How To Get A Headache

Some very common postures can give you a headache!

        Here's what to watch out for:

Leaning your head back to look upward toward a TV or computer monitor, or tilting the head backward to see a monitor through the near-focus part of bifocals, are common postural producers of headache. 

These postures causes the occiput (the bone across the back of the head)  to be stressed inferiorly. This inferiority may be more on one side or the other (unilateral) or global (bilateral). 

When patients present with this in my office, it may be in combination with a superiority of the posterior part of the second cervical vertebra, an additional complication which makes the headache even worse.

I make gentle, focused, precise adjustments that correct the problems without discomfort to the patient, and I provide ergonomic counseling to help keep this from happening again.  

A Piriformis Predicament

When there is pain, or numbness / tingling going down the leg, a patient’s first thought is often, “Uh-Oh. It must be a disc.”

Impingement of nerve(s) by a bulging disc can be the cause of these symptoms, but in the absence of any history of injury, such as a lifting strain or a fall or accident, or of disc problems, it is not necessarily the first thing suspected.

A common cause of such symptoms is impingement of the sciatic nerve underneath the piriformis muscle in the buttock. The piriformis may be in spasm, or the patient may have been sitting for prolonged times, or on hard surfaces, causing pressure on the sciatic nerve.

I release a piriformis spasm with the Activator instrument, and give the patient home care instructions and stretches to alleviate the problem.  

When The Kneecap Goes Awry

The kneecap (patella), which is embedded in the tendon of the quadraceps (quads) muscle(s) on the front of the thigh, “tracks” in a groove on the front of the femur, or thigh bone. The quadraceps tendon attaches below the knee to the tibia.

As the knee bends back & forth, the kneecap, which effects a mechanical advantage of 30% increase in the power production of our quads, slides in the bony groove.

If the kneecap becomes misaligned, as it slides there is abnormal wear & tear against the groove, and this can be the beginning of arthritis in the knee. There may be an audible “crunch” in the knee with squats. 

As an Activator Chiropractor, I have an effective adjustment for this condition, and I give the patient exercises that will help the kneecap stay in alignment. 

5 Key Facts About the Shoulder

(1)  It is the most complex and most mobile part of the body.

(2)  It consists of 4 articulations---the glenohumeral joint (top of the arm connects at the shoulder), the sternoclavicular joint (the collarbone connects near the throat), the acromioclavicular joint (outer end of the collarbone connects with a bony projection off the shoulderblade, and the scapulothoracic articulation (the scapula, or shoulderblade, contacts the rear chest wall).          

(3)  Pain in the shoulder may not be a shoulder problem, but be referred pain from 3 common sites---the heart, the lungs, and the neck. 

(4)  Shoulder dislocation involving the humerus (bone in the upper arm) is common because of the shallowness of the “cup” holding the humeral head. 

 (5)   Bursitis is common in the shoulder, caused by inflammation due to repetitive motions (e.g. painting, drywalling, throwing sports).

Services Medicare Doesn't Cover

       As it currently stands for chiropractic services, Medicare only covers adjusting the spine.

No coverage is provided for extraspinal treatment, e.g., for knee, shoulder, wrist, ankle, etc., problems. This is expected to change; chiropractors anticipate Medicare will eventually cover extraspinal problems.

Other essential services provided by chiropractors, also not currently covered by Medicare, are exercises; supports; home care, nutritional, or ergonomic counseling; stretches; and supplements.

Your chiropractor may prescribe / provide these services for you because they are essential to resolving your problem(s), but Medicare will not reimburse; you are responsible for payment.

Sacral Vertebrae

  An occasional variant in the anatomy of the lower spine is the failure to fuze of the 1st sacral vertebra with its neighbor below.

This results in an additional vertebra inferior to L5, where normally the sacrum is one bone consisting of several fuzed, no longer separate, vertebrae.

In some patients with this anatomical variant, it presents no problems, whereas in others the anomaly creates a vulnerability to low back stresses. 

These patients may need more frequent intermittent spinal balancing to maintain comfort and normal function. 

Is It the Meniscus??

  Pain in the knee may be due to any one or more of various possible misalignments or articular aberrances. 

The knee is a hinge joint, and as such it is not meant to move in other than an approximate sagittal plane.

