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protecting from falls

A New Way to Protect People from Falling?

 

protecting from falls

 

Read Time: [6 minutes]

Osteoporosis, falls, and broken hips are one of the biggest concerns of people 55 and up. The fear is real and justified, as falls are a leading cause of death and disability once you hit the age of 60. To combat this, conventional wisdom has suggested that older adults focus on increasing calcium, taking bone hardening drugs, and to keep monitoring your your bone scans.

This isn’t to say that bone density is unimportant. Bone density is really important! But bone density is REALLY, REALLY, REALLY hard to change once you’re at the age of risk. Your only source of protection are drugs like Fosamax. The problem with that is that bone hardening drugs like Fosamax have come under scrutiny for waning effects after 3-4 years.

Prestigious medical journals like the New England Journal of Medicine have shown that you may actually have a greater risk of thigh fractures if you stay on the medication for 5 years compared to placebo. [source]

Once you have osteoporosis, you are basically going to have it throughout your life. It’s not like you can just take the drug for 3 years, stop, and still be protected. You are expected to take this drug for the rest of your life, but doing that will increase your fracture risk.

It’s just one of those ironic moments in medicine when the cure can eventually cause the problem.

Addressing Balance and Coordination

The best time to address bone density problems is likely in early adult hood. Resistance training combined with a diet high in calcium and magnesium can help build thick and strong bone during your 20’s and 30’s. Trying to build bone in your 50’s and 60’s as a post-menopausal woman can be a losing battle. For many it’s way too late to try to increase bone density naturally.

However there is more to blame in for the devastating impact of falls beyond just soft bones. We also have to look at why people fall to begin with. Research suggests that just 15% of falls occur due to some external event (wet floor, pushed over, etc) and 15% of falls are a result of an underlying disease process (MS, diabetes, epilepsy).

That leaves a whopping 70% of falls are a result of a combination of factors that lead to poor balance and poor mobility.

Unlike soft bones, balance and mobility are traits that can be trained and improved upon throughout your life.

Common Way to Improve Balance

When it comes to balance, you have to address 3 parts of the nervous system. The visual system, the vestibular system, and the proprioceptive system. For ease of understanding, we’ll just call them your eyes, your ears, and your joints/muscles/skin.

balance and dizziness

By identifying which system is deficient, you can design interventions that can improve the balance of a human being. Some of these therapies include:

  • Vision therapy
  • Physical therapy
  • Strength training
  • Occupational therapy
  • Vestibular therapy

These are the most commonly prescribed recommendations for people with balance problems. But what if these therapies don’t work well for you? Many people are told that they just have to live with their balance issue.

New Research on Spinal Health and Balance

A recent study published in the Journal of Manipulative and Physiologic Therapeutics suggests that chiropractors may play a large role in helping people get their sense of balance back. The study looked at 30 patients receiving chiropractic care versus 30 controls. Both groups had measurements taken of various balance metrics and were tested at 4 weeks and 12 weeks.

Here are some of the charts from the paper:

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

The patients in the chiropractic group had a significant decrease in errors in joint position tests.

 

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

Patients in the chiropractic group had higher scores in a sound flash illusion test.

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

Link to paper: http://www.jmptonline.org/article/S0161-4754(16)00050-6/abstract

 Patients in the chiropractic group had a significant improvement in health related quality of life scores.

Do Tests Translate  to the Real World

So here’s the thing. The results look good on the charts, and seem to be significant. However, we can’t really make the leap that people will fall less by getting adjusted based on the results of this study. It’s just a good place to start.

What this study does tell us is that there’s something about patients who get adjusted seem to have a better sense of their own body. That’s the proprioception idea that we talked about earlier. If you have a better awareness of your body, then you will generally have better balance.

While we can’t make a leap based on this study, we do know that many patients under chiropractic care see some astounding changes in their balance and quality of life when they start getting their brain and spine connected.

Check out one of my favorite patient success stories below:

I am a 72 y.o. retired R.N. with history of Vertigo and Poor Balance.
Having had this problem for more than 20 years; I have seen many Doctors with little or no improvement.
On April 11, 2014, I walked into Dr. Chung’s office holding onto walls or anything available to keep from falling. After my first visit, I knew that I had finally met someone that truly cared. After my first adjustment, I was able to stand on my own.
Fast forward to 12 weeks of treatment, I am now able to go out without fear of falling.
I am now on the Maintenance Program and feeling stronger and able to “LIVE” and not merely :SURVIVE”.
Thank You Dr. Chung
You are the BEST !!!!!!

- Peggy McDaniel

Many doctors didn’t go into chiropractic because they want to be a quick solution for pain. They went into chiropractic because it can dramatically change the quality of someone’s life.

When you lose their sense of control over their surroundings, it can become devastating to your sense of independence. Our job is to find a way to give that sense back to you.

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Pinched Nerve

Anatomy of a Pinched Nerve

Pinched Nerve

Read Time: [6-7 minutes]

After the wide success of my article Anatomy of a Headache I decided to tackle another common problem we see every single day in the office.

Pinched Nerves

When someone gets an acute pinched nerve, it can be amongst the most painful problems that afflict human beings. Pinched nerves can leave people in lying in bed with an inability to work, exercise, sleep or play. When it happens people take on really strange and awkward postures to try to avoid the pain.

