Breaking News: The Aspirin Myth Debunked

Since the 1970’s the American Heart Association has recommended daily doses of baby aspirin to prevent or manage heart disease.  Millions of Americans have followed that advice for years.

Three (3) major clinical trials in 2018 questioned the validity and safety of a daily dose of aspirin.  Earlier this year the American Heart Association and the American College of Cardiology changed the clinical guidelines “recommending against the routine use of aspirin in people older than 70 years or people with increased risk of bleeding who do not have existing cardiovascular disease.”  A new study published on July 22, 2019, in the Annals of Internal Medicine, by researchers at Beth Israel Deaconess Medical Center, show the risk of taking daily aspirin out ways any benefit.  These findings affect over 30 million Americans older than 40 taking aspirin on a daily basis to prevent heart disease.  6 million Americans taking aspirin daily do so without their doctor’s recommendations.

If you are taking daily aspirin to “prevent” heart disease you should probably stop ASAP.  Please don’t do so without first consulting your PCP.  The only group of patients where the benefit out-ways the risks is those who have already suffered a heart attack or stroke.

I share this breaking news because you, or someone you care about, may be taking a daily aspirin thinking it is a good thing to do only to find out it is causing more harm than good.  Please don’t stop taking any medications without first consulting your PCP or specialist.

New Study Confirms Chiropractic Reduces Opioid Use

Opioid addiction and death is still out of control.  New guidelines and regulations are reducing the number prescriptions for opioid medications.  The death rate for opioid deaths dropped 4% in 2018 relative to 2017, but it was still close to 2000 in Massachusetts alone.

It’s crazy.  The US makes of 5% of the world’s population and consumes approximately 80% of prescribed pain medication.  Is it because culturally we can’t live with pain?  Or is the medical community only masking symptoms, not getting to the cause of the pain contributing to pain medication abuse and addiction?

Another fact- According to the National Institute of Drug Abuse nearly 80% of heroin users started with prescription opioids.

We can and should talk about causes of pain in the US.  We are meant to move, but we don’t.  Many of us sit all day at work, then go home and watch TV and go on our computers.   According a paper published in April 2019 in the Journal of the American Medical Association (JAMA)  the average amount of TV/video viewing time averages 2 hours a day and outside-of-work computer time increased by over an hour.  Total sitting time on a daily basis continues to increase.

“Sitting is the new smoking” now goes the mantra.  Sitting has been attributed to increased musculoskeletal pain in addition to increased risk of multiple diseases including obesity, cardiovascular disease, diabetes, cancer.   A recent study suggests it takes 1 hour of exercise on a daily basis to counteract the detrimental effects of sitting 8 hours.  Not enough of you reading this exercise one hour a day.  One solution is Active Sitting, and there is only one chair that can do that.  (Read More about Active Sitting)

Yes there are traumatic causes of pain including car accidents and injuries, and probably more commonly repetitive stress. The key to correct treatment is a detailed history and examination.  The majority of neck or back pain in the medical literature is labeled as “non-specific”. That means there is no obvious cause.  It is not caused by an apparent pathology or disc lesion.  From 34 years of clinical experience it is my opinion that these “non-specific” causes of pain are in fact caused by dysfunction in the mechanical movement of the body.  The spinal column is made up of 24 vertebrae, over 125 moveable joints, ligaments that hold them together and muscles that move them.  That doesn’t include the spinal cord which runs through it with a pair of spinal nerves exiting through small holes on either side of the spine (33 pair of spinal nerves in total).  Abnormal movement or restriction in any of these structures can cause pain.

A functional exam can usually uncover the cause of pain caused by dysfunction.  If the pain is more pathological of course imaging and referral is in the best interest of the patient. If the pain is functional than chiropractic care treats the symptoms and offer pain relief, but more importantly works to correct the cause.

Medications whether NSAIDs or opioids which are prescribed for pain relief only mask symptoms.  The goal of chiropractic care is correct the cause and advice patients on how to improve their lifestyle and ergonomics so they don’t keep hurting themselves.

