Thursday, November 15, 2018

Treatment And Prevention Of Whiplash Injuries


By Dr. John A. Papa, DC, FCCPOR(C)

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

2.    Wear your seatbelt at all times.

3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

4.    Never operate cell phones or other electronic equipment while driving.

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

6.  Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

7.  Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC.

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Thursday, November 8, 2018

Understanding Whiplash Injuries


By Dr. John A. Papa, DC, FCCPOR(C)

Whiplash is a common injury that can be experienced following a motor vehicle collision (MVC).  There are more than 100,000 whiplash cases in Canada each year.  The unique forces generated during these collisions can stress biological tissues and result in pain and decreased functioning for those affected.  This article provides a review of whiplash specifically focusing on the mechanics of injury, the associated symptoms, and general guidelines for the evaluation of any accompanying injuries.

Although rear-end collisions are the most commonly reported mechanism of whiplash injury, an injury may also occur following side and head-on collisions.  The forces generated from these types of impacts thrust the head (and to a lesser extent the entire body) back and forth, much like a snapping whip.  Injury results because the body is unable to compensate adequately for the speed of head and torso movement from the acceleration forces generated at the time of impact.  This will put stretch, compressive and shear stresses on biological tissues such as muscles, ligaments, joints and nerves.  As a result, this can generate pain symptoms, and affect range of motion, strength, coordination, and balance.  The onset of whiplash symptoms may immediately follow a MVC or may gradually develop over the first 24-72 hours.  A later onset of symptoms does not necessarily indicate a more serious injury.

Neck pain is frequently associated with whiplash injuries.  However, the whiplash mechanism may also cause injury and symptoms that include: whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.  The term WAD (Whiplash Associated Disorder) encompasses all of these potential symptoms and is commonly used to grade the degree of injury present.  Of the four Grades of WAD, Grades 1 and 2 represent the majority of whiplash cases.

Evaluation of whiplash injuries should include a proper medical history, along with a physical examination consisting of inspection, palpation for tenderness, range of motion, strength, neurological, orthopaedic and functional testing.  Signs of serious injury, such as fracture, are usually evident in early assessments and may require further diagnostic testing such as x-ray, CT scan, or MRI.  Chiropractors are healthcare professionals skilled in the diagnosis and treatment of whiplash injuries and are commonly involved in the management of WAD.

When an individual sustains a whiplash injury, injured tissues can become stiff and weak when they are not used, which can further exacerbate pain symptoms.  Therefore, a return to daily activities after whiplash injury is extremely important for successful healing as extended rest may prolong recovery.  Healing and a return to daily activities may be facilitated with active treatment and rehabilitative exercise prescription.  Join us next month when we specifically take a closer look at the treatment and prevention of whiplash injuries.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Tuesday, October 30, 2018

Understanding Sciatica


By Dr. John A. Papa, DC, FCCPOR(C)

The sciatic nerve is the longest nerve in the human body.  It is made up of five separate nerve roots originating from the low back region on each side, and runs from your pelvis through your buttock and hip area and into each leg.  It controls many of the muscles in your legs and provides feeling to your thighs, lower legs and feet.

"Sciatica" is a common term used to describe any type of pain/symptom that radiates into the leg.  "True sciatica" occurs when there is a mechanical and/or inflammatory irritation directly affecting any component of the sciatic nerve.  This differs from “referred” pain/symptoms which can arise from a bone, joint or muscle that can send pain/symptoms into the leg.

True sciatic symptoms may be felt almost anywhere along the nerve pathway.  These symptoms can radiate from the low back region, into the hip or buttock, and down the leg, into the calf, and even the toes.  The symptoms can vary widely and may include:  a cramping or achy feeling, tightness, burning or a sharp electric shock sensation, numbness, tingling, and leg muscle weakness.  The symptoms may start gradually and intensify over time.  Activities such as bending forward or to the side, walking, prolonged sitting or standing, and even coughing or sneezing may aggravate sciatica.

Below is a brief summary of three common causes of true sciatica:

1.  Spinal disc herniation/bulge – Spinal discs separate and cushion lumbar vertebra.  Repetitive and cumulative loads or a single heavy load has the potential to cause a disc bulge or herniation, thereby causing a mechanical and/or inflammatory irritation of the nerve root(s).  This most commonly occurs in adults aged 20-50.

