Dr Davis' Back & Wrist Pain Blog

Chiropractic is a Lifestyle Choice!

We have been practicing chiropractic in San Francisco for over 20 years now. And, even though the Financial District workforce has a high turnover, we still have quite a few patients that come in on a regular basis from when we first opened. Why would they do that..aren't they better yet?

Well, they come in because they want to have the benefits of chiropractic on an ongoing basis. Just like people exercise because they want the benefits of exercise every day. This is also the reason people eat right...they like what it does for them...it's a Lifestyle Choice...and so is chiropractic.

Sure, most of the time when we first meet someone it is for a specific "pain" related problem, like back pain, or neck pain, headaches, whiplash, or shoulder pain. But what ends up happening is a certain percentage of these people end up realizing that they function and feel much better because of the chiropractic adjustments and they want this to continue.

How often a patient comes in for what we call "maintenance care" varies patient to patient. We need to consider age, over-all health, daily stress levels, occupation, active sports, and any complications such as scoliosis or forward head posture (very common).

In general, it's probably best to see your chiropractor say once per month. Some come in more and some come in less. Our patients choose their visit frequency based on trial and error.

Most elite athletes, high profile business executives, and many in the entertainment industry such as rock musicians, actors, and television personalities, make chiropractic a key component of their healthy lifestyle...and you can too. Chiropractic is safe, gentle, inexpensive, time efficient, and highly effective.

One of the things that is so great about chiropractic adjustments is that a skilled chiropractor can work on many things in a matter of minutes. It's not unusual for me to work on a patients neck, mid back, low back, shoulders, and feet, all in the same visit. This is a lot of "bang for the buck".

Many clinics these days such as ours have walk-in and even no-wait policies so you can come whenever you feel like it and be seen right away. Consumers want convenience...even with their health-care,

Chiropractic is the worlds largest, drug-less healing profession. WHY?...because it works...not just for pain, but for over-all health and well-being...as a lifestyle choice.   

 To find out if you are a candidate for care at our San Francisco Chiropractic Clinic call 415-392-2225.

Serving zip code 94111 and downtown San Francisco since 1992

 

 

San Francisco Chiropractor Review: Whiplash

The Executive Express Chiropractic "Patient of the Week" is Stephanie Hernandez. Stephanie was involved in a car accident in San Francisco and suffered severe whiplash to her neck and back. Stephanie was barely able to move when we first began treatment and had night pain. After about 3 weeks Stephanie is feeling much better and is able to perform most work and home duties with minimum pain. Stephanie looks forward to her chiropractic visits and is hoping to be pain free soon.

Many whiplash patients suffer needlessly because they do not get the right kind of treatment. Chiropractic is the treatment of choice for whiplash and can help prevent arthritis and chronic neck and back pain which is common later in life from soft tissue injuries that do not heal properly.

Thank you for sharing your story Stephanie and we wish you a speedy recovery. And thanks for being such a great patient.

To schedule an appointment with one of our San Francisco whiplash doctors, call 415-392-2225.

How Much Exercise Is Too Much?

In today’s high-tech, fast paced society, we all tend to over think,  over complicate, and make things more difficult.  This is especially true when it comes to our health.  

For example, there is pretty good evidence that exercise is good for you and people who exercise are, in general, healthier than people who do not exercise.

Few people would dispute it,  but that simple statement can be taken to the EXTREME. How? Many people think if a little exercise improves health, then more must really improve health. 

Well, some researchers are now saying this thought process may be very very flawed.

Here is why:  Researcher Dr. James O’Keefe, a cardiologist at the Mid America Heart Institute of St. Luke’s Hospital in Kansas City, reported in the journal Mayo Clinic Proceedings that strenuous exercise might actually harm your heart.

         According to Daily Mail, “Extreme exercise, such as marathons, may permanently damage the heart and trigger rhythm abnormalities... [Researchers] say the safe ‘upper limit’ for heart health is a maximum of an hour a day, after which there is little benefit to the individual.

