Fighting obesity...

         ...of the Backpack

Our children are carrying too much weight, and I'm not just talking about their bodies.  We have a problem we can solve immediately: the weight they carry in backpacks.

Some children are carrying 20, 30, or even 40% of their body weight on their backs. Imagine: a grown man carrying a 3rd grade child around on your back at work--it would look ridiculous, because it is ridiculous!  Students should not be compromising their bodies for books and gear; we need to be smarter.  Let's talk about solutions:

First: weigh your child--then weigh their backpack.  It should be no heavier than 10% of their body weight.  If they are 80 lbs, this means 8 lb pack; 120 lb child = 12 lb pack.  Review every item and determine need.  Their health is more important than any school supply and a duplicate book copy is much cheaper than a doctor's visit.

Second: check the fit of the pack.  Select a small to medium sized pack to prevent over stuffing.  Encourage utilizing both straps, resting on the middle of the collarbone, not the edge.  Ensure the pack rests in the small of the child's back, not on their hips or glutes.

These encouragements apply to children of all ages.  Poor bag ergonomics can create back, neck, shoulder pain.  Yes, this goes for purses too.  [Tiptoe carefully, Dr. Anthony :) ] If your child has symptoms which might relate to their backpack, a chiropractor, physical therapist or other trusted physician may offer great help with a return to good form.  Don't let pain or dysfunction go unaddressed.  It is not "growing pains" to have symptoms from carrying too much for our body.

Decisions, Decisions

Do you remember what it was like to buy a bicycle...or a television--it was probably a little confusing.  You might have started your research online then visited a local store to mosey up and down the aisle trying to figure out how much you had to spend to get what you wanted.  Will it last?  Is this the right size?

It can be difficult to purchase a durable good, and even more difficult to make a health care decision.  You may start your research online by entering symptoms, only to find how many diseases you may have--most of which you've never dreamed of pronouncing.  Osteochondral...who?  Tenosynovitis...what?

Just as with durable goods, there's a lot of misinformation out there about your health.  Wouldn't it be nice to have a helpful guide--an advocate--to sort through the decisions?  "I wish my doctor had time for questions." The best physicians, doctors who have the most success in health improvement, are those that take time to understand their patients experience.  They take time to answer questions and share knowledge so that an informed decision can be made.

Information and wisdom is important in buying the right refrigerator, and it's even more important when making decisions about your health.  I encourage you to seek out doctors who have time for you, and who treat you with patience and empathy.

Scorn or Delight: Life as a Chiropractic Physician

What does "chiropractor" bring to mind for you?

I enjoy when my title is brought up in social context, because folks are rarely shy about sharing their perspective about my field of doctorate.  I imagine more pleasantries are offered for lawyers, real estate agents, pastors, and even customer service workers.  Something about Chiropractic Medicine conjures the desire to share a story.  The anecdote usually goes one of two ways: it's a love or concern kind of statement. 

Often, I hear about how a chiropractor in some distant city was a savior to the family--resolving numerous and surprising ailments.  This is the kind of doctor I would like to be: a physician who touches patients' lives, offering sound counsel and taking the time to empower people to live more fruitfully.

I also hear the "concerned" side--and too often.  Sometimes it starts with: "Do you know [so-and-so]?  He cracked my neck once even though I'd asked him again and again to not do it.  It hurt my neck more.  It was so jarring.  I had to stop after 3 months of visits, and he was still arguing me to stay."

I can't share strongly enough how much this story upsets me.  Both for the disappointing experience the patient had and also the future hesitancy for the patient to seek the best care possible (which may be a chiropractor).  I have committed my practice--our entire office--to delivering chiropractic care that promises 3 things:

1) We will not advise treatments that aren't helping you or you don't want.  We are not definied by our ability to adjust joints.  There is so much more we can do including soft-tissue therapy, rehab exercises, and nerve entrapment release.  Treatment should be comfortable.

2) We do not promote long term care.  You should be seeing significant improvement every week.  Patients understand that we don't use magic, but our average patient is finished in 3 visits.  30 visit averages and promotion of "maintenance packages" is unfortunate, manipulative, and not usually in the patient's best interest.

