10 Things Most People Don’t Know About Chiropractors

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1. Pain is the last symptom of dysfunction. A patient’s back is often restricted or unstable for months or years before it presents as a problem and they show up in a chiropractor’s office. In addition, the absence of pain is not health. While medication may be needed, if you take a pill and the pain goes away, the dysfunction that caused it still persists. Muscle, ligament and joint injuries often occur as a result of long-term biomechanical dysfunction, sometimes from past injuries, making the area more susceptible to future injury.

2. Athletes use chiropractors to stay well and perform better, not just for the occasional injury.

Athletes choose chiropractors because we are movement specialists. Chiropractors were spotted all over the Olympic coverage last year, and top athletes such as Michael Jordan, Tiger Woods, Michael Phelps, Tom Brady, Evander Holyfield, and Arnold Schwarzenegger have all been proud patients of chiropractors. These days it’s far more common than not for major athletes and sports teams to keep chiropractors nearby to help prevent injuries, speed injury recovery, improve balance and coordination, and give them a greater competitive edge.

3. The body does not perform as a cluster of separate mechanisms, but rather a cascade of events that all starts with proper control by the nervous system.

The nerves that travel through and control every function of your body originate at the spinal cord and their transmission may be disrupted if the joints of the surrounding spinal column are not moving properly. This disruption in biomechanical integrity combined with altered physiological function is what chiropractors call a subluxation. Below is a chart that illustrates the relationship of the spinal nerves exiting the vertebra branching off to the various organ systems. You can see why it is not uncommon for a chiropractor to treat a patient with mid-back pain who also suffers from irritable bowel system, a patient with a subluxated sacrum who has been unsuccessfully trying to become pregnant, or a patient with an upper back fixation and acid reflux.

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4. Doctors don’t do the healing.

Sorry to disappoint you, but a chiropractor will never fix your back. What we are able to do is restore proper motion in the joints, which relieves tension on the nerves and muscles and allows your body to do the healing that it is inherently made to do. As chiropractors, we believe that the body is a perfect organism in its natural state, and all disease comes from a disruption in the body’s proper transmission of signals by the nerves which affects its ability to heal and to defend against disease-causing agents. We never treat disease. We assess to find which spinal levels are causing the disfunction, and we adjust it to restore proper nerve flow so the nervous system may work as efficiently and effectively as possible.

5. Chiropractic is for all ages. Many seniors aren’t aware of the benefits of chiropractic care which can help them not only with pain relief, but also increase range of motion, balance and coordination, and decrease joint degeneration. There’s no patient too young for chiropractic either! Chiropractors check infants moments after birth for misalignments of the upper vertebrae that may occur as a result of the birth process. In addition to supporting overall health and well-being, parents also take their children to chiropractors to encourage healthy brain and nervous system development, to assist with colic, asthma, allergies, bed-wetting and sleeping problems, and to assist with behavioral disorders.

6. We know about more than your backbone! This surprises many people who had no idea that chiropractors give advice on nutrition, fitness, ergonomics and lifestyle, screen for conditions unrelated to the musculoskeletal system and refer out to other practitioners when necessary. Chiropractors are also able to complete specialties in other areas such as pediatrics, sports rehabilitation, neurology, clinical nutrition, and addictions and compulsive disorders.

Other than particular specialties and the differences in learning to adjust and learning to prescribe medication, our training hours are not dissimilar from that of medical doctor. The following are the classroom hours for basic science requirements compiled and averaged following a review of curricula of 18 chiropractic schools and 22 medical schools.

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7. Successful chiropractic patients accept responsibility. When somebody says that they tried chiropractic and it didn’t help, I cringe and get the feeling that they really missed the boat. Of course, there are cases with complicating factors, but I have heard this from people with straightforward chiropractic problems when it is very clear what has happened here. In most cases, one doesn’t acquire back pain over night, and it’s not going to go away over night. If a weak core from years of sitting at your desk is to blame for the additional stress on your joints, I would expect an adjustment to provide relief, but once the condition is no longer exacerbated, I would most definitely prescribe some exercises for you to do at home. I might also suggest we evaluate your nutrition if I suspect an inflammatory diet may be wiring you for pain.  Sure, I’m always happy to adjust someone, but if you’ve been given homework and you don’t do it, remember that this has to be a team effort!

