June Blog and Health News

June Office Hours: 

• I will be open all day on Thursday June 9 and closed at noon on Friday June 10 to leave town for a seminar.

Clinical Topic of The Month-Tennis Elbow

What is it?
Tennis elbow is referred to medically as lateral epicondylitis, suggesting an inflammation of the extensor tendons of the forearm.  Studies suggest that chronic cases actually display degenerative changes in the tendon suggesting tendinosis instead of the inflammatory tendinitis.  The point of pain is at the outside of the elbow.

How do I know I have it?  (Signs and symptoms)

• Pain on the outer part of elbow (lateral epicondyle).
• Pain with gripping or squeezing, wrist extension and lifting movements.  Firm handshakes when squeezed can hurt.
• Painful with any activities extending the wrist.
• Grip weakness and pain with any activities gripping-turning a door knob, shaking hands, holding a heavy glass of water, turning a screw driver, etc..

How do I get Tennis Elbow?

• Forceful blows or extension were thought to be early culprits suggesting tears at the tendons insertion into the bone.
• There may be alternation of the radial nerve in the area.
• Breakdown of the tendon due to overuse stress.

Prevention:

• Rest or back down the activity causing it.
• Maintain physical conditioning.
• Use appropriate equipment.
• Learn appropriate form.
• Use a tennis elbow strap to help diffuse shearing forces.

Diagnosis:

• Orthopedic testing (Cozen's).
• Medical imaging tests-x-ray, MRI, ultrasound (usually cost prohibitive)
• Generally made with signs and symptoms

Treatments:

• Manipulation (Mill's maneuver)
• Physical modalities-Ultrasound, electrical stim, ice, heat, vibration, laser therapy, exercises and stretching
• Deep tissue therapy (transverse friction massage, Graston or other instrument assisted soft tissue mobilization)
• Rest
• Anti-inlammatory medications (OTC or prescription)
• Bracing
• Medical interventions-surgery, botulism, cortisone injections

Personally, I use a combination protocol of manipulation (Mill's maneuver), instrument assisted soft tissue therapy (Graston), cold laser therapy, temperature therapy (mainly ice), stretching and exercises.  This combination seems to get the best results.

Health Snippets

Heart Attack Symptoms:
General:

• Pain or pressure in the chest.
• Discomfort spreading to the back, jaw, throat, or arm.
• Nausea, indigestion, or heartburn.
• Weakness, anxiety, or shortness of breath.
• Rapid or irregular heartbeatsWomen: 

Note:  Women are more likely than men to have heartburn, loss of appetite, tiredness or weakness, coughing, and heart flutters

May Blog and Nutrition/Health News

Office Hours Notice for May:

• We will be closed Memorial Day, May 30, 2011 to celebrate the holiday.  If you have an emergency, call 911.

Carpal Tunnel Treatment



What is Carpal Tunnel Syndrome:  carpal tunnel syndrome is compression of the median nerve as it travels through the carpal tunnel causing intermittent numbness of the thumb, index, long and radial half of the ring fingers.  The pain is generally worse at night.  It it is chronic, permanent damage can be causes to the nerve with constant numbness, muscle atrophy and weakness of squeezing the hand.  Although consided a repetitive stress problem, studies have not confirmed this.

Treatment:  Medical treatment consists of night splints and corticosteroid injections or surgery.  Conservative/Chiropractic Treatment:  splinting is used by chiropractors as well as mobilization or manipulation of the wrist joints, deep tissue work (Graston technique) to stretch the carpal ligament, exercises, icing, activity modification, and in my practice cold laser therapy.  I get the best results with LASER therapy and Graston technique (instrument assisted soft tissue mobilization), stretching, exercises and splinting.  I also find working the whole shoulder arm and wrist complex helps relieve tension.  Sometimes CTS is misdiagnosed when it is real a pronator entrapment of the median nerve in the forearm.

