Dr Davis' Back & Wrist Pain Blog

Cancer is rarely the cause of low back pain

San Francisco Chiropractor Comments:

We have helped thousands of patients with low back pain over the past 18 years at Executive Express Chiropractic in downtown San Francisco (formerly Front Street Chiropractic). Most of the time the low back pain is chronic or new and acute...and often times severe and debilitating.

Chronic back pain patients tend to respond almost immediately to chiropractic care which is nice. However, some patients with new (sudden onset) episodes of severe low back pain tend to be hard to manage right in the beginning. And some are concerned the low back pain might be something serious...like cancer. How concerned should they be? 

Here are some excerpts from an ABC News article entitled:  

A Relief? Lower Back Pain Unlikely to Mean Cancer

By Dr. Christopher G. Maher, from The George Institute of International Health in Sydney, who studied 1172 patients who came to general practitioners, physical therapists, or chiropractors with a new complaint of lower back pain.

"Many people worry that their back pain may be an indicator of something more serious," Maher noted in an email to Reuters Health. But among all 1,172 patients, only 11 cases were anything serious at all, and eight of those 11 were broken vertebrae.

Such fractures are serious, but are "not serious life-threatening diseases," Maher said. "There were no cases of cancer and no cases of infection."

My Take: Sure, we should be concerned and there are red flags that  helps doctors identify serious problems that may be causing low back pain...but my experience is that it's very rare (and research supports it).

Dr. Eben Davis is clinic director of Executive Express Chiropractic in downtown San Francisco. To schedule an appointment call 415-392-2225.

Herniated Lumbar Disc in San Francisco? Consider Nonsurgical Spinal Decompression with the DRX9000

San Francisco Herniated Disc Doctor Comments:

We have been helping patients with herniated lumbar discs in downtown San Francisco for about 18 years now at Executive Express Chiropractic (formerly Front Street Chiropractic). About 4 years ago we began to incorporate nonsurgical spinal decompression with the DRX9000 into our treatment regimen...and the results have been outstanding.

The DRX9000 is a very expensive machine (our machine cost around $150,000) that is designed and built to treat neurovascular compression syndromes such as herniated discs, lumbar disc bulges, lumbar stenosis, and facet syndromes.

The DRX9000 lumbar decompression system actually isolates on a specific spinal segment...say L5-S1 (the most common lumbar disc to herniate) and creates a pumping action on the disc which helps to flush toxins and waste products out and bring freshly oxygenated blood back in. The DRX9000 also elongates the spine which helps to break up fibrous adhesion's around the joint capsule and stretch injured muscles, tendons and ligaments, which were previously locked in place by the body as it tries to protect the injured area from further harm (this loss of motion leads to scar tissue).

Spinal Decompression of the lumbar spine with the DRX9000 is nothing at all like conventional spinal traction which can actually cause a herniated disc to become worse. The DRX9000 has a computer that is able to sense the natural, involuntary muscle guarding that occurs when a force is applied to the area of the injured disc (a protective mechanism). The computer senses the body's muscle guarding response and changes the amount of force in direct proportion to the muscle guarding at that moment in time...just like biofeedback.

So...the DRX9000 is able to work through the natural muscle guarding response, pump the disc and elongate the spine...promoting healing and regeneration. The DRX9000 also creates what's called a "negative pressure" inside the disc. Neurovascular compression syndromes by their very nature compress the disc and force the center of the disc (the nucleus) into the spinal canal or on to nerve roots (the primary source of pain and dysfunction)...not a good thing. The DRX9000 reverses this pressure allowing the nucleus to move back to the center of the disc (and off the spinal cord and nerves) where it belongs.

Does the DRX9000 help everyone that does it ? NO. Well...what is the success rate? It's very high...check out this Special Report on the DRX9000 that is a compilation of preliminary research done by the Mayo Clinic, John Hopkins University, and Duke University...very impressive.

