Many of us think of depression as a psychological condition. The causes of depression are sought in the person's childhood or in her personal circumstances as an adult. But within the last 10 or 20 years depression is increasingly being evaluated within a physiological context. Various disease states and physical disorders are being recognized as important contributors to depression. This viewpoint is empowering to persons with depression and often provides a way forward when progress has been minimal or absent.
Those with depression experience both physical and psychological pain. It is well-documented that chronic physical pain can lead to depression. Also, it is well-known that depressive states can cause physical pain. A feedback loop (vicious circle) is often created in which physical pain makes a person's depression worse and the person's depression makes the physical pain worse.
In addition, changes in brain physiology may cause a person to be depressed. In other words, abnormal electrical activity in the brain - which, of course, is not under the person's conscious control - may result in depression. The brain's electrical activity is evaluated by a method known as quantitative EEG (QEEG).1 For those with clinical depression, the QEEG often demonstrates too much slow-wave activity in the left front brain (prefrontal cortex) and too much fast-wave activity in the right prefrontal cortex.
For those with clinical depression, the light of the world is considerably dimmed. The mood of a depressed person is low and he loses interest in normally pleasurable activities. Depressive disorders interfere with a person's work and/or school activities, family life and social life, and overall health. Lack of energy, lack of appetite, and decreased physical activity are all associated with clinical depression.
An access to relieving chronic depression may be found in encouraging the person to begin to engage in physical activity.2,3 Such activity may be difficult for those who are severely depressed, and yet all persons with depression should be presented with this form of therapy.
Additionally, chiropractic care may be of great benefit for those with clinical depression. The pain relief and improved musculoskeletal function afforded by chiropractic care may help reduce the physical component of ongoing depression.
1Hargrove JB, et al: Quantitative electroencephalographic abnormalities in fibromyalgia patients. Clin EEG Neurosci 41(3):132-139, 2010
2Gill A, et al: Clinical Inquiries: Does exercise alleviate symptoms of depression? J Fam Pract 59(9):530-531, 2010
3Uebelacker LA, et al: Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract 16(1):22-33, 2010
We all want to get the most we can out of life. Whether we want to find a loving partner, work at a meaningful career, gather an abundance of financial resources, or have enough leisure time to pursue favored interests, the usual bottom line is that we want to be happy. Throughout thousands of years of history, the great philosophers have pointed to happiness as the worthwhile goal of all human activities. In the Nicomachean Ethics, Aristotle (384 B.C. - 322 B.C.) suggested that eudaimonia - happiness - is our best good.
Most of us would agree that the life we want to live involves achieving the greatest degree of happiness. Even if we haven't spent much time studying the works of Aristotle, we intuitively seek our greatest happiness. But such joy often escapes us, even at times when we think to ourselves that we ought to be happy. Various obstacles stand in our way, not the least of which is physical pain.
Physical pain can overshadow our various paths to personal happiness. We can tolerate acute pain for a while in the hope that it will go away soon, within a week or two at the most. But chronic pain is another matter. Often, extraordinary resources need to be utilized to maintain a positive attitude in the face of ongoing pain.
Many people experiencing chronic pain may find it difficult to imagine really living the life they want to live. Pain seems to influence everything. But there are many tools and techniques for diminishing the impact of chronic pain. The practice of yoga1,2 has consistently been shown to provide benefits, as has developing the habit of doing regular exercise3, such as walking or swimming. Engaging in enriching activities such as learning a new language, studying a musical instrument, and learning how to draw or paint with watercolors can shift one's focus away from pain and toward personal growth and development.
Also, chronic pain, at least that involving the musculoskeletal system, may benefit from chiropractic care. For example, chiropractic care can often help with chronic headaches, chronic neck pain, and chronic low back pain. For many people the benefit may be substantial. Your chiropractor is experienced in the care of many chronic conditions and will let you know whether chiropractic care is right for you.
