01.12.2020
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.
01.11.2020
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
Every year, hundreds of THOUSANDS of people will under go some form of spinal surgery. These surgeries range from spinal fusions, discectomies, disc replacements, and more. I would like to discuss a popular misconception. Many people think that if they’ve had surgery on their spine, then there’s no way that they can see a chiropractor. Now, based on what many people perceive of chiropractic, I can’t say that I blame them at all. If you’ve had rods, plates, and screws placed into your spine, then the thought of someone wrenching or twisting the spine, causing damage in the surgical attachments…it sounds downright terrifying. Not All Chiropractic Techniques Are the Same Most people associate chiropractic with a move you’d see out of a martial arts movie. The truth is, there are many ways to bring about a correction of the spine, and some are very gentle and non-invasive. Some are so safe that they can be used on elderly folks with osteoporosis, new born babies, people with herniated discs, and even people who have had surgery. In our office, we use only the most precise and gentle chiropractic approaches so that we can take care of people of any population. Needless to say, safety isn’t the main issue when you’re armed with the correct chiropractic tools. The big question that remains is:Can chiropractic help me even if surgery didn’t? I was taking care of a patient who had had surgery on her neck for neck pain and arm pain. Since the surgery, her pain persisted. She was tired of trying to fix the problem and had basically given up on herself. Very unlikely that she would ever walk into my office of her own. She was referred to the office to give Structural Correction care a try. After a consultation and an explanation of my adjusting techniques, she felt safe enough to give it a go. In a few short weeks, many of the symptoms she had before the surgery started to go away. Now here is a VERY VERY VERY important point: The adjustments did NOT NOT NOT make her pain go away Now this might sound crazy, but it’s not the adjustment that did the healing. Adjustments in of themselves have NO capacity to heal someone. The problem was that her neck had shifted so far out of place, that the nerves in her neck were being compressed and irritated. When you add the surgery on top of it, it had locked the neck in a shifted position even further. The adjustments simply help to restore the NORMAL alignment of the head and neck. When the spine goes back to normal, then the nerves can work again. It’s that simple. This is not an unusual situation. In fact, because of the focus on structural correction and the gentle adjustment techniques, I have been referred dozens of patients after surgery in the past, and almost all of them respond great to our care. When you, or someone you know has had surgery, there are very real limitations to how much the structure of the spine can be corrected. As much as I love and enjoy helping patients post-surgery, the best thing anyone can do is to have their structure corrected BEFORE surgery becomes part of the picture. That way you can achieve a maximum correction, and have less dependency on chiropractic to stay well.
01.09.2020
Dr. John Conflitti
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“80% of the country will have back pain during their life, why would turn away all of that potential business?” “If you don’t take care of the back, then what DO you take care of?” In my practice, I focus on Structural Correction and I deal exclusively with the alignment and mechanics of the spine. I’ve seen hundreds, if not thousands of patients with low back pain looking for someone to help them. So, how can a gentle approach to the neck help with back problems? I can probably cite a complicated study, or explain this long and complex pathway like the infographic shown below: But really, I’m sure you just want me to make sense of it all. So here it goes: 1. No matter where pain may be felt, it is always processed by the brain. That’s why there are many Secondary Conditions occur where there is nothing physically wrong to diagnose, but the pain is very real to that person. A person with Fibromyalgia deeply understands this concept. Proper structural alignment of the head and neck allow the brain stem to transmit the messages from the spinal cord properly. It ensures that there is no hypersensitivity to pain occurring at the level of the central nervous system. 2. Anterior head syndrome is a condition in which the head and neck has shifted forward in front of the shoulders. While this may not seem like much, but the weight of a 12 lb head reaching beyond the shoulders forces the muscles of the neck and back to pull harder than normal. This is because for every inch forward the head moves, gravity pulls 10 extra lbs onto the neck and back muscles. So a person with a 10 lb head can suddenly have the mechanics of a 30 lb head with just 2 inches of Anterior Head Syndrome. An interesting thing to note is that people with both neck pain and back pain will see their back pain go away before their neck pain. 3. According to a recent study in the Journal of Neurosurgery, deformities in the neck affect the alignment of the hips and pelvis. The two structures are linked together through a complex muscular sling. In other words, where the head goes, the neck goes and vice versa. Whether you’ve been told your SI joint or a herniated disc is the problem, Structural Correction may still provide an answer. Though not all cases of back pain are related to a Structural Shift in the spine, it’s an important factor that is not usually looked at by most doctors or Traditional Chiropractors. Rather than getting pigeon-holed into a symptom-treatment model, it may benefit you to have someone take a global look at the body, and how a structural shift can impact the spine and the central nervous system.
