Chiropractic care and tips for healthier living

Headaches & Migraine: Chiropractic vs.  Medication

Effectiveness & Safety

In randomized clinical trials, chiropractic  was 57% more effective in the reduction of headaches and migraines than drug  therapy

By Mark Studin DC, FASBE(C), DAPM, DAAMLP

It was reported in October of 2010 by Wrong Diagnosis that approximately  1 in 6,16.54% or 45 million Americans get headaches yearly, with many people  suffering daily. While the statistical numbers vary based upon your source of  information, it can be agreed upon that headaches are very common and shared  among Americans at an epidemic rate. Taking into account that a single pill for  many Americans to treat a headache can cost as much as $43, according to  Consumer Reports Health Best Buy Drugs, the overall cost to our economy totals  billions of dollars and we need to focus not on the treatment of the effects,  but the root of the cause.

When you suffer from headaches, it affects every facet of your life and  you search for immediate answers. Most often it is a medication, either  over-the-counter or prescription as evidenced by the amount of money spent as  previously reported. One of the first medications recognized for the potential  treatment of headaches is amatriptyline, commonly known by brand  names such as Elavil, Endep or Amitrol  as reported by Robert on About.com in 2006. It is also used as an  antidepressant. This medication has made up a large part of the billion dollar  industry along with over-the counter-medications. Although in many instances,  this drug is indicated, the question that arises is what are the risks of taking  this widely used medication?

The potential side effects of this medication targeted for headache  sufferers, according to drugs.com (n.d.), are: blurred vision, change  in sexual desire or ability, constipation, diarrhea, dizziness, drowsiness; dry  mouth, headache, loss of appetite, nausea, tiredness, trouble sleeping, and  weakness. Severe allergic reactions can be: rash, hives, itching, difficulty  breathing, tightness in the chest, swelling of the mouth, face, lips, or tongue,  chest pain, confusion, dark urine, delusions, difficulty speaking or swallowing,  fainting, fast or irregular heartbeat, fever, chills, or sore throat;  hallucinations, new or worsening agitation, anxiety, panic attacks,  aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of  well-being, restlessness, or inability to sit still, numbness or tingling in an  arm or leg, one-sided weakness, seizures, severe or persistent dizziness or  headache, severe or persistent trouble sleeping, slurred speech, suicidal  thoughts or actions, tremor, trouble urinating, uncontrolled muscle movements  (such as in the face, tongue, arms or legs), unusual bleeding or bruising,  unusual or severe mental or mood changes, vision problems, and yellowing of the  skin or eyes. Over the counter remedies of NSAID’s or aspirin have a  long list of their own of side effects.

The safety of chiropractic, in spite of rhetoric from naysayers, has  been documented in clinical trials by Miller and Benfield (2008), who  reported on children younger under 3 years old, “the youngest and most  vulnerable population…” (p. 420). There was one reaction reports for every 749  adjustments which was typically crying. None were reported to have any serious  side effects.

In adults, clinically, the majority of any side effects are soreness  that is transient. This is based upon this author’s 30 years of clinical  experience and teaching doctors of chiropractic who are trained in creating an  accurate diagnosis, prognosis and treatment plan. To say that more serious side  effects cannot happen is irresponsible. However, they are rare, non-life  threatening and usually transient in nature, no different than infants. To  ensure the best outcomes, like with any professional, you have to verify the  doctor’s credentials and experience, which is best accomplished by securing a  copy of the doctor’s curriculum vitae (his/her academic and professional  credentials).

Nelson et. al. (1998) reported on randomized clinical trials that took  place over an 8-week course. The results showed there was minor statistical  differences in outcomes for improvement during the trial period for chiropractic  care, amatriptyline and over-the-counter  medications for treating migraine headaches. It was also reported that there was  no statistical benefit in combining therapies. However, the major factor is that  in the post-treatment follow-up period, chiropractic was 57% more effective in  the reduction of headaches than drug therapy.

Bryans, et. al. (2011) confirmed Nelson’s  findings and reported that spinal manipulation (adjusting) is recommended for patients with episodic or chronic  migraines with or without aura and patients with cervicogenic headaches.  This follow-up study is not a comparison or comment on the use of drugs. It  simply demonstrates that chiropractic is a viable solution for many and can save  the government and private industry billions in expenditures both in health care  coverage, loss of productivity and avoidance of absenteeism in industry creating  a new level of cost as sequella to  headaches.