2.  Degeneration and Osteoarthritis – The normal aging process causes lumbar disc degeneration, osteoarthritis of lumbar joints, and occasionally vertebral slippage.  The consequence of these processes is that mechanical irritation from bony spurs and vertebrae, along with inflammation can cause symptoms of sciatica.  This most commonly occurs in adults over 50.

3.   Lumbar spinal stenosis – This condition causes sciatica due to narrowing of the spinal canal and/or nerve pathways.  This puts pressure on the spinal cord or nerve roots and causes neurovascular irritation.  This most commonly occurs in adults over 60.  It is usually secondary to degeneration and osteoarthritis.

Other causes of "true sciatica" include: direct irritation of the sciatic nerve by the piriformis muscle; direct trauma or injury to the sciatic nerve or nerve roots; and postural and mechanical changes associated with pregnancy.  Some common causes of sciatic-like symptoms or "referred" pain include: muscular trigger points and ligament sprains from the low back, hip, gluteal and pelvic regions; sacroiliac joint dysfunction; and arthritic low back, hip and knee joints.

Sciatica is a set of symptoms of a problem, rather than a diagnosis for what is irritating the nerve and causing the pain.  This is an important point to consider because the treatment for sciatica will often be different depending on the underlying cause of the symptoms.  Therefore, it is important to obtain an accurate diagnosis from a qualified health professional.

When sciatica strikes, there are conservative treatment options available.  These may include: mechanical traction, spinal manipulation and mobilization, soft tissue techniques, laser therapy, acupuncture, ice/heat application, electrotherapy, and rehabilitative exercise.  A qualified health professional can determine the cause of your sciatica and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Sunday, October 28, 2018

2018 Record Reader Award Winners

WE WON!!



We sincerely thank you for your votes and support in the 2018 Record Readers Awards.

New Hamburg Wellness Centre was awarded the following:
  • Favourite Chiropractic Clinic - PLATINUM 
  • Favourite Alternative Medicine Clinic - PLATINUM
  • Favourite Massage Therapy Clinic - GOLD

We are extremely proud and honoured to have received your nominations and votes for the last FIVE years in a row!

Come visit us at 338 Waterloo Street, Unit 9 in New Hamburg.
New patients are always welcome!
www.nhwc.ca
519-662-4441

Monday, October 22, 2018

Injury Prevention Tips For Hockey Players


By Dr. John A. Papa, DC, FCCPOR(C)

Hockey is a popular recreational sport enjoyed by individual's of all ages and abilities.  Due to the high speed and aggressive play involved, hockey can put players at risk for injury.  Although sticks, pucks, and skate blades can do damage, most hockey-related injuries occur due to collisions with other players and the boards.  Fatigue and low energy of participants due to poor endurance, insufficient rest, or too much ice time can also make them more likely to get hurt.

Most hockey injuries involve the upper body, and can include fractures, sprains and strains of the collarbones, hands, arms, and shoulders.  Low back, groin, hip, knee, and ankle injuries also occur frequently.  Concussions are the most common type of head injury and are often accompanied by neck injury/pain.

Included below are some tips to help hockey players avoid and/or minimize the chances of muscle and joint injuries.

1.  Proper training is important.  A good training program should involve cardiovascular, stretching, and strengthening exercises.
  • Cardiovascular training will increase endurance and decrease fatigue, which has been linked to injuries.
  • A comprehensive stretching program for the back, arms, shoulders, thighs, and legs should be performed both before and after games to keep muscles limber and prevent stiffness and soreness.
  • Strengthening programs improve a muscle’s ability to contract and perform joint movement.  Muscles also act as important shock absorbers and help prevent sprains and strains of vulnerable regions such as the back and neck, along with the shoulder, hip and groin regions.

2.    Get enough rest and hydration.  Since fatigue is one of the most common causes of injury, even the fittest players should often take breaks to rest.  Dehydration affects your energy level and your physical functioning.  Drink plenty of fluids before, during, and after play.

3.    Use the right equipment.  Properly fitting gear can make a world of difference when it comes to avoiding injury.  Replace worn out equipment.  Helmets have a life span of three to five years, depending on how often they are used.  Helmets with face shields have been proven to reduce the severity of concussions regardless of the player's experience level and position when compared to visors alone.

