Headache | Rook Torres

Jul 27 0

Chiropractic Care of Children…Is It Really Safe???

Posted by Rook Torres

In the late 1990s, an article published on the safety of chiropractic treatment of children also revealed significant benefits for children who received chiropractic treatment.

This article was written in response to safety concerns due to the increased utilization of chiropractic for various pediatric conditions.

One primary topic of discussion included the neurological and vascular complications associated with chiropractic treatment in pediatric patients.

This topic has been reviewed previously in adult patients and much of the same concerns can be associated with the pediatric patient.

The likelihood of a vascular injury in a pediatric case is certainly less than in the adult patient due to the pliability and flexibility of the neurovascular structures.

The incidence in the occurrence of stroke in teenagers (children under 15 years of age) is reportedly at a rate of 2.7 per 100,000 children was reported.

However, based on an extensive search dating back 32 or more years, only two reported cases of neurovascular complications related to pediatric patients who had received chiropractic care were found.

Based on the data derived from multiple sources, a conservative estimate of the number of pediatric visits to chiropractors in the United States over the same time frame amounted to over 500 million treatments.

THE REVIEW CONCLUDED THE CHANCE OF A NEUROVASCULAR COMPLICATION ARISING FROM THE CHIROPRACTIC TREATMENT WAS APPROXIMATELY 1 OUT OF 250 MILLION VISITS.

The article concluded the benefits outweigh the risks when applying cervical spine manipulation to any individual, including the pediatric population.

Based on their review, chiropractic care, as it relates to neurovascular complications, presents little risk to the pediatric patient. Even less than the general non-pediatric population which too, is extremely rare.

One other risk cited in its paper was potential damage to the growth plate (epiphysis – the growing ends of bones) of the growing child. However, in the 32+ year review, no reported research documentation could be found supporting this claim.

Another article reported ways in which parents might be able to detect spinal problems in children.

Unless an obvious trauma such as a trip and fall has occurred, it can be challenging in some cases to detect spinal issues, similar to the dentist discovering a non-symptomatic cavity.

More obvious findings parents can detect may include head tilt or leaning to one side, the child turning their whole body rather than their neck to converse or look at someone, sleep interruptions, a child rubbing their own neck, feeding /nursing difficulties on one side and crying/agitated behavior compared to the child’s “usual” behavior.

When children are able to communicate, they may complain of aches that many refer to as “growing pains.”

Less documented / anecdotal evidence that might suggest nervous system dysfunction include persistent earaches, sore throats, colic, headaches, bed-wetting, and others are conditions that parents may bring their children for chiropractic treatment.

From In Good Hands Magazine.

http://www.chiroweb.com/mpacms/dc/article.php?id=37423 Dynamic Chiropractic – September 7, 1998, Vol. 16, Issue 19 Chiropractic — Is It Safe for Children? By Claudia Anrig, DC; Claudia Anrig, DC Clovis, California
http://www.chiroweb.com/mpacms/dc/article.php?id=41406 Dynamic Chiropractic – July 29, 1994, Vol. 12, Issue 16
A Parent’s Guide to Chiropractic Care for Children Peter Fysh, DC San Jose, California

Jul 27 0

Do Spinal Curves In Your Neck, Mid Back and Lower Back Affect Your Health?

Posted by Rook Torres

Chiropractic was founded in 1895 after the hearing was restored in a patient following a spinal adjustment to the upper region of the spine.

Since then, our profession has been conducting research to help determine why spinal manipulation or adjustments work so well.

Many conditions have been studied, as well as the physiological responses to the adjustment including blood chemistry changes including hormone levels, blood pressure changes, circulation changes, and many other parameters of health.

Posture, bone alignment and spinal curves have been long been evaluated in patients presenting with muscle and joint complaints by most of the health care professions, including chiropractic.

But the question remains: how important are spinal curves in the overall health picture of the patient? Can alterations in the “normal” curve lead to future trouble or, be the cause of a current condition?

A recent study reported the results after conducting a “systematic critical literature review” where all research published on this subject was reviewed for quality and content.

