  these suggestions to help protect your back and improve your spinal  health.  

  • Maintain a healthy diet and weight
  • Exercise regularly
  • Maintain proper posture
  • Avoid prolonged inactivity or bed rest
  • If you smoke, seek help to quit

* Use good body mechanics when lifting 

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Scoliosis affects 5 to 7 million people in the United States. More  than a half million visits are made to doctors' offices each year for  evaluation and treatment of scoliosis. Although scoliosis can begin at  any age, it most often develops in adolescents between the ages of 10  and 15. Girls are more commonly affected than boys. Because scoliosis  can be inherited, children whose parents or siblings are affected by it  should definitely be evaluated by a trained professional. 

What is scoliosis?

Because we walk on 2 feet, the human nervous system constantly  works through reflexes and postural control to keep our spine in a  straight line from side to side. Occasionally, a lateral (sideways)  curvature develops. If the curvature is larger than 10 degrees, it is  called scoliosis. Curves less than 10 degrees are often just postural  changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis  (abnormal curvature toward the back). In most cases, the vertebrae are  also rotated.  In more than 80% of cases, the cause of scoliotic curvatures is  unknown; we call this condition idiopathic scoliosis. In other cases,  trauma, neurological disease, tumors, and the like are responsible.  Functional scoliosis is often caused by some postural problem, muscle  spasm, or leg-length inequality, which can often be addressed.  Structural scoliosis does not reduce with postural maneuvers. Either  type can be idiopathic or have an underlying cause. 

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by  limiting activity, causing pain, reducing lung function, or affecting  heart function. Diminished self-esteem and other psychological problems  are also seen. Because scoliosis occurs most commonly during  adolescence, teens with extreme spinal deviations from the norm are  often teased by their peers.  Fortunately, 4 out of 5 people with scoliosis have curves of less  than 20 degrees, which are usually not detectable to the untrained eye.  These small curves are typically no cause for great concern, provided  there are no signs of further progression. In growing children and  adolescents, however, mild curvatures can worsen quite rapidly—by 10  degrees or more—in a few months. Therefore, frequent checkups are often  necessary for this age group.  

How is scoliosis evaluated?

Evaluation begins with a thorough history and physical  examination, including postural analysis. If a scoliotic curvature is  discovered, a more in-depth evaluation is needed. This might include a  search for birth defects, trauma, and other factors that can cause  structural curves. Patients with substantial spinal curvatures very often require an  x-ray evaluation of the spine. The procedure helps determine the  location and magnitude of  the scoliosis, along with an underlying cause  not evident on physical examination, other associated curvatures, and  the health of other organ systems that might be affected by the  scoliosis. In addition, x-rays of the wrist are often performed. These  films help determine the skeletal age of the person, to see if it  matches an accepted standard, which helps the doctor determine the  likelihood of progression. Depending on the scoliosis severity, x-rays  may need to be repeated as often as every 3 to 4 months to as little as  once every few years. Other tests, including evaluation by a Scoliometer™, might also  be ordered by the doctor. This device measures the size, by angle, of  the rib hump associated with the scoliosis. It is non-invasive,  painless, and requires no special procedures. A Scoliometer™ is best  used as a guide concerning progression in a person with a known  scoliosis—not as a screening device. 

Is scoliosis always progressive?

Generally, it is not. In fact, the vast majority of scoliosis  remains mild, is not progressive, and requires little treatment, if any.  In one group of patients, however, scoliosis is often more progressive.  This group is made up of young girls who have scolioses of 25 degrees  or larger, but who have not yet had their first menstrual period. Girls  generally grow quite quickly during the 12 months before their first  period and if they have scolioses, the curvatures tend to progress  rapidly. In girls who have already had their first periods, the rate of  growth is slower, so their curves tend to progress more slowly.  

What is the treatment for scoliosis?

There are generally 3 treatment options for scoliosis—careful  observation, bracing, and surgery. Careful observation is the most  common "treatment," as most mild scolioses do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops  growing), and who have curves between 25 and 45 degrees. Surgery is  generally used in the few cases where the curves are greater than 45  degrees and progressive, and/or when the scoliosis may affect the  function of the heart, lungs, or other vital organs.  Spinal manipulation, therapeutic exercise, and electrical muscle  stimulation have also been advocated in the treatment of scoliosis. None  of these therapies alone has been shown to consistently reduce  scoliosis or to make the curvatures worse. For patients with back pain  along with the scoliosis, manipulation and exercise may be of help. Most people with scoliosis lead normal, happy, and productive  lives. Physical activity including exercise is generally well-tolerated  and should be encouraged in most cases.

