Monthly Archives: September 2017

Let’s Talk Arthritis

Every so often I have a patient comes into my office and informs me that their doctor says they have arthritis in their neck or back. Their immediate thought is that nothing can be done for that…..right?

Many people make the assumption that a diagnosis of “arthritis” condemns them to a life of constant pain and every joint pain must just be arthritis.

Nothing could be further from the truth. Let me explain.

First off let me say that ”arthritis” is a rather ‘catch all’ diagnosis often used to cover a myriad of conditions. The term arthritis comes from the terms “arth” meaning joint and “itis” meaning inflammation. So technically any inflamed joint is an arthritis so this diagnosis doesn’t really mean much.

The only types of arthritis that are systemic, meaning that they affect the whole body, are ones like rheumatoid arthritis, lupus, ankylosing spondylitis etc. The arthritis that the majority of individuals have is osteoarthritis or degenerative arthritis. There is some debate over whether there  is a type of systemic osteoarthritis but for this discussion let’s talk about degenerative arthritis.

Degenerative arthritis is the “wear and tear” type of arthritis that usually affects one joint but can affect multiple areas. Knees, hips, hands, neck and lower back are common sites. It is caused by repeated stress or trauma over time or a specific injury. These change the normal movement pattern of the joint causing the joint to become inflamed, painful and eventually to wear out.

In the spine this degenerative process involves the deterioration of the discs often with accompanying nerve pressure

The Chiropractic goal in these cases is to return the movement of the joint(s) to as close to normal as possible. This will reduce the symptoms and slow down the degenerative process in the joint.

Don’t let a diagnosis of “arthritis” disrupt your life…chiropractic can help

 

 

Preventing Injury When Lifting And Holding An Infant

Many mothers suffer from repetitive stress injuries from the daily physical demands of lifting, carrying and loading their infants into the car seat, high chair and crib. Preoccupied with the demands of newborn care and postpartum recovery, many moms easily overlook the fact that the regular care of a new baby can take its toll on many parts of the body, including neck, upper and lower back, arms, hips and knees.

Here are some of the best practices that I recommend to our new moms as well.

When carrying a car seat: many moms make the mistake of putting the car seat handle over their forearm. They lean sideways at the hip to accommodate the bulk and weight. This strains muscles in the back and will eventually cause pain to the arm holding the seat. Instead, grip the handle with both hands and carry the car seat in front of your body. Avoid standing and holding the car seat when it isn’t necessary- if you pause to chat outside your car, put the car seat inside first, or set it down at your feet.

When lifting your baby out of the crib: Make sure to lower the railing.  Lifting and holding the infant at arm’s length puts too much pressure on your spinal disks. Your arms will tire much more easily the further the baby is from your body. Instead, lower the railing, bring baby close to you, and lift from your knees.

Another common mistake occurs when lifting your toddler up onto your lap. Most moms will lean forward and pick the child up while still seated themselves.  This increases the weight of pressure on your spine anywhere from 3 to 10 times! To your spine, you’re no longer lifting a 15lb toddler- you could be experiencing as much as 150lbs of stress to your spinal discs.

Instead, get on the floor with your baby. Kneel on one knee and lift using your whole body. Then sit down together on the chair or sofa.

With any of these daily lifting scenarios, be mindful of your own discomfort- if you start to feel recurring pain or think you’ve injured yourself, don’t ignore it! Repeatedly stressing the same muscles and discs could exacerbate the problem quickly. Instead, treat your body well, be careful when lifting, and remember that caring for an infant or toddler can be a major physical demand.

Remember, chiropractic care can help correct and maintain your pelvis and spine during this post- delivery transition time.

Big Money? … The Truth About Athletic Team Doctors

Many young high school students preparing to further their education in the medical field are swayed by the allure of becoming the Team doctor, chiropractor, physiotherapist or trainer.

When I was in chiropractic school a professor told me chiropractors in the NFL made a salary of $250,000 per year. I believe my professor was telling me what they thought to be the truth  although they have been misinformed.

I recently read a wonderful article in the Canadian Chiropractic Association magazine, Back Matters, about the chiropractor for the CFL’s Toronto Argos. It was a very engaging read. What struck me as odd was that there was no mention of financials, abstract business arrangements, or any indication of how a chiropractor on a CFL team is reimbursed for their time.

