01.05.2025
Dr. John Conflitti
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Are you suffering because of age, or might it be something deeper?  “Don’t get old, you end up like this” “That’s just because of old age” “See, this is why you shouldn’t get older” These are some of the most common phrases that I hear when people talk about the pain they’re having. Most of the time, they’re being said by someone in their early 40’s; which is just more than half of an American’s lifespan (78 years of age: 2012). It’s spoken as if Father Time had a magic shot that make a person start experiencing pain and arthritis completely out of the blue when they hit nature’s halfway point. Let’s take a look at it for a second. When most people talk about the pain of getting old, they’re usually referring to a cascade of problems that’s lumped into the name Arthritis. We’re talking about the joint shrinking version known as osteoarthritis, and not the hot and burning inflammatory arthritis. Osteoarthritis is usually used to describe any one of these problems: degenerative joint disease, degenerative disc disease, spondylosis, bone spurs, and spinal canal stenosis. Let’s take a look at one example:   This is the x-ray of a spine from a side view. This is a person in their late 50’s or early 60’s with neck pain and arm pain for the past year. The yellow arrows are pointing to areas that have severe degenerative disc disease, estimated 40-50 years of breakdown. When these badly degenerated discs were pointed out to them, guess what was said? “Oh, those are just due to old age” Now, of course there will be wear and tear on the spine of a 60 year old person. There’s no question about that. But the extent of damage to the area of the spine is substantial. Now the interesting thing is this, how old is the healthy disc of the spine? That’s a trick question of course, because all of the discs are the same age. If this problem was strictly a matter of aging, wouldn’t you expect every single disc to have similar levels of degeneration? “Here’s the truth, this person did not have a problem of age; they had an aging problem.” There are definitive problems with the structure of this person’s spine. When a structural problem happens into the spine, 2 things can happen: The biomechanics of the spine become distorted and accelerate the wear and tear of the joints. Think about what happens to your car when the tires are improperly aligned. Would you expect the steering wheel to pull to one side? Would you expect one tire to wear out on one side faster than the other? Would you expect the ability for the tire to hold air to be different from side to side? The same thing happens to the joints of the spine too! The structural shift will distort the signals going in and out of the brain. As the spine shifts, the spinal cord and spinal nerves will misfire into the brain. This misfiring causes the muscles of the spine to tighten and spasm, and create dysfunction to anywhere where those nerves travel. Those are the facts. Here’s where things get tricky. This person had a problem in their spine for upwards of 50+ years. However, they did not show any signs of pain until the past year. What gives? Problems in the spine can be left undiagnosed and unidentified for several years. Research shows that many of us have herniated discs in the spine, and out of those people 60% of you will feel no symptoms.  Thus, a problem that should be of primary concern can be wreaking havoc on the body without us knowing it. With that said, these problems are almost always preventable. With proper exercise and proper postural awareness, you can save years of wear and tear on the spine, and maintain full function of the delicate nervous system. As with anything else, it’s always important that you protect the parts of your body that you hold most dear through routine checkups. We always find time to check our blood pressure, cholesterol, eyes, and of course your teeth.  When was the last time the structure of your spine was checked?