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Spinal Disc

Spinal Disc Problems

Eighty percent of people experience back pain, and at any one  point in time, approximately 20% of the population has back pain. For  many decades, doctors and scientists believed that most back pain was  caused by "slipped" or "torn" discs. We now know this not to be true.  Disc problems constitute only a small portion of the causes of back pain  and rarely require surgery for pain relief. 

What are spinal discs?

Spinal discs are a critically important part of your spinal  column. Along with the vertebrae, also called the spinal bones, they  perform many functions. The discs provide shock absorption, protecting  the spinal cord and ensuring flexibility of the spine. They also perform  other functions. The spinal discs are essentially ligaments (structures connecting  bones) that attach to the top and bottom of each vertebra. They are  thick, ligament-like outer rings, also known as annuli fibrosis. Because  they are arranged in an alternating pattern with the vertebrae, annuli  fibrosis allow flexibility while preventing the vertebrae from moving  too much and causing injury. Inside a single annulus fibrosis is a jelly-like substance called  the nucleus pulposis. It contains some proteins, but is primarily made  up of water. The nucleus provides more shock absorption than does the  annulus and it also acts as a fulcrum to direct the type of movement  through which each vertebra travels. 

What are the most common disc problems?

  • A disc "bulge" results from slight tears in the outermost  fibers of an annulus fibrosis. These small tears can be painful for a  short time. 
  • A disc protrusion/extrusion, also called "herniation," is a  more significant injury. It results from a complete or significant tear  of the fibers of an annulus-when some of the nucleus leaks through. A  herniation can also be painful and may even cause nerve compression. In  the most severe cases, the spinal cord can become compressed. 
  • The most common disc problem suffered by adults is degenerative  disc disease. This occurs when the nucleus loses water and small tears  develop in it. The body then forms osteophytes (bone spurs), along the  edges of the vertebra and the disc space narrows. We used to believe  that this was a function of "wear and tear" as we aged. The most recent  evidence shows that, most often, there is a hereditary link to the  development of degenerative disc disease. Degenerative disc disease can  also be caused by trauma/injury.

What are the common signs and symptoms of disc problems?

Common signs of disc problems include, but are not limited to:  

  • Back or neck pain
  • Leg or arm pain
  • Stiffness
  • Tenderness of the spine and spinal muscles

How are disc problems diagnosed?

Disc problems are most often diagnosed with the use of a thorough  history and physical examination, including examination of your nervous  and musculoskeletal systems. Your doctor will most likely move your  back and arms and legs into various positions while applying pressure to  your joints.  Plain film x-rays are helpful in only some forms of disc  problems. Magnetic resonance imaging (MRI) has become the mainstay for  the diagnosis of disc problems, as it images the discs quite nicely.  Your doctor may order an MRI if he or she feels it would be helpful in  diagnosing a disc problem and determining the proper course of care for  you. Most often, however, this is not necessary. 

How are disc problems treated?

Luckily, in most circumstances, disc problems are easily treated  with conservative interventions. Early in the course of an acute injury,  your doctor of chiropractic will very likely set a goal of pain  control, using several different physical modalities to reach it. Both  ice and heat have shown effectiveness in managing the pain of acute  low-back injury. Your doctor of chiropractic will help you determine  which is most effective for you.  In addition, getting you back on your feet and moving as quickly  as is safely possible is critical. Typically, the less time you spend in  bed, the better off you are in terms of long-term results. You'll also  need to learn not to be afraid to move. If you "baby" your back, in most  cases, the long-term results will be worse. Chiropractic spinal manipulation has also been demonstrated to be  a safe and effective tool in the management of disc problems.  Manipulation is especially effective when combined with therapeutic  exercise.  In most circumstances, spine surgery and injections are not  necessary in the management of disc problems- and they often cause more  problems than they're worth. Your doctor of chiropractic will discuss  all available treatment options with you and help you decide on the best  course of action. 

Can disc problems be prevented?

