Muscular or Not

low back pain chiropractic maintenance care
Women’s back pain outdoor while at work.

“Dr. Sellers, I think it’s just muscular.”

“What happened?” I ask.

The response is usually, “I’m not sure. I just woke up with it.”

As a chiropractor I hear this a lot in my office. On occasion it is true that the pain a patient presents with is just muscular. However, more often it is not.

Why?

First of all, a problem is never just muscular. Muscles move joints and what affects muscles affects the joints they move. Secondly, if a pain is purely muscular you won’t just wake with it. You will have done something to cause the muscle to hurt and will generally know what that “something” was. You will usually be able to associate your pain with an activity that over taxes or outright strains the muscle. If you injure or strain a muscle the pain is immediate. If you overtax a muscle it is possible that you will not feel it until the next day.

“So, if it’s not muscular, Doc, what is it?”

Good question! If 30 years of practicing chiropractic have taught me anything, it’s that nothing is ever as simple as it seems. There are a lot of things in the spine that can cause pain. Things we call pain generators. The three most common pain generators are discs, joints and nerves. Any of these, either alone or in combination, can lead a patient to believe that their pain is muscular.

Here’s what happens. When a disc, a joint or a nerve becomes inflamed, irritated or pinched the muscles that surround them begin to splint or tighten. This serves to protect the inflamed tissue. This tightness can be mild or it can be severe, like a spasm. The spasms are obviously painful. However, the less severe tightness can be too.

Why is that painful?

To help patients understand I ask them a few questions.

“What would happen if you were to do bicep curls all day long every day for a week or two?”

“Do you think your bicep muscle would become sore or painful?”

You bet it would. So, although the pain does not begin in the muscle it usually ends up there.

I fix the disc, joint or nerve problem and the muscle pain goes away.

Simple!

What’s that “popping” sound? It’s cavitation!

My patients often ask me what makes the “popping” sound during a neck or back adjustment. It is something called cavitation. What is cavitation? Before I get to that, let’s talk a little physics. Everything that is, exists in either one of three forms or states. It is either a solid, a liquid or a gas. The difference between any two of the three is how far apart the molecules are. In a solid, the molecules are very close together. In a liquid, the molecules are a little farther apart. In a gas the molecules are very far apart.

For instance let’s look at H2O or water. It’s three forms are ice, water and steam. The solid form or state is ice, the liquid state is water, and the gas state is steam. By raising the temperature you can melt ice and get water. If you continue to raise the temperature you can boil water and get steam. You can also cool steam into water again and freeze water into ice.

But, did you know you could freeze and boil water at room temperature? Here’s how.

You can do this using pressure. At room temperature H2O is liquid. If you keep the temperature the same or stable and increase the pressure what happens? You will push the molecules closer together and make it a solid or ice. What happens when you decrease the pressure in a liquid? You will pull the molecules apart and form a gas or steam. This is all without changing the temperature. Stay with me… We’re almost there.

Inside nearly all the joints in the body is a fluid called synovial fluid. This fluid lubricates and nourishes the joint. During a chiropractic adjustment the chiropractor/doctor? pulls the joint surfaces apart rapidly. This decreases the pressure inside the joint and pulls the molecules of the synovial fluid apart. When this happens the synovial fluid turns to a gas. This rapid change from a liquid to a gas is what makes the loud pop/popping sound. That is cavitation. If you take an x-ray after an adjustment you can even see a gas bubble in the joint.

WHY YOU SHOULD TAKE MAGNESIUM

As far back as I can remember I have had difficulty sleeping. I never had a hard time falling asleep. However, I was easily awakened and once awake, it took a while for me to get back to sleep. That all changed about 10 years ago when I began taking a cardiovascular support supplement. I took two doses daily but had to discontinue the morning dose because it made me so sleepy I could barely function. After a little research I found that it was the magnesium it contained that was the culprit. Since then I have done a lot of reading and have become a huge magnesium proponent in my practice. Here’s why.

Magnesium is everywhere. It is the eighth most abundant element, about 2.5 percent, in earth’s crust. It is highly water-soluble and is the third most common element dissolved in sea water. Sodium and chloride, or table salt, are the first two. Magnesium is the center of the chlorophyll molecule which gives plants their green color. Without it plants could not produce food or energy. Any dark green plant is, therefore, a rich source. Magnesium is the fourth most abundant mineral in your body and it is central to all of the energy-forming reactions in every cell. Over 350 enzymatic pathways in humans are dependent on magnesium.