01.04.2025
Dr. John Conflitti
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One of the most common problems I hear about with patients with chronic pain is that rainy weather seems to make things worse. Is there a real biological reason for this or is this just an old wives tale that has been passed on through time? Don’t Stop Believing: The Uncontrollable Factor People have been talking about how they can sense weather patterns in their joints for thousands of years. You’ve probably heard of this phenomenon from your grandmother or another relative whose arthritis pain flared up when it rains. They might say that they feel the rain in their bones. Hippocrates, the Father of Medicine, was the first to note changes in a person’s illness status due to weather way back in 400 BC. Yet, as long as this idea has been around, studies about this phenomenon have been inconclusive. Some studies show that pain patients can feel a difference, while others say that the weather makes no difference. It’s hard to study this effect because of the impact that belief systems have on pain. When human beings have a strong enough belief in something, it can drastically affect their perception of the world. This is seen in pain science all the time, and it makes studying pain very challenging and difficult. Short of locking people in a box and hiding them from weather reports, it’s hard to know how this affects humans with any degree of certainty. Animal Studies Leaving Clues While belief systems can impact humans, some of our furry friends have helped leave some clues. Scientists believe that the pressure in the air (barometric pressure) is what allows people to feel pain when the weather changes. When storms come, the pressure in the atmosphere begins to drop. The theory is that as air pressure drops, it decreases the amount of pressure on your joints leading to the joints and soft tissues to expand and irritate nerve endings causing pain. In Michigan, we get experience weather changes quickly so pain patients have the unfortunate opportunity to experience this regularly. Scientists tested this idea on guinea pigs and rats. They placed animals bred with with a pain predisposition into two environments. One group had normal air pressure while the other group had the air pressure lowered artificially. They found that the low pressure animals showed increased pain behavior compared to the controls. This is important because you can’t sway or convince an animal that lower pressure is going to make them hurt more. It’s a much closer relationship to cause and effect than can be currently studied in human beings.  So What? Is This Treatable? So we know that feeling weather changes when you have pain syndromes is at least plausible based on animal models, but why does it happen and is it treatable? The truth is, we still don’t really know what mechanisms cause this type of pain so we have no idea if it’s treatable or preventable. Based on my experience, I believe that when pain tends to be triggered or aggravated by weather, there’s likely a pain processing problem in the body. Tissue Damage vs Pain Perception The most common conditions associated with weather-related pain are osteoarthritis (wear and tear arthritis, not joints on fire arthritis), headaches, and fibromyalgia. The important thing to note about these 3 conditions is that the pain related to these conditions is NOT dependent on tissue damage. What does that mean? It means that the level of pain associated with these conditions is not tied to the amount of damage that’s in the body. When you have a sprained ankle, broken bone, torn muscle, or a cut, there is damage done to the tissues that sets off a series of chemical signals meant to trigger a pain response. It’s a very linear relationship. With joint degeneration, you might feel pain, you might not. With headaches and fibromyalgia, there’s not necessarily any physical damage that’s related to the the pain being felt. It’s not to say that the pain isn’t real, it just means that there’s no obvious source of damage that’s causing the pain. The problem is related to the way your brain processes pain. Your brain has a built in volume control for pain perception. It can turn these signals up in certain situations, and it can turn it down in others. Chronic pain patients have their volume dial on high all the time. It’s not just a matter of belief. Although that’s an important piece of the puzzle, there are other factors like: Brain oxygenation Hormones in the blood Global inflammation Joint movement, especially in the spine That’s why pain isn’t just a physical phenomenon. I’m sure you’ve been in a situation where you you suffered an injury, but you didn’t feel it until much later. This happens frequently after the shock of car accident, the thril of playing in a championship game, or the necessity of escaping a dangerous situation. You get stunned, your heart races, adrenaline is surging through the veins, and you don’t notice any pain until hours later when those hormones leave the blood stream. Pain Perception is Malleable This brings some good news and bad news. Bad News: It means that for lots of cases, there might not be a treatable lesion that is generating some of the chronic pain problems you’re feeling. Good News: This also means that your pain levels are malleable and there are different things you can do to turn down the volume of the pain you experience. Things like meditation, exercise, and cognitive therapy can all allow us to change our experience with pain, and get a little bit more control over how we feel. It gives us control over the volume dial. This is actually one of the primary mechanisms that Structural Corrections can help people with headaches, fibromyalgia, and arthritis related pain syndromes. We are not fixing or repairing damaged tissue, we are creating an environment for healthy neurological function. When the structure of the spine are disrupted, it decreases 2 things: Blood supply in and out of the brain Mechanical input into the brain Both of these factors cause the brain to be more sensitive to pain signals. When the spine moves better and normal blood supply is restored, you can see not only an improvement to someone’s weather related pain, but also an improved resiliency and control over chronic pain syndromes.
