Dale City VA Chiropractor

Is this headache a headache?

Headaches are a very common reason people come to see your Chiropractor in the Woodbridge, Dale City VA area.  Some times a headache is just that, a headache, but more often than not it is coming from the top of your neck.   This is the type of headaches your chiropractor in the Woodbridge, Dale City VA area can you with.

Research shows that spinal manipulation – the primary form of care provided by doctors of chiropractic – may be an effective treatment option for tension headaches and headaches that originate in the neck.

A report released in 2001 by researchers at the Duke University Evidence-Based Practice Center in Durham, NC, found that spinal manipulation resulted in almost immediate improvement for those headaches that originate in the neck, and had significantly fewer side effects and longer-lasting relief of tension-type headache than a commonly prescribed medication.

Also, a 1995 study in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulative therapy is an effective treatment for tension headaches and that those who ceased chiropractic treatment after four weeks experienced a sustained therapeutic benefit in contrast with those patients who received a commonly prescribed medication.

Headache Triggers

Headaches have many causes, or “triggers.” These may include foods, environmental stimuli (noises, lights, stress, etc.) and/or behaviors (insomnia, excessive exercise, blood sugar changes, etc.). About 5 percent of all headaches are warning signals caused by physical problems.

Ninety-five percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. These types of headaches are not caused by disease. The headache itself is the primary concern.

“The greatest majority of primary headaches are associated with muscle tension in the neck,” says Dr. George B. McClelland, a doctor of chiropractic from Christiansburg, VA. “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

 

What Can You Do?

The ACA suggests the following:

If you spend a large amount of time in one fixed position, such as in front of a computer, on a sewing machine, typing or reading, take a break and stretch every 30 minutes to one hour. The stretches should take your head and neck through a comfortable range of motion.

Low-impact exercise may help relieve the pain associated with primary headaches. However, if you are prone to dull, throbbing headaches, avoid heavy exercise. Engage in such activities as walking and low-impact aerobics.

Avoid teeth clenching. The upper teeth should never touch the lowers, except when swallowing. This results in stress at the temporomandibular joints (TMJ) – the two joints that connect your jaw to your skull – leading to TMJ irritation and a form of tension headaches.

Drink at least eight 8-ounce glasses of water a day to help avoid dehydration, which can lead to headaches.

What Can a Doctor of Chiropractic Do?

Dr. McClelland says your doctor of chiropractic may do one or more of the following if you suffer from a primary headache:

Perform spinal manipulation or chiropractic adjustments to improve spinal function and alleviate the stress on your system.

Provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins.

Offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

“Doctors of chiropractic undergo extensive training to help their patients in many ways – not just back pain,” says Dr. McClelland. “They know how tension in the spine relates to problems in other parts of the body, and they can take steps to relieve those problems.”

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Best way to sleep!

It seems like the easiest thing to do, lay down close your eyes and sleep.  Yet as most of us can agree it is not that easy.  Your Woodbridge, Dale City VA Chiropractor has a few ideas to help make sleeping easy.

Lower back pain: Patients suffering with low back pain (LBP) most often prefer beds that are firmer. One study purported that hard beds should be the first choice for LBP sufferers, but if that did not help, then they should try waterbeds. The recommendation is not that they should sleep on a rock-hard bed, but rather, that they need support. A firmer bed prevents the low back from sinking deeply into the bed and irritating the facet joints. Higher-end luxury beds can provide plenty of support along with comfortable padding, while lower-end discounted beds can provide the firmness, but with less comfort.

Upper back and neck pain: Patients who are suffering from upper back and neck pain often prefer softer or plushier bedding. The plushier cushioning in the bed allows the head and thoracic area to sink into the bed to support the cervical area. A pillow-top mattress, or one with softer foams, padding and quilting, can be a good recommendation. There are also several types of pillows that can provide extra support for the neck.

