August 1, 2019
Do you ever experience neck stiffness or pain with your headaches? Recent research suggests that neck and head pain are more related than you think.
One study examined whether headaches and cervical spine impairment were linked in patients with head pain. Of the patients evaluated, 90% had cervicogenic headaches, or headaches linked to neck pain. Furthermore, the severity of patients' headaches impacted the range of motion in their necks. This study demonstrates the strong relationship between cervical spine (neck) impairment and cervicogenic headaches.
Visit Dr. Jeremy Hozjan to determine whether your headaches are related to impairment and pain in your neck.
Hall TM, Briffa K, Hopper D, Robinson KW. The relationship between cervicogenic headache and impairment determined by the flexion-rotation test. Journal of Manipulative Physiological Therapy. 2010 Nov-Dec; 33(9):666-71.
July 31, 2019
What Is Thoracic Outlet Syndrome?
Thoracic outlet syndrome is felt as numbness, tingling, pain or decreased circulation in the shoulders, arms or hands.
The thoracic outlet is a bottleneck where an important bundle of nerves and blood vessels travel between the head and arm. The space is narrow and injury to the neck can cause inflammation of the muscles in the area, which can compress the nerves and result in symptoms.
Because the neck is complex, it can be tricky pinpointing the exact source of your pain, and other conditions can mimic the symptoms of thoracic outlet syndrome.
Chiropractic May Help
If you have symptoms of thoracic outlet syndrome after an injury, we might be able to help. Dr. Jeremy Hozjan can pinpoint the root cause of your pain and develop a treatment plan to help you reclaim your health.
July 29, 2019
Many patients with chronic carpal tunnel syndrome are told they need surgery to relieve the pain. While surgical interventions aim to relieve pressure on the irritated median nerve, the treatment may be too narrow in scope for some patients. Case in point: nearly a third of patients who receive surgery for carpal tunnel report a return in symptoms within two years of surgery.1
Recent research suggests there's more to carpal tunnel than wrist and arm pain: CTS could be related to problems in the neck.
A recent study from Journal of Orthopaedic and Physical Therapy assessed the cervical range of motion in 71 women with carpal tunnel syndrome. Compared to women without CTS, women with carpal tunnel had significantly restricted range of motion. The greater the pain intensity women experienced, the less able they were to perform lateral flexion away from the affected side. There were no major difference among women with minimal, moderate, or severe CTS.
This study confirms what chiropractors have known for years: that wrist pain can often be related to problems in the cervical spine. In fact, the cervical spine may be the source of wrist and arm pain for patients with cervical radiculopathy. That's why chiropractors use a more holistic approach to treating carpal tunnel syndrome, one that involves relieving irritation of the median nerve in addition to addressing any underlying concerns in the neck. Chiropractors can draw on a combination of spinal adjustments, trigger point therapy, exercises, and advice on ways to prevent overuse injuries.
Research shows that this holistic approach is successful for many patients with carpal tunnel. A 2010 study found that trigger point therapy administered by chiropractors resulted in 67% improvement in symptoms.2
In another study published earlier, CTS patients who received soft tissue mobilization and other chiropractic treatments had significantly reduced hand pain intensity after just a week of treatment. They also showed signs of reduced pain sensitivity in certain joints of the cervical spine.3
Case studies also suggest that chiropractic can be effective for chronic CTS patients who failed to improve with other methods like surgery, wrist splints, and drugs.4
If you suffer from ongoing wrist pain and CTS, remember that surgery is not your only option for relief. Chiropractic care could address the multifaceted nature of your pain to provide lasting relief of carpal tunnel syndrome.
1. Bessette L, Keller RB, Liang MH, Simmons BP, Fossel AH, Katz JN. Patients' preferences and their relationship with satisfaction following carpal tunnel release. Journal of Hand Surgery 1997;22:61320. Quoted in Hains G, et al (2010).
2. Hains G, Descarreaux M, Lamy AM, Hains F. A randomized controlled (intervention) trial of ischemic compression therapy for chronic carpal tunnel syndrome. Journal of the Canadian Chiropractic Association 2010; 54(3): 155163.