01.03.2025
Dr. John Conflitti
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As the Winter Equestrian season comes to a close here in Michigan, and golf season begins. While it appears to be a low impact sport to the average observer, golf can be a really stressful sport! While some golfers say the biggest stress is on their pride and their mental state, from a Structural standpoint golf has the biggest impact on the lumbar spine aka, the lower back. If you're serious about golf, then you have to be serious about the mechanics of your swing because a bad swing will wear down the discs, ligaments, and joints of the spine. The biggest threat is the coupled movement of excess rotation and extension. One bad swing isn't going to hurt you, but thousands of swings over the course of years can wreck even the strongest spine. The commonly missed factor in the health of a golfer is the structure of the spine. A spine with a Structural Shift in the hip and pelvis will not only make a golfer more susceptible to injury, but you're leaving a lot of force on the table. To make a long story short, you will make your best swing less efficient, and your muscles will fatigue more easily because you are wasting so much kinetic energy. When the spine is in the distorted position that you see on the left, then the force of a highly rotational swing gets sent into the discs and ligaments of the spine, instead of smooth transfer into the hip muscles. The result is more chance for the discs to tear, and poor muscular output leading to poor performance. If you are serious about playing golf throughout your life, and you want to play not just pain-free, but to your fullest potential, then you need to play without Structural Shifts.
You try to be an educated consumer when you’re choosing a car, house, or TV, but what about when you’re choosing something else that is also very important… such as a chiropractor? There are some key questions to ask yourself before choosing a chiropractor to care for your spine and nervous system. After all, your nerve system is a very important part of your body that controls all of your functions; picking a care provider is not something to jump into without careful consideration. So, here are some questions to ask yourself when choosing a Doctor of Chiropractic: 1) Why Am I Looking For A Chiropractor? This is the first question that you want to ask yourself to help you choose the type of chiropractor you go to. If you have a surface-level ache, pain, or strain, and you simply want a quick fix so you can get back on the road again, you’ll want to look for a chiropractor who will take care of you for the immediate issue. When you see a chiropractor for this type of objective, he/she generally will not do a complete assessment of your spine or nervous system, but will rather work on relieving acute pain/muscle spasms and improving range of motion. However, just like any other area of your health, there’s a difference between a quick fix and sustainable change. If you are looking for sustainable results or improvement for your spine or nervous system, or to get to the root cause of a recurring health concern, you would want to find a chiropractor to perform a comprehensive assessment. 2) Do I Want Less Or More… Or Maybe Both? Very often people are motivated to go to a chiropractor because they want less of something that they don’t like: back pain, neck pain, arm pain, shoulder pain, knee pain, something that is disturbing how they are living. They just want to go back to the way they were before. If that’s you, make sure you have the right expectation when you go in to the chiropractor that you really just want to experience less of something that is disturbing you. Some people want more. In addition to eliminating something that they don’t like, they would like to have more of what they do want: more energy, more joy, better sleep, better mental state, more life enjoyment and improved quality of life. When you want more of something, you want to look for a chiropractor who is going to be able to help you improve your overall function, retrain and reorganize your nerve system and not just get you back to a prior minimal state. The state that led to you ending up where you are now. 3) Am I Looking For A Conventional Experience Or An Outstanding Experience? The majority of conventional chiropractic practitioners, physical therapists, and other healthcare providers related to the spine are focused on eliminating the condition the patient is presenting with on the surface. This is generally working on temporary range of motion improvement, bone re-alignment, or muscle spasm and pain relief. If you want to have an outstanding experience, then find a chiropractor who can identify and focus on the underlying Structural dysfunctions that may be at the root cause of the structural and behavioral shifts which are affecting your health and life experience. Go for outstanding in your chiropractic care and your health. If you would like to have your nerve system checked for its Structural integrity, a consultation to discuss your concerns may be a great place to start. Find out where to go from here by contacting our office at248-287-8700
01.01.2025
Dr. John Conflitti
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Most people are familiar with the image on the top. An image of a lowly iceberg. It looks so simple to simply steer around and bypass it on the way to smoother seas. But if our past was a good teacher, then we know that by only paying attention to the surface, we can miss a dangerous obstacle in the depths. Our bodies are equipped with an incredible array of signals to let us know that something is wrong. Sometimes it comes in the form of a pain in the back, draining fatigue, or chest pain. The purpose of these signals is to tell us that something is wrong, but it’s up to us to look within to identify the cause. As long as we continue to exist in a healthcare system that only seeks to reduce symptoms, then we will continue to get the same results as those who only saw the tip of the iceberg. Unless we look towards the body’s healing capacity, and why it’s not operating at 100% full function, then we are missing the boat on the health challenges of millions of people. And there’s no amount of drugs, natural medicine, surgery, or insurance money that can save that ship from sinking.
