Toronto Health Blog

I sometimes get patient comments about what colleagues, co-workers, or related family members think about chiropractic. Specifically these comments are about neck adjustments and about the risk. Thus, I thought I would post some of the more common questions about neck adjustments and chiropractic in general.

Chiropractic care has a strong safety record and is widely accepted as a drug-free, surgery-free form of health care. However, no health treatment is completely free of potential adverse effects. Even common non-prescription pain relievers carry a risk. Fortunately, adverse effects associated with chiropractic adjustment are usually minor and short-term.

What is a neck adjustment and how do I benefit from this procedure?

A neck adjustment (also known as a cervical manipulation) is a precise manual procedure applied to the joints of the neck. Your chiropractor has received extensive training to perform this procedure. Neck adjustment works to improve the mobility of the spinal joints in the neck to reduce muscle tightness, restore range of motion and help relieve pressure and tension. Patients typically notice a reduction of pain, soreness and stiffness, improved ability to turn and tilt their head, and enhanced well-being.

What training do chiropractors have?

Chiropractors complete an intensive four to five year full-time program following university studies or graduation from CEGEP in Quebec. All chiropractors must pass national qualifying examinations and be provincially licensed in order to practice in Canada. Chiropractors are trained to take a medical history and assess your condition before making a diagnosis and proposing a treatment plan. Your chiropractor is trained to determine if a neck adjustment is right for you. He or she may decide to use massage, exercise or other therapies to treat your condition.

Is neck adjustment safe?

Yes, it is. Millions of neck adjustments are performed safely and effectively every year in Canada. Neck adjustment is performed well within the normal turning range of the head. There is less movement than it takes to look over your shoulder. One of the most recent studies into the safety of neck adjustment further confirms the safety of this procedure.(1) This particular study, conducted in 2007, looked at over 19,000 chiropractic patients and tracked more than 50,000 neck adjustments. It found no instances of serious adverse effects. By way of comparison, neck adjustment is significantly safer than other commonly used health remedies. For example, long-term use of non-prescription pain relievers carries a far greater risk of serious complications than neck adjustment.(2) Most patients experience immediate relief following an adjustment, however, some may experience temporary soreness, stiffness or slight swelling. In rare situations, patients may experience symptoms such as dizziness, local numbness, or radiating pain. If this happens to you, it is important to tell your chiropractor who can help you manage any effects of treatment.

I am worried about the risk of stroke from having my neck adjusted.

The most recent research into the rare cases of stroke found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit their family physician.(3) The study concludes that this type of stroke commonly begins with neck pain and/or headache which causes the patient to seek care from their chiropractor or family physician before the stroke fully develops. This type of stroke is extremely rare and has been known to occur spontaneously. Research continues as to why in very rare cases, some people are susceptible when most of us are not.

How do chiropractors know who should not have a neck adjustment?

Your chiropractor will take a careful history of your health, your recent activities, and any unusual symptoms you may have before deciding whether an adjustment is right for you. Chiropractic treatment guidelines help doctors of chiropractic identify patients whose neck pain symptoms are unusual and provide clear advice on when not to perform a neck adjustment. In these cases, the patient should be referred to a medical doctor for further testing. However, it is not always possible to distinguish ordinary neck pain from neck pain that may be related to pre-existing artery damage.

Why would neck adjustment have an effect on anything other than neck pain or headache?

Pain or discomfort in one area of the body may be linked functionally to discomfort arising from another area. That is why treating a problem in one part of the body may relieve symptoms in another part. If you look at a model of the spine, you can see that the spine is an interconnected structure. Adjustment at various points along the structure may be needed to help reduce stress on other parts of the spine and relieve discomfort.

Are all neck adjustment techniques equally safe?

Chiropractors are taught a variety of adjustment techniques and there is no evidence to suggest that any of these techniques is less safe than the others. Chiropractic techniques that are applied appropriately are effective and safe.

For more information on the chiropractic profession and chiropractic care visit the Canadian Chiropractic Association and the Ontario Chiropractic Association websites.