1Michalson A, et al: Yoga for chronic neck pain: a pilot randomized controlled clinical trial. J Pain 13(11):1122-1130, 2012
2Tilbrook HE, et al: Yoga for chronic low back pain: a randomized trial. Ann Intern Med 155(9):569-578, 2011
3Sullivan AB, et al: The role of exercise and types of exercise in the rehabilitation of chronic pain: specific or nonspecific benefits. Curr Pain Headache Rep 16(2):153-161, 2012
Cancer is a health issue for many families. It's important to understand that there are different kinds of cancers. Not all cancers are life-threatening. Some types may be very serious and some may be dealt with relatively easily.
First, it's important to distinguish between benign and malignant tumors. The words "tumor" and "cancer" are usually interchangeable.
Tumors (or cancers) affect how cells reproduce. Normal cellular reproduction is tightly regulated. Normally, cells reproduce at regular intervals. In a tumor, cell reproduction is unregulated - cells reproduce on their own schedule, rather than based on the needs of the body. The result is a mass of cells that is growing unchecked. The tumor mass "doesn't belong" - it's like it exists within its own world. But the tumor uses the body's precious resources to maintain its own existence.
Benign tumors are usually slowly growing. The benign tumor mass is surrounded by a membrane and is "well-encapsulated". A benign tumor may cause health problems when it reaches a size big enough to create pressure effects on the surrounding tissues. Such a tumor mass may create pressure on an important blood vessel, or it may kill nearby cells and tissues by the pressure it's exerting on them. Basically, the tumor isn't supposed to be there. There's no room for anything "extra" in the body.
Malignant tumors have more dangerous characteristics. In general, malignant tumors are more rapidly growing than benign tumors. Malignant tumor cells have the ability to make their way into the capillaries, traveling through the bloodstream until reaching suitable locations for new growth.1,2 A metastasis is a new malignant mass developing in a new location from that of the original tumor.
Also, malignant tumors have the unique ability to cause the body to build an individualized, extensive blood supply for the tumor. This process is called angiogenesis. This complex network of blood vessels supplies the malignant tumor with extra oxygen and nutrients to fuel its rapid growth. So, essentially, malignant tumors highjack the body's resources for the tumor's own benefit. Malignant cells are highly adaptive and deadly.
Medical treatment for malignant cancers includes
- Chemotherapy
- Radiation
- Surgery
Where does chiropractic treatment come in? Chiropractic care may be an important component of supportive care in cancer treatment. Your body needs to use all its available resources and energy to help fight cancer and assist in recovery. Gentle chiropractic treatment helps your body work more efficiently, improving overall mechanical function and easing stress on muscles and joints.3 These chiropractic benefits help make more energy available to assist your body in returning to a healthier state.
Chiropractic treatment helps support the process of recovery and the transition back to maximum health.
1Gavert N, Ben-Ze'ev A: Epithelial-mesenchymal transition and the invasive potential of tumors. Trends Mol Med 2008 (in press)
2Guarino M, et al: The role of epithelial-mesenchymal transition in cancer pathology. Pathology 39(3):305-318, 2007
3Demark-Wahnefried W, Jones LW: Promoting a healthy lifestyle among cancer survivors. Hematol Oncol Clin North Am 22(2):319-342, 2008
We all know someone with high blood pressure (HBP), possibly a beloved family member or a lifelong friend. This common problem affects one in four American adults.1 An alarming 75% of patients with type 2 diabetes also have HBP.2
High blood pressure is particularly dangerous because, for the most part, there are no symptoms until severe damage occurs. Heart disease, stroke, kidney disease, atherosclerosis, and eye disease are some of the serious problems that may result from untreated HBP.
Normal blood pressure is in the range of 120/80 ("120 over 80"). The first number represents the systolic pressure, the pressure at which your heart pumps blood into your arteries. The second number represents the diastolic pressure, the pressure in your arteries between heart beats (the resting pressure). The systolic pressure can increase, in the short term, in response to stress or physical activity. Systolic pressures over 140 and diastolic pressures over 90 suggest the possibility of HBP. Blood pressure readings should be repeated several times, over a period of several days, before a diagnosis of HBP is considered.