3) We will take the time required to solve the issue, including refer you to another specialist if that is what we think is best for your pain.  We spend on average 30-45 minutes PER patient and reserve 90 minutes for our new patient visits.  We put our actions where our heart is.

I hope the next time you bring up "a chiropractor I like" that you are able to talk about a different experience you've had a Tri-Synergy Chiropractic.

Tri-Synergy's New Intro Video

We are very excited to share our introduction video.  Tri-Synergy Chiropractic is Greensboro - High Point, NC's leading Chiropractic resource for gentle joint manipulation, Active Release Techniques (ART), and functional exercise rehabilitation.

Is it a pinched nerve? My neck is killing me!

Have you been told your neck or back pain was caused by a pinched nerve?  Have you heard a friend describe this issue or concerned you may be at risk?  Fear not--this description is often not accurate and not likely.

A "pinched nerve" refers to the space just next to the spine, where spinal nerves exit from the spinal cord and travel towards fingers, toes, and all the organs of the body.  If you've had pain anywhere from your neck to your fingertips, or low back down to your toes--you may have worried it could be a pinched nerve.  The space provided in the low back is more than enough for the nerves to fit through.  In fact, the space can often degenerate more than 50% and still have no symptoms!  The space in the neck is sufficient for the nerves to travel through even with inflammation.

In the chiropractic world, a pinched nerve is often described as the "garden hose theory", similar to a hose losing water pressure when it is kinked or someone is stepping on it.  This theory has no proper scientific evidence and should be disregarded as an explanation for treatment.

So if it's not likely a pinched nerve, what causes such pain?

The evidence points to irritation, adhesion, and perception.  Yes, just as the brain is powerful enough to let a grandmother lift a car to save her child or a football star finish a game on a broken ankle--your brain is powerful enough to misinterpret irritating signals as significant pain.  That means something can hurt really badly but not be very dangerous.  Our brains have an imperfect ability to perceive the level of danger.  As I remind my wife, the drive to skydiving is far more dangerous than actually jumping out of the plane.  Yet our brains have decided that the skydiving is more intense than anything else, just as irritation to a nerve--not a pinched nerve--can be more intense than other insults.

Adhesions are like cob webbing around tissue and can create tension instead of smooth, easy gliding.  Improper growth of connective tissue can create these stubborn changes, specific manual therapy can quickly eliminate these problems.  This leads to a more fluid tissue motion, whether it's muscle, nerve, tendon, ligament, or fascia.  Treating a "pinched nerve" should be focused on direct manual therapy and exercises that calm, release, and gently move the area.  This is the best way to avoid surgery, speed healing, and return to feeling normal.  Find a chiropractor, physical therapist, massage therapist, or physician who is focused on helping you move again, without relying on drugs to numb it or surgery to cut it.

Why does my back hurt so much?

Why back pain and neck pain are different than arm or leg pain.

I hear from patients frequently: "I didn't do anything that I remember", "I lifted some things this weekend but nothing out of the ordinary", or "I'm worried that I'm about to break!"

Intense back or neck pain can be very startling--even scary.  When pain appears without a specific incident or accident, it's hard to understand.  Neck, upper back, and lower back pain can feel like you're headed towards paralysis and not able to return to the activities you want to do or even need to do.  But why does neck pain or low back pain seem so much more challenging that wrist or ankle pain?

I suggest we remember that our neck and back muscles are most often controlled by the sub-conscious while our arms & legs are more often controlled by conscious decisions.  You actively choose to move your arm to reach in the fridge, but you probably put little thought into all the back muscles you need to hold your body in front of the fridge.  In that same way, our brains are able to discriminate more clearly what is happening to our elbow, while we have a greater challenge sensing where the pain is coming from in the back.  I am often told: "it hurts everywhere in my neck".  Which is another way of saying: "I can't tell where it's located." 