8. Chiropractic may help you get sick less. Studies have indicated that adjustments consistently reduce the production of pro-inflammatory mediators associated with tissue damage and pain, and may also enhance the production of immunoregulatory complexes important for healthy immune system defense. As far back as the deadly flu pandemic of 1917-1918, chiropractors noticed that their patients seemed to have fewer fatalities than among the general population and were able to publish their work in an osteopathic journal since no scholarly journals were accepting chiropractic data. The estimated death rate among patients of conventional medical care in the U.S. was estimated at 5 to 6 percent while the fatality rate among influenza cases receiving spinal adjustments was estimated at 0.25%.

9. “I heard I’ll have to go forever” is a myth. You may want to go to your chiropractor forever once you’ve started because you didn’t realize how great getting adjusted is, but your doctor won’t expect you to come for continuous care without symptoms. Generally, if you come in with pain, once you’ve been treated for your initial complaint, you’ll be scheduled for a few more appointments to make sure proper motion is being maintained, then it will be recommended you return occasionally to be checked just like you would go to the dentist to get checked for tartar buildup and cavities. Of course, many people still choose to see their chiropractor weekly or monthly for wellness or maintenance care.

10. Adjustments don’t hurt. There is no bone snapping or warrior-style pulling heads off spinal columns! The neck adjustment some chiropractors use causes anticipation for many new patients, but is actually much more gentle than they imagined, and involves a quick, direct thrust to a specific spinal bone. The sound an adjustment makes is called a cavitation and is only space being created within the joint causing gasses to be released from the joint capsule, which creates the popping or cracking noise. Also, chiropractic adjustments will not wear out your joints, as some imagine because they have been warned not to “crack their knuckles” for this reason in the past. Adjustments, unlike “knuckle cracking” or having your friend stomp on you while you lay on the carpet, are applied specifically to improve the motion of your joints and limit the small dysfunctions that over time can lead to arthritis. Most people after an adjustment describe the feeling as being “lighter”, having greater ease in moving the body, and being able to stand up taller.

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Don’t Call Them Pill Mills: Pain Management Practices Recoil at Bad Rap

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Imagine comparing The New York Times to the National Inquirer. Or Lawrence Olivier to Fabio. Or Van Gogh to Thomas Kinkade.

What Are Pill Mills?

Lawmakers and law enforcers have been cracking down recently on clinics, as well as doctors and pharmacies, that illegally or irresponsibly dispense prescription narcotics. These clinics, known as “pill mills”, sell prescription drugs to those who have no medical need of them, or in excessive amounts, and have directly contributed to many of the recent restrictions that have been placed on the distribution and availability of prescription drugs. Although they can be found all over the country, they have made most notable headlines in Florida and Texas, which the Drug Enforcement Agency believes to have the greatest numbers of mills.

“The typical pill mill,” says Vinod Malik,  a West Coast physician with several board certifications and the director of PRC Associates for 11 years, “you walk in, no appointment needed, no evaluation by a physician, you pay cash, you get your prescription, and you go home.”

How are Pain Management Clinics Different?

A pain management clinic (in the general legal definition) is a facility providing pain treatment options or that has at least one doctor licensed to prescribe controlled medication for pain. Pain clinics are subject to legal rules and standards, such as being licensed, being subject to inspection by the board and the state, employing licensed staff, etc. Prescription pain medication is regulated by federal law, so doctors who prescribe it “without a legitimate medical purpose or outside the usual course of medical practice” can be charged with drug trafficking. At “pill mills”, the doctor, pharmacist, or other operators sell these medications to people without valid medical reason, or in large quantities, making a significant profit for themselves in the process. People even travel from out of state to purchase medication from these mills. This flood of powerful and easily-accessible drugs has contributed to a significant rise in street usage of and addiction to narcotics; overdosing on prescription drugs is now the second-leading cause of accidental death in the United States.

Male Patient Visiting Doctor's Office With Back Ache

One particular Palm Coast pain management practice, as Kavita Sharma, a pain management doctor, prefers to identify it (rather than a mere “clinic,” because “no one can walk in and say, I want to be seen today”), couldn’t be further from that. No walk-ins are accepted. It’s a referral-only practice. It’s an elaborate, “interventional” pain management operation staffed by board certified doctors, each with at least two board certification, each predisposed to shun pills, each dealing directly and exclusively with his or her patients without the intercession of nurse practitioners or physicians’ assistants.  The four doctors have privileges at all Florida Hospital facilities. Pill mill doctors not only would generally be denied such privileges: they’d be segregated from the rest of the medical community, which doesn’t want to be associated with them.