They gathered 54 studies published between 1942 and 2008, which included over 20,000 patients and reported the association between the sagittal curve (curves when looking at a person from the side) and various health conditions.

There were many different types of studies and methods used to evaluate the sagittal curves of the lumbar (low back) (38 studies), thoracic (mid back) (34 studies) and cervical (neck) (6 studies) spine.

These methods included plain x-ray (25 studies), MRI (1 study), photographs (3 studies) visual analysis or, by the eye (5 studies) and those using a variety of instruments (21 studies).

A strong association was reported in five studies with an increased angle in the midback/thoracic spine (kyphosis – sometimes referred to as “humpback”) with lung disorders causing breathing problems.

Poor physical function and pelvic organ prolapse were also strongly associated with kyphosis.

A moderate association was found when the low back curve (lordosis) was reduced, which was associated with an increase in low back pain.

Similarly, future osteoporotic midback/thoracic compression fractures were moderately associated with kyphosis or “humpback” deformity.

Kyphosis was also moderately associated with heavy household activity, uterine prolapsed and death in three other studies.

No association was found in many studies.

The conclusion of the article reports most of the studies did not fulfill the basic requirements for this type of study or had design flaws.

They encouraged researchers to use new/better approaches to study this association between spinal curves and health and disease.

From In Good Hands Magazine.

Jul 27 0

The Many Functions of Your Nervous System

Posted by Rook Torres

Every movement, smell, taste, touch, sound, thought, and dream has its origin in the nervous system.

Every function of your body, both voluntarily and involuntarily is controlled, at least in part, by your nervous system.

To better understand how the nervous system works, it is necessary to discuss what makes up the nervous system.

The Nervous system is made up of two primary systems – the central nervous system and the peripheral nervous system.

The central nervous system (CNS) is made of the brain and spinal cord, while the peripheral nervous system (PNS) is comprised of nerves such as those in our arms, legs, and torso that deliver information back to the CNS for processing.

Many of the functions of the PNS are voluntary – that is, we can control actons like reaching for plate, swinging a golf club, or swimming.

Other actions are involuntary like the beating of the heart, breathing rates during exercise, digesting food, regulating our blood sugar, metabolism, and so on.

Many of the automatic involuntary functions are controlled by a subcategory of the PNS called the autonomic nervous system (ANS) which has two components: the sympathetic and parasympathetic nervous systems.

There is always activity in the sympathetic nervous system operating at a basal level called “sympathetic tone” and its activity increases at times of stress (producing a “fight-or-flight” response).

The parasympathetic nervous system basically does the opposite of the sympathetic nervous system.

When the heart rate increases (sympathetic response), the parasympathetic nervous system slows it down. Just as the “fight-or-flight” response relates to the sympathetic NS, a “rest and digest” function describes the parasympathetic NS.

Hence, the autonomic nervous system (ANS) is made up of nerves that innervate cardiac muscle, smooth muscle, and glandular tissue.

From a functional perspective, think of the nervous system as a highway with information being transmitted to and from different locations.

The roads or pathways bring information to the CNS (brain/spinal cord) and are called sensory nerves (afferent).

Consider what happens when you touch a hot stove…

In this example, your hand is quickly pulled away from the stove. To accomplish this, there are nerve fibers that connect or bridge between the afferent (sensory) and efferent (motor) nerves called interneurons.

To break this down even further, under a microscope, the space or junction between two neurons/nerves is called a synapse, which is a very narrow gap where chemicals called neurotransmitters allow an impulse to pass through the gap so an impulse can travel onto another “road” (nerve) to bring information to and from the CNS. Therefore, each synapse is like a ferry boat (chemicals) carrying a car (the impulse) across the gap to the next road in route to the brain and/or spinal cord. This gets further complicated as there are many different chemicals (“ferry boats”) called neurotransmitters that result in different types of responses. These responses are broadly classified into either those that excite or inhibit and result in an action that is incredibly fast, which is often needed to avoid injury or death. The example of touching the stove clearly describes the quick reaction that results from the combined chemical and electrical signaling that takes place. If these chemicals get out of balance, different reactions can occur and many of the medications used in treating depression, bipolar disorder, schizophrenia and other psychological conditions exert their effects directly on these neurotransmitters (such as serotonin).