While regular exercise will help strengthen your back, research  has demonstrated that staying fit and using proper body mechanics alone  will not prevent injury. The National Institute for Occupational Safety  and Health (NIOSH) recommends that individuals do not lift more than 50  lbs. Further, activities that require awkward or prolonged postures and  repetitive activities place individuals at high risk for musculoskeletal  disorders and disc problems regardless of body mechanics and fitness  level. Your doctor of chiropractic can conduct an ergonomic assessment  of your work and home activities to help you prevent injury. It is also critically important to have "spinal awareness." Make a  conscious effort, for example, to be aware of what posture you are  maintaining when you sit, stand, lie down, work, and exercise. Lift  objects with proper posture, including bending your knees, keeping the  object close to your body, keeping your back straight and lifting with  your legs. Never lift an object by bending over and twisting. You'll  only invite a back injury. If you experience any of the following, seek immediate medical care for a spine problem:  

  • Loss of bowel or bladder control
  • Inability to urinate and/or defecate
  • Acute loss of feeling in both buttocks and/or both arms
  • Inability to walk or use your arms (often from severe acute weakness)
  • Fever along with your back pain

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Patients with lumbar spinal stenosis—one of the most common  reasons for spinal surgery in older people—are commonly recognized by a  bent-forward, shuffling posture and a characteristic small-step gait.  Stenosis surgery, however, is a major procedure that is recommended only  when conservative methods of care aren't effective—or when stenosis is  caused by such things as tumors or accompanied by intolerable pain or  severe neurological problems, such as loss of bowel and bladder  function. 

What is stenosis?

Spinal stenosis is created by the narrowing of the spinal canal.  This narrowing may be caused by mechanical problems or by abnormalities  in the aging spine. It may or may not result in low-back pain, limping,  and a lack of feeling in the legs. Stenosis is often a degenerative condition. It may exist for  years without causing pain or discomfort, but a fall or an accident can  trigger characteristic stenotic pain. Numerous factors can cause  stenosis, such as thickened ligaments, expanding infection, abscess, a  congenital or developmental anomaly, degenerative changes, vertebral  fractures or dislocations, or a spinal cord tumor. Other conditions, such as a herniated disc, can mimic stenosis.  While herniated discs usually cause rapid and acute muscle spasm,  discomfort caused by stenosis builds gradually. Other conditions that  can be confused with stenosis include vascular claudication, peripheral  vascular disease, and abdominal aortic aneurysms.  Claudication—pain triggered by walking—caused by vascular disease  most often occurs after walking a fixed distance. Patients with spinal  stenosis, however, walk variable distances before symptoms set in.  Activities like riding a bicycle and walking up a hill can cause pain in  patients with vascular claudication, but not in those with stenosis. On  the other hand, standing makes pain worse for stenotic patients, while  it relieves vascular claudication. 

How is stenosis diagnosed?

Spinal stenosis can be diagnosed based on the history of  symptoms, a physical examination, and imaging tests. An MRI is a very  poor predictor of future disability in stenosis. An electrodiagnostic  study is more dependable for information on a stenotic spine. To  diagnose stenosis caused by an abscess or an infection, blood work  analyzed by a laboratory may be required, while vertebral tumors and  spinal tumors require finely tuned imaging. Although degeneration is the most common cause of the condition,  spinal stenosis can also result from longterm steroid use. Degenerative  stenosis also has multiple contributing factors, including disc  degeneration, disc bulging, bone spur formation around the vertebrae and  the facets, thickening of the soft tissues, and bulging around the  disc. Some anatomical factors, such as the enlarged, weakened bones  caused by Paget's disease, can complicate both the degenerative process  and treatment. 

How is stenosis treated?

There are three basic treatment approaches to spinal stenosis:  the conservative medical approach, which frequently involves bed rest,  analgesics, local heat, and muscle relaxants; the conservative  chiropractic approach, which includes manipulation, exercise and  self-care techniques; and surgery. The source of the stenosis often  dictates the treatment.  Although medications can provide pain relief, those powerful  enough to deaden the pain can also exacerbate patients' already  compromised sense of balance. When the patient loses bowel or bladder  control, suffers from intolerable leg pain and claudication, and has  progressive loss of function or spinal cord tumors, surgery is the first  and only option. The standard stenosis surgical procedure usually  involves opening up the spinal canal and decompressing the neural  elements by removing the bony structures that contribute to canal  narrowing. Although many patients do fairly well after the surgery, the  symptoms are likely to return after a period of time.  Recent studies show that although stenosis surgery will often  have good results up to two years, in the long run, outcomes are much  the same between surgery and conservative care. Some surgeries have to  be repeated years later. Many are far from fully satisfactory. Surgery  is a complicated procedure that irreversibly changes the structure of  the back.  In many mild and moderate cases of stenosis, however,  non-invasive conservative care, such as chiropractic, can help lessen  pain and discomfort, maintain joint mobility, and allow the patient to  keep a reasonable lifestyle, at least for some time.  A technique called distraction manipulation may be helpful in reducing leg discomfort. Home exercises are a major part of the conservative treatment  program. Recommended four or five times a week, the exercises, such as  bicycle riding or lying on the side and grasping the knees with the  arms, focus on flexing the spine in a forward position—stretching and  strengthening the lower back and stomach muscles and improving muscle  strength. Exercises designed to mobilize the involved nerves have been  found to be particularly helpful. Ultimately, stenosis is a chronic condition that cannot be  "cured," but it often can be improved, and improvement can be maintained  over the long term. Patients can work with a health care provider, such  as a doctor of chiropractic, to reduce symptoms and improve their  quality of life. Signs and Symptoms of Stenosis:  

