Can Chiropractic Improve Symptoms of Asthma?

According to the Centers for Disease Control and Prevention, as of May 2018, 1 in 13 Americans have asthma, representing 26.5 million people. Of these 26.5 million, 6.1 million children and 20.4 million adults suffer from this chronic disease.

The annual costs of asthma to society are approximately $80 billion in the US alone This substantial amount includes medical expenses, missed school or work days, transportation expenses to medical appointments, and lost productivity. Effective clinical management of asthma continues to pose significant public health challenges to the patients and the U.S. healthcare delivery system.

Standard treatment for asthma consists of a variety of medications. The gold standard of treatment is inhaled corticosteroids. Asthma inhalers are so much a part of daily life that they appear regularly as hand-held props in television programming and in film. In these shows, the difficulty of the moment for the character is acted out by having the player pull out her or his inhaler and take a quick puff. Additional standard medications include long-acting beta agonists, which open the airways, and leukotriene modifiers such as montelukast (Singular), which help to prevent wheezing and shortness of breath. Short-term relief during an asthma attack may be provided by rapid-acting bronchodilators such as albuterol (ProAir and Ventolin).

The primary challenge of asthma is that it is a chronic condition. There is no real end-point of the disorder and there is no cure. For most people, asthma symptoms persist long-term and likely require life-long medication. As well, there are numerous side effects associated with medication usage. For example, side effects of leukotriene modifiers may include depression, hallucinations, and suicidal thinking. Use of long-acting beta antagonists may enhance the risk of a severe asthma attack. Side effects of albuterol may include headache, dizziness, nausea, and vomiting, and sleep problems.

Importantly, regular chiropractic care is a key component of a comprehensive asthma management program. Chiropractic care detects and analyzes spinal joint dysfunction and associated nerve irritation and nerve interference that may contribute to the presence of asthma in a child or adult. As a chronic disorder, asthma has complex physiological causes and nerve interference may be a factor in the development of many, if not all, of these factors.

Next, chiropractic care corrects spinal dysfunction, helping to restore more normal spinal biomechanics and directly address the sources of nerve interference. Over time, regular chiropractic care helps to reduce the physiological stressors that are implicated in the symptoms of asthma and helps both children and adults obtain greater levels of long-term health and well-being.

Centers for Disease Control and Prevention: Asthma Surveillance Data. https://www.cdc.gov/asthma/most_recent_data.htm, last updated May 2018

Tursynbek N, et al: The Economic Burden of Asthma in the United States, 2008–2013. Ann Am Thoracic Soc 15(3):348-356, 2018

McClafferty H: An overview of integrative therapies in asthma treatment. Curr Allergy Asthma Rep 14(10):464, 2014

Can your diet affect joint pain?

Joint pain may be experienced as a result of an acute injury, such as an ankle sprain, knee sprain, or rotator cuff tear. Joint pain may also accompany varying types of joint inflammation, including osteoarthritis (degenerative joint disease), rheumatoid arthritis, psoriatic arthritis, and joint inflammation secondary to lupus erythematosus and irritable bowel syndrome. Of the numerous causes of joint inflammation, osteoarthritis is by far the most common, frequently affecting the lower back, neck, hips, knees, shoulders, and wrists. Many factors are associated with the development of osteoarthritis, including overuse, too little use, faulty biomechanics, and overall lack of exercise. Joint pain related to osteoarthritis may be improved and ameliorated to a certain extent by engaging in a comprehensive program of restoring more efficient biomechanics, targeted exercise, and healthy nutrition.

Diet is frequently implicated in various systemic inflammatory disorders and, in consequence, various joint inflammatory conditions. For example, celiac disease, a chronic inflammatory disorder, is often associated with gluten insensitivity or gluten intolerance. Malabsorption syndrome and leaky gut syndrome, both of which may be associated with joint inflammation, may be associated with gluten insensitivity or gluten intolerance. The inclusion of nutritional supplementation such as probiotics and prebiotics is helpful in the overall management of malabsorption syndrome and leaky gut syndrome. As well, instituting a gluten-free diet may be of assistance in managing gluten sensitivity, gluten intolerance, and conditions such as celiac disease.

Additionally, sugar, refined carbohydrates, saturated fats, monosodium glutamate, and alcohol are known causes and potentiators of joint inflammation. For certain individuals, dairy products, eggs, tomatoes, nuts, and coffee may exacerbate existing joint inflammation. In contrast, for most people, diets containing at least five servings of fresh fruits and vegetables daily help prevent the development of joint inflammation and help reduce inflammatory processes and thus ameliorate a primary cause of joint pain.

