Health Tips

January 2010

Heat and Ice

Patients often ask, “Should I apply heat or cold for this?” My answer always depends on the condition we are treating. Injuries usually respond best to cold packs, whereas spasms and arthritis may do better with heat. For most conditions, we want to increase blood flow.

Interestingly, both heat and cold will increase blood flow. The reason is that our bodies are constantly regulating the temperature of all our parts, and whether we heat or chill an area, our body responds by opening blood channels. Sometimes we even choose to use both by alternating heat and cold. Ice usually works best to reduce swelling, inflammation, and pain from acute injuries such as strains and sprains. I always give specific instructions on the proper use of ice, since like most other forms of treatment, there are right ways and wrong ways to apply the therapy. Next month, I will post a tip on how to properly apply an ice pack to your body.upplements are sold everywhere nowadays. The trouble is figuring out what you need, what you don’t need, and what you should avoid. Before we discuss these issues with a patient, we do a complete health assessment. Some of the products we recommend can be purchased here in the clinic, and some are available at the local health food store.

We often recommend products that contain all of the enzymes and nutrients that are naturally present in selected fruits and vegetables. If you rarely eat fruits and vegetables, you will really tell a difference in how you feel. Even if you already eat fruits and veggies, more is better in order to combat diseases caused by oxidation, such as arthritis and some forms of cancer.

February 2010

Icing Instructions

Last month, we discussed the issue of cold vs. heat when treating musculoskeletal conditions. Now I will provide exact instructions on how to properly apply ice to the neck, back, or an injured extremity. It is best to use a flexible, reusable ice pack in order to achieve an effective cold temperature and to conform to the curves of the body part.

Wrap the ice pack with a paper towel, not a bath towel. The paper towel gives just the right amount of insulation against your skin to avoid freezer burn. Put the wrapped ice pack directly against your skin, not over clothing. Keep the ice pack on for 20 minutes, then off for one hour. Repeat as directed. When icing, expect to experience 3 stages: 1) the area will feel very cold for a couple of minutes, 2) the area will start to “burn” for about a minute, then 3) the area will become numb. When the area is numb, you cannot feel a gentle scratch with your fingernail. This is the stage where swelling and pain will decrease. Remember, “Ice is Nice!”

March 2010

Self Adjusting

Patients sometimes ask, “Is it ok if I pop my own back (or neck)?” My answer is that it is only ok when you are stretching for exercise and you feel or hear the joints release. It is never ok to forcefully pop your own back.

In my office, I use a demonstration tool to show patients that each joint in the spine is supposed to move a little in order to accomplish overall motion. If one or more joints are stuck or move improperly, then other joints have to move too far, creating hypermobility. It is usually those joints that tend to wear out. Chiropractors focus on individual joints that need correction, and leave the others alone. Our goal is to achieve proper joint function throughout the spine, and proper nerve function throughout the body.

April 2010

Best Time to Exercise

Some people like to exercise in the morning, some in the evenings, and some just on weekends. Many have adopted the concept of exercising 3 times per week. Personally, I like to exercise every morning of every day. Simply roll out of bed onto the floor, and spend 15 to 18 minutes on an exercise routine before starting your day.

You might think that 15 to 18 minutes is not enough to make a difference in your health. But do the math. By the end of the week, you have exercised for 2 hours! The best part is that when you do this each morning, you set your body’s metabolic rate early, feel more energetic, and burn more calories throughout the day. There is also a tremendous emotional benefit in knowing that no matter what the day brings, you have done some exercise. Feel free to relax in the evening, go hang out in the gym, or whatever. Just remember, you have to start every morning with your exercises.

May 2010

Spinal Decompression

Spinal Decompression is really a term to describe the clinical outcome of proper traction therapy. The term “decompression” implies that the spine has become compressed (with painful consequences) and needs to have that compression reversed.

The older generation of spinal traction was effective in stretching muscles, ligaments, and joints in the back. Many people continue to obtain relief from pain with ordinary traction therapy. The newer Spinal Decompression units, such as the Dynatronics unit in the Bronson Clinic, allow the doctor to target specific disc levels and control the amount and direction of pull.

By controlling these variables, we are able to “decompress” the problem segments and promote regeneration of a healthier disc. With proper conservative treatment such as Spinal Decompression, along with activity modifications, most cases of disc protrusion do not require surgery.

June 2010

Calcium for Bones

Most doctors agree that we all need to take calcium as a supplement to protect against bone loss. Most also agree that we need 1,000 to 1,500 mg of calcium per day from all sources. But the real debate begins when talking about what type of calcium supplement is best. First, always look for the term “elemental calcium” to know how much you are actually getting. (example: 500 mg calcium carbonate = only 200 mg elemental calcium) Secondly, consider that calcium is only good for you if your body absorbs it.

The small intestine absorbs calcium best in an acid environment. So calcium carbonate needs to be taken after meals when the body secretes acid into the intestines. But calcium citrate has its own acid, so you can take it anytime. Just beware of too much acid that will cause indigestion and problems with reflux. Calcium gluconate and calcium lactate don’t have enough elemental calcium, so they are not cost effective. Stay away from dolomite, bone meal, and oyster shell. They may contain lead. Beware of ads that promote coral calcium as a cure-all. It’s just plain calcium carbonate.

July 2010

Order of Healthcare

Natural first, drugs second, and surgery last. That’s the logical order of proper healthcare when you really think about it. Chiropractic doctors are well trained and uniquely qualified to help restore the human body to normal function through natural methods.

