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Tips to Avoid Text Neck

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Tips to Avoid Text Neck

​In this age of mobile devices and smartphones, more and more patients are being diagnosed with neck pain associated with looking down at a screen. Studies have shown that young people are at increased risk of back and neck pain due to overuse of devices. Now, a new condition, dubbed “text neck,” is being found in smartphone-users of all ages, resulting in serious stiffness, strain, and pain in the neck muscles and cervical spine.

Americans send an average of around 2.19 trillion text messages every year, meaning that text neck has the potential of afflicting millions of people.

The condition is relatively new, and as Forbes reports in their article, How Texting Can Give You a Permanent Pain in the Neck, “It takes time…for a new condition to spread throughout the medical community. Some doctors who have never heard of text neck don’t think to ask patients with neck pain about their phone or computer habits.”

However, investigators of worker’s compensation claims are at the point that they look into the phone records of claimants with neck pain, and sometimes use their history of text messaging to get their compensation cases dismissed, attributing the neck pain to personal screen time rather than work.

There is no denying that a great number of people consider smartphones to be indispensable. And this overuse is causing what could be an epidemic of health problems into the future. A published in the journal Applied Psychophysiology and Biofeedback found that an overwhelming majority of 83% of participants reported some hand and neck pain during texting. Researchers in this study also found that people sending texts displayed other classic signs of tension, such as increased heart rates and holding their breath. Even when they said they were relaxed, they had signs of tension.

If you text or play games on your smartphone, you know that it is easy to get into the habit of holding your head forward-and-down while typing on it. Another studyconducted at the Center for Musculoskeletal Research found that 90% of people flexed their necks while texting, defined as bending the neck forward over 10 degrees past neutral alignment. In this study, it was discovered that the more texting that participants did, the worse their risk of neck or shoulder pain.

Especially susceptible to text neck are those of us who not only spend some of our leisure time on smartphones, but also spend much of our working time sitting at computers. All these hours spent in a flexed posture can add up to 30 pounds of extra weight on the upper vertebrae, straining the trapezius muscles and pulling the spine out of alignment over time.

Researchers are also finding that people over age 50 are more at risk of developing text neck. According to physical therapist Rob Worth, in an interview with Forbes, “People in their 50s and 60s have less tissue tolerance. Overuse injuries (like text neck) don’t heal as quickly.”

However, Worth said that young people are also at risk of permanent problems from text neck. He suggested that the stooped posture while typing on phones may freeze the position of the spine’s alignment, and years down the road, we may see people who are permanently stooped because of it.

If you suspect you have text neck, talk to your health-care provider. Your chiropractor or physical therapist can help you determine if you’re suffering from this ailment. These experts can also help design a treatment plan to relieve pain and regain range of motion, as well as advise you about preventing future injury. The following tips, summarized from the Forbes article, may help you avoid the risks of text neck:

  1. Hold your phone at a proper reading angle, rather than looking down. Your phone should be held directly in front of your mouth, a few inches across from your chin. Your eyes should look down rather than having to bend your neck down. Your shoulders should feel relaxed while you’re typing.
  2. Use a text-dictation program if you have one. Hold the phone in front of your mouth.
  3. Set a timer and take breaks. Avoid prolonged phone use by taking regular breaks where you put your phone down and do something else.
  4. Build strength and range of motion. In your workout routine, include exercises and stretches that strengthen your neck, back extensors, rhomboids, and latissimus dorsi muscles. For some ideas, check out this blog post from researcher Dr. Erik Peper.
  5. Drink water and maintain hydration.
  6. Use other forms of communication. Try calling your family and friends or seeing them in person to chat.

Quilter D. How texting can give you a permanent pain in the neck. Forbes June 7, 2013. http://www.forbes.com.

Lin IM, Peper E. Psychophysicological patterns during cell phone text messaging: a preliminary study. Applied Psychophysiology and Biofeedback March 2009; 34(1): 53-57.

Gold JE, Griban JB, et al. Postures, typing strategies, and gender differences in mobile device usage: an observational study. Applied Ergonomics March 2012; 43(2): 408-412.

Peper E. Improve health with fun movements: practices you can do at home and at work. The Peper Perspective blog; February 2, 2013.