01.12.2024
Dr. John Conflitti
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Pain after a car accident can be very strange and confusing. Take a look at these examples and tell me if this reminds you of a situation that you or someone you know. Person A: Healthy and fit 37-year-old man in a car and gets hit at 45 mph+. The impact drives his car into the car in front causing extensive damage. Person B: Healthy and fit 29-year old woman. Sitting in line in a parking lot when another car runs into the back of her at 10 mph or less. Minimal damage to the car and wore a seat belt. Which one do you think had a worse whiplash injury and had pain immediately and which do you think just had soreness that they wanted to get checked out? Both had substantial biomechanical changes on their x-ray and MRI, but only one had a significant amount of pain immediately after the incident. If you guessed that Person B with the parking lot bumper tap had the most pain, then you win! Congratulations! The Deceptive Nature of Pain Pain is one of medicine’s greatest tricksters. To this day, researchers and scientists don’t have a strong grasp on the nature pain disorders. Why is it tricky? Because the pain someone feels isn’t necessarily related to the amount of damage in the body. Patients with fibromyalgia have crippling pain despite not having any visible damage to their bodies. Pain is the most important factor to a patient, but it can be the most deceptive factor to a clinician. When it comes to taking care of people after an accident, we have to measure a patient’s function regardless of their pain status. What Happens to the Neck After an Accident? Insurance companies will only consider it an accident-related whiplash injury if you see a doctor within 14 days of the accident. So if you have no pain after the accident or the pain wasn’t bad enough to drive you to a physician until day 15, then you didn’t have a whiplash (I know how silly it sounds). But going back to the previous example, we know that both Patients A and B had biomechanical flaws as a result from trauma to the spine. Despite the fact that there were 2 very different accidents and 2 different pain statuses, there are similarities in what can happen to the neck even after the smallest collisions. Take a look at the video below which simulates an accident less than 10 mph.   What Happens to the Neck in an Accident? After watching the video, you can get the impression that a collision at just 5-7 mph causes rapid movement of the head and neck. Despite the fact that your body is encased by a 2 ton metal box, it’s easy to see that even though the vehicle stops moving, there is still a transfer of energy into the body. When you’re wearing your seat belt, it causes a rapid deceleration of your body, but your head will continue to move forward and backward very rapidly. In fact, a large enough force to the neck can actually produce a concussion even if there’s not direct contact to the head! These accidents would need somewhere around 90 G’s of force to the head. While that would cease to be a small accident, the smaller 10 mph accidents can produce 3-5 G’s of force which is enough to damage the tissues of the neck. The way your head accelerates and decelerates can put 3-6 G’s of force into the cervical spine. This force gets transferred into the ligaments, muscles, discs, and joints of the neck more than any other piece of anatomy. While the body can tolerate large amounts of force in brief periods, a large amount of force applied to a small region of anatomy as seen in a car accident can damage the tissues of the neck. Ligament Injury Ligaments are like the rubber bands of the spine. They can be stretched, but once they stretch too far, they can’t go back to normal again. As ligaments are damaged, scar tissue is used as a patch, but it’s not as functional as the stuff you were built with. Just like when you sprained your ankle as a kid and that ankle never worked the same, damage to ligaments of your neck can happen the same way. Fortunately, true sprains of the neck take a lot of force and don’t happen with most accidents. Muscle Strains When muscle works beyond its capacity, or gets stretched beyond its end range, it forms small tears within the muscle belly. That’s why there’s no consensus as to whether you’re better off knowing about a coming accident and bracing, or if you’re better off being surprised. Either