Learning Central

Chiropractic care is not just about fixing the problem, but also about learning and understanding the kinetics of your body to help prevent its return. Miller Chiropractic Wellness encourages you to be an informed patient to help aid and speed your recovery process.

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No individuals, including those under our active care, should use the information, resources or tools contained within to self-diagnose or self-treat any health-related condition. Diagnosis and treatment of all health conditions should only be performed by the doctor or other licensed health care professional.

Posted by: admin in Articles on February 1st, 2013

Each year Americans spend millions of dollars on travel, for business and pleasure.  All too often we are so tired from the traveling that it may be hours or days until we’re back on our feet .  No matter how you travel, you can arrive at your destination refreshed, relaxed and ready to go.

Don’t spend all your time sitting and looking out the window.  Get up and stretch as often as you can.  This will loosen muscles and prevent strain.  If you go by car or bus, take advantage of the rest stops.  Go outside, take a breath of fresh air, walk around.

If you’re planning a trip, a doctor of chiropractic can give you sound advice on staying comfortable.  If you’re back from a trip and feeling stiff, a chiropractic examination should be done to determine where your problems may be and how they can be corrected.

The Strain of Sitting

Whether travelling alone on business or on the way to a sunny resort with the family, long hours in a car or on an airplane can leave anyone stressed, tired, stiff and sore.  Prolonged sitting can wreak havoc on your body.  Even if you travel in a comfortable car or fly first class, certain pressures and forces from awkward positions can restrict the blood flow, building up pressure in the blood vessels, especially in your lower legs.

Treat travel as an athletic event.  Warm up before settling into a car or plane, and cool down once you reach your destination.  Take a brisk walk to stretch your hamstring and calf muscles.

In an Airplane

  • Stand up straight and feel the normal “S” curve of your spine.  Then use rolled-up pillows or blankets to maintain that curve when you sit.  Tuck a pillow behind your back just above the beltline and put another pillow across the gap between our neck and the headrest.  If the seat is hollowed from wear, use folded blankets to raise your buttocks.
  • Check all bags heavier than 5 to 10 percent of your body weight.  While lifting your bags, stand in front of the overhead compartment.  Do not lift your bags over your head,  rotate your spine or turn or twist your head and neck in the process.
  • When pushing your belongings under the seat, do not force the object with an awkward motion using your legs, feet or arms.  This may cause muscle strain or spasms in the upper thighs and lower back muscles.  Instead, sit in your seat, and gently guide your bags under the seat directly in front of you with your hands and feet.
  • While seated, change your position occasionally to improve circulation and avoid leg cramps.  Bring your legs in and move your knees up and down.  Prop your legs up on a book or a bag under your seat.

Travel by Car

  • Sit as close to the steering wheel as comfortably possible, with knees slightly higher than your hips.
  • Using a back support may reduce the incidence of low-back strain and pain.  The widest part of the support should be between the bottom of your rib cage and your waistline.
  • Take rest breaks to avoid fatigue.  Exercise your legs to reduce the risk of swelling, fatigue, or discomfort.  Open your toes as wide as you can, and count to 10.  Count to five while you tighten your calf muscles, then your thigh muscles, then your gluteal muscles.  Roll your shoulders forward and back.
  • Loosen and tighten your grip on the steering wheel to improve hand circulation and decrease muscle fatigue in the arms and hands.
  • While always being careful to keep your eyes on the road, vary your focal point while driving to reduce the risk of eye fatigue and tension headaches.

 The Bottom Line

If you follow these simple steps, you can enjoy pain free, safe travel.  If you do experience pain and stress from travel, doctors of chiropractic are trained and licensed to diagnose and treat problems of the spine and nervous system.*

*(Reprinted with permission of The American Chiropractic Association)

Posted by: admin in Articles on February 1st, 2013

Pain serves an important function in our lives.  When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and tells you to take care of the affected body part.  Chronic pain, on the other hand, persists for weeks, months, or even years.  Some people, often older adults, suffer from chronic pain without any definable past injury or signs of body damage.  Common chronic pain can be caused by many conditions including, but not limited to, headaches, low back problems, fibromyalgia, and arthritis.