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When you are sick, what better way to bo

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When you are sick, what better way to boost your immune system than improving your nervous system with chiropractic? http://ow.ly/SNW4O

Chiropractic Cuts Back Pain for 85% of Pregnant Women

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Chiropractic Cuts Back Pain for 85% of Pregnant Women

Many pregnant women do not seek medical attention for their back pain because they believe it’s just a “normal” part of pregnancy. It’s important to know that dealing with grueling pain that prevents you from accomplishing day-to-day tasks is anything but normal, even when you’re pregnant.

One common barrier to women seeking care for their back pain is a reluctance to take too many medications while pregnant. Fortunately, there are many drug-free, non-invasive options for relieving pelvic and back pain during pregnancy and beyond. A recent study confirms that chiropractic care can offer pregnant women safe and effective relief of pelvic and back pain.

The prospective cohort included 115 pregnant patients with lower back or pelvic pain who were treated with chiropractic care. After one week, 52% said they had already noticed improvements; that percentage jumped to 70% after 1 month; and eventually to 85% after three months. Patients showed significant reductions in pain and disability, as measured by NRS and Oswestry scores, respectively.

One year after the start of the study, 88% of patients reported improved back and pelvic pain post-delivery. This improvement is significant, given that having back pain during pregnancy typically sets women up for future episodes of back pain. These findings suggest that taking care of your spinal health while pregnant can have lasting benefits for your health.

These results add to previous findings from a randomized, controlled trial published last year in The American Journal of Obstetrics and Gynecology. Patients enrolled in the study had significant back pain at 24-28 weeks’ gestation, and were randomly assigned to receive either chiropractic care or standard medical care. At 33 weeks’ gestation, those in the chiropractic group had significant reductions in pain and disability, while the standard medical care patients did not.

Surveys show that most pregnant women are satisfied with the care they receive from chiropractors.Chiropractors use gentle, low-force spinal adjustments when working with pregnant women or other sensitive patients, like the elderly or children. These spinal adjustments are often combined with massage, stretching, and exercise rehabilitation for effective, natural relief. Chiropractic has also been shown to be effective for women with migraine during pregnancy.

References

Peterson CK, et al. Outcomes of pregnant patients with low back pain undergoing chiropractic treatment: a prospective cohort study with short term, medium term and 1 year follow-up. Chiropractic and Manual Therapies 2014;22(1):15.

George JW, et al. A randomized controlled trial comparing a multimodal intervention and standard obstetrics care for low back and pelvic pain in pregnancy. American Journal of Obstetrics Gynecology 2013;208(4):295.e1-7. doi: 10.1016/j.ajog.2012.10.869.

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Safety of Chiropractic Neck Adjustments Confirmed

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Safety of Chiropractic Neck Adjustments Confirmed

Spinal manipulation therapy is a widely-accepted method for treating back pain, neck pain, and headaches. Although previous studies have pointed to the safety of chiropractic neck adjustments, there has been some concern about the effect of the forces applied during spinal manipulation of the neck. It has been argued that there is the possibility of damaging the internal carotid artery (ICA) by such force. Previously, little was known about the strains sustained by the ICA during spinal manipulation therapy. In a recent study, researchers sought to examine the mechanics of the ICA during neck manipulation to determine whether spinal manipulation causes strains in excess of those experienced during normal everyday movements.

The researchers measured strains applied to the internal carotid artery (ICA) during neck spinal manipulation treatments. Peak and average ICA strains were measured in 6 cadaver spines during cervical spinal manipulation performed by chiropractic doctors. These number were compared with the corresponding strain experienced during diagnostic testing of the head and neck to simulate normal everyday movements.

The researchers found that ICA strains were no different during chiropractic manipulation of the neck than during normal everyday movements. Therefore, cervical spinal manipulation performed by trained chiropractors does not appear to place undue strain on the ICA.

Earlier research has also demonstrated the safety of chiropractic neck adjustments. In an extensive literature review from the medical journal Spine, researchers analyzed data from 28,807 chiropractic patients receiving a total of 50, 276 adjustments of the cervical spine.  Among the thousands of adjustments made, the only negative side effect reported was temporary, mild dizziness; no serious side effects were reported.

