Does Your Kaiser Doctor Know Best?

Case Study - Migraine headaches caused by cervical spine kyphosis.

A 48 year old female patient presents to Chiro-Health, Inc with complaints of daily migraine headaches, jaw pain, neck pain and severe muscle spasms.  She has had all these symptoms in the past but the last 2 months the frequency and intensity of the symptoms increased to unusual level.  The patient was  seen in our office before for occasional chiropractic adjustments for the same symptoms and chiropractic care always provided a relief.  During my meeting with the patient I suggested x-rays, since the condition was returning and it was getting worse.  The patient has Kaiser insurance, and is concerned about cost.  I suggest that she speaks to her Kaiser provider and request the x-rays to be done at Kaiser, this way they will be covered by insurance.  Next day, the patient calls me to ask me what views will she need, she got the Kaiser doctor to prescribe the x-rays, but the doctor did not know what x-rays to order. So naturally I e-mail the views needed and the Kaiser doctor orders the study.  The patient takes the x-ray in the Kaiser facility  the next day, and I receive an e-mail from the patient that her Kaiser doctor told her there was nothing wrong with the x-ray.  Look at the image.  The one on the left is the patient x-ray in a lateral view, taken from the side.  The one to the right is a lateral cervical (neck) spine that is very close to normal.  I showed these images to my twelve year old daughter and asked her which spine looked healthier, and she instantly picked the right image. These are my concerns:
1) Kaiser doctor does not see the need for x-rays, based on patient history, when they are indicated
2) Kaiser doctor does not know what are the views needed to evaluate cervical spine
3) Kaiser doctor misinforms the patient that the x-rays look great, no need for concern

I requested the x-rays and scheduled the patient for a follow up.  This is what's wrong with the left x-ray, which belonged to the patient:
There is a loss of cervical curvature
There is fusion between cervical vertebrae 5 and 6, most likely congenital (patient was born with it.)
There is phase 2 Degenerative Joint and Disc disease, meaning decreased motion, bone spurs, neurological deficiency

I started extension traction with the patient in our office, meaning that she laid over a pump that provided pressure to her cervical spine, over time it is expected that the curve will correct or at least improve.  The patient has been doing the traction at home for the last month, she has not had any migraine headaches, the pain and the spasm in the neck muscles have decreased by 80%.

I am upset with the fact that the Kaiser doctor, but I am sure that what she did is not because she did not care for the patient, but because she did not have the tools to care better.  All she could offer was  medication for the migraine and muscle relaxers.

The purpose of sharing this case study is to make these points: always get a second opinion, please ask to see your x-rays and the radiology report, know that chiropractic car could provide a natural solution to many conditions.  Consult with chiropractor to see if safe, natural chiropractic care could be appropriate for your condition.

For more information on this article or the cervical posture pump you can reach Dr. Mazgaloff at (415) 546-1461 or on the web at http://chirohealthsf.com/videos---links.html and watch the posture pump animation video.

Is Your Low Back Pain A Real Pain in the Butt?

Many people don't now that having weak glute muscles and hip abducters can lead to lower body injuries and changes in gait. So next time you're in the gym don't just work on your squat to look better at the beach, but also for a better overall quality of life. Lifestyle factor that lead to weak glute muscles, and glute medius more specifically are, sleeping on your side and flexing and adducting your top leg over your bottom leg. Standing predominantly with all of your body weight on one leg can cause the pelvis to move sideways and the hip joint to adduct; contributing to weak hip adductors. Ilitiobial band (ITB) syndrome, which is quite common can result from weak gluteus medius. Being unable to control thigh abduction and external rotation can place greater tension on the tensor fascia and ITB. Gluteus medius dysfunction can also contribute to patellofemoral pain syndrome, which results in decreased hip control and increased femoral adduction and internal rotation.
The following exercises can help with the aforementioned conditions. Before starting any exercise routine make sure to consult your doctor.

Side Lying Clams

 



Starting Position






 Ending Position. Hold for 3 seconds and slowly return to starting position.









Squats

 Starting Position

Ending Position. Make sure to keep back straight and go as far down as possible.








Sidestepping

 Starting Position

   Ending position. Take a step to the side as far as possible and return to starting position. Repeat on opposite side.
















Single Leg Sit Up/Down

 Starting Position. Begin seated.

 


Ending Position. Stand up on one leg slowly, and then slowly return to a seated position. Repeat on other leg.













Single Leg Step Up/Down

 Starting Position.




















Ending Position. Slowly climb up on one leg and slowly return down to starting position.


















Reference: Glute Medius & Hip Abduction Functional Training, www.dynamicchiropractic.com

Is Sitting the New Smoking?

As chiropractors in the Downtown/Financial District of San Francisco, we see the effects of sitting every day. Conditions include chronic headaches, low back pain, muscle spasms, stiff neck, hip pain, knee pain, degenerative disc disease in people as early as their 20's among other things. Many patients ask us why they have these pains and degenerative changes, since they are so young and otherwise healthy. Although they may not have the symptoms, most have on thing in common: 90% are sitting 6-12 hours a day.

Recently, Anup Kanodia, a physician and researcher at Ohio State University, Wexner Medical Center said, "Sitting is the new smoking".  According to an Australian study published in October 2012 in the British Journal of Sports Medicine, every hour of sitting, cuts about 22 minutes of the person's life, while it is estimated that smokers shorten their lives by about 11 minutes per cigarette.

No one wants to grow old with low back pain.  As chiropractors our goal is help you get out of pain, but more importantly to stay without pain, with better function, so that you can age as healthy as you possibly can be.  I have a 32 year old patient, who I love quoting: " I am here because I want to be the healthiest senior citizen I can possibly be."

Here is a look at how sitting affects us, as we sit for extended periods of time the posterior muscles in the low back, middle back, neck and pelvis become elongated, weak, inhibited, and underused. The hip and neck flexors on the other hand become short and taut. We mostly feel the muscle's response to sitting in the form of muscle spasms or tension, but the problem is far beyond the muscle. Prolonged slumped postures cause micro sprains and strains to the joints of the back and neck over prolonged periods of time. This leads to lose of neutral curvatures in the lumbar spine and the cervical spine, deformation of  ligaments that are elongated in the back and shortened in the front, disc compression, disc thinning, disc bulges, pain radiating to the arms or legs, or disc tears. The body overreacts to this damage and starts producing increased muscle tone, which feels like spasm, tension, knots in the muscles.  Naturally because it feels like spasm we start stretching the muscles instead of what we need to do, strengthen them.

So next time, you experience a spasm in the lower back, stiffness in the neck, sensitivity to certain movements or unexpected movements especially in the morning,  pain after sitting and standing,  or pain from sitting, standing, lifting or carrying, take into consideration that it may not just be a muscle spasm, and most likely a weakened disc that is likely to suffer further if not treated as such.  

Our chiropractors specialize in posture evaluation, muscle testing to identify front to back and left to right muscle imbalances.We are experts in differential diagnosis meaning we do all the orthopedic tests to help us differentiate a simple muscle spasm from, joint sprain/ strain and dysfunction , from disc protrusion or bulge.  We combine chiropractic, massage, physical therapy on the same visit to address all the structures involved: muscles, joints, nerves and discs.  For more information about this article and to contact Dr. Mazgaloff go to www.chirohealthsf.com.