Exercise helps to improve joint range of motion, strengthen supporting muscle groups, and increase the resiliency and flexibility of local soft tissues such as tendons and ligaments. Optimally, exercise is done five days a week for at least 30 minutes each day. Beneficial forms of exercise include walking, swimming, bicycling, yoga, and strength training. If you haven't exercised in some time, start slowly and gently, building up your capacity and stamina.

Regular chiropractic care plays a key role in the effective management of joint pain. By detecting and correcting sources of spinal nerve irritation and nerve interference, regular chiropractic care helps to optimize the functioning of your entire physiology. Potential causes of joint pain in the neck, mid back, and lower back are addressed directly, and joint pain in other locations is benefited by more normalized communication between those sites and the nerve system as a whole. In this way, regular chiropractic care helps improve the long-term overall health and well-being of you and your family.

Basu A et al: Dietary fruits and arthritis. Food Funct 9(1):70-77, 2018

Oliviero F, et al: Anti-inflammatory effects of polyphenols in arthritis. J Sci Food Agric 98(5):1653-1659, 2018

Aryaeian N, et al: The effect of ginger supplementation on some immunity and inflammation intermediate genes expression in patients with active rheumatoid arthritis. Gene 698:179-185, 2019

Can Chiropractic Help Alleviate Anxiety?

Many people of all ages experience depression and/or anxiety, whether on an occasional, frequent, or consistent basis. These symptoms may be transient, only occurring at a particular stage in one's life, or they may represent a specific condition such as a depressive disorder or a panic disorder.

Panic disorders are characterized by attacks of anxiety and overwhelming fear known as panic attacks. During a panic attack, a person may experience pounding or racing of the heart, breathing problems, dizziness, weakness, chills, and nausea. Additionally, during a panic attack a person may experience a feeling of being out of control and a feeling of impending doom.

Chiropractic care has a distinct and specific role to play in the management of panic attacks. Spinal bio mechanical dysfunction and spinal nerve irritation may be implicated in the causation of panic attacks, as such dysfunction and irritation can heighten physiological stress and participate in triggering feelings of anxiety. In other words, if your body is already on high-alert status owing to internal bio mechanical stress and neurophysiological irritation, then emotional and/or environmental triggers can more easily shift your adaptive responses into panic mode.

Regular chiropractic care helps one avoid such detrimental, cascading effects by detecting, analyzing, and correcting sources of spinal biomechanical dysfunction and spinal nerve irritation. By helping reduce baseline levels of internal physiological stress and restoring improved function throughout the body, regular chiropractic care helps mediate one's response to anxiety-provoking phenomena. It also helps alleviate muscular tension and pain and improve the functioning of one's cardiorespiratory, gastrointestinal, immune, and hormonal systems. Regular chiropractic care helps one gain higher levels of health and well-being as well as reduce the overall frequency and severity of panic attacks.

Engaging in healthy lifestyle choices, such as maintaining a nutritious diet and participating in regular, vigorous exercise, assists regular chiropractic care in improving one's health. Daily nutritious food intake enables your body to work properly. Nutritious foods help build strong cells and tissues and help remove toxins that accumulate from metabolic activity. Regular, vigorous exercise could include doing at least 30 minutes per day of activities such as walking, running, bike riding, swimming, and weight training on a five-day-per-week schedule. These healthful action steps work together to provide more energy, more restful sleep, and an overall positive mental attitude. There may also be unexpected benefits as your body and mind begin to work in harmony. Overall, the combination of healthy lifestyle activities and regular chiropractic care helps to optimize how your body works and reduces the impact of potentially anxiety-causing internal and external stressors.

Metzler DH, et al: Anxiety Disorders in Primary Care. Prim Care 43(2):245-261, 2016

Locke AB, et al: Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician 91(9):617-624, 2015

Williams JW Jr, et al: An Overview of Complementary and Alternative Medicine Therapies for Anxiety and Depressive Disorders: Supplement to Efficacy of Complementary and Alternative Medicine Therapies for Posttraumatic Stress Disorder. Washington, DC: Department of Veterans Affairs, VA Evidence-based Synthesis Program Reports, 2011

What Is TMJ Syndrome and How Can Chiropractic Help?

