On August 19, 2017 Dr. Schofield attended a conference, in Pittsburgh Pennsylvania, to learn current pain management methods. Topics covered which natural treatments work. In 33 years of practice Dr. Schofield has always searched and used innovative ways to alleviate and control the pain his patients are experiencing.
Chronic pain conditions like lower back pain, neck pain, headaches, sciatica, hip pain and shoulder pain are traditionally not helped by medications. Especially concerning is the increasing use of opioid medications for these types of problems. Fortunately, Dr. Schofield learns and continues to use natural treatment techniques for chronic pain in his Pittsburgh North Hills chiropractic office.
Over the years there have been many approaches for treating lower back pain. Traditional medical approaches have included the use of medications, injections and surgery. However, a recent research study by the American College of Physicians (ACP) published in the 2017 Annals of Internal Medicine has just released new guidelines advising a non-surgical and pharmaceutical free strategy.
A main concern in the United States is the ever-growing use of opioid medications causing addictions, overdoses and suicides. Opioids include Percocet, OxyContin and hydrocodone have been inappropriately prescribed in some cases for lower back pain. The new ACP guidelines advise against what are called “low value treatments” such as doctors prescribing opioid medications.
Instead nonpharmacological approaches are recommended by the ACP. These include nondrug treatments such as spinal manipulation which is typically performed by chiropractors, acupuncture, massage, tai chi and mindfulness-based stress reduction.
According to Roger Chou MD, professor of medicine, Oregon Health and Science University School of Medicine, and lead author of the new reviews on back pain treatment: “the biggest shift is prioritizing non-formal logic therapies using those first versus medication.” “This is the first guideline to really take this stance.”
The guidelines of the ACP also reject initially having patients get MRIs for lower back pain. The study notes that MRIs typically will not reveal findings relevant to the cause of the lower back pain.
Lower back pain that lasts for less than four weeks is considered acute. Low back pain lasting up to 12 weeks is considered subacute. Lower back pain lingering for more than 12 weeks is considered chronic. In all cases it is not wise to give into total bed rest. Gentle activity such as walking periodically daily and gentle appropriate stretching is more effective.
Physical measures such as chiropractic spinal manipulation, also called chiropractic spinal adjustments are recommended by the ACP.
Chiropractors are licensed as doctors. Their education involves typical undergraduate courses followed by five years at a chiropractic college. Following this they must pass national boards and become licensed in individual states in the US. Chiropractors then take continuing education classes for ongoing training.
Many responsible recognized insurances cover the initial evaluation by a doctor of chiropractic and treatment such as chiropractic spinal adjustments, physiological therapeutics and corrective exercises. These types of therapies been shown in numerous research studies to be beneficial for those suffering from acute, subacute and chronic lower back pain.
In advising nondrug, nonsurgical measures for the treatment of lower back pain the American College of Physicians guidelines published in the Annals of Internal Medicine have made a substantial shift in traditional prioritization of the treatment of lower back pain.
Many people experience what is called “wear and tear” arthritis. It is also called degenerative joint disease, osteoarthritis, degenerative arthritis and old age arthritis. It commonly occurs in all the joints of the body. It can develop from repetitive stress to the joints, trauma of the joints and can be from poor dietary habits.
The site of osteoarthritis is the area where two bones meet. This area is called a joint. The surface of the bones of a joint is lined with special cartilage that must be able to “resurface” itself because of ongoing wear. Normally, our body produces chemicals needed to handle the resurfacing. However, sometimes we don’t produce enough resurfacing chemicals to allow for normal thickness of the cartilage surface. When the cartilage degenerates, we can say that osteoarthritis has occurred.
This type of arthritis most commonly causes symptoms of early morning stiffness, stiffness following periods of rest, pain that worsens on joint use and loss of joint motion. If one were to look at an x-ray of the joint the two most common findings would reveal a narrowing of the joint space called bone on bone and bone spurs. These are x-ray signs that the degeneration has progressed and is now called degenerative joint disease.
Fortunately, there is a nonpharmaceutical supplement called glucosamine sulfate that has been called “nature’s arthritis cure.” Glucosamine sulfate is a vital chemical component needed by the cartilage of our joints. Our bodies normally produce glucosamine sulfate in sufficient quantities to fully resurface joint cartilage. When we traumatize a joint from one single episode or from repetitive stress we may not be able to produce enough of our own glucosamine sulfate to repair joint cartilage.