Arthritis and fibromyalgia: Patients suffering with multiple painful joints often prefer bedding with cushioning that disperses the weight across the greatest body surface. Frequently, such patients also have spinal complaints. Balancing cushioning with proper support for the spine requires a higher-end mattress. Since fibromyalgia is related to stress levels, it also is important to review pre-sleep rituals with patients to help relax them before going to bed.

Stomach sleepers: Sleeping on the stomach in a soft bed can stress the thoracolumbar spine. The weight of the belly and pelvis also compress the bedding. To provide support to the stomach, pelvis and thoracolumbar areas, a firmer mattress is necessary.

Side-lying sleepers: An estimated 73 percent of the population sleeps on its side.  Plush mattresses are often recommended to side-lying sleepers because they provide the best way to maintain the natural shape of the spine and the curves of the hips and shoulders while sleeping. Plush bedding will cradle the body and help disperse the weight of the body across the maximum surface area, instead of creating pressure points at the hips and shoulders. Special pillows also may be necessary to support the neck in a position parallel to the ground.

Seniors: Most seniors grew up sleeping on extremely stiff beds, because that was what manufacturers made at that time. Having slept on firm mattresses their entire lives, many prefer firmer bedding, even if their health conditions indicate that plushier bedding would be better. Some education may be necessary to convince an older person of the need to change mattresses.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Ooops I did it again

Remember just because you aren’t going pro it doesn’t mean you don’t try way harder than you should.  Or should I say you are way older than you were in high school!  We’ve all been there and you can’t really help yourself.  18 year old you comes out and it is just instinct but the difference is 40 year old you doesn’t bounce like 18 year old you!  Your Woodbridge, Dale City VA chiropractor has a few tips to help you prevent the injuries 18 year old you caused 40 year old you.

Anyone who concentrates all their exercise into 1 or 2 intense bouts a week could be considered a weekend warrior. But physicians agree that weekend warriors tend to be men older than 30, especially former competitive athletes who expect their bodies to adapt to—and recover from—activity the same way it did when they were teenagers.

But even people who are not super athletes can suffer injuries if they do intense activities over the course of a day or two, such as a weekend of yard work or cleaning gutters.

 

The types of injuries that frequently occur for weekend warriors are:

Muscle strains, such as hamstring injuries

Ligament sprains, particularly ankle sprains

Tendonitis in the Achilles tendon and elsewhere

Shin splints

Shoulder or rotator cuff injuries

 

Nearly all of these types of injuries can be resolved by following the RICE (rest, ice, compression, elevate) protocol. If pain lasts longer than a few weeks or doesn’t improve, make an appointment to see your doctor.

 

Prevent injuries before they occur

The main trigger for weekend warrior injuries is the abrupt transition from little or no activity to intense bouts of it. Muscles and soft tissues need gradual conditioning to perform at their best.

To prevent this, it’s important to exercise more regularly, if possible. Even if your main period of activity is on the weekends, try to fit in at least 1 or 2 periods of exercise on weekdays.

 

Build up activity slowly.

If you’ve been inactive for most of the winter or you’re starting training for a marathon in the fall, gradually increase your exercise time and intensity each week.

 

Warm up.

Before you jump into activity, warm up your muscles with 10 minutes of moderately paced activity like jogging, for example.

 

Stretch.

After doing a few minutes of light exercise, stretch your major muscle groups, such as your quads and hamstrings, as well as any muscles that will be heavily used during your chosen activity. You can also benefit from using a foam roller before you stretch, which has been shown to increase flexibility and lessen post-exercise pain.

Don’t forget to stretch after you finish exercising too. The findings about the benefits of pre-exercise stretching are mixed, but stretching after exercise has clear benefits for decreasing soreness and helping muscle tissue return to its normal state.

 

Use proper technique and proper equipment.

It may help to consult a coach, trainer, or physical therapist if you’re new to a sport or piece of equipment.

 

Find an exercise program.

A class or race training group can help you set a good pace for working toward your exercise goals.

 

Don’t push through serious pain.