The temporomandibular joint (TMJ) connects the temporal bone with the condylar process (flange of bone) of the mandible (jaw bone). There is a TMJ on each side of your skull. The joint provides for all motion of the jaw in relation to the skull, including elevation, depression, protraction, and retraction. The temporal bone is a highly complex structure. Cranial nerve VII (facial nerve) is located within the temporal bone's facial canal. The tympanic part of the temporal bone surrounds the external auditory meatus, forming the canal that transmits auditory signals to the auditory nerve.

The TMJ is a diarthrodial joint, as are many other joints in the human body, and comprises ligaments, a cartilaginous disc, a joint capsule, and a synovial membrane. As a diarthrodial joint, the TMJ is subject to inflammatory disorders, including degenerative arthritis, and movement of the TMJ may become quite painful. TMJ syndrome describes head, ear, and jaw pain; joint crepitus of the TMJ; joint dysfunction; and tenderness of the muscles of mastication. Joint crepitus is a sensation of grinding, grating, crunching, or popping upon movement of a joint. TMJ joint dysfunction is characterized by deviation of the jaw to one side on opening of the mouth and/or inability to insert 3 fingers vertically when the mouth is open. The jaw deviates to the side of a weak muscle, such as the pterygoids. The muscles of mastication are the masseter, temporalis, and pterygoids, all extending from the zygomatic and temporal bones to the mandible TMJ.

Regarding TMJ pain, sensory innervation to the TMJ is provided by the mandibular branch (mandibular nerve; V3) of cranial nerve V (the trigeminal nerve). Muscle spasm related to the TMJ may involve the motor branches of V3, which supply the masseter, temporalis, and pterygoid muscles. Muscle spasm may contribute to substantial pain as a component of TMJ syndrome.

TMJ syndrome may involve radiating pain, especially to the jaw line and ear, irritating the auditory canal. There may be aching facial pain, pain around and in the ear, and locking of the TMJ, interfering with normal opening and closing of the mouth.

Chiropractic care is an especially important component of a comprehensive, holistic program of treatment for TMJ syndrome. Chiropractic care detects, analyzes, and corrects spinal nerve irritation and spinal joint dysfunction. In the case of TMJ syndrome, the vertebral joints of the neck and their associated spinal nerves may be specifically implicated. Additionally, using gentle manual procedures directed toward the TMJ itself, chiropractic care is able to relax and reduce muscle spasm in the jaw muscles surrounding the TMJ and help to restore normal TMJ mobility. Additional treatment for TMJ syndrome may include use of a mouth retainer at night (nocturnal occlusal guard) to act as a "sling" and help prevent grinding of the teeth while asleep. As well, psychological counseling may be of benefit.

Overall, chiropractic care provides specific treatment for TMJ syndrome. Your chiropractor may also recommend a restorative nutrition program and exercise routines to assist your overall recovery and return to optimal health and well-being.

Chantaracherd P, et al: Temporomandibular joint disorders' impact on pain, function, and disability. J Dent Res 94(3 Suppl):79S-86S, 2015

Fernández-de-las-Penas C, Svensson P: Myofascial Temporomandibular Disorder. Curr Rheumatol Rev 12(1):40-54, 2016

Sanders C, et al: Temporomandibular Disorder Diagnostic Groups Affect Outcomes Independently of Treatment in Patients at Risk for Developing Chronicity: A 2-Year Follow-Up Study. J Oral Facial Pain Headache 30(3):187-202, 2016

The knee is a hinge joint and stability is provided by the large thigh muscles (the quadriceps and hamstrings), the cartilaginous medial and lateral menisci, the medial and lateral collateral ligaments, and the anterior and posterior cruciate ligaments. The cruciate ligaments are located within the knee joint and provide front-and-back stability to the knee. Specifically, the anterior cruciate ligament (ACL) helps prevent the shin bone (tibia) from sliding too far forward with respect to the thigh bone (femur). The cruciate ligaments also provide rotational stability to the knee.

The cutting maneuver, in which the foot is planted, the knee is flexed, the thigh is internally rotated, the shin is externally rotated, and with subsequent powerful contraction of the quadriceps is a position of vulnerability for the knee. Cutting maneuvers are common in sports such as soccer, basketball, football, and lacrosse. Cutting maneuvers may also be utilized in daily life, such as with the need to suddenly bend and twist the lower body.. Sudden, unanticipated cutting maneuvers may result in knee injury. Structures that may be damaged include the medial meniscus, the medial collateral ligament, and the ACL. This complex of injuries is known as O'Donaghue's triad. If there is significant joint swelling post-injury, it is likely that the ACL has been severely sprained and possibly ruptured.

