Pain

Jun 25 2014

How Much Education Do Chiropractors Have?

Most are surprised that chiropractors take a minimum of 3 years of undergraduate courses and then 4 years of chiropractic college. The 4485 total hours in chiropractic college is about the same as in medical school. (please see chart below) Areas studied include: physiology, pathology, histology, chemistry, bacteriology, diagnosis, neurology, X-Ray, psychiatry, geriatrics, pediatrics, obstetrics/gynecology, orthopedics, kinesiology and chiropractic adjusting. Most chiropractors take additional seminars to improve their knowledge and adjusting skill set. The California Board of Chiropractic Examiners requires chiropractors to take 24 hours of continuing education courses each year, as well. The chiropractic profession is recognized and governed by a state board in all 50 states.

education

If you have more questions about this topic and how chiropractic care can keep you healthy, talk to Dr. Lance Casazza.

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May 28 2014

No Pain? Then why go to a Chiropractor?

A common question I get from patients is why should I go to a chiropractor when I have no pain or symptoms? Or in other words why should I get adjusted all the time? So the question really is what are the benefits of chiropractic care BESIDES pain relief.

If we are talking about an injury, the false assumption is that the injury is healed once the pain is gone. That doesn’t make any sense. Think about a broken bone. A fracture hurts like crazy for a few days and then it gets placed in a cast and it doesn’t hurt, but it still takes several weeks to heal. That is also true for soft tissue/joint injuries. Consider a sprained ankle. Hurts like crazy and then it may never heal properly, but again it doesn’t hurt. DC’s are “rehabing” injuries to restore proper function versus just pain relief.

Chiropractors want to maintain and maximize your health, NOT wait until you are SO sick, ill or injured that it becomes difficult, if not impossible to regain your health. Just think of working out, dental care or car tune-ups, we all know we shouldn’t wait until we’re 20lbs overweight, until our teeth fall out or until our engine seizes. The answer to health is to be proactive, not reactive. Chiropractic works the same way.

So how can I tell if I am getting any benefit if I don’t have any pain?
Fair enough. So let’s take a look at what kind of changes most patients experience or can expect with CONSISTENT & REGULAR chiropractic care. Results will vary based on the starting point of an individual’s health. With that said here are some things we CAN measure.

Check these after each adjustment, weekly or monthly.

 Pain level (decreased pain & reoccurrence of pain)
 Range of motion of your neck, rib cage and low back. (you should notice better, pain free motion)
 Posture (use your camera/phone to take a pre & post picture)
 Breathing (use your camera/phone to take a pre & post video)
 Blood pressure (check after each visit and long term)
 Sleep patterns (length of time you sleep & more restful)
 Stress level drops
 Diet, exercise & weight changes (changing your awareness of  health often motivates patients to make healthier choices)
 Fewer colds (as your immune system functions better, you should get sick less often)
 Fewer headaches
 Decrease need for pharmaceutical drugs
 Possibly avoid surgery
 Increased energy level
 Overall just feel better!

So if you are interested in all of these health benefits chiropractic care is an excellent choice.

If you have more questions about this topic and how chiropractic care can keep you healthy, talk to Dr. Lance Casazza.

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May 14 2014

Why Do Chiropractors Want To Get Adjusted Even If They Have No Pain?

Great question. Please take this quiz to discover the reasons. (good luck)

Q: With increased motion are muscles around the joint: longer and more flexible or shorter and tighter?

A: longer and more flexible

Q: Muscles that are longer contract more effectively and efficiently and thus are stronger? True or False

A: True

Q: With more motion soft tissue adhesions that restrict joint motion tend to form more or less?

A: Less

Q:  Inflammatory chemicals trapped in muscles and joints pumps out faster or slower with increased motion?

A: Faster

Q: When you get adjusted you can breathe better, thus taking in more oxygen. True or False

A: True

Q: Can you breathe easier with good posture or bad posture?

A: Good posture

Q: Can chiropractic care help with your posture?

A: Yes

Q: What is the essential element for all cellular function, including the brain?

A: Yes oxygen.

Okay I get it chiropractic can affect every cell in my body. But how can I actually tell? Fair enough, so let’s take a look at what kind of changes most patients experience or can expect with CONSISTENT & REGULAR chiropractic care. Results may vary based on the starting point of an individual’s health, but with that said here are some things we CAN measure. You can check these things after each adjustment, weekly or monthly.

