Heroin addiction came up in the Democratic debate before the holidays. All three candidates acknowledged that prescription opioid pain medications, such as Vicodin and Oxycontin, often open the door to heroin abuse, and we need to tighten up regulations on opioid prescriptions.

Tighter regulation is a great start, but that only solves half of the problem. The thing is, people are in pain. They choose pain medications with serious side effects, because they are not aware of or are apprehensive about alternative methods for pain relief, including chiropractic adjustments.

Chiropractic Myth

Traditional chiropractors tell their patients that chiropractic works by realigning the spinal bones and removing pressure on the nerves. This statement is, at its best, an outdated and oversimplified view of human body.

Current research suggests that a mechanistic model does not adequately explain Chiropractic, and we ought to take neurophysiology into consideration.

The Force

Chiropractic adjustments introduce a mechanical force to a joint that, in turn, kick starts a chain of neurological reactions. (1) Think about a chiropractic adjustment as the force needed to activate certain sensors of the nervous system, rather than the force to move a bone. I know the mechanical, bone-aligning concept is much easier to grasp, but reality is more complicated.

3 Mechanisms Of How A Chiropractic Adjustment Relieves Pain

Our nervous system has a peripheral (yellow) and a central (purple) component. The long, skinny purple portion represents the spinal cord, and the rest of the purple part is the brain. Evidence has suggested that chiropractic adjustments affect ALL three parts of our nervous system.

1. Peripheral mechanism:

An animal study (2) had found that one single adjustment was able to significantly reduce inflammatory proteins (cytokines) in the blood. These cytokines stimulate sensors on nerve fibers that cause one to have pain and increase sensitivity to pain. (3)

2. Spinal mechanism:

Chiropractic adjustments activate sensors in the muscles (Golgi organs and muscle spindles) (1) that send signals through large sensory fibers. These large sensory fibers are thought to inhibit pain fiber signaling at the spinal cord level. (4)

3. Brain-based mechanism:

Advancing technology has allowed us to directly observe brain activity by measuring blood flow. This gives us direct evidence of how a specific therapy affects the brain. A recent study (5) using functional magnetic resonance imaging (fMRI) had observed that chiropractic adjustment changed the connectivity between brain regions that process pain.

Why Do We Care

1. Manual therapists often depend upon an alleged biomechanical mechanism in evaluation and treatment. (1) Unnecessary effort may be spent to correct the biomechanical fault (e.g. a disc bulge), while it has little to do with what the patient is experiencing. More on this topic in my previous blog post on spinal degeneration.
2. The neurophysiological model allows the clinicians to consider other potential mechanisms in the treatment of pain.
3. Understanding the mechanisms behind the treatment help build patient confidence and trust in their chiropractors.

References:

1. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009 Oct;14(5):5310538. [PubMed]
2. Teodorczyk-Injeyan JA, Injeyan HS, RueggR. Spinal manipulative therapy therapy reduces inflammatory cytokines but not substance P production in normal subjects. J Manipulative Physiol Ther. 2006;29:14-21. [PubMed]
3. Sommer C, Kress M. Recent findings on how proinflammatory cytokines cause pain: peripheral mechanisms in inflammatory and neuropathic hyperalgesia. Neurosci Lett. 2004 May 6;361(1-3):184-7. [PubMed]
4. Moayedi M, Davis KD. Theories of pain: from specificity to gate control. J Neurophysiol. 2013 Jan;109(1):5-12. [PubMed]
5. Gay CW, Robinson ME, George SZ, Perlstein WM, Bishop MD. Immediate changes following manual therapy in resting state functional connectivity as measured by magnetic resonance imaging (fMRI) in subjects with induced low back pain. J Manipulative Physiol Ther. 2014 Nov-Dec;37(9):614-627. [PubMed]

About the Author

Dr. Lily Semrow is a Board Certified Chiropractic Neurologist who focuses on Neuro-Structural Correction. She has a B.S. in Nutrition and a doctorate in Chiropractic. She has a passion for serving families, and helping people who could not get better through traditional and alternative means.

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The post How Do Chiropractic Adjustments Relieve Pain? – Chiropractor in Holland appeared first on Holland, MI Chiropractors | Brain and Body Chiropractic.

The patient was a 56-year-old woman who presented with elbow pain on both sides. The pain had been constant since a fall 6 months prior. She braced herself from the fall with both hands and was left with constant pain on the outside of her elbows.

She had consulted a couple other chiropractors. One of them suggested that she had tennis elbow, and gave her specific stretching exercises to perform at home.

