The use of painkillers and over-the-counter medications are very common for pain relief among many Americans. However, most are unaware that these medications may in fact be slowing the process of healing in many of the conditions they are attempting to treat. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be very helpful to decrease minor aches and pains, and help us continue with our daily activities, but at what point do they actually become harmful to our health?Inflammation is not always a bad thing. It is the body’s way of protecting itself and removing harmful factors so that healing can begin. After an injury, the body activates specific cells which attack the injured area. These cells will increase blood flow allowing more nutrients to flow to the area. It can also produce swelling which may also stimulate nerve fibers which cause pain.Knowing the importance of inflammation in the body, it becomes easier to appreciate how anti-inflammatory medications may inhibit tissue repair. There are 2 enzymes in the body which regulate different functions, COX-1 and COX-2. The second is responsible for signaling pain and beginning the process of inflammation, as well as stimulating part of the immune response. The delay in healing is due to the inhibition of prostaglandin production from the COX-2 enzyme. These prostaglandins control processes such as muscle and blood vessel constriction.Without inflammation, the healing process would be much slower as it would be difficult to initiate this healing process. Many practitioners even discourage the use of ice, as it may cause vasoconstriction (or narrowing of the blood vessels) and decrease the amount of nutrients brought to the injured area.Even with exercise, the harder you train, small micro-tears are occurring in the muscle. The more forcefully the muscles contract, the more damage may occur. Without inflammation to initiate healing, more and more injury may occur over time with repetitious activity. This is also one reason why taking NSAIDs before a work out could be harmful.Soft tissues such as muscle, ligaments, and tendons are not the only structures in the body affected by NSAID use. Injuries to bone, particularly fractures, are also affected when it comes to the remodeling phase. With fracture healing, the area undergoes the inflammatory process, new blood vessel formation, a callus forms, and new bone is laid down to the area of injury. Prostaglandins also play an important role in the formation of different types of bone cells. Therefore, long term use of NSAID pain relievers can delay the process of healing fractures, and may actually accelerate other conditions such as osteoporosis and joint deterioration.The effects of NSAIDs are not only harmful to the musculoskeletal system, but to other bodily systems such as the digestive tract as well. Over-the-counter medications such as Aspirin can cause excessive stomach acid production. Stomach acid is very acidic, as it is needed to break down food and nutrients we take in on a daily basis. The stomach has a protective coating so as to not become degraded from the acid. However, with constant higher levels of acidity than normal, this acidic environment can lead to a breakdown of the lining causing ulceration and bleeding in other areas of the gastrointestinal tract.So are we saying NSAIDs are all bad, all the time, in every situation? Of course not. However, there are consequences with repeated, long term use. Many athletes, for example, who are constantly training need to be aware of the effects which over-the-counter medications may carry. Injuries take time to heal, and it is important to take the time to allow the body to its job.
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic, inflammatory disorder affecting many joints in the body, most commonly in the smaller joints such as the hands and feet. While both rheumatoid and osteoarthritis both affect joints of the body, they differ in the fact that rheumatoid arthritis is not a “wear and tear” type of condition. This type of arthritis causes a painful swelling affecting the lining of the joints. It can eventually lead to erosion of bone and eventually joint deformity.Women are generally 2-3x more commonly affected by rheumatoid arthritis, it usually starts to show up around the mid-30s to 40 years of age. Rheumatoid is an autoimmune disorder in which the body mistakenly attacks its own tissues. The immune system is designed to protect the body from disease and infection. With an autoimmune disease, the immune system attacks normal and healthy cells of the body. Autoimmune conditions tend to run in families.Symptoms of the condition may vary in severity and often come and go, which is typical of an autoimmune condition. Swelling and pain are common in the extremities, and may increase with flare ups of the condition. During periods of remission, symptoms may fade or even disappear completely. Since it is a systemic disorder, it can