  • Pseudoclaudication—pain triggered by walking or prolonged  standing, which is usually improved by sitting in a forward leaning  flexed position
  • Numbness, tingling, and hot or cold feelings in the legs
  • Muscle weakness and spasms

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Temporomandibular Joint Disorder

Does it hurt when you chew, open wide to yawn or use your jaws?  Do you have pain or soreness in front of the ear, in the jaw muscle,  cheek, the teeth or the temples? Do you have pain or soreness in your  teeth? Do your jaws make noises loud enough to bother you or others? Do  you find it difficult to open your mouth wide? Does your jaw ever get  stuck/locked as you open it? If you answered "yes" to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint. Signs may include:  

  • Radiating pain in the face, neck, or shoulders; 
  • Limited movement or locking of the jaw;
  • Painful clicking or grating when opening or closing the mouth;
  • A significant change in the way the upper and lower teeth fit together;
  • Headaches, earaches, dizziness, hearing problems and difficulty swallowing.

For most people, pain or discomfort in the jaw muscles or joints  is temporary, often occurs in cycles, and resolves once you stop moving  the area. Some people with TMD pain, however, can develop chronic  symptoms.  Your doctor of chiropractic can help you establish whether your  pain is due to TMD and can provide conservative treatment if needed. 

What Causes TMD?

Researchers agree that TMD falls into three categories:  

  • Myofascial pain—discomfort or pain in the muscles of the jaw, neck, and shoulders;
  • A dislocated jaw or displaced disc;
  • Degenerative joint disease—rheumatoid arthritis or osteoarthritis in the jaw joint.

Severe injury to the jaw is a leading cause of TMD. For example,  anything from a hit in the jaw during a sporting activity to overuse  syndromes, such as chewing gum excessively or chewing on one side of the  mouth too frequently may cause TMD. Both physical and emotional stress can lead to TMD, as well. The  once-common practice of sitting in a dentist's chair for several hours  with the mouth wide open may have contributed to TMD in the past. Now,  most dentists are aware that this is harmful to the jaw. In addition to  taking breaks while they do dental work, today's dentists also screen  patients for any weaknesses in the jaw structure that would make  physical injury likely if they keep their mouths open very long. In that  case, they may use medications during the procedure to minimize the  injury potential, or they may send the patient to physical therapy immediately after treatment. In  less severe cases, they instruct patients in exercises they can do at  home to loosen up the joint after the visit. While emotional stress itself is not usually a cause of TMD, the  way stress shows up in the body can be. When people are under  psychological stress, they may clench their teeth, which can be a major  factor in their TMD. Some conditions once accepted as causes of TMD have been  dismissed—moderate gum chewing, non-painful jaw clicking, orthodontic  treatment (when it does not involve the prolonged opening of the mouth,  as mentioned above), and upper and lower jaws that have never fit  together well. Popular theory now holds that while these may be  triggers, they are not causes. Women experience TMD four times as often as men. Several factors  may contribute to this higher ratio, including sitting too long at the  workplace, general posture and higher heels. 