Until recently, some doctors who could not find a physical cause for a person’s pain simply suggested that it was imaginary–”all in your head.”  This is unfortunate because we know that all pain is real and not imagined, except in the most extreme cases of psyshosis.  Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain undergo structural changes.

Psychological and social issues often amplify the effects of chronic pain.  For example, people with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, taking care of children, or engaging in leisure activities.  In turn, spouses, children, and co-workers often have to take over these responsibilities.  Such changes often lead to depression, agitation, resentment, and anger for the pain patient and to stress and strain in family and other social relationships.

How is depression involved with chronic pain?

Depression is the most common emotion associated with chronic pain.   It is thought to be 3 to 4 times more common in people with chronic pain than in the general population.  In addition, 30% to 80% of people with chronic pain will have some type of depression.  The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.

People with chronic pain and depression suffer dramatic changes in their physical, mental, and social well-being and in their quality of life.  Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at awork.  This constellation of disabilitites starts a vicious cycle in that pain leads to more depression, which leads to more chronic pain.  In some cases, the depression occurs before the pain.

Until recently, we believed that bed rest after an injury was important for recovery.  This has likely resulted in many chronic pain syndromes.  Avoiding performing activities that a person believes will cause pain only makes his or her condition worse in many cases.

Signs and Symptoms

Some of the common signs and symptoms of chronic pain include:

  • Pain beyond 6 months after an injury
  • Allodynia-pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
  • Hyperpathia-increased pain from stimuli that are normally painful
  • Hypersensation-being overly sensitive to pain

Some major clinical depression will occur daily for 2 weeks or more, and often include many of the following:

  • A predominant feeling of sadness-feeling blue, hopeless, or irritable, often with crying spells
  • Changes in appetite or weight (loss or gain) and/or sleep (too much or too little)
  • Poor concentration or memory
  • Feeling restless or fatigued
  • Loss of interest or pleasure in usual activities, including sex
  • Feeling of worthlessness and/or guilt

It may help to stay active and to not avoid activities that cause pain simply because they cause pain.  The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.  Relaxation training, hypnosis, biofeedback, and guided imagery can help you cope with chronic pain.  Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.  Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and disassociation (detaching yourself from the chronic pain) can be useful.  Involoving your family with your recovery may be quite helpful, according to recent scientific evidence.

Feel free to discuss these or other techniques with your doctor of chiropractic.  He or she may suggest some simple techniques that may work for you or may refer you to another health care provider for more in-depth training in these techniques.*

*(Reprinted with the permission of the American Chiropractic Association)


What is the treatment for chronic pain and depression?

The first step in coping with chronic pain is to determine its cause, is possible.  Addressing the problem will help the pain subside.  In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.


Posted by: admin in Articles on January 4th, 2013

A Chiropractic Approach to Osteoporosis

Being able to move without pain or other limitations is extremely important in maintaining an acceptable quality of life, particularly as the mean age in society is moving upward.  A common cause for being admitted to an assisted living facility is due to morbidity and immobilization from osteoporosis.  In this widespread disorder, the bones weaken and become brittle as a result of demineralization and increased bone resorption rates.

While it is often thought of as an older person’s disease, osteoporosis can strike at any age and starts a chain reaction of poor quality of life, loss of mobility, pain and ultimately death.  The good news is that it can be addressed and reversed in the early and even some later stages.  Chiropractors are well positioned to assist people with this disease through a natural approach.

An estimated 44 million Americans are afflicted with osteoporosis.  The disease affects 55 percent of the people 50 years and older and often leads to fractures.  Approximately one in two women and one in four men over the age of 50 will have an osteoporosis-related fracture in their lifetime.  In 2005, osteoporosis was responsible for more than 2 million fractures, costing an estimated $19 billion, and is expected to rise to 30 billion by 2025.  In 2007, more people died from osteoporosis-related injuries than from ovarian and breast cancer.

Even more worrisome is the evidence of osteoporosis in pre-menopausal, younger women who frequently dieted in their teens and 20′s.  Many of these young women did not have substantial nutrition to build and maintain healthy bones or deposit sufficient mineral content to get them through aduthood and childbearing years.  Combining this with the growing baby boomer generation just starting to become seniors, the statistical data point to an epidemic that requires the attention of the chiropractic community.  The problem of osteoporosis is significant and will continue to grow.

