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Dr. Carson Durr

Talking about Chiropractic on Dr. Phil

Different Options for Back Pain

Out of the blue, your back starts to hurt. At first, it’s just an annoyance. You can live with it. You’ve had lower back pain before and it went away on its own.

Now it’s a few weeks later. You’ve got a low-grade pain that’s not getting any better. You’re actually worse, in fact, because your back hurts most of the time.

What to do?

You don’t want to run to a doctor. After all, it’s just back pain. Everybody has back pain. So you begin to solicit advice from your friends. And, of course, your friends have plenty of advice. “Do these exercises my doctor gave me.” “Do these stretches – they worked for me.” “Go to yoga class.” “I know a great Pilates instructor. She’ll get you in shape and your back will stop hurting.” “Take vitamins and drink more water.” “Meditate.”

Your friends mean well and it’s all very good advice. But none of it seems to work. Another month goes by and now the pain is increasing. It’s even affecting your sleep.

It’s time to see a doctor. But which one? For the most part, medical physicians are not experts on back pain. Typical recommendations include rest, moist heat, and anti-inflammatory medication.^1,2But, really, you’ve done all that. You need more specific advice.

Choices might include doctors of chiropractic, orthopedic surgeons, and physical therapists.

Many orthopedic surgeons are spinal specialists, but what they do is surgery. This would be a last resort, typically, after other treatment options have failed.

Physical therapists are highly skilled practitioners who focus on exercise, rehabilitation, and re-training. They are not primary care providers, and typically patients are referred to physical therapists by family physicians, chiropractors, and orthopedic surgeons.

Doctors of chiropractic are spinal specialists, too, and what chiropractors have to offer is expert conservative therapy.³ Chiropractors treat back-related problems all day, every day, and are the right doctor to see first.

As spinal specialists, chiropractors receive extensive training in evaluating patients with back pain. Chiropractors consider all aspects of the problem, and develop sound treatment plans based on the facts. If a person does not respond as anticipated, their chiropractor has a “Plan B” in place for further evaluation and possible referral.

When choosing a doctor, you’re allowed to ask questions and participate in the process. The strategy for follow-up is critically important.

First, if you’re improving and doing well, how will can you help keep the problem from recurring? Will your chiropractor prescribe stretches, exercises, and other self-care action steps to help you keep yourself well?

And, what steps will be taken if your problem and pain are not improving? Where might you be referred for further tests and evaluation? Chiropractic treatment is a powerful tool in most cases of back pain. Symptoms should begin to improve quickly. Have your chiropractor outline the “Plan B” if you are, in fact, not getting better.

Your doctor of chiropractic will be able to answer these questions.

If you would like to check out more information, check out our website.

¹Zuhosky JP, et al: Industrial medicine and acute musculoskeletal rehabilitation. Arch Phys Med Rehabil 88(3 Suppl 1):S34-39, 2007.
²Cayea D, et al: Chronic low back pain in older adults. What physicians know, what they think they know, and what they should be taught. J Am Geriatr Soc 54(11):1772-1777, 2006.
³DeVocht JW: History and overview of theories and methods of chiropractic. Clin Orthop Relat Res 444:243-249, 2006.

How to deal with arthritis

We’ve all seen the TV ads ─ nice-looking woman in her fifties, sitting on a nice sofa in a nice living room, rubbing her hands, in obvious pain. Of course, she’s not Lady Macbeth, trying to rub off the imagined blood of her murdered husband. She’s a woman with arthritis.

According to the Center for Disease Control, arthritis is the leading cause of disability in the United States.¹  Approximately 47 million people have doctor-diagnosed arthritis and 17 million have arthritis-attributable activity limitations.

Osteoarthritis, the most common form, is a degenerative condition affecting the joints and the soft tissues around the joints ─ the associated cartilage, ligaments, and tendons. The most commonly affected areas are the spine, the hands, and the shoulders, hips, and knees. The pain of arthritis, the reduced mobility, and the lifestyle accommodations needed for pain avoidance are discouraging and may even lead to depression.

Many anti-inflammatory drugs are available for the treatment of arthritis, and in recent years many of these have been found to cause severe side effects. Vioxx is the most notorious of these ─ cardiovascular complications caused a worldwide recall of the drug. Celebrex, another well-known arthritis medication, was also found to increase the risk of heart attack and stroke at high doses.

The very good news is there are several wellness-based treatment alternatives to long-term medication. These include exercise, diet, and in many cases, chiropractic treatment.