In fact...it's rare that  a patient with a herniated lumbar disc does not respond favorably to the DRX9000 at our San Francisco Spinal Decompression Center (check out our DRX9000 success stories and videos).  Note: You first have to be qualified because not all herniated disc patients are good candidates for nonsurgical decompression.

If you live or work in San Francisco and would like to find out if you are a candidate for lumbar decompression with the DRX9000...call Executive Express Chiropractic 415-392-2225 or request an appointment online.

There are mental components to back pain

San Francisco Chiropractor Comments:

I just read an interesting article on www.medicalnewstoday.com about a study of Danish caregivers (which is very physically demanding) that shows the fear of potential back pain (especially in those with previous back pain) actually contributes to it. The article is entitled:

'Back-Breaking' Work Beliefs Contribute To Health Workers' Pain

Here is an excerpt:

Whether from heaving, twisting, bending or bad lifting postures, it's well known that caring for the sick or elderly can lead to back pain. This often results in time off work or dropping out of caring professions altogether. Now Danish research published in the online open access journal BMC Musculoskeletal Disorders suggests that the fear of getting back pain from care work is predictive of actually developing it.

My Take: There are physical, mental, and chemical factors to consider with back pain...especially chronic low back pain.  Often times the cause is a mystery...and addressing the mental component with specific (non-traditional) techniques that involve patient education and information may reduce the fear of getting back pain. This can be accomplished many ways...the study suggests questionnaires and counseling. Interesting stuff.

Dr. Eben Davis is clinic director of Executive Express Chiropractic in downtown San Francisco. To schedule an appointment call 415-392-2225. 

 

Chiropractic Care and Mesothelioma Pain Management

San Francisco Chiropractor Comments:

Mesothelioma is a rare type of cancer that typically affects the lining of the lungs, heart and abdomen. It is caused by asbestos exposure which occurs when fibers are inhaled or ingested into the body and become lodged in body cavities, causing inflammation or infection. The life expectancy for mesothelioma patients is generally reported as less than one year following diagnosis as the cancer is typically not diagnosed until it is in later stages and is less treatable.

Cancer patients have included chiropractic care in their course of treatment to help control pain and alleviate headaches, tension and stress. According to the American Chiropractic Association, chiropractic doctors “have a deep respect for the human body's ability to heal itself without the use of surgery or medication. These doctors devote careful attention to the biomechanics, structure and function of the spine, its effects on the musculoskeletal and neurological systems, and the role played by the proper function of these systems in the preservation and restoration of health. A doctor of chiropractic is one who is involved in the treatment and prevention of disease, as well as the promotion of public health, and a wellness approach to patient healthcare.”

Two studies were published in the Journal of Manipulative and Physiological Therapeutics in January of 2001 that examined the cases of two patients fighting cancer. A 57-year-old man diagnosed with terminal pancreatic cancer experienced significant pain relief and was able to reduce the amount of medication needed following chiropractic care. He also reported an increase in his quality of life following a visit to a chiropractor.

A 54-year-old man diagnosed with lung cancer (a cancer often related to asbestos exposure) began seeing a chiropractor after experiencing little pain relief one year after he underwent surgery to combat his cancer. The man experienced pain relief immediately after beginning chiropractic care and discontinued use of all pain medications after two visits to his chiropractor. The Journal noted, “These clinical examples offer two specific instances of how chiropractic may improve the quality of a cancer patient’s life.”

To find out if you are a candidate for chiropractic care at Executive Express Chiropractic in downtown San Francisco please call 415-392-2225 or request an appointment online.

It's Never Too Late To Start Exercising

San Francisco Chiropractor Comments:

I have been working out with weights (and aerobics) for over 30 years...and I plan to do it until they put me in the grave. In fact...I am convinced that my exercise program will keep me here on earth longer, while at the same time keeping me healthier and feeling better (and looking better too). I like to say that exercise adds years to your life and life to your years. And...it's never too late to start.