So as you can see, the nervous system is very complex and yet, very balanced allowing us to function and perform in an automatic, coordinated way, so most of the time, we don’t have to think about what we are doing to a point of exhaustion.

Many things can negatively affect the functions of the nervous system such as trauma/injury, lack of sleep, stress, chemical abuse (alcohol, cocaine, heroin, etc.), and diet.

Chiropractic focuses much attention on balancing these functions through adjustments of the spine, which has both local and more distant effects through “somatovisceral” and “somatic” responses, thus affecting both voluntary and involuntary functions.

Management of sleep, stress, diet, exercise, and other aspects of life are important in maintaining a healthy lifestyle and quality of life.

Much of this information was obtained from In Good Hands Magazine and the following URL (check it out!): http://en.wikipedia.org/wiki/Nervous_system#Nervous_system_in_humans. This site includes many pictures of the CNS and PNS as well as a description of all the components that make up the nervous system.

Jul 27 0

Can Chiropractic Prevent Some Types of Arthritis?

Posted by Rook Torres

This question is asked frequently by patients visiting chiropractors.

To answer this question, let’s first talk about, “what is arthritis?”

The word “arthritis” is derived from “arth-” meaning “joint” and “-itis” meaning “inflammation.”

Hence, arthritis is basically swelling in the joint.

Many types of arthritis have been identified – in fact, over 100!

Some types of arthritis are primary (not caused by anything that can be identified), while others are secondary to a disease or other condition.

The 9 most common primary forms of arthritis are: osteoarthritis, rheumatoid arthritis, septic arthritis, gout, pseudogout, juvenile idiopathic arthritis, Still’s disease, and ankylosing spondylitis.

The most common type that virtually affects everyone sooner or later is osteoarthritis. This is basically the wearing out of the joint, which usually seen in the older person but can be found at any age after trauma or injury occurred or, after an infection in the joint.

The next most common is rheumatoid arthritis, which is an autoimmune disease where the person’s antibodies attack the joint (and possibly other tissues as well). This can occur at a young, middle or older age, whenever the body is triggered to produce the joint attacking antibodies. Crystals deposited in joints can injury the cartilage surface of which the most common is gout- often attacking the base joint of the big toe, and pseudogout.

SO NOW THE QUESTION – CAN CHIROPRACTIC PREVENT SOME FORMS OF ARTHRITIS?

The answer is yes…. sometimes. For example, when a spinal joint is fixated, stuck, or subluxated, the normal biomechanics of the spine are altered because of the faulty movement between the vertebrae.

Restoring movement can restore proper function so excess forces are not exerted on the adjacent levels.

A good example of this is when 2 or 3 vertebrae are fused together (surgical or congenital), the levels above and below the fusion have to work harder for the spine to move and function and tend to become osteoarthritic sooner than the other non-fused levels.

From a more broad approach, lifestyle changes including exercise, weight management, the use of a brace or splint, certain medications and dietary supplements can be helpful as well.

Exercise, in particular, can have significant benefits to the joint surface in both pain relief and slowing down or even stopping the degenerative process (osteoarthritis).

Diet emphasizing an anti-inflammatory approach includes the paleodiet or caveman diet where grains/glutens are avoided and lean meats, fruits, and vegetables are emphasized (see http://www.paleodiet.com/ and http://www.deflame.com/).

Here is a list of websites that offer additional information:

From In Good Hands Magazine

Jul 27 0

Adjustments vs. Other Treatments?

Posted by Rook Torres

Mechanical neck pain affects an estimated 70% of people at some point in their lives. Many different treatment approaches are available for neck pain, making it very difficult for those suffering from neck pain to know which treatment approach(es) to choose. Research in this topic has revealed some very interesting information that places chiropractic and spinal manipulation in a VERY STRONG POSITION – in fact, at the TOP OF THE HEAP!

