Fall Prevention

Falls are the leading cause injury deaths in people over the age of 65 and alarmingly the rate of deaths due to falls has increased dramatically in the last decade.  It has been postulated that side effects to medications may be a significant factor in this increase. Given our aging population, the numbers of serious injuries and deaths from falls is expected to continue to increase.

The first step in preventing falls is to have the neck checked for vertebral subluxations which may affect the posture orientation and equilibrium system of the body.  Chiropractic adjustments can be very effective to improve balance and prevent falls.    According to the Mayo clinic steps to take to prevent falls include keeping physically active, wearing sensible shoes, removing hazards from around the home, keeping living spaces well lit, and using assistive devices such as canes and walkers.

Here are some exercises to improve balance.  Please start the exercises at a slow pace.

1. Put yourself in the position that activates the dizziness and hold for 30 sec.  Repeat.  The symptoms should diminish with repetition.
2. Move the eyes up and down and side to side while keeping the head stationary.
3. Repeat exercise 2 while focusing on a finger held in front of the face.
4. Bend over as though you are picking something off the floor 20 to 30 times.
5. Watch a ball as you throw it from hand to hand 20 to 30 times.
6. Walk across an uncluttered room 10 times with your eyes open
7. Walk across the room 10 times while turning your head from side to side while focusing on fixed items on the walls.
8. Walk across the room 10 times with your eyes closed.  Make sure the room is safe!  You may need someone to assist you.

The best time to start a balance improvement program is before you have balance problems.  Prevention is the term.  Even if dizziness is already present, all people are capable of improving their balance.  Talk to your chiropractor.

Imbalance

When I use the term imbalance, I'm referring to dizziness which is also referred to as vertigo.  It can be a light headedness, a sense of being unstable, the room may be spinning or the person may feel like they are spinning in a stationary room.

Imbalance or dizziness is reported by 70% of non-institutionalized people over the age of 65.  Balance experts report that all people are capable of improving their balance.  It is one area that there need not be a constant decline.

Here's  a simple test to see how good your balance is: stand on one foot.  You pass if you can do it for 30 sec (under age 60), 21 sec (60-69) and 14 sec (70 - 79).  Now try it with your eyes closed.  Do this where you can grab onto something or have someone to catch you.  I don't want you to hurt yourself doing this test.  Your balance is good if you can last 21 sec, 10 sec. or 5 sec. for the age groups listed above. Try it.  How did you do?

Balance is controlled by three systems in the body.  The vestibular system in the inner ear receives the most attention and when imbalance occurs it is almost always blamed on inner ear problems.  But the posture orientation and equilibrium system which is concentrated in the upper neck is probably of equal importance.  The third system is the visual system,  All three of these systems work together to keep our body balanced.  If any one is impaired the others attempt to take over to keep us balanced.  Dizziness occurs when these systems fail.

Chiropractic adjustments have been shown to have a profound effect on the posture system which is concentrated in the upper neck.  Many people with balance problems have benefited from receiving chiropractic care.  There are also procedures within the chiropractic scope of practice that can improve vestibular function as well, including exercises.

The big concern with imbalance is that it leads to falls.  As we all know, falls can result in serious injuries, particularly in the elderly.  I'll discuss fall prevention in my next post.

More is Not Necessarily Better

Recently, a colleague with a shoulder problem was frustrated that low level laser was not helping his condition like he thought if should.  Then after our latest Activator Methods seminar we were both reminded of the fact that when using laser more is not always better.  As a matter of fact high levels of laser actually inhibit the healing process.  This is one of the known features of laser.  Low dosages stimulate healing while high dosages inhibit.  Inhibition, while seemingly negative, can be of great therapeutic value.  In my friend's case the high power he was using was not beneficial.  He has since reduced the power of his shoulder treatment and is getting better results.

The more is not always better approach applies to more than just laser.  I've used the light force Activator adjusting instrument for over 25 years.  The results I've gotten have been equal to or superior to many procedures which use much more force.  As a matter of fact a research study at the University of Calgary has demonstrated the Activator instrument created more bone motion than manual adjustments which used many times the force.  The Activator analysis system also follows the more is not necessarily better approach.  It indicates where to adjust, when to adjust and, of equal importance, when not to adjust.  The when not to adjust is often the toughest part for us chiropractors to grasp but the body responds best when we pay heed to it's needs and not our wants.  I know that my body responds best when I'm I receive the only the optimal number of adjustive thrusts.

In human nutrition, each individual responds to differently to levels of specific nutrients.  Some people need higher dosages than other to achieve benefits.  On the flip side, some people respond much better to lower levels of nutritional supplement intake.  That's what makes nutritional counseling such a challenge.  Each individual is different and more is not always better.