01.08.2020
Dr. John Conflitti
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If you have ever been to a doctor’s office and had an x-ray performed, you have likely heard about something called spinal degeneration. Spinal degeneration is a condition in which the discs and joints of the spine begin to narrow and often form bone spurs. If you’ve ever been to a chiropractor’s office and seen your x-rays, you’ve probably seen a chart that looks like this: You compared yourself to one of these images, and identified yourself within one of the various phases of spinal degeneration. Maybe you felt confused. Maybe you felt alarmed, perhaps even a little scared. Either way, you knew that your spine probably didn’t look like the “normal” and that you had work to do. How Bad is it Really? No one likes to be told that their spine is developing arthritic degeneration. It’s a sign that the days of our youth are fading, and a reminder that our bodies are not going to last forever. Everyone will develop some level of spinal degeneration as we get older. Regardless of whether someone has a lifetime of chiropractic, supplements, positive mental attitude, etc, we cannot stop discs from breaking down or bone spurs from forming. Once people get into their 40’s and 50’s, we expect to see some degree of degeneration in the spine to occur. Are there those in their 70’s without it? Sure. But those are OUTLIERS, and we don’t make predictions based on a handful of outliers. With that being said, here are some quick facts to know about spinal degeneration. 1. Degeneration ≠ Pain – One of the things that frustrates me is when someone tells a patient that they are going to live with chronic pain because they have spinal degeneration. While many people with degeneration do have spinal pain, an OVERWHELMING MAJORITY of people with degeneration have no pain what so ever. While a lot of people with pain have some level of spinal degeneration, that doesn’t mean that spinal degeneration is the CAUSE of their pain. I’ve seen many patients with massive spinal degeneration, and many of them will get better despite the fact that their degeneration has NOT CHANGED. We have to resist being trapped within a diagnosis, especially if that diagnosis has a high degree of inaccuracy.  2. Your Spine Isn’t Going to Fuse (Probably) – some patients have concerns that a doctor told them that their spine is fusing. This is always something that raises my eyebrows because there are less than a handful of situations where you would expect the segments of the spine to fuse together. Vertebra don’t fuse as they degenerate. Discs will get closer together to where there’s minimal space, but regular degeneration WILL NOT turn into a fused vertebra. They are completely different things.    We have NO idea what the time table is on degeneration. Except in cases of certain disease processes (i.e. – ankylosing spondylitis), this is nothing but fear mongering. Degeneration, not Death Sentence Degeneration can be a problem for some patients. Loss of hydration in the disc, and lack of movement in the spine can create problems for the brain and nervous system. Time and again, I’ve seen patients who have been told that their problem is related to arthritic knees, hips, and spines respond really nicely to Structural Correction. Even without seeing any change to the degenerated joint. If the arthritis were the sole problem, then no one with spinal degeneration would ever get better. Degeneration is a sign of a breakdown process, but it’s not usually the cause. We need to be freed from these self-defeating labels that hold us back from living the active and healthy lifestyle we all deserve. If you’ve been told that your pain or problem is because of arthritis or degeneration, it may be time to get another opinion. Call our office today and book your appointment to get back on the right track. 248-287-8700
01.07.2020
Dr. John Conflitti
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Outline: ·         When treating TMJ pain seems hopeless ·         Surgery may not be your best solution ·         TMJ pain may not be a jaw problem Patients with TMJ often see a large drop in the quality of their life: ·         “I feel like a baby because I can’t eat solid foods anymore” ·         “There are times where I just have to stop talking because all I can think about is the pain” ·         “That popping sound creeps me out and drives me nuts” A lot of people will experience jaw pain for a day or two if they bite into a hard/chewy piece of food, but imagine if your life was plagued with jaw pain every single day. We underestimate the importance of our jaw, but it’s the piece of anatomy that allows you to enjoy some of the finest pleasures in life. Everything from kissing, to chewing, to a casual conversation with friends becomes a burden when your jaw fails to function. Desperate Times and Desperate Measures Severe cases of TMD (Temporomandibular Disorders) can make people reach their breaking point quickly. Many of the patients that come to our office are usually looking at surgery as their next and final option because they don’t know what to do. Even worse is when a patient spends tens of thousands of dollars for surgery but the pain doesn’t go away. Procedures that help to remove or replace a degenerated disc in the joint are sometimes performed to eliminate this pain sensitive piece of anatomy. The problem is that a degenerated disc can show up on imaging, but it isn’t necessarily the cause of the pain. Unfortunately this happens more often than you might think, and it’s something that can make a patient with TMD hopeless if even surgery couldn’t get the job done. This isn’t to say that surgery is not the answer, or that surgery can’t help, but we have to remember