Neck Solutions

Neck adjustments reduces hypertension

Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients

From: Journal of Human Hypertension (2007), 1–6

It is well known that achievement of blood pressure goals in more than 70% of hypertensive individuals requires two or more antihypertensive agents. Based on the most recent NHANES 1999– 2000 data, blood pressure control in the US has not improved significantly. Moreover, many people have searched for alternative methods for lowering arterial pressure.

Since the early 1940s, a small cadre of chiropractic specialists have foregone typical ‘full-spine manipulations’, limiting their practice to precise, delicate manual alignment of a single vertebra, C-1 or Atlas; these practitioners make up the National Upper- Cervical Chiropractic Association (NUCCA). Unlike other vertebrae, which interlock one to the next, the Atlas relies solely upon soft tissue (muscles and ligaments) to maintain alignment; therefore, the Atlas is uniquely vulnerable to displacement. Displacement of C-1 is pain free and thus, remains undiagnosed and untreated, whereas health-related consequences are attributed to other aetiologies.

Minor misalignment of the Atlas vertebra can potentially injure, impair, compress and/or compromise brainstem neural pathways. The relationship between hypertension and presence of circulatory abnormalities in the area around the Atlas vertebra and posterior fossa of the brain has been known for more than 40 years. Studies by Jannetta et al. note arterial compression of the left lateral medulla oblongata by looping arteries of the base of the brain in 51 of 53 hypertensive patients who underwent left retromastoid craniectomy and microvascular decompression for unrelated cranial nerve dysfunctions. Such compression was not present in normotensive patients. Treatment by vascular decompression of the medulla was performed in 42 of the 53 patients and amelioration of hypertension was noted in 76%.6 Moreover, studies to clarify the mechanism by which decompression of the left rostral ventrolateral medulla relieves neurogenic hypertension are summarized in a review. It is clear from these studies that a sub-population of hypertensive patients improved their blood pressure after microvascular decompression.

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Ear pain referred from neck

Cervical spine causes for referred otalgia

From: Otolaryngology Head and Neck Surgery 2008 Apr;138(4):479-85

Present experience in diagnosis and treatment for referred otalgia secondary to cervical spine degenerative disease.

A study of 123 patients with ear pain. All patients had a normal otologic examination and diagnosed with unspecified otalgia. The causes for referred otalgia were categorized into Group I: otalgia from non-cervical spine disease (n = 72), and Group II: cervical spine disease-referred otalgia (n = 51). Pain relief following cervical spine physical therapy was assessed.

The most common cause for referred otalgia in Group I was Temporomandibular joint (TMJ) dysfunction (46%); most common cervical spine finding in Group II was cervical spine degenerative disease (88%). Cervical spine physical therapy in those documented patients all reported subjective pain relief.

As the population in America ages, cervical spine degenerative disease in the elderly will begin to emerge as a major etiologic source for referred otalgia. With a targeted medical history and physical examination one can use directed studies to diagnose cervical spine degenerative disease-referred otalgia, and this pain can be alleviated with cervical spine physical therapy.

Cryotherapy for soft tissue injury

Does Cryotherapy Improve Outcomes With Soft Tissue Injury?

From: Journal of Athletic Training. 2004 Jul–Sep; 39(3): 278–279

Based on the available evidence, cryotherapy seems to be effective in decreasing pain. In comparison with other rehabilitation techniques, the efficacy of cryotherapy has been questioned. The exact effect of cryotherapy on more frequently treated acute injuries (eg, muscle strains and contusions) has not been fully elucidated. Additionally, the low methodologic quality of the available evidence is of concern. Many more high-quality studies are required to create evidence-based guidelines on the use of cryotherapy. These must focus on developing modes, durations, and frequencies of ice application that will optimize outcomes after injury.

We often recommend ice for neck pain relief, usually for whiplash injuries, however, I find many patients do not tolerate cryotherapy on the neck well, especially in colder climates. It would be interesting to see some actual studies comparing cryotherapy to a more traditional martial arts approach using a properly designed liniment with light massage on recovery from soft tissue injuries.

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Singulair may cause suicidal thinking and behavior

FDA Warning for Singulair

FDA informed healthcare professionals and patients of the Agency’s investigation of the possible association between the use of Singulair and behavior/mood changes, suicidality (suicidal thinking and behavior) and suicide. Singulair is a leukotriene receptor antagonist used to treat asthma and the symptoms of allergic rhinitis, and to prevent exercise-induced asthma. Patients should not stop taking Singulair before talking to their doctor if they have questions about the new information. Healthcare professionals and caregivers should monitor patients taking Singulair for suicidality (suicidal thinking and behavior) and changes in behavior and mood.

This early communication is in keeping with FDA’s commitment to inform the public about its ongoing safety reviews of drugs. Due to the complexity of the analyses, FDA anticipates that it may take up to 9 months to complete the ongoing evaluations. As soon as this review is complete, FDA will communicate the conclusions and recommendations to the public.

Prevalence of Chronic Pain in the United States

Prevalence of Chronic Pain in a Representative Sample in the United States

From Pain Medicine Published article online: 11-Mar-2008

Objective. Chronic pain is a common reason for seeking medical care. We estimated the prevalence of chronic regional and widespread pain in the United States population overall, and by age, sex, and race/ethnicity.