The challenge as a chiropractor when adjusting, using laser therapy, or recommending nutritional products to determine the optimal level for each patient.  Too little and the results are poor.  Too much and the results are poor.  Reminds me of the three bears story.  The chair, the porridge, and the bed needed to be just rightto make Goldilocks happy .  Optimal therapy produces optimal results.  It can be a challenge to get it right.

Chiropractic vs Medicine for Low Back Pain

Many people consult chiropractors for their back pain only after they have tried everything else.  Researchers are now telling us this is the backwards approach to looking after acute low back pain.  A December 2010 research paper published in The Spine Journal compared medical care and chiropractic care for acute low back pain.  


You can read the abstract of the research paper by clicking the link above, but I will summarize the findings for you.  Acute low back patients where divided into two groups.  The first received "usual" medical care which consisted of a variety of treatments including medications, massage therapy, and physiotherapy.  The second group received chiropractic care for a period of 4 weeks.  The participants were evaluated for both pain and function in their lower backs at 8, 16, and 24 weeks after starting care.  Significantly, after 16 weeks 78% of the people in the medical care group were still taking narcotic analgesic medications.  They also had much poorer scores on the function of the low back.  That is the ability to perform normal daily activities.  At the 24 week mark, both groups had improved pain scores but the medical group showed no improvement whatsoever in back function.  The chiropractic group had significant function improvement.  Please note that chiropractic care was discontinued after 4 weeks while medical care was carried on throughout the study.


The authors of this study also specifically noted that "spinal manipulative therapy" (I prefer the term adjustment; see my 23/04/2011 post) is only effective when performed by chiropractors.  It is not effective when given by osteopaths, physicians, physiotherapists or other practitioners.


The data in this study shows that chiropractic care is astoundingly superior to medical care in improving the ability of people with acute low back pain to return to normal activities.  Although not specifically mentioned in the study, we can extrapolate that by delaying chiropractic care people under medical care will have a much more difficult time to returning to normal function.  They will suffer unnecessarily and the direct and indirect costs will be much higher.  The wise thing for people with low back pain is to consult a chiropractor first not last.

Summer Holidays

There is a magnetic appeal to be camping in the trees by a lake.  Sort of the quintessential Canadian summer holiday.  Scientists are now pinpointing to why this is so appealing.  The April 2011 issue of Cottage Life summarizes some of the findings.  Unfortunately, there is no link to this article on their website.

It turns out that besides emitting vast amounts of oxygen which helps us to feel good by opening and scrubbing our lungs, evergreen trees also release semi-narcotic aerosols that relax the nervous system.  Other chemicals released can reduce the heart rate and some have antiviral properties.

A psychologist from the University of Michigan has shown that spending time in nature improves memory, focus and mood.  The stimuli in nature refresh the brain and boost cognitive function.  It seems to be a perfect antidote to the short attention spans, anxiousness and reduced cognition we experience living and working in concrete and steel.  Another researcher at the university prescribes getting into nature to restore brain function and treatment of depression.  He calls his procedure "attention restoration therapy".

British researchers have demonstrated that outdoor activities improves self-esteem in youth and elevates mood in middle age adults. Adding water, such as a lake, to the equation multiplied the feel good effects.  That may be have something to do with all the negative ions found around bodies of water.

If you want to have a summer vacation that really refreshes you, these researchers say spend some time by a lake or river in the forest.  Even if you don't have a tent or trailer, just spending some time in nature will be rejuvenating.  We've all felt it.

Happy Mothers' Day

My mother loved flowers and I always got her a special bouquet for Mothers' Day.  If my sons are in town they always take their mother out for a nice meal, which she appreciates.  What mother doesn't relish a meal she doesn't have to cook?  Then I looked through all the flyers today and saw the thousands of things that should make a mother happy.  Many of them were nice and may be as pleasing to some mothers as flowers were to my mother or a nice meal is to my wife.  But are these the things a mother really, really wants?  I looked at all the things and wondered. 

I don't think things are what mothers really want.  I'm not a mother, so I may be out of line here, but I think what a mother really wants to know that her children are safe, healthy, and successful.  You can please your mother by being selfishly pursuing these qualities.  You can achieve them.  And your mother will feel blessed as a result!  I'm sure that's what gave my mother a real Mothers' Day boost. When she knew her children were safe, healthy, and successful, she was truly happy.

Give your mother the flowers, the meals and the gifts to show your love for her, but be the best you can be and you will be giving her the gift she really wants from her child.  Look after your health and pursue worthwhile goals all year long for your sake and you will make your mother happy.