4.    Respect the rules.  Promote sportsmanship and fair play.  Support a zero tolerance rule for illegal checks and maneuvers.

5.   Take care of injuries before returning to play.  This will ensure top physical functioning and help prevent further injury and chronic pain.

Chiropractors are healthcare professionals skilled in the diagnosis and treatment of hockey-related injuries.  In the event that you suffer a muscle or joint injury while playing hockey that does not subside,  consider chiropractic care.  For more information, visit www.nhwc.ca.  The author credits the Ontario Chiropractic Association (OCA) in the preparation of this educational information for use by its members and the public.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Wednesday, October 10, 2018

The Chiropractic Patient Experience

By Dr. John A. Papa, DC, FCCPOR(C)

 
In last week’s article “An Introduction to Chiropractic Care”, we specifically focused on the training and education of chiropractors, regulation of chiropractic, and the scope of chiropractic care.  This article will focus on the chiropractic patient experience written specifically from the author’s perspective of what patients experience at his private practice.  Individual chiropractic experiences may vary in different chiropractic settings dependent on practitioner interests, experience, education, and training.
 
Chiropractors provide diagnosis, treatment and management of disorders arising from the musculoskeletal system (joints, muscles, tendons, nerves, and bones), such as back pain and neck pain.  Before any treatment is commenced on a prospective chiropractic patient, there are several steps that are taken to ensure the case is one that can be helped with chiropractic care.
 
First, a thorough Medical History is taken which documents an individual's specific complaint and may also include questions concerning past surgeries and illnesses, medication use, general and family health history.  Second, a Physical Examination is performed consisting of orthopedic, neurological, and range of motion testing.  X-rays may also be ordered to help determine the source of pain or dysfunction.  Third, a Diagnosis and Prognosis is provided to the patient to let them know if their complaint(s) can benefit from chiropractic care.  If the complaint will not benefit from chiropractic care, a referral is made to the appropriate health discipline.
 
For all complaints that may benefit from chiropractic care, a proposed treatment plan is communicated to the patient, including type of treatment and duration.  Factors taken into consideration when developing a treatment plan for a particular individual include age, sex, severity and duration of complaint, lifestyle and environmental factors, physical health and fitness, medication use, and any other relevant health conditions.  In addition, factors relating to patient concerns and preferences are also taken into account, because patients always have a choice as to the type of care they wish to receive.
 
Chiropractors are trained to offer multi-modal physical therapy incorporating the use of different techniques commonly employed in combination with each other to decrease pain, stimulate healing, and restore overall function.  Chiropractic adjustments and mobilizations are just one mode of therapy utilized by chiropractors (but not with every patient), to restore normal motion and functioning in joints.  Soft tissue therapy is used to alleviate muscle spasm, decrease scar tissue, and increase pain free ranges of motion.  Electrotherapy involves the application of relaxing therapeutic electrical current or sound waves to the area of injury, dysfunction, or pain (i.e. TENS, interferential current, ultrasound).  Acupuncture can be used to promote healing, decrease pain, and control inflammation.  Rehabilitative exercise prescription may also be used to improve balance, coordination, strength, flexibility, and posture.
 
Contemporary chiropractic care provides many options for prospective and current patients seeking effective and safe therapy for their musculoskeletal complaints.  Additional chiropractic resources can be found at:  (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).
 
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.
 

Wednesday, October 3, 2018

An Introduction To Chiropractic Care

By Dr. John A. Papa, DC, FCCPOR(C)

Chiropractic is one of the largest primary contact health professions in Canada.  Approximately four and a half million Canadians use the services of a chiropractor each year.  Despite the professions growing popularity, there are still many in the public who don’t exactly know what services a chiropractor performs or what qualifications and training they possess.  This article is the first of a two part series introducing the chiropractic health discipline and the profession’s role in the health care system.
A large majority of patients who seek chiropractic care do so for complaints of the musculoskeletal system (joints, muscles, tendons, nerves and bones).  Chiropractors provide diagnosis, treatment and management of these complaints which may include but are not limited to:  back pain, neck pain, sciatica, whiplash, osteoarthritis, migraine and tension headaches, upper and lower extremity complaints, along with repetitive strain, sport, work and motor vehicle injuries.