The problem is none of us get enough magnesium. According to National Health and Nutrition Examination Survey (NHANES), 1999–2000, about 60% of US population consumed inadequate dietary magnesium. First of all magnesium is missing from most of our topsoil because of modern farming practices. So, unless you were eating a diet rich in organic food you’re not getting nearly enough. Add to that the fact that there are things that interfere with the absorption of magnesium. Regularly drinking caffeinated beverages, soda or alcohol can cause deficiency. Sodas contain phosphates that attach themselves to the magnesium inside your body, making it unavailable for absorption. The diuretic and mild laxative effects of caffeine in coffee result in the loss of minerals, including magnesium, via the urine and feces. Additionally, the acid present in coffee can erode the villi of the small intestine, reducing its ability to absorb nutrients. Other foods that can hinder magnesium absorption are non-fermentable or insoluble fiber, such as whole grain, bran and seeds and foods that are high in phytates and un-sprouted beans and soy. Of course, that does not mean that you should stay away from these foods all together. A high intake of calcium can cause your kidneys to excrete too much magnesium and can compete for the absorption of magnesium in your gut.

Here are a few good reasons why I push magnesium in my practice. First of all, it’s a great muscle relaxer, whether taken orally or in an Epsom salt bath. Epsom salt is magnesium sulfate. Most people don’t know that magnesium is more easily absorbed through your skin than in your gut. Secondly it helps keep your arteries clean and free from plaque. Laboratory studies in both cell culture and in animals have shown that magnesium blocks the calcification that leads to the atherosclerotic process and cardiovascular disease. For every 50 milligrams of magnesium the test subjects consumed coronary artery calcification was reduced by 22%. The January 2014 Journal of the American College of Cardiology: Cardiovascular Imaging reported that the chances of having any coronary artery calcification were 58% lower in those with the highest magnesium intake. Higher magnesium intake also helps reduce the risk of dangerous heart arrhythmias. A January 2014 report from the Framingham Heart Study found that individuals with the lowest serum magnesium levels were about 50% more likely to develop atrial fibrillation when compared with those who had higher magnesium levels. It can help lower high blood pressure and studies have also shown that magnesium also reduces systemic inflammation that can lead to numerous other degenerative diseases.

So what do I recommend. I tell my patients to take 500 mg of magnesium citrate, a highly bioavailable form, just before going to bed. That’s what I do. Magnesium citrate can cause loose stools in some people. In those cases where GI distress is a problem I generally recommend magnesium glycinate. I suggest taking more than 500 mg a day if you are heavy coffee drinker or if you drink a lot of soda’s.

Here are The Recommended Daily Allowance(RDA) of magnesium. This is the minimum level needed to prevent deficiency symptoms but not necessarily the maximum level you should take. The RDA varies by age and gender.

Children 1 to 3 years: 80mg, Children 4 to 8 years: 130mg,
Children 9 to 13 years: 240mg
Boys 14 to 18: 410mg, Girls 14 to 18: 360mg
Men 19 to 30: 400mg, Men 31 plus: 420mg
Women 19 to 30: 310mg, Women 31 plus: 320mg
Pregnant Women 19 to 30: 350mg,
Pregnant Women 31 plus: 360mg

Very large doses of magnesium in excess of 5000 mg daily over a prolonged period of time can cause toxicity. Signs of toxicity are very low blood pressure, nausea, vomiting, facial flushing, retention of urine, ileus, depression, and lethargy progressing to muscle weakness, difficulty breathing, irregular heartbeat, and cardiac arrest.

There are some people who should not  supplement with magnesium.

Contraindications to Magnesium Supplementation 

1. Kidney failure. With kidney failure, there is an inability to clear magnesium from the kidneys.
2. Myasthenia gravis. The administration could accentuate muscle relaxation and collapse the respiratory muscles.
3. Excessively slow heart rate. Slow heart rates can be made even slower, as magnesium relaxes the heart. Slow heart rates often require an artificial pacemaker.
4. Bowel obstruction. The main route of elimination of oral magnesium is through the bowel.
5. Certain prescription drugs : some drugs adversely interact with magnesium.

Otherwise healthy people should be supplementing with magnesium daily.

Is Your Antibiotic Harmful?

 

Several years ago a friend and patient of mine was spending some time with his family at the beach. On one particular day he rose from the sand and began an easy jog toward the water. After three or four steps he experienced what he said felt like being struck in one of his calves with a baseball bat. He fell to the ground and was unable to rise and walk. After getting home, a visit to his orthopedist revealed that he had a rather severe spontaneous tear of his calf muscle. He spent a couple of months walking in a boot.