have an effect on other body systems including the eyes, mouth, skin, lungs, blood, and blood vessels.Rheumatoid arthritis is usually bilaterally symmetrical, meaning when it is present in the hands, for example, then both are usually affected to the same degree. In the hands, we typically see enlarged joints of the knuckles and middle of the fingers. In advanced cases, the fingers may become deformed and deviate away from the thumbs. Swelling of the hands, feet, and elbows are also common with this condition.Diagnostic imaging can show many characteristics of this condition in different areas of the body. Bony erosion or a localized osteoporosis are some common findings on X-ray views of the condition. Lab testing is the best way to confirm the condition.Treatment of rheumatoid arthritis usually includes rest, anti-inflammatory medication, and some sort of an exercise or therapy program such as what may be offered in a physical therapy or chiropractic office. The goal is to detect and treat the condition early on to reduce or stop the inflammatory process as quickly as possible. Prevention of joint and organ damage, as well as improvement in physical function is important to reduce long-term complications. Consultation with a rheumatologist is also important in early stages to control progression of the condition.Degenerative or osteoarthritis is more commonly seen in the chiropractic office, however, it is important to remember that both types of arthritis are manageable with proper care. At Optimal Chiropractic, Drs. Chris and Emily treat patients with a wide range of conditions. Our focus is not only on treatment of a disease or condition, but prevention and education for all those who seek to improve their overall health.If you or someone you know is suffering with pain or muscle weakness caused by arthritis, we would love to help. Give our office a call at (208) 777-4305, we are located across from the Kootenai Urgent Care Clinic in Post Falls, Idaho.
Osteoarthritis - The Basics
Arthritis is a condition which affects the musculoskeletal system, specifically the joints. It can occur within any joint of the body. There are many different types of arthritis, all with their own causes, features, and symptoms.The most common type of arthritis is called osteoarthritis, which is generally described as an overuse syndrome. Repetition of a specific motion or activity can cause degenerative changes to occur within an area or joint of the body. Lack of movement or fixation of a joint can also cause arthritic changes over time. Larger, weight bearing joints such as the knee, hip, and spine are common joints affected with these degenerative changes, as well as the hands and shoulders from overuse.Both men and women of any age may have degenerative changes or arthritis. It is NOT an age related condition as it can occur in anyone at any time, with symptoms generally increasing if left untreated. Arthritis causes a change in the bones and joints which it effects. It often causes enlargement of the joint and a change in the shape of the bones within that joint.These bony changes can most often be seen from X-ray views of the spine or extremities being affected, although imaging is not always necessary for treatment. In the spine, bone spurring may be seen which can become larger over time. Also common is a decrease in joint space, or the distance between two bones. Disc spaces between the vertebrae of the spine will eventually become thinner with arthritic conditions.Other joints such as the hip or knee will also have a loss of joint space between the bones. The shape of the bones within those joints may also undergo changes in shape. Degenerated joints are not always symmetrical, meaning just because one knee or shoulder is arthritic, does not mean the other side is as well. Risk factors depend on stresses applied to that joint over time. Injuries from sports, an accident, or trauma can also lead to joint deterioration if not cared for properly.Those who suffer from arthritis often experience pain with certain movements or levels of activity. Exercise can often become more difficult, especially with more advanced stages. Pain and stiffness in the morning is common and may decrease throughout the day.It is important to keep arthritic joints mobile. Since repetitive motion or lack of movement can cause degeneration, mobilization of those joints is important to stop the progression of the condition. Exercise is important for mobilization as well, as long as it does not exacerbate the condition too much.Chiropractic care focuses on mobilization of the spine and extremities. When preventative measures are taken to keep the body mobile while also remaining stable, degeneration is much less common. After degeneration has already begun, our focus shifts to correcting or preventing the problems from becoming worse. Stretching and strengthening programs also help to relieve pain and prevent progression of degeneration.
