Neck Pain? It might be Spasmodic Torticollis

Spasmodic torticollis (“torticollis”) is a condition involving painful spasm of very specific muscles that attach to the neck. The term torticollis literally means “twisted neck.”

Typically, this condition involves spasm of the trapezius (Fig. 1)and/or sternocleidomastoid (SCM) (Fig. 2) muscles.  The most common presentation is strong spasm with pain on one side, which makes it difficult to turn the neck or actually holds it in a tilted and twisted position. 

The trapezius and SCM share a common nerve supply, the Spinal Accessory Nerve, which is also the 11th Cranial Nerve. Although cranial nerves typically begin and end within the skull, the Spinal Accessory Nerve is an exception, and has important internal connections in the cervical spine (neck). 

Frequently, torticollis occurs from having the neck in an awkward positon for a lengthy time. Because it is often noticed upon waking,

people usually tell us they “slept wrong.”  The spasm occurs because the abnormal positioning irritated a joint or nerve in the neck. Spasm is a protective mechanism designed to prevent further injury, in this case to a joint or a nerve.

Treatment involves reducing the irritation to the joint and nerve and stretching out the muscle. The most effective stretching techniques to reduce the spasm of torticollis are assisted stretches (done with a practitioner’s help) abbreviated PNF/PIR. When combined with chiropractic adjustment, electric stim for pain, and ultrasound to break up any trigger points, full recovery is usually realized with 2 weeks of regular care.  Persistent pain or stubborn trigger points may be addressed with acupuncture and massage.  If you think you might have this and it has not improved in a couple days, call today!

Pain Control Without The Pills

Pain is a very personal experience. It is often difficult for people to put their pain experience in words because the pain affects them in so many ways. Regardless, the first and foremost thing we must do is try to identify the source of the pain. Sometimes this is straightforward, such as a herniated disc clearly visible on MRI, sometimes it is not, like chronic pain that started years prior from seemingly nothing at all.

Once the source of the pain is identified, we can plan a course of action. While certainly medications have their place, we must remember that pills do not correct the cause of the pain, rather they mask it. Instead, we want to identify and address the root cause of pain.

Pain usually starts with an injury. Now, an injury may or may not be painful when it occurs. Sometimes, it takes a day or two before the pain comes, and by then you may have forgotten what happened. When an injury occurs, some of the cells that make up the injured tissue rupture and release chemicals that increase blood flow and cause swelling to occur. Take a bruise, for example. Bruises occur when a blood vessel is ruptured and blood leaks out into the surrounding tissue. Swelling distorts the tissue and increases pressure, which irritates local nerves. The nerve irritation is what causes pain.  The cycle of pain and inflammation will continue until the tissue is healed.

At our office, we attempt to address the root cause with several interventions that work best when used together. C.A.N.E. is an acronym we use for Chiropractic, Acupuncture, Nutrition, and therapeutic Exercises individually designed to hit pain at the source and put you on the path to true recovery.

As you can see, the treatments we use affect the cycle of pain and inflammation at multiple points to interrupt it and allow your body to heal the best it possibly can.  Without targeted interventions such as these, the body may lay down scar tissue with a loose collection of free nerve endings that typically result in the development of chronic, dull, achy pain. This type of pain is much harder to eliminate.

One of the most common questions we get about treatment is, "How long will it take for me to get better?" Most conditions respond very well within 2-4 weeks if we catch them right away. However, we have to remember that healing is a process, and what we do here is attempt to remove barriers to promote healthy healing. Every situation is unique, and we try very hard to reduce healing time and get you back to normal as quickly as possible.

Why live with pain when there are non-drug, non-surgical pain relief and healing options open to you? Call us today to see if C.A.N.E can help your condition!

Still not losing weight? This might be the problem...

I can tell you from personal experience, losing weight is serious business. We look for all the breaks we can get when trying to shed a few (or more than a few). One of the crutches I leaned on was diet soda. I had a particular fondness for Coke Zero and Diet Dr. Pepper. That sweet, fizzy nectar would calm the craving for sweets.

Over the past couple years, however, it's become harder to shed those unwanted pounds, even if I curbed my carbs to a level I knew would drop my insulin level enough to cause weight loss. Not sure what insulin has to do with weight loss? Click here. Once I cut out the diet soda, weight loss resumed at the expected rate.  I had a sneaking suspicion it was the culprit, so I did a little digging.

A study in Diabetes Care from 2009 examined how diet soda influenced the risk of metabolic syndrome (aka syndrome X) and Type II diabetes. The skinny is, if you'll pardon the pun, diet soda consumption was associated with a 36% greater risk of metabolic syndrome and a 67% greater risk of Type II diabetes vs. those who didn't consume diet soda.  Those are significant numbers! While this study examined diet soda specifically, I don't think it's a stretch to assume use of any artificially sweetened product will probably cause the same issues.