If you're experiencing neck or back pain, visit a chiropractor or physical therapist whom you trust.  Once a thorough exam has ruled out scary things (which would suggest more immediate or aggressive intervention), you can proceed toward conservative treatments knowing they are likely to help the most and have the least risk.  Conservative manual therapy (including manipulation, soft-tissue treatments, Active Release Techniques, and exercise) works so well because it treats the source of the problem, which is often that muscles, nerves, and ligaments are irritated.  The best way to calm them down is by providing calm, soothing input.  The kind of input that is gentle on the body, feels good, and helps you return to the activities you want to accomplish.

Attitude for Success: Making long term body changes

Last week, Jim came into my office finding it near impossible to walk.  He was supposed to be golfing with family in three days.  He had low back pain that had gotten worse over the past 2 months, a sharpness like a knife that prevented finding any comfortable position.  Fortunately, we were able to show him the exercises that would help his back calm down, and he was able to play 72 holes within 72 hours.  This is not the most amazing part...

...he came back from the trip and asked to learn what he could do to prevent that pain from ever returning.

Eliminating pain is exciting, and patients are--of course--glad to be out of pain.  Preventing future incidents is additionally rewarding.  Because I take much more time per patient than most physicians, I enjoy a unique opportunity to calm fears and educate for the future.  There is often exercises in rehab or activity that will prevent pain from returning in the same way.  I want to highlight the best start towards prevention which is a healthy mental attitude.  In three steps:

1) Loving Curiosity:  An attitude of curiosity and acceptance is crucial for lasting changes.  You must view your problem as a experience you are having, not a fault or failure.  Instead of thinking, "I have horrible posture" or "I am lazy and never exercise", you might ponder, "what get's in the way of me exercising?" or "what type of activity would I like to do?"  Too often we close the door on change by attacking the one we're trying to help: ourselves.

2) Seeking a plan:  Steps toward prevention most often include (a) optimal movement, (b) increased sleep, and (c) healthful diet.  Is there an area you would like more information on?  Do you think you could use an expert opinion on how to move, what to eat, or how to attain more rest?  Ask your physician or friends if they know an expert in that area.  Browse a few blogs and get some simple tips.  You could even comment on this blog and we'll continue the dialogue.  Be encouraged to take small steps, but keep stepping forward.

3) Following through: This is not about willpower.  Repeat that to yourself.  You will not continue activity which you do not truly enjoy.  You cannot force yourself to participate in something you find miserable or undesirable.  Dream of activity you would like to do, imagine how you might feel with appropriate rest, and how delicious healthful food might taste.  By all means, if you find yourself slowing momentum or worse yet, quitting--stop and return to step 1) Loving Curiosity.

You can best help someone you love, equipped with fresh ideas, and continuing to take small steps forward.  Best wishes on seeking the changes you desire!

Medicine at a Crossroads

The dying art of patient care

When you last went to the doctor, did you feel they tried to listen and explain...or did it feel like he took a guess at which medicine was going to make you better?  Did you feel more like a patient or a customer at a diner?

Our nation is engaged in a potent discussion over medicine, mostly over who is going to pay the bill.  Who gets coverage?  What coverage do we get?  Important questions.  More importantly, who's making these tough decisions?  I believe we're missing a huge issue about what role a doctor plays in our care.  It's like we're at the dealership haggling over price and financing without asking what car we get.  If we end up without a listening expert who will help us make good health choices, what car are we driving?  I believe now more than ever, we need an expert adviser who will help us negotiate questions of surgery, medications, and therapy options.

Psychiatrist Dr. Donald Levin offers an example of the compromises currently demanded by our health care decline.  In a recent interview (http://nyti.ms/fWL7tS), he described how as a result of managed care pressure, he was no longer seeing patients 45 min, with time to listen and solve, but rather 15 min visits to adjust medications.  Dr. Levin reveals, "I had to train myself no to get too interested in their problems."  This change in psychiatry is one of many areas of medicine that have shifted dramatically away from a model of 'listen, diagnose, & teach' to one of 'interject, order tests, & prescribe'.  Most upsetting, this shift is happening despite evidence that quality of care is greatly suffering. 