At the American Association of Pain Management’s Annual Meeting in March 2019, a study from Yale University was presented titled, “Is the Use of Chiropractic Care Associated with the Receipt of Opioid Prescriptions?  A Systematic Review”.  This was a Meta-analysis with a 95% confidence interval.  The results found that 49% of chiropractic patients were less likely to receive an opioid prescription than those who went the medical route for pain.  That is a huge difference.

One solution is for primary care doctors to refer to chiropractors before prescribing opioids or any medications for musculoskeletal pain.  That is not just my opinion.  Another JAMA study from May 2018 found that patients who had “usual medical care” plus chiropractic care felt better faster, with less medications and greater satisfaction than those with just “usual medical care” alone.  In this study the patients with “plus chiropractic are” were referred by their PCP to a chiropractor. (read more about this study)

The key to preventing opioid deaths is to stop the prescription of pain medications.  An excellent start is to refer musculoskeletal pain patients for chiropractic care as the first treatment.  The research has been done repeatedly in some of the most respected medical journals in the world.  Why aren’t medical physician groups encouraging treatments that are more effective and safer than medication?  Why aren’t insurance companies encouraging a greater use of chiropractic care?  I don’t have the answer.  They should!  There is a cost savings as well as faster outcomes in pain relief, without the dangerous side-effects of medications and addiction.  With this information please make sure you and your loved ones make better choices when it comes to pain relief.

If you have any questions, please email me at drbradweiss@performancehealthcenter.com

Quick Spring Gardening Tips

Month 2 at Performance Health Center! I am loving my work here. Treating patients every day and watching their pain levels decrease and their functional ability increase, is an amazing thing to be a part of.
Spring is finally here! This month I want to talk about outdoor chores. I have already had so many back pain complaints from people working hard outside for hours doing chores such as gardening, raking, lawn mowing etc.
Quick tips from your chiropractor for all your outdoor chores:
#1: STRETCH FIRST. Stretching prevents injury. Think “long and strong.” Long muscles are strong muscles. Short/tight muscles are weak, and vulnerable to rips and tears. Stretch for at least 5 minutes, ideally 10 before physical work.
#2: Have a seat! Winston Churchill said “Why stand when you can sit?” Bending over puts ½ your body weight on your low back, that’s 100lbs for the average person. Sit on a low stool for ground level activities. Have your legs and hips open, and knees and feet turned out, away from your body. Then lean forward and work between your knees. In this position, always support your upper body weight with your elbows on your knees.
#3: Knee pads! A pillow, blanket, something thick/foam-like material if you are working on your knees for long periods. Example, tending your garden.
#4: Switch sides! Don’t rake your entire lawn on your dominant side. If you start on your right side, switch to the left in 5 min, then switch back. This will balance out the physical demand you are putting on your body.
#5: PUSH don’t pull. We are strongest when we get behind something and push it forward. We are vulnerable when we pull something heavy. Pulling puts excessive strain on your back, neck and shoulders, your body has to fight to keep something from slipping or tearing. When mowing your lawn for example, or anything that involves moving a heavy object across the ground/floor, please always PUSH!

From all of us at Performance Health Center, have a great Spring! See you next month!

For more info contact me at: drel@performancehealthcenter.com

 

When the Best Treatment is NO Treatment

By Dr. Leslie El-Turkmani

I am so excited to be here at Performance Health Center! I’ve met so many nice people, and have already seen some amazing things.  Last week for example……I saw a patient with severe symptoms, crying in pain during the consultation, and could barely get through the physical exam. I knew something more serious was happening.  I told her to come back tomorrow with the MRI of her spine she had taken 1 year ago. The next day she came back, her MRI revealed a “Chiari Malformation.” A congenital condition where the bottom of the brain pushes down the spinal canal at the base of the skull. I knew she needed a neurological consultation right away.

I called our “go to” neurosurgeon, Dr. Krishna Nirmel and got her a priority appointment in 4 days. She should have seen a neurosurgeon at the time of diagnosis, as this condition should be monitored for life. Unfortunately, I had to refuse to treat her. Manipulation could be a contraindication to care. The good news is I may have saved her life or more serious complications from happening by referring her.

At Performance Health Center, we do a detailed consultation, and a thorough physical, orthopedic and  neurological examination on every patient we see. From the examination and my professional training from New York Chiropractic College, I was confident in my diagnosis. Sometimes the greatest treatment you make is to not treat. And you have to know the difference, and when.