According to the latest research...as long as you are still here on earth (no matter how old you are)...even if you have never exercised before...you can extend the duration and quality of your life by exercising (walking) as little as 4 hours per week. And the 4 hours can be broken up into 15 minute intervals.

I found this information at www.Yahoo.com, and the article is entitled:

Exercise can extend survival even in 'oldest old' 

Here is an excerpt from the article:

Even in the "oldest old," a little physical activity goes a long way, extending life by at least a few years for people in their mid- to late 80s, Israeli researchers found.

The three-year survival ratewas about three times higher for active 85-year-olds compared with those who were inactive. Getting less than four hours of exercise weekly was considered inactive; more than that was active.

The results "clearly support the continued encouragement of physical activity, even among the oldest old. Indeed, it seems that it is never too late to start," the researchers wrote in Monday's Archives of Internal Medicine, which published the study.

My Take: There appears to be a clear link between longevity and exercise. I say we exercise as long as we are here. We will feel better and last longer...it just make sense. Life Is Motion.

Dr. Eben Davis is clinic director of Executive Express Chiropractic in downtown San Francisco. To schedule an appointment call 415-392-2225 or request an appointment online.

Is Chronic Back Pain Overtreated?

San Francisco Chiropractor Comments:

I recently became a featured blogger on the excellent medical information website www.medpedia.com. I joined the back pain community and came across a controversial article entitled:

Overtreating Chronic Back Pain: Time to Back Off?

Here is an excerpt from the peer reviewed article:

 

Chronic back pain is among the most common patient complaints. Its prevalence and impact have spawned a rapidly expanding range of tests and treatments. Some of these have become widely used for indications that are not well validated, leading to uncertainty about efficacy and safety, increasing complication rates, and marketing abuses. Recent studies document a 629% increase in Medicare expenditures for epidural steroid injections; a 423% increase in expenditures for opioids for back pain; a 307% increase in the number of lumbar magnetic resonance images among Medicare beneficiaries; and a 220% increase in spinal fusion surgery rates. The limited studies available suggest that these increases have not been accompanied by population-level improvements in patient outcomes or disability rates.

We suggest a need for a better understanding of the basic science of pain mechanisms, more rigorous and independent trials of many treatments, a stronger regulatory stance toward approval and post marketing surveillance of new drugs and devices for chronic pain, and a chronic disease model for managing chronic back pain. (J Am Board Fam Med 2009;22:62– 68.)

 

My Take: That paragraph above speaks for itself.

 

As back pain doctors, we need to spend more time and resources on educating people how to take better care of themselves, and emphasizing the connection between a healthy lifestyle and a healthy spine. The spine like any other part of the body will degenerate prematurely if exposed to an unhealthy context over an extended period of time.

 

Sure, there are spinal injuries and traumas that happen to people that have nothing to do with a healthy lifestyle...but this is the exception, not the rule.

 

Chronic back pain (in my opinion), just like obesity, heart disease, diabetes, and cancer, mostly arise from poor life style choices such as a bad diet, lack of exercise, not enough rest, poor posture, stress, drugs, alcohol and smoking.

 

When you have an unhealthy lifestyle you are prone spinal problems and all kinds of other health problems as well. And once you develop chronic back pain, poor lifestyle choices are like throwing gasoline on a fire. 

 

MRIs, x-rays, steroid injections, surgeries, and medications all serve a purpose...but the purpose does not address the cause of chronic back pain. And like one of the Medpedia.com medical physicians (contributors) wrote...try telling a chronic back pain patient that wants access to all that modern medicine has to offer, that they can't have an MRI or a steroid injection when they feel they are entitled to it.

 

The system is a mess and everybody knows it. And the answer is obvious too (healthy lifestyle and prevention) ...but just seems impossible to implement all at once on a grand scale.