He had recently been on a round of the antibiotic, Cipro, and he knew that this drug could cause spontaneous tendon ruptures and muscle tears. That is what happened.

Cipro belongs to a class of drugs known as Fluoroquinolones. They are antibiotics commonly used to treat a variety of illnesses such as respiratory and urinary tract infections. These medicines include ciprofloxacin (Cipro), gemifloxacin (Factive), levofloxacin (Levaquin), moxifloxicin (Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin). More than 23 million patients received a prescription for one of them in 2011.

Renata Albrecht, MD, who heads the FDA’s Division of Special Pathogen and Transplant Products, estimates that spontaneous ruptures occur in about one in 100,000 people. But, the agency says, taking the drugs appears to triple or quadruple the risk.

There are other bad things these drugs can cause. In a 2001 study by Dr. Jay Cohen, the following reaction rates were documented:
* Nervous system symptoms occurred in 91 percent of patients (pain, tingling and numbness, dizziness, malaise, weakness, headaches, anxiety and panic, loss of memory, psychosis)
* Musculoskeletal symptoms in 73 percent of patients (tendon ruptures, tendonitis, weakness, joint swelling)
* Sensory symptoms in 42 percent of patients (tinnitus, altered visual, olfactory, and auditory function)
* Cardiovascular symptoms in 36 percent of patients (tachycardia, shortness of breath, chest pain, palpitations)
* Skin reactions in 29 percent of patients (rashes, hair loss, sweating, intolerance to heat or cold)
* Gastrointestinal symptoms in 18 percent of patients (nausea, vomiting, diarrhea, abdominal pain)

The FDA has told companies that the drugs must now carry “black box” warnings alerting doctors and patients that the drugs can increase risk of tendinitis and tendon rupture in some patients. A “black box” warning is the FDA’s sternest warning.

A study published in Medical Science Monitor in 2014 showed that one of the drugs, levofloxacin, caused the cells in the discs of rat spines to break down . This is a particular importance to me as a chiropractor. If you have lower back pain and know that you have taken one of these drugs be sure to tell your chiropractor.

When It Comes To Low Back Pain, Maintenance Matters!

Suffering from low back pain requires more than just a quick-fix.

A 2011 study conducted by two Egyptian medical doctors conclusively demonstrated that maintenance chiropractic care provided significant benefits for patients with chronic low back pain. (Study here)

What is Maintenance Care?

Maintenance care is what chiropractors recommend after their patients have completed an initial course of care for acute pain and correction of their misalignments.

The authors of the study, conducted by the Mansoura Faculty of Medicine, concluded that spinal manipulation (or what chiropractors call adjustments) is effective for treatment of chronic, non-specific, low back pain. However, to obtain long-term benefits for the patient, the study supports continuing a maintenance plan of spinal manipulation after an initial, intensive therapy course has been completed.

This study confirmed the findings of Martin Descarreaux, whose study was published in the Journal of Manipulative and Psychological Therapeutics in 2004. (Study here)

So, what does that mean for you?

Here’s the translation: Even after your misalignments have been corrected and your low back pain alleviated, it’s recommended to return once a month for maintenance care to keep pain and misalignments from returning.

If you suffer from low back pain and are looking for long-term relief, Dr. Bart Sellers at Chiropractic Associates of Mandeville can help. Contact our office today to schedule an appointment.

Chiropractics and Balance

Did you know?

Whether you’re having back pain or neck pain, problems in the spine can cause you to lose your balance. Chiropractic treatment of the spine can significantly improve your balance. Read on to learn about the link between spine problems and balance.

Think about this: if the normal range of motion in any one spinal joint is reduced by 50%, then 50% of the information that single joint supplies to the brain on movement, position, sense, and balance is also reduced. This means that the brain is unable to accurately perceive where the body is in space, and the direction in which it is moving. Is the body falling? In which direction?

And that’s just one joint. Consider that just in the lower back alone, there are 15 such joints. If you have restrictions in motion in all of those joints, then the problem is compounded or multiplied.

If your brain doesn’t know where your body is in space, if it can’t sense that you are losing your balance or if you are falling, then you can’t respond in an appropriate manner to keep yourself from hurting yourself.

Enter the chiropractor. Chiropractic adjustments to the spine restore normal motion to the spinal joints and improve the communication between your body and your brain. This improves your balance and reduces your risk of falling and injuring yourself.

If you’ve noticed back pain, neck pain, or any reduction in flexibility through your spine, call Dr. Sellers today at 985-624-9888 or contact us to schedule a chiropractic adjustment.

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