 

  • Range of motion of your neck, rib cage and low back. (you should notice better, pain free motion)
  • Posture (use your own camera/phone to take a pre & post picture)
  • Ability to breathe (use your own camera/phone to take a pre & post video)
  • Blood pressure (measure after each adjustment, long term as well)
  • Energy level
  • Getting a good night’s sleep (length of time you sleep & more restful)
  • Pain level (this includes reoccurrence of pain)
  • Diet changes (changing your awareness of health often motivates patients to make healthier choices)
  • Weight changes (changing your awareness of health often motivates patients to make healthier choices)
  • Exercise habits (changing your awareness of health often motivates patients to make healthier choices)
  • Fewer colds (as the immune system functions at a higher level, you should get sick less often)
  • Fewer headaches
  • Decrease need for pharmaceutical drug
  • Overall just feel better!

 

And this is why chiropractor’s want to get adjusted, even when they have not pain!

If you have more questions about the benefits of chiropractic care, talk to Dr. Lance Casazza.

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Apr 16 2014

The Chiropractic Question

Chiropractic is an often misunderstood profession. There are so many public misconceptions, that they are just accepted versus explored. At a seminar the other day the instructor asked all the chiropractor’s if they would get an adjustment EVEN if they were pain free, and 100% said yes! The instructor also said, “if the public knew and understood what all the chiropractors in the room knew and understood that they could not handle the crowds in their offices”! So the question is what do chiropractors know that most of the public does not.

Let’s explore!

In its’ simplest, purest form a chiropractic adjustment puts the joints of the body in motion. So what is all the fuss about motion. Well remember the last time you stopped working out and how fast you lost your strength or your cardiovascular endurance or your flexibility? Yes motion is what keeps your body running.

But don’t believe  me, check it out the next time you get adjusted. Try a before and after motion test.

The Neck Test. Move your head and neck through all the possible motions: side to side, rotate to the left and right, and tip your head forward and back. Then after you get adjusted try them all again, you will notice a remarkable change. Way easier and an increase in motion.

The Low Back Test. Same thing, lean forward and back, twist left and right, and lean left and right. Now get your adjustment and try again. Hmmm interesting, the same thing more motion.

The Rib Cage Test. This time just a simple breathing test. Take a big breath before and after an adjustment. You will notice a huge difference. Bring your phone with you and we can video you before and after, and then you can show your family and friends.

So now we know and have experienced the increased motion and breathing. Now that we have established the fact that chiropractic adjustments increase joint motion, let’s explore the benefits. I feel like a simple test is in order. Yes a chiropractic exam if you will. I ask the questions and you respond with what makes sense to you.

The official, yet unofficial chiropractic exam! Part I (yes the teaser portion)

Q: With increased motion are muscles around the joint: longer and more flexible or shorter and tighter?

A: longer and more flexible

Q: Muscles that are longer contract more effectively and efficiently and thus are stronger? True or False

A: True

Q: With more motion soft tissue adhesions that restrict joint motion tend to form more or less?

A: Less

Q:  Inflammatory chemicals trapped in muscles and joints pumps out faster or slower with increased motion?

A: Faster

Fun, isn’t it. Watch for the next blog, which continues the chiropractic exam!

If you have more questions about the benefits of chiropractic care, talk to Dr. Lance Casazza.

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Oct 15 2013

Chiropractic Even Without Pain?

Collage of several of Gray's muscle pictures

So a few weekends ago I was attending a seminar for chiropractors and the speaker asked all the attendees if they would want to get adjusted if they were pain free. Every chiropractor immediately responded YES!

I was not surprised by this one bit. The speaker went on to say that most people in the general population would be shocked and confused on why chiropractors would want care in the absence of pain. So I thought I would explain why I want an adjustment even if I am not in pain.

What’s going on here?

First we need to understand why any joint should be adjusted if it is pain free.

With routine daily activities, (driving, sitting at a computer, house chores, etc) in time the soft tissues (muscles, ligaments, discs, tendons, fascia) slowly begin to fatigue and fail.

What happens?