way, damage to the muscle tissue can happen depending on the nature of the collision. Muscle strains can be painful, but they can and do heal with time. Strain to muscle tissue is one of the most common sources of pain from whiplash injuries and resolve well with chiropractic and exercise. Disc Damage Accidents are one of the most common ways that people under 30 can suffer herniated discs in the spine. When the force of an accident overcomes the resistance of the disc material, small tears in the disc can result in the inner fluid spilling into the spinal canal. Sometimes this results in a pinched nerve, but most of the time it does not. A disc problem doesn’t have to be a big problem. Many people have disc damage and have no idea because it’s not symptomatic. Structural Shifting The muscles, ligaments, discs, and nerves of the neck help dictate the Structural Positioning of the spine. The force of an accident can deform one or all of these tissues leading to abnormal positioning of the head and neck. This leads to abnormal neurological input to the brain and what manifests as poor posture (slouching, head tilt, antalgic lean). While poor posture is not the problem that needs to be treated, it’s an objective sign of a nervous system is operating at less than its full capacity. Remember That It’s Not About Pain Remember at the beginning of the article we talked about how pain can be deceptive. The reason I wanted to point that out is because you can experience damage to all of the above structures and not feel an immediate onset of pain. Pain is just tricky like that. Whether you feel immediate pain or not, your neck should always be evaluated even after minor accidents because it gives the earliest and best opportunity to correct a silent problem.
01.11.2024
Dr. John Conflitti
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In my experience, I’ve found that whiplash is a commonly misunderstood diagnosis among the patient population. Many people self-diagnose the pain in the neck following a bad roller coaster ride or car accident as a whiplash injury. While they may or may not be correct, the truth is that whiplash is a type of injury with serious implications, and is frequently mismanaged by unscrupulous folks with a big stake in the business of personal injury. Whiplash is a common name for a group of neck disorders known as cervical acceleration-deceleration injury or cervical sprain/strain injury. It occurs when the head and neck are placed in motion and suddenly forced to a stop causing a hyperflexion or hyperextension motion.    This irregular movement of the neck causes the ligaments of the spine to sprain and the muscles to splint the unstable structure. This type of injury is also known to cause the discs of the spine to bulge and herniate, thus complicating matters even further. It’s easy to see how whiplash can be a real pain in the neck (pun intended), but most people treat it like a sprained ankle and hope that the pain goes away in a few weeks. However, there can be long term consequences; even for people who don’t have pain symptoms immediately. Research has shown that whiplash associated disorders are related to inflammatory and endocrine problems like those seen in chronic fatigue syndrome or fibromyalgia1. Whiplash is also associated with chronic pain by making your brain more sensitive to pain signals, which explains why so many people can suffer without any evidence of physical damage2. Additionally, people who report whiplash injuries after a rear-end accident are likely to show complaints of headaches, TMJ, back pain, fatigue, and sleep problems even 7 years later3! Whiplash has even been associated with chronic inflammation by making the body’s own immune system overly responsive to normal stimuli4,5. Though the focus of my practice has never been on auto-accidents cases, the truth is that most drivers will be involved in a collision no matter how good a driver they may be. Most will probably not experience pain immediately after a collision, especially if you’re in your teens or early 20’s. However, the impact of a vehicle traveling at speeds as low as 15 mph can show visible signs of structural damage to the neck. These include s-shaped curves in the neck, anterior ligament instability, atlas displacement, and Anterior Head Syndrome. A recent study has found that this type of trauma to the spine can cause parts of the brain and brain stem to slip further into the neck creating a condition called Chiari Malformation6. While they may not be painful in their early stages, these structural changes can pre-dispose the spine to early degeneration and arthritis if left uncorrected over the course of several years.  