Master Adjuster

A few weeks ago I attended a seminar for a chiropractic technique that I knew little about but was curious to find out more information on.  Also attending the seminar was a colleague I have known for years.  This fellow is a good friend.  I was struck when he told me he was adding this technique to the arsenal of methods that he regularly uses.  I was surprised.  This gentleman already utilizes an armada of techniques.

As the seminar progressed, I surveyed the room, and of the people attending whom I knew, I thought of the ones I most wanted to get adjusted by.  My friend was very low on the list.  The chiropractors at the top of my list were the ones who focused on a particular chiropractic technique.  Not to say they are not proficient at more than one technique, but rather that they focus on one technique.  It is their specialty.  They have mastered it.  I love getting adjusted by chiropractors who are masters of their technique.  The adjustments are usually special.  On the other hand when I've been adjusted by a jack of all trades chiropractor, the experience has never been so great. 

I want to be adjusted by a someone who is master of his technique.  I think my patients want the same.  That's why I have focused for 25 years on being the best I can be at using Activator Methods.  It seems I'm still learning the nuances of the technique.  When I give an adjustment, I'm confident my patient is getting the best adjustment I can give them.  I do have other adjunctive procedures I may use but they are not my main focus.  If a patient needs something I'm not proficient at providing, I like to refer them to someone who's a master in that procedure.  Be it laser, massage, ART, Thompson, NUCCA, cranio-sacral, etc. let the patient be treated by the practitioner who is the master at the technique.  That's what I want for myself.  That's what I think is best for my patients.

Technology Update

Our staff and doctors had the opportunity recently to have some training in the computer system we use at our office.  The program developer walked us through many of the capabilities of the system and give us previews of upcoming innovations.  It's hard not to get excited about new technology, especially when you are intrigued by technology like I am.

New technology can make it possible for us to do things we simply couldn't do before.  It can also result in increased demands on what we produce.  One of the things we are preparing for is participation in province wide access of patient records between all health care practitioners.  This should be of benefit to the patient by reducing duplication of services and procedures.  Communication of findings and concerns will be simplified.  However there is a rat's nest of concerns with implementing such a system, not the least of which is maintaining the privacy of the patient.  Coordinating the development of the necessary technology is huge and, not surprisingly, there has been very little direction from the province thus far.  That makes planning difficult and potentially very costly for an independent clinic like ours.  We know it will mean digitizing all patient records.

While improving our office computer system will potentially improve our ability to help our patients, it won't adjust their spines.  I still need to be a doctor.  I need to determine where the vertebral subluxations are and how to correct them most effectively.  Technology can be an aid, but it still comes down to my ability to release the healing powers of the body.  The body still does the healing - and it always will.  I always need to remember that when evaluating new technology.

Bed Wetting

Chiropractors have had great success helping kids with bed wetting problems.  Like any condition, finding the cause can involve some detective work.  Very often there are vertebral subluxations in the pelvis, low back or neck which cause interference in the nerve communication between the brain and the bladder.  If this is the cause, chiropractic adjustments help the situation.  Usually a short series of treatments and the child is dry.  Sometimes there are other causes which may require dietary changes or other treatments.

The most challenging bed wetting I've dealt with was the case of A.R.  He came to me at age 16 and his mother described how he had not had one dry night in his life.  You can imagine what that does to the self esteem of a 16 year old.  You can also imagine cleaning up every morning for 16 years. The family had tried everything they and their family physician could think of.  I knew from the onset this would not be an easy case!  I made no promises, just that I would try my best. 

After 16 years the neurological patterns are well established and take time to change.  In addition to the bed wetting, A.R. also complained of chronic pelvic and knee pain.  Unfortunately he lived quite a distance from the office and could not make frequent visits.  This slowed the process.
 

I started adjusting him using Activator Methods.  We also looked at his diet and had him reduce his soft drink and coffee intake as well as go off dairy products.  After his 10th treatment A.R. was dry for 3 nights in a row.  Over the next 4 months a consistent pattern developed where he would be dry for a few nights after each adjustment, but the wetting always returned.  A.R. persisted and came to the office as frequently as he could.  By the eleventh month, he was almost consistently dry.  I continued seeing A.R. for several more months but his usual complaints had changed to recurrence of the pelvic or knee pain not the bed wetting.  He was a different young man the last time I saw him than when he first came to see me.

Nerve interference from a vertebral subluxation can cause a host of problems.  Bed wetting is one of them.  As a chiropractor I treat the vertebral subluxation, not the bed wetting specifically.  The bed wetting is just a symptom.  The problem is the subluxation.