“Arnold-Chiari malformation” (CM-1) is caused by the “cerebellum” dropping down the “foramen magnum.” Named after German pathologists, Hans Chiari and Julius Arnold. The cerebellum, Latin for “little brain” is responsible for balance and motor control. The foramen magnum, Latin for “the great opening” is located at the base of the skull, about the size of a quarter with an oval shape. It allows passage of the brain stem and major arteries from brain to body, and vice versa. This herniation of the cerebellum down the foramen magnum is measured in millimeters. It can continue to drop further down over the years. This can lead to poor circulation due to unwanted pressure, and this pressure on the cerebellum can lead to issues with balance, dizziness, headaches, nausea, blurred vision, neck pain, and even atrophy of the structures.

The exact cause of CM-1 is unknown. It is a “malformation” because the individual is usually born with it. It can be symptomatic with signs like what my patient had, or asymptomatic for the individual’s entire life, depending on severity. It is fairly common, every 1:1000 births. It is more common in females. It is best diagnosed by MRI.

Take home message to my patients…pain is not a lifestyle! Nobody likes going to the doctor, but at least when you go see the chiropractor, you’re getting looked at nose to toes, inside and out to find the root of the problem

For more information, or to make an appointment call 508-655-9008.  If you have any questions please email me at DrEl@PerformanceHealthCenter.com

 

 

What is the Difference Between 50 degrees in the fall and 50 degrees in the spring?

Question: What is the difference between 50 degrees in the fall and 50 degrees in the spring?

Answer: In the spring 50 degrees feels warm!

This last weekend was the first “nice” weekend of spring!  When I went out to get the morning paper the birds were singing and overnight flowers had bloomed in my garden, including crocus, bluets and periwinkle.  After breakfast I went for my first mountain bike ride of the season.  There were many other bikers and trail runners out.  I rode by a baseball game- must have been opening day!  As I passed a playground it was full of parents with little kids playing on the swings and slides.  Heading home the landscapers were doing spring clean-ups and spreading mulch.

I love this time of year! For many after a sedentary winter the weather gets warmer and we into activity.  Spring sports are starting for our youth athletes, we itch to get our gardens back in shape, we tune up our bikes and spring into action.

Many of us spring into action too fast and furiously and pay the price in pain. Monday mornings after weekends like this our phone rings off the hook with people who hurt themselves.  We get the traumatic injuries, but more commonly it is caused by overuse.  “Spring cleaning” the garden, playing catch with our kids for hours,  running a little more than their bodies are ready for, or hitting the gym too hard trying to get into bathing suite shape.   Whatever the cause of that flair-up, it is almost always caused by doing too much too fast.  One of the 1st questions I ask in a treatment room is, “did you stretch first”?  The answer is universally no.

I hope you are not one of those Monday morning phone calls looking for emergency pain relief.  If you are know that we are here and ready to help you.  We have a long stretch of nice weather heading our way leading into summer which I want you to enjoy.  No one want to be sidelined from an injury that you could have prevented.

Please remember to pace yourself.  Stretch before and after activity.  If you get injured, before calling the office start with home care.  This leads to the age old debate of whether to ice or heat.   I’m a big fan of ice.  You can’t have pain without inflammation and ice is the best, safest and most localized anti-inflammatory.  The only time I recommend heat is if you wake up the next morning and you feel sore like you haven’t used muscles in a while.  If there is pain at a joint or along your spine then ice is probably the best therapy.  The best way to ice in the first 24 hours after injury is 15 minutes on, wait 15 minutes then repeat.  After 24 hours you should  ice for 20 minutes than wait an hour before repeating.   Whether you ice or heat it should be moist otherwise you can freeze or burn the skin.  I like to dampen a paper towel then squeeze all the water out. This is damp enough for the ice or heat to penetrate, but doesn’t make a wet mess.

Spring is also a great time to do a spring tune-up to your spine.  Your spine is made up of 24 vertebrae and has over 120 joints. It is the chassis for your torso and also houses and protects your spinal cord.  My job as a chiropractor is to make sure these joints are moving correctly and to make sure the muscles that move the spine and support your posture are balanced and functioning properly.  At Performance Health Center we take care of your spine and all the joints of your body.  Before you spring into spring activities, now is a great time for a body tune-up.