This happened to me over 20 years ago. As a chiropractor, I use my hands repetitively. As a result, I started to get symptoms of stiffness and soreness of my hands. I recognized that I was in the early stages of osteoarthritis.
I began to take a good quality brand of glucosamine sulfate consisting of 500 mg three times a day for a total of 1500 mg daily. Within weeks the pain in my hands resolved. I continued with the same amount of glucosamine for a full three months which allowed the cartilage to fully repair. Following this I reduced the dosage of glucosamine sulfate to 1000 mg per day and continued to do well. After a couple months, I tried reducing to 500mg per day but started to have discomfort return. So, I went back to 1000 mg per day and have continued to the present. My hands remain symptom-free and show no visible signs of degeneration of the joints.
In the past couple decades, I have seen hundreds of my patients get relief of osteoarthritis pain by taking glucosamine sulfate in the manner I just described. My experience has been that smaller joints like the hands, elbows, shoulders and knees seem to respond well to glucosamine sulfate supplementation. I cannot say that I have seen great results for joints of the feet, hips and spine.
We carry an excellent brand of glucosamine sulfate at our office that is made by a company called Metagenics. One bottle contains ninety 500 mg capsules. This will last one month if a person takes three capsules per day. My experience is that a person will know within that first bottle if it’s going to work. They will feel improvement of soreness. If it doesn’t work in the first month I would not suggest continuing. However, if there is improvement, I would recommend taking 1500 mg per day for three months. Then one can experiment with taking a lesser dosage and seeing how they do.
I will also mention that the quality of the product does seem to matter. I have seen that many people do not respond well to the supplement they may buy at a big box store, grocery stores and drugstores. If you do not have good results with the type you’ve purchased try the brand we carry in our office. One bottle of ninety 500 mg capsules costs $30 dollars.
Metagenics glucosamine sulfate supplements are made from shellfish. As a result, anyone who has an allergic response to shellfish should not take this product.
Supplementation of glucosamine sulfate is certainly worth trying. A short, initial trial for a small expense will let one know if there will be a benefit. If improvement occurs it is wise to continue using the supplement as a natural, low-cost method to minimize a potentially long-term degenerative disease.
I have seen a lot of things that could injure one’s neck. But I never dreamed that “over texting” would be added to the list.
However, a recent study indicates that 79% of the US population have their cell phones with them all the time, with only two hours of their waking day without the cell phone in their hand. That can lead to a lot of looking down over the course of weeks, months, years and ultimately a lifetime.
Ideally, the head- which weighs about the same as a bowling ball- should be back directly over the shoulders and upper back. If this is the case the neck, shoulders and upper back can comfortably carry the weight of our skull. However, if the head is carried in a forward posture, as when we are looking down at our cell phones, it causes stress and strain to our upper back, shoulders and neck.
I personally have asked my patients how many texts they send and receive in a day. I was stunned to hear numerous times that many, especially teenage girls, may approach one hundred! Certainly, that amount of forward head posture can lead to chronic postural positions that could lead to the, infamous, text neck.
Symptoms of text neck include upper back pain ranging from chronic, nagging pain to sharp, severe upper back in muscle spasms. Tension across the shoulders is another common finding. Of course, tension headaches in the back of the skull, temples, forehead, and behind the eyes commonly occur from neck problems. Migraine headaches are also a sequela of matters of the neck.
The best solution to avoid text neck is to improve upper body posture. If one were looking from the side, regarding posture, the opening of the ear should be on the same vertical line as the middle of the shoulder. Most people have a posture with the ear opening being forward of the vertical line. We tend to get tight in muscles of the front of the neck and chest and weak in muscles in the back of the neck and between the shoulder blades. It is wise to gently stretch the small muscles in the front of the neck by gently extending the head backwards a number of times and to stretch the pectoral muscles on each side by doing stretches that one commonly sees swimmers using.
Of course, spending less time texting and using handheld and computer devices should be encouraged. If one is using mobile devices and computers periodic rest breaks involving standing and walking are essential.
Text neck appears to be with us in the foreseeable future. Hopefully, with the above advice, you can avoid being included in the text neck statistics.