Mild muscle soreness is normal after a workout, but stop exercising if you experience sudden, piercing pain or if you have pain that’s getting steadily worse.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Try to remember…

Proper lifting is something we always pretend we do.  In a quick moment you twist, bend, lift and say ouch!  As your Woodbridge, Dale City VA chiropractor I am obligated to tell you how to lift properly but my business relies on you not lifting properly.  Fortunately for me most read this go ohhh yea than bend, twist, lift and say ouch.

Back pain and injuries from improper lifting techniques typically lead to three kinds of injuries to the muscles, vertebral discs, and joints.  Some injuries from incorrect lifting include:

Disc injury

Joint injury

Muscle injury

With improper lifting, you may experience a tear, rupture, or shift out of position of the soft cushions between your vertebrae, called discs.  If this injury does occur, the fibrous rings surrounding the soft leathery discs can bulge and even rupture.  This can cause the dislocated or ruptured disc to press against a nerve, causing pain and numbness to radiate down into you buttocks or leg.

Because of the numerous joints in your spinal column that connect all of the various bony structures, injury may occur.  A joint injury can be caused by a bad lift because it causes excessive strain on your joints, irritating tissue within them, and in some cases, locking them up.  As well, if you change position during a lift, you can place a lot of stress on your lower back muscles.  This added stress can easily strain and injure your back, usually in the form of a small twist or tear of a single muscle or group of muscles.

 

&;

An important rule to remember when lifting is to never bend from your waist and then stand upright to lift an item from the ground.  Keep your back straight and crouch first by bending at the knees or hips.  This all depends on where the item is that you are lifting and allows your arms and shoulder muscles to do the brunt of the lifting, rather than your back.  Some simple lifting techniques include:

Make sure you have a place to put the object you are lifting.

If you need to turn while lifting the object, use your feet to pivot, not your back.

Your leg muscles should be the ones providing the power during your motion to stand erect, not your back.

Keep the object close to your body in order to maximize the use of your arms and shoulder muscles.

Keep your chest forward and bend at your hips, or knees, not your lower back.

When lifting, push your chest out, pointing forward.  Avoid twisting or turning during your lift as this will cause injury.

Lead with your hips, not your shoulders and keep your shoulders in line with your hips.

Don’t lift any objects that are obviously too heavy.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Scoliosis isn’t always a bad diagnosis!

Scoliosis is more common than you would think.  Most of us have one because our heart is in the way so the spine bends around it.  That is considered normal and not usually a problem.  Your Woodbridge, Dale City VA Chiropractor has some information of the more serious types of scoliosis.

What is scoliosis?

Because we walk on 2 feet, the human nervous system constantly works through reflexes and postural control to keep our spine in a straight line from side to side. Occasionally, a lateral (sideways) curvature develops. If the curvature is larger than 10 degrees, it is called scoliosis. Curves less than 10 degrees are often just postural changes. Scoliosis can also be accompanied by lordosis (abnormal curvature toward the front) or kyphosis (abnormal curvature toward the back). In most cases, the vertebrae are also rotated.

In more than 80% of cases, the cause of scoliotic curvatures is unknown; we call this condition idiopathic scoliosis. In other cases, trauma, neurological disease, tumors, and the like are responsible. Functional scoliosis is often caused by some postural problem, muscle spasm, or leg-length inequality, which can often be addressed. Structural scoliosis does not reduce with postural maneuvers. Either type can be idiopathic or have an underlying cause.

What are the symptoms of scoliosis?

Scoliosis can significantly affect the quality of life by limiting activity, causing pain, reducing lung function, or affecting heart function. Diminished self-esteem and other psychological problems are also seen. Because scoliosis occurs most commonly during adolescence, teens with extreme spinal deviations from the norm are often teased by their peers.

Fortunately, 4 out of 5 people with scoliosis have curves of less than 20 degrees, which are usually not detectable to the untrained eye. These small curves are typically no cause for great concern, provided there are no signs of further progression. In growing children and adolescents, however, mild curvatures can worsen quite rapidly—by 10 degrees or more—in a few months. Therefore, frequent checkups are often necessary for this age group.

