Dr Davis' Back & Wrist Pain Blog

Migraine Headaches Health Update

Although most headaches are not life threatening, they can negatively affect your quality of life.  In severe cases, a headache is debilitating. Headaches have a wide range of causes, including infection, hangovers from alcohol consumption, fasting, and even serious conditions, such as brain tumors and strokes.

            The most common headaches include tension and migraine, which are associated with nervous system disorders. More than 90% of the U.S. population will experience some type of headache. 28 million Americans, including 1 in 5 women and 1 in 20 men, experience migraine headaches. In a migraine headache, the artery on the outside of the skull under the skin of the temple (temporal artery) enlarges. As this process occurs, nerves that surround the artery stretch and release chemicals that cause inflammation and pain. The larger the artery gets, the greater the pain. 

            Most people know Chiropractic care can be beneficial for tension/cervicogenic headaches. But, can Chiropractic care help migraines too? Here’s what research dating all the way back to 1998 says… The study, published in the Journal Of Manipulative And Physiological Therapeutics, compared amitriptyline (a medication), spinal manipulation, and the combination of both therapies.  There was a 4 week baseline period, followed by 8 weeks of treatment and then 4 weeks of follow-up on a total of 218 patients diagnosed with migraine headaches.

            RESULTS: “Clinically important improvement was observed in both primary and secondary outcomes in all three study groups over time. The reduction in headache index scores during treatment compared with baseline was 49% for amitriptyline, 40% for spinal manipulation, and 41% for the combined group.  During the post-treatment follow-up period, the reduction from baseline was 24% for amitriptyline, 42% for spinal manipulation, and 25% for the combined group.” 

            CONCLUSION: “There was no advantage to combining amitriptyline and spinal manipulation for the treatment of migraine headaches. Spinal manipulation seemed to be as effective as a well-established and efficacious treatment (amitriptyline). And on the basis of a benign side effects profile, it should be considered a treatment option for patients with frequent migraine headaches.”

To schedule a complimentary consultation for migraine headaches treatment in San Francisco, call 415-392-2225 and mention this blog post.

Health is Precious

It's easy to take good health for granted. The reason for this is because when we do things that do not promote long term health, such as drink, smoke, expose ourselves to too much stress, not get enough rest, or eat junk food...we don't necessarily pay the price for our poor decisions now...we pay the price later.

Most of us know the things that are good and bad as far a lifestyle choices. What we don't know is how quick a steady dose of poor decisions can manifest into a disease process, such as diabetes, heart disease, or cancer, that we do not even know is happening...often times until it's too late.

Did you know that half the time a fatal heart attack is the first symptom of heart disease? That's right...many people develop heart disease, which is mostly a disease of excess and poor lifestyle choices, don't know it, and suffer a fatal heart attack as the first sign or symptom. The others are lucky...they survive and are given another chance to do something about it. Some do...most don't.

It is very common for very successful people to ignore their health as they seek wealth. Only to find out later that health is true wealth. For without it, one is unable to enjoy life to it's fullest.

My favorite quote says it all:

"When Health is absent, Wisdom cannot reveal itself.  Art cannot become manifest.  Strength cannot be exerted.  Wealth is useless and Reason powerless" - Herophilus, 300 B.C.

Bottom Line: The lifestyle choices you make today matter. Once we become adults we are the stewards of our own health. Life is like a cafeteria. You can have whatever you want...but there is always a price to pay for your decisions...and the deserts are always at the front of the line. Sure, health is your natural state...but you must care for it and safeguard it against illness day in and day out with healthy choices. Why? Because Health is Precious.

Dr. Eben Davis is founder and clinic director of Executive Express Chiropractic in downtown San Francisco. 415-392-2225

 

Whiplash Facts: Part II

We have been providing treatment for whiplash in San Francisco for over 20 years. Whiplash if not treated properly can lead to ongoing pain and disability...even in mild cases. Of special concern are children who are often overlooked because they do not complain much. Anyway, last month we were unable to cover all the important whiplash facts you should know...here are the rest:

 1. Much has been published on the association between ongoing whiplash symptoms and litigation. There is now plenty of evidence that ongoing whiplash injury related symptoms occur regardless of the presence or absence of litigation.

2. The concept of a delay in symptoms means minimal injury is dispelled. In fact, it’s considered “the norm” that symptoms are delayed.

3. Mild traumatic brain injury (MTBI) or post-concussive syndrome can occur as a result of whiplash trauma. The good news is that, in most cases, recovery occurs within the first 3 months.

4. In the European Spine Journal, a recent study reported that between 1 and 2 years after a whiplash injury, 22% of patients’ conditions worsened. Condition deterioration at the 2 year mark has also been reported in other studies.