Something Does Not Add Up

Tennis elbow is damage of the tendons on the outside of the elbow. It is commonly due to overuse, but trauma can be a major player, too.

Although what this patient described was almost just like tennis elbow, the exam findings were inconsistent. She did not have pain exactly over the tendons, and we weren’t able to reproduce the pain with any orthopedic tests, either.

In fact, the pain she was experiencing followed the pattern of an inflamed nerve.

Results

Immediately after the first treatment, the patient was pain free for the first time in 6 months.

Since the patient lives on the other side of the state, we have not seen her again since. However, we did follow up with her 6 months after her initial visit to our office, and she wrote back, “Elbows are fabulous and have never had another problem!”

Things To Think About

1. Musculoskeletal injuries like this can affect the joint, muscle or nerve. Traditionally, chiropractors focus on the joints, and physical therapists focus on the muscles. Seldom does anyone pay attention to the nerves.
2. The immediate and lasting result this patient has experienced also confirms that she did NOT have tennis elbow. True tendon injuries take more time to treat and heal.
3. This patient responded great to the treatments and had a complete resolution, but it may take more work for others.
4. When peripheral nerve irritation is the cause of the problem, patients typically see great results within 3-5 visits. If this doesn’t work for you within that time frame, this treatment is not for you and we need to explore other options.

About the Author

Dr. Lily Semrow is a Board Certified Chiropractic Neurologist who focuses on Neuro-Structural Correction. She has a B.S. in Nutrition and a doctorate in Chiropractic. She has a passion for serving families, and helping people who could not get better through traditional and alternative means.

Want to keep up with future posts?

The post Case Study: Chronic Elbow Pain And Nerve Entrapment – Chiropractor In Holland appeared first on Holland, MI Chiropractors | Brain and Body Chiropractic.

Dizziness is a complex phenomenon that often has more than one cause. (1) Neck pain related dizziness is often ignored, because, to date, nobody can agree on its diagnostic criteria, and there is no specific lab test for it. (2) Also, it doesn’t explain why some people with really bad neck pain don’t have dizziness, while others with moderate neck pain do.

How Does A Neck Problem Cause Dizziness?
There are three systems that contribute to our sense of balance—vision, vestibular system (sensors in our inner ears), and proprioception (sensory from joints and muscles).

1. Proprioceptive disruption: There is more sensory input to the brain from the neck than any other spinal joints. It is reasonable to say that a disruption in this system can disrupt a person’s sense of balance. A study has confirmed that whiplash injury causes joint position errors in the neck, which is likely the cause of dizziness. (3)
2. Sympathetic dysfunction: This theory was abandoned until recent years. Scientists found that degeneration of the disc can compress a ligament in the neck and trigger sympathetic responses, such as vertigo, ringing in the ear, nausea, vomiting, and digestive issues. (4)
3. Blood Flow Disruption: Although this rarely happens, degeneration of cervical spine can temporarily cut off blood flow to the brain when turning one’s neck and cause dizziness. (5,6)

When Do I see A Chiropractor For My Dizziness?

Not all dizziness can be managed by conservative care. If a chiropractor is your first point of contact, with a thorough clinical exam, a well-trained chiropractor is able to identify the cause of dizziness in most cases and make proper referral if needed. Studies show that expensive diagnostics are rarely helpful in dizzy elderly people. (7)

If you have been to multiple doctors and specialists, and all your testing seems to come back normal, a problem in your neck maybe a contributor to your symptoms. Remember, there is no specific lab test for it, so many doctors don’t consider the possibility. However, studies clearly show an association between neck problem and dizziness. In this case, manual therapy, conservative treatment and vestibular rehabilitation are your best options. (2)

References:

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2352174/
2. http://www.ncbi.nlm.nih.gov/pubmed/26218949
3. http://www.ncbi.nlm.nih.gov/pubmed/12610847
4. http://www.ncbi.nlm.nih.gov/pubmed/25550947
5. http://www.ncbi.nlm.nih.gov/pubmed/19663339
6. http://www.ncbi.nlm.nih.gov/pubmed/16720191
7. http://www.ncbi.nlm.nih.gov/pubmed/8842072

About the Author

Dr. Lily Semrow is a Board Certified Chiropractic Neurologist who focuses on Neuro-Structural Correction. She has a B.S. in Nutrition and a doctorate in Chiropractic. She has a passion for serving families, and helping people who could not get better through traditional and alternative means.

Want to keep up with future posts?

The post Vertigo And Chiropractic: When All Else Fails – Chiropractor In Holland appeared first on Holland, MI Chiropractors | Brain and Body Chiropractic.