San Diego Chiropractic Blog

Chronic pain is defined as pain that persists longer than 90 days beyond the course of the natural expected healing time. As a chiropractor in San Diego, I get calls from both new and established patients on a regular basis who complain of back pain, neck pain, etc. One of the factors that comes into play when planning a chiropractic treatment program is the duration of the patients pain. In general, the longer that a patient suffers with a painful condition, the longer / more intense the treatment is needed in order to fix it. Acute or recent episodes of pain respond much quicker than do chronic conditions.

Pain is very difficult to quantify by any practitioner. Pain is subjective in nature and completely defined by the person experiencing the symptoms, the fact that chronic pain can exist without an obvious cause makes it much more difficult to treat.

I see the difficulties that my chronic pain patients have with their conditions on a daily basis. Aside from the actual pain that they experience, those who suffer with chronic pain often limit their activities for fear of exacerbating their conditions. They also have a much harder time focussing on mental tasks as the pain is a constant source of distraction. The more severe the pain, the more difficulties these people have with attention demanding tasks.

While we strive to avoid pain, pain is a wonderful tool of the nervous system. Pain lets us know of actual or potential tissue damage with an unpleasant sensation that directs our attention to the affected area so that we can either immediately take action to stop the process or focus on healing the injured body parts. Chronic pain sensations are a bit more insidious.

Chronic pain often involves a decrease in the sensitivity of the nerve fibers that send messages of pain from the damaged area. With a decreased sensitivity (threshold), the nerve is much more likely to transmit painful sensations to the brain then a healthy nerve / tissue combination. This activity within the nervous system is know as a wind up phenomenon and it is very difficult to stop once it has been established. In some other cases, nerve fibers that normally don’t carry painful sensations not only begin to transmit pain signals but it is thought that they may actually generate the signals themselves.

In my office, chronic pain is often the result of untreated sprain / strain type injuries of the joints. In untreated or under-treated sprain / strain injuries, the joint or the muscles that move the joint are laden with scar tissue that acts to either limit or alter motion of that joint. With time, the awkward, unnatural bio-mechanics of the scar tissue laden joint results in irritation, inflammation and finally pain and spasm. While chiropractic care is often successful at re-establishing “clean” bio mechanics of a joint, it is always better to get the care in the beginning of an injury versus waiting for that injury to become chronic, with a requiring more care with a decreasing chance of complete recovery.

Because of the possibility of an acute painful condition becoming a chronic one, I always encourage my patients to take care of themselves immediately when they first start to experience pain. I have practiced chiropractic care for almost two decades now and I can say that chronic painful conditions of the spine are devastating. Not only do they make you experience pain, but in most instances they limit your physical activities creating a situation that can easily degrade from inactivity secondary to pain, to de-conditioning and eventually to obesity and ill health in general leading to a dissatisfying lifestyle.

The bottom line on chronic pain is this - avoid it if you can. Don’t ignore your pain. Painful acute conditions that are left untreated can easily spiral into a chronic condition that has the potential to alter your lifestyle in a negative way.

Your’s In Good Health

Dr. Jones San Diego Chiropractor

www.JonesPainRelief.com

Is Chiropractic Care Addictive? I am asked this question on a regular basis.

There are many people who are under the impression that once you begin chiropractic treatment you have to keep going - almost like something bad is going to happen to you if you stop your care.

I understand how some people would come to think that chiropractic care could be addictive, after all, almost all medications that people get from their medical doctors for pain is addictive. I suppose that if you are in pain, are concerned about the addictive nature of the medications that you have taken in the past, and are going to the chiropractic for the first time that you may think that chiropractic care for pain may be addictive as well.

I can assure you that chiropractic care is not addictive but feeling good can be as powerful as an addiction. There are certain people that are more “in tune” with their bodies than others. Restrictions in joint motion and flexibility typically occur slowly over time and are not normally perceptible. Once these people start care they experience full, free range of motion of their joints without neck pain, back pain or headaches - and they like it. After formal care ends, a percentage of these people notice when their joints begin to lose their range of motion. Since they felt better under chiropractic treatment, they like to continue their care simply to feel better.