To see if your body is ready for the spring, or to get that spinal-tune-up that maybe overdue, please call the office at 508-655-9008.  If you have any questions please email me at drbradweiss@performancehealthcenter.com

 

The Future of Sitting is Here in Natick!

“Sitting is the new smoking” is quoted day in day out in the media. Research continues to be published documenting all the detrimental effects of sitting on the job including increased risk of high blood pressure, diabetes, cardiovascular disease and even cancer. 

I’m constantly talking and demonstrating to my patients on how to sit correctly and how to use the features of their ergonomic desk chair correctly.  The problem is that sitting is static and even the most expensive ergonomic desk chairs keep you locked in one position.  No matter how you slice it or dice it sitting is detrimental to our health and until now there has not been much you can do about it.  Standing desks are popular, but standing in one place all day is not good for you either. Life is motion and the more you move, the healthier you will be.

The future sitting has finally arrived. It is a concept called active sitting. I saw an ad a few months ago in a chiropractic trade magazine for a revolutionary new chair. I thought it was an exciting concept but I did not want to take a chance of buying a chair online without first having the opportunity to sit on. After looking at the website, reading and watching a few videos I was hooked.  I noticed the chair was made in Burlington Vermont, where I used to live.  I knew I’d be back for a visit soon. Three weekends ago I went to Burlington. The night before I call the 800 number left a message and got an immediate call back from Tucker Osler, M.D. the inventor, founder and owner of the company. I asked if I could visit the showroom. He said they don’t have an official showroom yet but he’d be happy to show me their workspace and allow me to demo the chairs.

Dr. Osler and I met, hit it off and spent a long time discussing our mutual passion for ergonomics, body mechanics and health.  The company is called QOR360 and they have several models of chairs.  These chairs have a unique patented seat rocker that keeps you moving, engages your core and puts you in good posture with your head over your shoulders and a lumbar lordosis.  I was sold! I truly believe that this has the potential of being the future of sitting.  It’s tough to change human behavior and habits, but if you could put your butt in these chairs, and give it a chance it will sell itself, especially those of you who sit in front of a computer all day.

I came home with two chairs, choosing the Ariel which is model designed to be an office chair.  One I am sitting on right now in my home office and other is in the reception room at Performance Health Center so my patients can experience this unique chair. Monday morning I showed the chair to Linda, my receptionist, so she could explain to our patients about the chair and encourage them to try it.  Linda sat down and declared that the chair “is mine”. I have since gotten a third Ariel so that Linda can actively sit all day and have a chair for patients to try in the reception area. The response has been enthusiastic!

If you are sick and tired of sitting in an office chair that hurts your back, keeps you immobile and compromises your health, I encourage you try out the Ariel chair in our reception area.  Performance Health Center is the only location in greater Boston where you can experience the future of sitting!

What is it like?  If you have ever sat on an exercise ball it is a similar concept. The problem with using exercise balls as desk chairs is that they are large and bulky, it is easy to you fall off them, they puncture and in order to move your pelvis the whole ball moves moving you away from your computer.  With a QOR360 chair just the seat moves. It forces the activation of your core muscles and encourages  good posture with your head over your shoulder.  It is on a stable platform so there is no danger of your falling off and getting hurt.  It allows you to sit in front of your computer but your muscles stay active and engaged.

Sitting on the a  QOR360 chair takes a little getting used to. You can’t just sit down for five seconds and experience it.  It is recommended that you sit for at least minute or two and feel how your body reacts. It forces you sit on one your “sit bones”(or ischial tuberosities to be anatomically correct).  My “sit bones” were a little sore after my first prolonged sitting session. I give Dr. Osler this feedback and he responses saying that is typical, and it does take a little getting used to it because you’re not used to sitting on your sit bones. If the seat cushion was softer you would not be able to find your sit bones. He was true to his word and now I can set for extended periods with no soreness. Still you should always get up and take breaks when sitting even with active sitting, at least every 15-20 minutes, even if just for a 30 seconds of full body motion.