  1. Muscles go into a contractile state with acute or chronic overuse, pain or not.
  2. Acute and/or chronic inflammatory chemicals flow into your muscles and other soft tissues, and they do not always cause pain but they begin to build-up.
  3. Acute and/or chronic inflammatory chemicals get trapped in your muscles and other soft tissues, and they do not always cause pain but they begin to build-up.
  4. Soft tissue adhesions begin to form (starting in 4 days of lack of proper motion) and tighten the tissues.
  5. All of these led to a decrease in proper joint motion, whether it is you low back, neck, shoulder, ankle etc. the same mechanism is occurring.

Then the adjustment!! 

The benefits of the adjustment

  1. Restores motion – both symmetry and range of motion
  2. Normalize biomechanics and load distribution of the joints
  3. Pumps out waste products and edematous fluid that had been trapped
  4. Improves blood flow, thus nutrition to the discs and articular cartilage
  5. Relaxes tight muscles
  6. Normalizes proprioception – position sense and kinesthesia
  7. Stimulates sensory-motor reflexes which improve dynamic muscular stabilization of joints
  8. Accelerates healing – as movement:
    1. increases metabolic rate of injured tissues
    2. increases collagen and protein production as the damaged tissue repairs
  9. Improves the alignment of new connective tissue to strengthen the soft tissue.
  10. Thoracic spine adjustments aid in improving your ability to breath.
  11. Oh yeah, and you feel amazing!!

Note: This is just the beginning of all the reasons I want to get adjusted as every part of your body functions at a higher level after a chiropractic adjustment.

See you soon…

If you have more questions about the benefits of chiropractic just ask: Dr. Lance Casazza.

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Oct 15 2013

Pain Theory vs Functional Theory?

Technique and Practice of Chiropractic

Pain theory is the idea that the only goal is to decrease or stop pain. Functional theory is the idea that we want the body region, soft tissue and joint to return to a maximum level of functionality.

A new patient wants or at least thinks they want just pain relief when they first come into a chiropractic office. There can be a huge disconnect between the chiropractor (who wants to restore function) and the patient (who wants pain relief) and why many patients are skeptical about chiropractic when they first come in. It is paramount that the patient understands the difference between the two ideals. And then if they still want just pain relief well then…

Pain Theory:

The quickest way to stop pain is to immobilize and ice the injured area. The good news is this will ease your pain. Just because you have no pain does NOT mean the joint is functioning properly!

The bad news is that with lack of motion and ice there are many negative physiological effects:

muscles atrophy and become weaker, muscles tighten reducing blood flow and function, soft tissue adhesions develop rapidly, proprioception of the joint is diminished and fluid flow (needed to bring nutrients into the injury site and remove toxic build-up) is slowed.

In other words besides decreasing pain everything to make the injury heal is being done backwards!

A Study Please:

Professor Lan Zhou and colleagues at the Neuroinflammation Research Centre at the Cleveland Clinic in Ohio discovered inflamed cells produce a high level of a hormone called insulin-like growth factor-1 (IGF-1) which significantly increases the rate of muscle regeneration. This suggests muscle inflammation after acute injury is essential to repair. Icing slows down the healing as it prevents the release of this hormone. This changes the idea that swelling must be controlled in order to encourage healing and prevent pain.

Additionally this could change how much patient monitoring is required when potent anti-inflammatory drugs are prescribed over a long period. It’s been known for a long time that excess anti-inflammatory medication, such as cortisone, slows wound healing. Federation of American Societies for Experimental Biology, Oct 2010.

Functional Theory: The idea here is let’s do everything we can to allow the injury to heal the best it can.

The goal is fast healing and maximal function. This is achieved by mobilization and heating of the injured site.

(Note: never determine this on your own, always check with your chiropractor as torn tissue or broken bones will both not respond well to this theory.)

The physiological effects of functional theory as compared to pain theory: muscles stay stronger and looser, adhesion formation is less, proprioception is maintained, and fluid flow is far better.

Chiropractic Adjustment: Functional theory is exactly what the adjustment is all about. Putting a joint into motion allows for optimal physiological function. A body/joint that moves well will always be healthier than one that does not.

If you have more questions about pain theory vs functional theory or chiropractic just ask: Dr. Lance Casazza.