that TMD is a problem that science has yet to reveal all of the answers, and dental surgery is still working on figuring out what works and when it’s appropriate. TMJ Pain May Not Be A Jaw Problem There are many different causes for TMJ pain. They can range from abnormal jaw movement, tight jaw muscles, and degenerated discs. These can all be problem areas for a TMJ patient, but they all have something in common. In fact, their commonality goes back to some of the same neurological mechanisms that contribute to neck pain and headaches. That’s why people with TMJ don’t just have jaw pain; they often have neck pain and headaches at the same time. It’s because almost all pain signals from the head and neck go through a small piece of spinal cord called the trigemino-cervical nucleus. Trigemino-cervical…..what???? Sometimes Pain is a Computer Problem So if you don’t have a medical background, some of that terminology might jump over your head. Instead of thinking anatomy, let’s talk about it like a computer.   Your brain and spinal cord are like a computer chip. The part of your computer chip that feels head and neck pain is the trigemino-cevical nucleus. Just like all computer chips, the quality of information that comes out is dependent on the quality of information that comes in. If you put junk information in, you get junk information out. The computer chip of your body relies heavily on information from the muscles and joints. These signals are like computer programs. Whenever these joints move poorly from bad positioning, then it’s like a bad program that gives faulty information about what’s happening inside the body. This can occur from malpositioning of the jaw, faulty jaw movement, neck positioning errors, and faulty neck movement. It’s like a computer virus going into your system and scrambling important signals into the brain. This tells the body to produce a junk signals including: Tight and tense jaw muscles Inappropriate inflammation Central pain sensitivity Can This Program Get Shut Off? Fortunately your body’s program for pain can be re-written by changing the way these joints move. A specialist like a neuromuscular dentist can use non-invasive methods to change the way your jaw moves and alter your bite with an orthotic. Chiropractors that can correct the craniocervical region can create a dramatic impact on the pain programming in the brain. That’s why both of these doctors frequently see similar patients, and will actually co-manage them between each other. Neck pain patients may get better relief from a dentist changing their bite, while some TMJ patients will get better relief from correcting their neck. While we can’t say for certain which takes priority, but many patients can benefit from an interdisciplinary approach to care. Take the time to get a Complimentary Consultation to find out what method fits with you. You may even find that getting the entire jaw/neck complex fixed may be the key to solving your TMD. Call our office today for your free consultation – Premier Chiropractic 248-287-8700
01.06.2020
Dr. John Conflitti
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As school starts around the country, many parents have concerns about backpacks and scoliosis screenings. What’s the truth? As I speak to more and more patients, I’ve come to a realization that there is quite a bit of confusion about what scoliosis is, and how it can affect your child’s health. Many people remember going into the school nurse’s office every so often and get a scoliosis test where they bend down from their waste and touch their toes, as shown below. The most common screening test for scoliosis. But what is scoliosis? Scoliosis involves a curved deformity in the spine. Now here’s where it gets funky. There are good curves and bad curves in the spine. When you look at someone from the side, the spine normally has 3 curves that curve to the front, back, and front again. These curves provide strength and stability to the spine in gravity. A scoliotic curve is seen from the front or back, and may indicate a structural abnormality or congenital deformity. Good curves are visible if you look at someone from the side. When you look at someone from the front or back, curves in the spine are a bad sign and may indicate the presence of scoliosis. Many people can have a scoliosis and never feel any effects or symptoms from it.  Others may experience more common symptoms like back pain, neck/shoulder tension and posture/cosmetic problems. In rare cases, the curvature can become large enough (50 degrees or more), that it can compress the chest cavity causing respiratory and cardiac problems, and become a surgical issue. Scoliosis comes in 2 main forms. There are is a functional scoliosis which is typically named idiopathic scoliosis, and there is a scoliosis called structural/anatomical scoliosis. A structural/anatomical scoliosis is called by a malformed vertebra which can force the spine to a curved position as it seeks to get back to center. This type of scoliosis cannot be fully corrected and it can also lead to larger curvatures depending on how malformed the vertebra is. A functional/idiopathic scoliosis is named as such because there is typically no medically known cause. This is the most common type of scoliosis.  