 

So in the meantime, as a healthcare provider specializing in chronic back pain naturally, all I can do is make sure my patients understand that they steer themselves in the direction of health or illness with every lifestyle choice they make. But the thing is...not everyone knows what the good choices are...and that's our job...to teach and educate.  We do this with live seminars, one on one consultations, newsletters, and this blog...to whoever will listen...so we can sleep at night.

 

Hey, we understand that modern medicine is amazing and we need everything that is has to offer (it saved my life, more on that another time). But when it comes to preventing chronic back pain and life threatening illnesses in the first place nothing beats a healthy lifestyle. Health is our god given birth right and I believe that health is a spontaneous occurrence when the conditions are right. So why not spend at least some of our time teaching our patients these principles and limit drugs and surgeries to emergencies or as a last resort. Because just like the article says...surgical outcomes improve the less they are used.

It's just the smart and ethical thing to do.

 

Dr. Eben Davis is founder and clinic director of Executive Express Chiropractic in downtown San Francisco. To schedule an appointment call 415-392-2225 or request an appointment online. 

 

 

 

 

 

The NFL and Chiropractic

Well, the NFL season has kicked off and both our Bay Area teams looked solid.   There were also many injuries the first week in the NFL including Donavan McNabb, Anthony Gonzalaz, and Brian Urlacher to name a few. There is one thing that the NFL players don’t have to worry about (in this day in age when Health care is such a big topic of discussion) and that is getting the best quality health care available.  When the NFL players are competing at the highest intensity day in and day out, they need all the help they can get to stay at their peak performance level.  This not only makes fans happy, it makes owners, coaches, and players happy.  

What kind of treatment do these NFL players get?  All teams have a team doctor; all teams have a team trainer, and all have a team chiropractor. What does the chiropractor contribute to the players that allow them to reach their full potential?  Well, the answer is simple: Chiropractors help the player’s nervous systems function the best they possibly can.  Good health is directly proportional to the nervous system’s ability to communicate with all the cells, tissues, glands, and organs of your body, and the spine houses and protects the nervous system. Paradoxically...the same spine that protects your nervous system when it is in alignment...will offend and irritate it when it's out of alignment. Chiropractors call this condition a vertebral subluxation and it's what we treat.  If the spine is in proper alignment, and the joint is not stuck, then the spinal nerves will be able to exit without any interference.  If any segment in the player’s spine is subluxated then the chiropractor adjusts it back into place.  With all the hard hits and falls the players take, their spines are constantly getting subluxated. 

The adjustment is not the only treatment these NFL players receive from chiropractors. They also receive soft tissue work, but not just any soft tissue work…most receive the only patented soft tissue therapy in the world: Active Release Technique (A.R.T.).  In fact, the founder of A.R.T. is the Denver Bronco’s chiropractor.  A.R.T. restores the soft tissue back to normal by breaking up the adhesions that have developed through injury, allowing  the muscles contract and lengthen the way they are supposed to.

The diversity of relationships among the 32 NFL teams and their chiropractors has generated the formation of the Professional Football Chiropractic Society (PFCS). Their main goal is to provide consistency among constituents, as they take the best practices from each alliance and create a template to apply to chiropractors who work with other pro sports teams.  They meet each year at the NFL Scouting Combine in Indianapolis for their annual meeting.

Here is what some Hall of Fame players have to say about chiropractic:

“My first experience with chiropractic care was right before the 49ers were to play the Cincinnati Bengals in Super Bowl XXIII in 1987,” said Jerry Rice in the promotional video. “A couple of our key players were injured and a chiropractor turned things around. I quickly became a believer and ever since, I have had the benefit of chiropractic care.”“Football is a very rough and vigorous sport,” said Rice in the video. “Many of the pass patterns in a game — either long or short — required a maximum effort. I took some vicious hits from players nearly twice my size. [Rice is 6’2” and his playing weight was 200 pounds] Thankfully, I had the durability to withstand these tackles — or I would never have succeeded or lasted as long as I did. Chiropractic was the key to keeping me in the game.”