Prevention is always the optimal policy, as third-degree ACL sprains (torn ACL) typically require ACL reconstructive surgery. Postoperative rehabilitation includes progressive physical therapy and at-home exercise. This recovery period usually ranges from 8 to 12 months.

Prevention of ACL injuries involves flexibility routines and lower extremity strengthening exercises. Flexibility activities may include yoga, Pilates exercises, and regular stretching of the quadriceps, hamstrings, and calf muscles. Lower extremity strength training includes squats, lunges, quadriceps extension, hamstring curls, calf raises, and toe raises. A primary result of an ongoing flexibility and lower extremity strength training program is optimization of knee proprioception, that is, increased neurological activity of the knee joint regarding its positioning in 3-dimensional space. Enhanced proprioception will help distribute cutting maneuver physical forces around the knee joint more effectively, reducing the likelihood of injury. As well, flexibility and exercise programs provide resilience and increased strength to the musculoskeletal structures comprising and supporting the knee.

Regular chiropractic care provides necessary support for both knee injury prevention programs and postoperative recovery. By detecting and correcting sources of biomechanical dysfunction and nerve interference, regular chiropractic care helps create a physiological environment by means of which you and your family can obtain the greatest benefit from your exercise activities. In the same way, if ACL reconstruction ever becomes necessary, regular chiropractic care helps assist the effectiveness of the recovery program and helps your body achieve the greatest benefit from rehabilitation protocols.

Benjaminse A, et al: Revised Approach to the Role of Fatigue in Anterior Cruciate Ligament Injury Prevention: A Systematic Review with Meta-Analyses. Sports Med. 2019 Jan 18. doi: 10.1007/s40279-019-01052-6. [Epub ahead of print]

Biscarini A, et al: Knee flexion with quadriceps contraction: A new therapeutic exercise for the early stage of ACL rehabilitation. J Biomech 49(16):3855-3860, 2016

Smeets A, Malfait B: Is knee neuromuscular activity related to anterior cruciate ligament injury risk? A pilot study. Knee. 2018 Nov 8. pii: S0968-0160(18)30903-30907, 2018. doi: 10.1016/j.knee.2018.10.006. [Epub ahead of print]

Yard work can be both a necessary and enjoyable activity for many, whether you live in a condo with a small yard, a suburban community, or on a sprawling ranch in rural America. However, yard work can often cause the unprepared to sustain a musculoskeletal injury, especially to the lower back. Knowing how to prepare for yard work is usually appropriate for most adults in order to avoid unanticipated and unwanted problems.

Yard work typically involves repetitive bending, lifting, and twisting activities, and may include maintaining a bent-over position for several minutes at a time. All of these actions and postures may place significant biomechanical stresses on the joints, muscles, and ligaments of the lower back. This may result in injury to anatomical structures that have not been trained to support such loads. Effective yard work preparation involves core exercise training and general fitness activities such as cardiorespiratory exercise and strength training accompanied by an understanding of safe bending and lifting techniques.

Core exercises train your deep abdominal muscles, including the rectus abdominis, internal and external obliques, and the very important transversus abdominis. Regular sit-ups will train the rectus abdominis, but this is the most superficially located of your core muscles. Your oblique and, especially, your transversus abdominis provide stability and support to your lumbar spine and pelvis, helping to ensure that your bending, lifting, and twisting activities will be relatively safe and injury-free in most daily contexts.

Core exercises include many routines familiar to older fitness enthusiasts and former high-school athletes, such as squats, pushups, and jumping jacks. More recent additions to the core exercise group include the plank, hip presses, leg crossovers, and forward and backward lunges. Core exercises only require an exercise mat and possibly some lightweight dumbbells for squats and lunges. They can easily be done at home or outdoors in your backyard or neighborhood common area. The addition of upper and lower body strength training and cardiorespiratory exercise such as walking, running, swimming, and cycling will provide a complete fitness program that will enable you to fully engage in vigorous activities of daily living such as yard work, carrying heavy packages, and other household chores.

