The Four Phases of the Whiplash Injury

Whiplash injuries are not confined to auto accidents and often occur during a slip, fall or while playing sport. However, we’ll look at what typically occurs in an auto accident, which is the most common and most severe cause of whiplash.

As a vehicle hits the rear of your car, your body goes through an extremely quick and violent acceleration and deceleration, and all four of the phases described below happen in less than half a second. Each phase involves a different force acting upon your body, which contributes to the overall injury, bringing vertebrae, nerves, discs, muscles, and ligaments into the fold.

• Phase 1: Your car is shunted at great speed from underneath you. Your mid-back is flattened against the back of the seat, creating an upward force in your neck, which compresses your discs and joints. As your momentum continues forward with the car, your head flies backward, and this whips violently at your neck. Only a well-adjusted head rest can help minimize the damage this causes, lessening the backward travel of your head. However, the majority of damage to the spine will already have occurred before your head hits the head rest, as studies show that head rests only reduce injury by 11% to 20%.
• Phase 2: Your torso reaches its peak forward acceleration at twice the speed of the impacting vehicle, while your head continues moving backwards. Your neck goes through an abnormal S-curve as your seat back springs your torso forward. This moment causes extreme compressive forces on the neck and significant damage to bone, joint, nerve, and discs.
• Phase 3: Your torso is now settling back down in your seat, and your head and neck are both accelerating forward at their peak speed. This happens as the car is slowing anyway, but this deceleration is aided by your foot planting itself firmly on the brake pedal after possibly lifting off at the moment of impact. This sudden braking severely increases the flexion injury of your neck. Assuming a seat belt is being worn, it now takes the strain of your forward movement.
• Phase 4: The most damaging part of the whiplash sequence now occurs. The seat belt stops your torso but your head continues forward. The neck bends violently forward, straining muscles and ligaments, tearing fibers in the spinal discs, and forcing vertebrae beyond their normal movement. Your spinal cord and nerve roots are stretched and damaged, and your brain hits your skull, potentially causing mild to moderate brain injury. Where a seat belt has not been used, your head is free to move forward and strike the steering wheel, dash or windshield, causing even more severe brain injuries.

Injuries from Whiplash Trauma

There are so many variables involved in how an accident occurs, as there are with the individual victim, so it is impossible to predict them all. Injuries are sometimes felt immediately or within an hour of the accident but more often due to the immediate shock, which causes the body to release endorphins and adrenaline, the true symptoms surface weeks or even months later. Generally, though, there is an array of conditions that are often seen following a whiplash:

• Neck Pain: the single most common complaint as reported by over 90% of people. Pain often radiates into the shoulders, between the shoulder blades, and into the head. All the tissues in the neck tend to be affected by whiplash, including the muscles, ligaments and nerves, and the facet joints and discs between the vertebrae.
• Headaches: following neck pain this is the second most common complaint, affecting over 80% of sufferers. Although headaches occasionally result from direct brain injury, most are triggered by injured muscles, ligaments and facet joints in the cervical spine, referring pain into the head. It is therefore vital to treat the supporting structures of your neck in order to combat headaches.
• TMJ: Temporomandibular Joint Dysfunction (TMJ) is a less common disorder that follows whiplash, but can be debilitating if it occurs. TMJ manifests as pain, clicking and popping noises in the jaw when moved. Untreated, TMJ can worsen and cause headaches, facial pain, ear pain and difficulty eating. This is a condition for which chiropractors are specially trained, or you may be referred to a TMJ specialist depending on the severity.
• Brain Injury: Mild to moderate brain injury is fairly common after whiplash, due to the movements as described in the four phases. The brain is very soft and suspended in cerebrospinal fluid, so that when the brain is jolted within the skull, it can be bruised or bleed. Whiplash victims may temporarily lose consciousness or have mild concussion, but more common is a feeling of mild confusion or disorientation following the crash. Long term effects include mild confusion, difficulty concentrating, sleep disturbances, irritability, forgetfulness, loss of sex drive, emotional upset and depression. In certain cases, the nerves that feed your senses of smell, taste and even sight may be affected.
• Dizziness: following a whiplash this is usually temporary and can improve with chiropractic care. It is the result of injury to the facet joints of the cervical spine, but in some cases it may be due to damage to the brain or brain stem.
• Low back Pain: Despite the neck bearing the brunt of the damage, your low back can also be easily injured by whiplash, and this is reported by over 50% of those involved in rear impact collisions, and in nearly 75% of those in side impact accidents. Although the low back does not suffer the same extent of flexion-extension injury as the neck, it still experiences a great compression during the first two phases of the whiplash process.

Recovery from Whiplash

Mild whiplash injuries treated correctly usually heal within six to nine months. However, 20% of victims will still be suffering pain, weakness or restricted movement two years after their accident, and it is likely that some degree of disability or pain will afflict theses people for many years more, if not for life.

