Chronic Neck Pain

Successful treatment plans for chronic neck pain should include home care counseling for postures and ergonomics.

There are usually modifications that can be made in the patient’s positions & pastures during different activities—e.g., computer use, kitchen chores, sitting, standing, and sleeping—that will help.

An important key to change is the patient’s developing an awareness of their body’s positioning, and this may take some practice. I often recommend setting a timer, using it as a reminder to “check in”—where is my head? am I slumping? leaning in to see my computer monitor?

Using the right pillow for sleeping, changing the height of one’s computer monitor so that it is at eye level, getting computer glasses with corrective lenses if one is having a hard time seeing the screen, raising the height of one’s work space on the kitchen counter—-all are simple things that can make a big difference.

Accentuated Curve in the Low Back

  An abnormally accentuated lumbar curve, whether congenital or acquired, can result in disequilibrium and vulnerability in the lower back.

Sometimes this is partially alleviated with postural counseling, Activator adjustments, and specific exercises. If the patient habitually “locks back” their knees when standing, changing this habit often helps a lot.

Ergonomic counseling about sitting, sleeping, etc. can also help.

But often these are only partial solutions. A patient with this condition may need more consistent chiropractic treatments, the frequency of which can be judged according to what works for each individual. 

A Torqued Tibia

Rotational stresses acting on the proximal tibia (where the large bone in the lower leg, the tibia, articulates at the knee) are common in people who drive a lot, e.g. for a job.

The tibia is not meant to rotate at this joint, but will tolerate some rotational stresses for short periods of time or if the stress is not repetitive or chronic.

Patients whose work requires a lot of driving often come in with aberrance and pain in their right (gas / brake foot) knee. Usually I find, and adjust to relieve / correct, rotational stress of the involved proximal tibia. 

Medicare "Advantage" Plans

If you are eligible for Medicare, but choose a Medicare Advantage Plan, you have opted for private insurance that is outside of Medicare.

Medicare Advantage plans are offered by private companies, e.g. Humana, United Health, Blue Cross, etc., and often include benefits not provided by regular Medicare, such as vision, dental, etc. 

This type of private insurance plan must conform in certain ways to the rules of Medicare--such as limiting charges for certain services--but is administered by the private companies which sell the plans. Patients still have many of the rights and protections provided under original Medicare.

Whiplash From a Fall

Being rear-ended is not the only way one can suffer whiplash. A fall that “whips” the head and neck will have a similar result, and often takes a similarly extended recovery time.

Though the cause is different, my treatment plan is the same:  rest, anti-inflammatories such as ice and topical arnica, gentle chiropractic adjustments with the Activator instrument, and active care as soon as possible (stretches and exercises) to assist healing.

A Key Headache Solution

Persistent headaches that are unrelieved by clearing the cervicals, the cranial rhythms,, and occipital tension can have a hidden and often unsuspected etiology.

The key, discoverable by a highly trained, Advanced Proficiency Rated Activator Chiropractor like myself, may lie in the position of the posterior arch of C2.

When the arch is abnormally stressed superiorly, it often causes a headache.

This is quickly and comfortably corrected with the Activator instrument, applying the correct contact on the C2 posterior arch, and vectoring the instrument to make the adjustment. 

A "Hitched Up" Hip

Patients often tell me they feel that one of their hips feels “higher” than the other. 99% of the time, they are correct!

A common underlying cause of this is distortion in the pelvis.

The “pelvic girdle,”  or pelvic composite, consists of several movable joints—-the sacroiliac, lumbosacral, hip, and pubic symphysis joints. Distortion of the pelvis can involve one, two, or several being misaligned or aberrant positionally in articulation with their neighbor(s).

After careful assessment of the pelvis, I make precise, directional adjustments with the Activator instrument to correct the distortion and bring relief of discomfort or a “hitched up” hip.

"Knock Knees"

Remember when you were a kid and some other kid you knew had knees that “bent in,” or “bumped” each other? 

Sometimes this was somewhat insensitively referred to as “knock knees.”