However, slight rotation of the tibia at the joint with the femur, posteriority or anteriority of the proximal tibia, misalignment of the fibula, medial or lateral tibial-femoral joint compression, etc., can occur. These aberrances, even to the slight extent of millimeter(s), can cause discomfort or affect the knee’s range of motion.

If pain persists after all the “usual suspects” of misalignments / aberrances are screened & corrected, an Activator chiropractor looks to the medial and / or lateral meniscus. Often a carefully-vectored Activator adjustment on the inside or outside of the knee solves the problem and stops the pain.

Unilateral Head Pain

  Pain on just one side of the head, in the jaw region or near the ear or cheekbone, can be a simple headache, a TMJ problem, or a dental issue.

However, for these patients it is important to include a condition called vasculitis in the list of possible diagnoses.

Vasculitis is an inflammation of blood vessels. When this occurs in the side, or temporal, region of the head, it is called “temporal arteritis,”  an inflammation in the temporal artery. There may be swelling as well as pain, and the area may be tender to the touch. Often there is a fever.

This is a serious condition, and can have serious consequences. It can spread to the blood vessels of the eyes and possibly cause blindness. If suspected, the patient should immediately be referred to an M.D.

Medicare--Allowed # of Visits

  Medicare typically allows 12 chiropractic treatments (visits) per year.

However, certain things that often go along with aging are considered by Medicare to justify an extended, or longer term, of chiropractic care.

These conditions, called “co-morbidities,” may complicate, or impede healing, making the number of treatments necessary to resolve a chiropractic problem greater.

A common co-morbidity is spinal disc degeneration, usually associated with spondylosis, or bony spur formation around vertebral edges. Another term for this is DJD, or degenerative joint disease. 

Sciatica, spinal stenosis (narrowing of the spinal canal), and foraminal encroachment (narrowing of the opening(s) where the nerves exit the spine) are also co-morbidities, as are health conditions which may complicate or impede healing such as diabetes and osteoporosis.

Unrelenting Rib Pain

  Pain that starts in the front of the chest or in the back, near the spine, and develops along the path of a rib, and that is unresponsive to chiropractic treatment, may be an outbreak of shingles.

The patient will describe no injury or trauma, no upper respiratory infection or cough, which might be affecting the region. Yet the pain persistently worsens.

A shingles viral outbreak follows the path of the related sensory nerve, called a “dermatome.” Dermatomes wrapping around in the thoracic region resemble the paths of our ribs, so initial symptoms of shingles are often misinterpreted as rib pain.

Anyone who has had chicken pox carries the herpes zoster virus in the nerve ganglia alongside their spine. The virus is dormant until conditions such as hyperthermia or stress trigger an outbreak.

Low Back Compression

  Patients who present with central low back pain, especially if the lumbar curve is accentuated, often exhibit compression between the sacrum and the 5th, or lowest, lumbar vertebra.

The patient will often say they “just can’t get comfortable,” even in bed. Sometimes pulling the knees to the chest is relieving, but standing, as well as sitting, cause worsening of the pain.

I relieve the compression by appropriately-vectored adjustments with the Activator instrument, and give the patient stretches & exercises. 

Ergonomic counseling for correct sitting & standing postures is helpful to prevent recurrence of the compression.

OUCH!!--I've Got Gout!

  You wake up with severe, burning pain in the joint at the base of your big toe, and it’s swollen and red.

Chances are, you may have gout!

This is a type of arthritis that is of metabolic origin---too much uric acid in the blood causes sharp crystals to collect in a joint, usually the big toe, and more commonly in men than in women.

This happens because you consume too many foods high in purines, organic water-soluble compounds that oxidize to form uric acid. 

Meats are high in purines; so is beer, seafood such as scallops & sardines, beans such as garbanzos or lentils, vegetables such as asparagus or mushrooms, & wheat bran & wheat germ. Inflammatory foods such as sugar and wheat (all wheat in the U.S. is highly hybridized, thus containing foreign polypeptides that are highly inflammatory) are also culprits.

Your chances of getting gout are higher if you are overweight, drink too much alcohol, eat too many foods containing purines, or drink beverages sweetened with fructose (fruit sugar) or foods with high-fructose corn syrup (soft drinks, ice cream, sports drinks, breakfast cereals).