Osteoporosis Prevention

Compared to other life-threatening conditions, osteoporosis prevention is simple, affordable, and easy to implement.  Undertaking the rsponsibility of educating the public about osteoporosis, as well as recommended natural treatment approaches, should be a major part of the chiropractic message.

The National Osteoporosis Foundation (NOF) lists five simple steps for an individual to optimize bone health and prevention:

1.   Engage in regular weight-bearing exercise.

2.   Get the daily recommended amounts of calcium and Vitamin D.

3.    Avoid smoking and excessive alcohol.

4.    Have a bone density test, and take medication when appropriate.

5.    Talk with your health care provider about bone health.

The great news from these guidelines above is that osteoporosis is a preventable disease.  Most significant is that each of these steps falls squarely into the field of chiropractic.  As the NOS and its research have shown, a sensible approach to treating osteoporosis is a combination of early detection, weight-bearing exercise, implementing lifestyle changes that promote bone growth, proper nutritional support, and adding pharmaceutical intervention in more advanced cases.

Preventing osteoporosis can be as simple as staying up-to-date on your bone density tests.  If it has been over a year since you’ve had the test and you have any of the risk factors of osteoporosis, then a bone density test would be the next step.

Bone mineral density (BMD) tests are simple, cost effective and non-invasive.  They measure bone density quickly and accurately in various sites of the body.  Virtually every hospital or radiology clinic has modern, safe equipment and accepts referrals from chiropractors.  Most BMD tests are also fully covered and even recommended by many health insurance companies.  It is also helpful to interpret bone-related hormone levels via blood analysis.  Many of these can be accomplished with pinprick blood kits in lieu of blood draws and are therefore avaliable for the DC to perform.

Treating Osteoporosis

Once diagnosed with osteoporosis, the patient should start with weight-bearing exercise, as an initial form of treatment.  Weight-bearing exercise can be done in many forms including exercise bands, free weights and a variety of resistance machines.   Whole body vibration (WBV) is a form of weight-bearing exercise that has been particularly well documented to benefit bone growth.

WBV is a safe, effective and affordable form of in-office treatment exercise and rehabilitation.  With very few contraindications, WBV has a very high compliance rating because of its ease of use.  The vertical displacement of the WBV platforms creates sufficient micro-contractions of the muscles to exercise and strengthen the muscles and bones.  A minimum of 3 to 5 mm vertical displacement at a frequency of 20Hz and 50 Hz is the recommended unit requirement.  By using specific static and dynamic exercise patterns, chiropractors can incorporate WBV as part of their osteoporosis treatment programs.

Weight-bearing exercises like WBV are particularly effective for osteoporosis when combined with proper nutritional supplementation.  Many of the supplement companies in the chiropractic world offer various combinations of nutrients as osteorosis supplements.  At a minimum, an osteoporotic supplement should include vitamin D, calcium, magnesium, protein and omega-3 fatty acids, but other natural products can provide synergistic benefits as well.

Along with early dectection, exercise and nutrition, lifestyle changes, such as smoking cessation and reducing alcohol consumption, are important components of addressing osteoporosis.  Osteoporosis represents a huge problem facing the American public.  Take the time to learn more about preventing and treating osteoporosis before any symptoms begin to show up.*

*(Reprinted with permission of the American Chiropractic Association)


Posted by: admin in Articles on November 7th, 2012

Understanding Your Body Mass Index

Body mass index, or BMI, is important to understanding the health consequences your weight has on your body.  Researchers have found that BMI can be directly related to a person’s risk for many diseases.  Because increased weight and obesity have such a profound effect on health, making it the leading cause in preventing many diseases, knowing your BMI is as important as understanding your cholesterol and blood pressure.

You can easily calculate your BMI using your weight and height with the following equation:

  • Multiply your weight x 704.
  • Square your height (in inches).
  • Divide your weight from step 1 by your height in step 2 to determine your BMI.