This is about as addictive as chiropractic care can be. It is really no different from those who exercise and / or diet and feel better and therefore continue with their plan.

In closing, you can receive chiropractic care with no fear of developing a physical or physiological dependency on the treatment. Most chiropractors, myself included, know that chiropractic care is of great benefit to the health of your spine. Keeping your spine well adjusted is akin to keeping your teeth brushed and flossed - but it is not addictive.

Your’s In Good Health

Dr. Jones San Diego Chiropractor

www.JonesPainRelief.com

Many problems with the neck and upper back affect the shoulder and visa versa. There is a good reason for why this happens and I will use this post to explain it.

There is that old saying regarding the human body that goes something like “everything is connected”, of course in this instance we are talking about anatomy - specifically a kinematic chain.

In a kinematic chain, the function / health of adjacent joints are dependant on each other. A simple example of a breakdown among joints in a kinematic chain and the resulting consequences would be a person who sprains their ankle, limps on that ankle for several days and then develops knee pain secondary to the limp caused by the injured ankle. If the limping or gait impairment continues for any period of time, the irritation can involve the hip and eventually the low back. The ankle, knee, hip, sacroiliac joints and the joints of low back all form a kinematic chain.

In a similar yet more complicated arrangement, the vertebra of the cervical and thoracic spine are intertwined with the shoulder joints. The shoulder is made up of a series joints that allows for a tremendous amount of movement in a number of planes. Compared to the knee, for example, that only allows for about 120 degrees of flexion and very little rotation and translation, the shoulder is incredibly mobile. While, like the shoulder joint has ligaments and a joint capsule that tie the humorous to the scapula and the clavicle, the primary source of stability of the shoulder joint is the muscles, many of which attach into the cervical and thoracic vertebra.

Regarding the spine - in particular the cervical and thoracic spine - the joints found in the spinal column have considerably less motion than do most other joints in the body. That being said, the cervical spine displays the greatest amount of motion found in the spine while the thoracic spine is the most limited in its flexibility. Many of the big muscles of the neck and upper back insert onto the scapula and the clavicle links these two joint complexes together.

In many cases, shoulder pain or dysfunction can result in spasms of the larger muscles that help stabilize the shoulder - most of these muscles originate from the vertebra of the neck and upper back. The stress of this spasm can cause pain or dysfunction in the neck and upper back. Because of the shared muscles between the neck, upper back and shoulder girdle, the exact opposite scenario can occur with a primary spinal problem causing muscle spasms that have a negative effect on the shoulder.

Both the shoulder and the neck joints display complex, compound movements. Adjacent joint complexes like these that share major muscle groups make for an increased likelihood of pain / dysfunction spreading to include the second joint or in this case, joints.

Your’s In Good Health

Dr. Jones

www.JonesPainRelief.com

Migrain headaches are a common complaint in my San Diego Chiropractic Clinic. Researchers and medical professionals have developed many different theories regarding the cause of migrains.

Many chiropractors, my peers, believe that in some instances migrains are caused by misaligned vertebra that pinch certain nerves in the upper cervical portion of the spine. I see patients’ migrain headaches respond favorably to chiropractic care in my clinic on a regular basis. That being said, misalignments of the upper cervical vertebra don’t explain all cases of mirgain headaches because all of my patients don’t get better.

Other different theories about the cause of migraines include:

Vascular pressure changes in your brain; from initial blood vessel constriction and a drop in blood flow, followed by dilation and stretching of blood vessels, which activates pain-signaling neurons. These dialations and constrictions can include blood flow increases of up to 300%.

Changes in your serotonin levels; when levels drop, blood vessels including those in your brain become swollen and inflamed, which can lead to migraine pain.

Neurological disorders; related to nerve cell activity that crosses your brain, causing pain. In this case, it is thought that the release of neurotransmitters across the cortex of your brain can directly stimulate the trigeminal nerves found in your brain stem, setting off a chain reaction that ends in the pain signals of a migraine.

A nervous system disorder involving your brain stem. Your brain stem is your control center for alertness, perception of light, noise and smell, cerebral blood flow, cardiovascular function and pain sensitivity — many, if not most, of which are part of the symptoms of a migraine attack.

