Friday, February 15, 2013

The Life You Want to Live

The Life You Want to Live

Chiropractic Care and Chronic Pain
Regular chiropractic care can provide substantial benefit for people with chronic pain. By focusing on the spine and nerve system, chiropractic care gets to the source of many chronic musculoskeletal problems including headache, neck pain, and back pain.
Chiropractic care helps restore more normal spinal mobility, which in turn helps restore more normal function in the nerve system. By removing sources of irritation to spinal nerve roots, chiropractic care helps reduce the impact of incoming pain signals. The result is often a reduction in the amount of pain a person is experiencing, and a lessening of the intensity of chronic pain patterns. As pain diminishes, muscles relax, improved circulation is reestablished, and oxygen and other vital nutrients are delivered to cells and tissues that need them the most. In this way, chiropractic care helps improve overall health.
We all want to get the most we can out of life. Whether we want to find a loving partner, work at a meaningful career, gather an abundance of financial resources, or have enough leisure time to pursue favored interests, the usual bottom line is that we want to be happy. Throughout thousands of years of history, the great philosophers have pointed to happiness as the worthwhile goal of all human activities. In the Nicomachean Ethics, Aristotle (384 B.C. - 322 B.C.) suggested that eudaimonia - happiness - is our best good.
Most of us would agree that the life we want to live involves achieving the greatest degree of happiness. Even if we haven't spent much time studying the works of Aristotle, we intuitively seek our greatest happiness. But such joy often escapes us, even at times when we think to ourselves that we ought to be happy. Various obstacles stand in our way, not the least of which is physical pain.
Physical pain can overshadow our various paths to personal happiness. We can tolerate acute pain for a while in the hope that it will go away soon, within a week or two at the most. But chronic pain is another matter. Often, extraordinary resources need to be utilized to maintain a positive attitude in the face of ongoing pain.

Many people experiencing chronic pain may find it difficult to imagine really living the life they want to live. Pain seems to influence everything. But there are many tools and techniques for diminishing the impact of chronic pain. The practice of yoga1,2 has consistently been shown to provide benefits, as has developing the habit of doing regular exercise3, such as walking or swimming. Engaging in enriching activities such as learning a new language, studying a musical instrument, and learning how to draw or paint with watercolors can shift one's focus away from pain and toward personal growth and development.

Also, chronic pain, at least that involving the musculoskeletal system, may benefit from chiropractic care. For example, chiropractic care can often help with chronic headaches, chronic neck pain, and chronic low back pain. For many people the benefit may be substantial. Your chiropractor is experienced in the care of many chronic conditions and will let you know whether chiropractic care is right for you.

1Michalson A, et al: Yoga for chronic neck pain: a pilot randomized controlled clinical trial. J Pain 13(11):1122-1130, 2012
2Tilbrook HE, et al: Yoga for chronic low back pain: a randomized trial. Ann Intern Med 155(9):569-578, 2011 
3Sullivan AB, et al: The role of exercise and types of exercise in the rehabilitation of chronic pain: specific or nonspecific benefits. Curr Pain Headache Rep 16(2):153-161, 2012

Monday, February 11, 2013

Film Producer Jeff Hays Facebook Status

From Jeff Hays, Producer of the independent film "The Doctored": 
Since many people are not is friend on facebook, I thought his post is worth wild at sharing! Please enjoy... 
- Dr. Jon Wise DC, CCWP

I had a minute (ok, an hour or two) on this flight back to SLC so I thought I'd type out my notes on Marcia Angell's talk that I attended on Thursday at Grand Rounds at the U of U Medical School. 

She is the former Chief Editor for the New England Journal of Medicine, a Senior Lecturer at Harvard Medical School. She wrote "The Truth about Drug Companies and how they deceive us" which was a NY Times best seller in 2010.

She made some great points, I want to use her in an upcoming film. These are just scattered notes that I made listening to her but some are great.

Here are my scattered, random notes:

An editorial posed the question, "Is academic medicine for sale?" the answer was "no, the current owner is quite happy."

Drug companies do not have "education" budgets they have marketing budgets. No 10K for any drug company lists an education budget, regardless of how they and their PR companies try to masquerade them as an educational organization.

Most clinical trials are funded by drug companies.

One positive trial is enough to approve a new drug, even is 10-15 other trials fail.

Until the 80's, drug companies gave grants to academic institutions. Grants were arms length. Now drug companies own the studies, and academics are hired hands. Many times in multi-location trials, the academics are not even allowed to see the data collected in their study. The drug companies alone decide whethere to publish or not. Now a new industry was formed, CRO's that competes with drug companies for these study dollars, further insuring compliance and complicity from academics.

At Harvard Medical School, NOTHING is absolutely prohibited as a conflict of interest.

2/3'rds of academic chairs receive department income from drug companies.

3/5's of academic chairs receive personal income from drug companies.