Whiplash injuries need to be treated by specially trained professionals who know and understand the condition. The most effective treatment combines chiropractic care with rehabilitation of the soft tissues, and a self-care routine.

Chiropractic Care

Chiropractic care involves the manual manipulation of the spine to restore normal movement and position to the vertebrae. This is the most important and effective treatment to ensure that whiplash damage is minimized. Your chiropractor may also use trigger point therapy, massage therapy, exercise rehabilitation, and other soft tissue rehabilitation treatments.

Soft Tissue Rehabilitation

‘Soft tissue’ refers to anything in the body that’s not bone, so that includes muscles, ligaments, tendons, nervous system, spinal discs and internal organs. It is these soft tissues that are damaged most by whiplash, with the muscles, ligaments and discs taking the majority of the impact. Unless the correct therapies are used to stimulate healing, the result may be permanent impairment and disability. Treatments include trigger point therapy, massage therapy, electro-stimulation, stretching, and specific exercises to boost strength and range-of-motion.

Home Care

How you behave outside the chiropractor’s office will significantly enhance or detract from the treatment given inside it. Your daily home and work routines must be guided by your recovery plan, so that the treatment sessions have maximum benefit. You should: apply ice packs, carefully limit daily activities, stretch, exercise, supplement nutritionally, and get plenty of rest.

Medical Intervention

Severe whiplash may require the input of a physician to complement your overall treatment. This may mean anti-inflammatory medications, muscle relaxants, trigger point injections, or even epidural spinal injections. The point of these is short-term pain relief; they are not intended as curative or long-term options. No drug will restore normal joint movement or stimulate muscle repair. Surgery may be necessary for a badly herniated discs, when a disc is impinging on the spinal cord, and in some cases with spinal fractures.

Are You Suffering from a Whiplash Injury?

Whether you have recently been involved in an auto accident, or if you had one several months or years ago and whether or not the symptoms are now starting to show up or not, in any case the sooner that you have your spine fully evaluated and begin a course of treatment the better your chances are for a maximum recovery. Be sure to provide as much detail about your injuries as possible to help your Chiropractor fully understand your condition.

Consider that your spinal cord runs down a space in the centre of the vertebrae, which protects it from harm. Along large bundles of nerves running out from between each pair of vertebrae, nerve impulses are sent to every part of the body. From your cervical vertebrae, impulses are sent to your arms, and some into your upper back. Thus pain in your arm, such as numbness, tingling, cold, aching, or “pins and needles”, may be referred from the neck. People with neck problems may mistake their pain for carpal tunnel syndrome, a condition in the hands that is often caused by repeating the same repetitive motions for long periods.

Neck problems can also lead to headaches, muscle spasms in the shoulders and upper back, ringing in the ears (tinnitus), inflammation in the middle ear (otitis media), temporomandibular joint dysfunction (TMJ), or simply a restricted range of motion and severe tightness in the neck and upper back. Issues from the neck can show up in the upper back because many neck muscles originate there, including the trapezius, the levator scapulae, the cervical paraspinal muscles and the scalenes.

Causes of neck and upper back pain

Most times, neck and upper back pain is the result of not just one factor. Injury may be combined with poor posture, subluxations (misaligned spinal vertebrae), mental stress, or disc problems.

Injuries: Easily the most common injury to the neck is whiplash, the sudden, violent whipping motion of the head in an accident. It is most often associated with a car accidents, but it can happen when playing sport, or any other time the head suffers this particular whipping trauma. When this happens, the supporting muscles, ligaments and other connective tissues in the neck and upper back are damaged, but the full effects of this may not be felt for weeks or even months. This is why anyone who suspects they may have suffered whiplash should be extremely careful not to aggravate it, even if they feel no immediate ill-effects. An assessment should be sought from a chiropractor, in case treatment is needed to minimize the effects and guard against possibly permanent damage. 50% of whiplash victims in one study were shown to still be suffering the effects of the injury many years after settling their insurance claims.

Poor Posture: Poor posture is one of the most common causes of neck pain, and can also cause headaches. Unlike sudden injuries, which we usually know have happened, bad posture occurs over time and is something we soon begin to feel as normal. Everyday activities such as reading in bed can create issues and pain later on, and anyone working on a computer for extended periods is certainly susceptible to developing a forward head posture (FHP) and spinal subluxations. The rule is to keep your neck in a neutral position if possible. Avoid craning or hunching the neck, or remaining in the same position for too long. If this is unavoidable, try to practice correct posture to minimize any problems. Ideally, the head should be kept in a neutral position, back supported, knees slightly lower than your hips, and arms supported.