TMD Diagnosis and Treatment

To help diagnose or rule out TMD, your doctor of chiropractic  (DC) may ask you to put three fingers in your mouth and bite down on  them. You may also be asked to open and close your mouth and chew  repeatedly while the doctor monitors the dimensions of the jaw joint and  the balance of the muscles. If you have no problems while doing these  things, then the problem is not likely to be TMD. Your DC can then look  for signs of inflammation and abnormalities. Sometimes special imaging,  an x-ray or an MRI may be needed to help confirm the diagnosis.  If you have TMD, your doctor may recommend chiropractic  manipulation, massage, applying heat/ice and special exercises. In most  cases, your doctor's first goal is to relieve symptoms, particularly  pain. If your doctor of chiropractic feels that you need special  appliances or splints (with the exception of the "water pack" and other  guards against teeth grinding), he or she will refer you to a dentist or  orthodontist for co-management. In addition to treatment, your doctor  of chiropractic can teach you how to:  

  • Apply heat and ice to lessen the pain. Ice is recommended  shortly after the injury or after your pain has started. In the later  stages of healing, you need to switch to heat, especially if you are  still experiencing discomfort.
  • Avoid harmful joint movements. For example, chomping into a  hard apple is just as bad as crunching into hard candy (some hard  candies are even called "jawbreakers"—for good reason).

And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.   

  • Perform TMD-specific exercises. Depending on your condition,  your DC may recommend stretching or strengthening exercises. Stretching  helps to loosen tight muscles and strengthening helps to tighten muscles  that have become loose. Special feedback sensors in the jaw can be  retrained, as well, if needed.

TMD and Surgery

In some cases, TMD may not respond to a conservative approach—for  example, when there is a disc problem in the joint itself—and may  require dental treatment or surgery. Remember, however, that surgery and  other permanent, irreversible treatments should be considered as a last  resort. According to the National Institutes of Health, certain  irreversible treatments, such as surgical replacement of jaw joints with  artificial implants, may cause severe pain and permanent jaw damage. Complications from artificial jaw-joint implants, for example,  have led the Food and Drug Administration to recall certain implants. 

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Tension Headaches

Headaches are more common in adults, although they can develop at  any time in life. Approximately 4 out of 5 children have headaches at  some point, but most are benign and self-resolving. In fact, many adults  who suffer from headaches report having the first headache in  childhood. Headache symptoms usually begin gradually. In fact, the sudden  onset of severe headache may signify a serious problem and requires  immediate medical attention. Common headache is often described as achy,  dull or throbbing pain. It typically begins at the base of the  skull/upper part of the neck and may radiate into the eye(s), the  temple, or other locations. Headaches may be felt on one or both sides  of the head. Often loud noises or bright lights may make them worse.  Some patients may become nauseated or experience odd smells, sounds, or  sights before and during the headache attack.  

How Is a Headache Evaluated?

Early diagnosis and treatment are important in identifying a  serious underlying cause for your headache. In most cases, an in-depth  history and physical examination can help determine if your symptoms are  related to an easily treated problem, or if it is more serious. Your  doctor can use other tests that reproduce the symptoms of your headache  to help develop a specific management plan for your condition, or refer  you to another health care provider. X-rays, laboratory tests and even  advanced imaging studies like magnetic resonance imaging (MRI) may be  necessary. Your doctor may ask you to complete a headache diary, recording:  

  • day and time of the headache
  • headache location
  • what the headache feels like
  • what you were doing when the headache began
  • how long the headache lasts
  • what makes it feel better or worse
  • anything else you notice before, during, or after the attacks

What Is the Treatment for Headaches?

Headache treatment is cause-related. Doctors of chiropractic  often treat patients with tension-type headaches and headaches caused by  problems with the joints and muscles in the neck, as well. Joint manipulation and mobilization of the neck, along with  stretching and strengthening exercises, have been demonstrated to be  effective in the treatment of this type of headache.  Massage and other forms of soft-tissue treatment can sometimes be  helpful. Scientists are also investigating other therapies, such as  acupuncture, to prevent and treat this disorder. Over-the-counter pain relievers, such as acetaminophen, can be  used for an occasional headache, but not for long-term headache  management.  More serious causes of headache require aggressive treatment, and  your doctor of chiropractic can assist you in finding a medical  headache specialist.  The majority of patients with headache recover completely after  treatment. Unfortunately, the recurrence rate is relatively high,  particularly with tension-type headache. If you have any questions or  concerns about headache, feel free to discuss them with your doctor or  chiropractic.  

What Causes Headaches?

Headaches can be primary and secondary. Primary headaches do not  result from some other health condition. The most common type of primary  headache is caused by problems with the neck muscles. Changes in the  blood vessels inside the skull usually cause migraines. Other common  types of headache include "cluster" headaches—headaches grouped together  over weeks at a time; sinus headaches, associated with allergies and/or  sinus infection; and headaches from poor vision. Secondary headache results from some other cause or  condition—head injury, concussion, blood vessel problems, or high blood  pressure—or from side effects of some medications, infections in the  head or sinuses or elsewhere in the body. Rare headache causes include  tumors, aneurysms and other abnormal growths inside the skull, and toxic  substances in the blood. Certain foods, such as monosodium glutamate  (MSG), a food flavor enhancer, may cause headaches, as well.  