There is now very little innovative research coming from drug companies, most all is "me to" drugs that are already proven successful.

Industry is now dictating the research agenda, academics are having their agenda decided for them. Most all is targeted research on me too drugs, nothing on prevention or health.

Main cause of bias is squelched studies.

In a review of 70 studies of antidepressants, 37 of 38 studies were published. Of 33 of 36 negative studies were either not published or were rewritten to appear positive.

The FDA will not publish a negative study without the permission of the drug company.

In "me too" drugs, they don't run trials against existing drugs, but against placebos, for fear of underperforming existing, less expensive drugs. They will also run a trial testing against an existing drug but using half the effective dose. (She gave the example of this happening with Lipitor and Claritin.)

CME's have now approved drug companies to teach for continuing ed credit. The drug companies pay the institutions and even the doctors for this privilege. She says this is like a beer company teaching about alcoholism. It is marketing masquerading as education. Drug companies now own their own CME companies.

Because of all of this industry money, doctors learn to practice a very drug-intensive form of medicine. Dr's are led to believe that new drugs are superior to older drugs even though that is often false. Drug companies rarely compare their new drugs to older drugs at the proper dose, they compare to placebo.

The medical profession needs to wean itself from all of this industry money.

Disclosure does not resolve conflict of interest. "We're so drenched in market ideology that any resistance is considered Quixotic, and odd."

When she was at the NEJM, she could rarely publish a study in psychiatry, cardiology, or orthopedics because there was rarely a study in those fields without a conflict of interest that violated their rules.

Pfizer gave an $85 million gift to UCSF and now has their scientist in the lab working next to the academics.

Coming next is off-lable marketing of drugs, in ads direct to consumers. The Supreme Court has upheld this based on freedom of speech!

Now New Zealand no longer allows direct to consumer drug company ads; the US is now the only country in the world that allows this!

Big Pharma presents itself as high risk, when in fact there is none. They are on welfare big time.

The often close unprofitable plants because of problems with the plant. But there is never a problem with a plant where they make statins!

In her review of the FDA advisors who approved Vioxx, the majority of them were receiving income from drug companies that made cox 2 inhibitors.

Drug companies also name the generics, and they purposefully make them unpronounceable to direct people to the better-named brand drug version.