Typically a person who experiences migrains often can identify a “trigger” that they can point to as the culprit of their headaches. If you have migrains and have not attempted to identify your triggers you should. The following is list of some common migraine triggers.

Allergies: Including food allergies / sensitivities and chemical sensitivities.

Dehydration and / or hunger

Changes in sleeping patterns: Both missing sleep and oversleeping can trigger a migraine.

Stress: Emotional stress or trauma can trigger a migraine.

Physical exertion: Intense exercise has been known to bring on migraines.

Hormones: Some women experience migraines before, or during their periods, during pregnancy, or during menopause.

Other factors: Bright lights, fluorescent lights, loud noises and strong smells (even pleasant ones) can trigger a migraine. Weather changes, seasonal changes, and changes in altitude can also act as a trigger for a migraine.

All of the above causes of migraines are significant and some are downright scary. New research studies, however, point to a few potential cures of migraines that just may work for you. A recent study found that vitamin supplementation of vitamin B6, B12 and folic acid has the potential to reduce the frequency and severity of migrains.

Recent studies have also found that 42% of those suffering from migraine headaches are also suffering from a vitamin D deficiency.

It follows that supplimentation of B6, B12, folic acid and vitamin D may provide significant migraine relief for a portion of you reading this post.

Your’s In Good Health

Dr. Jones

Personal Injury Doctor San Diego

Have you ever noticed how tight your neck, upper back and shoulders are after a long day of sitting at the computer?

There are a number of factors that contribute to this tightness. Simply the stress of deadlines, an overbearing boss or an annoying co-worker can make your shoulders rise up and your head push forward. And this stress is the result of just the emotional stress of work. When you add the real physical strains of a poorly designed work station on top of the emotional stresses that already exist you have a perfect recipe for a repetitive stress injury.

A large part of designing an ergonomically friendly workstation revolves around limiting the “reach” for items that are frequently accessed.

The distance that you have to reach for any object in your workspace can have major implications on your health. In general, workers should have the items that they use on a regular basis through the day such as the mouse and keyboard for computer users or the telephone for a receptionist or a sales person, positioned close to their bodies so as to avoid awkward or overreaching.

As a general rule, the best positioning for your keyboard and mouse allows you to operate them while your shoulders hang straight down at your sides and elbows are slightly extended. This position reduces the stress of overreaching and allows for completion of your tasks with less muscular effort.

There are many ergonomic apparatus that allow for proper placement of your computer input devices. Pull out keyboard trays, split keyboards, mouse platforms and even foot controls help reduce the ongoing stresses of computer input.

Even with these devices, it takes awareness to maintain an ergonomically friendly work environment.

For a nice selection of high quality ergonomic office products you can visit www.comfortkeyboard.com.

Your’s In Good Health

Dr. Jones

www.JonesPainRelief.com

Why do I have back pain?

Being a chiropractor in San Diego, I hear this question all the time. Back pain and neck pain are the two most common complaints that my patients experience. The fact that my practice is in San Diego probably decreases the frequency of these complaints compared to what doctors in other parts of the country deal with. People in San Diego tend to be more active which actually lowers the incidence of low back and neck pain.

Over fifteen years ago when I first started practicing chiropractic care in San Diego, most of my low back pain patients and neck pain patients for that matter were not related to office work. Most of the cases that I had when I first started practicing were do to injuries like car accidents and falls or heavy work.

In the mid to late nineteen nineties, I started to see a trend in injury mechanisms among my patients. They were starting to attribute their pain to long hours of sitting at the computer.

Sitting all day at the computer not only causes back pain but it also causes neck pain, headaches, carpal tunnel syndrome, pinched nerves and various arm problems.

Lower back pain is primarily due to poor sitting posture. When we are standing up with good posture, our lower backs have a sweeping forward bowing curve that resembles a stretched out letter “c”. This shape distributes our bodies weight evenly throughout the spine. When we sit, this curve reverses, greatly increasing the stress on the joints and discs in the spine.

With time, this postural stress results in irritation and inflammation resulting in pain and muscle spasms.

Once the low back has reached a point of pain and spasms, chiropractic care is necessary to relieve the pain, improve the biomechanics of the spine and relax the muscles.