Subluxations: These are extremely common in the neck and upper back area, thanks to the weight of your head resting on such an unstable part of your spine. The majority of subluxations are centered around four areas:

• The top of the cervical spine where it meets the skull
• The middle of the cervical spine which supports the greatest weight of the head
• The transition between the cervical and thoracic areas of the spine
• The middle of the thoracic spine which supports the greatest weight of the upper body

You can check for signs of subluxation yourself. Look in the mirror and see if your head is tilted or if one shoulder rides higher than the other. Does one sleeve appear shorter than the other; does a necklace hang off-center? Ask someone to look from the side and see if your head sits noticeably forward from your shoulders (the aforementioned FHP). Subluxations need to be corrected as soon as possible. Over time, they stress the body, throwing all sorts of problems into areas that are then forced to compensate until everything is out of kilter and pain results.

Stress: Mental and emotional stress causes the muscles to tense, especially those in the back and neck. This “muscle guarding” is a primitive survival response to avoid injury in the face of danger, but it ends up causing injury when it happens for any length of time. If pinching the trapezius muscle causes you to wince, that is a sure sign your muscles are tight and trigger points almost certainly exist. Exercise and deep breathing/relaxation techniques are useful for combating stress.

Herniated Discs: A herniated or bulging disc will put pressure on the nerves that exit the spine through that area. Lumbar discs are more prone to herniating than cervical discs, but trauma such as whiplash can provoke a herniated cervical disc.

A consultation with your chiropractor should be scheduled if you are experiencing any pain in your neck or upper back that does not resolve very quickly.

For decades, osteoarthritis has been considered a part of aging. But not anymore. Recent research points out that older people don’t have to suffer from osteoarthritic pain. And, surprisingly, people much younger than 65 can develop osteoarthritis.

What Is Osteoarthritis?

Osteoarthritis (OA), or degenerative joint disease, affects more than 20 million Americans and is more common in women than in men. The disease affects the cartilage, which is a slippery tissue on the ends of bones that meet in a joint. Normally, cartilage helps bones glide over one another. In an OA patient, however, the cartilage is broken down and eventually wears away.

As a result, instead of gliding, bones rub against each other, causing pain, swelling, and loss of motion.¹ Although the majority of patients with OA are 65 and older, recent research shows that osteoarthritis is not a by-product of aging. Family history of OA, being overweight, lack of exercise, and prior joint injuries are suggested as OA risk factors.

How Is Osteoarthritis Diagnosed?

OA is diagnosed through a combination of clinical history, patient examination, and x-rays. Other tests, such as drawing fluid from the joint, are sometimes used.

The signs of OA include:

• Steady or intermittent joint pain
• Joint stiffness after sitting, sleeping, or otherwise not moving for a long time
• Swelling or tenderness in the joints
• A crunching feeling or the sound of bones rubbing against each other.

If you experience any of these signs, consult your health care provider. While the diagnosis is relatively easy to make, it is often harder to establish whether or not OA causes the patient’s symptoms. That’s why the treating doctor needs to not only make the diagnosis, but also rule out other disorders and conditions that can make the symptoms worse.¹ Timely diagnosis and treatment can help manage pain, improve function, and slow the degeneration.

Should Osteoarthritis Patients Exercise?

Exercise is one of the best forms of OA treatment and prevention. It strengthens the muscular support around the joints and improves and maintains joint mobility and function. In addition, exercise helps control weight and improves the patient’s mood and outlook, which are important factors influencing the severity of the symptoms.

If you suffer from OA, consider the following exercise tips:

• Low impact or non weight bearing activities, such as walking, stationary training, and light weight training work best for OA patients.
• Use strengthening exercises if the key muscle groups that relate to the function of the joints are weakened by the degeneration.
• If you are overweight, start exercising carefully, so as not to put too much stress on the knee and ankle joints.
• Stair climbing, water aerobics, Theraband workouts, and similar exercises will help to keep the joints mobile without straining them.
• Learn to read the body’s signals and know when to stop, slow down, or rest.

How Can Your Chiropractor Help?

Doctors of chiropractic, by the nature of their work, can detect the earliest degenerative changes in the joints. They see the impact of degenerative changes in the spine, as well as in the hips, knees, and other weight bearing joints. Doctors of chiropractic are also trained to relieve the pain and improve joint function through natural therapies, such as chiropractic manipulation, trigger-point therapy, or some massage techniques.

Doctors of chiropractic can provide exercise counseling, helping you choose exercises that are best for you. If a sore or swollen joint prevents you from exercising, talk to your doctor of chiropractic about other drug free pain relief options, such as applying heat or cold to the affected area. In addition, your doctor of chiropractic can help you choose proper supplements that play important roles in OA prevention and treatment.

References

1. Osteoarthritis: Handout on Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. July 2002.

The reason low back injuries are so prevalent is that this is a highly unstable part of the spine, much like the neck. Whereas the thoracic spine is supported and stabilized by the rib cage, the upper and lower spinal areas are on their own, so to speak. It is to our benefit in one way because it allows us greater flexibility to carry out more tasks, but it also makes us vulnerable to injury.

Having said that, provided the low back is cared for, it is able to offer immense support and withstand great forces. If that were not so, power lifters would not be able to do what they do, hoisting hundreds of pounds of weights off the floor. On the other hand, if your low back is weak or misaligned, even the lightest of movements can create problems.