How is scoliosis evaluated?

Evaluation begins with a thorough history and physical examination, including postural analysis. If a scoliotic curvature is discovered, a more in-depth evaluation is needed. This might include a search for birth defects, trauma, and other factors that can cause structural curves.

Patients with substantial spinal curvatures very often require an x-ray evaluation of the spine. The procedure helps determine the location and magnitude of the scoliosis, along with an underlying cause not evident on physical examination, other associated curvatures, and the health of other organ systems that might be affected by the scoliosis. In addition, x-rays of the wrist are often performed. These films help determine the skeletal age of the person, to see if it matches an accepted standard, which helps the doctor determine the likelihood of progression. Depending on the scoliosis severity, x-rays may need to be repeated as often as every 3 to 4 months to as little as once every few years.

Other tests, including evaluation by a Scoliometer™, might also be ordered by the doctor. This device measures the size, by angle, of the rib hump associated with the scoliosis. It is non-invasive, painless, and requires no special procedures. A Scoliometer™ is best used as a guide concerning progression in a person with a known scoliosis—not as a screening device.

Is scoliosis always progressive?

Generally, it is not. In fact, the vast majority of scolioses remains mild, is not progressive, and requires little treatment, if any.

In one group of patients, however, scoliosis is often more progressive. This group is made up of young girls who have scolioses of 25 degrees or larger, but who have not yet had their first menstrual period. Girls generally grow quite quickly during the 12 months before their first period and if they have scolioses, the curvatures tend to progress rapidly. In girls who have already had their first periods, the rate of growth is slower, so their curves tend to progress more slowly.

What is the treatment for scoliosis?

There are generally three treatment options for scoliosis—careful observation, bracing, and surgery. Careful observation is the most common “treatment,” as most mild scoliosis do not progress and cause few, if any, physical problems. Bracing is generally reserved for children who have not reached skeletal maturity (the time when the skeleton stops growing), and who have curves between 25 and 45 degrees. Surgery is generally used in the few cases where the curves are greater than 45 degrees and progressive, and/or when the scoliosis may affect the function of the heart, lungs, or other vital organs.

Spinal manipulation, therapeutic exercise, and electrical muscle stimulation have also been advocated in the treatment of scoliosis. None of these therapies alone has been shown to consistently reduce scoliosis or to make the curvatures worse. For patients with back pain along with the scoliosis, manipulation and exercise may be of help.

Most people with scoliosis lead normal, happy, and productive lives. Physical activity including exercise is generally well-tolerated and should be encouraged in most cases.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Hurts to breath!

Back pain around the shoulder blades can be muscular but it can also be a rib subluxation.  Also known as a popped rib!  It sounds horrible but it is very common and your Woodbridge, Dale City VA Chiropractor has seen quite a few.

1  Moist Heat, One of the biggest complaints, when a rib is out, is muscle spasming. Heat will help you endure a muscle spasm. There is a caveat, however. Heat brings blood to an area and it can help with lactic acid build up as well.

2  Massage, but be careful. As mentioned, muscles are often tight when a rib is not functioning properly. massage can really help to calm down the muscles. Here again, a word of warning. Often times, the person giving the massage will feel a good sized bump and mistake what is really the head of the rib for a muscle knot. Rubbing this bump will not only be painful but can increase symptoms. Working on the areas around it can be quite helpful. Massaging after the rib is moving again is great.

3  TENS or Electric Stimulation. A great, non-drug option for killing a spasm and managing pain is to use e-stim, TENS or something similar. These are basically devices that send electrical pulses through wires and patches over muscles.

4  Get it adjusted! At the end of the day, until the rib starts moving properly it will cause problems. Not all chiropractors are great at adjusting ribs as they can be difficult. Likewise, you really need to have the specific rib adjusted and not just do a general spine adjustment. Even after you get it adjusted it may still feel out. Remember that the muscles have most likely tightened around it and formed a knot. Symptoms can take a while to settle down.