If you can’t get to Natick, MA, to sit on the QOR360 chair, know that it comes with a 30 day money-back guarantee.  The QOR360 chair can only be bought on-line, if you use the code PHC at check-out you will get a 5% discount.   Sorry if this blog sounds like a sales pitch, but after 34 years in practice helping people in pain caused by sitting all day this is the best solution I have found.  It really believe the QOR360 chair is the future of sitting. Like all paradigm shifts, it is going to take little time to gain traction.  If sitting on the Ariel chair in my reception room for a few minutes is not enough to convince you that this is the chair you should be sitting on at work, I’ll let you take one back to the office for up to a day so you can give it a good test drive.  Of course, your co-workers will be curious and hopefully you’ll share and let them try it as well.  Please call in advance at 508-655-9008 to make sure our loaner chair is available.

For more information please email me at drbradweiss@performancehealthcenter.com.  Of course check out the QOR360 website.  Please visit us at Performance Health Center  in Natick if you want to experience the future of sitting.  Lastly, if you are going to purchase remember to use the code PHC to get your 5% discount.

Play More Tennis and Live Longer!

That’s right.  Yet another new study has come out showing the health benefits of being active, this time as it relates to longevity.  The December 2018 issue of the Mayo Clinic Proceedings has a research study titled: Various Leisure-Time Physical Activities Associated with Widely Divergent Life Expectancies: The Copenhagen City Heart Study.  This study following 8577 participants for up to 25 years looking at various forms of physical activities to see which gave the most benefit in adding years to life. 

Playing tennis was the most beneficial extending life expectancy by 9.7 years relative to the sedentary control group.  Seven other leisure activities also increased life expectancy, but not as much! 

Here is the list:

Tennis-        9.7 years

Badminton- 6.2 years

Soccer-         4.7 years

Cycling-       3.7 years

Swimming-  3.4 years

Jogging-       3.2 years

Calisthenics-3.1 years

Health Club Activities- 1.5 years

The study tried to analyze what makes tennis and the other top life extending activities more beneficial than the later activities on the list.   One big difference is that tennis, badminton and soccer tend to be social sports that depend on interactions with others. According to the authors, “Belonging to a group that meets regularly promotes a sense of support, trust, and commonality, which has been shown to contribute to a sense of well-being and improved long term health”.   They also state, “A scientifically rigorous and widely cited meta-analysis on the topic found that social support had a stronger effect on long-term survival than any other factor, including being a nonsmoker, staying lean, or having normal blood pressure”

Another possible reason that tennis, badminton and soccer participants have increase longevity is that these sports require quick interval bursts of full body motions compared to the other sports studied which have more continuous repetitive body motions.  The jury is not out, but according to the study, “a growing body of evidence indicates that short repeated intervals of high intensity exercise appear to be superior to continuous moderate intensity PA (physical activity) for improving health outcomes”. 

It’s a New Year and no better time to make a commitment to being active.  Exercising in a health club may not increase longevity as much as playing tennis or even cycling, but it does have significant benefits which include reducing the risk of many types of cancer, developing Type 2 Diabetes, decreases cholesterol levels, reduces the risk of heart disease and increased the natural protection of cold and flu viruses to name a few.

I’m an avid tennis player so was very happy to see these benefits in longevity.  The moral of this study is that you need to be active to live longer. Of the 8577 participants in this study, 12% reported being sedentary and 66% engaged in at least 1 activity.  The weekly average was almost 7 hours of activity a week.  That’s about 1 hour a day which is the minimum recommended by many different studies.

A study in Lancet in 2016, concludes that it takes 1 hour of exercise a day to reverse the negative mortality effects of sitting 8 hours on the job.  Less than 25% of us meet this minimum requirement. More and more studies are demonstrating the importance of motion.  My favorite mantra to my patients is, “life is motion”.  The Mayo Clinic study is just the latest.  It also give hints on which activities you might want to focus on if you want to live longer. It really doesn’t matter what you do, just do something for at least one hour a day.  It doesn’t have to be continuous.  In fact, the Lancet article suggests you move at least 5 minutes every hour, making the 1 hour of exercise cumulative rather can consecutive!  Just walking is an excellent exercise. The social interaction of walking with a friend probably increases the benefit exponentially!