The old approach to low back pain and injury was to let it heal on its own, as it was assumed this happened naturally. Recent research shows that this is not the case; it may ease for a while but often returns. This points to the importance of promptly attending to any low back pain through chiropractic care to prevent a recurrence.

Low back pain can result from many conditions, such as sprained ligaments, strained muscles, ruptured disks, myofascial pain (muscular trigger points), and inflamed joints. It can happen following an obviously traumatic incident such as during hard sport, or it can be triggered by something as simple as sneezing where a weakness existed previously. It may also be the result of conditions such as arthritis, bad posture, obesity, mental stress, kidney stones, kidney infections, blood clots or bone loss.

This great variety of causes means it is very important not to assume the reason for any low back pain you may be experiencing. Professional help should be sought to identify the problem, or to at least rule out anything more serious. Doctors of chiropractic are specially trained in assessing low back pain, and offering appropriate treatment.

Common Causes of Low-Back Pain

• Subluxations: This refers to disruptions in the normal movement or position of the vertebrae, resulting in often debilitating pain and inflammation. In the lumbar spine, it is the point between the lower spine and the sacrum that is most usually subluxated. Thankfully, chiropractic treatment can effectively remedy subluxations, reducing pain and inflammation, and this improvement is often instantly felt following treatment.
• Herniated Discs: It may surprise you that a herniated disc does not necessarily cause any discomfort in the low back. One study showed that half of those adults suffering from herniated or bulging discs did not even know it. However, a herniated disc can refer serious pain to other parts of the body, and they rarely recover to their previously perfect state. Chiropractic care is an effective way to retard this deterioration.
• Sprains, Strains and Spasms: Individuals who lead fairly sedentary lives during the week and then go a little crazy at the weekend are most prone to this kind of low back pain. Someone who perhaps has a game of soccer or a hard game of squash to blow out the cobwebs can end up overstressing themselves very quickly, suffering injuries that cause pain and inflammation.
• Stress: Mental stress causes your blood pressure and heart rate to rise, and stress hormones to flood your system. This leads to a tightening of the muscles, which are then more susceptible to injury. Ongoing muscular tension makes them weak, sore and full of trigger points, which are small concentrated knots that refer pain to other parts of the body, sometimes quite distant from the trigger point. Relaxation techniques, breathing exercises, and physical exercise are all important in combating stress.

Chiropractic Treatment of Low Back Pain

Low-back pain is bread and butter to a doctor of chiropractic, and usually treated with comparative ease. Adjustments are made to the lower lumbar vertebrae and pelvis, thus returning normal functioning to your bones and joints. Numerous studies have shown that chiropractic is the most effective treatment for low back pain, being cheaper to administer and producing far better long-term improvements. This is because it is only chiropractic that seeks to realign the spine and re-establish normal vertebral motion. Conventional treatments such as muscle relaxants, pain killers and bed rest do no more than temporarily mask the symptoms, and do not attend to or correct the root cause of the problem.

Stress has been called the spice of life, the common cold of the psyche, and even a socially acceptable form of mental illness. No doubt, stress can be beneficial for example, a deadline can help us focus and become more alert and efficient. Persistent or excessive stress, however, can undermine performance and make us vulnerable to health problems, from cancer and heart disease to substance abuse and obesity.

Stress is a physical and mental response to the difference between our expectations and our personal experience, real or imaginary. While reacting to stress, the body goes through alarm, resistance, and exhaustion. Released hormone epinephrine, or adrenaline, prepares the body for physical action (“fight or flight”) by increasing heart rate, blood pressure, and blood glucose levels. Then, the body releases glucocorticoid cortisol, or hydrocortisone, producing anti-inflammatory and immunosuppressing effects.

Consequences of Chronic Stress

Although occasional stress can be of benefit, too much stress is taxing on the body. Excessive levels of glucocorticoids can hinder growth, delay wound healing, and increase risk of infection. Chronic stressors or their constant anticipation can make us believe that we must always be on guard, leading to anxiety. Feelings of hopelessness or avoiding solving our problems can spark depression.

Past or present psychological distress can also lead to pain, particularly low back pain, which often comes with leg pain, headaches, sleep problems, anxiety, and depression. Stress may even be a more powerful pain generator than strenuous physical activity or repetitive motion. Research shows, for example, that pain in adolescents is associated with depression and stress, but not with computer use or physical activity.

Stress is highly individual and depends on our circumstances. For example, we react to stress better if we can vent our frustrations, feel in control, hope that things will change for the better, and get social support.

Gender also determines how we handle stress. Women are easily stressed by household problems, conflicts with people, or illness in people they know. Men get more significantly affected by job loss, legal problems, and work related issues. Men are also more likely to get depressed over divorce or separation and work problems. Depression in women, however, is more likely to spring from interpersonal conflicts or low social support, particularly from family.