“Pill only” therapy generally goes against the doctors’ principles and medical philosophy: they’re there to cure patients of their pain or their dependence on narcotics, not to feed it. And they do so mostly through “interventional” means such as injections, radiofrequency ablations, and other, equally tongue-twisting procedures that pill mill patrons have no use for.

Patients are required to sign a narcotic agreement and submit to urine tests to ensure that they’re following their prescribed regimen. If any diversion is detected, it’s a sign that the patients are either abusing the drugs or selling them. If, for example, they’ve been prescribed certain pills but their urine doesn’t show that they’ve been using them at the correct dosage, they’re not in compliance with their narcotic agreement.

“If they don’t comply with that they get fired,” Sharma says. “You actually discharge the patient if they don’t comply with or fail a narcotics screening.” She adds: “Word on the street is, if you want your pills, don’t go top these doctors. They won’t write prescriptions for it.”

The general public has been made little aware of the challenges posed by pill mills or of the important nuances and differences between pill mills and pain management practices.

In response, some states have now placed limits on the amount of drugs doctors can prescribe, which some argue has made it more difficult and expensive for people who actually need them to obtain them. Either way, doctors engaging in criminal activity with their prescriptions at pill mills have made even legitimate doctors subject to closer scrutiny.

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Signs that a facility may actually be a pill mill include not requiring a physical exam, x-rays or medical records before being prescribed drugs, being able to pick your preferred medication, being directed to “their” specific pharmacy, and treating pain solely with pills. Pill mills also tend to open and close very suddenly, as an attempt to evade law enforcement.

So pill mills, for now, continue to thrive, feeding addictions—and damaging the reputation of the legitimate and necessary pain management profession.

Original articles here & here 

Chronic Pain Common in Children

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A new study shows that chronic pain is common in children and that girls suffer more often from chronic pain than boys.

Researchers in Nova Scotia reviewed 32 studies on pain in children and found that headaches were the most common complaint. 23% of children between the ages of 7-18 had weekly headaches and 5% daily headaches. Abdominal pain, back pain and musculoskeletal pain were common, too. Overall, between 11% and 38% of children in the studies experienced some type of chronic pain.

“These rates are of great concern, but what is even more concerning is that research suggests that the prevalence rates of children have increased over the last several decades,” said lead investigator Sara King, PhD, Assistant Professor at Mount Saint Vincent University in Halifax. “We found that persistent and recurrent chronic pain is overwhelmingly prevalent in children and adolescents, with girls generally experiencing more pain than boys and prevalence rates increasing with age. Findings such as these argue that researchers and clinicians should be aware of the problem and the long-term consequences of chronic pain in children.”

Chronic pain is defined as pain that persists or progresses over a long period of time and is often resistant to medical treatments. Persistent or recurring pain may cause children to miss school, become less social and puts them at a greater risk of developing anxiety, depression and low self-esteem.

Although the causes aren’t always known, chronic pain could be triggered by a number of different medical conditions such as diabetes, arthritis, migraine, fibromyalgia, cancer, shingles, sciatica, and previous trauma or injury. Chronic pain may worsen in response to environmental or psychological factors.

While the method for describing pain intensity has improved, chronic pain in children is escalating and long-term effects can grow into adulthood. Finding the causes of chronic pain can help lessen negative long-term effects for them when they reach maturity.

Understanding pain patterns in children may ease their suffering and help explain how and why adult chronic pain occurs. “Results of this review indicate that persistent and recurrent chronic pain is overwhelmingly prevalent in children and adolescents and should be recognized as a major health concern in this population,” the authors said.

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Their study appears in the December issue of the journal Pain

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Back Pain Management 101

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Are you doing everything you can to relieve your back pain?

(HealthNewsDigest.com) – West Orange, NJ, April 28, 2015 – People with chronic back pain may have already tried an array of non-invasive pain management methods to dull the ache, including exercise, medications, physical therapy, hot and cold packs and other techniques. But many don’t know about three innovative non-surgical procedures that can radically increase the odds of longer-term relief, according to pain management specialist Brian A. Bannister, MD, of Atlantic Spine Center. With back pain affecting 80% of adults at some point in their lives, learning about this trio of procedures should be considered Back Pain Management 101, along with all the other conservative treatments used to keep up an active lifestyle in the midst of recurring back pain.