         “A review of research evidence by US physicians says intensive training schedules and extreme endurance competitions can cause long-term harm to people’s hearts. Activities such as marathons, iron man distance triathlons, and very long distance bicycle races may cause structural changes to the heart and large arteries, leading to lasting injury.”

         Dr. James O’Keefe said, “Physical exercise, though not a drug, possesses many traits of a powerful pharmacologic agent. A routine of daily physical activity can be highly effective for prevention and treatment of many diseases, including coronary heart disease, hypertension, heart failure, and obesity.

         “However, as with any pharmacologic agent, a safe upper dose limit potentially exists, beyond which the adverse effects of physical exercise, such as musculoskeletal trauma and cardiovascular stress, may outweigh its benefits.”

         Dr. O’Keefe thinks the research suggests that extreme endurance training can cause elevated cardiac biomarkers and transient structural cardiovascular changes that normalized in about a week.

         The review found:

• Approximately 12% of seemingly healthy marathon runners showed evidence for patchy myocardial scarring.
• The two-year follow-up showed a significantly higher rate of coronary heart disease in marathon runners versus runners who do not run marathons.
• Elite level athletes commonly develop abnormal electrocardiograms. Studies show that too much exercise can lead to abnormal heart rhythms. 
• Continued excessive exercise may lead to arterial wall stiffening.

         It is important to note that Dr. O’Keefe mentioned long-term, vigorous exercisers have a lower death and disability rate than non-exercisers.

         If the information in the report is accurate, exercising like crazy is better than not exercising at all… but moderate exercise is better than over-doing it.

         Many people (marathon runners, triathletes, etc.) were enraged by this report, and quite frankly, many factors were not accounted for in this research.

         For example, does nutrition change the results?  What about high carbohydrates versus low carbohydrates?  The list here could go on and on...

         But the really important point is:  EVERYTHING HAS LIMITS.

         For example, most people believe that drinking water is good for you.  Not always. If you drink too much water, you can actually DIE. In fact, a 2005 study in the New England Journal of Medicine found that close to one-sixth of marathon runners develop some degree of hypernatremia, or dilution of the blood caused by drinking too much water.

            Drinking the proper amount of water is good for you.  Too little is bad.  Too much is also bad.

            We may need to look at exercise the same way.  Too little exercise is bad and too much is also bad.

            Genetically, we are all different. We all have different amounts of stress and strain we can take.

            But, we all have a threshold.  Exercising up to that threshold will be beneficial, but crossing it will not be beneficial and probably harmful.

            Will some people be “okay” doing marathons or triathlons because they are genetically superior?  Probably. It’s just like some people smoke and live to be 95 years old and seem to be “healthy” their whole lives.

            Then again, other people get lung cancer in their 40’s and don’t survive it.

            Famous Chiropractor Jack Lalanne frequently said it is all about moderation.  He thought it was better to exercise a little every day than to go crazy every now and then. He was probably on to something. 

             Chiropractic is the perfect workout companion. Chiropractic adjustments help the body rest and recover from physical exertion and reduces the liklihood of injury.

To schedule an appointment with one of our highly trained San Francisco Chiropractors call 415-392-2225

San Francisco Chiropractor Review: Back Pain

The Executive Express Chiropractic "Patient of the Week" is Alexis Waxman. Alexis presented with chronic back and neck pain from long hours of studying at law school. Alexis had tried other forms of treatment including acupuncture, massage, and physical therapy, but nothing seemed to help. We have treated Alexis with a combination of chiropractic adjustments, massage, exercise, and traction and she has responded great so far. Alexis looks forward to being pain free soon and loves our walk-in, no wait service. Check-out her video review of our chiropractic services.

                                  

Chiropractor Reviews San Francisco

To schedule an appointment with one of our San Francisco Chiropractors call 415-392-2225

Fibromyalgia and Foot Pronation

We have been providing 100% natural Fibromyalgia treatment in San Francisco for over 20 years now.