Stress on the Job

The workplace has become a major stressor, contributing to the risk of hypertension and heart disease. Recent studies have shown, however, that what stresses us out is not so much the job demands, but our attitude toward them. For example, people who react with anger to their high job strain or who are worried about their chronic work overload have much higher morning corsisol levels. Lack of a sense of control over a job is also associated with higher blood pressure, especially in women and in people with higher socioeconomic status.

Stress Relief Is Important

No matter what stresses you out, consider taking active steps to change your attitude toward stress and to reduce stress in your life.

The following list will help guide you towards achieving a healthier, more vibrant body.

Regular Chiropractic Care

Chiropractic treatment is holistic, meaning it addresses your overall health. Vast amounts of research have shown chiropractic care to be one of the most effective treatments for back pain, neck pain, headaches, whiplash, sports injuries and sundry other musculoskeletal problems. It is also known to be beneficial to many other functions within the body, such as helping to lower high blood pressure, reducing the frequency of childhood ear infections (otitis media), and improving asthma.

Chiropractic is not just about relieving pain; it aims to restore the body to its natural state of optimal health. Various forms of treatment are used to this end, including manual adjustments, massage, trigger point therapy, exercise rehabilitation, coupled with advice on diet and lifestyle choices that impact your health. Left alone to work unimpeded, your body has an amazing ability to heal itself and maintain health, thus the chiropractor’s job is to remove the impediments to those good things taking place.

Ideally, chiropractic care should be an ongoing event in your life, much as regular exercise and healthy eating should be. The stresses of modern life, the little incidents and accidents that happen to us, daily wear and tear, mean that aches and pains are pretty much inevitable, unless steps are taken to minimize their effects. One of those steps is chiropractic care to ensure your joints last longer, you feel better, move with more freedom, and stay healthier and more active for as long as possible during your life.

Good Posture

Good posture is important because the further your posture deviates from what is correct, the more stressed your spine and back muscles become. This leads to stiffness and pain. Correct posture allows the spine to naturally take the strain as it was designed to do. Imagine carrying a bag in the normal way with your arm at your side. Then think how much extra burden you give yourself if you hold the bag out in front of you. Think of the muscles that then have to compensate to not only hold the bag, but also to rebalance the shift in your weight.

The Wall Posture Exercise is a good way to check your posture and understand how it should be. Rest back against a flat wall and bring your heels, shoulders and head backwards until they touch the wall. Sensing how this feels, step away from the wall and try to maintain that position for as long as possible throughout the day.

Less Stress

Stress is a major cause of bodily tension and its associated pain and problems. The list of things and events that can stress you is endless. Job, family, money, illness, lack of sleep, commuting, moving house, relationships, bereavement, divorce – anything that causes you to feel something is not as you would like it to be can cause you stress. If you think about that now, you’ll realize that’s an awfully long list.

Many people will not even realize that they are stressed if they’ve learned to live with the things that they don’t like in their life. You may also be stressed because of the things you fear might go wrong in your life. Many times, stress can be down to your perception of a situation, not how the situation actually is. Real or not, your body responds to stress by raising blood pressure, heart rate, respiration, metabolism, and the blood flow to your muscles. Over a sustained period of time, these effects and the release of stress hormones can be highly detrimental to your health.

Assuming you cannot eradicate every stressful situation from your life, you must learn to manage and mitigate it. Practice some relaxation techniques, breathe deeply, and get some exercise. Your body will thank you for it.

Watch Your Weight

There can’t be many people that don’t understand the importance of maintaining a sensible body weight to stave off such conditions as coronary heart disease, diabetes, high blood pressure, and colon cancer. Being overweight, however, can also be a big factor in the development of low back pain. This is because the spine is only designed to support a certain amount of body weight. Overly burdened by excess body weight, the spine becomes stressed and may end up suffering structural damage. Osteoporosis, osteoarthritis (OA), rheumatoid arthritis (RA), degenerative disc disease (DDD), spinal stenosis, and spondylolisthesis are all known to be significantly exacerbated by being overweight.

Being overweight also contributes to feelings of fatigue, as well as difficulty breathing and shortness of breath. When these symptoms lead you to avoid activity and exercise, then the situation is made worse because lack of exercise contributes to many types of back pain.

If you are overweight and suffer from low back pain, it is obviously in your interests to change things. Talk to your doctor about how best to lose weight in a safe and healthy manner to ensure lifelong weight control rather than the yo-yo effects of the latest fad diets.

Buy a Good Mattress

The positive benefits of sleep are often underestimated, but getting enough good quality sleep is essential for your overall health and quality of life. Sleep debt is costly for society in both fiscal and physical terms, therefore sleep must be a priority and not relegated to something we grab if and when we have the time. Back problems can be caused by not sleeping well, or made worse by it.