Dr. Levin's son is pursuing his own career in psychiatry.  Dr. Matthew Levin stated, "I’m concerned that I may be put in a position where I’d be forced to sacrifice patient care to make a living, and I’m hoping to avoid that."  Hoping?!  Well, I'm hoping our nation demands that quality patient care continue to be a ethical mandate for all physicians, not a secondary question to who else in lining their pockets.

The current drive of medicine to produce assembly line results offering an algorithmic response to human health denies value in our uniqueness as individual patients and the dynamic ways in which we respond to care.  We would do well to demand health care that puts the patient first--instead of the insurance companies reimbursement rates or a physician's changing salary.  We're trading a sit down family meal for a drive through hamburger...and paying more for it!  The cost is the declining quality of patient care and higher costs for all.

Truth in Numbers - How risky is chiropractic care?

What the cost of insurance says about the safety of Chiropractic Medicine

Just paid my malpractice insurance bill--whew!  A whole $480 later, I and my patients are protected against any risks of practicing Chiropractic Medicine.  Yes, you read that clearly: 480 dollars...for the whole year.  Many of you pay more than that for car insurance--much, much more.  The insurance company is basically saying that your drive to the grocery store is more risky than all the treatments I have so far provided.  Kind of amazing.

Curious what your other doctors pay for their insurance?  Why not ask one?  In North Carolina, where our rates are often lower than the national average, MDs still pay significantly more than $400.  General internists are often in the $10,000 - $40,000 / year range.  Specialists like Ob/Gyn, cardiac, and surgeons can often range upwards of $250,000 per year.  A quarter of a million dollars for a year's coverage!  Why so expensive--because the insurance companies know that having back surgery is likely 500 times more risky for their bottom line than you choosing a chiropractor.

This is especially important to me to clarify the worries of risk.  There are still some people, and unfortunately, some experts, who are concerned about the risks of seeing a chiropractor.  I recently treated a student-athlete who's team staff warned him that seeing a chiropractor could be dangerous for his back.  It's disappointing to have misinformation create fear.  And that information couldn't be further from the truth.  This patient was back on the field with no pain in 2 visits, treated with both joint manipulation and muscle re-education.

Chiropractors are trained to use neurologic and orthopedic testing as part of a full physical exam, in the same way that every physician should, to rule out patients who may be at risk from specific treatments.  Manipulation is only one technique we use at our office.  We use soft-tissue treatments, including functional rehabilitation and Active Release Techniques more frequently to get the fastest and best results with little risk.  Next time you think of your car insurance, you might remember how safe and effective chiropractic care can be.

Numbness in the fingers: one patient's story

Gail was in a bad car accident 8 weeks ago--thank goodness she's alright.  She's almost back to normal except for the burning in her fingers on both hands and soreness in her forearms.  Fortunately, a friend told her about our office--especially how we expect results within a few visits.  I took over 40 minutes listening to her story, and it surprised me how clearly she described the moment of injury.  She said that the airbag came out so fast, it ripped her hands from the wheel before she could let go.  I pondered what I would ask my students about this case: "which muscle begins in the forearm, crosses the wrist, attaches to the fingers, and would explain burning in the fingers and pain in the forearm?"  Any guesses??  ...

Flexor digitorum profundus/superficialis indeed!  Sounds like a likely scenario for the symptoms she describes.  What does this mean?  It means Gail's story matches her continued symptoms, and it's likely something that can be treated and resolved quickly.  It means that following a thorough exam (to make sure we're not jumping to conclusions but evaluating the facts), we can gently treat these muscles in the palm side of her forearm and look for quick relief and comfort.

Happier ever after?  Yes.  But could have been much smoother.  Another chiropractor had told her that she had whiplash in her neck and that's what caused her pain.  He adjusted her neck for 6 weeks without improvement to her pain.  He told Gail she needed to stick with his program, and she would be better in a few months.  Disappointing!  She asked her primary care MD, and he prescribed her pain killers and told her to return if it didn't get better.  I wish he had known about the care we could provide.  I'm most glad that Gail is feeling better and able to use her hands without burning or pain.