In addition to chiropractic care for back pain, the patient must seek out an ergonomic chair and have it adjusted properly for their body. In many cases, I suggest a complete workstation analysis to help prevent future problems with other computer related stresses.

Your’s In Good Health

Dr. Jones

www.JonesPainRelief.com

Approximately 25% of all people injured in whiplash accidents never make a complete recovery. Residual problems such as headaches, neck pain, back pain, numbness and tingling sensations are common ongoing complaints.

My Chiropractic office in San Diego treats patients for whiplash injuries throughout the year. During the rainy season, however, these injuries are much more common.

Whiplash injuries primarily do damage to the soft tissues that move and support the spine. During the whiplash accident, muscles and ligaments are stretched and torn. Muscles and ligaments that are damaged by whiplash accidents go through a process that involves irritation, inflammation and scar tissue formation. Our bodies tend to over produce scar tissue which causes problems in the future. Excessive scar tissue formation causes restrictions in range of motion, impingement of nerves and pain with cold weather.

Because of the nature of this healing process, chiropractic treatment is especially effective in treating whiplash injuries. Scar tissue builds up in a disorganized web of fibers and often hampers the range of motion of the joints of the spine. Chiropractic adjustments improve range of motion by breaking down scar tissue that is not needed and would only serve to limit normal motions of the spine.

The spine is like any other mechanical structure in that the closer that it moves to the way it was designed to move the fewer problems you will encounter with it. For us, this means a reduced chance of experiencing the symptoms that I referred to in the opening paragraph of this post.

The bottom line is that residual symptoms are common after whiplash injuries and they can range from being a slight annoyance to a source of significant disability.

Chiropractic adjustments combined with therapies such as electrical muscle stimulation, hot packs and ultrasound are very effective in treating those suffering from whiplash injuries.

If you have been involved in an auto accident be sure to have your injuries evaluated and treated by a chiropractor. You will experience the immediate benefit of pain relief and the long range benefits of a healthy spine.

Here’s To Your Health

Dr. Jones

www.JonesPainRelief.com

In my San Diego Chiropractic clinic, I provide treatment for many types of injuries. Typical injuries that result in neck pain, back pain, chronic headaches, sciatica etc., include auto accidents, work related injuries, injuries caused by domestic chores and sometimes things as simple as sleeping in an awkward position.

Of these patients suffering from neck pain, back pain and other injuries, I would say that at least 50% of them ask, “what can I do for myself to make sure that this doesn’t happen again?” This question served as the inspiration for this article and I will address it in this post.

To begin with, neck pain and back pain are great motivators.

When people are in pain they take a proactive approach to their health. People often inquire about what kind of stretch or exercising that they can start right away. Unfortunately, this enthusiasm has to be placed on hold because the best thing that you can do while your injury is new is to apply ice packs to the injured area and rest.

Over my 15 plus years in practice I have seen a large percentage of enthusiastic patients ignore this advice and end up giving their conditions a major set back. The time to start exercising and stretching your back for most of us is when it is out of its acute stage of pain.

My biggest struggles in practice have been dealing with my patients exercise and diet habits. Exercise is one of the few things that a patient can do at home, outside of chiropractic care, to help prevent or diminish the chances of developing back pain.

After an injury, you should approach exercise cautiously - almost to a point where the exercise that you are performing feels like it is doing nothing. If you can get through a few low intensity exercise sessions like this without aggravating your condition, you should slowly add resistance, time or distance allowing you to build confidence and strength at the same time.

You have to remember to incorporate a sensible approach to exercising after a back injury. Be sure to exercise and stretch under the advise of a health care professional. Strong and flexible muscles add strength and support to your spine and will provide much needed stability.

I have always tried to help the patients of my San Diego Chiropractic office with their neck pain and back with stretches and exercises. The combination of chiropractic care with stretches and exercise allows for quicker, more complete healing.

Your’s In Good Health

Dr. Jones

www.JonesPainRelief.com

Do you pay attention to your nutritional intake?

While most of us think that what we eat and the supplements that we take are important, most of us are hit and miss at best. I know that personally I have to dig deep within myself to avoid fattening and sugary foods. I also have to keep my supplements in plain sight or I will forget to take them.

