If you happen to be a fibromyalgia pain sufferer, and you live in Boca Raton, you may have just stumbled on a great resource, that is very hard to come by.

Let me clarify that.

Fibromyalgia doesn’t just occur in Boca Raton. It occurs everywhere. But, It is typically very difficult t find a doctor that understands the “ins and outs” of fibromyalgia no matter where you live.

A doctor that actually believes that fibromyalgia even exists, empathizes with fibromyalgia sufferers, and most importantly, is going to offer you a natural, non-prescritpive, safe, and effective solution to your fibromyalgia pain.

Sound too god to believe? I think not.

Unfortunately, most doctors still wonder if you really have all the fibromyalgia symptoms, ailments, complaints, aches, and pains. Especially when all the diagnostic tests that you have performed all come back negative.

How frustrating is that? To do a battery of test performed, only to have them come back negative, and be looked at like you are making it all up?

The truth of the matter is this: Fibromyalgia is a very difficult condition for a number of reasons.

Doctor are sometimes just as confused as you are when it comes to Fibromyalgia

Because doctors are taught to learn about lab tests, blood test, special studies, imaging, biopsies, and many other rapidly evolving techniques to learn and understand what is wrong with us, when the test do come back negative, they are almost at a stand still, left scratching their heads.

When all the test come back negative, it is wrongly assumed that nothing most be wrong with you.

I’m here to tell you that that is plain WRONG.

Hence, the diagnosis of Fibromyalgia usually becomes a process of elimination.

At Boca Raton Health Center, we believe we understand Fibromyalgia.

That I believe is one of THE most important important variable that determined whether you will beat fibromyalgia, or fibromyalgia will beat you.

How well your doctor understands fibromyalgia is Paramount.

That said, how one copes with Fibromyalgia also comes down to YOU. How “pro-active” will you be in coping with the fibromyalgia symptoms. Sometimes learning about fibromyalgia pain can be overwheleming. But when you understand what fibromyalgia is, along with why you have fibromyalgia, you have a recipe for eliminating fibromyalgia.

We mentioned earlier, that fibromyalgia is really a diagnosis of exclusion.That’s because Fibromyalgia does not currently have any specific diagnostic test to CONFIRM the presence of fibromyalgia.

Conditions Associated with Fibromyalgia

• neurological conditions (example different muscular dystrophies and pain syndromes)
• mental disorders,
• immune disorders,
• musculoskeletal,
• endocrine,
• and autoimmune disorders

Doctors must rule out all these before a diagnosis of Fibromyalgia is reached.

Therefore, the right doctor that comprehends the presentation of fibromyalgia, will typically suspect fibromyalgia from the onset, while eliminating other disorders along the way.

This is essential when tackling the pain associated with fibromyalgia.

As a Boca Raton Chiropractor, We eliminate all other conditions, and fibromyalgia is suspected from the beginning. When this happens. intervention for your fibromyalgia can start a lot earlier.

The criteria for Fibromyalgia Diagnosis:

The first American College of Rheumatology (ACR) published criteria happened in 1990. The ACR’s current criteria for defining fibromyalgia syndrome includes:

1. a history of pain that is affects all 4 quadrants of the body (both left and right side, above and below the waist),
2. the pain last more then three months
3. the presence of at least 11 (out of a possible 18) tender points.

It is estimated that 2-4% of the population suffer with fibromyalgia.

I believe this is WAY to low. That’s because the criteria put forth by the ACR is one such that if you suffer with some but not all of the above, you are not considered to have fibromyalgia.

That’s is, many people have other symptoms associated with fibromyalgia, not included in the ACR’s criteria. Other fibromyalgia symptoms not laid out in the criteria that many fibromyalgia sufferers have are: insomnia or not having deep restful sleep, irritable bowel syndrome or (IBS), mental confusion, fatigue or chronic fatigue, and only 4 of the 18 trigger points.

Some of the complaints can be quite bizarre. When you combine all the uncertainties and question marks, it’s easy to see why fibromyalgia is misunderstood both by you and your doctor.