One key ingredient in having a good night’s sleep is a good mattress. The following advice will help you select the mattress that’s right for you:

• Choice of mattress is a highly personal matter that depends on the individual. What may be perfect for you may be terrible for someone else. There is no magic mattress that works for everyone with low back pain. What’s important is to find a mattress that helps you sleep without pain and that does not create problems for the next day
• Find a mattress with good back support to guard against low back pain. It should provide support while allowing the spine’s natural curves and alignment to be unaffected. Generally, a medium-firm mattress is usually better than a firm mattress.
• Don’t put off buying a new mattress if yours is obviously past its prime. A visible sag in the middle is a good indicator. Placing a board under the mattress is not a long-term fix, and may even cause more problems.
• “Orthopedic” or “medically-approved” mattresses should be taken with a pinch of salt. Extensive medical research or controlled clinical trials have not been carried out on the issue of mattresses and low back pain.

Wear Orthotics

Orthotics are special inserts for your shoes to keep your feet functioning properly. This is crucial because your feet are your foundations, supporting you when you stand, walk, or run. They serve to protect your spine, bones, and soft tissues from the damge that can be caused by moving around, and they can better do this when they are in stable and correct positions.

The foot has three arches that provide exceptional supportive strength, distributing the weight of the entire body across them. If one arch is compromised, the other two must take the extra strain, and the whole foot then starts to become affected.

Custom-designed orthotics stabilize and balance your feet, boosting your body’s performance and efficiency, reducing pain, and contributing to your overall wellness. You spend around two-thirds of your day in shoes, so it’s important to find inserts that provide optimal support.

Drink More Water

Water is your life source. Drinking enough water means you are helping your body remain healthy and function at its best. Most people do not drink enough water. The average person should be consuming around ten cups of water a day, or just over a half gallon.

Water accounts for 60% – 65% of your total weight, and is the most abundant nutrient in your body. It is also the least forgiving of your nutrients, in that you cannot go more than a couple of days without it. Water transports nutrients, oxygen and waste products around the body, it regulates your body temperature, and it is the medium in which all your body’s chemical reactions take place.

Drinking coffee, tea, juices and soft drinks is not a substitute for drinking enough water, because, along with the water they contain, they also contain products the body will need to eliminate, thus robbing you of water to do so. Any drink containing caffeine is even worse because it is diuretic, so you actually end up with a net loss of water from your body. Because the food and drink you consume will contain water, you do not need to drink a full half-gallon of water every day. Instead, a good guide is to get a 1.5 liter bottle of water and make sure you drink that each day, or two of those if you are exercising heavily.

More Fruits and Vegetables

Most people do not eat enough fruit and vegetables in their diet, despite the huge amount of public information telling them to do just that. Fast food and snack food has taken the place of fruit and vegetables, adding in dangerous amounts of salt, sugar, and bad fats. Some people may go weeks without consuming fruit or veg.

Fruits and vegetables have always figured highly in the evolution of the human body, and many of the compounds unique to plant foods are required by your body for it to function correctly. Reducing fast and processed foods and swapping in fruit and veg instead can make a huge difference to how you feel and function.

Less Sugar

A recent USDA study reported that the average American consumes 134 pounds of refined sugar every year; that’s 20 teaspoons a day. If that seems unbelievable, consider the following facts:

• A 12 oz. can of Pepsi contains 10 teaspoons of sugar
• A 2 oz. package of candy contains 11 teaspoons of sugar
• A 16 oz. cup of lemonade contains 13 teaspoons of sugar
• A cup of Frosted Flakes contains 4 teaspoons of sugar

This excessive consumption is desperately unhealthy, contributing to obesity, Type II diabetes, heart disease from elevated triglycerides, kidney stones, rotten teeth, chronic fatigue, and reactive hypoglycemia. The types of foods high in refined sugars include soft drinks, candy, cake and donuts, and many condiments. Check the labels when food-buying, and choose products sweetened with apple juice or stevia, rather than sugar or high-fructose corn syrup. The latter is also the most craved source of food for the cancer cells in your body.

Supplement with a Multivitamin

Some experts consider this is not necessary if you are getting sufficient quantities though a healthy, natural, raw food diet. However, it has to be considered that along with the good things we may be taking in, we are also exposed to far more toxins and pollutants in other foods and in our environment – all of which sap and tax our body’s supplies of vitamins. Our ancestors who did not supplement did not have to cope with these, or the constant electromagnetic field from power lines and cell phones around us. They were also less stressed and more active than we are today. As your body is under this bombardment day in, day out, it is a good idea to ensure that you have a good supply of defensive vitamins and nutrients.