It is also always important to pay attention to optimal bending and lifting practices. Prior to performing bending, lifting, or twisting activities, you should make sure your abdominal muscles are activated by breathing in and flattening out your stomach. Next, get as close as possible to the object you’re intending to lift or otherwise manipulate, bend your knees, and bend forward at the waist, continuing to keep your abdominal muscles strong. Then, lift the object while keeping it close to your center of gravity and straighten your legs. By adhering to this sequence of maneuvers, you’ll be able to safely lift objects of reasonable weight, as well as safely engage in productive yard work and gardening.

1Caneiro JP, et al: Physiotherapists implicitly evaluate bending and lifting with a round back as dangerous. Musculoskelet Sci Pract 2018 39:107-114, 2018

J Back Musculoskelet Rehabil

2Kumar T, et al: Efficacy of core muscle strengthening exercise in chronic low back pain patients. 28(4):699-707, 2015

3Turner LW, et al: Influence of yard work and weight training on bone mineral density among older U.S. women. J Women Aging 14(3-4):139-148, 2002

At some point during the course of her pregnancy, a woman may begin to experience low back pain and even sciatica, that is, radiating pain down the back of a leg. The likely explanation for most of these cases of obstetric-related low back pain is the increased mechanical load due to the weight of the developing fetus, amniotic fluid, and placenta. Many times, low back pain is transient and resolves on its own. However, pregnancy-associated low back pain may persist for more than a week and require conservative treatment to help reduce pain and achieve resolution.

Chiropractic care is the optimal conservative treatment for pregnancy-related low back pain, with or without sciatica. The musculoskeletal structures affected by the increased weight of pregnancy are the vertebral joints of the lumbar spine, the sacroiliac joints, the local ligaments, and spinal musculature. The sacroiliac joints, especially, contain numerous pain receptors and sacroiliac joint dysfunction often causes a substantial component of a pregnant woman's low back pain.

Chiropractic care identifies, analyzes, and corrects these sources of lumbar spine and sacroiliac joint dysfunction and nerve irritation. As a result, information exchange between the brain and the rest of the body is optimized. The ability of the lumbar vertebrae and the sacroiliac joints to bear weight and manage the increased mechanical stresses of pregnancy is facilitated. Stimulation to pain receptors is reduced and the supporting musculature is enabled to relax. Function improves and a sense of improving health and well-being is restored.

In the case of a breech presentation, the buttocks and/or feet of the fetus are positioned closest to the birth canal, rather than in the more typical vertex presentation, with the fetus's head being closest to the route of delivery. A breech presentation occurs during 3-4% of all full-term births. Factors that may be associated with a breech presentation include prior pregnancy, the presence of twins, and too little or too much amniotic fluid. A breech presentation may be identified by specific palpation of the abdomen and confirmed, if needed, by an ultrasound of pelvic examination.

Chiropractic care may be utilized in the overall healthcare management of a breech presentation. If the pregnant mother-to-be chooses a vaginal delivery, chiropractic care may be employed to provide integrative support. By detecting and correcting spinal misalignments and sources of nerve interference in the mother-to-be, chiropractic care helps to optimize all of her physiological processes, including supporting the health and well-being of her developing fetus. By helping to restore and maintain peak physiological function in the mother-to-be, chiropractic care helps provide an environment that supports the activities of other members of the healthcare team in attempts to turn the fetus so that the orientation is head down, and otherwise helps support an optimal outcome of a vaginal delivery.

1Berhan Y, Haileamlak A: The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. Brit J Obstet Gynecol 123(1):49-57, 2016

2Fischbein SJ, Freeze R: Breech birth at home: outcomes of 60 breech and 109 cephalic planned home and birth center births. BMC Pregnancy Childbirth 18(1):397, 2018 doi: 10.1186/s12884-018-2033-5

3Alcantara J, et al: The use of validated outcome measures in the chiropractic care of pregnant patients: A systematic review of the literature. Complement Ther Clin Pract 21(2):131-6, 2015

"Sciatica" is an older term describing the symptoms of inflammation of the sciatic nerve, also known as sciatic neuritis. Sciatica involves radiating pain down the back of one lower extremity, usually including the back of the thigh and back of the calf, possibly extending into the foot. Sciatica pain may be described as sharp, shooting, gnawing, and/or burning, and may be accompanied by numbness and tingling. Intensity may range from mild to severe and frequency may range from occasional to constant. The onset is generally gradual and not necessarily associated with a precipitating event.