What it boils down to is that when the taste buds tell the brain, "Hey, we just ate something sweet," whether it's sugar or an artificial sweetener, the brain tells the pancreas, "Time to squirt some insulin into the blood stream to handle the sugar." Exposure to elevated insulin levels over a prolonged period eventually causes cells to become desensitized or resistant to insulin. The effects are pre-diabetes, metabolic syndrome, and eventually, Type II diabetes.

Still crave the crispness of soda, but don't want to increase your risk of diabetes? There are many varieties of non-caloric flavored club sodas and sparking waters that contain no artificial sweeteners whatsoever. They're quite satisfying and may help get you off the diet soda!

Nettleton JA, Lutsey FL, et al. Diet soda intake and the risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2009 Apr 32(4); 688-94.

Road Trip Travel Tips

Summer-ish weather and cheap(er) gas add up to ROAD TRIP!  With the warmer weather, we've already made some runs up the Red Arrow Highway into Southwestern Michigan. Soon more and more of us will be getting out of Dodge to de-stress and visit friends, families and see more of this great country. We've compiled some tips for healthier, more comfortable travel.

1. Adjust your seat, headrest, and mirrors. This recommendation is particularly important to prevent driver fatigue, but is also necessary to properly support the spine and minimize injury in a collision. First, adjust your seat so that you are comfortably able to keep both hands on the wheel and operate the pedals with your back fully against the seatback. Second, the top of the headrest should be even with the top of your head. This is vitally important to reduce the chance of serious injury during front and rear collisions. Next, while sitting with your back against the seatback and head against the headrest, adjust your mirrors so you can see outward in this fully supported position.
2. Drink water. This ubiquitous recommendation is especially important in all types of travel because traveling promotes dehydration. Downside: You’ll have to stop at the rest area more often. Upside: You’ll automatically comply with item 6!
3. Open the windows. You’ve probably heard that the air inside your home is more polluted than the air outside. What kind of air do you think is circulating in the cabin of your car with 2 or more people and perhaps a pet?!! Even if it's hot or a little chilly, open a window for a minute or two to get fresh air into your car. 
4. Put away the phone and/or tablet. There's a lot to see outside that's far more interesting than another story about another celebrity. Plus, the head down posture added to the vibration from the road will leech the water content out of the discs in your neck, leading to stiffness, pain, and spasm.
5. Consider a neck pillow. If you're going on a particularly long drive, or you're one of those people who fall asleep quickly when riding in a car, consider a wrap around neck pillow to keep your head from falling forward or to the side. The last thing you want is waking up with a "kink" in your neck.
6. Hit the breaks! Take the time to get out of the car, stretch, and walk around every 2 hours. This will prevent some of the muscle stiffness and static strain that comes from prolonged sitting and immobility. Movement also helps lubricate your joints and keep your discs hydrated.

So, hopefully these tips will make your next road trip more comfortable and enjoyable. If you find yourself wandering into Southwest Michigan, don't pass up the Swedish bakery in Harbert (cash only) or the Whistle Stop for a coffee (both on the Red Arrow Highway, Route 12)!

Three Techniques to Reduce Stress (and Pain) Now!

Let's face it: we live in a stressful time. There are myriad factors that contribute to our stress: work, family, bills, and our special treat this year: politics. Some stress is good, like the excitement before receiving an award or the upcoming wedding of your child. The problem really stems from chronic stress and our inability to come down from it. High blood pressure and trouble sleeping are two physical effects of chronic stress, but it does have another effect as well: the amplification of pain.

Stress amplifies pain not by intensifying the signal itself, but by making the perception of pain more noticeable in the brain. Much like we become irritable to stimuli that would normally be ignored, stress removes our ability to ignore pain signals. If the pain becomes overwhelming, it might trigger muscle spasm or a migraine. This, in turn, may increase stress!  It can become a vicious cycle.

The following techniques may help you manage stress more effectively. They can be done anywhere, but would be most effective in a quite place where you won't be disturbed.

1. "2 to 1" breathing. This simple breathing technique is typically taught in yoga. It's simple to explain but often requires practice to do correctly: When you inhale, simply count how long it takes you to breath in, then, try to take twice as long to breath out. So, if it takes you three seconds to breath in, take six seconds to breath out.  This engages your diaphragm, the muscle that helps you draw air into your lungs. By slowing down the movement of the diaphragm, we activate the parasympathetic division of our autonomic nervous system. The parasympathetic division is responsible for "down time activities," such as eating and sleeping, as opposed to the sympathetic division, commonly referred to as "fight or flight."
2. Visualization. Imagine yourself in the most relaxing environment you can think of. For some it's a tropical beach, for others it might be a mountain stream. Close your eyes and visualize yourself there, without any cares or concerns. Let any worries pass as quickly out of your head as quickly as they come. Not letting stressful thoughts infiltrate your mental vacation is the most difficult aspect of this exercise. It's a discipline to turn your brain off to the outside world, but it's well worth practicing.
3. Progressive Muscle Relaxation. This is a stress management classic. Starting at either the top of your head or the tips of your toes, you will contract and then relax more and more of your muscles. For instance, if you start at your toes, contract just your toes for a few seconds, squeezing as much as you are comfortable with and then completely relaxing them. Next, contract and relax the muscles of your toes and your feet. Then, do the toes, feet, and ankles. Continue until you reach the top of your head. PMR makes you aware of where you are already tight, and what it actually feels like to relax.