Get Into the Light

One of the most important nutrients for your mind and body is sunlight. Many people don’t think in terms of sunlight being a nutrient, especially with the scaremongers telling you to avoid the sun or die of skin cancer, but it certainly is. Sunlight and the vitamin D it promotes in your body is necessary to regulate proper hormone function, calcium absorption, and bone health, as to keep your daily sleep-wake cycle (circadian rhythm) working well. If you suffer from a lack of sunlight, you are more likely to experience the following:

• Seasonal depression, known as Seasonal Affective Disorder (SAD)
• Disturbed, poor quality sleep
• Poor performance at work, especially in night-shift workers
• Disrupted melatonin regulation
• Reduced cortical brain activity
• Compromised immune system

Manmade light is not a substitute because it is not the full-spectrum light you get from the sun. Too little sunlight and too much artificial light is known to create problems with lack of concentration and lethargy. One study even showed that calcium absorption in the elderly fell away when too much time was spent indoors, and increased in those who spent time outside. This would have serious implications for bone strength and especially osteoporosis. Sunlight is also known to have a massive effect on mood, lowering stress and feelings of depression, and boosting feelings of happiness.

The following advice will help you increase your exposure to sunlight:

• Spend at least 15 minutes outside every day, even when it’s cloudy. Full-spectrum daylight is still available and is still beneficial.
• Use a special full-spectrum light box during the darker months to ensure a good dose of the right light, especially if you suffer from SAD.
• Only wear sunglasses in very bright light or to protect the eyes from flying objects such as sand or dust. Sunglasses create unnatural light for your eyes.

A Healthy Heart

Heart disease is the number-one killer of adults in America, and most deaths are preventable through changes to lifestyle choices. The key changes are: exercise, diet and body weight, not smoking, and vitamin supplementation.

Exercise is crucial not just for your neuromusculoskeletal system; it also hugely protects your heart health. Regular exercise makes your body far more able to assimilate oxygen, burn calories, and maintain normal blood pressure.

Diet and body weight are obvious factors in heart health. Carrying too much weight and eating the wrong foods can quickly lead to heart problems. Amazingly, it takes around one mile of additional blood vessels to supply just one pound of additional fat. That’s a huge extra burden on your heart, pushing your blood through all that extra tubing. Multiply that by 30, 40 or 50 pounds of additional fat, and you can imagine the stress placed on your heart.

Smoking is like living your life inside a burning house in the effects it has on your body. It degrades the collagen in your skin, causing premature wrinkling, destroys your lung cells, promotes heart disease, and causes cataracts and cancer because of the oxidizing effect of the free radicals released into your blood stream.

It can also worsen back pain by dehydrating the spinal discs. As bone is a living tissue that is dependent on your other body functions to stay healthy, an interruption to these other systems means bone is not able to rebuild itself. Bone formation is especially boosted by regular physical exercise and healthy hormonal activity, both of which are compromised by smoking.

Smoking decreases oxygen levels in the blood and increases the level of harmful substances, such as carbon monoxide. The nicotine from smoking causes the small blood vessels that feed your spinal discs to constrict, reducing their supply of nutrients. This results in your discs eventually becoming dehydrated, leading to degeneration. Smoking in perimenopausal or postmenopausal women is particularly risky as it increases estrogen loss, which can result in a loss of bone density and more chance of developing osteoporosis.

Vitamins E and C and folic acid are the most important supplements for a healthy heart. Vitamin E helps to prevent the cholesterol in your blood from becoming oxidized. This is the most dangerous aspect of high cholesterol in the blood. Vitamin C helps to strengthen the collagen tissues around artery walls, so they are less susceptible to tears. It also prevent cholesterol plaques developing inside the coronary arteries. The B-vitamin folic acid (also called folacin), reduces the homocysteine level in the blood. Homocysteine is a by-product of your metabolic process which can significantly hasten the onset of heart disease. You should ideally take at least 400 IU of vitamin E, at least 500 mg of vitamin C (preferably 1000mg), and 40 mcg of folic acid.

Does it hurt when you chew, open wide to yawn or use your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it?

If you answered “yes” to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.

Signs may include:

• Radiating pain in the face, neck, or shoulders;
• Limited movement or locking of the jaw;
• Painful clicking or grating when opening or closing the mouth;
• A significant change in the way the upper and lower teeth fit together;
• Headaches, earaches, dizziness, hearing problems and difficulty swallowing.

For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.

What Causes TMD?

Researchers agree that TMD falls into three categories:

• Myofascial pain: discomfort or pain in the muscles of the jaw, neck, and shoulders
• A dislocated jaw or displaced disc
• Degenerative joint disease, rheumatoid arthritis or osteoarthritis in the jaw joint.

Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD.

Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist’s chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, today’s dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment.  In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.

While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.

Some conditions once accepted as causes of TMD have been dismissed: moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes.

Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, posture and higher heels.

TMD Diagnosis and Treatment

To help diagnose or rule out TMD, your doctor of chiropractic (DC) may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the balance of the muscles. If you have no problems while doing these things, then the problem is not likely to be TMD. Your DC can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis.

If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, your doctor’s first goal is to relieve symptoms, particularly pain. If your doctor of chiropractic feels that you need special appliances or splints (with the exception of the “waterpack” and other guards against teeth grinding), he or she will refer you to a dentist or orthodontist for co-management.