Supplements are important for those who suffer from neck pain, back pain or any other type of joint pain. They are especially important for those who are recovering from injuries such as car accidents, work injuries and sports injuries. Nutritional support for injured muscles and ligaments is important during the various healing stages.

The following recommendations cover nutritional support for bone and joint health as it relates to sprain / strain injuries. That being said, these recommendations will also help you maintain your spinal health.

Nutritional support is a valuable asset to your chiropractic care.

The following supplements are considered very important.

Chondroitin Sulfate: 500 - 1000 mg daily - Nutritional support for strengthening joints, ligaments and tendons

Glucosamine Sulfate: Take as directed. - Very important for the formation of bone, tendons, ligaments, cartilage and synovial (joint) fluid

MSM: 500 - 1000 mg 3 X daily - This is a sulfer compound that reduces pain and inflammation. MSM is also important for joint and tissue repair

Calcium: 1500 - 2000 mg daily - Needed for repair of connective tissue. You should use two forms of calcium - calcium chelate and calcium gluconate. Very important for skeletal strength (especially for women but men should supplement as well.)

Magnesium: 750 - 1000 mg daily - Works in conjunction with calcium

Essential Fatty Acids: Take as directed - Promotes cardiovascular and cellular health.

Grape Seed Extract: Take as directed - A powerful anti-inflammatory

Manganese: 15 mg daily - Strengthens wounded ligaments and tendons

Your’s In Good Health

Dr. Jones

www.JonesPainRelief.com

My Chiropractic office in San Diego, California provides treatment for many patients who complain of lower back pain that is accompanied by leg pain. The term for this leg pain is sciatica and it implies that the leg pain is due to a compression of the sciatic nerve.

More often than not, sciatica is due to compression of the nerve at the point where it exits the spine. The typical scenario is that one of the five joints in the lower part of the spine will become misaligned, irritated and inflamed, putting pressure on the sciatic nerve and causing leg pain.

Because so many cases of sciatic pain are caused by spinal misalignments, in many cases this condition is effectively treated with chiropractic care.

Chiropractic treatment for sciatica can involve spinal adjustments, hot packs, ice packs, electrical muscle stimulation, ultrasound, traction and specific stretches / exercises. Typically, chiropractic treatment for this condition requires a course of care rather than a single visit.

Although many cases of sciatica are due to simple spinal misalignments, there are other causes of this condition that must be examined. Some of the other leading causes of sciatic pain are as follows.

1) Bulging Disc: A bulging disc is also known as a slipped disc. This means the gel-like center of the disc bulges up against the nerve root. Disc bulges can cause pain, numbness, tingling, and muscle weakness. Typically, disc bulges generate pain with sitting, bending and twisting motions.

2) Lumbar Spinal Stenosis: Spinal stenosis is a type of nerve compression that most often affects older people. Leg pain similar to sciatica can occur as a result of lumbar spinal stenosis. The pain is usually brought on by activities such as standing or walking and relieved by sitting down.

3) Spondylolisthesis: Spondylolisthesis is a disorder that is characterized by one vertebra slipping forward over the vertebra below it. When the vertebra slips and becomes displaced, spinal nerve root compression occurs and often causes sciatic leg pain. Spondylolisthesis has many possible origins including developmental (found at birth, develops during childhood) or acquired as a result of degeneration, trauma or physical stress.

4) Trauma: Sciatica can result from nerve compression caused by external forces from such things as motor vehicle accidents, falls, work injuries and sports injuries.

5) Piriformis Syndrome: Piriformis syndrome derives its name from the piriformis muscle and the pain that arises when the muscle irritates the sciatic nerve. The sciatic nerve runs beneath the piriformis muscle and develops pain when muscle spasms develop compressing the sciatic nerve. It may be difficult to diagnose and treat due to the lack of x-ray or MRI findings.

6) Spinal Tumors: Tumors are abnormal growths that are either benign or cancerous. Fortunately, spinal tumors are rare. When a tumor develops in the lower back, there is a possibility for sciatica to develop as a result of nerve compression.

More Coming Soon

Dr. Jones

www.JonesPainRelief.com