Medications and other forms of invasive care are often necessary and it  is critical for a trained doctor to perform an accurate history and physical and  when indicated, advanced diagnostic testing (CAT scans, MRI’s, etc.) to ensure  there aren’t more serious underlying complications. However, based upon the  results of the research provided by Nelson et al. (1998) and Bryans  et. al. (2011), it should be chiropractic first, drugs second and surgery last  to render better outcomes with less potential side effects and a quicker return  to productivity.

References:

1. Wrong  Diagnosis. (2010, October 6). Prevalence statistics for types of headaches and  migraine conditions. Health Grades Inc. Retrieved from http://www.wrongdiagnosis.com/h/headache_and_migraine_conditions/prevalence-types.htm

2. Consumer  Reports Health Best Buy Drugs. (n.d.). Treating migraine headaches: The triptans, Comparing effectiveness, safety, and  price. Health.org. Retrieved fromhttp://www.consumerreports.org/health/resources/pdf/best-buy-drugs/triptanFINAL.pdf

3. Robert, T.  (2006, May 26). Amitriptyline: Headache and migraine drug  profiles. About.com. Retrieved fromhttp://headaches.about.com/od/medicationprofiles/a/amitriptyline.htm

4. Drugs.com. (n.d.). Amitriptyline side  effects. Retrieved fromhttp://www.drugs.com/sfx/amitriptyline-side-effects.html

5. Miller, J. E., & Benfield, K. (2008). Adverse effects of spinal  manipulative therapy in children younger than 3 years: A retrospective study in  a chiropractic teaching clinic. Journal of Manipulative and Physiological  Therapeutics, 31(6), 419-423.

6. Nelson, C. F., Bronfort, G., Evans, R., Boline,  P., Goldsmith, C., & Anderson, A. V. (1998). The efficacy of spinal  manipulation, amitriptyline and the combination of both  therapies for the prophylaxis of migraine headache. Journal of Manipulative & Physiological Therapeutics, 21(8), 511-519.

7. Bryans, R., Descarreaux, M., Duranleau, M., Marcoux, H., Potter, B., Ruegg, R.,… White, E. (2011). Evidenced-based  guidelines for the treatment of adults with headache. Journal of  Manipulative & Physiological Therapeutics, 34(5),  274-289.

Buddy, a 10 1/2 year old black lab mix, was severely injured when his 6 month old canine housemate ran into his front right leg at full speed.  His owner recalled that I treated animals and called in a panic.  He had been injured 2 weeks prior to her phone call to me and did not know where else to turn.  Watching him walk into the office brought a tear to my eyes as Buddy could hardly walk.  That first visit, a Monday, was difficult as I evaluated him as  I could not elicit a pain response from Buddy.  I poked, prodded, pushed and pulled, but got nothing from him to tell me where he was hurting.  I did a gentle chiropractic adjustment, massage and applied the class IV K-Laser for his first treatment.  I instructed his owner to use Mineral Ice and to apply ice on his leg and right shoulder area.  When he came back 2 days later, I as able to elicit a response as I examined him.  Pain was under the shoulder, leg and right neck.  He left and was able to put some more weight on his leg.  That Saturday, he was a little better, but not much. Treatment protocol was the same as we continued to do a spinal adjustment, massage and K-Laser.  On Sunday, Buddy’s mom called me at home and told me that Buddy was not progressing and that she wanted to put him to sleep.  I asked her to give me 5-6 more visits and then we would talk more.  He progressed each day the following week.  That next Friday, Buddy’s veterinarian and I talked and agreed with my treatment protocol.  Buddy was progressing, but we did not want to give false hope.  I received a text from Buddy’s mom that Sunday saying how awesome he was doing!!  He was walking quickly and smoothly.  He still had a slight limp, but is able to put most of his weight on his leg.  Buddy just got  back from the Poconos on a vacation and is doing great!  Chiropractic care, the K-laser and veterinary medicine all worked together and  saved Buddy’s life!