As an example, a woman weighing 155 pounds who is 5 feet 4 inches tall would calculate her BMI as follows:

  • 155 x 704 = 109120.
  • 64 inches2 = 4096.
  • 109120/4096 = a BMI of 26.6.

According to the World Health Organization, there are three categories of obesity:

  • BMI of 25 – 29.9:  grade 1 obesity (moderately overweight)
  • BMI of 30 – 39.9:  grade 2 obesity (severely overweight)
  • BMI of >40:  grade 3 obesity ( massive/morbid obesity)

A BMI of 27 or higher is associated with increased morbidity and mortality and is generally considered the point at which some form of treatment for obesity is required.  A BMI between 25 and 27 is considered a warning sign and may warrant intervention, especially in the presence of additional risk factors, such as diabetes or cardiovascular conditions.  To calculate you target BMI, use the following formula:

  • Desired BMI x height squared/704 = goal weight.*

*(Reprinted with permission of the American Chiropractic Association).

Posted by: admin in Articles on November 7th, 2012

Wellness” has become a buzzword among the public, health care practitioners, and legislators alike.  But what exactly does it mean, and how can people benefit from it?  The Amerian Chiropractic Association (ACA) defines wellness as “an active process that promotes health and enhances quality of life.”

“With the enactment of health care reform legislation this year, the public is going to hear more and more about the importance of wellness, staying healthy and ultimately reducing health care costs caused by chronic diseases such as heart disease and diabetes,” says ACA President Dr. Rick McMichael.  “It’s time for people to undertand that they have the power to take charge of their health and be well enough to do the activities they enjoy.”

Dr. Scott Bautch, a doctor of chiropractic from Wausau, Wisconsin, explains wellness further.  “We consider wellness the act of adding potential to peoples’ lives.  Whether that potential is the ability to avoid cholesterol problems, quit smoking, or exercise more, it’s all individual to each person.  In other words, wellness is about giving people specific skills that will help them flourish in life.”

Finding a Wellness Coach

“If you’re interested in health and wellness, a good place to begin is by talking about it with a doctor of chiropractic.  They are well-known for their expert care of back pain, neck pain and headaches, but they also offer patients a variety of conservative recommendations and counseling on general health and wellness,” says Dr. McMichael, “while medical doctors screen you for diseases with lab tests and by examination.”  Your chiropractor will screen you for diseases, but he or she will also ask you about your lifestye and behaviors that may put you at risk for injury or illness.  The chiropractic approach is drug-free, instead of writing a prescritption, and offer spinal adjustments, rehabilitative exercises, nutritional counseling and lifestyle modifications to move patients toward optimum function and wellness.

Typically, when a new patient visits a DC, one of the first things the doctor will assess is functional capacity.  The DC will focus on decreasing pain and returning the patient to normal daily activities, including exercise.  In the intermediate stage, a chiropractor will continue therapeutic care, but also begin to address factors that may have led to the patient’s pain by recommending lifestyle modifications.  An example of intermediate care might include managing the patient’s obesity with counseling on diet and exercise.  In the final stage of wellness care, a DC will help the patient take responsibility for his or her own health through patient education, enabling the person to independently maintain and even advance the level of wellness achieved.

Adjust Your Attitude

Learn coping skills to deal with life’s ups and downs.  The way you deal with stress can be a huge factor in whether or not someone is well.  You can boost your attitude in a variety of ways:  enjoying nature, looking for humor in life’s mishaps, listening to relaxing music, and creating a support system of people who you can turn to in times of trouble and stress.  Taking a yoga or a Tai Chi class may also be helpful.

Start Moving

Increase daily movements by walking more.  Take the stairs when possible.  Adding more motion to your life can be a huge step toward living well.

Food For Fuel

Once the first two components of wellness are addressed, the doctor of chiropractic will address a patient’s diet.  It’s surprising for some to learn that making even a few simple changes, such as eating more raw or organically grown foods, drinking more water and consuming 25 to 30 grams of fiber per day, can positively impact your health and help prevent a variety of adverse health issues in the future.*

*(Reprinted with the permission of the American Chiropractic Association)

Posted by: admin in Articles on June 5th, 2012

While some fitness enthusiasts relentlessly seek out the latest, trendiest exercise crazes, many others are returning to good, old-fashioned walking to help them feel great and get into shape.  Whether enjoying the wonder of nature, or simply the company of a friend, walking can be a healthy invigorating experience.  And thanks to its convenience and simplicity, walking just might be right for you, too.