“Many people with lower back pain are aware how common the problem is, but don’t think to visit a health care provider who specifically treats patients dealing with it every day,” says Dr. Bannister. “That needs to change if they’re to avail themselves of the widest possible array of non-invasive treatments that might help them live their lives normally again, painlessly.”

Three effective back pain management procedures

What are these non-surgical procedures? Dr. Bannister explains:

  • Epidural steroid injections: These injections deliver a long-lasting steroid and a local anesthetic into the epidural space in the spinal cord. The steroid cuts inflammation and irritation of the nerves and the anesthetic interrupts the transmission of pain signals. Epidural steroid injections are commonly used for many causes of back pain, including radiculitis (pain that radiates from an irritated spinal nerve root); compressed nerves in the neck or lower spine; degenerative disc disease; spinal stenosis; herniated discs; and sciatica.
  • Radiofrequency nerve ablation: Also known as radiofrequency lesioning or neurotomy, this treatment uses a specialized device to block nerve signals in affected spinal areas, with relief lasting 3 to 18 months. Fluoroscopic x-rays allow the accurate placement of a special heated probe next to affected nerves. Radiofrequency nerve ablation is used to treat spinal arthritis; stenosis; facet arthritis; whiplash; and sprains and strains.
  • Spinal cord stimulator: This procedure inserts electrical wires into the spinal canal to stimulate the spinal cord, producing electrical impulses that interfere with pain signal transmission to the brain. Painful spinal cord stimulation is then replaced with a more pleasant tingling sensation in areas where pain is usually felt. Spinal cord stimulation is done on patients whose previous spine surgery failed, or have severe nerve-related pain or numbness, or have neuropathic pain and surgery is not an option.

Tips and advantages to non-surgical procedures

All treatments have pros and cons, but this trio of non-surgical back pain management techniques boasts an impressive list of advantages, according to Dr. Bannister. Not only are they minimally invasive, but they require minimal or no blood loss, reduce the reliance on pain medications, and don’t involve removal of muscle or bone.

An additional benefit really stands out: The pain relief these procedures provide can help confirm a patient’s specific diagnosis – the initial cause of their back pain. Pinpointing the diagnosis can then help doctors decide what may eradicate the pain permanently.

“Many of these procedures take less than an hour to complete, and patients can go right back to work or other activities,” Dr. Bannister says. “From a quality of life aspect, these treatments are great. I’m hoping more chronic back pain sufferers learn more about them in order to take advantage of these benefits and get back to doing their favorite things without nagging pain.”

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Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. www.atlanticspinecenter.com,www.atlanticspinecenter.nyc

Brian A. Bannister, MD, is a pain management specialist board-certified in anesthesiology at Atlantic Spine Center.

See original article here 

What is Pain Management?

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The specialty of chronic pain management

1. What does a pain management specialist do?

A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause at all.

As the field of medicine learns more about the complexities of pain, it has become more important to have physicians with specialized knowledge and skills to treat these conditions. An in-depth knowledge of the physiology of pain, the ability to evaluate patients with complicated pain problems, understanding of specialized tests for diagnosing painful conditions, appropriate prescribing of medications to varying pain problems, and skills to perform procedures (such as nerve blocks, spinal injections and other interventional techniques) are all part of what a pain management specialist uses to treat pain. In addition, the broad variety of treatments available to treat pain is growing rapidly and with increasing complexity. With an increasing number of new and complex drugs, techniques, and technologies becoming available every year for the treatment of pain, the pain management physician is uniquely trained to use this new knowledge safely and effectively to help his or her patients. Finally, the pain management specialist plays an important role in coordinating additional care such as physical therapy, psychological therapy, and rehabilitation programs in order to offer patients a comprehensive treatment plan with a multidisciplinary approach to the treatment of their pain.

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2. What should I look for in a pain management specialist?

The most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem and with whom you feel a comfortable rapport. Since many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques, pain specialists today must have more training than in the past, and you should learn about how your pain physician was trained and whether he or she has board certification in pain management.

The widely accepted standard for pain management education today is a fellowship (additional training beyond residency which occurs after graduating from medical school) in pain management. Most fellowship programs are associated with anesthesiology residency training programs. There are also fellowship programs associated with neurology and physical medicine and rehabilitation residency programs. The fellowship consists of at least one year of training in all aspects of pain management after completion residency training. When a physician has become board certified in their primary specialty and has completed an accredited fellowship, they become eligible for subspecialty board certification in pain management by the American Board of Anesthesiology, The American Board of Psychiatry and The American Board of Neurology, or the American Board of Physical Medicine and Rehabilitation. These three are the only board certifications in pain management recognized by the American College of Graduate Medical Education.