How Can Headaches Be Prevented?

Muscle-tension headaches can often be avoided by maintaining  proper posture and neck movements while performing your normal  activities. You should:   

  • Avoid slouching
  • Avoid reading with your neck bent forward
  • Keep your computer monitor at eye level
  • Take frequent breaks from reading and working on the computer.
  • Try a low-fat, high-complex carbohydrate diet.

A recent study demonstrated that such a diet can dramatically  lower the frequency, intensity, and\duration of migraine headaches.  

What are the signs of a serious headache?

You should call your doctor and/or seek emergency care if:  

  • You have a stiff neck and a fever along with your headache.
  • It is painful to bend your head to your chest.
  • Your speech is slurred.
  • You have vision changes.
  • You feel numbness or weakness in your arms or legs.
  • Your headache lasts longer than 3 days.
  • You recently injured your head and your headache will not go away.
  • You often get headaches in the morning.
  • You have a sudden headache although you normally don't have them.

Other signs of serious headache include:  

  • The worst headache you've ever had
  • Worsening or more frequent headaches
  • Headache that wakes you from sleep
  • Personality changes along with headache
  • Early morning vomiting without headache.

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People with vertigo know that the law of gravity prevails, but  their brains get confused. They feel like they are tilting in space, or  that the world is spinning or moving around them. Nausea, sweating,  headaches, vomiting, and fatigue may add to their discomfort. 

What Is vertigo?

Vertigo is a type of dizziness. Dizziness is generally described  as a floating feeling of instability or unsteadiness. Unlike other types  of dizziness, vertigo—an illusion of movement when no movement takes  place—is a sign that can be objectively tested. Some patients have  overlapping signs and symptoms of vertigo plus lightheadedness or  dizziness. 

Causes of Vertigo

Most vertigo is caused by problems with the peripheral or central  nervous system. Vertigo that originates in the peripheral nervous  system is often connected with issues in the inner ear. Such causes of  vertigo include benign paroxysmal positional vertigo (BPPV), acute  vestibular neuronitis, labyrinthitis, and Menière's disease.  Vertigo related to the central nervous system is brought about by  disorders of the brain or the spinal cord. Acoustic neuroma, migraines,  and multiple sclerosis are included in this category, as is  cervicogenic vertigo. Cardiovascular problems such as vertebrobasilar  insufficiency are among vertigo's many possible sources, as well. Vertigo can also be caused by a wide variety of medications such  as antidepressants, anticonvulsants, antihypertensives, diuretics,  barbiturates, salicylates (e.g., aspirin), and sedatives or hypnotics.  Cocaine can cause vertigo, as can nitroglycerin, quinine, and some  prescription and over the- counter cold medicines. Antibiotics that have  been linked to vertigo include gentamicin and streptomycin, as well as  antineoplastics such as cisplatin and carboplatin. Metabolic issues—such as diabetes mellitus, hypothyroidism, high  blood triglycerides, hypoglycemia, and food allergies/gluten  sensitivity—can also cause or worsen vertigo. Other patients' vertigo  can be traced to motor vehicle accidents, falls, or work-related and  other types of traumas or illnesses. 

Diagnosis and Treatment

To diagnose the cause of vertigo, your health care provider will  perform an examination, including a variety of positioning tests, to  check if they will reproduce the sensation of motion. Other tests may be  necessary, as well. 

Benign Paroxysmal Positional Vertigo (BPPV)

About 65 percent of vertigo is caused by BPPV—a result of calcium  debris in the inner ear. The Epley maneuver—a procedure in which the  patient is rapidly moved from lying on one side to lying on the other in  order to move the calcium debris to a less-sensitive location in the  inner ear— helps the majority of patients with BPPV. Studies show that  up to 80 percent of patients recover after a single treatment with the  Epley maneuver, and most BPPV cases respond to two to three Epley  treatments.  BPPV, however, has a tendency to recur. About 15 percent of  patients will experience BPPV again within 12 months of the first  episode; in 20 percent, BPPV comes back after 20 months, and in 37  percent, after 60 months. In addition, the Epley maneuver is  contraindicated in patients with severe carotid stenosis, heart  diseases, and severe neck problems, such as cervical spondylosis with  myelopathy or advanced rheumatoid arthritis. Even without treatment, BPPV tends to resolve in weeks or months.  Your doctor can also recommend vestibular rehabilitation exercises  (called the Brandt-Daroff exercises after the name of their inventor)  for you to perform at home. Each exercise position should be maintained  for 30 seconds if there is no vertigo—or for 30 seconds beyond the point  where the vertigo stops. The exercises should be repeated five to 10  times and performed three times a day for four to six weeks. 