On June 3rd and 4th 2017 Dr. Schofield attended ongoing training in proper observance of insurance, Medicare and HIPAA privacy protocols. The training took place in Tampa Florida. The government has been directing doctors to maintain practices of awareness in this ever changing sphere.
I will never forget something that happened when I first began my chiropractic practice over 30 years ago.
It began when a young man named Arthur entered my office. Arthur was the very first patient I treated who came to me as a result of injuries he suffered from an auto accident. Four months earlier he had been knocked unconscious due to a traumatic automobile collision. He was taken by ambulance to an emergency room where he regained consciousness and was soon well enough to be released. Following this he began to have symptoms typical of accident trauma, developing neck pain, back pain and headaches.
However, what I remember most about Arthur was that he said: “I don’t feel like I’m firing on all cylinders.” I wasn’t sure what he meant until he explained further. He was finishing his PhD and would soon be starting medical school at Johns Hopkins. Obviously, he was brilliant but following the accident he didn’t feel that he could mentally concentrate, study or focus normally. That helped me understand why he wasn’t “firing on all cylinders.”
Arthur had suffered a concussion. 85% of concussions will be better in 7 to 10 days. If symptoms persist, as in the case of the remaining 15% (and Arthur) it is called Post Concussion Syndrome.
Interestingly however, studies reveal damage to the neck also occurs during a head injury, playing a major role in Post Concussion Syndrome.
I’ve come across this many times in practice. The good news for Arthur was that after having chiropractic treatment he was back “firing on all cylinders” and performing normally.
Let’s investigate this further.
Many symptoms of both concussion and upper neck injuries such as whiplash are similar. Those injured may have headaches, lightheadedness, nausea, concentration problems and fatigue.
It has been determined in research studies that damage to the neck also occurs during a head injury. In fact studies reveal that it is practically impossible to have a concussion without also injuring the neck. Some researchers are linking both the brain injury and the neck injury and terming it “Cervicogenic Post Concussion Syndrome.” Cervicogenic means “from the neck.”
When undergoing treatment for this type of problem it is not only important to treat the concussion through ongoing brain rest but it is also vital to have possible injury of the upper neck evaluated properly so that this potentially important anatomical area is not missed.
Chiropractors are healthcare specialists that are trained to examine and treat upper neck problems that occur from trauma that one would find in sports and in accidents like whiplash.
Published studies show that chiropractic management of patients with Cervicogenic Post Concussion Syndrome result in rapid and sustained improvement of signs and symptoms, allowing the patient to return to full recovery.
All patients suffering from Cervicogenic Post Concussion Syndrome should be evaluated by a chiropractor for cervical spine evaluation and treatment.
For more information about Dr. James Schofield visit this website. Learn more about treatment of neck injuries and related Post Concussion Syndrome.
Many of Dr. Schofield’s patients who have neck pain, lower back pain, sciatica and herniated discs may require an MRI or have already had an MRI. By analyzing the MRI Dr Schofield is better able to diagnose his patient’s condition and render effective treatment.
Solutions for neck and lower back pain, herniated discs and sciatica offered by a chiropractor are both safe and natural. Many of these types of conditions are successfully treated without the use of drugs or surgery.
Research studies show that chiropractic care has been helpful in improving 90 percent of lower back disc herniation and sciatic leg pain conditions.
Dr. Schofield attended postgraduate training on June 3, 2017 in Tampa Florida.
Visit here for more information about Dr James Schofield and for non-surgical treatment of sciatic nerve pain click here.
Welcome to my first blog post! To be fair I have been blogging for number of years at another website. When I discontinued using that website I lost control of those old posts. So now with this blog site I hope to have personal control over owning the information I’d like to pass on.
I like to read research regarding health topics. Yes, it can be pretty dry and academic. But, I feel I have an ability to “translate” medical academic research into everyday English in my blogging. Anyone having an interest in improving or maintaining their health, naturally, can benefit from these posts.
I believe that being healthy is easy. With modern medical devices, super-pharmaceuticals and involved surgical techniques we might be led to believe that being healthy is complicated and difficult. While none of us would want to be without lifesaving emergency medicine going back to simple basics, has been and still is the only way to be truly healthy, to feel and look younger, to be the weight we desire, to reduce stress, increase energy and decreased fatigue, and have resistance to sickness and injury.
I hope you will follow and enjoy these continued essays and thoughts.
Dr. James J Schofield