NUTRITION NEWS:

• Apple polyphenols extend fruit fly life span by 10% by apparently working on SOD (superoxide dismutase) and catalase.
• Cup of Joe:  a Swedish study found less strokes in coffee drinkers.
• Parkinson's and Vitamin D:  vitamin D insufficiency was highly prevalent in cases of recent onset of Parkinson's Disease.
• Vitamin D and Lung Cancer: increasing vitamin D could help prevent lung cancer recurrence.
• Vitamin E Supplementation and ALS (Lou Gehrig's Disease):  a 23% reduced risk for ALS was found in supplementing for 2-4 years and 36% for over 5 years of supplementing.
• Peripheral Neuropathy:  old dysfunctional mitochondria (cell powerhouse) might cause peripheral neuropathy (John Hopkins).
• Green Tea vs. Alzheimer's:  green tea consumtion may protect against Alzheimer's disease.
• Green Tea and Kidneys:   green tea is rich in catechins and flavinoids is a potent anti-inflammatory and anti-oxidant with health benefits against, cancer, cardiovascular disease, body weight and insulin sensitivity as well as protecting the kidneys.
• Glaucoma Nutrition:  a nutritional formula of maritime pine bark extract and standardized bilberry extract shows promise in reducing intraocular pressure.
• Aging Eyes:  a special topical formula of soy and rice bran extracts supported by phytonutrients found in blueberries and antioxidants from pemgranate and tea extracts have been show to quickly target dark circles and eye puffiness.
• Triglycerides:  tocotrienols (class of vitamin E) in a recent study lowered triglycerides by 28%  At doses of 100-200 mg/day they have been shown to reduce LDL and total cholesterol by as much as 37%.
• Echinacea: echinacea in one study resulted in a 10% decrease in cold severity and about a half a day less of symptoms.
• Calcium Supplements for Osteoporosis: Calcium supplements with/without vitamin D moderately increase cardiovascular events including heart attacks and warrants a reassessment of their role in managing osteoporosis.
  

OTHER HEALTH NEWS:

• Optimal Heart Health:  Blood Pressure below 120/80 mmHg, Body Mass Index (BM) below 25, fasting glucose below 100 mg/Dl, and cholesterol below 200.
• Prescription Drug Abuse:  The FDA has taken steps with the Department of Justice, Health and Human Services, Veterans Affairs, and Defense and others to deal with the recreational use of prescription drugs via focusing on removing unused prescription drugs from homes, and dealing with "pill mills" and doctor shopping through law enforcement.  Unused prescription drugs have shown up as party drugs where drugs are dumped in a bowl without knowledge of their effects, what they are for, or the risks and side effects of taking them.  The drugs are often stolen from parent's medicine cabinets and could include opiods as well as things like heart medications, and pain medications to name a few.
• Allergies:  Allergies are inflammation.  The following foods can help fight allergies naturally:  Salmon: Fatty coldwater fish like salmon (EPA and DHA) are omega 3 fatty acids.  Trout, tuna, nuts and seeds are also omega 3 sources.  Grape juice: Grape juice is a good source of resveratrol and antioxidant (may reduce asthma inflammation), red wine (even more resveratrol), blueberries, (may help lower blood sugar) and peanuts all contribute to resveratrol Beans: loaded with the B vitamin folate which may reduce allergic reactions.  Cutting back of pro-inflammatory red meat is also good.  Apples have quercetin a flavonoid which may stem histamine production and cool inflammation. Yogurt: has loads of probiotics for gut bacterial which lowers immune substances that affect allergies. Carrots:  colorful diets (veggies) have cartoneoids may have an allergy-quelling effect.  Mix It Up: mix up your diet but avoid inflammatory foots:  sugar, high saturated fats, red meat, heavy carbohydrate diets, and heavy fast foods.
• CAMS and Osteoarthritis:   What complementary and alternative medicines (CAMs) work with osteoarthritis.  A recent review found that capsaicin gel, SAM-3 were the most supported and some evidence that MSM, rose hips (vitamin C) and  Indian Frankincense (5-loxin or boswellia) may be effective.   

Sources:  Google images, Medscape, Real Age, Life Extension.

OFFICE HOUR CHANGE

Office Hour Change for April
The office will be closed April 27 (Wednesday) and 28 (Thursday) and Saturday the 30th. 
Dr. Riggs will be out of town.  Normal hours should be in effect Friday the 29th.

If you have an emergency during my absence please call 911 or go to the emergency room

April Blog

OFFICE HOUR REMINDER:  I will be closed April 14th, Thursday all day (normally only morning hours).