Fibromyalgia (FM) is a condition that (typically) evolves slowly over time and often occurs for no apparent reason. The diagnosis is usually made by excluding other conditions leaving you with a diagnosis that in the absence of anything else, “….must be fibromyalgia.” Of course, the problem with that approach is that we all want to know, “…what caused this problem to start with?” In the end, we typically have to accept the fact that, “…it just did,” and move on to, “…now what are we going to do about it?”

            A multi-disciplinary (involving several different types of doctors and approaches) treatment approach has been found to work well with Fibromyalgia patients. This approach may include medications from a primary care doctor who is aware and sensitive to this potentially disabling condition, massage therapy from a muscle relaxation point of view, clinical psychology when the stresses associated with FM become overwhelming and out of control, and chiropractic to quarterback joint mobility, diet management, exercise training, modality use, as well as offering foot orthotics. Coordinated care effort utilizing several disciplines is what is reported to be the most successful approach.

            Because chiropractic embraces the concept of treating the whole person, this premise fits perfectly in the treatment plan for the FM patient since the entire body is considered, not just a specific area or system. In this approach, we assess posture, movement, alignment, and function and implement treatments to improve each of those areas.

            During the postural assessment, because we are a 2-legged species, the feet must be carefully assessed for function and alignment. If you watch people walk, you will often see their ankles roll in with each step and for some, this can be quite dramatic where the ankle rolls in almost hitting the floor. What’s interesting is that most people don’t even know they are doing it! The truth is, most people with flat feet (technically called pes planus) and rolling-in ankles (or, ankle pronation) don’t have any foot pain or symptoms associated with the altered function. In fact, people with very high arches (pes cavus) usually have more foot pain than the flat footed person. If you look at shoes of those of us who pronate (which is about 80% of us), the wear pattern is usually quite excessive on the outer corner of the heel. Sound familiar? It is very common! So, why bother “fixing” ankle pronation if it doesn’t hurt? The answer is that biomechanical function is altered and it negatively affects the rest of the body quite significantly. Here’s what happens. When the ankle rolls in, the knee has to “knock” inwards, the hip has to impinge inwards, the pelvis on that side drops and the spine has to compensate for the pelvic drop and bend away from that side. Watch the shoulders and head sway back and forth as the pronated/flat footed person walks the next time you’re walking at the grocery store, mall, or airport.

            So, how does the use of foot orthotics help the FM patient? It has been reported that it takes up to seven times more energy to walk when the ankles pronate excessively. Chronic fatigue is a frequent complaint in the FM patient, and the less energy expended from walking, the more energy will be left over for other daily tasks. Also, the biomechanical stresses on the ankle, knee, hip, and spine will be smaller from wearing foot orthotics, correcting the excessive side-to-side strain on the various joints. The journal Clinical Rheumatology recently reported a significant benefit when foot orthotics were used in the treatment of FM. The bottom line is that this is a VERY SIMPLE FIX and when so much of FM is so difficult to treat, this a no brainer!

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Doctors in San Francisco call 415-392-2225. Mention this blog post for a complimentary electronic foot scan to detect pronation or any other pedal foundation abnormalities (Value $99).

Related articles:

Chiropractic Case Management of Fibromyalgia

What Causes Fibromyalgia?

 

San Francisco Chiropractor Review

The Executive Express Chiropractic "Patient of the Week" is Jennifer Ruocco. Jennifer has been a patient of ours for over 15 years. Jennifer works for a popular gaming company in San Francisco and had developed neck, arm, and hand pain from extreme computer use and gaming (testing new products). Jennifer has found that chiropractic adjustments 2 times per month helps to negate the physical stress of her job and are an integral part of her healthy lifestyle. Many people are concerned that they have to see a chiropractor forever. Jen laughs at this. It's like saying to get the benefits of eating healthy you have to eat healthy forever.  Chiropractic is a tool that can be used many ways. It can be used as a quick fix for back and neck pain or as an ongoing  lifestyle choice...and everything in between. Chiropractic is 100% natural and very affordable. For many it's a No Brainer.

For a complimentary consultation with one of our San Francisco Chiropractors, call 415-392-2225 and mention this blog post.