Benefits of Walking

You don’t need to become a member of an expensive gym to go walking.  Except for a good pair of walking shoes, it requires virtually no equipment.  A sedentary lifestyle has a debilitating influence on people’s health as they age, therefore, exercise is imperative.  Walking accomplishes all of the following and more:

  • Improves cardiovascular endurance
  • Tones muscles of the lower body
  • Burns calories-about 80 if walking 2 miles per hour, and about 107 if walking 4.5 miles per hour
  • Reduces risk of heart diease

Selecting Shoes

Too many people choose fashion over function when purchasing their shoes for walking, not realizing that poor-fitting shoes not designed for the purpose of walking can do more than hurt their stride and may lead to pain throughout the body.

  • Make sure our shoes fit properly.  The balls if your feet should rest exactly at the point where the toe end of the shoe bends during walking.
  • Select shoes with plenty of cushioning in the soles to absorb the impact.
  • Shop at the end of the day or after a workout when your feet are generally at their largest.  Be sure to wear the type of socks you usually wear during exercise.

Once purchased, don’t walk your shoes into the ground.  While estimates vary as to when is the best time to replace old shoes, most experts agree that between 300 and 500 miles is optimal.

Getting Started

Walking just 12 minutes every other day can offer important health benefits.  But in order to increase your longevity, try to eventually work up to 30 minutes five days a week.  Experts agree that to be considered “active,” adults should try to take 10,000 steps each day.  Wearing a pedometer is an easy way to track your progress.

Tips to help you get started on your walking program:

  • Move your arms freely in coordination with the opposite leg.
  • Don’t stoop your head or look down as you walk.  This will challenge the normal forward curve of your neck, which in turn will cause you to carry your weight improperly.
  • Don’t carry weights.  They’re better used as a separate part of your exercise regimen.
  • Expect a little soreness in the thighs and calves for the first week or two.  If you experience more than a little soreness, check with your doctor of chiropractic.
  • Walk briskly, with “purpose.”  Simply sauntering, while relaxing and enjoyable, is not an effective form of cardiovascular exercise.

Walking Surfaces

Some walking surfaces are better than others on your musculoskeletal system.  Walking on a cushioned or rubberized track is ideal because it absorbs most of the impact of your walking.  Most recreation centers offer this type of track free of charge.  Grass is another good surface, but watch out for hidden dips or holes in the ground.  Walking on a surface with no give, such as concrete or on a mall floor, is not your best choice because this type of surface will not absorb much of the impact your body will experience.  If you do choose to walk on such a surface, be extra careful to select highly-cushioned shoes.

Pain and Injury

If you experience pain or injury in a particular area, such as a knee or a hip, the root of the problem may lie somewhere else.  Injuries of this nature are usually not regional, or isolated, but systemic.  A problem in the foot or ankle can create an imbalance in every step, leading to discomfort or injury that moves to the knees, hips, low back, or elsewhere.  If you suffer from pain beyond typical muscle soreness, your doctor of chiropractic can diagnose and treat your pain or injury and get you back into the swing of your walking routine.  Your doctor of chiropractic may also help customize a wellness program that is right for you and has the expertise to help keep you in the mainstream of life.*

*(reprinted in part with the permission of the American Chiropractic Association)

Posted by: admin in Articles on April 7th, 2012

Don’t Take Arthritis Lying Down!  Years ago, doctors hardly ever told rheumatoid arthritis patients to “go take a hike” or “go for a swim.”  Arthritis was considered an inherent part of the aging process and a signal to the patient that it was time to slow down.  But not so anymore.  Recent research and clinical findings show that there is much more to life for the arthritis patient than the traditional recommendation of bed rest and drug thereapy.