These types of curvatures can be corrected and reduced significantly through conservative means when caught before a person is fully developed. The real question is, should you be worried? The truth is, if you’re just worried about pain, then probably not. Many times, scoliosis is asymptomatic, especially in children. In fact, most people will probably go through their childhood with no knowledge that it is even there. For the category of idiopathic scoliosis, it is often the secondary result of a structural shift in one or more bones in the spine. A curve is usually not described as a scoliosis until it reaches the 10 degree mark. Most people are concerned when the curvature surpasses 20 degrees, as that’s when bracing becomes a common recommendation, and cosmetic concerns become more obvious (postural problems, protruding shoulder blade, etc). When the curve grows 40 degrees, surgery starts to become a real option for treatment. The key is catching these curves early. Scoliosis is most commonly found in girls during adolescence, which is a great window of opportunity for structural correction, no matter how small the curve may be. Just like how a bent frame of a car can create suspension problems and tire wear/tear, a bent spine can increase the damage the spine experiences throughout life. I’ve seen x-rays of people well into their 40’s and 50’s who have never experienced spine pain, but will show a scoliotic spine with disc degeneration and bone spurs in the exact pattern that the structural alignment would dictate. As the spine shows early wear and tear, the nerves can get damaged and cause secondary conditions as well as changes into the muscles, ligaments, and even the vital organs of the body can start to show. As a worried parent, what can you do? Here are a few tips: Get a spinal check up by someone who is focused on the health of the spine! Nurses and general practitioners do a great job of identifying major curvatures using basic screening tools, but these will typically identify cases of scoliosis that are excessively large and may be candidates for surgery. A chiropractor focused on structural correction instead of pain relief can recognize smaller deviations and provide tools to correct them if necessary. Avoid the one shoulder back pack routine. It may look cooler and be more comfortable, but extra forces on a spine that isn’t optimally positioned can increase scoliotic curves. Stay active. Movement is life and a spine that moves early and often has more pliability and flexibility than one that is sedentary and stiff. Keep the weight down. If you had a crooked house and you add more weight to it, what happens to the house? It breaks down faster. The same thing happens to the body. If you build more mass on top of a crooked structure, it will lead to earlier degeneration. Stay fit.
01.05.2020
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.
Overview: Pain from the ribs. How’d it happen? Why does it hurt so bad? Painful but fixable “It hurts right here (points to middle of back), especially when I take a deep breath in.” “It’s like someone is poking a knife in the middle of my back” “Every time I try to stand up all the way, my back spasms.” “I just want to crack this pinch in my back.” There are times when pain can literally take your breath away.  That sharp, stabbing pain coming from a very pinpoint spot in the middle of your back.  Sometimes it’s just a really annoying feeling that won’t go away, but other times it can make you feel crippled by back spasms. In many cases, this pain comes from the joint where your ribs connect to your spine. Sometimes people will say that you have a rib head that’s “out of place”, misaligned, or sprained. For the sake of today’s article, we’ll just call it rib pain. It’s a frustrating problem because it can happen out of nowhere. Sometimes you just wake up with the pain, other times it’s from twisting or turning too quickly. Fortunately, even though we don’t know much about the pain, we do have effective strategies to help manage it when you feel it. Why Does It Hurt So Bad? The interesting thing about pain from a rib head is that the intensity and level of annoyance is really high for a problem that is pretty harmless. It’s not like a herniated disc where you may have other serious complications that arise, but the pain can sometimes be as debilitating. Although this joint won’t result in pinched nerves that can cause muscle weakness or loss of feeling, it is extremely dense in pain generating tissue. The ligaments shown on the image above, as well as the direct connection of the rib to the vertebra can be full of pain fibers called nociceptors. This joint is not supposed to have very much movement. If the joint gets overloaded and sprains the ligament, or if there is too much friction between the joint surfaces, then it stimulates an aggressive pain response in the brain. When the pain response is initiated, the nervous system often looks to brace an area of injury, this typically comes in the form of muscle tightness and spasticity. As the muscles tighten around your ribs, it limits your ability to breathe in deeply. The muscle spasticity may also compress the nerves, arteries, and veins passing around the curvature of the ribs causing additional sources of pain and discomfort. Unlike other parts of the body like the hand, shoulder, and low back, you don’t have a choice in moving your ribs. Your ribs move whenever you take a breath, and breathing is a little bit important to the maintenance of life. The more it moves, the more it can agitate the painful joint even if there’s minimal tissue damage. How to fix it? For most people, this pain will go away within a week without any treatment. However, if you have the pain for longer, you may need a little bit of outside help to correct the problem. Most chiropractors can address the pain with a spinal adjustment to the thoracic spine or rib head. Typically patients will feel a substantial amount of relief within a few visits. When combined with some corrective exercise, you probably won’t have any further issues unless you reinjure the joint.   Whether your problem is brand new or chronic, a Structural Corrective approach to the spine can lead to substantial relief.