Normal Neck X-Ray S-shape X-ray Characteristic of Whiplash As a chiropractor focused on Structural Correction, I see patients everyday with Secondary Conditions like headaches and TMJ related to accidents that took place many years earlier. While some of these patients suffered painful injuries and received treatment following an accident, most people will walk in and say they didn’t have any symptoms until years later. When someone asks why their pain seemed to come out of nowhere, I can usually look at their x-ray and see that the structure of the neck fits the familiar S-shape of a previous rear end collision. Here are your take home messages: First, problems can grow in the body in the absence of symptoms. Much like cancer and heart disease don’t happen overnight, people with chronic pain usually under go slow physiologic changes in their brain and hormonal systems for years before they have a condition that won’t go away. Second, if you have a physical/structural problem, then you must go beyond treating the pain symptoms to help get full resolution of the problem. Whiplash injuries cause distinct structural problems in the spine. While pain relief is important, making the pain go away while leaving the structure in bad shape is like taking the battery out of a smoke detector when a fire is burning in the house. Whiplash associated disorders can be a complicated problem that requires a comprehensive solution. When selecting a team of doctors, make sure that you have someone in your corner that can look at you from a functional standpoint rather than sheer pathology, that addresses the structure of your spine in 3-dimensions, and understands the nature of traumatic injuries. References:   1. Banic B, Peterson-Felix S, Anderson OK et al. Evidence for spinal cord hypersensitivity in chronic pain after whiplash injury and in fibromyalgia. Pain. January 2004. 7-15.  2. Berglund A, Afredsson L, Jensen I, Cassidy JD, Nygren Ake. The association between exposure to a rear-end collision and future health complaints. J of Clinical Epidemiology. Aug 2001 (54): 851-856.  3. Kivioja J, Rinaldi L, Ozenci V et al. Chemokines and their receptors in whiplash injury: elevated RANTES and CCR-5. J Clin Immunol. Jul 2001; 21(4): 272-7  4. Kivioja J, Ozenci V, Rinaldi L. Systemic response  5. Gaab J, Baumann S, Budnoik A et al. Reduced reactivity and enhanced negative feedback sensitivity of the hypothalamus-pituitary-adrenal axis in chronic whiplash associated disorder. Pain. December 2005. 119(1). 219-224.  6. Freeman MD, Rosa S, Harshfield D et al. A case-control study of cerebellar tonsillar ectopia (Chiari) and head/neck trauma (whiplash). Brain Inj. 2010; 24(7-8): 988-94.    If you have experienced this kind of injury, call our office today and book your consultation. 248-287-8700
01.10.2024
Dr. John Conflitti
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1. Significant injuries occur at low-speeds. 2. Women suffer greater injuries than men because they have less strength in their neck muscles. 3. Early mobilization is critical. Use of a cervical collar actually gives worse results than no treatment at all. Immobilization following injury causes muscle wasting and loss of strength that significantly delays recovery. Corticosteroids damage articular cartilage & decrease collagen strength & repair. Early mobilization improves healing & repair of bone, cartilage, ligaments, & tendons. It also improves joint proprioception, which helps to prevent early joint degeneration.  4. Most whiplash injuries are occult and cannot be identified on conventional imaging such as x-ray, MRI, or CT scans. 5. The peak inflammation associated with whiplash is located around the C2 vertebra and is the most common origination of headache symptoms. The C2/C3 facet joint in particular is the cause of cervicogenic headache 53% of the time. 6. The severity of vehicle damage is not predictive of injury or outcome. Stiffer vehicles actually increase the probability of long-term consequences because the forces get focused on the head & neck. A more accurate predictor of outcome is if the injured person experiences acute neck pain within the same day of injury. These people are 3x more likely to report chronic neck pain 7 years later. Also of note, younger people generally have a better prognosis & require less treatment. 