This condition, professionally called “genu valgum,” can be due to a rotation of the femoral head in the ball-and-socket hip joint, or to pronation of the foot, both of which result in an abnormal “Q angle” relating to the knee.

Foot pronation, or the falling inward of the medial side at the plantar arch, is the most easily correctable. Appropriate orthotics, often over-the-counter if properly fit, will help.

Orthotics should be consistently worn; going barefoot should be avoided.

As an Advanced Proficiency Rated Activator Chiropractor, I precisely evaluate and adjust the bones of the pelvis, hip, knee, foot, and entire involved lower extremities for this condition.

Prepare for Summer Fun

As summer approaches, patients begin to come in with sequelae of warm weather activities, one of which is water skiing.

Having fun water skiing without appropriate preparation of one’s musculature, especially the muscles of the low back, can lead to unpleasant consequences.

Simple strengthening exercises that prepare the muscles for summer activities can prevent a lot of unnecessary discomfort.

Pain That "Caps" the Shoulder

When there is pain in the deltoid area, around the upper area of the arm at the shoulder, or at the insertion point of the deltoid muscle on the outer upper arm, it often is not due to a problem in the shoulder itself.

Rather, the origin of the pain is in the neck.

Misalignments or degenerative changes in the spine in the lower cervical region, at C6 - C7, can cause this pain that presents this way in the upper shoulder.

No-Till Farming

Want a vibrant, healthy garden that produces nutrient-rich vegetables, herbs, fruits, etc. while sequestering carbon by increasing soil organic matter (SOM)?

Disturb the soil as little as possible.

At Singing Frogs Farm north of San Francisco, a “No Till No Kill” system is an example. 

They cover their planting beds with mulch and compost instead of plowing or using herbicides. New plants are inserted directly into the compost; they use a high biodiversity of cash & cover crops which are continuously rotated to break weed, disease and pest cycles.

This system retains more water, requiring less irrigation, & produces high crop yields. 

It has increased SOM by 400% in under six years, sequestering significantly more carbon.

        The Singing Frogs system is applicable to more than 80% of farms around the world---the majority of farms are under 5 acres.  https://regenerationinternational.org/2021/03/08/best-practices-how-regenerative-organic-agriculture-and-land-use-can-reverse-global-warming/

Listen to a podcast by owners of Singing Frogs Farm at https://www.resilience.org/stories/2015-05-27/paul-elizabeth-kaiser-sustainable-farming-2-0/  

"Noisy" Knees

  If you hear a “crunching” or “grinding” noise in your knee when you bend it, this is a sign of an arthritic, or degenerative, condition called Chondromalacia Patella.

For various reasons, the patella, or kneecap, may begin tracking abnormally as it slides up and down in a groove on the front of the femur with bending of the knee, resulting in abnormal “wear & tear” in the articulation.

If not corrected with the proper treatment plan, the condition can advance to painful and debilitating arthritis.

The patella should be adjusted by vectoring the ACTIVATOR instrument appropriately to correct its tracking. I also give the patient exercises to prevent recurrence.

Nerve "Maps"

      Areas of our skin receive sensory innervation from particular spinal nerves. 

      These sensory areas, called “dermatomes,” are predictable from person to person, and can be “mapped” on a model of the human body.

      An a an example, if a patient presents with pain, or with numbness & tingling, in a specific area of the arm or hand, the doctor can identify the involved spinal nerve(s) based on the dermatome map of the upper extremity.

      As an Advanced Proficiency Rated Activator Chiropractor, once the involved nerve(s) is / are identified, I can make precise, gentle adjustments accordingly to relieve nerve impingement & help relieve the patient’s symptoms.

Gardening With Native Plants to Attract Birds

Have you ever considered that garden plants native to your area have advantages for birds and for you as well?

A landscape of drought-tolerant natives will use less water in your garden, can be more resistant to native pests, and natives provide food suited for area birds.