01.03.2020
Dr. John Conflitti
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If you have ever been to a doctor’s office and had an x-ray performed, you have likely heard about something called spinal degeneration. Spinal degeneration is a condition in which the discs and joints of the spine begin to narrow and often form bone spurs. You may have even been shown a poster with the stages of spinal degeneration on it, and asked to pick which stage you are in. You compared yourself to one of these images, and identified yourself within one of the various phases of spinal degeneration. Maybe you felt confused. Maybe you felt alarmed, perhaps even a little scared. Either way, you knew that your neck probably didn’t look like the “normal” neck, and that you had work to do. How Bad is it Really? No one likes to be told that their spine is developing arthritic degeneration. It’s a sign that the days of our youth are fading, and a reminder that our bodies are not going to last forever. Everyone will develop some level of spinal degeneration as we get older. Regardless of whether someone has a lifetime of chiropractic, supplements, positive mental attitude, etc, we cannot stop discs from breaking down or bone spurs from forming. Once people get into their 40’s and 50’s, we expect to see some degree of degeneration in the spine. Are there those in their 70’s without it? Sure. But those are OUTLIERS, and we don’t make predictions based on a handful of outliers. With that being said, here are some quick facts to know about spinal degeneration. 1. Degeneration ≠ Pain – One of the things that really frustrates me is when someone tells a patient that they are going to live with chronic pain because they have spinal degeneration. While many people with degeneration do have spinal pain, an OVERWHELMING MAJORITY of people with degeneration have no pain what so ever. While a lot of people with pain have some level of spinal degeneration, that doesn’t mean that spinal degeneration is the CAUSE of their pain. I’ve seen thousands of patients with massive spinal degeneration, and many of them will get better despite the fact that their degeneration has NOT CHANGED. We have to resist being trapped within a diagnosis, especially if that diagnosis has a high degree of inaccuracy. 2. Your Spine Isn’t Going to Fuse (Probably) – some patients have come to me with concerns that a doctor told them that their spine is fusing. This is always something that raises my eyebrows because there are less than a handful of situations where you would expect the segments of the spine to fuse together. I took an x-ray on one of these patients and all that was visible was moderate disc degeneration. A very common finding on x-ray, and nothing to get very alarmed about. They were under the impression that their spine would be fused together within 5 years if they didn’t get this fixed. This is absurd for a couple of reasons: 1. Vertebra don’t fuse as they degenerate. Discs will get closer together to where there’s minimal space, but regular degeneration WILL NOT turn into a fused vertebra. They are completely different things. 2. We have NO idea what the time table is on degeneration. None. Nada. Zilch. Except in cases of certain disease processes (i.e. – ankylosing spondylitis), this is nothing but fear mongering. Degeneration, Not Death Sentence Degeneration can be a problem for some patients. Loss of hydration in the disc, and lack of movement in the spine can create problems for the brain and nervous system. Time and again, I’ve seen patients who have been told that their problem is related to arthritic knees, hips, and spines, respond really nicely to Structural Correction. Even without seeing any change to the degenerated joint. If the arthritis were the sole problem, then no one with spinal degeneration would ever get better. Degeneration is a sign of a breakdown process, but it’s not usually the cause. We need to be freed from these self-defeating labels that hold us back from living the active and healthy lifestyle we all deserve. If you’ve been told that your pain or problem is because of arthritis or degeneration, it may be time to get another opinion. 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 at 248-287-8700
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