5  Mind your posture and quit trying to stretch it. Typically, ribs go out because of a forward head and shoulder posture. So, why do we always try and stretch that same way to get it to feel better? Likewise, stretching spasming muscles does not really work. It drives me crazy when I adjust a rib and the first things my patient does is check to see if stretching forward still hurts. That is like separating a wound to see if it has healed yet. If you keep doing it, it will never heal. Instead, look straight ahead and pull your shoulder blades down and back. Here is the vintage YouTube video I created to demonstrate. If you do this exercise and it is still really painful, chances are the rib is out again.

Ribs can definitely be tricky. Sometimes they stay in after one adjustment and sometimes they take several adjustments. Usually, the longer it is out the more adjustments it will take. The rib joints at the front where it connects to the sternum can go out, too. These are also very painful and can be adjusted, although it is a different method. Please remember that although rib pain is brutal, it is not that damaging. Stressing about it will only complicate the healing process. If you have pain to one side of the spine by the shoulder blades, in the front next to the sternum, radiating along the ribs, or all of the above, just come in and we can either help you or, at least, point you in the proper directions.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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Sleeping should be easy…

Going to sleep sounds easy enough but it is not as easy as it seems.  Getting a good night’s sleep is a rare commodity these days.  Your Woodbridge, Dale City VA Chiropractor has some useful tips on achieving that goal.

Back pain can make it tough to get a good night’s sleep. At the same time, how you sleep may make things worse — while certain sleep positions put strain on an already aching back, others may help you find relief.

Although back pain and sleep problems are linked, the connection isn’t well understood. “There is not a lot of science behind sleep as a major cause of back pain,” says Santhosh Thomas, DO, MBA, a spine specialist with the Cleveland Clinic and associate medical director of the Richard E. Jacobs Medical Center in Avon, Ohio.

Experts do believe, however, that people with sleep problems experience more problems with back pain. “Sleep deprivation is known to affect mood and functional ability and negatively impacts perception of pain,” Dr. Thomas says. Pain in turn can affect the quality of your sleep, according to the National Sleep Foundation, leading to a lighter sleep state and more frequent waking throughout the night.

What’s more, there’s a relationship between the severity of pain, overall mood, and the ability to function — and a good night of sleep can improve all these symptoms, at least temporarily, according to a study published in the November 2016 issue of the Annals of Behavioral Medicine.

Worst Sleep Positions for Back Pain

Some sleep positions can put added pressure on your neck, shoulders, hips, lower back, knees, and even your heels, all of which can lead to pain, Thomas says. There’s no one-size-fits-all sleep position to kick back pain, but you can try a few tricks to get it under control so that you can sleep more soundly.

The most common offender? Sleeping on your stomach. “Typically, sleeping on your stomach can flatten the natural curve of your spine, putting some additional strain on your back muscles,” Thomas says.

Plus, stomach sleeping means that your neck is rotated, which can actually result in neck pain or back pain between your shoulders, says Paul Grous,  a physical therapist and spine specialist with Penn Therapy & Fitness in Woodbury Heights, New Jersey.

Don’t worry about keeping your body in the same position all night. It’s normal for you to move around a bit while you sleep, and that’s a good thing because a little movement can help ease pressure on your back. “Any sleeping position has the potential to amplify back pain if you maintain it for too long,” Thomas says.

Grous adds that the real culprit may not be sleep position but your daily activity — or a lack of it.

“My opinion of the biggest causative factor for back pain in our population is the amount of time we spend sitting during waking hours,” he says. “We sit too long and we don’t sit properly — we sit slouched with our backs rounded.”

During daylight hours, try to vary your posture as much as possible, and practice good posture when standing and sitting to help ease back pain at night.

Sleep Positions That Help Relieve Back Pain

First, you’ve got to be comfortable to get a good night’s sleep. Thomas suggests making a few simple modifications to your regular sleep position to help take a load off your back:

 

If you’re a back sleeper: Put a pillow under your knees to allow your spine to maintain its natural curve.