Still can't relax?  You may need some help!  Consider massage therapy or acupuncture. As strange as it sounds, most patient report a profound sense of relaxation both during and some time after their visits. We've recently lowered our prices for massage and acupuncture, so it's a perfect time to try either or both!

Pre-diabetes: Why you need to take weight loss seriously now!

Prediabetes is a condition in which blood glucose levels are higher than normal (normal range 70-100mg/dL) but not high enough to be diagnosed with diabetes (levels over 125mg/dL). Risk factors include being overweight (BMI > 25), being older than 45, high blood pressure, and family history.  Pre-diabetics are at a very high risk for developing Type II diabetes, stroke, and heart disease.

The typical recommendation is to eat less and exercise more. The problem with that equation is that it is not sustainable. Exercise makes you more hungry because the energy requirement of the body is increased.  Exercise is great for preventing, or even reversing prediabetes. 30 minutes 5 times per week, or 150 minutes total, has been linked to a reduction in blood glucose levels. However, it is almost impossible for people to eat less when they exercise this much.  If it were easy, 86 million Americans would not be prediabetic.

Furthermore, most people think that eating fewer calories is best accomplished by eating less fat, because fat has roughly double the calorie content per gram that carbohydrates. Let's get something straight here: The "calories in/calories out" mindset is critically flawed. This is because the TYPE of calories you eat influences how your body burns FAT.  Not all calories are created equal: If you eat a diet of 1000 calories per day consisting of 70% carbohydrate, you will gain weight, not lose it! You'll also be heading straight toward prediabetes or diabetes, because your blood glucose levels will increase and remained elevated on such a diet. That is because INSULIN determines whether you get fatter or leaner from each meal you eat, and insulin is released when there are carbohydrates in a meal. Protein and fat, however have little to no effect on the secretion of insulin into the blood. So, to put it simply, if you control your insulin level, you will control your weight. 

Losing weight does NOT mean STARVING yourself, it means controlling your insulin, and therefore your bloodsugar levels. You can eat until you're full and lose weight, if you EAT THE RIGHT KINDS OF FOOD. We can teach you how to eat well and lose weight!  There are two options:

1. Check out our dedicated weight loss website, www.fatlossdoc.net

2. Attend our FREE seminar, Wednesday January 27th at 6:15pm in the office.

There is a RIGHT WAY to lose weight, eat healthy, and feel full and satisfied!  Let us show you how!

Why I Love This Mouse...

I heard an interesting statistic on the radio the other day.  It seems that within a few years, 47% of the jobs in this country will involve the use of a computer on some level.  From the perspective of the office, I've noted a gradual shift in the percentages of patients who suffer from lower back pain (LBP) and those who suffer neck and arm pain (NAP).  A slow but steady decline in the number of LBP complaints has been accompanied by a similar increase in the number of NAP patients.

During the history or initial discussion of a NAP problem, the subject of computer use typically comes up.  I don't have an exact number, but the
percentage of people with a NAP condition who list computer use as an irritant to their pain is very, very high.

While computer use itself may not be as strenuous as doing construction, it does lend itself to chronic static strain and repetitive use disorders, such as neck pain and carpal tunnel syndrome, respectively.  Both of these can be alleviated, or even eliminated, with proper workstation setup.

This diagram is a good general setup for your workstation.  We have copies at the office, if you would like one.  Now, back to the mouse...

Moving the mouse around typically involves using your dominant hand and arm to get the cursor to the spot you would like it to be.  Why this needs to involve your entire arm, shoulder, and neck is beyond me. Especially when this particular movement seems to be the source of a lot of NAP issues.  The mouse pictured is a far better choice because you only have to move your index and middle fingers a small amount to move the cursor instead of your entire arm.  No more reaching, no more "wax on/wax off" to get the cursor to where you need it.  These are available through any office supply store or online for around $30.  If you use a computer for any significant part of your day, it's worth every penny to minimize strain and repetitive use injury.

NAP problems usually resolve quite quickly if the source of pain is correctly identified and the right treatment is applied.  Call us today to see if we can help you start feeling better now!