Before you start any new activity you should have a functional musculoskeletal examination to determine if you are capable.  At Performance Health Center we specialize in getting our patients out of pain and in optimum functional health so they can enjoy pain-free active living!  Wishing all our friends and patients a Healthy, Active and Happy New Year!  For more info email me at: drbradweiss@peformancehealthcenter.com

Share This With Your PCP!

Unfortunately the following saga is way too typical in our office. Last month I saw a new patient who had severe low back pain (LBP) for over 2 years. The pain was so severe she was living on pain meds, going right home from work and going to bed. She was not participating in life and was extremely frustrated. She had seen her Primary Care Physician (PCP) from the onset of her pain. She was referred to multiple specialists for advanced testing, injections and more medications, none of which gave her any real relief or hope.

Finally after two (2) years, at the repeated encouragement of Lyn Rome, her hair stylist, she came into my office, explained in detail all she had been through and the frustration of living with pain. My exam ruled out all the “red flags” or pathological causes of her pain. My diagnosis was dysfunction of her left Sacro-iliac joint and sciatic nerve entrapment. Simply put, the largest joint in her body (in the butt area) was stuck and the longest and thickest nerve in the body which goes from the low back to the toes was not gliding properly. Of course she also had muscles spasms because her muscles were short and tight to protect the joint that was not moving, setting up a visors cycle of pain that kept perpetuating itself.

I felt confident I could help her, but since she was skeptical and nervous from her prior medical treatments I recommended a 2 week trial of chiropractic care to see how she would respond. I wish all of my patients responded so quickly, but after 2 treatments she had significant decrease in pain, stopped the pain meds and didn’t have to go right to bed after work. Obviously the trial of care was successful and she is on the road to recovery.

Two (2) years of her life was wasted because of ignorance (or bias) on the part of her PCP. Unfortunately this is a scenario I see all the time at our office, but it shouldn’t be that way. Any competent medical doctor who keeps up with the literature should know that chiropractic care has been well documented as an effective treatment for LBP. (It is not the only condition we treat, but the most researched). There really is no excuse for collaboration between your PCP and the chiropractic profession for the best interest of the patient, especially for the treatment of LBP.

Now there is even more proof! In the May 2018, on-line edition of the JAMA (Journal of the American Medical Association), a new studies found that “usual medical care plus chiropractic care reported a statistically significant improvement in low back pain intensity and disability at 6 weeks compared with those who received usual care alone.” In a study of 750 people, from the ages of 18-50, the addition of including chiropractic care documented statistically significant improvement included less reported pain, less disability, more patient satisfaction and less pain medications used. Across the board including chiropractic care reduced pain and suffering.The conclusion of this study states, “this trial provides additional support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines”. Note the words…as currently recommended in existing guidelines.

The number one cause of disability worldwide is LBP! At least 20% of Americans will have LBP lasting at least 1 day over the next 3 months. LBP is the 2nd reason why patients visit their PCP. The direct cost of LBP in 2010 was $34 billion, and adding in lost work and productivity costs the US economy up to $200 Billion. At the present time only 8-14% of the US population receives chiropractic care annually. So why aren’t PCPs referring to chiropractors. Getting historical, there have been excellent studies validating chiropractic care and multiple government reports recommend a greater utilization of chiropractic care.

As far back as 1993 the Ontario Ministry of Health published what is called the Manga Report. The Manga Report’s conclusion was to make chiropractors the gatekeepers for treating LBP for many reasons concluding: “On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate; there is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain; and there is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management.”

Then in 1994, the US Agency on Health Care Policy and Research (AHCPR) released Clinical Guidelines for Management of Acute Low Back Pain. These Guidelines were created an expert panel to provide PCPs with recommendations on the assessment and treatment of LBP. Again the conclusions included:
• Conservative treatment such as spinal manipulation should be pursued in most before cases considering surgical intervention;
• Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.

