Category Archives: Health Conditions

Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is in the category of less common diseases that you may not know that your chiropractor can treat.  Don’t worry, you probably don’t have it.  Recently the topic came up and I promised to create a post to provide some basic information on the topic of AS.

AS RibbonFirst let me cover what it is.  AS is an inflammatory disease and can be classified as a type of arthritis.  It causes pain in joints and bones, particularly in the spine with the most common complaint being the low back.  In the most severe cases it can cause bones to fuse together.  It is much less common than your typical  osteoarthritis and is also harder to diagnose because of the similarity of its symptoms to so many other conditions.  When you walk into a doctor’s office complaining of low back pain, they won’t jump to the conclusion that you have AS.

Your chiropractor can diagnose AS using a combination of your health and family history, blood tests and radiologic tests, but they won’t usually go hunting for this condition.  It is more often found after other things are ruled out or discovered incidentally with X-rays for other conditions.  This is a sexist disease usually affecting men, but that doesn’t mean that women can’t have it.  AS is also not an illness that comes on late in life.  It usually makes its self known before the age of 35.  The cause of AS is unknown still, but is likely genetic, meaning that it runs in families.  As with most diseases whose causes are unknown there is no known cure yet.  There are however treatments.

Most medical treatments for AS focus on management of pain and symptoms, but there are some medications that have been found to slow the progress of the disease.  Your chiropractor should be able to help you manage or reduce your symptoms as well as slow down the progression of the disease without medication.  As always he should also keep in close contact with your other providers that may be treating you, most likely your  rheumatologist, and together they should come up with a plan of action specific to you.

Image by Cienpies Design http://www.cienpies.net

Image by Cienpies Design http://www.cienpies.net

The treatment with the best results for AS is improving your range of motion and flexibility with exercise, diet, and joint mobilization.  You can do much of it on your own at home with guidance from your provider.  Your chiropractor should already be using these tools to treat any low back pain, but they will be even more important if you have AS.  Your chiropractor may or may not adjust your spine depending on your condition, but managing your care does not require manipulation if you don’t want it.

In the past some practitioners would recommend not seeing a chiropractor for AS because possible risks were unknown.  No studies have found increased risk to people with AS when treated with chiropractic manipulation, and recent research indicated benefits even at the late stages of the disease.  While most of the research is focused on finding a cure to AS here’s a link to an excellent case study of improvement with chiropractic management of AS.

Fevers

Image: Ambro / FreeDigitalPhotos.net

Mom, almost instinctively, checks your forehead for a fever to see if she should keep you home from school.  That’s a good plan.  If your body is ill, one of the proper responses is for it to develop a fever.  The fever is not the problem however; it is part of your body’s solution. 

A recent question by a parent of a child with an ear infection brought this up.  Most parents get scared when their child gets sick and this is perfectly normal.  They should.  This information may help to calm you down.  Our bodies were masterfully designed to be able to combat illness on their own.  Sometimes they need a little help, but often are capable if we just provide the right environment for health.

When it comes to temperature normal is not 98.6° F (37° C).  That is a number for the text books, but anything from 97° F to 99° F may be normal for you.  A normal fever (in a person greater than 3 years old) is between 102.2° F and 104.5° F (39° C and 40° C). This temperature is not bad and should be considered beneficial; it is being regulated by the body and is still under control.  It’s ok.

A fever above 104.5° F (40° C) is not going to cause damage, but does indicate more seriousness and you should see a doctor if you have a fever that gets to this level or a low grade fever for more than 5 days.  Damage to the body or brain is not going to occur until temperatures of 108° F (42° C) or higher.  So don’t panic.

Over the counter fever reducing drugs are not even recommended by the American Academy of Pediatrics.  In the case of home medication for children with fevers they suggest and I agree that treatment should be provided to “improve the child’s overall comfort rather than focus on the normalization of body temperature.”  If a child can’t sleep due to pain then they will have more difficulty getting well.  Care should focus on proper fluid intake and comfortable rest and not on reducing the fever.  For additional information please see this article by Claudia Anrig, DC.

Menier’s Disease: New Research

Patients doing their own research on conditions occationally bring me something that they find interesting to get my opinion.  This recently happened with an article on MÉNIÈRE’S DISEASE AND JOINT INJURY.  The full title is “The Potential Role of Joint Injury and Eustachian Tube Dysfunction in the Genesis of Secondary Ménière’s DiseaseI thought I’d just share that review with you.

Meniere’s Disease is a disorder of the inner ear causing many different symptoms from vertigo to ringing in the ears to hearing loss.  The article really seems to be just an idea that the authors have been pondering and sought to find evidence to back up their idea.  Not very scientific in my opinion.  What they’ve really done is see if there is any validity to their hypothesis so that they can do further studies.