In addition to treatment, your doctor of chiropractic can teach you how to:

• Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.
• Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (some hard candies are even called “jawbreakers” for good reason). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.

Perform TMD specific exercises. Depending on your condition, your DC may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.

Causes of Sciatica

Sciatica is a sign that something is putting undue pressure on a nerve in your lower back. Most usually, the nerve is being compressed by a bulging or herniated lumbar disc. Another cause is piriformis syndrome, which happens when the piriformis muscle lying directly over the sciatic nerve becomes tight or goes into spasm, putting pressure on the nerve. Men can occasionally suffer sciatica from sitting for too long on a wallet in their back pocket.

Pain pattern of sciatica

The classic sciatic pain is that which radiates from your lower spine to your buttock and down the back of your leg. This may be accompanied by numbness, tingling, and muscle weakness in the affected leg. The severity of the pain can vary from a mild ache, to a sharp burning, to excruciating discomfort. Sometimes, the pain may feel akin to an electric shock. Sciatic pain usually comes on gradually and worsens over time, and can be exacerbated by when you sit, cough or sneeze.

Treatment of sciatica

Sciatic pain can very often be relieved through a treatment combination that includes chiropractic care, stretching, and deep tissue massage (trigger point therapy) of the piriformis muscle. If the piriformis muscles are identified as the main culprits, the pain is chronic, and if the combined treatment of Chiropractic, stretching and deep tissue massage is not effective, then a trigger point injection may be recommended, whereby a small amount of anesthetic is injected directly into the muscle to help break the cycle of spasms, however this is considered extremely rare.

The most obvious signs of ADHD are:

• Inability to pay attention
• Hyperactive behavior
• Impulsive behavior
• Difficulty in concentrating

Between 3 and 5% of children in the United States (around 2 million kids) are thought to have ADHD, and more boys suffer than girls. That equates to at least one child in every class of 25 to 30 children, although many more are labeled as having ADHD who may simply be badly behaved. For this reason, proper diagnosis is recommended so that children are not needlessly treated and perhaps medicated for a condition they do not have.

Research is ongoing into the causes of ADHD, and current thinking suggests it is down to an overactive nervous system, combined with the brain’s failure to properly filter out unnecessary sights, sounds, thoughts and emotions. Chiropractors are not in the business of directly treating ADHD, but they are able to help rectify certain elements that may be stressing the nervous system, such as:

• Removing spinal subluxations that interfere with the nervous system
• Offering dietary advice to eliminate common trigger foods
• Testing for allergens that may stress the nervous system
• Suggesting ways to eliminate or reduce problem chemicals in the home

Conventional medicine tends to treat ADHD with a chemical called methylphenidate, commonly known as Ritalin. Although this is a stimulant that acts to speed up the nervous system, its net effect is to calm the sufferer, possibly because it activates the filtering out process in the brain. The problem is that Ritalin does nothing to cure ADHD; it only hides the symptoms. And when Ritalin is taken for an extended period, it can actually damage the brain’s proper functioning.

It is therefore important to look at less drastic options if your child has ADHD, and one of these is chiropractic treatment to de-stress the nervous system.

While there is a long list of other diseases that may cause bone loss, including certain cancers, hyperthyroidism, and malabsorption syndrome, it is the metabolic factors that define osteoporosis. These include the levels of calcium and vitamin D, and the activity of osteoblasts, which are the bone cells that produce bone matrix. Bone matrix is made up of organic components such as collagen, and inorganic materials such as phosphate and calcium. When we talk about bone loss, it is the bone matrix which is being described.

It is the weight bearing bones that are chiefly affected by osteoporosis – the pelvis, femur (thigh bone), and lumbar vertebras. Naturally, bone loss in these structures can lead to serious fractures with potentially devastating results.

Osteoporosis can be brought on by many conditions, circumstances, and deficiencies. The menopause is strongly linked to the condition, as are being over 50 years old, smoking, inadequate calcium, vitamin D, and dietary protein, and a lack of exercise.

Consistent weight bearing exercise is very important to strengthen the vulnerable bones and prevent loss of bone mass. Walking, running, cycling, and strength-training exercises all stimulate both your muscles and bones to build up stronger. This physiologic bone-building response is known as Wolff’s law, which says that bone remodels when physiologically stressed. In other words, mechanical challenges cause your bone to build more bone, producing stronger, denser bones that are much less likely to fracture.

Chiropractic Care for Osteoporosis

The spinal adjustments that a chiropractor makes directly impact the proper functioning of the nerve system. A misaligned spine will cause tight and inflamed spinal ligaments and muscles, and restricted mobility anywhere along the spine. This results in a poor flow of information between the nerve system and the rest of your body, which means that there is an increased likelihood of disease taking hold.

Regular chiropractic care, along with vigorous exercise and proper nutrition, will create the correct environment for your body to become as strong and resistant to osteoporosis as possible.