1. Safety of Chiropractic Manipulation of the Cervical Spine: a prospective national survey. Thiel HW, Spine, October 1, 2007, 32:21.
2. American College of Gastroenterology
3. Risk of Vertebrobasilar Stroke and Chiropractic Care. Cassidy JD. et al. Spine, February 15, 2008, Volume 33, Issue 4S Supplement.

Anyone can fall, but unfortunately the risk of falling increases as you get older. Many older individuals can suffer falls that can take a toll on independence. Hip fractures are the most common type of fall injury among seniors. It has been also found that a significant number of injury - related deaths can also be traced back to a fall. Therefore, here are some useful tips to help prevent falls from occurring.

Exercise

Making your body stronger is one of the best ways to prevent falls. It also helps you feel better. Exercises that help improve your balance and coordination, such as Tai Chi, yoga, and dancing tend to be the best. Health Canada recommends at least 30 to 60 minutes of exercise a day for older adults. A 10 minute walk in the morning and a 10 minute walk at lunch all add up at the end of the day.

Eat well

Maintaining a healthy diet and not skipping meals can increase your energy and strength. Missing meals can lead to weakness, irritability, and dizziness.

Slip and fall proof your home:

In the halls and on the stairs

• Mark the edges of stairs clearly with a non-slip grip in an easy to see colour.
• Make sure hallways and walkways are cleared of anything that you can trip over (i.e. books, shoes, bags, etc.).
• Replace light bulbs with a slightly higher wattage to make your home brighter. As you age, brighter lights may help you see better.
• Install night lights in halls and stairways.
• Install handrails on both sides of staircases. Be sure to take off your reading glasses and keep your hands free at all times when walking up or down the stairs. This allows both hands to control your yourself if you do start to fall.

In the Bathroom

• Install grab bars next to your toilet and in the tub or shower.
• Consider a raised toilet seat and a bench for the tub or shower.
• Use non-slip mats inside and outside the bathtub and shower.
• Quickly dry any wet areas on the floor to prevent slips.

In the Kitchen

• Clean up spills quickly to prevent slipping.
• Put commonly used items on lower shelves and cabinets so a step stool is not needed.

More tips

• Wear shoes with good support and non-slip soles.
• Use aids for walking, balancing, hearing, and seeing if needed. Have your vision and hearing checked annually.
• Ensure that a telephone is within reach of your bed and keep emergency numbers nearby.
• Always sit down to put on or take off shoes and clothes.
• Don’t be too proud to ask for help for things you cannot do on your own.

Check it out

• Have your medical doctor or pharmacist review your medications. Some medications can cause dizziness and weakness, which can affect your balance and perception. Make sure that your medical doctor or pharmacist explains all of the possible side effects of your medications so that you are well informed.
• Have your strength and balance assessed by a chiropractor. A doctor of chiropractic can provide specific advice to help you stay steady on your feet.

Chiropractic is here to help. Chiropractors can help you prevent falls by assessing your strength and balance capabilities. Be safe and informed. Should you suffer an injury from a fall, a chiropractor can also assess your injury and provide treatment for your pain.

Chiropractic is a great way to deal with everyday aches, pains, and injuries that occur to all of us at some time or another. Staying healthy and functional is the most important aspect of our lives. Chiropractic can help with hands on health care that really works. Below are some common questions and facts on chiropractic.

When should I consider chiropractic care?

There are many reasons to seek chiropractic care. Work, accidents, sports injuries, household chores, even the stress of daily living can cause painful joint and spinal problems. Even sore ankles and feet, elbow and wrist pain can be treated. Even if you do not have painful symptoms, chiropractic care can help you maintain a healthy spine improve joint function throughout your body.

Here are some of the most common reasons why people will visit a chiropractor:

• Back pain
• Neck pain
• Headaches
• Whiplash
• Strains and sprains from daily activities
• Repetitive strain injuries
• Work and sports related injuries
• Arthritis
• Foot, ankle, wrist, and elbow pain
• Restricted movement in the back, shoulders, neck or limbs

Benefits of chiropractic care

Chiropractic treatment is skilled, hands on health care that relieves pain and helps your body function its best. Here are just some of the ways chiropractic can help you.