Gout is successfully treated by changing what you eat and drink. It is important to drink lots of pure (devoid of chlorine or other chemicals) water to help your body flush out waste products and toxins. 

Plantar Fasciitis

   Pain in the bottom of the foot, usually in the arch further back toward the heel, may be plantar fascitis. It is caused by injury or inflammation of the plantar (bottom of the foot) fascia. The plantar fascia is a band of fibrous connective tissue on the sole of the foot.

The pain may come on slowly, related to chronic pronation (a falling inward of the inside of the arch) combined with a “fallen” arch, or be more acute, due to an injury---landing hard on the sole of the foot, quick acceleration / deceleration when walking or running, or repetitive shock of hard heel strike during the gait cycle.

My treatment includes carefully aligning the bones of the foot with the Activator instrument, support of the arch with orthotics, exercises to strengthen the arch, stretches to maintain flexibility, and ice and other applications for inflammation.

The patient must not go barefoot---there must be NO weight-baring without orthotic support.

Could It Be My Pillow??

   No, not the My Pillow advertised an infinitum on TV---I seriously doubt those provide proper and adequate support for the cervical spine.

If you aren’t sleeping on a proper pillow, one that correctly supports the curve of the neck, this may be the reason you have persistent neck and upper back pain.

When the pillow you sleep on allows your head to tilt downward toward the mattress, or pushes your head upward at an angle, it is not serving you. Your neck should be parallel with your mattress when you are lying on your side, and if on your back, your head should not be angled abnormally up or down.

The right pillow gives consistent, resistive support to the spine throughout the night.

It doesn’t compress, as does a pillow filled with down or feathers. 

It doesn’t deform, as a buckwheat pillow will.

It doesn’t squash down where your head and neck press on it, creating a depression that discourages movement during the night, as a memory foam pillow does.

Look for an orthopedically-designed pillow, such as the one I sleep on----I have them available in my office for patients.

Bench Pressing / Ergonomics

   Dropping the elbows too low while bench pressing heavy weight can cause stress injuries to the acromioclavicular joint in the shoulder.

The outer end of the collarbone, near the front and top of the shoulder, articulates with the acromion process, a bone projecting forward from the scapula. The clavicular part meets the acromion part, forming the “acromioclavicular, or AC, joint.

One of several joints making up the shoulder complex, the AC joint is particularly subject to injury because it is essentially two bones butting together, held by ligaments.

Recently a patient who had come from working out at the gym presented with shoulder pain due to over-stressing the AC joint while bench pressing.

Precise adjustments with the Activator instrument, combined with home care & ergonomic counseling, were the solution.

It's a Veggie! It's a Fruit! It's Full of Vit. C!

         Often thought of as a vegetable, red bell peppers are actually classified as a fruit, because they have seeds.

        Red bell peppers are an excellent source of Vit. C---one cup contains 117 mg---and they are low in sugar.

They also contain multiple antioxidant compounds---a single red bell pepper has 30 different antioxidants. They are one of the most nutrient-dense foods one can eat.

https://www.organicconsumers.org/news/veggie-thats-a-fruit-more-vitamin-c-than-an-orange?utm_medium=email&utm_source=engagingnetworks&utm_campaign=OB+673&utm_content=OB+673

Yep, It's All Connected

  “The thigh bone’s connected to the knee bone, the knee bone’s connected to the.....” as the saying goes. 

And it’s true. The technical term is “a kinematic chain.” Meaning the movement of one part affects or is linked to movements of the other parts.

Thus a problem at the hip affects the knee and possibly the foot, a problem at the ankle affects the knee & in turn the hip, a distorted pelvis reverberates down into the lower extremities, etc.

So if you come in with hip pain, I'm going to also check your pelvis, knees, ankles, and feet. If you have knee pain, I will likewise check your lower extremity above and below your knee, as well as your pelvis. 

Unless the whole kinematic chain is addressed and corrected, you're not likely to get lasting relief.

A Common Issue at the Base of the Neck

        Stress at the juncture of the cervical spine with the thoracic region, at the lower neck, may cause compression between the parts of the vertebrae that touch each other and the neighboring soft tissues.