7. Upper Cervical spine is most injured when head & neck are in flexed & rotated position at time of impact (e.g. looking at cell phone or child in back seat). 8. Whiplash patients are 5x more likely to suffer from chronic neck pain compared to control population. 9. Whiplash patients are at a significantly increased risk for premature disc degeneration. Most common site of disc injury is C5/C6. 10. Cervical range of motion is the most important indicator of physical impairment. It has proven to be 90% accurate in diagnosing people with whiplash symptoms. Flexion and extension are usually the most impaired movements. 11. Over 90% of whiplash patients under chiropractic care showed notable improvement over a 6 month period of care. Chiropractic treatment has been shown to be 5x more effective than Celebrex or Vioxx within 9 weeks of treatment. Chiropractic care has also been shown to have a 2x greater success rate than standard medical care, and a significantly higher success rate than Physical Therapy. Some measured markers include less work absences and less reliance on pain medications. Passive joint motion is superior to active exercise therapy. 12. In order to get the best therapeutic outcome, treatment must be initiated within the first 3 months following whiplash injury. Recommended guidelines for acute or sub-acute recovery with treatment ranges from 2 months to 2 years, with a mean of 7 months. An appropriate initial treatment frequency is 2-3 x per week for the initial 10 weeks of care.
01.09.2024
Dr. John Conflitti
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“My kids are way too young for spinal problems…” During my years in practice, people have often asked why we check so many kids in the office. Most people are under the impression that children are way too young to have a structural problem in the spine. For the most part, you would be absolutely correct. About 60% of the kids we check in the office have no structural problems at all, and thank goodness for that. However, statistics from the Center for Disease Control show some alarming numbers. Each year, over 1 million children between the ages of 0-5 will be hospitalized due to a fall. Another 700,000 will be hospitalized from an accidental trauma. That’s not even including the number of kids who will suffer a trauma to the spine, but are never taken to the ER! Now think about this, most people will never even know or think about taking their kids to a chiropractor following a fall or trauma. The great news is that kids are extraordinarily resilient to injury. They bounce back up, and their ability to heal is just much better than that of an average adult. However, structural problems in the spine don’t necessarily cause neck pain and back pain, especially in children. What they can do is create other secondary conditions. Whenever there is pressure in the nerves at the base of the brain from a structural misalignment at the top of the neck, many kids can show conditions like:  Asthma Allergies Immune problems Ear infections ADHD Torticollis These are just some of the common conditions that parents bring their kids to chiropractors for. While it’s not a chiropractor’s job to treat these symptoms, they are signs that the nerve supply from a child’s spine is compromised. On many kids, this can be tied to a difficult or traumatic birth process. The best part of all is how much kids love getting gentle adjustments. It’s often times a parent’s worst nightmare to take their kids to a doctor. The screaming and tantrums on display at a pediatrician or a dentist can unnerve even the strongest parent. A child and infant adjustment is very different than adults, and you’ll usually see kids jumping on to my tables excited to be checked! But the most important reason that kids should be checked early is just because it makes sense. When most of us adults develop some bad secondary conditions, x-rays usually show that a problem has been growing in the spine for 15+ years. Why let kids develop the same problems that us adults have had. Just like we take our kids for a dental check-up to ensure that they are free of cavities, our kids deserve a structural check-up to prevent the damage of a developing spine.