Chiropractic practitioners undergo a rigorous course of study similar to that of other health professionals.  Training involves a minimum of three years undergraduate university education, followed by another four years of intensive academic and clinical education at an accredited chiropractic college.  Becoming licensed to practice chiropractic requires all eligible candidates to pass national and provincial examinations before applying to the Licensing Board.  Specialized post-graduate training enables the chiropractors of today to offer their patients additional treatment options.

Chiropractic in Canada is regulated by provincial statute in all provinces (The Chiropractic Act, 1991), created in accordance with the Regulated Health Professions Act (RHPA, 1991).  Chiropractors along with medical doctors, dentists, psychologists, and optometrists have the legislated right and obligation to communicate a diagnosis and to use the title doctor.  The College of Chiropractors of Ontario, like the colleges in each of the other provinces, is similar to the regulatory bodies for other health professions.  It is responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.

Chiropractic is well recognized within the health care system.  Chiropractic care is covered by the Workplace Safety and Insurance Board (WSIB) for occupational injuries, by automobile insurance in the event of a motor vehicle accident (MVA) injury, and by many Extended Health Care (EHC) plans.  A medical referral is not necessary to access chiropractic care.  Chiropractic adjustments are just one mode of therapy utilized by chiropractors today (but not with every patient).  Some chiropractors are also trained to employ other forms of physical therapy such as acupuncture, electrotherapy, soft tissue therapy, and rehabilitative exercises.  If your complaint is not something that would respond favorably to chiropractic care, a referral is made to the appropriate health professional.

Additional chiropractic resources can be found at: (www.nhwc.ca), (www.chiropractic.on.ca), and (www.ccachiro.org).  Join us next time for the second part of this series on chiropractic where you will learn about the chiropractic experience from a patient’s perspective.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Wednesday, September 26, 2018

Low Back Or Leg Pain Aggravated By Back Extension

By Dr. R. Greg Lusk, DC

Spine flexion, or bending forward of the spine, has been the main movement or function discussed in the articles I've written to date, and rightly so as it is the dominant activity that produces and perpetuates low back pain. However, it's counterpart, spine extension, which often plays a relieving role for most cases of low back pain, can be a source of aggravation in others. Specifically, in a low back with prominent osteoarthritis (OA), which is the general term for degenerative disc and/or joint disease, the structural changes can result in disc space narrowing between our vertebrae, the development of bone spurs, and/or the thickening (i.e. hypertrophy) of the bony sides of the joints (facets) or other soft tissues (e.g. ligamentum flavum). Collectively, these changes can narrow the hole(s) between the vertebrae (foramen) where our spinal nerves exit and even compress the nerve(s) as it passes through the opening. Back extension exaggerates this narrowing (i.e. stenosis) further and can lead to low back and leg pain, numbness, weakness, and a reduced ability to stand or walk. Medically, this is referred to as neurogenic claudication or degenerative lumbar spinal stenosis (DLSS).


Now, since low back OA is incredibly common, particularly with increasing age, it is important to realize that this doesn't mean that back extension is bad for everyone with OA. Remember that disc bulges are in fact part of low back OA and can irritate nerves that travel down the legs, but that they often respond well to back extension exercises while being aggravated by spine flexion. This highlights the need for case by case management with investigation of the patient's symptoms and then confirmation via assessment. With respect to a patient with DLSS, it is often reported that low back or leg symptoms are aggravated with either standing or walking, but alleviated with sitting or bending forward. It may even be noted that walking while pushing a shopping cart or riding a bike, which flex the lumbar spine and open up the spaces where the nerves exit the spine, are comfortable. Assessment of ranges of motion and nerve tension in the legs are components of an examination that could then be done to increase confidence in the diagnosis of DLSS.