More San Francisco Chiropractor Reviews.

Whiplash Trauma From Side Collisions

We have been providing whiplash treatment in San Francisco for over 20 years. Whiplash is most commonly studied when it is a result of a rear collision where the occupant of the vehicle is injured  from a flexion (forwards) and extension (backwards) whip-like mechanism of injury, but what happens when a T-bone type of impact occurs?

The answer to this question is quite similar to many of the factors associated with any collision: the size of the bullet vs. target vehicle, the speed at which the collision occurs, the deployment or lack thereof of the airbag(s), the position of the neck at the time of impact, the “build” of the patient (skinny/tall vs. muscular), the road conditions, the “springiness” and angle of the seat back, and so forth. Unique to side impacts is the location of the strike to the target vehicle (front, middle, rear) and perhaps more importantly, the lack of space between the occupant and the point of the strike as there is a relatively shallow “crumple zone” between the occupant and the side of the vehicle.

Probably one of the best examples of how side impacts from different angles can be appreciated is to think about what happens to a person when they ride the “Bumper Cars” at the local fair. Though many fairs have now banned that “ride,” you may recall participating or watching those kids who were “having fun.” When a bumper car is struck in a classic “T-Bone” manner in the front end, the target car is spun around and the occupant hangs on for dear life. Similarly, a side strike from to the rear of the bumper car spins the back end around. When the occupant is aware of the impending crash, they grip the wheel, tuck their head by shrugging their shoulders and make their body rigid and typically, do not get “whipped around” as much as those that don’t anticipate the impact. Because the bumper cars don’t dent or crush (that is, there is no plastic deformity where damage occurs, only elastic deformity where there is no damage or, no energy absorption by crushing of the car), ALL of the crash energy is transferred to the occupant or the contents. If a person has a purse lying on the floor of the bumper car, it can go flying out and spill all over. Similarly, the person who is unaware of the impending collision will “go flying,” giving great satisfaction to the driver of the bullet bumper car.

When considering factors such as plastic vs. elastic deformity, side air bags, and the shallow crumple zone on the sides of motor vehicles, some manufactures stand out in their ability to protect the occupants in side impact collisions. Generally, those vehicles with a stiff side and roof structure have been found to be the best in protecting the occupant from injury by maintaining the survival space and dissipating the energy, or force, of the impact away from the occupant. Manufactures that stand out include Volvo, Mercedes, and Subaru. They have had the best design for decades and remain at the forefront for occupant protection in side impact collisions. The combination of energy absorbing side structure design and the side airbag has proven to be one of the most important factors in improving the crashworthiness in side impact collisions. Side air bags became popular in the 1990s. In 2012, more than 95% of all passenger cars sold in the US are equipped with side impact airbags as standard equipment.

We realize you have a choice in where you choose your healthcare 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.

If you have been involved in a car accident and would like a complimentary consultation with one of our San Francisco Whiplash Doctors...call 415-392-2225.

Serving zip code 94111 since 1992

Neck Pain and Your Pillow

The relationship between neck pain and your pillow is more important than most of us realize! Though we all may have at one time or another slept on a variety of surfaces, and used any number of pillows (flat, medium, bulky) made of different materials (foam, feather, air, water, or memory foam), it’s usually not until neck pain and/or headaches start to become an issue that we start to think, “…how important is my pillow?” Thankfully, the question has been addressed in a randomized peer-reviewed study. So, what did they find out?

            The goal of a pillow is to support the neck more so than the head. In a study headed by Dr. Liselott Persson, MD, of the department of neurosurgery at the University of Lund in Sweden, researchers tested whether specific neck pillows have any effect on neck pain, headache and sleep quality in people suffering with chronic (>3months), non-specific neck pain. They also researched whether there was an optimum or “best” type of pillow that was preferred by their 52 patient group. They used 4 different pillows, 1 “normal” pillow and 3 of which were specially designed, each having a different shape and consistency. Over a 4-10 week time frame, the pillows were randomly distributed to the neck pain group who then graded them according to comfort, the effects on neck pain, sleep quality and headache using a questionnaire, and also described the characteristics of an “ideal pillow.” Researchers and participants concluded the “ideal pillow” (for reducing neck pain and headaches and improving quality of sleep) includes a soft pillow with good support under the neck’s curve (lordosis).