The vertebral parts that touch are called the facets. Here the compression causes a “jamming” of the bone areas together. The adjacent soft tissues become involved, and the result is similar to a clenched fist. 

This causes pain to be referred out into the shoulder, and it can be persistent, usually needing precise intervention to resolve.

Most often the patient presents with complaints of a shoulder problem. However, the real cause of the problem is not in the shoulder at all, but in the neck.

I see this problem often in my office. Specific, precise adjustments with the Activator instrument release the compression and bring patients relief.

Distortion of the Rib Cage

  Often when patients present with pain in the thoracic region, an underlying, global aberrance of the rib cage is involved. 

The patient may say, “I feel twisted,” or “Something feels pulled.”’ They may have been coughing, may have tripped on a curb, fallen, or lifted something while their upper body was turned to one side.

After adjusting misalignments in the thoracic spine, including relieving jammed ribs at their articulations with vertebrae, I always check the status of the rib cage.

Nine times out of ten, I find a torquing of the ribs, in which one side is stressed superiorward, while ribs on the opposite side are stressed downward.

Precise, vectored, subaxillary adjustments with the Activator instrument correct the global rib cage distortion, and put the “finishing touch” on relieving the patient’s discomfort. 

Got Toxic Oils??

If you have grapeseed oil or rice bran oil or canola oil in your kitchen cabinet, you have TOXIC OILS. 

     "Designer oils" such as rice bran and grapeseed oil, commonly promoted as "healthy," are, in fact, extremely toxic. Here's why: these oils are highly processed. Canola oil, which many people assume is healthy because, like olive oil, it is monounsaturated, is also in the HIGHLY PROCESSED category. 

     Processing is necessary to extract the oil from rapeseed (canola), rice bran, and grape seeds, and may include extraction with heat and solvents, as well as chemical bleaching, degumming, and deodorizing. 

     Because the raw oils have monounsaturated and polyunsatured components, when exposed to heat, they readily oxidize. Oxidized oils are toxic and very inflammatory to our bodies.

     Avoid these oils, and use cold pressed, extra virgin olive oil instead.

Headaches / A Myriad of Causes

  Identifying the cause(s) of headaches, ranging from chronic, unrelenting headaches to acute ones, is a challenge faced by M.D.s and Doctors of Chiropractic alike.

There are many different types of headaches, and multiple causes. Nutritional issues should be considered---food triggers may be involved, in which a person gets headaches when they ingest certain foods or food additives. 

Stress, both biomechanical (e.g. postural stress, repetitive motion, injuries) and emotional / psychological, is often part of the picture. Tension headaches are among the most common.

Aberrances of the cranial rhythms is another frequent occurrence closely related to headaches. When I balance a patient’s cranial rhythms, their headaches often disappear.

Sleep apnea is also now recognized as another source of headaches, in which abnormal proportions of oxygen & carbon dioxide result from interruptions in breathing.  

A Secret to Relieving Sciatica

 Sciatica, pain down the leg, is caused by nerve impingement. Location of the impingement is commonly thought to be in the lumbar spine, where the nerves exit between the vertebrae and travel down to the legs, forming the large nerve “trunk” called the sciatic nerve.

If there are degenerative changes in the lumbar spine, and / or if there is history of injury, the lumbar region may indeed be the site of impingement.

But another, often overlooked, site of impingement that causes sciatica is in the gluteal region, where the sciatic nerve passes between the muscles, specifically underneath a muscle called the piriformis. If the piriformis is in spasm, it can cause sciatica.

Episodes of pressure on the piriformis, such as from sitting on hard surfaces, can also impinge of the sciatic nerve where it passes under the muscle, resulting in sciatica.

Orthopedic tests and X-ray can help discern the origin of impingement, but often a trial treatment of precise Activator Chiropractic adjustments, specific stretches, and home care counseling can solve the problem, making X-ray unnecessary. 

Fire Safe Council of Santa Cruz County

   

  I am proud to be a  Community Partner 

      with

Fire Safe Council of Santa Cruz County

A 501(c)(3) Nonprofit Corporation

Whose Mission is to Educate and Mobilize the People of Santa Cruz County

to Protect Their Community, Homes, and Environment from Wildfires 

Learn how your tax deductible contribution 

to become a Community Partner can help at:

https://www.firesafesantacruz.org/community-partners-2019

The Helpfulness of Hedgerows

    Throughout millennia, farmers have used linear plantings of trees and shrubs, or “hedgerows,” to create windbreaks to protect their crops. A “bonus” benefit was the plants’ roots holding the soil and protecting against erosion.