Medical treatment for HBP consists of blood pressure-lowering medications (antihypertensives). This group of drugs is typically effective in reducing pressure, but getting the dosages right may be tricky and there may be unwelcome side effects.
Lifestyle strategies and activities (complementary medicine, lifestyle medicine) offer significant, well-documented benefits in reducing blood pressure levels. Regular, frequent exercise is an important part of all lifestyle programs targeted toward lowering blood pressure and reducing the risk of cardiovascular disease and stroke.3,4 Regular exercise makes your heart stronger, and a stronger heart pumps blood more easily and efficiently. Over time, regular exercise may reduce blood pressure levels by an average of 10mm.
Meditation is another key reducer of blood pressure levels.5 Much more than a New Age fad, meditation has consistently demonstrated benefits related to several health issues. And, meditation is easy to do. All you need is a comfortable chair or cushion that allows you to sit in a straight posture without any tension. There's no special breathing to do and you don't have to do any chanting.
To meditate, sit facing a blank wall (if possible) and let your hands relax in your lap. Tilt your head slightly downward, and let your eyes achieve a soft focus at that slightly downward angle. Breathe easily and gently. Breathe in and visualize energy going up your spine in the back. Breathe out and visualize the energy going down your spine in the front. Silently say "one". Continue up to "ten" cycles, and begin again at "one". That's it!
How long? This is completely up to you. Start with five minutes twice a day, and gradually build up to 20 minutes twice a day. You'll probably notice you're feeling much more at ease, more relaxed, with more energy during the day than before you started meditating. The benefits are powerful, and again, there is a profound effect on high blood pressure.
Your doctor of chiropractic can help participate in a complementary approach, assisting your body and you nervous system to function at peak performance.
1Undiagnosed hypertension is common among urban emergency room patients. Medscape Medical News, Sept 2, 2005 - http://www.medscape.com/viewarticle/538785.
2Schutta MH: Diabetes and hypertension. Epidemiology of the relationship and pathophysiology of factors associated with these comorbid conditions. J Cardiometab Syndr 2(2):124-130, 2007.
3High blood pressure and exercise: Why activity is key. August 11th, 2006 - http://www.mayoclinic.com/health/high-blood-pressure/HI00024.
4Zanabria E, Welch GL: Hypertension and exercise. American Fitness March-April 2003.
5Walton KG, et al. Psychosocial stress and cardiovascular disease. Effectiveness of the Transcendental Meditation program in treatment and prevention. Behav Med 28(3):106-123, 2002.
According to a recent report, cardiovascular disease claims more lives worldwide than any other disorder.1 Diseases of the heart and blood vessels, including coronary artery disease, are responsible for more than 4 million deaths in Europe each year2 and almost one-third of all deaths worldwide. In the United States, coronary artery disease is responsible for nearly 20% of all disease-related deaths. Each year approximately 1.5 million Americans suffer a heart attack. Despite decades-long public health campaigns conducted across the globe, heart disease remains a powerful, formidable foe.
A large part of this problem is related to three classical risk factors for heart disease: high blood pressure, high cholesterol levels in the blood, and diabetes. As worldwide epidemics of obesity and diabetes continue to worsen, it is easy to understand why heart disease remains a number one killer. Obesity is strongly linked to high cholesterol levels, and the combination of diabetes and overweight/obesity is strongly linked to high blood pressure. As the epidemics persist, so does the prevalence of heart disease risk factors. No public health issue exists in isolation, and this is especially true for heart disease.
However, there is good news. Heart disease, hypertension, diabetes, high serum cholesterol levels, and overweight/obesity are all lifestyle disorders. This means that we can take meaningful action on our own behalf and begin to do things that will positively impact our long-term health and well-being. Such lifestyle changes are important for everyone, as people of all ages, races, and genders may be affected by lifestyle diseases.