Happy holiday’s everyone!

Dr. Mike

“Rhonda G” came in three (3) weeks ago complaining of vertigo (dizziness).  These episodes began in February with no know etiology (cause). She was unable to go swimming, go to the gym and focus on everyday tasks.  Sometimes the episodes were so severe that she was unable to drive. She underwent vestibular therapy (which helped on a temporary basis)  and was taking a variety of medications.  These medications included “Antivert” and a predisone patch among others.  She had previously been under the care of a chiropractor for an unrelated condition, but she since moved, and had not gone to see him in over a year.  Many times when patients complain of vertigo, I look in their ears to rule out an inner ear infection and to determine the amount of wax in the ear which can be part of the  cause.  Although she had no inner ear infection, she did have waxy build up in both ears, left being worst than right. I supplied her with a take-home ear wax removal system to be done 1 time per day for 4 days.  Since she also complained of sinus issues, I supplied her with a take home sinus rinse to be done 2 times per day as needed.  Upon spinal examination, I felt a misalignment of the atlas (C1) vertebrae. The vertebrae was locked to the left.   This is by far the most important vertebrae in our spine as a misalignment can cause a variety of symptoms.  There were also a multitude  cervical (neck) muscle spasms with  diminished left neck rotation.  After I applied moist heat to her neck (to relax the neck musculature), I adjusted the Atlas vertebrae to release it from its locked state and to re-align it.  She had immediate relief!  She was amazed how after 5 months of vertigo and with all of her previous treatments, how one chiropractic adjustment could get rid of her vertigo.  She has been coming in 2 times per week just to keep atlas aligned and to keep an eye on her.  She had one episode of vertigo 4 days ago, and we did the same routine on Friday the 14th of July and in a matter of minutes, it again was gone. 

Thanks for the opportunity “Rhonda” and glad you are feeling better.

Till next time

Dr Mike

Hey everyone:

I have had many patients complain of shoulder pain recently.  They cannot move their arms because their shoulder will not “work”.  Most of these patients had shoulder stiffness for a little while and one day just could not move it. It could have been to trauma, repetitive use or anything of the sort.

Cause: I’d like to look at  the biomechanics of the shoulder girdle.  The bones are made up of the humerus (arm), clavicle (collar bone) and scapula (wing bone).  There are 4 muscles that make up the “rotator cuff” (Supraspinatus, infraspinatus, teres minor and subscapularis).  and a few others that help with shoulder motion.  As we all know, the shoulder joint (glenohumeral joint or GH for short) is a ball and socket joint. This gives the shoulder its rotation motion.  This humerus (ball part of the socket) needs to have a certain amount of “motion” to be able to function properly in the socket of the scapul.  When that joint “gets jammed” or stops its normal motion, the muscles around the joint have to work harder.  Overtime, these muscles get tight, go into spams, develop inflammation and scar tissue.  As this chronic process is happening, the bone moves less and less and less and the muscles work more and more creating more pain and less range of motion.

Treatment:  There are multiple issues that require a certain treatment protocol that have to be done to get a desirable result.  The first thing that we usually do is electrical stimulation with moist heat. This gets the muscles to relax and get some nutrition to the area.  We then will use a Class 4 laser to penetrate the deep muscles and ligaments to relax deep muscle spasms, heal any minor muscle and ligament tears and to get more nutrition to the deep levels.  We will then adjust the clavicle, scapula,upper back and of course, the humerus.  Usually there is no pain involved and many times, there is instant relief.  Not 100% cured, but relief.  Finally, we instuct the patient to do a variety of exercises at home to keep the bones moving and the muscles.  When the bones are in motion and the muscle begin to relax, range of motion is restored.  Frequency and amount of treatments is done in an individual basis. 

Conclusion:  Repetitive motion disorders, sports injuries and other injuries usually begin with a lack of bone joint motion.  Muscle have to compensate and symptoms ensue.  Pain medications and muscle relaxers will not fix the cause of the problem.  These type of injuries are not difficult to repair, it just takes a little bit of work on my part and a little bit of work on the patients.

Thanks for reading and see you next week.