The benefits of chiropractic care both in human suffering level and economic savings is well documented and recommended by multiple government agencies. I still don’t understand why the chiropractic profession is not getting more referrals from the medical profession. Going back to the patient in the first paragraph, in her words she lost 2 years of her life and had lost hope of ever being able to function and doing the most basic activities like walking with her husband or sitting in a restaurant. My bias is that she should have been referred for chiropractic care after the pain lasted for 2 weeks while following her PCPs advice. When the pain persisted and multiple therapies failed, at the very least her PCP could have said I don’t know much about chiropractic health care, but since you are not feeling better why don’t you give it a try.

I don’t fault the present generation of medical doctors. Chiropractic care is not part of their educational curriculum. I have seen this first hand. For eight (8) years family practice residents first at University of Vermont and then Tufts had a one (1) day rotation at my office. I asked each resident in all your years of medical school and residency how much did they learn about chiropractic health care. The answer across the board was “nothing”. Then I’d ask how much did they learn about the musculoskeletal system? The answer across the board this time was “not much”. Then I’d ask my final question which was how many vertebrae are in the spine? In 8 years only 1 Family Practice Resident was able to rattle off the correct answer which is 24.

Then the medical resident spent the day with me watching me interact and treat my patients. At the end of the day across the residents would say how impressed they were. They didn’t realize the scope of chiropractic practice and the benefits of manipulation. My advice was always the same. When you finish your residencies and hang up your shingle to practice, meet a few chiropractors in your community, find one or two that you feel comfortable with and refer your patients to them. Unfortunately this type of rotation at a chiropractic office was and still is a rare event in the training of medical residents.

Hopefully you have read down this far. The only way your PCP is going to know about this new study (and historical guidelines) is if you share this article with them. Please email your PCP and attach this article. Ask if he/she has read the new JAMA study on the significant benefits of including chiropractic care in collaboration with “usual medical care” for patients with low back pain? If not the link is here: Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial

Sharing this article with your PCP this will help build bridges between the two professions and the winner is you, the consumer of health care.

For more information please contact me at drbradweiss@performancehealthcenter.com

The Concussion Muscle

Concussions are awful. There are close to 4 million sports related concussions in the U.S. every year. Your brain gets shaken up like an egg inside its shell. The skull doesn’t crack but the brain gets rattle around. You might lose consciousness, balance, ability to talk, have a headache and the world appears fuzzy. You go through concussion protocol testing and spend anywhere from a few days to weeks resting.
Slowly you start to feel better and eventually get on with life. 15% of concussion suffers have lingering effects which last beyond 3 months which is labeled “post-concussion syndrome. Persistent symptoms include inability to concentrate, memory issues, fatigue, dizziness, irritability, anxiousness, insomnia, blurry vision, noise and light sensitivity, and headache.

A recent study from the American Journal of Neuroradiology (AJNR) tried to determine if there was correlation between the suboccipital muscles and recovery time from post-concussion syndrome. The suboccipital muscles connect the upper neck vertebrae to the back part of the skull called the occiput. There are seven (7) muscles that make up the suboccipital muscles. An MRI of sixty-four consecutive patients with post-concussion syndrome was performed and symptoms were tested using standard concussion protocols.

Of the seven (7) suboccipital muscles only one (1) muscle’s cross-sectional diameter proved to have a direct association with post-concussion symptoms. That muscle is the Rectus Capitus Posterior Minor. (RCPMinor). There was a direct correlation with the RCPMinor and “greater symptom severity, longer recovery time, poor verbal memory performance and headache”. None of the other suboccipital muscles had a direct correlation.
What is so special about the RCPMinor muscles that it effects the recovery time ofpost-concussion syndrome? The RCPMinor is the only suboccipital muscle that has a ligament bridge that connects to the dura mater of your spinal cord right where your brain and spinal cord join. The dura mater is the outer protective membrane of the spinal cord. The theory is that the RCPMinor tugs on the spinal cord covering contributing to post-concussion symptoms.

I am only aware of one soft tissue technique that can isolate, evaluate and treat the RCPMinor muscle. That technique is called Active Release Techniques® or (ART). ART is patented and consists of over 500 specific protocols which differentiate, isolate, evaluate and treat the individual muscles in the body. The goal of ART is to release adhesions or scar tissue in muscles, ligament and nerve pathways in the body, in essence the soft tissues of the body. ART is cutting edge and is becoming the gold standard in treating soft tissue injuries. ART is done by hand. In order to become certified in ART you need to go through a certification course. Certification needs to be renewed every year. There are only 40 +/- certified ART providers in Massachusetts.