• Improved movement in your neck, shoulders, back, and torso
• Better posture standing or sitting
• Relief from headaches, neck, and back pain
• Prevention of work related repetitive muscle and joint injuries
• Enhanced athletic and sport performance
• Improved flexibility
• Relief of pregnancy related discomfort and back ache
• Correction of gait and foot problems
• Chiropractic. Helping you feel and function better. Naturally.

What is an adjustment?

An adjustment is a highly skilled and precise movement applied by hand to any joint of the body. An adjustment momentarily loosens a joint and helps to promote its normal motion, relieving pressure on the joint and surrounding nerves. When a joint is adjusted, a gas bubble forms and pops which causes the popping noise like when people crack their knuckles. As one treatment builds on the next, adjustments give your body a chance to heal as proper joint function is restored.

Why is spinal health important?

The body has an information highway which is your nervous system that is protected by the spine. The nervous system travels out between the vertebrae or joints of the spine to carry messages from the brain to every corner of your body. Stress and strain on the vertebrae can put pressure on the nerves in the affected area. That is why a problem with your spine can have far reaching effects causing symptoms such as arm or leg pain. Making sure your spine is as healthy as possible is important for the short and long term.

Evidence based and patient centered care.

Chiropractic adjustment techniques have been researched extensively. Complications are very rare and side effects, such as temporary soreness, are usually minor. A chiropractor is well trained to determine if your problem will respond to chiropractic care or if you require referral to another healthcare provider. Chiropractors are regulated health professionals with a licensing college that is charged with protecting the public and setting standards for the profession.

What is chiropractic health care?

The word chiropractic comes from ancient Greek and simply means done by hand. Adjustment of the joints of the body has been used in the healing arts for many centuries and is at the heart of modern chiropractic care. Chiropractors are specialists in manual adjustment of the vertebrae of the spine and all other joints of the body. Adjustment helps to relieve pain and restore normal functioning to the spine, joints and supporting structures of the body allowing you to enjoy your everyday activities again as quickly as possible. Chiropractors are also trained to prescribe therapeutic exercise, provide nutritional counseling, and recommend rehabilitation and injury prevention strategies.

Did you know?

Back pain, neck pain, and headache are the most common reasons why people first consult a chiropractor. If aching joints and muscle pain are affecting your ability to get through the day and keeping you away from your favourite activities, consider chiropractic care.

Heading out to tee off? An early golf season is upon us. Below are some tips every golfer should know.

The warmer weather has golfers raring to hit the greens. However, dedicated golfers who want to make the most of their season should follow these simple tips that will not only improve your golf game but, most importantly, will help to keep you injury free.

1. When lifting your golf bag, try to bend you knees and lift using your legs, not your lower back.
2. Always warm up with a few minutes of aerobic activity, such as brisk walking to get the blood flowing and muscles warm.
3. Stretch the muscles in your back, abdomen, legs, and shoulders before your game.
4. Use clubs that are the correct length for you, so you do not have to bend or overextend your back.
5. Wear proper golf shoes with good arch support and soft spikes for greater cushioning and shock absorption.
6. Use a pull-cart rather than carrying your clubs.
7. Take some lessons on how to swing and choose the correct club to improve your efficiency and keep stress off your body.
8. Occasionally practice swinging in the opposite direction in order to balance the stress on the muscles in your back.
9. Bend your knees and use a golf club for support when stooping to retrieve your ball.
10. Always stretch to cool down after finishing a round.

If you experience pain during or following your game, it is important that you seek out treatment immediately. The longer an injury is allowed to linger, the more difficult and lengthy the healing process can be. Good luck out there.

Many back problems are indeed preventable. By following some of the simple tips below, you can help your back stay healthy, keeping you on the job and the best you can be. Workplace safety is essential to your health, now and for the future. Watch for these common causes of back and neck trouble at work:

1. Lifting heavy and awkward loads.
2. Long periods of standing.
3. Long periods of sitting.
4. Poor posture.
5. Poorly designed work stations (home and office).
6. Poorly fitted or set up chair (home and office).
7. Computer screen at the wrong height or angle.