A more complete list of Fibromyalgia Symptoms:

Sleep disturbances
headaches and facial pain
abdominal discomfort
poor digestion
irritable bladder
numbness and tingling
chest pain
cognitive disorders
environmental sensitivity (sensitive to light noise, odors, weather, as well as allergic reaction to a variety of substances)
disequilibrium
Allodynia (lower the average pain thresholds)
central sensitization (nerve cells that supply the brain become more excitable, overamplifying sensations of pain)
Carol Jessop MD, reports that a sample of close to 1000 of her fibromyalgia patients showed:

• 100% had muscular pain
• nearly all suffered from fatigue and inadequate sleep
• most were battling depression
• 40% had Raynaud’s syndrome (cold hand and feet with poor circulation)
• 24% had anxiety
• 10% had elevated temperature
• 65% had low temperature (suggesting thyroid problems)
• 86% had low blood pressure (suggesting adrenal problems)
• 85% had white spots on their nails (suggesting poor digestion and absorption)
• 73% had IBS
• 82% tested positive for yeast in their stool culture
• 80% had bloating, gas, and/or indigestion
• For a more thorough list of clinical signs of fibromyalgia click here

Fibromyalgia is also closely associated with arthritis, however, with Fibromyalgia, usually their is joint pain or inflammation. Instead Fibromyalgia sufferers have generalized muscle and soft tissue pain.

So whether your still asking yourself the question “Do I have Fibromyalgia”, or your doctor is wondering whether you have ANYTHING, let alone Fibromyalgia, knowing WHAT fibromyalgia is, will lead you to WHY you have fibromyalgia.

Knowing the “Why” I have Fibromyalgia is as important the “WHAT” in Fibromyalgia.

Knowing the Why you have Fibromyalgia, will allow you to ultimately beat Fibromyalgia.

Give us a call and we can discuss doing a no charge no obligation consultation to determine whether you are suffering from Fibromyalgia.

We can review your history, and determine if the risk factors exists for getting fibromyalgia. Once we do that, we can provide a holistic, nutritional and therapeutic solution to fibromyalgia pain in Boca Raton.

In fact, many studies exists that examine the long term effects of whiplash type injuries from a car accident. One in particular determined that 55% of the people studied had residual consequences 17 years later(1). Sadly, many of these participants still continue to receive some type of ongoing rehab. Many of my patients ask me whether or not they should use a neck collar after an accident. With respect to this topic, a lot of controversy exists. The purpose of this article is to discuss the research related to this topic. So lets have some fun with this topic.

Think of it as a battle: In the red corner, we have the champion, the “SOFT COLLAR”, and in the blue corner, we have the challenger, the “Early Mobilization/early movement”. However, in order to evaluate the pros and cons of using a soft collar for the neck after a motor vehicle/whiplash type accident, it’s important to first talk about the basic fundamentals of soft tissue injuries and the healing process itself. John Kellet M.D, an Australian physician published a comprehensive review of the literature on this topic in the journal Medicine and Science in Sports and Exercise and titled it: Acute soft tissue injuries-A review of the literature(2). The article goes on to describe 3 phases of soft tissue repair when injured.

* Phase 1: The Acute Inflammatory or Reaction Phase

Lasting up to 72 hours immediately after the injury, it involves dilation of the blood vessels, increased blood flow with the accompanied immune response, cleaning up of the area by white blood cells, and the resultant inflammation. Pain is produced from tissue damage and the inflammation itself.

* Phase 2: Regeneration of Repair Phase

This phase lasts anywhere between 48hours to 6 weeks. It is in this phase that the injured tissue is trying to “repair” itself, thus the name. Collagen cells are produced and laid down at the injured site. However, the collagen that is laid down is weak, and laid down in an irregular pattern. These collagen fibers continue to strengthen between 3 to 14 weeks after the injury, and even up to 6 months.

* Phase 3: The Remolding Phase

Overlapping with phase 2, this phase may last up to 12 months or longer. In this phase, the collagen that has been laid down continues to be “remodeled” in the way that its strength is improved, and oriented along with the healthy tissue.

So in the words of William Shakespeare: “To Collar or Not To Collar?, That is the Question”

When a soft collar is recommended and used after an accident the goal is to immobilize the injured area. This supposedly prevents more trauma/injury to the unstable area, as well as lends support to the injured tissue. All things being equal, with no resultant bone trauma (ie, dislocation and/or fracture), the injury is said to be a “soft tissue” injury. So in the case of soft tissue injuries, immobilization with a soft collar would be detrimental to the process of healing as described by Dr. Kellet, as early mobilization and movement would seem to improve the timing and healing quality. If we think about the second phase of healing that we just described, where the collagen fibers that are laid down are trying to orient themselves along the line of stress, then it would make sense that it is the early mobilization and movement that is in fact responsible for its organization. Dr. Kellet expresses that immobilization of soft tissue injuries with the use of soft collars in particular, results in diminished endurance, that ultimately causes loss of strength and muscle wasting that may delay full recovery “for a year or more”.

Another study done in 2000 by Dr. Pekka Kannus, MD, PhD, adds to our understanding of soft tissue injuries. Published in the journal The Physician and Sports Medicine his article was titled: Immobilization or Early Mobilization after an Acute Soft-Tissue Injury?(3) Dr Kannus basically summarizes his study with the following: “Experimental and clinical studies demonstrate that early, controlled mobilization is superior to immobilization” This article too adds to the support focusing early mobilization following soft tissue injury and avoiding immobilization.

