Have You Lost Work Time Because of Your Back Pain?
October 9, 2009
“I can’t believe how much my low back hurts! I don’t know if I can go to work with it like this!” Does this sound familiar? Have you ever missed work because of low back pain? Well, if you have, you’re certainly not alone! In fact, over 80% of the general population seeks some type of health care provision at some point in life because of low back pain and many of those lose work time. Lost work time is often associated with not being able to tolerate certain positions such as prolonged sitting, standing, bending, twisting, reaching, or combinations of these. Sometimes, just getting to work is next to impossible as the car ride alone may intolerable! There is nothing more depressing than not being able to move due to the sharp knife-like feeling in the back every time you try to change positions.
However, it’s one thing to lose a day or two or even a week of work but what about those that can’t work for longer time periods, like several weeks or even months? This can become life altering as avoidance of moving for fear of that knife-like sensation in the back can quickly lead to muscle weakening, weight gain, lethargy, depression, and a host of other negative residuals. Many articles have been published in the past that tried to identify ways determine early on in the course of back treatment, who might be at greatest risk of not improving or becoming disabled. The term, “yellow flags” has been used to describe such factors and some success in identifying those prone to becoming disabled has been reported. In May 2009, another attempt to identify injured workers who were at risk for becoming disabled or, not being able to return to work for at least 3 months was published. Of the 346 injured workers that were followed for 6 months after the sick leave period began, 47% failed to return to work. There were five questions found to adequately screen those who were not able to return to work or were at greatest risk of becoming disabled. The 5 questions included:
1. Do you expect to return to work within 6 months?
2. How much does the pain interfere in your daily activities?
3. It is not advisable to be physically active?
4. Do you feel generally nervous?
5. Do you feel generally scared?
The good news is that chiropractic manages these types of acute back pain quicker and better than any other form of health care. This is reflected by the highest percentage of consumers seek chiropractic over any other form of alternative health care for back pain relief according to the May, 2009 issue of Consumer’s Report.
To learn more about Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, and South Plainfield.
Post-Traumatic Fibromyalgia
October 7, 2009
Fibromyalgia (FM) has a long reputation for being a controversial diagnosis. Some health care providers (HCPs) feel FM is a legitimate condition that warrants treatment and research while others feel it’s a “garbage can diagnosis” that HCPs throw patients into when they’re not sure what diagnostic label to use for a patient’s condition. Regardless of the personal beliefs of individual HCPs, there have been two general classifications of FM – primary and secondary. Primary FM occurs when there is no underlying health condition participating in the patient’s overall health status and onset of FM. Secondary FM results from an underlying condition that contributes significantly to the patient’s health status, such as irritable bowel syndrome and over time, gives rise to the onset of FM.
Posttraumatic FM belongs to the secondary FM classification when the traumatic related injury results in the patient developing FM. A Canadian study reported that 25-50% of FM patients reported a traumatic event just before the FM symptoms began. This study surveyed different specialty physician groups to determine which issues were most important in causing the onset of widespread chronic pain after a motor vehicle trauma. Five factors were studied to determine how important each was to the HCP in arriving at a FM diagnosis in a case study of a 45 year-old female with a whiplash injury who developed chronic generalized pain, fatigue, difficulties in sleeping and diffuse muscle tenderness. These five factors included:
- The number of FM cases diagnosed weekly by the HCP
- The patient’s gender
- The force of the initial impact
- The patient’s psychiatric history before the trauma
- The initial injury severity
Also described as important were the patient’s pre-injury health status, fitness level and psychological health. All HCP groups were reluctant to blame the car accident as causing FM, but rather placed more importance on the patient attitude, personality, and level of emotional stress. The least important of the five points were numbers 3 and 5. The orthopedic group also included “ongoing litigation” as a cause but as a group, they were the least likely to agree on the FM diagnosis (29%) in the 45 year old case study. Rheumatologists were highest at 83%, followed by general practitioners at 71%, and physiatrists at 60%. A most interesting observation was that once the data was analyzed, ONLY the patient’s pre-accident psychiatric history remained in the model of predicting agreement or disagreement with the FM diagnosis.