If you’re a stomach sleeper: Put a pillow under your lower abdomen and pelvis to ease back strain.

If you’re a side sleeper: Draw your legs up slightly toward your chest and sleep with a pillow (a full body pillow can be comfortable) between your knees.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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My aching head!

Headaches are one of the biggest complaints, outside of neck and back pain, that I see as your Woodbridge, Dale City VA Chiropractor.  Not all headaches are created equal and some come from the top of your neck. This is the complaint that chiropractic care can really make a difference.

 

Occipital neuralgia can be debilitating but there are treatments, including chiropractic, that are very effective. Understanding occipital neuralgia can help patients better manage it so they can minimize the pain and symptoms of the condition.

 


What is occipital neuralgia?

Occipital neuralgia is a neurological condition that affects the occipital nerves which run from the top portion of the spinal cord, through the scalp, transmitting messages to and from the brain. There are two greater occipital nerves, one on each side of the head, from between the vertebrae located in the upper neck through the muscles that are located at the base of the skull and back of the head.

While they do not cover the areas on or near the ears or over the face, they can extend over the scalp as far as the forehead. When those nerves are injured or become inflamed, occipital neuralgia is the result. A person with this condition may experience pain at the base of their skull or the back of their head.

 

What are the symptoms of occipital neuralgia?

Pain is the prevalent symptom of occipital neuralgia. It often mimics the pain of migraine headaches or cluster headaches and is described as throbbing, burning, and aching.

There may also be intermittent shooting or shocking pain. Typically, the pain begins at the base of the skull but may radiate along the side of the scalp or in the back of the head. Other symptoms include:

Pain is experienced on one side (but sometimes both sides)

Pain behind the eye of the side that is affected

Tenderness in the scalp

Sensitivity to light

Pain triggered by neck movement

 

What causes occipital neuralgia?

Irritation or pressure to the occipital nerves are what actually cause the pain. This may be due to tight muscles in the neck that squeeze or trap the nerves, injury, or inflammation.

However, much of the time doctors are unable to determine the cause. There are several medical conditions linked to occipital neuralgia:

 

Tight neck muscles

Diabetes

Trauma or injury to the back of the head

Gout

Tension in the neck muscles

Whiplash

Inflammation of the blood vessels in and around the neck

Infection

Neck tumors

Cervical disc disease

Osteoarthritis

 

What are the treatments for occipital neuralgia?

Occipital neuralgia treatment focuses on pain relief. It often begins with conservative treatments that include:

Chiropractic

Rest

Heat

Physical therapy

Anti-inflammatory over the counter medication

Massage

In more severe cases the patient may be prescribed a stronger anti-inflammatory medication, muscle relaxants or in some cases an anticonvulsant medication.

If these therapies are not effective or do not bring about the desired level of pain relief, then doctors may recommend percutaneous nerve blocks and steroids. Sometimes surgery is recommended in cases where the pain is severe, chronic, and is unresponsive to more conservative treatments.

 

Chiropractic for occipital neuralgia

Chiropractic was once considered an “alternative” treatment for occipital neuralgia, but now it is often a regular part of recommended patient care. The advantage of chiropractic over medication or surgery is that chiropractic does not come with the side effects of drugs or the risks of surgery.

 

Another advantage is that chiropractic seeks to correct the root of the problem, not just manage the pain like other treatments.

Chiropractic treatment for occipital neuralgia may include lift adjustments, heat, massage, and traction. This will bring the body back into proper alignment and take the pressure off of the nerves as it loosens the neck muscles.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

Map Link

 

Ice your back… even in the winter

I know it is cold out and the last thing you are thinking about is putting ice on your back.  That being said I see more winter low back injuries due to slips and snow shoveling.  Your Woodbridge, Dale City VA Chiropractor has the goods on why ice will help even though it isn’t what you want to do!