3. De-la-llave-Rincon, A. Response of pain intensity to soft tissue mobilization and neurodynamic technique: a series of 18 patients with chronic carpal tunnel syndrome. Journal of Manipulative and Physiological Therapeutics 2012; doi:10.1016/j.jmpt.2012.06.002.
4. Crafts GJ, et al. Chiropractic management of work-related upper limb disorder complicated by intraossesous ganglion cysts: a case report. Journal of Chiropractic Medicine 2011; 10(3): 166-172.
July 26, 2019
As if sleepless nights and endless crying weren't enough, parents of infants with colic often endure a string of unsuccessful treatments and frustrating doctors visits as they struggle to fight the elusive condition. But new research offers hope to parents searching for natural treatment of infant colic: chiropractic therapies produced clinically and statistically significant reductions in crying time in colicky babies in a recent study.
Previous research has examined the effects of chiropractic therapies on colic with inconclusive results. In a 2006 study from Britain and in a 1999 Danish study, manual therapy was associated with significant reductions in crying time. In both studies however, parents were not blinded to the treatment infants received, leading critics to worry that parents' knowledge of the treatment biased their reporting on infant crying time. In a 2002 Norwegian study that did blind parents to the treatment, no significant differences were found between a manual therapy and a placebo treatment. In still another study, two different manual therapies reduced crying time but there were no placebos for comparison. These varying results meant that although some evidence pointed to the benefits of chiropractic care for colic, questions lingered about parental bias and treatment efficacy.
Researchers from the Anglo-European College of Chiropractic sought to investigate these questions in a study of 104 infants with colic. They divided the patients into three groups: in the first group, the infants were treated and the parents were aware of treatment; in the second group the infants were treated and the parents were blinded to treatment; and in the third group the infants were not treated and the parents were blinded to the lack of treatment.
After ten days, all three groups had significant reductions in crying time but the infants in the treatment groups saw greater improvements. Babies who received chiropractic therapies cried for an average of 1.5 hours less than untreated infants. Treated infants with blinded parents had a 44% reduction in crying time, compared to a 51% reduction in crying time for infants with parents who were aware of treatment. Those who received no treatment had just an 18% reduction in crying time. The slight differences between treatment groups were not statistically significant, suggesting that parental bias did not substantially alter reporting of crying time. The improvements were considered clinically significant by two cutoffs: a reduction in crying time by 30% and crying for 2 hours or less a day.
Researchers pointed to studies showing that moderate finger pressure can induce a relaxation response in adults, decreasing heart rate and increasing alpha and beta brainwave activity. Other studies have found that manual impulse can similarly result in reduced heart rate in infants. This relaxation response could be a potential mechanism behind the reduced crying time. If colic is indeed related to musculoskeletal conditions as hypothesized by some authors, manual therapies could also address underlying musculoskeletal disorders.
While larger studies are needed to confirm these results, the study suggests that chiropractic therapies could be beneficial for infants with colic. Previous research suggests that chiropractors can play a role in treating colic related to infant headache. Doctors of chiropractic can also advise you in making nutritional and dietary changes to minimize allergic reactions that may also be an underlying cause of colic.
Miller J, Newell D, and Bolton J. Efficacy of Chiropractic Manual Therapy on Infant Colic: A Pragmatic, Single-Blind, Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics 2012; 35 (8): 600-607.
Marchland AM, Miller JE, Mitchell C. Diagnosis and Chiropractic Treatment of Infant Headache Based on Behavioral Presentation and Physical Findings: A Retrospective Series of 13 Cases. Journal of Manipulative and Physiological Therapeutics 2009; 32 (8): 682-686.
July 25, 2019
According to a recent study, patients treated with chiropractic adjustments experienced a 50% reduction in the number of cervicogenic headaches they experienced.
What Are Cervicogenic Headaches?
Cervicogenic headaches are non-throbbing, steady headaches felt at the back of the head, with pain extending downwards through the neck and between the shoulder blades. Some patients also experience dizziness. Such headaches are caused by dysfunction in the cervical spine (the portion of the spine located in the neck).
Previous studies showed that chiropractic treatments can alleviate both the pain and disability resulting from cervicogenic headaches. This study showed that chiropractic treatments can also reduce the frequency of such headaches.