            There are many styles of contoured cervical or neck pillows that vary considerably. This study supports the use of a specially designed style over a normal pillow. So what are some of the things to look for? First, consider your neck’s length and girth.  When you look in a mirror, do you have a neck that is short vs. long or, narrow vs. wide? This will direct you to a pillow that has a larger “hump” for your neck to be cradled in if it’s a long neck and, the height of the hump – taller for the slender neck or, shorter for the wide neck. Some pillows have 2 options of “hump” sizes (located on the long edges of the pillow) – one short and flat and the other side taller and wider. Others recommend lying in the middle of the pillow if you’re a back sleeper vs. lying on the edge of pillow when sleeping on your sides. A measurement taken from the neck to the point of the shoulder determines if the pillow should be a small, medium, or large. Water filled and/or air filled pillows can be varied by the amount of water or air added. The bottom line of which is “best” is based on comfort and support. Regardless of which you choose, it can take several days to get used to the new pillow, so we recommend using the pillow for at least 1 week. By then, you’ll know if you chose the right style. 

            We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, 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.

We sell Tempur-Pedic pillows at our San Francisco Chiropractic Clinic. We do this because we believe it is the best all around pillow and offers great value. However, it's not a bad idea to visit a store where they have a variety of cervical pillows so you can try them out and see what feels most comfortable.

In the SF Bay Area we recommend Relax the Back Store.

To schedule an appointment with one of our San Francisco Chiropractors for a complimentary cervical pillow demonstration call 415-392-2225 or just stop by during open hours (9-6 M-F, 9-1 Sat).

Dr. Eben Davis

 

Carpal Tunnel Syndrome – More Facts!

We have been providing nonsurgical treatment for carpal tunnel syndrome in San Francisco for over 20 years now. Carpal Tunnel Syndrome is often times misdiagnosed and not treated properly. We try to stay current with the latest research and keep our patients and followers updated on these pages.  

Carpal Tunnel Syndrome (CTS) is a condition where a nerve in the wrist gets pinched resulting in numbness, tingling and sometimes grip strength loss. One of the first symptoms of CTS involves waking up at night due to the numb, tingly sensations. This initially occurs once in a while but  eventually  becomes more frequent, leading to very un-restful, sleepless nights. Most people do not initially attribute this sleep interruption to CTS but rather report, “…it’s coming from sleeping on my arm or lying in a funny position.” Because restful sleep is a very important health issue, this early CTS symptom should prompt the person to investigate the problem, but usually they wait, sometimes for months or even years, making treatment more challenging.

            Other symptoms may include waking up in the morning with wrist and/or hand pain, difficulty buttoning a shirt or threading a needle, radiating arm symptoms into the forearm, shoulder and/or neck, dropping silverware, pens, coffee cups, and, a specific pattern of numbness such as the index, middle, and part of the ring finger. The degree of functional loss varies from none to total disability, not being able to work or carry out many home activities. Some people notice the symptoms during the day while performing fast, repetitive movements such as playing piano, typing, using a computer mouse, crocheting/knitting, writing, assembly work, and more. Some of the most frustrating complaints from CTS patients are lost work time (due to both CTS symptoms and fatigue from not sleeping at night), a loss in earnings, lack of dexterity (buttons, tying shoes, turning a key in a door or car, fixing hair, applying make-up), daytime grogginess, and irritability that can impact their quality of life, including their relationships.

            A question that often arises is, what is carpal tunnel syndrome? A simple answer is “tendonitis” or, inflammation of the tendons that connect the muscles on the palm side of the forearm (flexor muscles) to their respective tendons that attach in the hand and fingers. Digging a little deeper, there are nine of these tendons that travel through the tunnel, rubbing together as we move our fingers and all is usually well unless there is too much friction resulting in swelling in this confined space. In fact, CTS remains silent until the swelling starts pushing or compressing the median nerve at which point the numbness, tingling, pain, etc., are noticed. 