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Jul 21 2013

Inflammation & Pain: Good or Bad?

Inflammation and Pain - Good or Bad?

Okay, so let’s take a look at inflammation. Many people think that inflammation is a bad thing. Well sometimes it is and sometimes not.

Acute Inflammation

Remember the acute inflammatory process is what helps heal the tissue. Hypothetically, if it were possible to remove all the inflammatory chemicals after an injury, the damaged tissue would NOT heal. The key is to control inflammation versus stopping it.

Ice vs. Heat

So if the injury is severe and there are obvious signs of inflammation; (pain, heat, redness, swelling and loss of function), then ice works well as it causes the blood vessels to vasoconstrict thus slowing down the flow of inflammatory chemicals into the injured soft tissue.

If the injury is mild and there are minimal or no signs of inflammation then heat works well. Think about what works best after a hard day’s work. A nice hot tub is effective as your muscles are tight and even though there is some minor inflammation occurring it is best to keep the blood vessels open and encourage the fluids to flow on through! NOTE: Always consult with me first in terms of using ice or heat, if you are uncertain.

Chronic Inflammation

This is a bit different. Chronic inflammation may occur in soft tissue from old nagging injuries that never heeled properly or from serious disease processes of visceral organs. This can be serious stuff!

Now For Pain!

Pain should be seen is neither good or bad, rather as an indicator that something is happening. The severity of pain does not always correlate with the severity of the injury. Here are some examples: Calf cramps, paper cuts, hitting your shin on the coffee table, these all hurt like crazy but are no big deal. Certainly you are not headed to the ER.

Try this. Pinch the skin on your forearm. Go ahead. That really hurts, but the lesson is a high degree of pain is not always a big problem.

And try this. Bend your finger back until it’s painful. (I know crazy, silly stuff). A biopsy of the tissue won’t reveal a tumor, infection or any lesion. But releasing the finger and letting it return to its “position of comfort” will allow the pain to subside. We need to think about low back and neck pain in a similar way -functionally.  97% of back pain seen by primary care physicians is mechanical in origin -there’s something wrong with the muscles, ligaments or connective tissues. Physician & Sports Medicine, 1997.

The Potential Bad News. On the flip side many deadly diseases, cancer and diabetes, are life threatening but can cause virtually no pain in the early stages.

Chiropractic Edge! So many people are fearful of chiropractic because it may hurt or it looks like it hurts.

The reality is that for most patients it is a painless event. More importantly it can give you great relief! It is possible that you may be sore for a few days after the initial adjustment or two, but that is just old trapped inflammatory chemicals releasing and new chemicals flowing in. This can last 1-3 days and is a NORMAL part of the healing process.

If you have more questions about inflammation or chiropractic just ask: Dr. Lance Casazza.

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Jun 13 2013

Proper Stretching – How and Why to Do It

Tight Muscles. First we need to understand why a muscle is tight.

Muscles can be short and tight for many reasons:

  1. physiologically the muscle is in a partially contracted state from posture or overuse
  2. neurologically the muscle is in an “on” state or excited overly contracted state
  3. adhesions have formed in and around the joint and/or muscle causing restriction
  4. decreased blood flow, which means less oxygen and nutrients (electrolytes) that allow for proper muscular function

There are many stretching techniques. All stretching methods can be effective, but there are a couple tricks that can make your stretching even more beneficial.  Let’s take a look.

Collage of several of Gray's muscle pictures, ...
Collage of several of Gray’s muscle pictures, by Mikael Häggström (User:Mikael Häggström) (Photo credit: Wikipedia)

Classic Stretching. What we learned in high school was just stretch the tight muscle. This is relatively ineffective because the tight muscle is still attempting to contract or is in a partially contracted state. You will still gain some flexibility but this is the least effective method.

Try This. Sit on the floor and with your feet out in front of you and knees open and extended try and touch your toes. This is your baseline study. Now take a big breathe in (2-5 seconds) and then blow it out and try to touch your toes again. You will likely notice a big difference. Lesson: muscles love oxygen, this is why when you go for a hike you breathe harder as your muscles are simply demanding more oxygen!

Another Trick. Proprioceptive Neuromuscular Facilitation Stretching (What is that?)