Does your work day involve heavy or awkward lifting? Does it require long periods of sitting in front of a computer? Do you spend hours behind the wheel driving? If you answered yes to any of these questions, you are at increased risk of back strain or injury. This could lead to recurring problems or pain if not managed properly. Below are important tips to help keep your back healthy at work.

If your job involves physical labour:

1. Warm up with some stretches before you begin work. Five or ten minutes of simple movements can make all the difference to your day. Try some lunges, partial squats, toe push ups, and knee to chest stretches. Wrap your arms around yourself and turn as far as you can one way, then the other. With hands on your hips, bend to one side, then the other. Rotate each ankle, then each wrist. Now you are ready to start your work day.
2. Lifting can be a source of serious trouble for your back and spine. Position the object you are lifting close to your body and use your knees, and arm and leg muscles, to slowly lift the object. Make sure you keep the load close to you body as best you can. Keep your back straight and be sure that the trunk of your body is pointed in the same direction as your feet. In other words, try not to twist your back in relation to your feet.

If your job means standing for most of the day:

• Take mini breaks and move around a bit. Do some easy stretches, like bending side to side, stretching your arms overhead, and shaking out your legs and arms. When working, try to stand with one foot slightly raised and resting on a rail, block, or whatever makes sense in your work area and is acceptable to your supervisor or workplace safety coordinator.

If you sit all day:

You may work at a desk, a computer screen, or take phone calls all day. Sounds easy on the body, but non-active or static work posture can also take a real toll on your health. Here are some tips to help you along the way:

1. Never cradle the phone receiver between your shoulder and neck. Try to hold the receiver in your hand, use a headset, or use a speakerphone.
2. Avoid sitting with your legs crossed. If you must cross them, alternate sides from time to time or cross your ankles. This will put less strain on your lower back.
3. Try to arrange your desk so that the items you use most frequently are closer to you or at least within arms reach.
4. If you do a lot of computer work, centre the monitor in front of you, positioning it so that the first line of text, or window you are working wth, is at eye-level. Place the keyboard directly in front of you and lay out your papers just to the side of your keyboard. Even better, put your reference material in an upright document holder, so that you do not have to constantly raise and lower your head, which may cause a tension headache.

No matter how many safety precautions you take and warm-ups that you do, inevitably, there will come a time when you will experience some kind of injury. From mild to severe in nature, below are five simple rules to help speed your rate of recovery in the first 72 hours of ligament sprains or muscle strains. However, be sure to remember if you are unsure of the severity of your injury, consult a qualified health provider to diagnose the injury properly.

Whether it is an ankle, knee, shoulder, or wrist sprain-strain, all you need to remember is PRICE as explained below.

P is for Protection.

Protect the injured area from sustaining any more damage. A sling or elastic wrap (tensor bandage) is most often used to support an area. Avoid activities that aggravate the injury or make it worse.

R is for Rest.

Rest will allow the injured area time to heal. Again, avoid activities that cause pain, especially sharp pain, swelling, or discomfort. However, it may be hard but try not to avoid all activities. For example, if you injure your shoulder, you may still be able to go for a walk. Try to do some form of exercise to keep up your cardiovascular levels of fitness and also prevent muscles from becoming weak.

I is for Ice.

Ice should be applied to an injured area as soon as is possible to control pain. You can use an ice pack, frozen vegetables, or a bag of crushed ice wrapped in a damp towel. The damp towel will provide protection to your skin from burns and help to transmit the cold to the tissue more effectively. Ice can be applied every hour for as many times as possible in the first 72 hours. You can apply the ice for 15 minutes at a time maximum and try not to fall asleep with it on. Then keep the ice off for 45 minutes to allow the tissue to return to normal temperature. If you notice a white area on the soft tissue stop icing immediately as it could indicate frostbite. If you have diabetes, vascular disease, or any other disease involving decreased sensation, consult a health professional before applying the ice. The ice will help to reduce pain and inflammation to your injured muscles, joints, and other soft tissues. It may even slow bleeding if a tear has occurred.

C is for Compression.

Use a tensor bandage to wrap the injured area. Ensure that the wrapping is not so tight as to cut off or impair blood circulation. Compression is used to help stop swelling. When wrapping, begin at the end furthest away from the heart. For example, when wrapping an ankle, begin at your toes and work your way up to your calf.