The Dangers of Texting
Modern day technology is having a negative effect on our spine and body mechanics. Think back to 10 years ago, cell phone usage wasn’t anywhere near what it is today. Only half or maybe a third of high school students even had a cell phone back when texting was limited to about 200 per month. Nowadays, however, it seems the average age to receive your first smart phone is around 10 years old. Below are some details about the bad cell phone habits the doctors at Optimal Chiropractic see with many patients.Notice the position many people develop when texting, gaming, or surfing on their cell phone. It is rare to see a person sitting up straight, shoulders back and eyes forward with their arms up to eye level using their phone. The typical posture we see is a person bent or hunched over looking down with the phone at the waist. Business insider reports from 2013 stated smartphone users age 18-24 send an average of 67 texts each day, and around 2,022 texts per month. Not including texts received, which is around 1,831.Text neck is a common term used to describe the strain caused to the cervical spine from cell phone usage. The head is constantly in a state of forward posture, which chiropractors describe as anterior head carriage. The human head weighs around 10-12 pounds in the average adult. However, as the neck is bent forward and down, the weight held by the cervical spine begins to increase due to the weight of gravity pushing down. Studies have shown every inch of anterior head carriage adds 10lbs to the weight of the head, increasing the pressure on the cervical spine.Forward head carriage and upper back hunching can lead to a number of issues including headache, reduced lung capacity, muscle weakness and shortening, neck pain, neurological issues, dizziness, and even depression. At Optimal Chiropractic, we recommend changing your posture when using your smartphone and other devices. Bring the device up to your eye level, rather than bending down toward it. Use a special case or stand to hold up devices such as a tablet or reading materials. Last, but not least, perform exercises throughout the day to improve posture and strengthen the muscles deep within the neck.If you are interested in learning more about what you can do to improve your posture and overall quality of life, give our office a call. We would love to see you and your family to help you achieve your optimal health and wellness goals.
Do you suffer from Depression?
Depression is not a sign of weakness or a negative personality, it is a major public health problem and a treatable condition. There are different types of depression as well, including seasonal, postpartum, and even anxiety can be considered a form of depression.Many of us feel down or sad at times, however, it becomes a problem when that feeling lingers day after day. Lack of interest in activities and the persistent down-in-the-dumps feeling is a sign that something more serious may be going on. When these feelings interfere with the ability to carry out daily functions and appreciate things in life, then the condition may require treatment. These feelings can last for weeks, months, or even years with a wide range of physical and emotional symptoms.The exact cause of depression is unknown. Events in a person’s life may be a trigger among other risk factors. Certain types of brain chemistry may also be a contributing factor, certain circuits in the brain which regulate mood may not work as efficiently. Women may be more likely to suffer from depression, although men are also susceptible. Some other common risk factors include:• Family history, or spouse with depression• Stress, fatigue, decreased energy• Illness, persistent aches or pain, headaches• Hormonal changes• Anxiety, insomnia, personality disorders• Concussion or other traumatic brain injury• Drug/alcohol abuse• Domestic violence• ObesitySocial and emotional factors can also play a role in depression. Negative thoughts and beliefs can bring a person down. Lack of social support or lack of control over certain circumstances can cause a feeling of helplessness. These factors as well as lifestyle choices may lead to low self-esteem.Symptoms and risk factors can be very similar, and can vary from person to person depending on how they deal with stress. Symptoms can change over time, some of which include:• Persistent sadness, anxiety, emptiness• Hopelessness• Guilt, helpless• Tired or exhausted• Restless, irritability, insomnia• Trouble concentrating or remembering• Appetite changes, weight loss or gain• Thoughts of death or suicideIf you have any of these symptoms it is important to seek help or treatment. There are no specific diagnostic tests for the condition. Personal and family history may be taken into account with a focus on the above symptoms. Mental health exams may be done to give the doctor more detailed information about thoughts and memory to rule out a number of causes.Treatment in the chiropractic office may be quite different from that of a medical office. Chiropractic focuses more on lifestyle changes to help decrease the feelings of depression. Dietary changes or supplementation may be helpful. Certain B-vitamins and omega-3 fatty acids may help to reduce symptoms. St. John’s wort is an herbal supplement that has shown some evidence to fight mild depression, be sure to talk to your health care professionals to make sure any medications will not be affected by supplementation. A regular exercise program has also been shown to relieve some symptoms of depression, especially in cases connected to obesity or dissatisfaction with self-image.Treatment options can vary depending on the severity. More serious cases of depression may need to be treated with medication or therapy such as counseling designed to help cope with personal difficulties. Medications used to treat depression are believed to improve the communication between nerve cells, the goal is to make them run normally. There are many other treatment options, the goal is to find what works best for each individual in each situation. Depression is a treatable condition which should not be ignored.