What about any studies that specifically looked at the outcomes of people who actually used cervical collars, and compared them to those that did not and utilized early mobilization, for treatment of acute soft tissue whiplash injuries?

Well, orthopedist K Mealy and colleagues asked this question and published their study in the British Medical Journal in an article titled (4): Early Mobilization of Acute Whiplash Injuries. In this study, 61 patients with acute whiplash injuries were studied. Of the patients studied, 31 received active treatment, while 30 received a cervical collar and were called the “standard treatment” group. The active treatment group received ice in the first 24 hours and then mobilization of the neck and daily exercises for the neck. These daily exercises were performed every hour at home, within the limits of pain, and no pain medications was needed. The other group that received the soft collar were advised to rest for 2 weeks before beginning gradual mobilization.

So what were the findings? Well, these authors concluded: “…more rapid improvement can be achieved by early active management without any consequent increase in discomfort”. Again, clearly early mobilization was superior to the cervical collar in this study.

With all these studies, they really point in favor of the the use of early mobilization, and discourage the use of soft collars.

So back to our analogy of a battle, it seems that the soft collar has been knocked out in the first round, and is down for the count vs its competitor of early mobilization of movement. But what kind of motion or mobilization is best?

It turns out, that from all the research I examined, that the rotation motion encourages regional blood flow, and facilitates the removal of exudate, thus allowing healing to occur by aiding nutrition of joint structures. So what should we take away from this lopsided victory? Well, again, all things being equal, with a soft tissue injury of the neck due to a whiplash type accident, soft tissue collar may promote inactivity which can delay recovery with patients with WAD. As well, early mobilization, and familiarity with proper exercises and movements to properly manage both the acute and chronic whiplash injured patient is supported by all the research, and is highly recommended.
References:

1. Mark Rosenfeld, RPT; Aris Seferiadis, RPT; Jane Carlsson, RPT, PhD; Ronny Gunnarsson, MD, PhD; Active Intervention in Patients with Whiplash-Associated Disorders Improves Long-Term Prognosis: A Randomized Controlled Clinical Trial; Spine 2003; 28(22):November 15, 2003: 2491-2498
2. Kellet J; Acute soft tissue injuries-a review of the literature; Medicine and Science in Sports and Exercise; October 1986;18(5): 489-500.
3. Pekka Kannus, MD, PhD; Immobilization or Early Mobilization After an Actue Soft Tissue Injury? The Physician And Sports Medicine; March 2000; Vol. 25 No 3. pp 55-63.
4. K Mealy, H Brennan, GCC Fenelon; Early Mobilisation of acute whiplash injuries; British Medical Journal; Vol. 292, March 8, 1986, pp 656-657

Till next time, watching your back, and neck.

Doctor Joel Rosen

A brand new enemy is lurking in the streets that we live in these days. The houses we sleep in, the schools we go to, the job we work at, and basically everywhere we go. This enemy is getting bigger and badder, meaner and meaner, and it is ultimately ravaging our health on a daily basis.

Anyone who has watched Star Trek before knows exactly about the dreaded Borg. For those of you that don’t (sorry for showing you my Star Trek geekiness), this race functions on being “wired in” with their fellow Borg at all times.

They were part of “cells”, or were organized in units, and they were organized like drones similar to bees when they slept in the hive. You would have the Queen bee, and the rest of the colony. The Borgs were similar to this, but they had the technology to communicate and “assimilate”, or all be part of one big giant communicating civilization.

Sorry if that appeared to nerdy for those who never watched star trek, and I apologize to all the die hards who believe my explanation was completely off. Either way, that is the way I remember it.

So what does this have to do with the evil enemy that I spoke of, that I believe is taking over the world as I know it, and surely taking over the way we communicate with each other?

Well, with the advance of technology people seem to be connected to the hand held devices at all times. Text messaging with each other through out the entire day, being on Facebook, Twitter, MySpace, YouTube, and any and all other communication platform. Its not a far stretch to call us the “New Borg.”

We have seen the enemy, and he is us.

Its true, this evil enemy that exist is ourselves, and our insatiable appetite for being in constant communication with each other. We text message our friends, we email each other, we Facebook each other, we add a tweet to our Twitter account, blogging, etc. Nowadays, all of this can be accomplished on our phones, from the palms of our hands.

Geez, what did we do before we had these capabilities, before these hand held devices, surely we were living in the dark ages?

So how is this our enemy?

Well, given that more and more young people are constantly connected, unfortunately, the position the mere act of communicating puts our neck and spines in, through-out the entire day, is really wrecking havoc on our bodies.