5. More detailed studies that followed whiplash patients through time, reported that 45% remain symptomatic at 12 weeks (3 months) and 25% at 6 months. Others reported the recovery time in most “minor cases” is 8 weeks (2 months), time to stabilization (not recovery) in the more severe cases was 17 weeks (4 months), and in the most severe category, 20.5 weeks (5 months). Hence, the concept that whiplash, like all other injuries heal in 6-12 weeks is challenged (note, there is little support for this common myth).

6. Each year, approximately 1.99 million Americans are injured in motor vehicle collisions.

7. Since 1990, a mean of 40% of a pool of whiplash patients from all vectors of collision (that is, rear, front or side impacts) were still symptomatic at a 2 year follow up. 59% of ONLY rear-end collision patients remained symptomatic at a 2 year follow-up.

8. Although these estimates vary, approximately 10% of WAD (whiplash associated disorders) injured subjects become disabled to a point of not being able to continue working.

9. Children who sustain whiplash injuries display sleep disturbances, nightmares, difficulty talking to parents and friends (brain injury), mood changes, poor academic performance and fears of participating in higher impact sports. Moreover, children tend to be overlooked in the evaluation and treatment process since they tend to complain less.

10. If the size of the 2 impacting vehicles is the same, an 8 MPH impact produces 2 times the force of gravity. When the bullet vehicle is larger than the target vehicle, the difference increases dramatically. 

 We realize you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

To schedule a complimentary consultation with one of our whiplash doctors in San Francisco, call 415-392-2225. Mention this blog post and receive a complimentary ice pack

Whiplash Facts Part I

 

Fibromyalgia: A Detailed Patient Description

Fibromyalgia (FM) is surrounded by much controversy in what establishes a diagnosis, what are the consistent historical features, and most importantly, what can be done about it – the treatment strategies.  Doctors seem polarized, either they “believe in it” or don’t. The result is a frustrated patient because after multiple attempts, they can’t get a straight answer from their health care provider. Consequently, the patient doesn’t know where to turn.  A very important article, published in September 2011, discusses from the patient’s point of view, their experience in living with this condition.

            The study consisted of 6 female patients diagnosed at a university hospital with FM, which by the way, means all other conditions that create similar symptoms have to be “ruled out” or, considered first. Therefore, many tests are typically run to make sure there isn’t some other serious underlying condition hiding behind the symptoms associated with FM. As a background, the authors describe FM as “…a chronic syndrome with no cure.” Because of this, they state, “…a thorough understanding of the illness experience is therefore key in the palliative care of patients…” They acknowledge that care givers of FM patients often include chiropractors and other manual therapists and knowledge of the “…meaning and reality of living with this condition” is reported as being ESSENTIAL for all health care providers who manage FM patients. The focus of the study was to carefully look at the personal, occupational, and social impact of the condition on patients’ lives and their views about the future. Structured interviews with each participant were analyzed.

            Results showed that FM impacted all aspects of life with 4 main themes arising from the data: 1) Personal life impact; 2. Occupational life impact; 3. The forecasted impact on future life; 4. Social interaction impact. Specifically, most of the participants had stopped working and felt useless. Leisure activities were greatly affected, as many described opting to not participate in various leisure oriented activities (such as going for walks, shopping, attending social events). FM was described as altering family bonds with some being made stronger while others were destroyed, resulting in separation and/or divorce. FM patients were reported to be “relieved” when a diagnosis was “finally” made, as it marked an end to a period of uncertainty. The participants were often ambivalent to interaction and despite some positive points, frustration prevailed from “perceived incomprehension” or, not really understanding why they feel the way they do. At times, this made it hard to discuss their symptoms and personal experiences. This study reveals the negative impact of FM and how complex and individual that is. 

            What is important about this study is that it alerts those of us who treat FM that we need a more efficient diagnostic process and we need to be better educated so that we can provide a multifaceted treatment option approach as each FM patient’s needs vary because of how each patient “deals with” the condition. We need to really listen to the patient to determine what treatment goals they are interested in and we must create treatment plans that center around those needs and desires, possibly including checklists so everyone stays on task as it’s quite easy to become distracted by the symptoms of FM. We are sharing this information with you so that you can feel comfortable approaching us with the many concerns and issues that surround FM.

            If you, a friend or family member requires treatment for Fibromyalgia in San Francisco, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment call 415-392-2225

Carpal Tunnel Syndrome: What is it?

Carpal Tunnel Syndrome (CTS) is a condition that results from pressure applied to the median nerve on the palm side of the wrist that causes numbness, tingling, weakness, and/or muscle damage affecting the thumb side of the hand and fingers, including the thumb, index, 3rd and thumb side of the 4th finger. There is literally a tunnel through which 9 tendons and their sheaths, some blood vessels, and most importantly, the median nerve travel through to get to the thumb and fingers. As these tendons slide back and forth in their sheaths, friction can build up, leading to swelling when fast, repetitive finger related work is performed, such as working on a computer, especially for prolonged time frames without proper ergonomics and rest periods.  The “syndrome” starts when the swelling occurs and the numbness/tingling/weakness complaints begin.