“Chiropractic's been a big part of my game. I only wish I had tried chiropractic care a few years sooner when I first started having back problems.” –Joe Montana

LaDainian Tomlinson called to ask Emmett Smith about his longevity, how he'd rushed for 1,000 yards for 10 straight seasons. Smith's advice? Massages on Monday and Friday and ''find a good chiropractor.''

Chiropractic is paramount not only to NFL players, but to the general public as well.

To schedule an appointment for NFL caliber chiropractic care or Active Release Techniques (ART), please call Executive Express Chiropractic at (415) 392-2225. Or request an appointment online.

Runners Knee: An Equinox Fitness Personal Training Tip

Is Your Knee Pain Runners Knee (Patellofemoral Pain Syndrome)?

Knee pain….many people have had knee pain at some point in their lives. There are many things that can cause knee pain, but few people realize that poor posture can actually be causing their knee pain. For example, the most common overuse injury to the knee is Patellofemoral Pain Syndrome (PFPS), which is simply a mistracking kneecap which causes irritation. Symptoms include pain behind or around the kneecap usually towards the center. There may also be pain at the back of the knee, a sense of cracking, or that the knee gives out.  Steps, hills, and uneven terrain can aggravate PFPS.

PFPS typically occurs in younger people, women, and runners, but anyone can develop PFPS symptoms if there is increased stress on the knees. Often times, the mistracking of the kneecap is caused by improper hip alignment in the ankles, hips, and/or low back, and isn’t even a direct problem with the actual knee joint. Correcting these other misalignment's often clears up the PFPS by allowing the kneecap to track properly.

Here are some specific exercises to help prevent Runners Knee.

Chiropractors can also help with runners knee. The doctors at Executive Express Chiropractic specialize in working on extremities and treating not only knees, but the entire body as a whole. Strengthening exercises and specific stretches, especially to the thigh muscles as well as proper alignment  can help prevent knee pain and PFPS.  The fitness trainers at Equinox fitness club can offer an array of exercises specifically designed to lessen and prevent knee pain (and other joint pain) from happening.

The doctors at Executive Express often work hand in hand with Equinox trainers to rehabilitate injuries and return patients back to normal.

Sean Barnes is a Tier 3 trainer at Equinox.  He is a NCSA Certified Strength and Conditioning Specialist. 

To schedule a consultation with Sean, please contact Equinox Fitness Club at (415) 291-6619 and ask for the Executive Express Chiropractic Special Offer.

 

Fall is in the Air by Jill Nussinow, The Veggie Queen™

As the weather changes (can you believe that we’ve already had our first rains?), your immune system requires a boost. Luckily, we have amazing produce here in the Bay Area at this time of year that can help in the process.

Both Vitamins A and C help keep your immune system running well. Most yellow-orange and red-fleshed vegetables and fruit such as sweet potatoes, ripe sweet and hot peppers, tomatoes and cantaloupe are good sources. So are greens, which is what I’ll be discussing today.

It’s funny but in the summer I eat lots of salads but  I hardly eat any greens as they don’t taste nearly as good as they do when they haven’t been kissed by summer’s heat which tends to make them bitter. In the winter when greens such as kale, collards, mustard and Swiss chard, have been touched by winter’s chill, they develop a sweetness, as a complement, to their slightly bitter quality that makes them all that much more delicious. In the shoulder season, which is now, they are quite tasty and abundant.

As you likely know, greens really cook down. In the South, no one would likely cook his or her greens for less than an hour, and certainly not without salt pork or a ham hock for flavoring. Well, that doesn’t work for me as a vegetarian so the following recipe combines two in-season foods to produce an easy-to-make but incredibly tasty dish that can be made in the winter with canned tomatoes. If you have some fresh red ripe bell peppers, feel free to cut them up and add them for even more flavor and great nutrition. If you add a cup or more of cooked white beans such as Cannellini or garbanzo, you have an almost complete meal.