Today’s farmers know that these plantings of vegetation among their crop fields have multitudes of other benefits to the farm. 

With the right mix of plants, including flowering ones, hedgerows attract beneficial insects that prey on crop pests. They also serve to suppress weeds, because over time they out-compete the weed “seed bank,” and help keep out wind-blown weed seeds.

Hedgerows can be of linear, or other configurations, and can also include grasses and herbs. The root systems improve water quality by acting as filters to catch sediment and filter surface water before it drains into aquatic habitats such as ponds, creeks, or rivers.

Hedgerows create a sheltering habitat for wildlife, such as birds that feed on crop insect pests, and pollinators which fertilize crops.

California native plant hedgerows are said to be easy to establish, and once mature, are drought-tolerant.

Learn more at www.HedgerowsUnlimited.com 

  

Mysterious Shoulder Pain

 There are times when pain in the shoulder may not be due to a local problem in the shoulder, but may be originating somewhere else. To ease the pain, its specific origin must be determined.

Often a patient presents with an unimpeded range of motion, no soreness or tenderness to palpation of the shoulder, and no history of injury or stress to the involved shoulder. Yet the pain is unrelenting; the patient is unable to get relief by changing position or posture.

With this scenario---no signs of local trouble in the shoulder---my attention goes to the neck, where impingement of the nerves going into the shoulder region can cause “referred” pain. Referred pain shows up in one place, but its actual cause is somewhere else. 

My treatment for this kind of shoulder pain includes precisely clearing misalignments in the cervical vertebrae, appropriate neck stretches, and postural counseling. 

        Often a better cervical pillow is also key to lasting relief.

Excessive Extension in the Low Back

 The normal curve in our low back is an “extension,” or forward-facing curve.

In some people, this curve is abnormally pronounced, which can be due to chronic locking back the knees when standing, or the accentuated curve may be part of the congenital anatomy of the low back.

This excessive extension can cause chronic low back discomfort, partly due to posterior compression between the lumbar vertebrae and / or compression between L5 and the sacrum.

My treatment plan for these patients includes precise, gentle adjustments to the spine and pelvis with the Activator instrument, accompanied by exercises to strengthen the abdominal muscles, specific stretches, activities of daily living (ADL) advice, and postural counseling.  

Head-Forward Postures

  Our head should be in line with the center of gravity of our body. Any position of the head that is forward of our center of gravity gets us in trouble.

For example, “craning” the neck / head to look upward / forward toward a TV or computer monitor, or tilting the head backward to see a monitor through the near-focus part of bifocals, is a common cause of neck pain, tension, and headache. 

This posture causes the occiput (the bone across the back of the head, just above the spine) to be stressed inferiorly. This inferiority may be more on one side or the other (unilateral) or global (bilateral). The result is tension across the back of the neck and head.

Working at a desk, at a kitchen countertop, etc., with the head bent forward of the body’s center of gravity leads to similar problems of neck & upper back pain, tension, and headache. 

Note also that when we are sitting, if we lean forward from our hips, our head in this position  is again out in front of our center of gravity; we immediately begin to feel the stress in our neck. Be mindful of this; rest your back against the chair, feel your head comfortably in line with your center of gravity. 

Hiatal Hernia

        In this condition, part of the stomach bulges or protrudes up through the diaphragm and into the chest cavity, at the opening (hiatus) where the lower end of the esophagus passes through the diaphragm into the stomach.

The muscle of the diaphragm becomes weak at this place, allowing the protrusion. This weakness can be congenital, age-related, due to some kind of trauma, or possibly post-surgery. Intense exercising that puts pressure on the diaphragm and abdominal muscles, or repetitive lifting of heavy weights can also cause the weakness. 

Symptoms that may present with hiatal hernia are “heartburn,” also called acid reflux, if food and stomach acid back up into the esophagus. Chest or abdominal pain can be accompanying symptoms, as well as shortness of breath. Obesity is often associated.