One such study looked at benefits of spinal manipulative therapy (SMT) in patients with acute and subacute neck pain. This study compared three study groups: 1. SMT only, 2. medication only, and 3. Home exercise and advice (HEA). This study randomized 272 neck pain patients suffering from neck pain for 2 to 12 weeks into a 12 week treatment period using 1 of the 3 treatment approaches tracking the results with the participant-rated pain as the primary treatment outcome measure. Secondary outcome data was obtained from other approaches. The results showed that the group treated with SMT, “…had a statistically significant advantage over medication after 8, 12, 26 and 52 weeks. HEA also had a statistical advantage over medication. Lastly, similar benefits were calculated between the SMT and exercise group. The conclusions support SMT and exercise/advise to be the choice over medication for acute and subacute neck pain patients. Regarding exercise, a similar study showed that “high-dosed supervised strengthening exercise” with and without SMT, was superior to a “low dose home mobilization exercise and advice group at 4, 12, 26, and 52 weeks.”

Regarding chronic neck pain patients (that means pain that has been present for greater than 3 months), this study evaluated the changes that occurred in 191 patients. These patients were randomized to 11 weeks of 1 of 3 treatment groups and evaluated at 3, 6, 12, & 24 months after treatment. The 3 treatment options included: 1. Spinal manipulative therapy (SMT) only, 2. SMT with low-tech neck exercises, or, 3. A form of exercise using a MedX rehab machine. The results support the highest level of patient satisfaction was found in the 2nd group (SMT with low-tech exercise), suggesting that when patients present for treatment, spinal manipulation with low-tech exercises results in the most satisfied patient. These findings are important as this study evaluated the LONG-TERM benefits in patients who have had neck pain for a long time (i.e., “chronic”), where most studies only look at the short-term benefits.

Similar conclusions were reported from perhaps the largest scale study on neck pain based on research from 1980 to 2006 on the use, effectiveness and safety of noninvasive treatment approaches for neck pain and associated disorders. Their review of over 350 articles supported manual therapy (manipulation and mobilization) and supervised exercise to again, SHINE in their conclusions.

What is important is that ALL these studies support what chiropractors do: manipulate the neck and give supervised exercises! So, what are you waiting for? SPREAD THE WORD to everyone that you know who has neck pain – CHIROPRACTIC MAY BE THE BEST CHOICE!!!

Article from In Good Hands Magazine

May 04 0

Chiropractic Care…Safe and Cost Effective

Posted by Rook Torres

With the debate raging on about health care reform, a pilot study indicating chiropractic care and other physical medicine approaches may reduce costs is VERY TIMELY!

In 2008, Wellmark Blue Cross and Blue Shield conducted a 1-year pilot program designed to study the quality of patient care. The researchers concluded that the use of chiropractic and other physical medicine services significantly improved clinical outcomes and reduced health care costs. The 2008 Iowa and South Dakota pilot study included 238 chiropractors, physical therapists and occupational therapists that provided care to 5500 Wellmark patients with musculoskeletal disorders. They reported 89% of all patients receiving physical medicine services improved at least 30% within 30 days. These statistics were so impressive that they decided to continue the program.

Supporters of chiropractic treatment praised the findings, saying that the cost-effectiveness of the method has been documented in several studies.

The president of the American Chiropractic Association, Glenn Manceaux, referred to a 2005 study published in the Journal of Manipulative and Physiological Therapeutics that found chiropractic and medical care have comparable costs for treating chronic low-back pain, with chiropractic care producing significantly better outcomes. Similarly, a study published in a 2003 edition of Spine medical journal found that manual manipulation provides better short-term relief of chronic spinal pain than a variety of medications, he said – “Especially during the health care reform debate, it’s important that chiropractic and other conservative care methods are taken into serious consideration as a cost-effective alternative to the utilization of expensive surge

May 04 0

Patient Satisfaction with Boise Chiropractic Care

Posted by Rook Torres

At a time where patients are constantly being forced to go to different health care providers each year due to their prior doctor “…not being on the list,” are patients truly satisfied with the care/treatment they receive?