If you are like Mr. Stock Image here where you lean away to one side and lift your arm, you might have a pinched nerve in your neck. Image Credit: Can Stock Photos

If you are like Mr. Stock Image here where you lean away to one side and lift your arm, you might have a pinched nerve in your neck.
Image Credit: Can Stock Photos

 

But there’s a lot of misconceptions about what a pinched nerve actually is. A lot of people feel like if their neck or back has a pinching or stabbing type pain, then it’s likely a pinched nerve. However, multiple types of neck pain can lead to a pinching type of pain.  A true pinched nerve involves multiple factors.

1. A Tissue Offender

There are several different types of tissues that can pinch a nerve. Bone, muscle, tendons, and calcified ligaments are all compress nerve tissue throughout the body. Even tumors can cause pinched nerves, but those are in much more rare circumstances.

The overwhelming majority of pinched nerve pain stems from a problem you’re probably familiar with. The slipped/herniated disc. Tearing of the outer part of the disc allows for a gel like material to spew out into a small space where a nerve travels.

Most herniated discs don’t cause problems. I can take an MRI of 100 random people with no pain and chances are high that many of them will have a disc herniation.

The herniation only becomes problematic when it is large enough, or you move in a way to force this gel into the nerve against some of the other hard structure in the spine.

When a disc breaks down and leaks a hard fluid on top of the nerve, the nerve can become pinched between a rock (bone) and a hard place (disc) Image Credit: Can Stock Photos

When a disc breaks down and leaks a hard fluid on top of the nerve, the nerve can become pinched between a rock (bone) and a hard place (disc)
Image Credit: Can Stock Photos

2. Soft and Sensitive Nerves

Nerve tissue is soft and sensitive. Even small amounts of pressure against a nerve can make it go haywire. They are like the iPhone charging cables of the tissue world. Just a little bit of stress and the whole thing comes unraveled.

That’s why your body protects the most sensitive nerve tissue (brain, spinal cord, spinal nerves) in a case of bone called your skull and your spine.

But it’s not just sensitive to pressure. It’s also sensitive to chemical signals like inflammation. Which brings us to the third important piece of anatomy.

3. Inflammatory Chemicals

Inflammation from a torn or damaged disc can build up around the nerve and stimulate the nerve to create a pain response. This is especially true when you injure a disc very suddenly….like in a car accident or picking up a heavy box. Cells from your immune system rush to the site of damage and try to clean up the mess. The result is a large number of inflammatory molecules called cytokines and substance P fills that area and can trigger a pain response from the nearby nerve.

I always compare the body’s use of inflammation to a fire/burning process. When your body uses inflammation it is like using a fire to burn away germs or damaged tissue in the body. The main problem with fire is that it can sometimes cause damage your own body too. This is especially problematic when inflammation affects a nerve.

Image from published article: Inflammation ain intervertebral disc degeneration and regeneration. Journal of the Royal Society Interface. 2015. http://rsif.royalsocietypublishing.org/content/12/104/20141191

Image from published article:
Inflammation ain intervertebral disc degeneration and regeneration. Journal of the Royal Society Interface. 2015.
http://rsif.royalsocietypublishing.org/content/12/104/20141191

 

When a Pinched Nerve is a Serious Problem

The pain from a pinched nerve can be excruciating. It’s not uncommon for someone with pain from a fresh pinched nerve to go to a hospital to get checked for something serious.

With that said, the pain from a pinched nerve is not the worst thing that can happen. The worst case scenario for pinched nerves are a loss of function.

If you have a pinched nerve and you start to have things like weakness and complete loss of feeling in your arm, legs, or hands, then it can be a serious issue that needs to be addressed by a surgeon. In cases of pinched nerves in the lower back, sometimes the nerves can affect bowel and bladder function leading to a condition called Cauda Equina syndrome which is a medical emergency.

If left for too long, your muscles can begin to atrophy and you may never get full function back. These are scenarios that shouldn’t be trifled with.

90% of Pinched Nerves Can Be Addressed Conservatively

That previous section wasn’t meant to scare you, but it’s a reality that we sometimes we have to face. The good news is that the vast majority of pinched nerves respond great to conservative care. That means things like physical therapy, anti-inflammatories, and decompression can all be helpful modalities in dealing with pinched nerves.

All of the above therapies can provide some relief from the pain of a pinched nerve, but one thing that is important is addressing some of the biomechanical issues that lead to a herniated disc becoming a pinched nerve.

 A Delicate Balancing Act

The spine has many functions. It protects the delicate spinal nerves, it’s the central attachment point for numerous muscles, and allows for a wide range of movement. Another key function is the way that it distributes force throughout the body.

One of the key facets of Normal Structure is that it provides an ideal way for the human frame to distribute force evenly through the body’s muscles and joints. When we lose normal structure, we start to put more stress on some parts of the body over others leading to increased joint stresses in select areas.

body imbalance

Loss of Normal Structure leads to abnormal joint stresses

Want proof that your structure exacerbates pain from a herniated disc. Look at the way that people hold their posture. People with pinched nerves usually can’t stand bending their neck or back in a specific direction, so they lean towards one side over the other. You’ll also see that they avoid forward bending too.

But why? Because bending forward and into the side of the pinched nerve will increase force into the disc and force it further into the nerve.

When your spine bends forward and to the right, it's going to push that purple-ish goo further into the nerve

When your spine bends forward and to the right, it’s going to push that purple-ish goo further into the nerve

That’s why correcting the underlying foundation of the spine helps with pinched nerves because we can help the body naturally equalize the forces going into your discs. Sometimes the body will actually find a way to make the herniated disc go away! Although it’s not expected, the body is always going to move in a direction of healing itself, and sometimes that means getting rid of an offending disc problem.

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