As an Advanced Proficiency Rated ACTIVATOR Chiropractor, I have an effective, comfortable adjustment for this condition. The adjustment usually brings immediate relief to the patient, but relief is temporary.   

Specific yoga can help this condition, and sometimes sleeping on a wedge that elevates the upper body can help, as can weight loss, nutritional changes and eating smaller meals.

Harmful Secrets of LED Light

         Many people are converting the lighting in and around their homes from incandescent bulbs to LED  ones, in the interest of energy savings and longer bulb life. This seems like a good idea, right? In fact, before making this conversion, we would do well to consider:

LEDs emit high amounts of blue light; they have very little red, and no infrared, light frequencies. The blue light, without the counterbalancing reds, can damage the cells in our eyes. 

  The red  frequencies, missing in LEDs, are important for repair and regeneration of cellular damage.

LED light impedes sleep because it suppresses melatonin production. Regular exposure, especially after sunset, may contribute to worsening of sleep. 

LED light negatively affects the mitochondria, the energy-producing components of our cells, impeding production of the energy needed for healthy metabolism. 

Incandescent lighting most closely resembles full-spectrum natural sunlight, which is the healthiest for us.

We can make our light environment healthier by using incandescent lighting in areas where we spend the most time---kitchen, office, etc., and only using LEDs in areas such as hallways, closets, garage, etc. 

Learn more at https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side , https://www.ncbi.nlm.nih.gov/pubmed/21164152,  https://academic.oup.com/jcem/article/90/5/2755/2836826

Thank You--To the Kneecap!

           Our kneecap, aka the patella, gives us a 30% increase in the power production of our quadriceps, the muscles in the front of our thigh that, when activated, extend, or straighten, the knee.

Embedded in the tendon of the quadriceps, the kneecap articulates against the front of the lower end of the femur, the thigh bone. 

Below the kneecap, the fibers of the quadriceps tendon continue as the patellar ligament. The patellar ligament starts from a “bump” on the front of the kneecap and goes down to attach to a “bump” on the front of the tibia, the large bone in the lower leg.

The kneecap holds, or raises, the patellar tendon off the femur, thus improving the angle of approach of the tendon to its lower insertion on the tibia. This is how it increases the power generation of the quadriceps. 

The Right Pillow

  For many patients, changing to a better pillow is a critical key to a healthy and comfortable cervical spine, a solution to chronic neck pain & tension, and relief for headaches.

         I have personally experienced this. After five whiplash injuries in my youth, I found that regaining full and reasonably comfortably functioning involved using the right pillow.

What is the “right” pillow? 

Our pillow should give us consistent, resistive support during sleep. A down pillow will not provide this because, no matter how carefully you shape & place it when you first lie down on it, it will deform during the night.

Likewise, a memory foam pillow, which indents when you lie on it, does not give consistent support---its softness is appealing, but it is not serving the health of your cervical spine.

The “right” pillow supports the normal curve of your neck, whether you lie on your back or your sides to sleep. It allows your head & cervical spine to remain in alignment with the rest of your spine, not bent up or down.

The pillow that I sleep on, and that I recommend for my patients, provides this, and patients can get this pillow in my office.

Trigger Points

  A persistent, recurring painful spot in a muscle that does not respond to adjacent osseous (bone / joint) adjustments may be a trigger point.

Often the patient reports “the pain came back the next day,” or “it still hurts” after a Chiropractic treatment, and they may have trouble locating the exact site of their pain. Palpating muscles in the general area will often cause the patient to jump or flinch when the painful locus is pressed.

A distinguishing characteristic of trigger points is that they “refer,” or send out, pain in predictable patterns distant from their origin in a muscle. They often develop after muscle strain, repetitive motion, poor posture, or when a patient is chronically stressed or anxious. 

Also referred to as “myofascial pain,” trigger points were famously discovered and treated by Janet Travell, M.D., who authored two extensive textbooks on trigger points in the muscles of the body, mapping trigger point patterns of referred pain.

Dr. Travell also served as White House Physician for Presidents John F. Kennedy and Lyndon B. Johnson.

Dr. Travell relieved trigger points with application of cryotherapy and injections. I treat them with the Activator instrument, and have the patient apply ice at home.