Dr Mike Burak

I have decided to take a break from my usual health tip blog and discuss my Uncle Jack, who as many of you know, passed away the Friday before last.
I grew up working at my dad’s gas station. He was partners with my grandfather and my dad. Therefore, I basically saw Uncle Jack every Saturday, a couple of summers every day and family holiday dinners. We were always close, and got closer the past few years when he underwent open heart surgery to fix a leaky heart valve. Growing up, he taught me how to drive, work on cars, how to have a good work ethic and much more. When I opened my practice 15 years ago, he would visit, get treatments and just hang out and talk with patients.
I know that he was not in good health the past few years. He was never prouder than when we had family gatherings at his house.
I miss you and love you Uncle Jack. Rest in peace. Say hi to grandma, grandpa and dad.

till next week

Dr Mike

As many of you may know, I am a certified animal chiropractor, or a “chiropractitioner”. I completed the course about 4 years ago and have been treating animals ever since (with the approval of the pets vet). 3 weeks ago, I got a referral from another chiropractor to treat one of their patient’s 8 year old German Sheppard. The dog walked in scrapping the top of his right paw on the ground. This was causing scabbing due to wounds and he was scrapping the hair off of his paw. He could not urinate correctly because his back hurt too much. After evaluation, I noticed his right pelvic bone was not functioning properly. I explained to the pet owner that since his right pelvic bone was not moving, and the surrounding musculature was working in overtime, causing the muscles to be in a state of spasm. I adjusted the dog using a mechanical tool which is non-invasive to put the pelvic bone into motion. I then used an muscle massage to work the muscle spasm to make him feel better.
The results were almost immediate as when he left here, he urinated correctley and jumped back into the owner’s vehicle.
Last week we added the K-laser to our protocol and the results have been outstanding. He is feeling better, playing again and running around like a puppy! The owner was so satisfied, that she referred 2 more dogs to us!
If you have any questions about animal chiropractic, please do not hesitate to ask!!

Till next week.

Dr Mike

Sciatica…what is it?, what causes it? and how do I get rid of it?
Many new patients come into my office complaining of sciatica…but after doing a case history, many times the sciatic nerve is not being pinched.
The sciatic nerve is a “5 gauge wire” coming from nerve roots L3, L4, L5, S1 and S2. The nerves exit the spine and come together to make one new nerve, the sciatic nerve. It is the longest nerve both in length and diameter. The nerve runs down the back of the thigh, splits at the knee and the remaining 2 nerves run down the leg to the foot. That is the nerve path for the sciatic nerve. When a nerve is pinched, the pain is a very sharp shooting pain. One can also feel numbness and tingling, loss of motor strength and have a diminished knee and/or ankle reflex. They can also have increased or decreased sensation compared to the other leg. In other words, a dull and achy pain down the back of the leg is not “true sciatica”. There are 3 common different ways that the sciatic nerve can be pinched.
The first is at the lumbar level where one or more of the nerves exit. The nerve root can be pinched via a disc herniation or severe arthritis. A herniation is commonly diagnosed through MRI, although there are orthopedic tests which can be done to determine if the disc is herniated without getting this expensive test. Mechanical traction via disc decompression at a chiropractor’s office is a very common, non-invasive way to retract the disc off of the nerve for pain relief and improved function. Laser therapy can also be used to try and heal the tear in the disc to prevent the disc from herniating in the future.
The second way the nerve can be affected is at the sacro-iliac joint. The nerve can be pinched at the pelvic joint and chiropractic adjustments with laser therapy can help to relieve that pressure.
The third most common way that the sciatic nerve can be pinched in the buttocks also. Most commonly is under the piriformis muscle. That condition is called “Piriformis Syndrome”. The piriformis muscle is as big as the last digit of your pinky and is mid-way down from the beginning of the buttocks muscle. The sciatic nerve runs under the piriformis muscle. When that muscle goes into spasm, the patient will experience sciatica!!! This is not a difficult thing to fix, but it does time because piriformis syndrome take a long time to develop.
Don’t forget, just because and MRI reveals a disc herniation, it does not mean that it is pinching a nerve.
Please ask me or your chiropractor if you have any questions. I hope this blog helped to differentially diagnose sciatica and exactly what sciatica is. See you next time