General comments

Icing may be used along with compression, elevation, bracing, and/or support when treating acute injuries.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can produce a similar effect to icing. However, they may delay healing with acute injuries (like sprains, strains, and fractures). If your doctor recommends medicine, make sure you are aware of the right dosage and when to take it, and if there are any side effects.

The use of ice and heat is just one part of a treatment program. Even if symptoms are relieved, there is usually a need for exercises to restore flexibility and joint motion, strength, general fitness, and sport-specific skills.

Use of ice

Effects of ice: Decreases circulation, metabolic activity, and inflammation and numbs the skin.

Benefits of ice: Decreases pain, swelling, inflammation, and muscle spasm/cramping. Best used after exercise or after pain-producing activity.

Risks of ice: Prolonged use can cause frostbite.

Methods for applying cold therapy: Ice packs, ice bath/ice whirlpool, ice massage. (See “Options for applying ice.”)

When not to use ice

Immediately before physical activity

If area of icing is numb

When the pain or swelling involves a nerve (such as the ulnar nerve or “funny bone”)

If the athlete has sympathetic dysfunction (an abnormality of nerves that control blood flow and sweat gland activity)

If the athlete has vascular disease (such as poor circulation due to blood loss, blood vessel injury, compartment syndrome, vasculitis, blood clots, or Raynaud disease)

If there is skin compromise (such as an open wound; a wound that has not healed; skin that is stretched, blistered, burned, or thin)

If the athlete has cold hypersensitivity, including cold-induced urticaria (hives from cold)

How long to use ice

Two to 3 times per day (minimum); up to once per hour.

Duration varies with technique; usually 20 to 30 minutes per session. (See “Options for applying ice.”)

Ice may continue to be useful in treatment as long as there is pain, swelling, inflammation, or spasm. There is no need to switch to heat after 48 hours or alternate between ice and heat.

3 options for applying ice

  1. Ice packs are best for icing larger areas of pain, swelling, or spasm (like a swollen knee, deep thigh bruise, muscle strain, shoulder tendonitis, or neck or back spasm).

Materials

Small cubes or crushed ice in plastic bag.

Bag of frozen vegetables (such as frozen peas).

Reusable commercial ice pack or circulating “cryocuff” (made specifically for therapeutic icing). Do not use blue ice packs directly on the skin; they are colder than frozen water and can cause frostbite

Method

Place on the affected area for at least 20 minutes per session. Hold in place with a towel, elastic wrap, or shrink-wrap.

 

  1. Ice bath/ice whirlpool is used to reduce swelling in peripheral joints (such as with ankle sprain, wrist sprain, or severe shin splints).

 

Materials

Bucket or tub with mixture of ice and water

Method

Immerse affected area for 20 to 30 minutes per session. Do not use an ice bath if there is an open wound, bleeding, or a skin infection.

 

  1. Ice massage is used to reduce superficial, well-localized inflammation (for example, tendonitis of the hand, wrist, or elbow; heel or elbow bursitis; ganglion cyst; apophysitis; or irritation of a growth plate).

 

Materials

Ice cube or frozen ice cup (made by freezing water in a paper or Styrofoam cup)

Method

Rub ice in a circular pattern over the affected region for 8 to 10 minutes per session.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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A real pain in the… JAW

TMJ or more correctly TMD is a very common problem and a cause of some patient’s headaches.  It is a small joint that causes some big pain.   Your Woodbridge, Dale City VA Chiropractor has some information that explains the main cause of the pain.

Does it hurt when you chew, open wide to yawn or use your jaws? Do you have pain or soreness in front of the ear, in the jaw muscle, cheek, the teeth or the temples? Do you have pain or soreness in your teeth? Do your jaws make noises loud enough to bother you or others? Do you find it difficult to open your mouth wide? Does your jaw ever get stuck/locked as you open it?

If you answered “yes” to some of these questions, you may have a temporomandibular joint disorder, or TMD. TMD is a group of conditions, often painful, that affect the jaw joint.