Lifestyle changes primarily involve modifications to diet, engaging in consistent vigorous exercise,3 and getting sufficient rest. For example, it is well-known that many people in the developed world consume more calories than they need on a daily basis. The excess calories are stored primarily as fat. Reducing daily food consumption, while adhering to the basic principle of eating from a wide variety of food groups, including fresh fruits and vegetables, will likely result in weight loss and a normalization of high cholesterol levels. Assisting in this process is the practice of engaging in regular vigorous exercise. A proven method is to exercise for 30 minutes five times per week. Such exercise can include walking, cycling, running, swimming, and strength training. The specific choice of exercise is less important than the consistency. The payoff for your commitment to a healthy diet and regular exercise is significant. Research shows that prevention strategies such as lifestyle modifications account for a 50% reduction in mortality from heart disease. This is a huge return on investment.
But in order to reap these rewards, a commitment of time and effort is required. In today's world, good health doesn't just happen. We have to work at it. It's up to us to choose whether we're worth it, whether we want to continue to enjoy a full range of relationships and activities, whether we want to be healthy and well for many years to come. If the answer to these questions is affirmative, lifestyle changes become very important.
1Carmon B: Biochemistry to behaviour. Nature 493:S2-S3, 2013
2Perk J: The power of disease prevention. Nature 493:S6, 2013
3Winter KH, et al: Hypertension Prim Care 40(1):179-194, 2013
As we get older, years and decades of mechanical stress may lead to deterioration of joints, ligaments, and tendons. This degenerative process, commonly known as arthritis, primarily affects weight-bearing joints such as the hips and knees and those found in the lumbar spine. The shoulder, too, is especially prone to undergo arthritic changes owing to its extreme mobility. The extensive range of motion at the shoulder is built-in to the design of this structure, but the tradeoff is instability. The design of the shoulder sacrifices stability for mobility.
Degenerative disorders of the shoulder typically involve the rotator cuff. This broad, flat structure is composed of the muscle-tendon units of the four rotator cuff muscles: the supraspinatus, infraspinatus, subscapularis, and teres minor. The thick covering of the rotator cuff surrounds the head of the arm bone and supports and strengthens the shoulder joint. But owing to the shoulder's inherent instability contrasted with its great mobility, the soft tissues of the rotator cuff undergo repetitive stress and strain. Ultimately, degenerative changes may occur, leading to the two prominent symptoms of pain and restricted range of motion.
An entire orthopedic sub-specialty focuses on treatment of chronic shoulder pain and includes long-term use of anti-inflammatory medication, corticosteroid injections when medications do not provide sufficient relief, and eventually surgery to repair tears in the various rotator cuff tendons. "Revision" surgery is commonly performed when the benefits of prior surgery are exhausted.1
The good news is that in many cases, a more optimal approach is available, one that utilizes the body's own natural recuperative powers. For many people, chronic shoulder pain can be reduced and chronic loss of mobility can be improved by engaging in specific activities and performing specific rehabilitative exercises. The goals of rehabilitation are to increase shoulder range of motion and build up shoulder strength. As these goals are accomplished, the likely result is reduction of intensity and frequency of occurrence of shoulder pain.
Engaging in an overall strength training program is an important general approach to managing chronic shoulder pain.2,3 Strength training should be done progressively, starting with light weights and building up over time. Exercises specific to the shoulder include seated dumbbell or barbell presses, dumbbell or cable lateral raises, seated bent-over rows, and internal and external rotation exercises done with very light dumbbells on a flat bench. If one has experienced an acute shoulder injury, early rehabilitation should precede rehabilitative strength training. Early rehabilitation includes pendulum exercises and finger-walking up a wall in both forward-facing and side positions.
Your chiropractor is experienced in injury rehabilitation and will be able to help you design an effective flexibility and strengthening program for improved shoulder function.
