Saturday, October 27, 2012

The Facts About Osteoporosis

 By:  Dr. John A. Papa, DC, FCCPOR(C)

Osteoporosis is a disease of bones that decreases bone mass and strength, making them more fragile and susceptible to fracture.  Osteoporotic fractures of the spine and hip are linked to an increased risk of death within the first year after fracture.  Other effects of osteoporotic fractures can include chronic pain, depression, loss of freedom and long-term disability.  Below are some additional facts about osteoporosis.

·        The risk of major osteoporotic fracture in Canada is among the highest in the world.  The cost to the Canadian health care system of treating osteoporotic fractures is currently estimated to be $1.9 billion annually.
·        Osteoporotic fractures are more common than heart attack, stroke and cancer combined.  Each year over 125,000 Canadian women suffer osteoporotic fractures affecting the spine, hip, wrist, shoulder, pelvis, and other regions in the body.  The diagnosis of a single fracture increases the risk of subsequent fractures.
·        Some of the risk factors for osteoporosis include:  advancing age, female gender, family history, caucasian race, early menopause, use of certain medications, tobacco and excessive alcohol use, insufficient physical activity, and dietary calcium and/or vitamin D deficiency. Although considered a female health issue, osteoporosis is also becoming a major health concern among males.
·        Bone mineral density testing (BMD) can help identify those at risk for osteoporotic fracture and in need of health care management.
·        Increasing dietary calcium and vitamin D can help reduce bone loss.  Other key nutrients, which have been identified as being crucial for healthy and strong bones, include the correct balances of vitamins C, E, and K, and micronutrients magnesium, boron, potassium, and folic acid.
·        Precautions can be taken by osteoporotic individuals to minimize the risk of slip and fall injuries inside and outside the home.  Regular exercise can also improve an individual's strength, balance, and coordination and help with preventing falls and the risk of fracture.
·        Resistance (weight-bearing) exercise is best for directly reducing the rate of bone loss.  Non-weight-bearing exercises such as swimming, cycling, and walking must be combined with resistance exercise to be of benefit in slowing bone loss.  Examples of resistance exercise include the use of ones own body weight for performing movement (i.e. squats, push-ups), weight machines in a fitness facility, dumbbells, and resistance tubing.  Resistance loads need to be greater than those experienced during normal daily activities.  The effects of resistance exercise are site specific, meaning that only bones that are loaded through resistance will benefit from the activity.  To maintain the positive effects of exercise on bone, the program must continue throughout life.

Although certain risk factors cannot be controlled in combating bone loss, there are natural lifestyle choices an individual can make in preventing the onset of osteoporosis and the risk of fracture.  For more information on lifestyle, dietary and exercise management strategies concerning osteoporosis visit

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, October 18, 2012

Common Back Pain Myths
By:  Dr. John A. Papa, DC, FCCPOR(C)

Back pain is the second most common medical complaint after the common cold.  80% of all Canadians will suffer from at least one significant episode of back pain in their lives.  Below are some of the common myths surrounding back pain and what modern thinking and science has to say about them.
Myth 1:  If you’ve injured a disk (i.e. herniation, rupture), you must have surgery.
Truth:  Surgery to relieve back pain should only be used as a last resort.  Even if specific testing reveals a damaged disk, recovery often results without surgery.  An injured disk in the back may become inflamed and put pressure on nerves and surrounding pain sensitive structures. 
Non-surgical treatment aims at minimizing pain and discomfort from joint irritation and muscle spasm, and prescribing specific exercises to help with recovery.

Myth 2:  Most back pain is caused by injuries or heavy lifting.
Truth:  Injuries caused by heavy lifting do not account for all back pain.  In up to 85% of cases, individuals can’t recall a specific incident that brought on their back pain.  Back pain can result from a single exposure to a bending or twisting incident or it can be small cumulative loads placed on the spine over time.  Scientific research also links the following risk factors to back pain: smoking, being overweight, poor posture, poor physical fitness, and stressful life events.

Myth 3:  X-ray images, CT and MRI scans can always identify the cause of pain.
Truth:  Even the best imaging tests cannot identify a muscle spasm or ligament sprain that may be the cause of pain.  Imaging is usually reserved for special cases such as those suffering trauma in a fall or accident, surgical candidates, unresolved cases of severe chronic back pain, and suspicion of underlying tumor, infection or other serious disease.
Myth 4:  If your back hurts, you should take it easy until the pain goes away.  Bed rest is the mainstay of therapy.
Truth:  Clinical data indicates that individuals who remain active do better than those who try bed rest.  Remaining active means continuing with daily activities as tolerated and easing back into a regular routine.  Activities may have to be modified while recovery occurs, but movement is important for recovery provided it does not put the individual at risk for further injury.
Myth 5:  Diagnosing back pain is simple and straightforward.
Truth:  The causes of back pain can be complex and difficult to diagnose.  There are many biological tissues that can generate pain in the back.  These may include muscles, ligaments, bones, nerves, and joints.  Quite often it is a combination of several or all of these structures that can manifest into back pain and even referred pain into the buttock or leg regions.  A licensed health practitioner who deals with back pain is best trained to diagnose the source(s) of your problem and prescribe appropriate therapy when required.  For more information, visit

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, 2012

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 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  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.