            There are many causes of CTS.  Most commonly, CTS occurs in people whom perform fast, repetitive motions including (but not limited to):  typing on a computer keyboard, using a computer mouse, sewing, driving, assembly line work, painting, writing, use of hand tools, sports such as racquetball or handball, and playing musical instruments. Many of these tasks involve bending or twisting of the wrists (think of a violin or flute player and you get the picture). CTS most often occurs in people 30-60 years old, affects women more than men and, can be either caused or contributed by other conditions such as fracture/trauma to the wrist or hand, arthritis of the wrist, diabetes, alcoholism, hypothyroid, kidney failure and dialysis, menopause, premenstrual syndrome (PMS), and pregnancy, infections, obesity, rheumatoid arthritis, SLE, and others.

            Symptoms most commonly include numbness or tingling in the thumb-side palm, thumb, 2nd, 3rd, and thumb half of the 4th fingers. The symptoms can extend to the elbow or higher to the neck or shoulder, can affect both hands (but one is usually worse than the other), and can interfere with daily activities such as buttoning shirts, opening jars, holding onto the steering wheel, riding a bike, working with the hands, etc.

            During an initial examination, our San Francisco Carpal Tunnel Doctors will often check your sensation with a sharp pointed object, percuss (tap) over the palm-side wrist, ask you to hold your hands back to back and palm to palm while counting the seconds to numbness, test grip strength, and also check the neck, shoulder and elbow as these areas refer pain back and forth. Sometimes, he or she will order an EMG to test the nerve’s damage. Conservative chiropractic treatment is highly effective and DEFINITELY should be done FIRST, before injections, medications, or surgery!

It's also important to know that the median nerve, which is the nerve involved with CTS, originates in the neck. Pressure on the median nerve (roots) in the neck can cause the same symptoms as true carpal tunnel syndrome. This is why a true carpal tunnel expert will always examine you from the neck to the finger tips on both sides. The reality is...true CTS is rare...the primary cause of most carpal tunnel symptoms are pinched nerves in the neck (read: carpal tunnel and pinched nerves in the neck).

            We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

To schedule a complimentary consultation with one of our carpal tunnel doctors in San Francisco, call 415-392-2225. Mention this blog post for a complimentary consultation.

Related Articles:

Can a chiropractor help hand pain?

How does a chiropractor treat carpal tunnel syndrome?

 

San Francisco Chiropractor Review

Executive Express Chiropractic San Francisco "Patient of the Week" is Georgianne Compton. Georgianne presented with neck pain and numbness and tingling in the leg which was interfering with her daily workouts. Our San Francisco Chiropractors have used chiropractic adjustments, exercise, massage, and TLC to get Georgianne back on track. Check-out what she has to say about us.

Chiropractor Reviews San Francisco

To schedule an appointment with a chiropractor in San Francisco call 415-392-2225

San Francisco Chiropractor Reviews

         Check out our collection of San Francisco Chiropractor Reviews on our YouTube Channel.

Executive Express Chiropractic has been serving the Financial District for over 20 years. We are considered by many to be the Best Chiropractor in San Francisco.

Do Chronic Sinus Problems Cause Headaches?

We have been providing treatment for headaches in San Francisco for 20 years now. During this time many of our patients have had sinus related headaches.  You know, these are the headaches that hurt over the sinuses (above the eyes or in the cheek bones next to your nose) and, when you blow your nose, it’s not pretty!  Sinus infections often lead to sinus headaches – wouldn’t you say that’s a true statement?

            A recent November 2011 study begs to differ. Researchers took 58 patients with a diagnosis of “sinus headache” made by their primary care physician and asked them the following questions:

1. Have you had a previous diagnosis of migraine or tension-type headache?
2. Is their clinical evidence of a sinus infection during the past 6 months?
3. Is there the presence of  “mucopurulent secretions” (that’s the “not so pretty stuff” when we blow our nose)?

            All 58 patients clearly seemed to have chronic sinusitis with an acute flair up and were given complete thorough examinations by a neurologist and an ears, nose, throat specialist (otolaryngologist) on a monthly basis for 6 months during treatment. The surprising results showed that final diagnosis in these 58 cases were 68%, 27% and 5% of the patients really had migraine, tension-type headache and chronic sinusitis with recurrent acute episodes, respectively. Treatment during the 6 months included antibiotic therapy in 73% of the patients with tension-type headache and 66% with migraine. Sinus endoscopy (taking a look up the sinuses with a scope – ouch!) was performed in 26% of the patients, and therapeutic nasal septoplasty (surgery!) was performed in 16% of the migraine patients and 13% of patients with tension-type headache (a pretty BIG mistake, wouldn’t you say?).  The conclusion was that many patients with self-described or primary care physician diagnosed “sinus headaches” have no sinonasal abnormalities, but instead, met the criteria for migraine or tension-type headache.