In the suboccipital region it is possible to isolate and evaluate the RCPMinor muscle using ART. If the RCPMinor is found to be short & tight, a specific tension is applied to the muscle which can normalize the tone and function. I have been an ART provider for 20 years. I have helped many patients suffering from whiplash injuries, headaches and post-concussion symptoms. Even before this study was published I have found that clinically the RCPMinor is a key muscle to treat to resolving post-concussion symptoms. As a side note, if you are suffering from whiplash injuries due to a car accident then it might be a good idea to get a lawyer involved, particularly if the accident wasn’t your fault. A lot of law firms will have a contact us page and this will help you to find the best lawyer for you and your case.

It’s not important to remember the name of the Rectus Capitus Posterior Minor muscle, but it is important to know that ART is one technique that is very effective in finding, evaluating and treating this muscle. If you, a family member or friend has been frustrated due to post-concussion syndrome, chronic headaches or whiplash injury, please get evaluated by an ART certified provider.
To find a certified ART provider anywhere in the world clink this link: http://activerelease.com/find-a-provider.asp

If you would like more information please contact me at: drbradweiss@performancehealthcenter.com

Your Mind is Powerful; Use it Wisely!

More and more evidence is proving what we’ve been told our whole lives is true; “You are what you think.”   Hopefully, after you read this you’ll be more careful about what you think about because it can fundamentally affect you and your health!

It’s now a few years old, but in 2011 the “milkshake study” was published.  The same exact milkshake was given to the subjects on 2 separate occasions, except the labels were different each time. One label was “indulgent” and stated the milkshake was high calorie and fat.  The other label on the exact same milkshake was “sensible” and was described as low calorie and low fat.  Amazingly enough, the milkshake was metabolized differently in the subjects even though the ingredients were exactly the same.  The Indulgent labeled shake produced a significant decrease in the levels of Grehlin, one of our body’s “hunger hormones”. The drop in the hunger hormone was 3 times greater than in the sensible labeled milkshake.  When drinking what was believed to be a high fat, high calorie shake the body was fooled by the mind and was made to feel fuller, or more satiated.  The difference in how the milkshake was metabolized in the body was physiological.  The bottom line is what the body believed it was consuming affected how it was metabolized in the digestive system.

Additional studies have shown that the placebo effect in medications can be as high as 50%.  When a patient’s medical doctor says that medication is effective for their ailment, the mind believes it and feels better even though they are only consuming a sugar pill.  What is even more amazing is that the placebo effect exists even when the patient is told they are getting a placebo. This is called an open-label placebo.   Sounds crazy, that even when they are told they are taking a sugar pill, many patients feel better.

These are just a few examples of research documenting that your mind is pretty powerful and what you say, think and hear can influence you in ways that you never thought possible.  To read more about how your mind and body are affected by your thoughts, actions and beliefs all you need to do is Goggle positive thinking studies.  I got over 9 million results in less than half a second.  The take away is that the brain is more powerful than we realize. You need to be careful about what you say, especially your “self-speak” and you should focus on positive and empowering thoughts.  It’s not always easy to be positive.  You may have developed bad thought habits over the years and will need to make a conscious effort to be positive.

I try to be positive in both my personal and professional life. Chiropractic care is not a placebo, but I have found during my 34 years in practice what I say and how I say it can influence and improve how my patient’s respond to treatment.  For those patient’s I feel I can help, I focus my explanations in realistic terms, but always try to focus on the positive changes that will happen in their bodies as they receive their chiropractic treatments.  I remind my patient that it takes time to get healthy especially with chronic pain syndromes causes by joint dysfunctions, muscles imbalances and degenerative changes.  I also know that when my patient’s stick with their treatment recommendations they are usually glad they did both short term and long term.

You might have already forgotten many of the New Year’s resolutions you made just two months ago, but being positive it not as difficult as it may seem. If you need more motivation-Positive people live longer and are healthier!  Yes, there is research on that too!

DrBradWeiss@PerformanceHealthCenter.com