Wednesday, February 6, 2013



The effect of posture on health is becoming more evident. “Spinal pain,
headache, mood, blood pressure, pulse and lung capacity are among the
functions most easily influenced by posture. The corollary of those
observations is that many symptom5s, including pain, may be moderated or
eliminated by improved posture”.(1)
One of the most common postural problems is the forward head posture (FHP).
Since we live in a forward facing world, the repetitive use of computers, TV,
video games, trauma and even backpacks have forced the body to adapt to a
forward head posture. Repetitive movements in a certain direction will
strengthen nerve and muscle pathways to move that way more readily.(2),(3)
An example would be the adaptation of the body to do gymnastics easily after
repetitive practice. It is the repetition of forward head movements combined
with poor ergonomic postures and/or trauma that causes the body to adapt to
forward head posture.
Ideally, the head should sit directly on the neck and shoulders, like a golf ball sits on a tee. The
weight of the head is more like a bowling ball than a golf
ball, so holding it forward, out of alignment, puts a strain
on your neck and upper back muscles. The result can be
muscle fatigue and all to often an aching neck.(4) Because
the neck and shoulders have to carry this weight all day is
an isometric contraction, this causes neck muscles to loose
blood , get damaged, fatigue, strain, cause pain, burning
and fibromyalgia. When spinal tissues are subject to a
significant load for a sustained period of time, they deform
and undergo remodeling changes that could become
permanent. This is why it takes time to correct FHP. In
addition, FHP has been shown to flatten the normal neck
curve, resulting in disc compression, damage and early
arthritis.(5) This abnormal position is also responsible for
many tension headaches, often termed carcinogenic
FHP also causes tension in the TMJ (temperomandibular joint) or jaw joint, leading to pain,
headaches and bite problems. Some evidence exists that postural positions can affect the nerve
tissue by altering blood flow to the spinal cord.(6) People with uncorrected FHP can potentially
suffer chronic or unpleasant conditions such as, pinched nerves and blood vessels, like thoracic
outlet syndrome, muscle and tissue pain, syndromes like fibromyalgia, chronic strains and early
degeneration and arthritis.(7-14)
FHP is relatively easy to detect. Have the person you are checking look up at the ceiling,
down at the floor and then straight ahead. Find the center of the shoulder and draw an imaginary
“F.H.P. leads to long term muscle strain,
disc herniations, arthritis, and pinched
nerves” Mayo Clinic Health Letter
volume 18 #3, March 2000
line up. It should land through the middle of the ear’s hole
(external auditory meatus). Any forward head posture should be
immediately checked by a chiropractor. Medical doctors do no
fix these types of problems. “Despite considerable evidence that
posture affects physiology and function, the significant influence
of posture on health is not addressed by most physicians”.(1)
Remember, long standing postural problems like FHP will cause
spine and nerve damage and symptoms are rarely present early
Children are now using backpacks to carry school books weighing
up to an alarming 30-40 lbs! This forces the head forward to counter
balance the weight resulting in abnormal stress to the discs, joints
and nerves of the neck, shoulders and lower back.
Computer Ergonomics-
Positioning computer screens too low, coupled with the repetitive
motion of moving the head forward to read the screen is a primary
factor in FHP.
Video games/TVMost
kids use poor posture when playing video games and watching
TV. Repetitively sitting in one position for long periods of time
causes the body to adapt to this bad posture.
Falls and trauma can cause whiplash resulting in muscle imbalance.
This pulls the spine out of alignment forcing the head forward.
According to Renee Calliet, M.D., if the head weighs 10lbs and the
center of the ear sits directly over the center of the shoulder, the load
on the spine and its tissue is only 10lbs. However, if the head is translated forward, it’s weight
will increase by 10lbs for every inch forward it is. In effect, if the center of the ear is three
inches forward from the center of the center of the shoulders, the weight of the head on the spine
and its discs, joints and nerves is 30lbs.!(10)
1. The first step in correction is to be examined and x-rayed by a chiropractor to identify the
exact measurements of the FHP. Once that is established, a specific corrective care program for
FHP is given, including adjustments and specific exercises. The chiropractor will point out poor
ergonomics and situations that pre-dispose you to FHP and give you practical solutions.
2. For office use and video game play, place your computer
monitor height so the top third of the screen is even with your
eyes and the screen is 18” - 24” from your face. Support the
lower back. If children sit on the floor looking upward, have
them use a floor pillow armchair and sit up straight.
3. Every 20-30 minutes, sit up straight and pull the neck and head
back over the shoulders. Hold for a count of 3 and do 15-20 reps.
Alternatively, stand against a wall with a small pillow at your midback,
move your head back to touch the wall, hold for a count of 3
and do 20-25 reps.
4. Always use a back support pillow when sitting or driving. By supporting the low back, the
head and neck will move back over the shoulders.
5. At home, lay face down on the floor and extend your head and
shoulders up, while pinching your shoulder blades together. Hold for
a count of 3 and do 15-20 reps.
6. Backpacks - maximum backpack weight should be 15% of the
child’s weight. Never wear backpacks over one shoulder. Always
use a waist belt, and if available, a chest belt to neutralize the load.
Without these belts, the head will move forward to compensate for the load. A new type of
backpack with an air bladder has been shown to significantly reduce
weight without a strap.
Monitoring good posture is essential for optimum health.
With a little effort and a chiropractor on your health team, you can be
assured a future doing things you love to do rather than suffering
from damage and degeneration that poor posture can bring.

(1) John Lennon, BM, MM, C. Norman Shealy MD, Roger K. Cady MD, William Matta PhD,
Richard Cox PhD and William F. Simpson PhD
Postural and Respiratory Modulation of Autonomic Function, Pain & Health.
AJPM Vol 4. No 1 January 1994
(2) Restak R.M. 1979 The Brain: The Last Frontier NY Warner Books
(3) The Laws of Fasciculation Porland’s Medical Dictionary. Dorkonos
(4) Mayo Clinic Health Letter. March 2000, Vol 18 #3
(5) Gore DR, Sepic SB, Gardner GM. Roentgenographic findings of the cervical spine in asymptomatic
People. Spine 1986;6:591-694
(6) Adams CBT, Logue V. Studies in cervical spondylotic myelopathy part I: movements of the cervical
Roots, dura, and cord and their relation to the course of the extrathecal roots. Brain 1971;94:557-568
(7) -(14) Donatelli R, Wooden M. Orthopedic Physical Therapy New York: Churchill Livingstone Inc. ,
(8) Cailliet R. Low Back Pain Syndrome. Philadelphia: FA Davis Co.,1981
(9) Cailliet R. Neck and Arm Pain. Philadelphia: FA Davis Co., 1981
(10) Cailliet R. Soft Tissue Pain and Disability. Philadelphia: FA Davis Co.,1977
(11) Reilly B. Practical Strategies in Outpatient Medicine. Philadelphia: WB Saunders Co.,1984
(12) Lee D. Principals and practices of muscle energy and functional techniques. In: Grieve GP(ed.)
Modern Manual Therapy of the Vertebral Column. New York: Churchill Livingstone, 1986.
(13) Bourdillon JF, Day EA, Bookhout MR. Spinal Manipulation. Oxford: Butterworth-Heinemann, 1991
(14) Lewit K. Manipulative Therapy in Rehabilitation of the Locomotor System. Oxford: Butterworth
Heinemann, 1991.

So Please make your appointment to Evaluated your Forward Head Posture and find a solution to fixing it!
Dr. Jon Wise, DC, CCWP