NECK PAIN: 

Acute neck pain can be caused by many things.  Strains/sprains to the neck from whiplash, sports, or certain sudden movements can result in muscular or ligament pain.  Injuries to the muscles take about 4-6 weeks to heal and ligament and tendon injuries take somewhat longer.  Mechanical joint pain can also result from sleeping postures, physical activities, repetitive movement injuries, and simply moving wrong.  When the joint locks and prevents normal joint motion pain often results.  Osteoarthritis/degenerative disc disease can also lead to neck pain.  Calcium build up called spurs can sometimes press on sensitive nerve structures resulting in radiating pain and lack of normal movement.  Disc injuries (swelling or herniation) can lead to severe neck pain due to disc material pressing on nerves.  Vascular problems (heart disease, artery disease) can also cause neck pain as can viral infections, certain cancers, and some diseases.


Chronic neck pain frequently results from years of abuse and the development of degenerative changes in the spine such as decreased disc spaces, calcium spurs, narrowed nerve openings, structural changes, and abnormal muscle and ligament tension.  Chronic musculoskeletal problems are generally progressive-i.e., they get worse with time and age.

Thoracic Outlet Syndrome:  This is another condition often accompanying neck pain and arm pain or numbness and tingling.  Generally, it is caused by mechanical pressure on the bundle of nerves and vessels coming out of the neck.  The increased pressure can be caused tight muscles in the neck or chest, an extra rib in the neck, postural problems, blocked arteries, and other causes.

Treatment options abound.  Conservative treatment may involve chiropractic manipulation, mobilization, stretching, exercises, structural changes, nutritional support and various physical medicine modalities to relax muscles and speed up healing.  LASER therapy also works well with neck pain.  Non-responsive cases may require steroid injections or surgical intervention.  Doctors of Chiropractic are trained to provide conservative treatment for acute and chronic neck pain.  By focusing on the normal structure and function of the neck we have various methods available to us.  My clinic focuses on manipulation (low force and traditional), traction, physical medicine modalities (ultrasound, electrical stim, exercises) and the use of low level LASER therapy to help return patients to normal in as short a time as possible.  Chronic cases and patients with radiating pain may take longer than normal due to tissue and structure changes and the nature of the condition.  Referals are provided in non-responsive cases.  Medical treatment may include:  medication, injections, or surgery.  X-rays may or may not be necessary depending on clinical findings and the patient's response to treatment.

NUTRITION NEWS:

• There is evidence that fish oil, vitamin D, carnosine, multi-vitamins and a healthy life style can slow the rate of telomere shortening which is responsible for aging.  Recent research has made strides in discovering how to prevent telomere shorting and thereby extend life span.
• Magnesium supplements may reduce diabetes risk.
• Green tea may help prevent Alzheimer's disease.
• Eating lots of fruits and vegetables can give you a healthy glow.
• Increased zinc intake was found to be associated with lower risk of prostate cancer death.
• Vitamin E was associated with longer life span in a Finnish group over 71.
• High dietary fat, cholesterol linked to increased breast cancer risk.
• Belly fat puts women at risk for osteoporosis.

Change in Office Schedule

My Schedule has changed for the end of the month.  I WILL be in the Office on March 31, April 1 and Saturday April 2.  I will be closed Thursday April 14 for an eye doctor appointment in Lubbock.

Losing Weight Eating Healthy

OFFICE SCHEDULE FOR MARCH: 
Saturday 3/12/11:  the office will open at 11 AM instead of 10 AM.  Dr. Riggs has to do a relicensing teleseminar from 8-11
Thursday 3/31/11 and Friday 4/1/11 and Saturday 4/2/11:  The office will be closed.  Dr. Riggs will be out those three days.  If an emergency go to the emergency room:

HEALTHY EATING

Eating healthy is a challenge in modern society with all the fast food restaurants, our busy lifestyle and our time constraints.  However, the highly processed food market appears to contribute heavily to our national obesity epidemic.  A recent article by Dr. Alex Vasquez (DC, ND, DO) has suggested a supplemented form of the paleolithic/mediterranean diet.  The paleolithic diet is the diet eaten by our ancestors when they were hunter/gatherers.  The mediterranean diet is considered to be very heart healthy.

What does the diet recommend?  Here are the components.  As a side note, I have been following the diet and have lost 23 pounds since January.