What is Rheumatoid Arthritis?  The word “arthritis” means “joint inflammation” and is often used in reference to rheumatic diseases.  Rheumatic diseases include more than 100 conditions, including gout, fibromyalgia, osteoarthritis, psoriatic arthritis, and many more.  Rheumatoid arthritis is also a rheumatic disease, affecting about 1 percent of the U.S. population (about 2.1 million people).  Although  rheumatoid arthritis often begins in middle age and is more frequent in the older generation, it can aso start at a young age.

Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints.  Several features distinguish it from other kinds of arthritis:

  • Tender, warm, and swollen joints.
  • Fatigue, soemtimes fever, and a general sense of not feeling well.
  • Pain and stiffness lasting for more than 30 minutes after a long rest.
  • The condition is symmetrical.  If one hand is affected, the other one is also.
  • The wrist and finger joints closest to the hand are most frequently affected.  Neck, shoulder, elbow, hip, knee, ankle, and feet joints can also be affected.
  • The disease can last for years and can affect other parts of the body, not only in the joints.

Rheumatoid arthritis is highly individual.  Some people suffer from mild arthritis that lasts from a few months to a few years and then goes away.  Mild or moderate arthritis has periods of worsening symptoms (flares) and periods of remissions, when the the patient feels better.  People with severe arthritis feel pain most of the time.  The pain lasts for many years and can cause serious joint damage and disability.

Should Arthritis Patients Exercise?  Exercise is critical in successful arthritis management.  It helps maintain healthy and strong muscles, joint mobility, flexibility, endurance, and helps control weight.  Rest, on the other hand, helps to decrease active inflammation, pain, and fatigue.  For best results, arthritis patients need a good balance between the two:  more rest during the active phase of arthritis, and more exercise during remission.  During the acute systematic flares or local joint flares, patients should put joints through their full range of motion once a day, with periods of rest.  To see how much rest is best during flares, patients should talk to their health care providers.

The following exercises are most frequently recommended for patients with arthritis:

  • Range of motion exercises-stretching and dance help maintain normal joint movement and increase joint flexibility.   These can be done daily and should be done at least every other day.
  • Strengthening exercises-weight lifting will help improve muscle strength which is important to support and protect joints affected by arthritis.  Should be done every other day unless pain and swelling are severe.
  • Aerobic or endurance exercises-walking, bicycle riding, and swimming will help improve the cardiovascular system and muscle tone and control weight.  Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body.  Should be done for 20-30 minutes three times a week unless pain and swelling are severe.

If the patient experiences unusual or persistent fatigue, increased weakness, decreased range of motion, increased joint swelling, or pain that lasts more than one hour after exercising, they need to talk to their health care provider.  Doctors of chiropractic will help patients develop exercise programs to achieve maximum health benefits with minimal discomfort and will identify the activities that are off limits for this particular arthritis patient.

Nutrition for the Rheumatoid Arthritis Patient:    Arthritis medications help suppress the immune system and slow the progression of the disease, but for those who prefer an alternative approach, nutrition may provide complementary support.  Evidence shows that nutrition may play a role in controlling the inflammation and possibly slow the progression of rheumatoid arthritis.  Some foods and nutritional supplements may be helpful in managing arthritis:

  • Fatty-acid supplements
  • Deep-sea fish such as salmon tuna, herring, halibut
  • Tumeric-a spice that is used to make curry dishes may also be helpful.  A 95% curcuminoid extract has been shown to significantly inhibit the inflammatory cascade and provide relief of joint inflammation and pain.
  • Ginger extract-shown to be beneficial in terms of inflammation.
  • Nettle leaf extract-may inhibit some inflammatory pathways.
  • A vegetarian or low-allergen diet.

Always consult your health care provider for advice in beginning a diet regimen for your condition.

What Can Your Chiropractor Do?  If you suffer from rheumatoid arthritis, your doctor of chiropractic may help you plan an individualized exercise program the may help you restore the lost range of motion to your joints, improve your flexiility and endurance, and increase your muscle tone and strength.  Doctors of chiropractic may also give you nutrition and supplementation advice that may be helpful in controlling and reducing joint inflammation.*

*(reprinted in part with the permission of The American Chiropractic Association).


Posted by: admin in Articles on March 16th, 2012

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

What is scoliosis?