For patients with severe symptoms, surgery may be an option where bone and ligaments around the stenosis are removed to decompress the nerve. However, for those with mild to moderate symptoms related to DLSS there have been encouraging results published when participants completed a 6 week spine mobility boot camp. The multimodal program included manual therapies to improve mobility in the low back and hips, numerous daily exercises that promote spine flexion, and education with respect to body repositioning for symptom relief. Self-rated disability, leg pain intensity, and improved walking tolerance were improved upon completion of the program and persisted for 3.5 years. Exercises examples include lying on your back and pulling either one or both knees to your chest, pulling one knee to the chest and then leaning it across the body toward the opposite hip, seated toe touching, and riding of a stationary bike. Walking with a posterior pelvic tilt, where you rotate your pelvis to tuck your tailbone and/or raise the area where a belt buckle would rest, which opens up the lumbar joints, is an example of body repositioning during activity. Timing your baseline walking duration prior to symptom onset, and then re-checking after performing these sorts of things for a number of weeks would allow you to monitor your progress and assess the value of your effort.

This article is for general information purposes only and is not to be taken as professional medical advice.

Monday, September 24, 2018

PLEASE VOTE FOR US!




The New Hamburg Wellness Centre has been nominated as a top 10 finalist in this year's Record Reader Awards in the following 3 categories:

1.      Favourite Chiropractic Clinic

2.      Favourite Massage Therapy Clinic

3.      Favourite Alternative Medicine Clinic


We are asking for your support to help us get to a winning position.

All you need to do is:

    1. Login in with your email and password if you have voted in previous years

OR

    1. Select "Register a new account" if you have not voted in the past

  • Select Health, Wellness & Beauty and select each of the above 3 categories and vote for New Hamburg Wellness Centre.

For those with multiple e-mail addresses, you can register with each address and vote again!


Voting will take place from Saturday September 22nd until Saturday September 29th at midnight.

Please share this with your contacts.

We appreciate your support!

Thank-you in advance.


Friday, September 14, 2018

Understanding Medical Acupuncture Treatment


By Dr. John A. Papa, DC, FCCPOR(C)

Acupuncture is a 2000-year-old Chinese treatment in which needles are inserted into specific points on the body.  The World Health Organization (WHO) lists approximately four-dozen different conditions that can legitimately be treated by acupuncture.   Acupuncture treatments can be particularly helpful for pain complaints such as:  muscular strains, joint sprains, arthritic pain, neck and low back pain, rotator cuff tendonitis, tennis elbow, hip, knee and leg pain, sciatica, bursitis, migraine and tension headaches.

The term "Medical Acupuncture" refers to acupuncture performed by a licensed health care professional who has training in the health sciences.  Practitioners of Medical Acupuncture derive the concepts of disease, dysfunction, and healing from the western biomedical understanding of pathology, anatomy, physiology and biochemistry.  Under this model, the act of inserting an acupuncture needle into the body is believed to result in the following:

·      Pain Control - Pain-blocking substances are released locally and by the central nervous system to suppress the transmission of pain.
·   Inflammation Control - Natural anti-inflammatory chemicals are released locally, and inflammation control centers are stimulated in other parts of the body.
·   Blood and Lymphatic Flow - Enhancement of blood and lymphatic flow locally and throughout the body allows for the delivery of fresh oxygen and the removal of injury debris from the injury site.

The needles used for acupuncture are much smaller than a standard hypodermic needle.  These needles are solid, not hollow, and have a finely tapered point as opposed to a bevelled cutting-edge point.  The sensations felt during needle insertion range from feeling nothing at all, to mild tingling, to slight numbness/achiness, to small electrical pulsations distant to the site of insertion.  All these sensations typically subside once the needles are removed.  It is common practice nowadays for practitioners to use sterile disposable needles that are discarded following treatment.

As with any health intervention, there is always a potential for side effects and adverse reactions.  The good news is that acupuncture performed by an experienced and knowledgeable practitioner is relatively safe and infrequently yields minor side effects.  These may include but are not limited to: a slight discoloration at the acupuncture site that is temporary and not dangerous; minor bleeding; nausea; short-term fatigue or drowsiness; or a short-term increase in pain before relief sets in.  An experienced and knowledgeable practitioner aims to avoid treatment of certain points during pregnancy, over wounded or infectious areas, to individuals who are hemophiliacs, and to individuals who have needle phobia.

Medical Acupuncture treatments can be safely and successfully employed to help promote healing and recovery from pain complaints including muscle and joint injuries.  Acupuncture treatments are also often utilized in conjunction with other rehabilitative strategies such as exercise prescription, manual adjusting and mobilization techniques, and soft tissue therapy.  For more information visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.