Dr Mike

Why I am a Chiropractor… I am a Chiropractor because I want to find the CAUSE…not treat the EFFECT. People come to me in pain. Pain is easy to treat. I want to find out WHY they are in pain. Taking pills and getting shots treats the pain, or the effect. Anyone can treat pain…I want to find the CAUSE! I want to find the cause of people’s headaches, their lower back pain, their mid back and neck pain, their sports related injuries and other problems. If I can find the cause, I will not only get rid of their pain, but I will make them feel better than they did before they had the pain!! I will increase their range of motion, make their body feel better than it has in years and years!! I am a chiropractor because I want to fix the hole in the roof, not just paint the ceiling or replace the drop ceiling tile. I want to know the mechanism of injury so I can treat the cause and give the body the ability to heal itself. I am a chiropractor because I want to improve lives! This is why I am a chiropractor

This past week, I had 3 patients who were complaining of plantar fascitis and 2 of them have heal spurs. When they told me that they had this condition, I told them that I could help them. They were shocked and asked how a chiropractor could help with plantar fascitis. I thought that an explanation of this condition and treatment protocol would be a great discussion this week.
Faulty feet biomechanics is the cause of this problem. The plantar fascia is the covering of the muscles on the bottom of the foot. It begins at the heal and connect to the toes. The foot is designed to have a moderate arch on the inside (medial aspect) of the food 1/2 way up. When one’s foot loses that arch, the fascia begins to stretch. Over time, the fascia begins to calcify at the heal and then offy (turn into bone) in a spur formation. You can imagine the pain you would feel if everytime you walked, you walked on a spur. In additoin, the inside of the foot where the foot dropped goes into chronic (long term) spasm.
Conventional medicine treats plantar fascitis with a cortisone shot, and if need be, then with surgery where they shave the spur. They may get rid of the pain, but they do not get rid of the cause!!
Being a chiropractor, I want to find the cause of a problem. The treatment protocol that I use is the following:
1) Custom designed pelvic stabilizers (orthotics) to correctly support all 3 arches of the foot. I will also put in grooves so the spur is fitting into an area where the patient does not put pressure on it. The orthotics are casted using a digital scanner while the patient is standing.
2) K-Laser treatment at the source of the calcification/offification at the heal.
3) Massage at the medial aspect of the foot where the foot muscles are in spasm
4) Chiropractic adjustments to the feet
5) Stretching exercises to be done at the office and at home
6) Finally, a plantar fascia foot splint to be worn at night relieve fascia pressure.

In about 2 weeks, patients have pain relief and can function! Don’t forget, this problem did not start yesterday, and will not go away tomorrow. But with this protocol, you will be running around without foot pain in no time !

See you next week.

Dr Mike

Hi

Patients ask the most interesting questions and I wanted to address a few of them today. “Hey Doc, when you feel my spine, what are you feeling for?” and ” Hey Doc, what is the popping sound that I hear?”.

These are great questions that I hear repeatedly. As a chiropractor, I am trying to make sure that the spine and ilium (pelvic bones) are in their proper position and motion. When vertebrae stop being in proper position and motion, symptoms occur. These symptoms include pain, stiffness, diminished range of motion and more! For example, some patients complain that they have a hard time walking after a period of time, which can be attributed to a lack of motion and position of one of the pelvic bones. Some patients notice that when they back up their vehicle, that they cannot turn their head very well, which can be a lack of motion in the neck vertebrae. Many more symptoms can be attributed to misaligned vertebrae. When I feel your spine, I feel for vertebrae that are not moving correctly (locked in position) and that are “out of place”.

After I find these misaligned vertebrae, I put a thrust with my hands to restore the motion in the joint and put the vertebral segment back into its proper place and motion. That is why patients almost feel immediate increase in range of motion in their back and neck after they are adjusted. And the “popping” sound??? That is simple. Each 2 vertebrae are made up of 3 joints. When I put the vertebrae into motion, compressed air is released and you may hear a sound or an “audible”. That’s it, the sound is really no big deal.

I hope this answered some questions. If there are any questions that you would like answered, please do not hesitate to ask.

Till next time

Dr. Michael Burak

www.drmikeburak.com