Other Types of Vertigo

Treatment for vertigo caused by other conditions depends on the  individual case. Ménière's disease patients, for example, can benefit  from a low-salt diet. Treatment for vertigo associated with migraine  headaches should include dietary changes, such as reduction or  elimination of aspartame, chocolate, alcohol and caffeine. A regular  program of exercise, reducing stress, getting adequate sleep, and  performing vestibular rehabilitation exercises can also help reduce  symptoms. Vestibular neuronitis and labyrinthitis, which are often attributed to viral infections,  can also be treated with vestibular exercises. In chronic or seriously  disabling cases of vertigo, a short course of vestibular-suppressing  medications can help provide temporary relief.  Working with your doctor of chiropractic to improve postural  issues can also bring relief to patients whose vertigo is exacerbated by  a sedentary lifestyle or working in certain positions for extended  periods. Flexed positions—such as those assumed by dentists or dental  assistants—can compromise extensor muscles and cause postural  imbalances, which may result in vertigo. To restore balance, volleyball,  basketball, and other sports involving the extensor muscles may be  helpful. In patients with cervicogenic vertigo, a general ergonomic  assessment of work and life activities can help identify contributors to  the problem.  

Nutrition and Stress Reduction

A balanced diet can provide nutrients necessary for proper  function of organs and restore nutrient imbalances, some of which may  contribute to vertigo.  In addition, some supplements and herbs may be helpful in reducing vertigo:  

  • Vinpocetine may help balance the sodium channel in the brain and prevent inflammation.
  • Vitamin B6 has been shown to be effective with nausea and may also help with vertigo.
  • Ginkgo biloba has been shown to reduce vertigo symptoms in a few studies.
  • Fish oils improve the cognitive function and may also be  helpful—especially when vertigo is caused by a brain dysfunction  problem.
  • Chromium (at least 200 mcg a day) may be helpful in patients  whose vertigo is caused by a blood sugar imbalance. Good dietary sources  of chromium are brewer's yeast and barley flour. Refined sugars, white  flour products, and lack of exercise can deplete chromium.

Excessive stress exacerbates many conditions, and vertigo is no  exception. Physical exercise and meditation, adequate sleep and other  stress reduction techniques can all help contribute to recovery from  vertigo and should be a part of the treatment regimen. At Ash  Chiropractic and Wellness, we can help create an appropriate exercise  program for you and counsel you regarding healthy lifestyle and stress 

Vertigo patients who present with the following signs should go immediately to the emergency room:

  • double vision
  • headache
  • weakness
  • difficulty speaking
  • difficulty waking up or staying awake
  • difficulty walking
  • inappropriate actions
  • difficulty controlling arms or legs
  • abnormal eye movements

Nystagmus, which is characterized by uncontrollable, rhythmic, or  jerky eye movements, is one of the signs of BPPV. However, additional  diagnostic tests and/or ear, nose, and throat or neurological  evaluations should be done in patients who have nystagmus to rule out  possibly harmful structural causes.  

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The signs and symptoms of whiplash often do not develop until 2 to 48 hours after the injury. Whiplash is a generic term applied to injuries of the neck caused  when the neck is suddenly and/or violently jolted in one direction and  then another, creating a whip like movement. Whiplash is most commonly  seen in people involved in motor vehicle accidents, but it can also  occur from falls, sports injuries, work injuries, and other incidents.  Most whiplash injuries are associated with forward and backward  movement of the head and neck on the shoulders. Side-impact crashes, in  which a person's head is turned, may result in side-to-side or even  oblique whiplash-style injuries to the neck. Although severe whiplash injuries can result in paralysis and even death, most such injuries are relatively mild. 

What structures are injured in a whiplash?