In addition to learning about your pain physicians training and board certification, you also should ask whether they have experience with your specific pain condition and what types of treatments they offer. Do they only perform procedures or do they use a multidisciplinary approach to pain management? Who do they refer to for other treatment options such as surgery, psychological support or alternative therapies? How can they be reached if questions or problems arise? What is their overall philosophy of pain management?

3. How can I be referred to a pain management specialist?

The best way to be referred to a pain management specialist is through your primary care physician. Most pain physicians work closely with their patients’ primary care physicians to insure good communication, which in turn helps provide the optimum treatment for their patients. Patients are also often referred by specialists who deal with different types of pain problems. Back surgeons, neurologists, cancer doctors, as well as other specialists usually work regularly with a pain physician and can refer you to one.

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4. What should I expect during my first visit to a pain management specialist?

On your first visit to a pain management specialist, he or she will get to know you and begin to evaluate your particular pain problem. This will usually involve a detailed history, a physical exam and review of tests that you have had performed. The questions you are asked and the physical examination will focus on your particular problem, but your pain physician will want to know about past and current medical history as well.

Often you will be given a questionnaire before your first visit that will ask detailed questions about your pain problem, and you will probably be asked to bring any imaging studies (such as X-rays, computed tomography [CAT] scans, or magnetic resonance imaging [MRI] scans) or other tests that have already been done. You should know before your first visit whether or not a procedure is anticipated. If so, you may need a driver to take you home.

Most importantly, this visit is an opportunity for your pain physician to begin to analyze all of this new information and discuss with you an initial assessment of your pain problem. He or she may know exactly what is causing your pain, or perhaps further diagnostic procedures will be needed. But no matter what type of problem you have, you should leave this first visit with a clearer understanding of your pain and the course of further evaluation and treatment that is planned.

Original Article Here

How to avoid lower back pain during sleep! *ZzZzzz

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If you have ever used the phrase “I must have slept funny” to explain why you woke up with an achy back, you’re not alone.

In fact, research shows one in three people experience back and neck pain after a single night’s sleep.

Occasional back pain after sleeping can sometimes stem from your sleeping surface or from the position in which you sleep.

We got this email from a viewer:

Dear Dr. Manny,
Lately I have been waking up with a stiff and painful lower back, even when I don’t have pain the night before. What could be going wrong?
Thanks,
Ally

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Simple changes may help relieve some of the strain your back may incur while you rest.

Many physicians suggest trying a new mattress if your bed is too hard or sags in the middle. Mattresses that are too stiff or too saggy do not properly support the joints, causing pain.

“To some extent there’s no magic formula because we’re all different shapes and sizes, but it’s a matter of finding a comfortable mattress,” Grant Wilson, a physiotherapist and the co-author of “7 Steps to a Pain-Free Life,” told FoxNews.com. “Most people are more comfortable with a reasonably firm mattress and certainly a solid base. A reasonably firm mattress keeps the spine straight and therefore lessens pressure on all the joints and the structures around the spine.”

How you sleep also impacts how you feel in the morning. It’s estimated that 17 percent of people sleep on their backs– a position widely known to help with back pain.

Wilson said there are two sleeping positions you should try to avoid.

“Sleeping on your side and curled up in a ball is not the best position because it tends to build up that pressure in the structures and discs in the back, particularly if we sustain that posture for a long time at night. You want to be in a more neutral position,” Wilson said. “And some people sleep on their stomach, but again that’s not advisable, particularly if people have neck pain or headaches.”

If you sleep on your back or on your side, Wilson suggests using a night roll, a belt-like pillow with the padding on the back.

“The idea of a night roll is that by wearing it around your waist, it fills in the gap between your hips and your rib cage, and therefore keeps the natural curves in your back and in your spine,” he said.

Night rolls can be purchased online and at some local pharmacies. Wilson said you can also try to make one yourself at home by rolling up a full-size bath towel and tucking it into one leg of a pair of pantyhose or tights.

“Roll it up so that it’s a nice firm ball, put that around your waist and either pin it or just tie it in place, so it’ll stay firm if you roll from side to side during the night,” he said.

If your back pain continues, Wilson advises speaking with your doctor.

Original Article Here