Find out why “yards with non-native plants create ‘food deserts’ for bugs and birds,” find the best plants for your area, and learn how to create your native plant garden at: 

https://www.audubon.org/PLANTSFORBIRDS?emci=c10dc46c-ff2b-eb11-9fb4-00155d43b2cd&emdi=2b6388a5-d02d-eb11-9fb4-00155d43b2cd&ceid=721242

"Craning the Neck"

Have you ever heard the expression, “don’t crane your neck?” It’s really good advice---”craning,” or straining, the neck, such as to better see a computer screen, or when accommodating to bifocal lenses, sets one up for neck pain and headaches.

These postures cause abnormal cervical stresses, and one of the common results is a superior misalignment of the posterior arch of the 2nd cervical vertebra, C2.

In my practice, about 80% of my headache patients have this misalignment.

It is corrected by precise, gentle adjustment with the Activator instrument.

Got Cranial Rhythms?

    We all do. 

The bones in our head have very subtle, normal, rhythmical, motions. 

These motions are not synchronized with our heartbeat or breath. They are characteristic to the cranium, and are thought to be related to the circulation of the cerebrospinal fluid that bathes the brain and spinal cord. 

Abnormalities in the rhythms can be associated with headaches or vertigo, or just feeling "out of sorts." 

I find that balancing the cranial rhythms often relieves a patient’s headaches, and can be effective for vertigo as well. 

Balancing patients' cranial rhythms is part of my focus on overall, full-body balancing.

More "Bang" for Your Exercise "Buck"

An exercise routine can be great, but if performed when the body is in dis-equalibrium, aka a state of imbalance, it will not be maximally effective.

For example, strengthening the muscles that support the low back, including the abdominals, is an essential part of relieving low back pain, protecting the low back and keeping it healthy.  However, when your underlying framework---the bones and joints of your pelvis and spine---is skewed, or out of alignment, your exercises won’t work, or hold, as well.

I can help; as an Advanced Proficiency Activator Chiropractor, my focus is on restoring balance and equilibrium to your body, which supports & enhances your exercise regimen.

GERD

Gastroesophageal Reflux Disease, or GERD, is a common and uncomfortable condition caused by dysfunction of the circular muscle (sphincter) at the lower end of the esophagus.

This allows stomach acid to seep back up into the lower esophagus, resulting in irritation, inflammation, and burning pain (“heartburn”). 

It is important for this condition to be addressed by a medical doctor, because chronic, untreated GERD can lead to more serious consequences.

In the meantime, I have an adjustment, done with the Activator instrument, that often brings temporary relief.

Persistent Tendonitis

When bicipital tendonitis, which is inflammation of the tendon that attaches the biceps muscle in the upper arm to the shoulder, is not resolving with a full-component treatment plan, as an Advanced Proficiency Rated ACTIVATOR Chiropractor, I look for what may be keeping the patient’s healing from progressing.

Culprit #1 is biomechanical. Specifically, the humerus, the bone in the upper arm, can be rotated, causing stress on the bicipital tendon as it “rides” in a grove on the front of the humerus. The rotation can be medial or lateral. Both cause stress on the inflammed tendon. The solution is a precise, directional adjustment with the ACTIVATOR instrument to correct the rotation. The adjustment may need repeating over the course of several office visits.

The #2, and critically important, culprit is the patient’s nutrition. If (s)he is eating foods that cause inflammation, such a sugar, damaged fats, etc., this will significantly slow or even block healing.

Medicare and Maintenance Care

Medicare guidelines state that it will only pay for chiropractic treatment that is Medically Reasonable or Necessary (defined as treatment that yields a significant improvement in clinical findings and patient functionality). 

To you, and in the clinical judgement of your chiropractor, your treatment may be CLINICALLY APPROPRIATE:  it may enhance your life, relieve your symptoms, support your health and well-being, or prevent the deterioration of a chronic condition. 

But treatment that is CLINICALLY APPROPRIATE may not fit Medicare’s definition of MEDICALLY NECESSARY. 

Your chiropractor, by law. must inform Medicare when your care becomes maintenance care, thus clarifying to Medicare that this care is not reimbursable, and you will be responsible for payment.

Muscle Cramps

Those painful muscle cramps that awaken you at night will often be alleviated by magnesium (Mg). 