Signs may include:

Radiating pain in the face, neck, or shoulders;

Limited movement or locking of the jaw;

Painful clicking or grating when opening or closing the mouth;

A significant change in the way the upper and lower teeth fit together;

Headaches, earaches, dizziness, hearing problems and difficulty swallowing.

For most people, pain or discomfort in the jaw muscles or joints is temporary, often occurs in cycles, and resolves once you stop moving the area. Some people with TMD pain, however, can develop chronic symptoms. Your doctor of chiropractic can help you establish whether your pain is due to TMD and can provide conservative treatment if needed.

What Causes TMD?

Researchers agree that TMD falls into three categories:

Myofascial pain—discomfort or pain in the muscles of the jaw, neck, and shoulders;

A dislocated jaw or displaced disc;

Degenerative joint disease—rheumatoid arthritis or osteoarthritis in the jaw joint.

Severe injury to the jaw is a leading cause of TMD. For example, anything from a hit in the jaw during a sporting activity to overuse syndromes, such as chewing gum excessively or chewing on one side of the mouth too frequently, may cause TMD.

Both physical and emotional stress can lead to TMD, as well. The once-common practice of sitting in a dentist’s chair for several hours with the mouth wide open may have contributed to TMD in the past. Now, most dentists are aware that this is harmful to the jaw. In addition to taking breaks while they do dental work, today’s dentists also screen patients for any weaknesses in the jaw structure that would make physical injury likely if they keep their mouths open very long. In that case, they may use medications during the procedure to minimize the injury potential, or they may send the patient to physical therapy immediately after treatment.  In less severe cases, they instruct patients in exercises they can do at home to loosen up the joint after the visit.

While emotional stress itself is not usually a cause of TMD, the way stress shows up in the body can be. When people are under psychological stress, they may clench their teeth, which can be a major factor in their TMD.

Some conditions once accepted as causes of TMD have been dismissed—moderate gum chewing, non-painful jaw clicking, orthodontic treatment (when it does not involve the prolonged opening of the mouth, as mentioned above), and upper and lower jaws that have never fit together well. Popular theory now holds that while these may be triggers, they are not causes.

Women experience TMD four times as often as men. Several factors may contribute to this higher ratio, posture and higher heels.

TMD Diagnosis and Treatment

To help diagnose or rule out TMD, your doctor of chiropractic (DC) may ask you to put three fingers in your mouth and bite down on them. You may also be asked to open and close your mouth and chew repeatedly while the doctor monitors the dimensions of the jaw joint and the balance of the muscles. If you have no problems while doing these things, then the problem is not likely to be TMD. Your DC can then look for signs of inflammation and abnormalities. Sometimes special imaging, an x-ray or an MRI may be needed to help confirm the diagnosis.

If you have TMD, your doctor may recommend chiropractic manipulation, massage, applying heat/ice and special exercises. In most cases, your doctor’s first goal is to relieve symptoms, particularly pain. If your doctor of chiropractic feels that you need special appliances or splints (with the exception of the “waterpack” and other guards against teeth grinding), he or she will refer you to a dentist or orthodontist for co-management.

In addition to treatment, your doctor of chiropractic can teach you how to:

Apply heat and ice to lessen the pain. Ice is recommended shortly after the injury or after your pain has started. In the later stages of healing, you need to switch to heat, especially if you are still experiencing discomfort.

Avoid harmful joint movements. For example, chomping into a hard apple is just as bad as crunching into hard candy (some hard candies are even called “jawbreakers”—for good reason). And giant sandwiches can cause the mouth to open too wide and have a destabilizing effect on the jaw.

Perform TMD-specific exercises. Depending on your condition, your DC may recommend stretching or strengthening exercises. Stretching helps to loosen tight muscles and strengthening helps to tighten muscles that have become loose. Special feedback sensors in the jaw can be retrained, as well, if needed.

 

Doroski Chiropractic Neurology

3122 Golansky Blvd, Ste 102

Woodbridge VA 22192

703 730 9588

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