The research involved 80 people with chronic cervicogenic headaches. Patients received either light massage or chiropractic adjustments. Within each group, half received high doses of the treatment, while the other patients received lower doses. The light massage treatments involved several minutes of gentle neck and shoulder massage, while the chiropractic treatments consisted of high-velocity, low-amplitude adjustments of the upper back and neck
Improvements with Chiropractic
Patients who received chiropractic treatments improved substantially more than those receiving massage. On average, chiropractic patients saw their headaches cut in half. At the conclusion of the study, chiropractic patients required one-third less pain medication than at the start, and reported a 50% reduction in symptoms.
The researchers found no major differences between patients receiving 8 chiropractic treatments and those who received 16 treatments. Those who received more treatments did have slightly more improvements in terms of neck disability. More research is needed to determine the optimum number of chiropractic treatments, but the researchers have concluded that chiropractic adjustments are an effective method of treating cervicogenic headaches. Research shows that chiropractic can also relieve migraine headaches.
Haas M, Spegman A, Peterson D, Aickin M, Vavrek D. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. The Spine Journal 2010; 10: 117-128.
July 16, 2019
Chiropractic care may be more effective in preventing recurring episodes of low-back pain than traditional treatments. In a recent study, patients receiving chiropractic had lower rates of recurring disability than patients under the care of a physician or physical therapist. With a growing body of research pointing to the recurring nature of acute back pain, the findings could help with efforts to prevent persistent pain in these patients.
The study, published in the Journal of Occupational and Environmental Medicine, included 894 cases of work-related low-back pain gathered from the data of a major US insurer. Patients were divided into groups based on the provider type: chiropractic, physician, physical therapist, a combination of physical therapist and chiropractic or a combination of other health-care providers. During the initial episode of back pain, patients in the traditional care groups had longer durations of disability and higher usage of pain medication than chiropractic patients. (The mean average duration of disability days for physician group was 119 versus 58 for the physical therapy group and 49 for the chiropractic group.)
The researchers also looked at the health maintenance period after the initial episode of back pain to analyze whether patients experienced recurring episodes of pain. After controlling for various demographic and pain severity factors, patients in the physician and physical therapy groups were significantly more likely to have recurring disability compared to chiropractic patients. Despite the advantage of chiropractic over other provider care in terms of disability recurrence, the risk of recurrence among chiropractic patients was as low as patients who weren't seeing any provider during the health maintenance period. This interesting result led researchers to hypothesize that during the maintenance period, the success of chiropractic could lie in preventing patients from receiving treatments of "unproven cost utility or dubious efficacy" from traditional providers.
Avoiding expensive procedures and tests likely contributed to the reduced cost of chiropractic care for patients during the health-maintenance phase. The weekly cost of health maintenance care for the chiropractic group was $48 compared to $87 for the physician group and $129 for the physical therapy group.
The findings suggest that chiropractic care could be a more affordable and effective method of preventing recurring back pain than medical treatments.
?Cifuentes M, Willetts J, Wasiak R. Health maintenance care in work-related low back pain and its association with disability recurrence. Journal of Occupational and Environmental Medicine 2011; 53(4): 396-404.
July 15, 2019
Higher Pain Tolerance
Active women may have a higher pain tolerance than inactive peers. A new study found that women who regularly engaged in vigorous activity were less sensitive to pain than inactive women.
Researchers from the University of Wisconsin and the Middleton Memorial Veterans Hospital enlisted 21 healthy women to participate in the study. Using self-reported and accelerometer measures of physical activity, they classified women as meeting the recommended guidelines for physical activity or not. Women then underwent a procedure involving noxious thermal stimuli and reported their experiences with unpleasantness and pain.
Higher Activity, Less Pain Sensitivity
Active women experienced less pain and unpleasantness than inactive women. The more minutes a participant regularly spent performing vigorous exercise, the less pain intensity and pain unpleasantness she experienced. This significant relationship was not found for moderate activity or sedentary time.
Reducing pain sensitivity could be a major reason why exercise helps to ameliorate symptoms of migraine, fibromyalgia, and back pain.