Whiplash injuries most often result in sprain-strain of the neck.  The ligaments that help support, protect, and restrict excessive  movement of the vertebrae are torn, which is called a sprain. The joints  in the back of the spine, called the facet joints, are covered by  ligaments called facet capsules, which seem to be particularly  susceptible to whiplash injury. In addition, the muscles and tendons are strained— stretched  beyond their normal limits. The discs between the vertebrae, which are  essentially ligaments, can be torn, potentially causing a disc  herniation. The nerve roots between the vertebrae may also be stretched  and become inflamed. Even though it is very rare, vertebrae can be  fractured and/or dislocated in a whiplash injury. 

What are the common signs and symptoms of whiplash?

Approximately two thirds of people involved in motor vehicle  accidents develop symptoms of whiplash. Interestingly, the violence of  the crash is not a definitive indicator of pain or even the amount of  pain. Generally speaking, however, those involved in more severe  accidents have more signs and symptoms. Another important and interesting aspect of whiplash is that the  signs and symptoms often do not develop until 2 to 48 hours after the  injury. This scenario is relatively common but not completely  understood. Some speculate that it may be due to delayed muscle  soreness, a condition seen in other circumstances. The most common symptoms of whiplash are pain and stiffness in  the neck. These symptoms are generally found in the areas that are  "whiplashed." For example, during a whiplash, first the head is lifted  up from the upper-cervical spine. This creates a sprain/strain in the  region just below the skull, where symptoms usually occur. Symptoms may  also commonly be seen in the front and back of the neck. Turning the  head often makes the pain and discomfort worse. Headache, especially at the base of the skull, is also a common  symptom, seen in more than two thirds of patients. These headaches may  be one-sided (unilateral) or experienced on both sides (bilateral). In  addition, the pain and stiffness may extend down into the shoulders and  arms, upper back, and even the upper chest. In addition to the musculoskeletal symptoms, some patients also  experience dizziness, difficulty swallowing, nausea, and even blurred  vision after a whiplash injury. While these symptoms are disconcerting,  in most cases, they disappear within a relatively short time. If they  persist, it is very important to inform your doctor that they are not  resolving. Vertigo (the sensation of the room spinning) and ringing in  the ears may also be seen. In addition, some patients may feel pain in  the jaw. Others will even complain of irritability, fatigue, and  difficulty concentrating. These symptoms also resolve quickly in most  cases. In rare cases, symptoms can persist for weeks, months, or even  years. 

How is whiplash diagnosed?

To make a diagnosis, a thorough history of the injury and the  patient's previous medical history are taken. Preexisting conditions,  such as arthritis and/or previous injury, may increase the severity of  the signs and symptoms of whiplash. Following history-taking, an  in-depth physical examination, with concentration on the  neuromusculoskeletal system, is performed. When appropriate, X-rays of  the neck may be taken. If the doctor suspects that the soft tissues (for  example, discs or ligaments) in the neck are injured, more advanced  imaging studies, such as magnetic resonance imaging (MRI), may be  ordered. 

How is whiplash treated?

Staying active
One of the most important  aspects of whiplash management is for the patient to stay active, unless  there is some serious injury that requires immobilization. Patients  should not be afraid to move and be active, within reason. In addition,  your doctor will often prescribe an exercise or stretching program. It  is particularly important to follow this program as prescribed, so that  you can achieve the best long-term benefits. Soft-cervical collar
The use of a  soft-cervical collar remains controversial. Some suggest that such  devices are inappropriate, as they act as a "crutch" and encourage a  patient to avoid activity. Others suggest that, with proper counseling, a  collar can help a patient slowly return to normal activities. There is  no controversy, however, when discussing the length of time that a soft  collar should be worn—no more than one week. Chiropractic manipulation and physical therapy
Ice  and/or heat are often used to help control pain and reduce the muscle  spasm that results from whiplash injuries. Other physical therapy  modalities, such as electrical stimulation and/or ultrasound, may  provide some short-term relief. They should not, however, replace an  active-care program of exercise and stretching. Spinal manipulation  and/or mobilization provided by a chiropractor can also give relief in  many cases of neck pain. Surgery and injections
Surgery, injections,  and other invasive options are rarely necessary but are available, when  appropriate. They are generally reserved for patients with more severe  injuries to the discs, vertebrae, and nerves in the neck region. 

Can whiplash be prevented?

Generally speaking, whiplash cannot be "prevented," but there are  some things that you can do while in a motor vehicle that may reduce  the chances of a more severe injury. Always wear restraints (lap or  shoulder belt), and ensure that the headrest in your vehicle is adjusted  to the appropriate height. 

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