If you aren’t getting an absorbable form of magnesium----Mg citrate or Mg glycinate are good--- in your supplement regimen, and there are no contraindications, consider trying it.

The target dose is 400 mg / day, and it’s best to start with 100 mg / day, gradually increasing to  the target level. Slowly building to the target dose will help avoid diarrhea. 

Tale of a Wayward Sacrum

  Persistent pain in the low back may be due to a tilted sacrum. When this happens, it puts stress on the ligaments of the sacroiliac joints, which are broad, weight-bearing joints in the pelvis on either side of the triangular-shaped sacrum. 

The resulting stress on these ligaments causes pain.

When attending to this problem, careful balancing of the pelvic region is critical, and the sacrum must not be overlooked.

Precise, directional adjustments with the Activator instrument solve the problem and relieve the pain.

An Untrustworthy Knee

Patients often come in describing their knee as “feeling like it’s going to give way,” or “fees like I might fall.” 

This is often noticed most when going down stairs or steps.

The problem is likely a posterior proximal tibia----a backward misalignment of the large bone in the lower leg at its articulation at the knee. When this occurs, it causes a pulling on the achilles tendon in the back of the ankle, stressing the heel bone upward.

The adjustment is made to the proximal tibia, and also to the calcaneus, or heel bone. Both must be addressed to alleviate the problem.

Farmer's Footprint

Exposing the human & environmental impacts of chemical farming is the mission of “Farmer’s Footprint,” an organization encouraging and educating about better, healthier ways of food production.

                https://farmersfootprint.us

The guiding premise is that“a century of monocrop farming and reliance on pesticides has damaged our nation’s once-fertile soils and the health of every American. The rapid increase in pesticide use over the past few decades has coincided with this explosion of chronic disease.”

Awareness is growing that glyphosate, the active ingredient in the herbicide Roundup, is implicated in many chronic diseases.

Watch a 20-min. film about one farming family who are abandoning chemical farming, nurturing their soil back to health, and working in concert with Nature:

https://farmersfootprint.us/watch/  

Iliotibial Band Syndrome

Pain in the outer side of the knee or hip can be caused by friction against the knee / leg / hip by a thick band of connective tissue alongside the thigh called the Iliotibial Band (ITB).

This is common in runners, weight lifters, and activities at the gym, etc., that involve repetitive bending of the knee with resistance. The ITB becomes excessively tight with repetitive use, which exacerbates the friction.

I address this by adjusting the hip, the knee, and releasing tension in the ITB with the Activator instrument. It is important for the patient to stretch before and after workouts, if running to stay on level surfaces, and to wear supportive shoes.

A distorted pelvis can contribute to this condition, so it is important for the patient to check in with me periodically for pelvic balancing.

Groin Pain

Patients presenting with pain in their groin have a particular kind of pelvic distortion involving the joint in the front of the pelvic girdle, called the pubic symphysis.

It is a movable joint which has a disc, like the discs in our spine. 

In most people, this joint is stable unless complex, usually severe, pelvic distortion occurs, or  if a mother who has carried a baby and given birth. In these instances, the pubic symphysis often becomes misaligned, and 99% of the time, a consequence is groin pain. 

As an Advanced Proficiency Activator Chiropractor, my job is to determine the nature of this misalignment, and correct it gently & precisely with the Activator instrument. The adjustment brings immediate relief. 

Protection From Blue Light

The blue light from computer screens, TVs, & cell phones causes eye fatigue, and is often a source of headaches and sleep disturbances.

The best solution I have found for this is BPA-free plastic glasses from Northland Outpost whose orange lenses block 95% of blue light. These are comfortable worn alone, and they also fit easily over my corrective lenses for watching TV.

These glasses, available on Amazon,

https://www.amazon.com/Blue-Light-Blocking-Glasses-Insomnia/dp/B076GTTQLJ/ref=sr_1_5?dchild=1&keywords=northland+outpost+blue+light+blocking+glasses&qid=1612016903&sr=8-5

are very lightweight and reasonably priced. Since I’ve been using them my eye fatigue, especially from computer use, is significantly reduced.