We do this by relieving interference to the nervous system through spinal adjustments, by promoting normal physiology through nutritional modification, and by encouraging a balance between mind and body with lifestyle enhancement. Drugs and surgery may be necessary, but should be reserved for disease and damaged tissue, not generally just to deal with pain. Many primary care physicians now recognize this approach and refer patients to the Bronson Clinic for chiropractic care prior to increasing medications or sending them to the surgeon.

August 2010

Osteoporosis Medications, Avoid Long-Term Use

An unusual type of bone fracture has been reported in women who have taken bisphosphonates for osteopenia and osteoporosis for more than 4 years, according to 2 studies reported at the American Association of Orthopaedic Surgeons 2010 Annual Meeting. Bisphosphonates have been shown to prevent the rapid loss of bone that occurs during the first years of menopause and to reduce the incidence of fracture in postmenopausal women.

However, there have been reports of "peculiar" fractures — that is, low-energy femur fractures. Biopsies in the study showed that the bone quality was similar to “very, very old bone” in people who took the medications longer than 5 years. The problem seems to be that long-term use of the medications causes too much bone “build-up” without the natural bone “turn-over.” Researchers are in the process of developing a consensus statement to warn the public. Meanwhile, the question is if the FDA should put out warning signs because these new types of fractures represent a “catastrophic complication” that may affect the lives of many women.

September 2010

Diet and Lifestyle Still Top Bone Loss Prevention Strategies

Diet and lifestyle should remain first among osteoporosis management options despite major advances in treatments over the past few years, according to the North American Menopause Society. The group's position statement on osteoporosis management emphasized that all postmenopausal women should be encouraged to reduce their risk of bone loss and osteoporotic fractures by:

• Maintaining a healthy weight
• Eating a balanced diet
• Obtaining adequate calcium (1,200 mg per day at age 50 and beyond) and vitamin D (800 to 1,000 IU vitamin D3 per day)
• Participating in appropriate exercise
• Avoiding excessive alcohol consumption
• Not smoking
• Taking measures to prevent falls

The NAMS also publishes guidelines for osteoporosis drug therapy, and recommends bisphosphonates as the first-line option for osteoporosis in postmenopausal women. (Please see last month’s Health Tip by Dr. Bronson titled, “Osteoporosis Medications, Avoid Long-Term Use.” July 2010)

The group also states that repeat bone mineral density scans should be done no more than every two to five years for postmenopausal women not on treatment. (Note: This recommendation appears to be on the basis of cost, since most scans in radiology clinics cost $250 to $300 and include the spine and hips. The Bronson Clinic provides a bone density scan of the wrist for only $25, so most of our patients prefer to do the test annually and graph their bone density over time.)

Source reference: North American Menopause Society "Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society" Menopause 2010; 17: 25-54.

October 2010

Gout Not Just For Men

Gout has historically been considered a male disease, and most research has been limited to men. However, the disease burden among women has been growing, with the incidence doubling in the past two decades, according to an article published in Arthritis & Rheumatism.

Elevated levels of uric acid increase the risk of gout in women, a finding that has not previously been reported, researchers said. Other risk factors independently associated with incident gout in women were increasing age, obesity, alcohol consumption, hypertension, and diuretic use.

These data suggest that women may be more susceptible than men to beer and spirits as a risk factor for gout, a finding that should be confirmed by future studies.

Source reference: Bhole V, et al "Epidemiology of gout in women: fifty-two-year followup of a prospective cohort" Arthritis Rheum 2010; 62: 1069-76.

November 2010

Exercise Can Beat Obesity Gene

An hour a day of moderate to vigorous exercise can overcome the effect of a gene variant that predisposes people to obesity, researchers said. The implication, they said in the April issue of Archives of Pediatrics & Adolescent Medicine, is that recommended exercise levels can "ameliorate the deleterious effect" of the gene variant.

The gene variant in question -- dubbed rs9939609 -- is the so-called A allele of the fat mass- and obesity-associated gene, or FTO. Each copy of the A allele has been estimated to correspond with an extra 1.5 kilograms in body weight.

Some studies have shown that exercise benefits people carrying one or more copies of the allele, the researchers said, but others have not found an effect.

Source reference:  Ruiz JR, et al "Attenuation of the effect of the FTO rs9939609 polymorphism on total and central body fat by physical activity in adolescents: The HELENA Study" Arch Pediatr Adolesc Med 2010; 164(4): 328-33.

December 2010

High Protein Low Carbohydrate
Diet an Option in Obese Teens

A high-protein, low-carbohydrate diet is a safe and effective way for severely obese teenagers to lose weight, according to a new study. Effective treatment options for young people who are obese are limited, and diets have been controversial. Concerns have been that a high-protein, low-carbohydrate diet in children could adversely impact growth and might increase cholesterol levels.

To investigate, the researchers studied a group of 14-year-old children who were at least 175% above ideal weight, but were free of type 2 diabetes and other co-morbidities.

On average, those on the high-protein, low-carb diet lost 29 pounds over 13 weeks, while those on the low-fat diet lost 16 pounds. Nine months later, both groups had maintained the weight loss. "We had expected the high-protein, low-carbohydrate group to quickly regain all the weight lost, but this did not occur," the researchers said. This suggests that with ongoing support, these patients could perhaps have achieved even more weight loss.

The high-fat, low-carbohydrate diet also appeared to be safe, with no serious harmful effects on growth, bone mineral density, and various metabolic parameters, such as cholesterol levels. Both groups had declines in LDL cholesterol and increases in HDL cholesterol.

Dr. Bronson’s recommendation: Reduce sugar and other complex carbohydrates from our children’s diets. Don’t allow your children to eat white bread. Look at the list of ingredients in the food and drinks you buy, and don’t buy anything with high-fructose corn syrup in it.

Reference: J Pediatr 2010.

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