The reality is that chiropractors in the CFL and NFL do not get reimbursed fairly for their time. Essentially, it is volunteer work – and it is the same for the medical staff as well. A team medical doctor in the CFL makes a little over $2,000 per year in travel stipend. In fact, believe it or not, the team MDs in the NFL actually pay anywhere from $300,000 to $750,000 per year to be the official group MDs for that NFL team. Chiropractors in the NFL and CFL usually receive tickets, memorabilia, and team clothing as compensation. These were all verified by team DCs and MDs from both respective football leagues.

A CFL team medical doctor, who asked to remain anonymous, said doctors in pro sports in Canada usually receive a minimal travel stipend. This doctor contends that MDs, DCs, physios, chiropractors and trainers are all undervalued in Canadian athletics. “Most MDs do it because they love the sport. It definitely does not have a financial reward. It’s a personal reward.”

The CBA allows NFL teams to hire medical groups who pay the team between $300,000 to $750,000 per year to be considered as the team’s official doctors. The medical group who becomes the team doctors can recoup their money by billing players and team staff for all medical services provided that year. The NFL teams then use a portion of the money paid to them to advertise for the medical groups at games, on TV and print media.

Wait a second. The doctors pay the team? According to Dr. David Geier, a medical doctor, this is actually true.

“Often there is a separate contract that allows the physicians to advertise that they are the official team physicians. Those contracts involve huge amounts of money. Whether paying a lot of money to advertise serving as a physician for a pro team generates enough patients to make it worthwhile is debatable,” Geier says.

In an article by Darren Rovell, NFL Raiders’ team medical doctor for eight years, Dr. Robert Huizenga, said: “In this arrangement, a medical organization provides the team doctors often for free and also pays for a marketing arrangement which advertises the deal to fans. Does the Hospital For Special Surgery in New York really have the best doctors for the Mets, Giants, Knicks, Nets and Red Bulls or is it because they pay for the right to say they treat the teams?”

Voltaren…just another topical gel?

Over the years in my office the question of which topical cream or gel is best or what which one do  I recommend, is one of the most common ones.

All topical rubs (Tiger Balm, Deep Relief,  A535, Icy Hot, Bio Freeze) work on the same premise known as the “GateTheory” of pain control. Their active ingredients (menthol, camphor, methyl salicilate) act as counterirritants which trick the brain into paying more attention to the warming or cooling sensation than to pain.

As far as which one is best, it is purely preference.  They can work differently for each person.  In my office I like BioFreeze because it seems to work best for most people.

Over the last number of months patients have been asking about a new topical rub called Voltaren. Is it just another rub like the others… absolutely NOT. Here’s why.

Voltaren is the brand name for a drug called Diclofenac. Diclofenac is a pain reliever in the drug class NSAID (non-steroidal anti-inflammatory drug). Voltaren can be taken orally (diclofenac potassium) or used as a topical rub (diclofenac sodium)

How NSAIDs Work.

All non-steroidal anti-inflammatory drugs like Advil (ibuprofen),  Motrin,  Aleve (naproxen), Celebrex and  including diclofenac sodium  are designed to inhibit activity of COX-1 and COX-2 enzymes, which cause the pain. This enzymes are produced by the cells of the body, and are responsible for the creation of the agents called prostaglandins, which promote inflammation, pain and fever

Diclofenac is a nonselective NSAID, which means that it blocks both COX-1 and COX-2 to stop the production of more types of prostaglandins than some other NSAIDs. This means that it is more likely to cause side effects due to the action of the other prostaglandins that are reduced.

Obviously a topical rub is less likely to produce side effects than oral intake but let’s cover them anyway.

Nausea

Heartburn (dyspepsia)

Diarrhea

Headache

Dizziness

Gastrointestinal ulcer

Gastrointestinal bleeding

Hypertension

So is Voltaren topical gel safe and effective? Because so little of the active ingredient is absorbed into the rest of the body (6-10%) it appears to be safe from side effects.

Voltaren topical gel appears to be very effective for knees, feet & hands, elbows, shoulders and back) pain.