If you really like greens, cook a couple of bunches at once. This dish makes great leftovers. I can often eat one bunch myself, and there’s no harm, only good, in doing so.

Another great immune system booster is mushrooms, which I will be discussing in-depth next month.

Greens Braised with Tomatoes and Thyme

Serves 4

I am always looking for new ways to cook greens to make them tasty and interesting. It seems almost impossible to eat too many of them.

6        cups chopped greens, such as kale, turnip, collards or your favorite

1 ½    cups peeled, seeded, chopped fresh or canned, diced tomatoes

½       cup red wine or vegetable stock

1        teaspoon Sucanat or agave syrup

3        cloves garlic, minced

1-2     sprigs fresh thyme

1        cinnamon stick

1-2     tablespoons fruity olive oil (optional)

¼-½   teaspoon salt (optional)

Freshly ground black pepper

Combine all ingredients in a nonreactive saucepan and simmer covered for 30 minutes. Uncover and cook another 15 minutes, or longer to reduce slightly if you prefer a thicker sauce.  Remove the cinnamon stick and thyme stems. Serve as a side dish or over whole wheat noodles, quinoa or other grain.

From The Veggie Queen: Vegetables Get the Royal Treatment by Jill Nussinow, MS, RD, The Veggie Queen™, http://www.theveggiequeen.com

Why do some people exercise hard every day and still gain weight?

San Francisco Vegan Chiropractor Comments:

I have friends, relatives and patients (and I see people in the gym) that exercise all the time...but they are always overweight...how could that be?

Well...I think if we were to ask 1000 people this question, the #1 answer would be poor diet. And you know what?...they would be right.

Hey, Michael Phelps would get fat eating some of the stuff I see people that I know eat that exercise frequently. The body is efficient...but the typical American Diet will cause us to blow-up...even with exercise...it just happens slower.

Sure...some people can eat more garbage than others...and there are genetics, and hormones, and glandular issues (usually salivary glands)...but for the most part YOU have complete control over your waistline. 

Lets put it this way...I have never personally known anyone that had a clean diet and exercised frequently that was overweight. I have known hundreds of people that claimed they had a clean diet, but then when I actually saw what they were eating I knew it was hogwash.

I hear stuff like "life is not worth living if I can't enjoy my food". Or..."you should see what so and so eats if you think this is bad". Or..."I eat really good I just can't lose weight"...then they load up their salad with blue cheese dressing and shower bacon bits and butter globs on their baked potato.

Hey...we have a knack for taking decent food and turning it into calorie packed fat fuel.

Then, there are all the magic bullet pills and potions that give you the missing ingredients so your body can metabolize fat and shred it in the gut before it goes into your cells...please.

My secret...and I eat more than anyone I know...and I don't ever count calories...is to eat the right foods. Foods that will fill you up and have just the right amount of protein, carbohydrates, and fats. 

A starched based diet (plant foods) will do this. And the best resource I know of for plant based nutrition is www.drmcdougall.com. Don't starches make you fat? Sure if you load them up with rich sauces and butter. Heck, two small baked potatoes will fill your whole stomach and its about 300 calories. Two small cubes of butter adds another 300 calories...of fat. And the fat you eat is the fat you wear (a Dr. McDougall quote).

If you eat right you can eat as much as you want. You will never win the battle by trying to eat less of the same bad foods. The hunger drive will eventually win.

Sure, there are lots of people that actually do think they are eating right that just need to be educated on what the right foods are...which is why I write this blog, give seminars, and talk to anyone that will listen about plant based nutrition.

When you consider the fact that obesity (and all the killer diseases it leads to) is the #1 preventable cause of death in the US, doesn't it make sense to take what you (and your kids) are eating serious?

Check out Dr. McDougall's website and some of the recipes...you will be amazed at how easy these foods are to prepare, how good they taste, and how much better they make you look and feel.

Dr. Eben Davis is clinic director of Executive Express Chiropractic in downtown San Francisco.