When lower back pain is accompanied by radiating lower extremity pain, it is useful to attempt to assess the relative distributions of such pain. If low back pain predominates or low back pain and sciatica pain are fairly equal in distribution (approximately 50% of the pain is in the low back and approximately 50% of the pain is in the lower extremity), then the sciatica pain may likely be caused by mechanical dysfunction in the low back. If sciatica is associated with a herniated disc, then leg and buttock pain will be the dominant symptom, compared with low back pain. In the case of a herniated disc, there may also be leg muscle weakness and diminished sensation in the affected leg. Pain that radiates only to the buttock and thigh is probably not related to irritation of the sciatic nerve, but rather to mechanical disorders of the low back and/or sacroiliac joint.

Regular chiropractic care is a primary natural remedy for sciatic pain. Regular chiropractic care detects and corrects spinal dysfunction that may be a source of sciatica pain. For example, altered spinal biomechanics may impinge and irritate spinal nerves, causing nerve inflammation and associated radiating pain. By helping to restore optimal spinal biomechanical function and relieve sources of nerve irritation, regular chiropractic care helps to restore the integrity of the sciatic nerve and reduce inflammatory pain and other symptoms.3

In addition to in-office care, your chiropractor may recommend the use of ice applications and stretching/exercise to assist in managing sciatica pain. An ice pack or plastic bag filled with ice cubes may be applied to the lower back for 15 minutes every few hours to help reduce associated muscle pain, muscle spasm, and sciatic nerve inflammation. Importantly, ice applications should always be wrapped in a thin towel so as to avoid placing the cold pack directly on the skin. Gentle stretching for the quadriceps, hamstrings, and calf muscles will assist in restoring optimal biomechanical functioning to both the trunk and the legs. Gentle exercise, including walking and riding a stationary bike, will similarly assist in the process of recovery. Overall, your chiropractor is your go-to resource and the best manager of the range of natural remedies to help resolve sciatica pain.

1Ramaswami R, et al: Management of Sciatica. N Engl J Med 376(12):1175-1177, 2017

2Deyo RA, Mirza SK: Clinical Practice. Herniated Lumbar Intervertebral Disk. N Engl J Med 374(18):1763-1772, 2016

3Lewis RA, et al: Comparative clinical effectiveness of management strategies for sciatica: systematic review and network meta-analyses. Spine J 15(6):1461-1477, 2015

The focus of chiropractic treatment is the spinal column and nerve system. Most of us are familiar with the application of chiropractic treatment methods in the care of the human population. What is not generally known is the fact that chiropractic treatment can be applied in the care of the veterinary population. Historically, chiropractic treatment of animals most typically involved the care of horses, but veterinary chiropractic also includes the care of cats and dogs, those furry loved ones for whom many of us provide food and shelter.1

The basic principles are the same. Spinal misalignments cause nerve irritation and soft tissue inflammation. Soft tissue inflammation causes pain, muscular tightness, decrease in joint range of motion, altered biomechanics, and, ultimately, injury. Such musculoskeletal injuries may be mild, moderate, or severe and time to recover depends on the nature of the injury.

Additionally, nerve irritation causes an altered flow of information between the brain and the rest of the body. At the cellular level, these structures may receive incorrect information regarding the timing and performance of their functions. At the other end of the feedback loop, the brain may receive inaccurate information regarding the biochemical state of the cells themselves. Depending on which organ systems are affected, nerve irritation may impact any or all of the cardiorespiratory, digestive, hormonal, and immune systems. As a result of undetected nerve interference, both people and animals may begin to demonstrate signs and symptoms of various illnesses.

The range of human disorders is generally well known. With respect to early warning signs and symptoms of diseases common to animals, horses may cough, be depressed, or lose their appetite. Cats may experience weight loss, dry coat, thirst, and sneezing. Similarly, dogs may experience a change in appetite, lethargy, dehydration, and labored breathing. Overall, most of these animal disorders may be related to conditions associated with named disease entities as well as nerve irritation.

Chiropractic treatment provides great benefit in the care of horses, cats, and dogs by addressing many of the underlying causes of common disorders. By detecting and correcting sources of nerve irritation and restoring optimal biomechanics of the spine, chiropractic care helps to restore normal physiology and function. As many of the root causes of the disorder are corrected, your beloved animal begins to feel better and demonstrate increased liveliness and well-being.