Posttraumatic FM can result from any type of trauma, not just motor vehicle collisions. Other “secondary” FM causes besides trauma, can include systemic conditions such as irritable bowel syndrome, chronic fatigue syndrome, and other internal disorders that in part, alter the person’s ability to obtain restorative sleep. Hence, an important focus of treatment should be placed on helping the FM patient obtain restful sleep. Chiropractic management strategies have included manipulation, mobilization, soft tissue therapies, physiological therapeutic agents such as electrical stimulation, ultrasound, the training for home use of traction, the use of nutritional counseling and supplementation, and the training of exercise. Many studies support success with this multidimensional approach to treating FM as chiropractic attacks the FM condition from multiple directions, often yielding highly satisfying results. We are committed to help you or a loved one that may be suffering with FM, and sharing this information may be one of most significant acts of kindness you can give.
To learn more about Fibromyalgia, register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, and South Plainfield.
Neck Pain – Non-Surgical Treatment Options
October 5, 2009
There are many treatment options for those suffering from neck pain. There is conventional medical care where the family doctor will usually prescribe a muscle relaxant, anti-inflammatory, and/or pain killer to help patients through episodes of acute neck pain. However, many patients with neck pain have been through the process of treatments associated with medications and simply cannot tolerate the adverse side effects of stomach pain common with anti-inflammatory drugs such as ibuprofen (Advil, Nuprin, Mediprin, etc.), Aleve (Naproxen), or aspirin. Others don’t like the groggy, drunk-like feelings associated with pain killers or the sleepiness associated with muscle relaxants. Therefore, these patients often turn to complementary / alternative care.
As noted in the May, 2009 issue of Consumer’s Report for low back pain, chiropractic was the most sought after form of treatment, but there has been no extensive review of neck pain regarding evidence-based treatment approaches – at least not until February, 2008. An international “team” representing 9 countries screened over 31,000 titles of articles published between 1980 and 2006, reviewed more than 1200 articles and eventually reported on 552 studies in their final report. Their findings included the following:
- In the US, 54% utilized complementary (alternative) treatment approaches compared to 37% that obtained conventional medical care.
- Neck pain was the 2nd most common reason Americans obtained chiropractic care.
- Chiropractic was found to be the most frequently reported form of treatment for upper back or neck pain (ahead of massage therapy, relaxation therapy, acupuncture).
- Those who obtained complementary AND conventional medical care were much more likely to perceive the complementary/alternative therapy as being helpful (61% vs. 6.4% for neck conditions and 39.1% vs. 19% for headaches).
- Women more commonly obtained care than men for neck/shoulder pain (29% vs. 18% men) over a 4-6 year time frame.
- Manual therapy (mobilization, manipulation, stretching) was associated with greater pain reduction in the short-term among patients with acute whiplash when compared with usual medical care, soft collars, passive modalities, or general advice.
- For non-whiplash neck pain (without arm radiating pain), manipulation or mobilization, exercise, low level laser therapy (LLLT), and “…perhaps acupuncture…” were reported as more effective than no treatment, sham, or other alternative interventions.
- For both whiplash and non-traumatic neck pain, supervised exercise with or without manual therapy was favored over usual medical care or no care.
What does all this mean? Simple! Everyone who is suffering from neck or upper back pain should seek chiropractic care which includes manipulation, mobilization, exercise training, and activity modifying advice, as these approaches have been found to be more effective than usual medical care! Why waste time with a “wait and watch” with or without drug intervention approach when the evidence favors chiropractic related interventions. If you, a friend, or a loved one is struggling with neck or upper back pain, we will properly assess your condition and administer the appropriate care that is required. We will coordinate care with other health care services when necessary. This recommendation may represent one of most significant acts of kindness you can offer those that you truly care about.