     Because we walk upright on 2 feet, the human nervous system constantly works through reflexes and postural contol to keep our spine in a straight line from side to side.  Occasionally, a lateral or sideways curve develops.  If the curvature is larger than 10 degrees, it is called scoliosis.  Curves less than 10 degrees are often just postural changes.  Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back).  In most cases, the verterae are also rotated.

     In more than 80% of the cases, the cause of scoliotic curvatures is unknown.  We call this condition idiopathic scoliosis.  In other cases, trauma, neurological disease, tumors, and the like are responsible.  Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed.  Structural scoliosis does not reduce with postural maneuvers.  Either type can be idiopathic or have an underlying cause.

What are the symptoms of scoliosis?

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

How is scoliosis evaluated?

     Evaluation begins with a thorough history and physical examination, including postural analysis.  If a scoliotic curvature is discovered, a more in-depth evaluation is needed.  This might include a search for birth defects, trauma and other factors than can cause structural curves.  Patients with substantial spinal curvatures very often require an xray evaluation of the spine.  This procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis.  In addition, xrays of the wrist are often performed.  These films help determine the skeletal age of the person to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression.  Depending on the scoliosis severity, xrays may need to be repeated as often as every 3 or 4 months to as little as once every few years.

     Other tests, including evaluation by a Scoliometer might also be ordered by the doctor.  This device measures the size, by angle, of the rib hump associated with the scoliosis.  It is a non-invasive, painless, procedure requiring no special procedures.  A Scoliometer is best used as a guide concerning progression in a person with a known scoliosis, not as a screeing device.

Is scoliosis always progressive?

     Generally, no.  In fact, the vast majority of cases remain mild, non-progressive, and require little treatment, if any.  In one group of patients, however, scoliosis is often more progressive.  This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period.  Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly.  In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.

What is the treatment for scoliosis?

     There are generally three treatment options for scoliosis–careful observation, bracing, and surgery.  Careful observation is the most common treatment, as most mild scolioses do not progress and cause few, if any, physical problems.  Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees.  Surgery is generally used in the few cases where the curves are greater than 45 degrees and are progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.

     With help from your doctor of chiropractic,  spinal manipulation, therapeutic exercise, wearing of a heal lift to compensate for uneven hip and/or leg length, and electrical muscle stimulation have been advocated in the treatment of scoliosis.  None of these therapies alone have been shown to consistently reduce scoliosis or make it worse.  For patients with back pain along with the scoliosis, manipulation and exercise may be of help.  Most people with scoliosis lead normal, happy, and productive lives.  Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.*

*(reprinted with permission of The American Chiropractic Association)

Posted by: admin in Articles on March 10th, 2012

Find the Right Shoe

Your feet are your foundation and keeping them comfortable in properly fitted athletic shoes is very important for your entire body.  There is no such thing as the best shoe, as every pair of feet is different and overall comfort is a very personal decision.  For people who have normal feet, stability shoes with a slightly curved shape are usually recommended.  If you have flat feet, consider motion-control or high-stability shoes with firm midsoles that don’t twist or bend easily.  Stay away from high-cushioned, highly-curved shoes. For those with high-arched feet, the best choice is flexible, cushioned shoes and avoid purchasing motion-control or stability shoes which reduce foot mobility.

Shoe Purchasing Tips

Match the shoe to the activity. Running shoes are primarily made to absorb shock as the heel strikes the ground.  In contrast, tennis shoes provide more side-to-side stability.  Walking shoes allow the foot to roll and push off naturally during walking, and they usually have a fairly rigid arch, a well-cushioned sole and a stiff heel support for stability.

If possible, shop at a specialty store.  Employees at these stores are often trained to recommend a shoe that best matches your foot type and stride pattern. Also shop late in the day or after a workout when your feet are at their largest.  Wear the type of socks you usually wear during exercise, and if you use orthotic devices for postural support, make sure you wear them when trying on shoes.

Be sure to have your feet measured every time. Foot size often changes with age, and most people have one foot larger than the other.  Measure feet while standing in a weight-bearing position because the foot elongates and flattens when you stand, affecting the measurement and the fit of the shoe.