Ouch! At The Elbow

You’re chopping vegetables, making a salad, brushing your hair, stacking kindling for the fireplace, hammering a nail---any of a multitude of actions that involve bending your hand backwards at your wrist---and you notice pain at your elbow.

What’s going on?

The muscles that bend your band backward at your wrist connect to the bone in your elbow. The tendon that attaches these muscles, called the “wrist extensors,” at the elbow can become irritated & inflammed, often due to overuse.

The result is that every time you activate your wrist extensor muscles when using your hand, there is a pull on the inflammed tendon at your elbow, and it hurts. 

What’s the solution? 

This situation can be very persistent of not treated. My protocol includes precise, gentle adjustments of the forearm and wrist with the Activator instrument, protection of the irritated tendon by use of a compressing band, anti-inflammatories including ice and topical arnica, and soft tissue therapy to the involved muscles.

New Medicare Deductible

We have cycled into a new “year” with Medicare, and there is a new annual deductible that must be met before reimbursement will kick in.

The 2020 deductible, $198, has increased to $203 for 2021. 

Compared to typical private health insurance deductibles, Medicare continues to be fair and reasonable, in my opinion, and Medicare continues to cover Chiropractic care for the spine. 

Regenerative Agriculture

 

“Just transitioning 10 percent of agricultural production to best practice regenerative systems will sequester enough CO₂ to reverse climate change 

and restore the global climate.” 

 Reversing Climate Change through Regenerative Agriculture - Regeneration International

Regenerative Agriculture uses farming and grazing methods that rebuild the soil’s organic matter, restore soil biodiversity (organisms and microorganisms), sequester more carbon in soil, and increase the amount of water the soil can hold.

It’s done by:

---disturbing the soil as little as possible; aka “no-till” farming. No plowing, which disturbs healthy soil fungi & microorganisms & increases erosion,

---cover crops, composting, & crop rotations to feed nutrients into soil,

---managed grazing to stimulate plant growth & increase soil fertility. 

Learn more here:   www.regenerationinternational.org/why-regenerative-agriculture/

Neurovascular Compromise

 A common example of neuromuscular compromise is Thoracic Outlet Syndrome (TOS), when the nerves and / or blood vessels (brachial plexus) coming from the neck and going down the arm are subjected to pressure or abrasion (impingement) that compromises their normal function. 

Symptoms include numbness & tingling, reduced or altered sensation, or pain in the arm or hand.

Causes can be impingement between the scalenes (vertical muscles on the sides of the neck), between the clavicle & 1st rib, or a posterior distal clavicle (result of a direct frontal blow). Sometimes this is a sequela of whiplash injury; or chronic stress & tension affecting the neck, including postural stress; or from repetitive motion / overuse syndrome.  

I have precise, gentle adjustments to relieve the impingement, and give the patient stretches, exercises, and ergonomic counseling.

5 Secrets of the Right Pillow

IT PROVIDES CONSISTENT, RESISTIVE SUPPORT

to maintain the normal curve of the neck,

IT KEEPS THE HEAD IN LINE WITH THE SPINE

not bent up, or bent down,

IT DOES NOT SQUASH FLAT OR DEFORM

with movement during the night,

IT IS ORTHOPEDICALLY DESIGNED

to normalize posture during sleep,

IT WORKS FOR BOTH SIDE OR BACK SLEEPING

so you can change position.

Rotator Cuff

  Sometimes mistakenly thought to mean bones in the shoulder, the Rotator Cuff actually consists of 4 muscles which help maintain shoulder mobility, stability, & function.

These muscles are called the “S.I.T.S.” muscles, an acronym for the 4 components---the Supraspinatous, Infraspinatous, Teres minor, and Subscapularis muscles.

Of these 4, the Supraspinatous is most commonly injured. It attaches across the top of the scapula to the top of the humerus, the upper bone of the arm. “Swimmer’s shoulder” is an injury to the Supraspinatous tendon, caused by repetitive forceful adduction of the arm against the resistance of the water.   

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.