Studies show that chiropractic neck adjustments can reduce pain in patients with neck disorders,whiplash, dizziness, and headaches

Herzog W, Tang C, Leonard T. Internal Carotid Artery Strains During High-Speed, Low-Amplitude Spinal Manipulations of the Neck. Journal of Manipulative and Physiological Therapeutics 2012; pii: S0161-4754(12)00156-X. doi: 10.1016/j.jmpt.2012.09.005.

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Chiropractic Eases Infant Colic, Study Suggests

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Chiropractic Eases Infant Colic, Study Suggests

As if sleepless nights and endless crying weren’t enough, parents of infants with colic often endure a string of unsuccessful treatments and frustrating doctors visits as they struggle to fight the elusive condition. But new research offers hope to parents searching for natural treatment of infant colic: chiropractic therapies produced clinically and statistically significant reductions in crying time in colicky babies in a recent study.

Previous research has examined the effects of chiropractic therapies on colic with inconclusive results. In a 2006 study from Britain and in a 1999 Danish study, manual therapy was associated with significant reductions in crying time. In both studies however, parents were not blinded to the treatment infants received, leading critics to worry that parents’ knowledge of the treatment biased their reporting on infant crying time. In a 2002 Norwegian study that did blind parents to the treatment, no significant differences were found between a manual therapy and a placebo treatment. In still another study, two different manual therapies reduced crying time but there were no placebos for comparison. These varying results meant that although some evidence pointed to the benefits of chiropractic care for colic, questions lingered about parental bias and treatment efficacy.

Researchers from the Anglo-European College of Chiropractic sought to investigate these questions in a study of 104 infants with colic. They divided the patients into three groups: in the first group, the infants were treated and the parents were aware of treatment; in the second group the infants were treated and the parents were blinded to treatment; and in the third group the infants were not treated and the parents were blinded to the lack of treatment.

After ten days, all three groups had significant reductions in crying time but the infants in the treatment groups saw greater improvements. Babies who received chiropractic therapies cried for an average of 1.5 hours less than untreated infants. Treated infants with blinded parents had a 44% reduction in crying time, compared to a 51% reduction in crying time for infants with parents who were aware of treatment. Those who received no treatment had just an 18% reduction in crying time. The slight differences between treatment groups were not statistically significant, suggesting that parental bias did not substantially alter reporting of crying time. The improvements were considered clinically significant by two cutoffs: a reduction in crying time by 30% and crying for 2 hours or less a day.

Researchers pointed to studies showing that moderate finger pressure can induce a relaxation response in adults, decreasing heart rate and increasing alpha and beta brainwave activity. Other studies have found that manual impulse can similarly result in reduced heart rate in infants. This relaxation response could be a potential mechanism behind the reduced crying time. If colic is indeed related to musculoskeletal conditions as hypothesized by some authors, manual therapies could also address underlying musculoskeletal disorders.

While larger studies are needed to confirm these results, the study suggests that chiropractic therapies could be beneficial for infants with colic. Previous research suggests that chiropractors can play a role in treating colic related to infant headache. Doctors of chiropractic can also advise you in making nutritional and dietary changes to minimize allergic reactions that may also be an underlying cause of colic.

References

Miller J, Newell D, and Bolton J. Efficacy of Chiropractic Manual Therapy on Infant Colic: A Pragmatic, Single-Blind, Randomized Controlled Trial. Journal of Manipulative and Physiological Therapeutics 2012; 35 (8): 600-607.

Marchland AM, Miller JE, Mitchell C. Diagnosis and Chiropractic Treatment of Infant Headache Based on Behavioral Presentation and Physical Findings: A Retrospective Series of 13 Cases.  Journal of Manipulative and Physiological Therapeutics 2009; 32 (8): 682-686.

 

 

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Chiropractic Offers Holistic Approach to Carpal Tunnel Syndrome

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Chiropractic Offers Holistic Approach to Carpal Tunnel Syndrome

Many patients with chronic carpal tunnel syndrome are told they need surgery to relieve the pain. While surgical interventions aim to relieve pressure on the irritated median nerve, the treatment may be too narrow in scope for some patients. Case in point: nearly a third of patients who receive surgery for carpal tunnel report a return in symptoms within two years of surgery.1

Recent research suggests there’s more to carpal tunnel than wrist and arm pain: CTS could be related to problems in the neck.