01.07.2024
Dr. John Conflitti
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One of the most common and troublesome problems is a condition known as Temporomandibular joint dysfuction, or TMD for short. In fact, many of you may have heard someone talk about their TMJ or having TMD, but didn’t quite know what it was. TMD involves the joint that connects your jaw to your head. Proper movement of this joint is critical to proper function. It has a profound affect on people because dysfunction of that joint can cause a variety of problems including: Sharp/stabbing jaw pain Inability to open the jaw properly Headaches Neck pain Painful clicking Teeth grinding Clenching and much more... It has rapidly become one of the more common reasons for visits to a neurologist and pain clinics, because of the dramatic impact that this sensitive piece of anatomy has on a person’s quality of life. Many times, this condition is treated with medications. In some cases, muscle relaxers or injections to the joint. What does this have to do with the neck? A search of PubMed will show numerous references for increased incidence of TMD in conjunction with a whiplash injury, or head/neck trauma. A systematic review of these papers show that people with whiplash/head injury actually have more severe pain and more pronounced dysfunction of the joint. Another review showed that just treating the TMJ in these whiplash related cases poor outcomes suggesting that the cause of the problem may be outside the joint itself. The whiplash associated cases showed just a 48% improvement compared to the non-whiplash cases which improved 75% of the time. That leaves a huge amount of people who are still in pain and suffering because the primary insult to the body was not addressed properly. TMD usually comes in 2 varieties: 1. Muscular dysfunction – the muscles of the jaw (pterygoids, masseter, temporalis) become hypertonic and dysfunctional creating painful musculature and sloppy movement. 2. Articular dysfunction – the joint itself can have problems. Dislodging of the disc, arthritic degeneration, and inflammation can irritate the very sensitive nerve endings that cover the joint. Not much can be done about arthritic breakdown of a joint. However, this is a less common cause of TMD. The most common causes of TMJ problems stem from muscular imbalance and dislodging of the articular disc. In a way, these two problems are intimately related. When you have bad jaw muscles moving the jaw abnormally, then it leaves more room for the articular disc to shift out of place. So what can make these jaw muscles dysfunctional? To know that, we have to know what controls the muscle. Every muscle in your body is controlled by a nerve. Whether it be a big bulky bicep, an achy sore back muscle, the blood pumping heart muscle, and the food digesting stomach. For the jaw muscles, a special nerve called the Trigeminal Nerve emanates from the skull and provides innervation for the face, jaw muscles, teeth, brain, and other important structures. (as seen in the above image) The trigeminal nerve is one of twelve specialized nerves called Cranial Nerves. The unique thing about Cranial Nerves is that they do not exit out of the spine. They actually begin come out of the brain and the brainstem, and exit out of the skull. Therefore, a problem with one of the cranial nerves is usually indicative of a problem at the brain stem. Cervical Displacement, Whiplash, and the Brain Stem One of the reasons that our office gets referrals is because of how Cervical Displacement impacts the health and function of the brain stem. While the top of the neck doesn’t apply direct pressure to the brain stem, the movement and function of the neck has large implications for this important piece of anatomy. When someone has an episode of whiplash, there can be substantial damage and injury to the neck, but the more concerning portion is what happens to the nervous system. A phenomenon known as Central Sensitization occurs. This problem happens when the brain stem fires inappropriately to the limbic system (controls the basic emotions (fear, pleasure, anger) and drives (hunger, sex, dominance, care of offspring)) and reticular activating system (the places where pain is interpreted in the brain). When this happens, even the slightest touch or movement can trigger a pain sensation in the brain. This is why many doctors can find no physical damage to the body, but people will suffer with chronic pain issues like fibromyalgia. People recognize this quickly when the pain is stemming from the neck, shoulders or back, but the reality is that this same thing is happening in the jaw muscles. To get to the root of someone’s problems, we have to evaluate this critical, but under studied part of the nervous system.  How does Structural Chiropractic address this? 1. Restore healthy biomechanics to the spine – create a state of Normal Structure in the neck so that the proper signals get to the brain. 2. Increase circulation through the brain – proper alignment ensures that blood to and from the brain stem properly. Proper blood flow means better nerve firing. 3. Restore health biomechanics to the jaw – Once the neck alignment is restored, most of the time the jaw will reset on it’s own. However, sometimes gentle jaw adjustments may be necessary. 
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