E is for Elevation.

Raise the injured area above the level of the heart, especially at night. This can be done by putting a pillow or two under the affected area. This uses gravity to help reduce swelling by draining excess fluid.

Then what?

After the first 48 hours, slowly start to use the injured area again and continue icing for another day. You should gradually see improvement in the ability of the affected area to move without pain and to support your weight. If your injury is not improving by the fourth or fifth day, consult a chiropractor or other qualified health professional. Various treatment modalities can be used to help decrease pain during the acute phase and during rehabilitation. Stretching and specific exercises can be prescribed to help prevent future injuries. Adjustments and mobilizations may also be used to increase joint mobility.

Tension type headache, you can take control.

Tension type headaches are one of the most common forms of headaches and yet they are not well understood. Most people describe having a band of pressure around their head that can last from 30 minutes to a week or more. Tension type headaches can be related to muscle hypertonicity, or tension, in the upper back, neck, and scalp. One of the best ways to combat tension headaches is through lifestyle and ergonomic changes. The following are some helpful tips.

Exercise regularly.

Exercise can help reduce the frequency and intensity of headaches. Exercise relieves stress, relaxes your muscles, and increases the levels of beta-endorphins, which are a natural stress reliever of the body. So try not to just sit around, go for a walk, bike ride, or run.

Healthy lifestyle.

Behaviors that promote general good health may help prevent headaches. This includes following regular eating and sleeping schedules and avoiding excess caffeine and alcohol.

Stress management.

Stress is a commonly reported trigger for tension type headaches. Reduce stress in your life by organizing your day ahead of time. Try relaxation techniques such as deep breathing, yoga, and meditation. Take time away from your busy life to do the things you love to do. Consider seeing a counselor to develop new coping skills. Be aware they are also trained to help you identify events that trigger headaches and work towards a resolution.

Muscle relaxation.

Muscle tension is associated with tension headaches. Applying heat or ice to sore muscles in the shoulders and back of the neck may ease the tension. Usually you can not go wrong with heat if it makes it heel better. However, if it makes your headache worse or your neck throb try using ice to deal with the pain. Massage is another way to relieve muscle tension. Gently massage the muscles of your head, neck, and shoulders with your fingertips. Or better yet, have someone else do the massage for you. A warm bath can also do wonders for those tight, achy, and stiff muscles.

Perfecting your posture.

Good posture can help keep your muscles from tensing up and reduces strain on your body. A jutting head (anterior head carriage) combined with slumped shoulders (slouching) can bring early fatigue and tension to your neck and upper back. When standing, your head, shoulders, hips, and ankles should line up, one comfortably above the other. Have a friend or family member look at you from the side. Your knees should be slightly bent and your feet should be shoulder width apart.

Telephone.

Use your hand to support the telephone against your ear and alternate sides regularly. Do not cradle the phone between your ear and your shoulder. If you are on the phone a lot, consider using a headset or speaker to reduce strain on your neck and arms.

Headache diary.

Record when your headaches occur and what you were doing before they started. Try to recognize the factors that cause or aggravate your headaches. This can be invaluable in defining how to manage your headaches. Be sure to tell your health care provider if you have noticed any changes in your usual headaches such as frequency, duration, or intensity. Also, be very sure to let them know if your headaches begin to worry you (i.e. the worst headache you have ever had).

Dealing with some of the above issues can help you get back on track to controlling your pain and discomfort. A visit to a chiropractor or other health care provider may be necessary to rule out any mechanical or structural issues related to your tension headaches. There are better ways to be comfortable and healthy.

All the best to everyone for the holiday season and have a prosperous and healthy new year. May all your resolutions come to pass. Also, be sure to check out last years holiday post for great stress relieving ideas.

In a pervious post I talked about how Hockey can be a great way to get in shape and have fun for the whole family. However, proper warm-up and cool-down is an important aspect of the game that allows you to stay healthy and active all season long.

Remember:

• Never stretch a cold muscle. Always warm up actively by getting your heart rate up a bit for improved blood flow before stretching.
• Do not overstretch and be comfortable while doing it.
• Do not bounce when stretching.
• If you experience pain that lasts longer than your usual post-game soreness, ice the area and consult a chiropractor.