To learn more about Back Pain Relief, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
Carpal Tunnel Syndrome (CTS) – “Fact Sheet”
October 2, 2009
What is it? Carpal Tunnel Syndrome (CTS) occurs when a nerve on the palm side of the wrist is pinched. It is named after the area of the wrist from where the symptoms occur. The Carpal Tunnel is basically a horseshoe shape made from 8 small carpal bones and the ends of the horseshoe are connected with a ligament thus completing the “tunnel.”
What are the symptoms? CTS symptoms include pain from swelling of the tendons inside the CT. When the nerve pinch occurs, numbness, tingling, or a half asleep sensation into the 2nd, 3rd, and 4th fingers occurs. This is often worse at night due to the wrist being bent when asleep. This often wakes the person and shaking/flicking the hand/fingers is needed to “wake them up.” Grip weakness is also associated with CTS such as difficulty opening jars.
What are the causes? Usually, over use from tasks including repetitive line work (meat/fish/poultry packing, cookie/food packing), typing, sewing, carpentry, waiting tables, and the like. Other “contributors” include hormone related conditions such as hypothyroid, dysmenorrhea, diabetes, and obesity. These fast/repetitive movements cause swelling of the tunnel’s contents (9 tendons and the median nerve) and the nerve is pushed into the ligament connecting the ends of the horseshoe/tunnel.
Who is at risk? Gender is a significant factor as women are 3x more likely to develop CTS than men as the CT may be smaller in woman. The dominant hand is often first affected and more severe. Hormone imbalances as described above also increase risk.
How is it diagnosed? The history of the symptoms as well as physical examination of the hands, arms, shoulders and neck can lead to the proper diagnosis. The exam consists of trying to reproduce the numbness into the fingers by pressing/holding over the CT and other areas where the nerve runs down the arm (including the neck where the nerve originates), tapping over the CT with a reflex hammer, bending and holding the wrists at the extreme endpoints of motion. Also, poking the skin with a sharp object and comparing the 2nd to 4th fingers to other parts of the hand and the opposite side commonly yields differences between the two sides. Questionnaires and hand diagrams completed by the patient are helpful and quantify the degree of severity. Tests used during the course of treatment help track improvements. More sophisticated testing includes an EMG (nerve conduction test) that tests the motor and sensory changes when the nerve is pinched.
How is it treated? Chiropractic approaches include manipulation of the wrist, hand, forearm, shoulder and neck, specifically addressing the areas of greatest restricted motion. Soft tissue therapy includes massage, active release, graston, trigger point, and a host of physical therapy modalities such as light/low level laser, IFC, ultrasound, microcurrent, and low frequency approaches. Exercise training to be repeated multiple times per day is very helpful. Wrist bracing especially at night is also a common treatment approach used by all health care providers. Nutritional counseling and supplementation is also very helpful.
How can it be prevented? Work station assessments, staying in shape (avoid obesity), taking “minibreaks” when doing repetitive work, and proper treatment for conditions like hypothyroid, diabetes, and other disorders associated with CTS.
To learn more about Carpal Tunnel Syndrome, sign up for a free report, or click here to register for a Free, In- Office Evaluation. If you are looking for faster service, feel free to give us a call at one of our two New Jersey locations. For our Bayonne, NJ location, call 201-339-8889, and for our Scotch Plains, NJ location call us at 908-490-1800. Just tell them that you read this article and you will receive our complimentary in-office evaluation (a $245 Value).
Article by Dr. Eric Chludzinski, DC. Dr. Chludzinski is the founder of Hudson Center for Spinal Care located in Bayonne and Scotch Plains, New Jersey. In preparation for his career, Dr. Chludzinski attended St. Peter’s College in Jersey City, NJ graduating in 1998 with a Bachelor of Science in Natural Science. He continued his studies at Life University School of Chiropractic in Marietta, GA graduating in the class of 2002 as a Doctor of Chiropractic. Dr. Chludzinski services all of Union County and Hudson County, including Jersey City, Hoboken, Harrison, Kearny, Newark, Elizabeth, Westfield, Clark, Fanwood, Plainfield, Watchung, Mountainside, Berkeley Heights, South Plainfield
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