1Keener JD: Revision rotator cuff repair. Clin Sports Med 31(4):713-725, 2012
2Lewis JS: A specific exercise program for patients with subacromial impingement syndrome can improve function and reduce the need for surgery. J Physiother 58(2):127, 2012
3Andersen LL, et al: Effectiveness of small daily amounts of progressive resistance training for frequent neck/shoulder pain: randomised controlled trial. Pain 152(2):440-446, 2011
Chronic knee pain is notoriously difficult to treat successfully. Persons with these problems often become discouraged as they shuttle from specialist to specialist, from rheumatologist to orthopedic surgeon to physical therapist to acupuncturist and back again. Lack of progress and improvement becomes understandable when one considers that typical evaluation and treatment are directed at the symptoms. But with chronic knee pain, and many other pain syndromes, actual benefits may be obtained by addressing underlying biomechanical problems.
Faulty biomechanics are at the root of many ongoing knee problems. Of course, various other diseases and orthopedic conditions may cause the same type of chronic pain. The most likely of these possibilities need to be considered and ruled out before a diagnosis of biomechanical knee pain is established. Osteochondritis dissecans, a torn meniscus, and synovial effusion are all frequently encountered in persons over age 40 with chronic knee pain. Rheumatoid arthritis, lupus, and ankylosing spondylitis are a few rheumatologic conditions which may result in sporadic or chronic knee pain.1
When these medical entities have been eliminated as possibilities, a biomechanical causation becomes probable. How does a person develop "faulty biomechanics"? In fact, most of us have never received effective instruction in how to use our bodies. We stand and sit in all kinds of unsound postures, slouching and slumping and generally giving in to every available force of gravity. We stand with all our body weight on one leg, neck and shoulder muscles gripped tightly and abdominal muscles sagging and protruding. When we sit we slump down, stressing the lower back with poorly tolerated mechanical forces, or sit for hours with legs crossed, stressing the lower back, hips, and knees.
Over the course of a lifetime, our bodies have continually tried to adapt to a range of inefficient and stressful postures and habits. But eventually no more adaptation is possible.2 As a result joints, muscles, ligaments, and tendons break down and fail. We experience this failure as pain. And once this type of pain has started, it is not going to go away unless the underlying causes are corrected. Specifically, the person's biomechanics need to be restored closer to normal.
Correction of posture takes time and can only be accomplished gradually. The key is to learn what to do, learn how to do it, and to be working on posture every day.3 The most important thing is to begin. Three basic biomechanical corrections are as follows: (1) When standing, be sure to have your weight over the balls of your feet and to have your weight evenly distributed on both legs. (2) Activate your deep abdominal muscles by visualizing an "inner lift". (3) Have straight lines of force running down your legs (rather than lines of force crossing at your knee, creating torsion and tension). Visualize "straight energy" flowing from your hip sockets, straight down through the center of your knees, straight down to your feet, between your first and second toes.
Visualizing and implementing these three biomechanical corrections on a daily basis represents the first series of steps toward improving knee mechanics and reducing chronic knee pain.
1Yusuf E, et al: Do knee abnormalities visualised on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis 70(1):60-67, 2011
2Suri P, et al: Low back pain and other musculoskeletal pain comorbidities in individuals with symptomatic osteoarthritis of the knee: data from the osteoarthritis initiative. Arthritis Care Res (Hoboken) 62(12):1715-1723, 2010
3Bennell KL, Hinman RS: A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. J Sci Med Sport 14(1):4-9, 2011
The condition of fibromyalgia creates many challenges for a person with this disorder. These challenges often go far beyond the characteristic chronic pain which alone can be potentially debilitating. Those with fibromyalgia have pain in many locations and the presence of multiple pain sites is often confusing to their doctor or doctors. Family physicians, internists, endocrinologists, and even pain management specialists and rheumatologists often have great difficulty in comprehending the full extent of fibromyalgia and the serious health and well-being issues that are caused by the disorder.
Persons with fibromyalgia have so many symptoms that an uninformed physician may find it easier to refer such patients to a psychologist or psychiatrist. But the physical symptoms of fibromyalgia are real. The sufferers have widespread pain on a chronic basis. Additional symptoms include fatigue, sleep disturbances, numbness or tingling in the hands and feet, joint stiffness, and cognitive dysfunction (brain fog). Depression commonly affects those with fibromyalgia.