Exercise is critical in restoring mobility and, over time, in reducing pain.^2,3  Persons with osteoarthritis often experience a vicious cycle of deteriorating symptoms. Pain causes reduced mobility (pain avoidance), which (paradoxically) actually causes more pain, which causes further reductions of mobility . . . . Activities of daily living ─ getting out of a chair, opening a jar, bending and lifting ─ become a real challenge as the person struggles to avoid further pain.

So, restoring mobility is key. Exercise ─ very gently at first ─ is the answer. Range-of-motion activities to get the joints moving again are very beneficial, including
•    Arm circles
•    Wrist circles
•    Shoulder shrugs
•    Side-to-side bending for the lower back
•    Gentle knee bends
•    Ankle circles
•    Flexing and pointing the feet

Walking is a perfect exercise for treatment of arthritis. Begin by walking one block, then two, then around the block. Walk five minutes daily for a week, then increase by a minute or two each day. Get up to 15 minutes of gentle walking, then begin to gradually increase your pace. The increased mobility will not only reduce pain, but also provide a cardiovascular benefit and improve one’s ability to perform activities of daily living.

Chiropractic treatment, in combination with an exercise program, may assist in restoring joint mobility and reducing pain. Gentle chiropractic manipulative therapy is designed to improve mobility of spinal joints. As spinal joint motion improves, pain lessens, and a positive cycle of return-to-function begins.

¹“Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation.” CDC Morbidity and Mortality Weekly Report  55(40);1089-1092, 2006.
²Huang MH, et al: A comparison of various therapeutic exercises on the functional status of patients with knee osteoarthritis. Semin Arthritis Rheum 32(6):398-406, 2003.
³Suomi R, Collier, D: Effects of arthritis exercise programs on functional fitness and perceived activities of daily living measures in older adults with arthritis. Arch Phys Med Rehabil 84(11):1589-94, 2003.

Movement is the key to it all

Imagine waking up one morning with a frozen shoulder where you couldn’t move your upper arm more than a few inches in any direction. How much would that impact your ability to do your job? How much would that affect your ability to drive your car or even to dress yourself? How much would that affect your ability to concentrate on anything other than your shoulder? Obviously, if your shoulder did not move correctly, it would have a dramatic impact on your life. Well, the same is true with movement in every part of your body. If things aren’t moving the way they are supposed to move, it will have a negative impact on your ability to function at work, take care of the demands of everyday life, and even your ability to concentrate.

Many patients with severe low back pain report that their pain came on suddenly when they did something as simple as bend down to pet their cat, put on their socks, or pick up the newspaper. Just about everyone would agree that a person’s body should be able to handle such simple movements. So what has happened?

In every one of these cases, the joints of the patient’s body were “all locked up” — they were barely moving at all. When the joints in one area of the body do not move the way they should, other areas of the body are forced to move more in order to compensate. This creates a significant stress on those areas that have to pick up the slack, and it soon leads to pain and inflammation. At the same time, the areas that don’t have normal movement will slowly worsen as the muscles continue to tighten, the joints stick together, and the ligaments and tendons shorten. This leaves the body in a very unstable condition; if left unchecked, this process will continue until the body can hardly move at all. That is how a person comes to suffer flare-ups of pain at the slightest provocation.

Most of us have seen people who have lost most of their normal mobility: they look like bodies have been starched stiff whenever they try to move around. This is especially prevalent among the elderly. Contrary to popular belief, however, this is not an inevitable effect of aging; rather it is the inevitable effect of not maintaining the body’s mobility through exercise, healthy alignment, and body mechanics. There are people in their 60s, 70s, or even older, who are stronger and more flexible than the average person in their 30s, simply because they keep themselves exercising.

Maintaining mobility is critical in order to live free from pain and disability. Maintaining good mobility is not difficult, but it does not happen on its own. Just as in developing a good posture, it is necessary that you perform specific exercises and stretches to keep your muscles, ligaments, and tendons flexible and healthy. In addition, it is necessary that all of the joints in your body are kept moving correctly as well. Although this can be achieved to a great degree through stretching, most people also find routine chiropractic adjustments to be very beneficial.

Stay Active, Stay Happy

Dr. Carson and his wife Kelsey hammin’ it up in the Gallatin Range.

Dr. Gentempo Explains What We Do

One of the best Chiropractic educators explains the truths about what we do and how we do it.

Chiropractic and Neck Pain

Who hasn’t had neck pain at one time or another? What’s more, many of us have experienced on-going neck troubles at some point during our lives. Looking at human anatomy, it’s no wonder pain strikes us so often in this vulnerable area. While the neck structure gives us an amazing range of movement with which to see our environment, it also leaves us prone to injury of the muscles, ligaments, tendons and joints. But by making regular visits to the chiropractor, paying attention to posture and doing regular stretching and strengthening exercises, our necks can be pain-free.