            So, the next question is, what can be done to stop the inflammation from compressing the nerve? A very common treatment approach is the use of a cock-up splint at night, which stops us from bending the wrist in our sleep. In a normal, non-CTS wrist, the pressure in the carpal tunnel increases 2-fold when we bend our wrist; however, if inflammation already exists inside the carpal tunnel, the pressure increases by many multiples. This is why sleep interruption is so common in CTS as we just can’t control our wrist position at night. Another common anti-inflammatory approach is cortisone shots into the carpal tunnel and/or taking an anti-inflammatory drug like ibuprofen. The chiropractic answer to anti-inflammation is ice (preferably ice massage over the palm side wrist) and anti-inflammatory nutrients such as ginger, tumeric, boswellia, and others. What gives chiropractic the “edge” over non-surgical medical care is the addition of joint and soft tissue manipulation of the hand, wrist, forearm, elbow and when needed, the shoulder and neck. The latter improves circulation, reduces fixation or adhesion between tissues and allows the tendons to slide with less friction resulting in better function as noted by longer ability to play piano, type, write, etc.

            Another “key” item to CTS treatment is identifying and finding a solution to a poorly designed workstation so the wrist/hand does not have to work in an awkward manner. Here, the position of a computer screen, how a tool is held, and how long repetitive work is allowed are modified.

            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 an appointment with a carpal tunnel doctor in San Francisco call 415-392-2225. Mention this blog post for a complimentary consultation.

Serving zip code 94111 and local areas since 1992

Why Are Avocados So Good For You?

I grew up in Florida, home of the big avocados. We used to grow them in our yard. I have always known that they were good for you, but was never really too concerned with why. But now I am. 

So...why is the avocado so great? 

First, it has a very high level of oleic acid.  Oleic acid is a monounsaturated fat that aids in fat metabolism. 

            Avocados also have high levels of lutein, zeaxanthin and Vitamin E.  Lutein and zeaxanthin are carotenoid antioxidants.  According to the American Optometric Association:

            “Many studies have shown that lutein and zeaxanthin reduce the risk of chronic eye diseases, including age-related macular degeneration (AMD) and cataracts. 

“Lutein and zeaxanthin are carotenoids that filter harmful high-energy blue wavelengths of light and act as antioxidants in the eye, helping protect and maintain healthy cells.”

            Avocados also contain ionic potassium and folate.  Potassium – Sodium ratios are very important to keep your heart healthy and functioning properly.

            If you eat vegetables (and you should), here’s another great thing about avocados...

            According to Natural News, most vegetables contain high amounts of carotenoid based antioxidants. “Studies have shown that these antioxidants are lipophilic (fat-loving) and are absorbed best in the body when combined with a healthy fat such as oleic acid.”

A study published in the Journal of Nutrition in March 2005 showed that adding avocados to salad increased absorption of alpha-carotene, beta-carotene and lutein 7.2, 15.3, and 5.1 times higher, respectively, than the average amount of these carotenoids absorbed when avocado-free salad was eaten.

In other words, eating avocados in your salad and with vegetables is (most likely) a very good thing!

What Type Of Avocados Should You Eat?

Both Florida (the big avocados) and Hass avocados are good for your digestive tract because they contain soluble and insoluble fiber.  However, Hass avocados have higher concentrations of lutein, zeaxanthin and some other nutrients. 

Can Avocados Prevent Skin Wrinkling?

Some think avocados can prevent wrinkles and skin aging.  It is believed avocados are great anti-aging foods because they contain D-manno-heptuloe sugar. This sugar has been shown to improve skin epidermis by boosting collagen formation. 

Avocados contain antioxidants that may reduce age spots, decrease inflammation and help scars to heal. Amazing Huh? So...load up the plate. Avocados are the real deal!

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