If so, what exactly are the reasons and factors that drive patient satisfaction with Chiropractic?

The process of measuring patient satisfaction can be viewed from several different angles.

One study looked at the improvement of the patient’s condition and only 57% of the satisfaction score was based on improvement.

Because the concept of measuring satisfaction is multifactorial, more important methods of measuring patient satisfaction had to be considered.

A recent study did just this – they measured parameters that included pain, disability (activity tolerance), satisfaction with information received, effectiveness of care, caring, and quality of care.

The information was obtained by two different interviewers with similar information received regardless if it was the doctor or a third party.

THE RESULTS SHOWED ALL PATIENTS REPORTED HIGH LEVELS OF SATISFACTION AND THOUGH THE CLINICAL OUTCOMES REGARDING PAIN AND DISABILITY WERE MOST IMPORTANT, THE INFORMATION RECEIVED THAT HELPED PATIENTS UNDERSTAND WHAT WAS WRONG WITH THEM, AND, WHAT COULD BE DONE (BY BOTH DOCTOR AND PATIENT) TO SPEED RECOVERY AND PREVENT FUTURE EPISODES WERE VERY IMPORTANT FACTORS IN THE OVERALL SATISFACTION SCORE.

Patients also wanted timely information so they were kept up-to-date with what was being done at various points in time during care.

The information had to be understandable and informative and explained in “layman’s terms” so that they “learned something” from the information received.

Caring included four questions:

Does the doctor believe what the patient tells them?
Does the doctor understand the patient’s concerns?
Was the doctor comfortable dealing with the patient’s pain?
Was the doctor concerned about the patient after they left the office?

The information gathered included treatment, doctor confidence, and prognosis (how long it might take to get better). Also, effectiveness was further divided into listening, knowledge, experience, and the use of an active management approach.

The conclusion of the study emphasizes the importance of using a mixed-method approach when examining patient satisfaction.

This includes quantitative “scores” from questionnaires as well as qualitative information about the encounter including information, caring, and effectiveness.

May 04 0

How to Explain Chiropractic to Others in Boise

Posted by Rook Torres

We cannot thank our family, friends, patients, and allied health care providers enough for referring patients to our practice.

There is no other form of advertising that attracts the quality of patients as those our patients refer to us.

So, here’s some information that may help you tell others about us: Chiropractic has been around since 1895 and is the third largest healthcare profession in the world:

The primary focus of treatment includes the neuromusculoskeletal system (nerves, muscles, joints) such as disk herniations (e.g., sciatica, pinched nerves), sprains and strains, sports injuries, neck pain (e.g., whiplash), headaches, and many others.
The treatment includes a “hands-on” approach where massage, manual traction, joint manipulation and mobilization are commonly utilized. In general, the treatment typically feels good and patients look forward to the process.
In many cases (such as low back pain, neck pain, headaches), chiropractic care may function as the primary or only treatment that is needed. However, when other medical conditions co-exist, the combination of chiropractic and medical treatment is often better than either one by itself (depending on the condition).
Doctors of chiropractic commonly refer back and forth with medical and osteopathic doctors, creating a “win-win” for the patient and providers.
Over the last 20-30 years, a significant volume of research has been published finding chiropractic approaches to be either equal or superior to other forms of healthcare provision for low back and neck pain, headaches, and other conditions.
Many hospitals, medical clinics and VA facilities have integrated chiropractic into their healthcare systems. Medicare and Medicaid have included chiropractic coverage since the 1970’s and most private insurers include chiropractic coverage due to the significant volume of research reporting the benefits, cost savings, and patient satisfaction.

Your individual story may actually be the most important thing you can share.

The following are a few of the many websites that include great information about chiropractic that may also be appreciated by the potential “internet savvy” future chiropractic patient:

We look forward to giving your family, friends, and co-workers the same quality care that you’ve been receiving!