Frequent chiropractic adjustments help prevent neck pain from occurring in the first place, but some everyday activities such as poor posture during watching TV, using a computer, reading a book or talking on the phone can easily trigger neck pain. Here are a few tips for avoiding neck pain throughout your day:

• Pay attention to your posture. Check with your chiropractor for guidelines to help improve your everyday posture.
• Do not read hunched over a desk or table. Prop reading material at eye level.
• If you spend long periods on the phone at work or home, consider using a headset rather than cradling the phone between your head and shoulder.
• Don’t crane your neck to see a poorly placed computer monitor. Place the monitor at eye level, square to your shoulders if possible.
• Ask your chiropractor to show you neck exercises to strengthen weak areas or relax tight muscles.

Neck pain that won’t go away or keeps coming back can signal a more serious underlying problem such as a subluxation or degeneration in the joints (such as what occurs with arthritis). If you experience neck pain that doesn’t abate within 24 hours, seek the advice of your chiropractor for diagnosis and treatment.

Avoiding Painful Leg Cramps

Your mind has finally stopped racing and you’ve just nodded off, only to be rudely awakened by a deep knot of sudden pain in your thigh, calf or in the arch of your foot.  Athletes and high heel wearers alike are often awakened from sleep by the infamous nocturnal leg cramp or “charley horse.” And though these occasional cramps usually are not serious, they are undeniably painful and downright annoying.

Check your H20 levels

The exact cause of leg cramps is not known, however, they are most often associated with dehydration and electrolyte imbalance. That said, and you’ve heard it before, drinking the optimal amount of water – 7 to 8 eight-ounce glasses of water per day – is the first line of defense against “charley.” Staying hydrated is also important for overall health, so the water speech bears repeating!

Stretch those stems

Also, simple stretches before bed can stave off cramps. Try this simple stretch before you hop into bed each night:

1. Stand facing the wall, 30 inches away.
2. While keeping your heels on the floor, lean forward, put your palms on the wall, and slowly move your hands up the wall as far as you can reach comfortably.
3. Hold the stretched position for 30 seconds. Release.
4. Repeat steps 1 through 3 two more times.

Just remember, when stretching, to take it slowly. Jolting right into a deep stretch and quick bouncing motions through the stretch are mistakes that can cause injury.

Supplement your regimen

If you’re still bothered by occasional cramping, your diet may need slight supplementation. According to Charles Kuntzleman, EdD, associate professor of kinesiology at the University of Michigan at Ann Arbor, taking a daily supplement of 400 IU of Vitamin E is usually very helpful. If the cramps persist, your body may be experiencing a lack of calcium and magnesium, found in dark green, leafy vegetables such as kale and broccoli. Dr. Kuntzleman suggests supplementing with daily dosages of up to 1,000 milligrams of magnesium and 500 to 1,000 milligrams of calcium.

How can chiropractic help?

Circulation is crucial for rushing nutrients from food and supplements to the areas of the body that need healing most. Chiropractic adjustments can improve circulation and greatly reduce healing time. Remember to inform your chiropractor if you’re experiencing muscle cramps.

Headaches = NOT normal = Just fix the problem

If you have a headache, you’re not alone. Nine out of ten Americans suffer from headaches. Some are occasional, some frequent, some are dull and throbbing, and some cause debilitating pain and nausea.

What do you do when you suffer from a pounding headache? Do you grit your teeth and carry on? Lie down? Pop a pill and hope the pain goes away? There is a better alternative.

Research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

But to get to the bottom of the problem, you first need to find out what is causing your pain. Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

What Can You Do?

If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.

Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.

Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.

Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

In addition, the ACA and its Council on Nutrition suggest you avoid the following food “triggers”:

Avoid caffeine. Foods such as chocolate, coffee, sodas and cocoa contain high levels of the stimulant.

Avoid foods with a high salt or sugar content. These foods may cause migraines, resulting in sensitivity to light, noise, or abrupt movements.

Avoid drinking alcoholic beverages. These drinks can dehydrate you and cause headache pain.

Other headache sufferers may want to avoid not only caffeine, but also high-protein foods, dairy products, red meat and salty foods.

What Can a Doctor of Chiropractic Do?

Chiropractors may do one or more of the following if you suffer from a primary headache:

Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.

Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.

Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Doctors of chiropractic undergo extensive training to help their patients in many ways – not just back pain.

If your headache is symptomatic of a health problem that needs the care of another discipline, your doctor of chiropractic will refer you to an appropriate specialist.