The ear has 3 sections, inner, middle, and outer.  The inner ear is sealed off and in your skull and is what does all of the work you might associate with the ear, hearing and balance.  The middle ear is simply a cavity with facilities to allow the outer ear to “talk” to the inner ear and is drained by the eustachian tube into the back of your throat.  The middle ear is usually where ear “infections” occur.  The eustation tube becomes blocked and can’t drain the middle ear so fluid builds up or an infection may grow.  If this occurs frequently, medical doctors sometimes, (instead of fixing the tube that your body has) insert additional tubes that drain to your outer ear.

The bones in your neck join the skull right behind your ear.  If you put your finger right there you feel a soft spot between the bump of your skull your jaw and your ear.  Those are the joints that the article talks about, the upper cervical spine and the TMJ.  The close proximity has always caused people to justify a relationship between those joints and the ear. Neurologically there has been no direct connection found that I’m aware of. These authors are proposing an indirect nerve connection in order to explain why TMJ or neck injuries can lead to Menier’s disease. 

From a chiropractic perspective their hypothesis also implies the reverse, that patients with Menier’s Disease might benefit from chiropractic management.  To be determined…

Cold Laser Therapy and de Quervain’s

People have been asking lately about laser therapy, so I thought I’d explain it a little and sneak in a quick condition at the same time.

De Quervain’s is the name for tenosynovitis of the thumb extender and abductor muscles.  Which is to say the tendons that move your thumb hurt at the wrist because inflammation isn’t allowing them to move properly.  It is more common in women, but anyone doing repetitive motions with their thumb such as typing, cashiering, mechanics, etc. is susceptible.  If you have it you may notice a “squeaky thumb,” pain when moving your thumb and decreased grip strength.  In my experience this condition doesn’t usually go away on it’s own.  Similar to carpal tunnel syndrome it just keeps coming back unless you receive proper care.

Many things are done for treatment of this condition.  Chiropractic manipulation and massage of the area are beneficial as well as reducing use.  You’ll likely need to talk with your employer about decreasing or changing your duties for a time while you heal.  There are also many electrical modalities that are beneficial for de Quervain’s.

That’s where the Cold Laser comes in.  Cold Laser is called many names but it is all the same thing, particular light waves that have been found to increase cellular metabolism.  In essence when exposed to these wavelengths of light your cells heal faster, and hurt less.  That’s a good thing.

LLLTIt’s an odd sort of treatment because you normally don’t feel anything at the time.  Kind of like magic with good research behind it.  We just put this wand with a laser or LEDs on the injured area and hold it there for a few moments with the light on.  The reason I bring Low Level Laser Therapy (LLLT) up with this condition is the relief time.  Generally speaking my patients are able to notice effects of LLLT within the first day, but I had a patient with de Quervain’s who claimed instantaneous relief with LLLT.  It was amazing to me and worth reporting to you.

So, if you have pain at your wrist from thumb movement visit your chiropractor and ask them about Cold Laser Treatment.

Thoracic Outlet Syndrome

I’ll begin my discussion of common chiropractic conditions with Thoracic Outlet Syndrome (TOS).  I had a patient the other day present with this, so I thought I’d start with it.

This syndrome is usually noticed with tingling, numbness, or odd sort of ache in your arm or hand.  Symptoms are commonly only on one side, but can be present in both.  People will often notice these symptoms more when they raise their hands over their head.  If you’ve ever had your arm “fall asleep” or hit your funny bone it is similar, but more constant.

These symptoms can be caused by problems with blood vessels, but 95% of the time they have more to do with the nerves of the arm.  These nerves come out of the spinal cord from the lower neck and go through places where they could be easily pinched or irritated.  Starting at the spine these nerves travel through a narrow space in the bones then through the muscles of the neck called the scalenes.  They then travel between the ribs and collarbone, through the armpit, and then through the muscles of the arm and forearm. At any point or many points in this trip they can be compressed by inflammation, sprain, strain, subluxation or other injury that has occurred.  So there may be more than one source.

Depending on the cause there are many things that your chiropractor will do to treat TOS. They will correct any subluxations that they find that may be contributing, they should recommend massage for any tight muscles, as well as ultrasound or laser therapy to address other soft tissue components.

There are also things that you can do.  If diagnosed with TOS you should avoid overhead work, limit your work with your arms to light duty for the duration of care, usually about 8-12 weeks.  You should modify your activities such as decreasing your upper body workout level or alternating the arm you use to carry your bags or child.

Approximately 85% of patients with TOS will improve with conservative care.  Occasionally surgery or more invasive measures may be necessary to remove scar tissue adhesions, an extra first rib, or if there is vascular involvement.

TOS can be frustrating, but it is also very treatable.  As with every condition, the sooner you come in for help the better.  I have seen great results in treating this condition, and would be happy to help you with it.  Contact your local chiropractor for additional information.