Ellingson LD, Colbert LH, Cook DB. Physical activity is related to pain sensitivity in healthy women. Med Sci Sports Exerc 2012;4 4(7):1401-6.
July 13, 2019
In an article written to educate the public about back pain, the Journal of the American Medical Association (JAMA) has suggested that patients seek chiropractic and other conservative back-pain treatment before taking more invasive measures.
The article says that surgery is not usually needed for treating back pain and should only be considered when other conservative methods fail.
This recommendation reinforces what the American Chiropractic Association (ACA) teaches patients, as well. Chiropractic should be the first line of defense against musculoskeletal pain.
The article has been published online on the JAMA patient page titled "Low Back Pain," and discusses the causes, symptoms, diagnosis, treatment options, and prevention of low-back pain. The doctors who wrote the article go on to explain that the back is comprised of bones, nerves, muscles, and soft tissues like ligaments and tendons. Back pain can be a result of problems with any of these structures.
Because chiropractors are neuro-musculoskeletal experts, they are well equipped to manage and prevent low-back pain.
In an interview about the JAMA article, ACA President Keith Overland, DC, said that he and his colleagues at ACA were encouraged to see chiropractic suggested for back-pain treatment. He confirmed that in many cases, back pain can be alleviated without the use of drugs or surgery, "so it makes sense to exhaust conservative options first."
And chiropractic makes sense for reducing health-care costs as well. Dr. Overland went on to say, "Research confirms that the services provided by chiropractic physicians are not only clinically effective but also cost-effective, so taking a more conservative approach at the onset of low back pain can also potentially save both patients and the health care system money down the line."
If you have low-back pain, follow the advice of these reputable medical communities. Call Dr. Jeremy Hozjan today at 704-523-2367.
American Chiropractic Association. JAMA suggests chiropractic for low back pain. Businesswire May 8, 2013. businesswire.com.
Goodman D, Burke A, Livingston E. Low back pain. JAMA Patient Page April 24, 2013; 309(16): 1738. doi:10.1001/jama.2013.3046.
July 10, 2019
What Is Frozen Shoulder Syndrome?
Frozen shoulder syndrome, or FSS, is a painful condition causing night pain and restricted shoulder range of motion. Medical treatments for FSS often include stretching or injections of medications and steroids. Unfortunately, these treatments do not always provide lasting results in many patients.
Chiropractic Treatment of FSS
To see if chiropractic could help, a recent case study evaluated the effects of chiropractic spinal adjustments in patients with FSS. After 1-2 months of chiropractic care, 98% of patients had significantly improved range of motion, and 32% of patients had completely regained normal shoulder adduction.
Chiropractic Lowered Pain Scores
Patients also experienced substantial improvements in pain, with the median average pain score dropping from a 9 out of 10 to a 2 out of 10.
Study Confirms Previous Research
This case study suggests chiropractic care is a viable option for patients with frozen shoulder syndrome. Earlier research has shown that manual therapies like chiropractic are effective for pain in the shoulder and upper back.
Murphy F. Chiropractic management of frozen shoulder syndrome using a novel technique: a retrospective case series of 50 patients. Journal of Chiropractic 2012; 11: 267-72.
July 9, 2019
Many patients with chronic back pain wonder how to keep the pain from becoming worse or returning. Research suggests that exercise may be the best way to prevent back pain.
The recent literature review involved an analysis of 20 studies testing various methods of preventing back pain such as exercise, stress management, ergonomic education, training in ergonomic lifting methods, lumbar-support back belts, shoe inserts, and programs to reduce lifting frequency at work. The authors of the review analyzed and compared the outcomes of each treatment.
Of the treatments analyzed, only exercise was shown to consistently produce substantial relief of back pain. Most of the exercise studies focused on methods of strengthening the abdominal and back muscles. Of the studies involving exercise intervention, 7 of 8 scientific studies concluded that exercise resulted in a statistically significant improvement in back pain. In one study, patients who exercised had 127 fewer sick days than those who were inactive.
Exercise is crucial component of chiropractic treatment. A doctor of chiropractic can show you how to perform safe exercises for reducing back pain.
Bigos S, Holland J, Holland C, Webster J, Battie, Malmgren J. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. The Spine Journal 2009; 9: 147-168.