Choose shoes for their fit, not by the size you’ve worn in the past.  The shoe should fit with an index finger’s width between the end of the shoe and the longest toe.  The toe should not feel tight.  The heel of your foot should fit snugly against the back of the shoe without sliding up or down as you walk or run  Keep the shoe on for 10 minutes to make sure it remains comfortable.

Once you have purchased athletic shoes, don’t run them into the ground. Once shoes show wear, especially in the cushioning layer, they also begin to lose their shock absorption.  Worn shoes may cause injuries like shin splints, heel spurs, and plantar fascitis.

Correct with Orthodics

Feet are to the skeletal system what a foundation is to a house.  If the foot has a structural abnormality, the body must compensate, often to the detriment of the legs, low back, or other areas.  To correct an abnormal or irregular walking pattern, consider custom-designed shoe inserts, called orthotics.  They alter the angle at which the foot strikes the ground, improving foot function, and often reducing pain.  Your doctor of chiropractic may help fit you with such orthotics.

*(reprinted in part with permission of the American Chiropractic Association)

Posted by: admin in Articles on November 5th, 2011

     Patients with lumbar spinal stenosis are commonly recognized by a bent-forward, shuffling posture and a characteristic small-step gait.  Stenosis surgery, however, is a major procedure that is recommended only when conservative methods of care aren’t effective–or when stenosis is caused by tumors or accompanied by intolerable pain or severe neurological problems, such as loss of bowel and bladder function.

What is Stenosis?

     Spinal stenosis is created by the narrowing of the spinal canal, which may be caused by mechanical problems or by abnormalities in the aging spine.  It may or may not result in low-back pain, limping, and a lack of feeling in the legs.  Numerous factors can cause stenosis, such as thickened ligaments, expanding infection, abscess, a congenital or developmental anomaly, degenerative changes, vertebral fractures or dislocations, or a spinal cord tumor.  Spinal stenosis can also result from long-term steroidal use. 

     Other conditions, such as a herniated disc, can mimic stenosis.  While herniated discs usually cause  rapid and acute muscle spasm, discomfort caused by stenosis builds gradually.

     Conditions  that can be confused with stenosis include vascular claudication, peripheral vascular disease, and abdominal aortic aneurysms.  Claudication, or pain triggered by walking, caused by vascular disease, most often occurs after walking  a fixed distance.  Patients with spinal stenosis, however, walk variable distances before symptoms set in.  On the other hand, standing makes pain worse for stenotic patients, while it relieves vascular claudication.


     Spinal stenosis can be diagnosed based on the history of symptoms, a physical examination and imaging tests.  An MRI is a poor predictor of future disability in stenosis.  An electrodiagnostic study is more dependable for information on a stenotic spine.  To diagnose stenosis caused by an abscess or an infection, blood work analyzed by a laboratory may be required, while vertebral tumors and spinal tumors  require finely tuned imaging.


     In many mild and moderate cases of stenosis, non-invasive conservative care, such as chiropractic, can help lessen pain and discomfort, maintain joint mobility and allow the patient to maintain a reasonable lifestyle, at least for some time.  A technique called flexion distraction may be helpful in reducing leg discomfort. 

     Home exercises are recommended four or five times a week.  Especially helpful are stretching and strengthening of the lower back and stomach muscles and improving muscle strength, such as bicycle riding or lying on the side and grasping the knees with the arms while focusing on flexing the spine in a forward position.

     Although medications can provide pain relief, they can also exacerbate stenosis patients’ already compromised sense of balance.

     When the patient loses bowel or bladder control, suffers from intolerable leg pain and claudication, and has progressive loss of function or spinal cord tumors, surgery may be recommended.  Although many patients do fairly well after the surgery, the symptoms are likely to return after a period of time.  Recent studies show that, in the long run, outcomes are much the same between surgery and conservative care.  Some surgeries have to be repeated years later.  Many are far from fully satisfactory.  Surgery is a complicated procedure that irreversibly changes the structure of the back.

     Stenosis is a chronic condition that cannot be cured, but it often can be improved, and improvement can be maintained over the long term.  Patients can work with their doctor of chiropractic to reduce symptoms and improve their quality of life.*

*(Reprinted with permission of the American Chiropractic Association)

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