May 04 0

Chiropractic Care…Safe and Cost Effective and…

Posted by Rook Torres

“Ever since I was in my early teens, I’ve had muscle and joint problems that would come and go but never put me down where I couldn’t function. I was very active and played basketball, tennis, and ran in track but over the last 10 years I’ve avoided a lot of activity due to my problems. Now, after having a couple of children and gaining some weight, I notice more frequent and intense back problems and I’m getting quite concerned over the changes that have been taking place and afraid to do things. I talked about this with my family and friends and some have recommended chiropractic, some recommend physical therapy, others suggest medication and one even suggested shots! Quite frankly, I’m totally confused as to what to do!”

This scenario may sound familiar to many people.

The choice of health care provision is a personal one, often influenced by those around you – family, friends, teachers, and more!

It seems like everyone is an “expert” with different opinions and their advice, often conflicting, can lead to confusion about what is best for you.

There are many ways to approach back trouble, regardless of the diagnosis or condition.

First, all health care providers are biased in that they naturally focus on their specialty. If you choose to consult with a surgeon, s/he will look at your condition from a surgical perspective. Various surgical options may be discussed, tests are usually recommended and the process begins.

When consulting with a family physician, the typical approach is pharmaceutical or drugs such as anti-inflammatory medications (Advil, Nuprin, Ibuprofen, Aspirin, Aleve, Tylenol, etc.), heat or ice, activity modifications (possibly rest or mild/moderate activity), and possibly referral for chiropractic or physical therapy.

In reviewing the various guidelines, it is recommended to start with the least invasive, safest, most cost effective approaches first.

Unless “red flags” like cancer, fracture, infection or progressive severe neurological losses are present, surgery is not a logical initial approach.

Chiropractic has been recommended as a first or initial choice as it has been found to be safe, highly satisfying, non-invasive, and cost effective.

The typical approach includes a thorough history, an examination that includes an analysis of posture, motion, function and includes the whole body.

For example, if one leg is short, the pelvis will tilt and spine is often crooked. That needs to be corrected for both long and short term results.

If the feet pronate and the arches are flat, the effects on gait/walking on the ankle, knee, hip and back can lead to trouble or perpetuate current problems.

Deconditioning or, being out of shape is an important aspect included in the chiropractic management process.

If these methods fail to bring about satisfying results, referral for more invasive approaches will be considered.

May 04 0

What Type of Doctor Should You See In Boise For Back Pain?

Posted by Rook Torres

Have you ever considered who is the best in Boise suited to treat back pain?

Since there are so many treatment options available today, it is quite challenging to make this decision without a little help.

To facilitate, a study looking at this very question compared the effectiveness between medical and chiropractic intervention.

Over a 4-year time frame, 2780 patients were followed with questionnaires. Low Back Pain patients were treated using conventional approaches by both MDs (Medical Doctors) and DCs (Doctors of Chiropractic).

Chiropractic treatments included spinal manipulation, physical therapy, an exercise plan, and self-care education.

Medical therapies included prescription drugs, an exercise plan, self-care advice and about 25% of the patients received physical therapy.

The study focused on present pain severity and functional disability (activity interference) measured by questionnaires mailed to the patients.

It was reported that chiropractic was favored over medical treatment in the following areas:

Pain relief in the first 12 months (more evident in the chronic patients)
When LBP pain radiated below the knee (more evident in the chronic patients)
Chronic LBP patients with no leg pain (during the first 3 months)

Similar trends favoring chiropractic were seen for disability but were of smaller magnitude.

All patient groups saw significant improvement in both pain and disability over the four year study period.

Acute patients saw the greatest degree of improvement with many achieving symptom relief after 3 months of care.

This study also found early intervention reduced chronic pain and, at year 3, those acute LBP patients who received early intervention reported fewer days of LBP than those who waited longer for treatment.

While both MDs and DCs treatment approaches helped, it’s quite clear from the information reported that chiropractic should be utilized first.

These findings support the importance of early intervention by chiropractic physicians and make the most sense for those of you struggling with the question of who to see for your LBP.

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