Setting. We examined the data from 10,291 respondents who participated in the 1999–2002 NHANES (National Health and Nutrition Examination Survey) and completed a pain questionnaire. Items allowed classification of chronic (≥3 months) pain as regional or widespread. We used regression models to test the association of sex and race/ethnicity with each pain outcome, adjusting for age.

Results. Chronic pain prevalence estimates were 10.1% for back pain, 7.1% for pain in the legs/feet, 4.1% for pain in the arms/hands, and 3.5% for headache. Chronic regional and widespread pain were reported by 11.0% and 3.6% of respondents, respectively. Women had higher odds than men for headache, abdominal pain, and chronic widespread pain. Mexican-Americans had lower odds compared with non-Hispanic whites and blacks for chronic back pain, legs/feet pain, arms/hands pain, and regional and widespread pain.

Conclusion. The population prevalence of chronic pain in the United States was lower than previously reported, with smaller sex-related differences and some variation by race/ethnicity.

Exercise Helps Chronic Pain

The Immediate and Long Term Benefits of Physical Conditioning in Chronic Pain Patients

From: American Academy of Pain Medicine 24th Annual Meeting: Abstract 105.

Introduction: A frequent co-morbid condition of chronic pain is profound physical deconditioning that results from inactivity. Objective assessment of physical conditioning in patients with chronic pain has been impeded by several factors that this study attempted to overcome. Of primary importance is verifying the efficacy of a physical reconditioning program. Further, decreases in pain, depression, and anxiety following treatment in a pain rehabilitation program have been well documented; however, no study has determined the immediate effects of brief exercise on these factors. The purposes of this study are a) to determine the effect of a 3 week aerobic training program on physical conditioning, and b) to assess the acute effects of a brief (10 minute) exercise protocol on pain, mood, and perceived exertion.

Conclusion: This research suggests that relatively modest exercise leads to improved mood and physical capacity, which has further implications for mortality risk. Further, it suggests that brief exercise is a safe, cost-free, nonpharmacologic strategy for immediately reducing depression and anxiety.

Icy Hot Recall

Chattem, Inc. announced that it is initiating a voluntary Nationwide recall of its Icy Hot Heat Therapy products, including consumer samples that were included on a limited promotional basis in cartons of its 3 oz. Aspercreme product. Chattem is recalling these products because it has received some consumer reports of first, second and third degree burns as well as skin irritation resulting from consumer use or possible misuse of these products.

Chattem Issues URGENT Voluntary Nationwide Recall of Icy Hot Heat Therapy Products (Feb. 8)

Indoor Allergies

Symptoms of indoor allergies

Indoor allergy sufferers will often wheeze, sneeze, cough and hack their way through the winter months, thinking they have a chronic cold. In actuality, they are probably reacting to indoor allergens. Some symptoms between a cold and allergies are similar, such as sneezing and a stuffy or runny nose. But, if your symptoms are also accompanied with a fever, sore throat, colored nasal discharge, and aches and pains, then you probably have a cold. With allergies, there is never a fever, the nasal discharge is clear, and eyes may become red and itchy. Furthermore, while a cold usually lasts about a week, allergies can last all year.

Prevention of common indoor allergens

The key is to focus on sites where allergens accumulate. The term “allergen” refers to any substance that can trigger an allergic response. First, you must know which allergens or irritants in your home provoke your symptoms.

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Olivier Parmesan and Asiago Garlic and Basil Dip Warning

Olivier brand Parmesan and Asiago Dip with Garlic and Basil

Dr. Mark Horton, Director of the California Department of Public Health (CDPH), today warned consumers not to eat Olivier brand Parmesan and Asiago Dip with Garlic and Basil, because of the possibility of contamination with Clostridium botulinum. The product was distributed to William-Sonoma retail stores nationwide and to Olivier Napa Valley retail stores located in Truckee and St. Helena, California.

Aging and physical activity

The Association Between Physical Activity in Leisure Time and Leukocyte Telomere Length

From: Arch Intern Med. 2008;168(2):154-158

Background Physical inactivity is an important risk factor for many aging related diseases. Leukocyte telomere dynamics (telomere length and age-dependent attrition rate) are ostensibly a biological indicator of human aging. We therefore tested the hypothesis that physical activity level in leisure time (over the past 12 months) is associated with leukocyte telomere length (LTL) in normal healthy volunteers.

Methods We studied 2401 white twin volunteers, comprising 2152 women and 249 men, with questionnaires on physical activity level, smoking status, and socioeconomic status. Leukocyte telomere length was derived from the mean terminal restriction fragment length and adjusted for age and other potential confounders.

Results Leukocyte telomere length was positively associated with increasing physical activity level in leisure time; this association remained significant after adjustment for age, sex, body mass index, smoking, socioeconomic status, and physical activity at work. The LTLs of the most active subjects were 200 nucleotides longer than those of the least active subjects. This finding was confirmed in a small group of twin pairs discordant for physical activity level (on average, the LTL of more active twins was 88 nucleotides longer than that of less active twins).

Conclusions A sedentary lifestyle (in addition to smoking, high body mass index, and low socioeconomic status) has an effect on LTL and may accelerate the aging process. This provides a powerful message that could be used by clinicians to promote the potentially antiaging effect of regular exercise.

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