Paleo-Mediterranean Diet:

• Emphasis on fruits, vegetables, nuts, seeds and berries and lean proteins such as chicken, fish, lean meats, soy, and eggs.  This is a high anti-oxidant, high fiber and anti-cancer oriented diet.
• Soy and whey protein isolates (anti-cancer, heart protective, mood enhancing).
• Avoids:  potatoes, starchy vegetables, wheat, grains including rice (due to high glycemic index and load).  Avoid wheat, barley, rye (high glycemic index and gluten sensitivity)
• Forbids:  colas.sodas, processed foods and manufactured foods.

Supplementation:

• Supplemented with multi-vitamin and minerals with limitation of 10000 IU of vitamin A in childbearing age women.  Helps reduce inflamation and is health promoting.
• Vitamin D3:  4000 IU although some respond better to 10000 IU.
• Fatty Acid Supplementation: 
• ALA (omega 3 flaxseed), EPA (omega 3 -fish oil), DHA (omega 3 fish oil, algae), GLA (omega 6-borage oil), EPO (black currant seed oils),  Oleic acid (flax and borage seed oil).
• Olive oil for salads and cooking (omega 9- oleic acid + other anti-inflammatory/anti-cancer phytonutrients).
• Improves diabetic neuropathy, respiratory distress, Chron's, lupus, RA, cardiovascular disease, eczema, migrains, depression, osteoporosis, musculoskeletal pain, MS.

PROBIOTICS for gut flora modifications:

• Good bacteria and yeast (probiotics), prebiotics (fiber, arabinogalactin, inulin), and fermented foods (kefir and yogurt if not allergic to milk).
• Advantages-restores the gut microbial balance.

Iodine and Iodide:

• 12mg/d is consistent with intake in countries like Japan
• Antioxidant, antimicrobial, mucolytic, immunosupportive, anti-estrogen and anti-cancer.

Balance- March Blog

Balance

   We all seek to achieve balance in our lives.  Excess tends to invite problems in many ways.  Excessive waste invites pollution, degradation of our environment and leads to things like a break down of the ecosystem.  Excessive intake of bad food can lead to a multitude of health problems:  diabetes, high cholesterol, heart disease, and many degenerative diseases.  Excessive cell production is of course cancer. 
   Achieving balance can be difficult.  We are inundated with opportunities to engage in excess:  fast food restaurants galore, fast cars, drugs and alcohol, and media overload.  Balance on the other hand requires discipline.  The ability to temper impulses and desires with what is healthy and safe, right and wrong, dark and light, etc.  This is much the ying yang concept of the orient.  In the health area, balance can be a very difficult challenge.  We are busy as a society:  rushing, rushing constantly.  It is far too easy to grab a fast food burger or a donut than to fix a healthy breakfast or prepare some fruit.
   Some thoughts on balance:

1. Take the time to find quiet.  Find or set up a special place in your house where you can just sit and have quiet with no interruptions, no phones or internet, no noise, and minimal light.
2. Breathe.  Learn to breath properly and practice breathing.  There are many types of breathing exercises available from yoga, chi qong, tai chi and martial arts that have rejuvenating abilities.
3. Clear the mind.  Practice prayer or meditation or whatever your method of getting in touch with the ethereal or energy of your spirit.  This is a good place to practice breath as well.  Learn to get all the noise that courses through our minds to be quiet.  One person said a long time ago that "all of mankind's ills come from the inability to sit quietly in a room and be alone."  Or something to that effect.
4. Practice relaxation.  Relax the mind, relax the body, relax the breath.  Let all the tension progressively release from your body.  You can lie or sit and start with an area of the body and relax it totally.  Then move to another area and work through the whole body.
5. Learn to make balanced decisions.  Help your body function best by choosing positive alternatives to fat, sugar laden fast food meals.

   Balance can also be addressed other ways in the body.  Often times musculoskeletal injuries are a result of imbalances in the function of muscles.  Over time muscle imbalances cause joints to break down and cause pain and dysfunction.   An example is low back pain caused by weak hip flexor muscles.  I find almost all the time in women with low back pain, for example, that either the major hip flexors or secondary hip flexors on one or both sides are weak.  The result is the body has to recruit other muscles to walk and perform normal activities.  Like a misaligned wheel on your car, over time your start having problems (breakdown) due to repetitive stress. 
   Muscular imbalances can be treated with the laser to restore the energy connections, unless there is severe nerve injury.  By fixing the connections further or future injuries can be prevented.  It allows balanced stressors and minimizes wear and tear.  Maintaining balanced muscle function is essential to an effectively functioning musculoskeletal and nervous systems.