Try This. Sit on the floor and with your feet out in front of you and knees open and extended contract all of your posterior muscles, that is your calves, hamstrings and gluts (butt muscles), effectively your toes will be pointing away, (plantar flexion). Contract these muscles for 5-10 seconds, then relax for 1-2 seconds, while you take a slow deep breath, (2-5 seconds). Now stretch again and try and touch your toes. Again you will likely notice a marked difference.

This technique is called “Contract-Relax-Passive Stretch” and should be used for all stretches.

Here is the protocol for all muscles:

Contract muscle to be stretched for 5-10 seconds.

Relax it for 1-2 seconds, while taking a slow deep breath for 2-5 seconds.

Passively stretch the muscle & hold the stretch for 15-30 seconds or less based on your tolerance/comfort.

Repeat 3-5x or less based on your tolerance/comfort or need.

Allow 30-60 seconds of rest between repetitions.

In the next blog we will discuss bad stretches and what to avoid, until then stay loose!

If you have more questions about stretching just ask: Dr. Lance Casazza.

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Mar 25 2013

The Importance of Good Posture

English: Bad posture

We always hear about the importance of posture. Your mom or a teacher constantly reminded you when you were young to “sit-up straight”! So let’s take a closer look and see if they were onto something.

First a study and the importance of posture?

Posture affects and moderates: spinal pain, headache, mood, blood pressure, pulse, respiration, sympathetic function, homeostasis, autonomic regulation, breathing and hormone production. Sound pretty important!

American Journal of Pain Management, 1994

Dramatic respiratory changes.

Did you know that after age 20 that your vital capacity, (maximum volume of air that a person can exhale after maximum inhalation), decreases 5-20% per decade! Mostly due to postural changes! Brian K Ross MD, University of Washington

A quote from someone in the know:

“Better than 90% of the energy output of the brain is used in relating to the physical body in its gravitational field. The more mechanically distorted a person is (bad posture), the less energy available for thinking, metabolism and healing.” – Dr. Roger Sperry, Nobel Laureate

Sit-up Straight! Loss of proper joint structure and function (due to poor posture) increases adhesion formation in the soft tissue in and around the spine. Grieve, Common Vertebral Joint Problems, 1988

Now go take a look. Next time you are out, start observing people over 50. First ask yourself; do they have good or bad posture. Then ask yourself if they look healthy or not. You will discover that almost always people with good posture look younger and healthier than those with bad posture. Very interesting indeed.

How about a couple of demonstrations? Try this.

First sit-up straight and take a big breath in and out. Notice how full a breath you can take.  Now hunch over and breathe again. The difference is obvious. With chiropractic adjustments and proper stretching you can maintain or improve your ability to breathe.

Here is another demonstration. Try this.

Stand up straight with good posture, (head directly over shoulders, no tilted head) and put your arm out at 90° to your side. Have someone behind you push down on your arm as you resist their effort. Your shoulder should hold strong. Now slump over (anterior head translation and flexion) with bad posture and have your partner push down again, your shoulder should be weak and you should have some difficulty holding it up. That does seem odd, it is as if your muscle was shut off. Try this on your family and friends.

Explanation. With good posture your brain can communicate through your spinal cord to all your muscles and vital organs. In turn your muscles and vital organs can communicate back to your brain. This is your autonomic nervous system at work. There is a constant two-way flow of information that helps run all your systems and keeps you alive. With poor posture you can see that information is slowed and the systems do not work at 100%. With proper posture you can maintain proper nervous system function.

Big benefit! Maintaining your autonomic nervous system function is one of many benefits of chiropractic care that has nothing to do with pain. All too often the public thinks that chiropractic care is only useful for low back pain. Not so, in future blogs we will continue to discuss other benefits of care that are not pain related.

Chiropractic adjustments: Routine care is the best way to maintain proper posture. If you have more questions about the importance of posture and how chiropractic care can help, talk to Dr. Lance Casazza.

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Casazza Chiropractic
2716 V Street, Sacramento CA 95818
Office: (916) 447-2200 – Fax (916) 447-7930
Email Dr. Casazza: [email protected]

Hours
Mon. 8-1 and 3-5;
Tues.-Thurs. 8-1  and 3-6;
Fri. 8-1 and 3-5; Sat. 8-12

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