            So, what does this mean?  Well, for one thing, too many antibiotics are prescribed for tension-type or migraine headaches and have no place in the treatment process of these two common headache categories.  Side effects of antibiotics include (but are not limited to):  stomach and intestinal irritation, nausea, and if one is allergic to the antibiotic, a potentially life-threatening condition call anaphylactic shock.  Let’s not forget to mention that sinus surgery was performed in 29% of the cases where the sinuses were NOT causing the headaches and we all know the risks of undergoing anesthesia and surgery can include death and infections, among other problems.

            Chiropractic was reported to be a wise choice in the treatment of headaches by several publications, one of which provided a large review of the literature on the “Effectiveness of manual therapies: the UK evidence report,” released in 2010 (http://chiromt.com/content/18/1/3). In this report, both migraine and cervicogenic-type (headaches that start in the neck) headaches were found to have strong research support for manipulation or, chiropractic adjustments. In this day and age, you can be very confident that choosing chiropractic services for headache treatment is a wise, safe, and very cost-effective approach for a very disabling condition.

            We realize that you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for headaches, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

To schedule an appointment with a San Francisco Headache Doctor, call 415-392-2225. Mention this blog post and receive a complimentary consultation and headache assessment.

How Long Does a Chiropractic Visit Take?

We have been practicing chiropractic in San Francisco for about 20 years now. During this time we have refined and perfected our systems in response to what we feel serves the patient best. Most of our patients spend the majority of their day sitting in front of a computer and when they come to see us they have limited time.

Here's the deal...most of the time spent in a typical chiropractors office is in the waiting room (see our No-Waiting Room above). Then, when you finally get in to see the doctor you wait even more. Then, finally, the doctor comes and orders some therapy. Then, some 30 minutes later you finally get your adjustment which typically only takes a few minutes. Then you wait at the front desk to pay. 

Well...it did not take long to figure out 20 years ago that this does not serve the San Francisco Financial District in a way that lends itself to building a booming practice. Maybe some patients would do this if they were in severe pain...but who would want to deal with this 1-2 hour long routine for a maintenance visit or weekend warrior soreness?...Not many!

So...we experimented with a no-waiting concept and online appointments. We figured if we could eliminate the wait, we could actually spend more time on treatment, yet the entire visit time that the patient needs to allocate for the visit is cut in half. Seems like common sense HUH?

It's easier said than done though...as this requires a special layout and extra staff to pull-off.

So...we kept working on it and refining our systems. Then we hired one of the top architects in San Francisco (Martinkovic Milford)...and found the ideal location (Embarcadero Center) to execute our plan.

We also wanted to reduce our carbon foot print so we built the clinic from scratch using almost 100% eco-friendly materials (see the Executive Express Chiropractic Design Statement).

Fast forward 3 years and here we are.

A typical office visit is first made either online or by phone. Our initial intake form is filled out online on our secure server to save the patient the time of doing this at the clinic. This allows the doctors to review all cases and set-up the patient file before the patient arrives.

When the patient arrives they sign a few forms and within a few minutes are meeting with a doctor. A short while later we have our highly trained staff administer a spinal warm-up massage to the chief complaint. We do spinal flexion/extension traction/exercise to elongate the spine, stretch the spinal muscles, and prepare the spine for the adjustment. then the doctor performs the adjustments and does any special exercises, home care instructions, and answers any questions. Our entire first visit (second visit also) is under 50 minutes (vs. up to 2 hours at other clinics).

If after the report of findings on the second visit the patient requires further care...subsequent visits are around 30 minutes or less and include all of the above without the exam and consult. Sure, there are times we need to spend more time...but there are also times the patient wants less...just the adjustment and be on their way.

So how long does a chiropractic visit take?

It just depends where you go. At Executive Express Chiropractic in San Francisco it's 30 minutes or less...unless more is indicated. No Waiting is the key....and online intake forms.  And it's not easy to pull this off.

And get this...appointments are optional. About 50% of our patients prefer the security of an appointment...but the other half just come when they want...and we get them right in...guaranteed.

The beauty of the no appoinment needed policy is that busy executives, weekend warriors, or just people that have some soreness...can just pop right in without all the drama that goes with a typical chiropractors visit.

I know this all sounds great...and it really is. In fact...why dont you come check us out for yourself.

Mention this blog post and receive $20 off our already low ($99) initial exam and adjustment. It will be $79.

That's the other thing...we do not feel new patients should pay an arm and a leg to see us. We make our care affordable for most people...students and elderly included.

To make an appointment with one of our San Francisco Chiropractors and take advantage of our special offer, call 415-392-2225 and mention this blog post.