Pre-game stretches:

Hamstring Stretch:

1. Lay on your back and bend one knee towards the ceiling. Hold the back of the thigh with both hands and straighten the knee as much as you can by raising your foot towards the ceiling. Hold the stretch for one second, then bend the knee and straighten again. Repeat 20 times on each leg.

Groin Stretch:

2. Stand with your feet slightly wider apart than your shoulders. Bend your knees. Shift your weight to the right leg. Reach down and across your body with your left hand to touch your right foot. Point your right hand up to the ceiling at the same time. Keep your back parallel to the ground. Then shift your weight to the left leg. Repeat 10 times on each side.

Hip Flexor Stretch:

3. Stand with you feet shoulder-width apart. Step forward with your right foot into a lunge position. Your right knee should be directly over the toes of your right foot. Keep your left leg and you back straight. Extend your arms straight in front of you and bring your palms together. Turn your upper torso to the right keeping your pelvis and hips stationary. Hold for one second and repeat 10 times on each side.

Post-game stretches:

Quad Stretch:

1. Stand with your back to a wall or the rink boards. Kneel onto you right knee (you can use a pad for cushioning) with your right foot flat against a wall. Your left knee should be bent in front of you at a 90 degree angle for support. Place your hand on your left knee for balance and lean back slightly to stretch your right quad muscle. Hold the stretch for 10 seconds. Switch legs and do 3 stretches on each side.

Glute Stretch:

2. Sit on the ground with one leg slightly bent behind you (outside of leg facing up) and one leg slightly bent in front of you (inside of leg facing up). Lower your chest toward your knee keeping your back straight and holding your chin up. Hold the stretch for 10 seconds. Switch legs and repeat 3 times on each side.

Hip Stretch:

3. Lay on your back with your knees bent and feet flat on the floor slightly more than shoulder width apart. Lower your right knee to the floor and place your left ankle on top of it pushing the knee towards the ground. Keep your hips flat on the floor at all times. Hold the stretch for 10 seconds. Switch sides and do 3 stretches on each side.

Play safe, stay fit, and have fun.

Cell phones emit radiation when you talk and send text messages between yourself and other callers. Health risks are not confirmed at this time; however, some but not all studies of frequent cell phone users suggests an increased risk for brain and mouth tumors and children’s behavior problems. Therefore, to be on the safe side, the Environmental Working Group recommends following the tips below to help reduce your exposure.

Buy a low radiation phone.

1. Look up your phone on the EWG’s buyer’s guide. Your phone’s model number may be printed under your battery. Consider replacing your phone with one that emits the lowest radiation possible and still meets your needs.

Use a headset or speaker

2. Headsets emit much less radiation than phones. Choose either wired or wireless as both seem to emit the same amount. Some wireless headsets emit continuous, low level radiation, so take them off your ear when you are not on a call. Using your phone in speaker mode also reduces radiation to the head.

Listen more and talk less.

3. Your phone emits radiation when you talk or text, but not when you are receiving messages. Listening more and talking less thus reduces your exposure.

Hold your phone away from your body.

4. Try holding your phone away from your torso when you are talking, not against your ear, in a pocket, or on your belt where soft body tissues absorb radiation.

Choose texting over talking.

5. Cell phones use less power (i.e. less radiation) to send text than voice. Also, texting keeps the phone, and thus radiation, away from your head unlike when you speak with the phone at your ear.

Poor signal? Stay off the phone.

6. Fewer signal bars on your phone means that it emits more radiation to get the signal to the tower. Make and take calls when your phone has a strong signal.

Limit children’s phone use.

7. Young children’s brains absorb twice the cell phone radiation as an adult’s. The EWG, along with numerous other health agencies recommends limiting children’s use to emergency situations only.

Skip the radiation shield.

8. Radiation shields such as antenna caps or keypad covers reduce the connection quality and force the phone to transmit at a higher power with higher radiation.

Visit the Environmental Working Group-Cell phone radiation webpage for more detailed information on this topic. Talk to you soon