A recent study from Journal of Orthopaedic and Physical Therapy assessed the cervical range of motion in 71 women with carpal tunnel syndrome. Compared to women without CTS, women with carpal tunnel had significantly restricted range of motion. The greater the pain intensity women experienced, the less able they were to perform lateral flexion away from the affected side. There were no major difference among women with minimal, moderate, or severe CTS.

This study confirms what chiropractors have known for years: that wrist pain can often be related to problems in the cervical spine. In fact, the cervical spine may be the source of wrist and arm pain for patients with cervical radiculopathy. That’s why chiropractors use a more holistic approach to treating carpal tunnel syndrome, one that involves relieving irritation of the median nerve in addition to addressing any underlying concerns in the neck. Chiropractors can draw on a combination of spinal adjustments, trigger point therapy, exercises, and advice on ways to prevent overuse injuries.

Research shows that this holistic approach is successful for many patients with carpal tunnel. A 2010 study found that trigger point therapy administered by chiropractors resulted in 67% improvement in symptoms.2

In another study published earlier this year, CTS patients who received soft tissue mobilization and other chiropractic treatments had significantly reduced hand pain intensity after just a week of treatment. They also showed signs of reduced pain sensitivity in certain joints of the cervical spine.3

Case studies also suggest that chiropractic can be effective for chronic CTS patients who failed to improve with other methods like surgery, wrist splints, and drugs.4

If you suffer from ongoing wrist pain and CTS, remember that surgery is not your only option for relief. Chiropractic care could address the multifaceted nature of your pain to provide lasting relief of carpal tunnel syndrome.

 References

1. Bessette L, Keller RB, Liang MH, Simmons BP, Fossel AH, Katz JN. Patients’ preferences and their relationship with satisfaction following carpal tunnel release. Journal of Hand Surgery 1997;22:613–20. Quoted in Hains G, et al (2010).

2. Hains G, Descarreaux M, Lamy AM, Hains F. A randomized controlled (intervention) trial of ischemic compression therapy for chronic carpal tunnel syndrome. Journal of the Canadian Chiropractic Association 2010; 54(3): 155–163.

3. De-la-llave-Rincon, A. Response of pain intensity to soft tissue mobilization and neurodynamic technique: a series of 18 patients with chronic carpal tunnel syndrome. Journal of Manipulative and Physiological Therapeutics 2012; doi:10.1016/j.jmpt.2012.06.002.

4. Crafts GJ, et al. Chiropractic management of work-related upper limb disorder complicated by intraossesous ganglion cysts: a case report. Journal of Chiropractic Medicine 2011; 10(3): 166-172.

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Study Finds MRI Overused for Back Pain

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Study Finds MRI Overused for Back Pain

A panel of experts recently collaborated in a study which analyzed orders for MRI scans in two large hospitals. They found that more than half the cases in which a lumbar spine MRI scan were done should not have been ordered in the first place. The panel deemed 29% of the MRI referrals inappropriate, and another 27% of “uncertain value”.

It was also discovered that family physicians were the biggest culprits in ordering unnecessary low-back MRI scans. Only 34% of family doctors’ orders were considered appropriate, compared to 58% of orders by physicians of other specialties.

The research team, lead by Dr. Derek Emery, wrote, “Eliminating inappropriate scans and some uncertain value could reduce the harm that accrues from unneeded investigations and result in significant cost savings.”

The use of lumbar spine scans has risen drastically, even though there is a weak correlation between their findings and clinical signs and symptoms. The study noted the possible reasons for their overuse, including patient expectations, doctors’ concerns about litigation, and lack of physician accountability in regards to cost. The expert panel recommended strict guidelines for doctors and better patient education.

The only orders where the MRI scans were routinely deemed appropriate was in cases of post-operative leg or back pain. However, these accounted for only 17% of the low back MRI orders.

The findings of the study confirmed what many doctors already understand about MRI overuse. Imaging for low-back pain is one of the top five overused tests and treatments listed by both the American Academy of Family Physicians and the American College of Physicians.

Other studies have pointed out overuse of MRI for other patient conditions, including headache and sciatica.

Emery D, et al. Overuse of magnetic resonance imaging. JAMA Internal Medicine 2013; online first 25 March: doi 10.1001/jamainternmed.2013.3804.

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