Chiropractic treatment for pets is similar to chiropractic treatment for people.2,3 Depending on the particular animal, chiropractic adjustments may be used. For others, soft tissue techniques such as muscular relaxation, kinesiology, and trigger point therapy may be utilized. The overall goal is to restore spinal integrity and restore optimal function to the nerve system, the body's master system. In this way, chiropractic care helps all members of your extended family achieve high levels of health and wellness.

1Hesbach AL: Manual therapy in veterinary rehabilitation. Top Companion Anim Med 29(1):20-23, 2014

2Haussler KK: Equine Manual Therapies in Sport Horse Practice. Vet Clin North Am Equine Pract 34(2):375-389, 2018

3Edge-Hughes L: Canine thoracic costovertebral and costotransverse joints: three case reports of dysfunction and manual therapy guidelines for assessment and treatment of these structures. Top Companion Anim Med 29(1):1-5, 2014

Should you use heat or ice on your painful injury? The best method of solving this important riddle is to assess the nature and source of the pain. Essentially, a new injury, that is, one that you sustained within the last 48 hours, is best treated with ice. Chronic pain, or pain that you have had for a long time, is generally best treated with moist heat. Understanding the mechanisms of injury and the physiological and biochemical causes of pain helps us to differentiate the indications for applying ice or applying moist heat.

The primary rule is that you can never go wrong with applying ice. Ice calms things down and, although an ice application may be uncomfortably cold for a few moments, the overall effect is soothing. Cold decreases local metabolism and constricts small blood vessels (arterioles). Cold reduces nerve conduction velocity, that is, the speed at which nerve impulses are transmitted, and therefore reduces the number of pain signals that reach your brain per unit time. Thus, ice applications provide vasoconstriction, analgesia, and sedation. Ice is indicated for acute musculoskeletal injury, burns, insect bites, bleeding, and snake bites. Ice should not be used for gout, rheumatoid arthritis, Raynaud's phenomenon, history of vascular impairment, and cold allergies. As well, ice should not be used for a patient in a coma.

Moist heat increases local metabolism and dilates small blood vessels. Vasodilation results in increased nutrition, increased activity of white blood cells (phagocytosis), and increased removal of waste (metabolic end-products and damaged cellular structures). Moist heat provides analgesia, sedation, and reduces muscle spasms. Heat is best for chronic pain and muscle spasms. Contraindications to moist heat include acute musculoskeletal injury, area of diminished sensation, acute skin conditions, pregnancy, malignancy, diabetes, encapsulated swelling, hemorrhagic disorders, and suppurative conditions.

Generally, ice applications are used for acute injuries within a 72-hour time frame from the onset of the injury. Acute injury damages local capillaries, causing blood to leak into the spaces between cells and tissues, where it doesn't belong. Such uncontained blood causes pressure on local nerve endings, creating pain. Also, pressure is applied to nearby cells, causing extended injury and possibly cell death. Thus, limiting the amount of blood leaking out of disrupted capillaries is critical in slowing the effects and reducing the impact of musculoskeletal injury. Ice performs this function. Ice reduces swelling, reduces pain, and provides a sedative effect.

When applying ice, it's very important to avoid damaging the skin. Ice packs should always be wrapped in a towel. Ice should rarely be applied directly to the skin. Duration and frequency of ice applications is not an exact science, but a useful guideline is to apply ice for 15 minutes every two hours for a moderately acute injury, using three to four ice applications per day. However, you will know instinctively when the time is right to apply the next ice pack.

Moist heat applications follow similar guidelines. Dry heat should never be used. Moist heat packs should be wrapped in a towel and are applied for 15 minutes every two to three hours, up to several applications per day.

Recovering from injury requires your body to put forth a great deal of effort and requires support from the nerve system, the body's master system. Regular chiropractic care provides great assistance in the process of recovery from any injury. By detecting and correcting spinal misalignments and sources of nerve interference, regular chiropractic care helps ensure optimal functioning of the nerve system. Thus, regular chiropractic care helps facilitate your recovery and helps you return to your full range of activities as quickly as possible.

1McCarberg B, D'Arcy Y: Options in topical therapies in the management of patients with acute pain. Postgrad Med 125(4 Suppl 1):19-24, 2013

2Piana LE, et al: The Cold, Hard Facts of Cryotherapy in Orthopedics. Am J Orthop (Belle Mead NJ) 2018 Sep;47(9). doi: 10.12788/ajo.2018.0075

3Mayer JM, Mooney V: Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Arch Phys Med Rehabil 87(10):1310-1317, 2006