Owing to the presence of so many chronic symptoms, fibromyalgia is notoriously difficult to treat. Such patients are typically taking multiple medications, prescribed by multiple specialists attempting to combat the problems that fall within their particular branch of medicine - pain management, rheumatology, and psychology/psychiatry.
Despite taking several medications on a long-term basis, most fibromyalgia patients tend not to improve. Depression and chronic pain take a profound toll, and daily living becomes quite burdensome. Many fibromyalgia patients despair of ever finding even a partial solution.
Attempts to address the problems of fibromyalgia by just treating the symptoms often fail. As the physiologic causes of the disorder are unknown, holistic approaches have a much greater likelihood of success. Multidisciplinary treatment is needed to impact this systems-wide disorder, including chiropractic care, nutritional recommendations, psychological counseling, and a gradual return to increased levels of physical activity and exercise.(1, 2, 3)
Headaches are an unfortunate and painful part of life for many Americans. In fact, an estimated five percent of adults in this country suffer from chronic migraines or severe headache pain.
We spend billions of dollars each year on over-the-counter and prescription pain medication for relief from those nagging headaches. But these drugs have the potential to cause even more pain. Nonsteroidal anti-inflammatory drugs (NSAIDs), a type of medication including OTC brands such as Advil, Motrin, and Excedrin, have been associated with side effects like stomach bleeding and ulcers, and even liver failure. In fact, one possible side effect of many NSAIDs is a headache!
And if you manage to avoid the side effects, these medications really only mask or diminish symptoms. But it's the cause that counts and that's where chiropractic comes in. Here's how: The nervous system is the "master system" in the body, controlling and coordinating all other systems - respiratory, immune, circulatory, etc. Sometimes, there are areas in the spine where one or more of the vertebrae may have experienced a loss of function, creating pressure on, or otherwise irritating, spinal nerves. This irritation interferes with the signals, or "communication," traveling over those nerves, which can compromise the health and proper function of every system in the body. Regular adjustments by your chiropractor can positively affect the nervous system, aid nerve transmission and thus, the body's ability to heal itself.
Still a skeptic? Scientific research indicates chiropractic is an effective, natural answer to headache pain. During a major 1995 study comparing several weeks of drug therapy to several weeks of chiropractic care, 82 percent of patients given drug therapy reported side effects including drowsiness, weight gain and dry mouth. Heart-related problems and glaucoma also were associated with the drug therapy. On the other hand, chiropractic patients reported no side effects. And after four weeks of treatment, patients who used drugs began having headaches again, while members of the chiropractic group continued to express headache relief, as well as higher levels of energy as compared to the drug therapy group.
So put down the pain-relief medications, talk to your chiropractor about your chronic headaches, and experience a natural, drug-free approach to headache relief, today!
In the United States, about 20 million people have been diagnosed with asthma; nearly 9 million of them are children. The most common treatment for Asthma has been the use of corticosteriod inhalers.
A new study found that breathing techniques can cut the use of asthma reliever inhalers by more than 80% and halve the dose of preventer inhaler required in mild asthma, research finds.
The new study, published in the journal Thorax, compared the impact of two breathing techniques on symptoms, lung function, use of medication and quality of life among 57 adults with mild asthma.
One technique focused on shallow, nasal breathing with slow exhalations, and the second technique used general upper body exercises, accompanied by relaxation.
The participants, who used a preventer inhaler and required reliever inhaler at least four times a week, were randomly assigned to one or other breathing technique.
Participants practiced their breathing exercises twice a day for around 25 minutes over a period of 30 weeks. They were also encouraged to use a shorter version of their exercises in place of reliever inhaler, and to use reliever if the exercises did not work.
Researcher Professor Christine Jenkins, of the the Woolcock Institute of Medical Research, Sydney, New South Wales, Australia, found that the use of reliever medication fell by 86% in both exercise groups, a process which began within weeks of starting the exercises, and was maintained over eight months. She writes: "Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently."
By the end of the study, the participants dropped from using around three puffs of their reliever inhaler each day to approximately one puff every third day. Preventer dose requirements were also cut in half.