Neck pain, shoulder pain, carpal tunnel syndrome, headaches, tingling into the upper extremity, all are conditions that are becoming more and more prevalent with the young, much more frequently.

Heck, I even read on twitter with keyword updates that allows you to see what people are texting with the keyword that you select (neck pain).

In their tweets, most younger folks say how bad their neck pain is, how they just woke up in pain, and have no idea what they did. Well I can tell you, if you even use twitter, chances are that you are also a “texter”, and you probably are known to spend an hour or three on the computer.

Chiropractor Dean Fishman, founded the Text Neck Institute, and coined the term “Text Neck”. I think this is a great term because it is really turning into an epidemic. Text neck according to Dr. Fishman is Text Neck is: “a repetitive stress injury to the body from using hand held mobile devices such as mobile phones, portable gaming units, MP3 players, e-readers and the like”.

Dr. Fishman further goes on to elaborate on what some of the finding of text message are. Seeing younger and younger patients with degenerative changes, otherwise known as early arthritis. A reversal of the normal neck curvature, is the second finding.

With both these changes in the neck, the individual develops a forward head carriage, which then leads to chronic pain. Muscles, ligaments, discs, and joints all become chronically overstretched, and ultimately, the aforementioned headaches, neck pain, upper back pain, carpal tunnel pain, and numbness and tingling develop.

So what solution(s) do I suggest to combat this evil enemy?

Well the obvious and easiest choice would be go to a health care specialist who has a lot of experience focusing on a forward head carriage, and reversing of the cervical curvature.

Doctors of chiropractic have the market cornered in this area (in my opinion), and can help identify mechanical restricted areas, help re-set/re-align the proper structure of the neck, and educate the patient to avoid this harmful position in the first place.

However, that said, I always say that even if you go to your chiropractor, it is but a mere drop in the bucket to the remainder of the day, the time your neck remains in forward head position based on all the postural stressors you experience. Simply put, your neck is trained to be in the Forward Head Position (FHP).

With this posture, you have what is indicative of a FHP, and is also known as an “upper crossed syndrome”. With the upper crossed syndrome, the deep neck flexors in the front, and the rhomboids of the back, become chronic weak.

Additionally, the front pectorals, and the rear upper trapezius muscles become tight. Combined together, the neck gets the “TEXT NECK” that Dr. Fishman coined.

The other solution is to learn the exercises that will strengthen the weakened, neck flexors and rhomboids, and learn the exercises that will restore the tightened pectorals and upper trapezius muscles.

Being aware of your posture when texting, sitting, working, driving, relaxing, reading, and everything else we do in our lives will ultimately become automatic, and I guess, will be the super hero to eliminate the enemy.

Till next time, watching your back and neck.

Doctor Joel Rosen

Anyway, the article goes on to say that lipodissolve is being used as a nonsurgical alternative to liposuction, which is supposedly used to dissolve fatty deposits around the legs, arms, and belly. I happen to live in Florida, and if you believe that above claim, I also have some great land to sell you in these parts, just so happens it in a swampy area, but I got to tell you, it’s an up and coming area. The FDA further goes on to say in this article claims made for lipodissolve injections are false and misleading in that they are not supported “substantial evidence or substantial clinical experience”. I don’t know for sure what the motivation behind FDA’s push for “cracking down” on these supposed fat melting injections it may very well be that it doesn’t like the competition with its state hospitals.

Either way, I guess it doesn’t really matter what the motivation of the FDA are, if at the end of the day the general public is protected from dangerous and unproven technology However, the entire story stinks of hypocrisy when I read it, and felt the need to at least give some kind of commentary of my own. Number one, it’s not like the liposuction procedures are proven safe and effective, just ask Kanye West mother who died of a cosmetic surgery. Number two, the FDA is missing the entire point of what the actual procedure implies, and misses the boat on a valuable opportunity to not only protect the public, but actually educate and empower the public.

Unfortunately, it’s not the entire FDA’s fault. As a society that wants everything now, without the accountability, we tend to live in the “should be” world, vs. the “is” world. We should be able to have a magic pill. You know, the kind that is a purple one, that you watch on television, running though a field, smelling the flower, floating on air, and all your problems can be helped by the purple pill. You can go to bed at night, take the magic pill, and presto you wake up in the morning, and all your problems are fixed. That is the “should be” world. Who wouldn’t want to live life this way? On the other side of the coin, you have the “is” world.

The reality is, we have to be accountable for our actions and there is a cause and effect. Whereas in the “should be” world you have the magic pill, on the other side of the spectrum, you have the cold hard reality. The cold hard reality is you don’t get to be Jack in the bean stock, buy some magic pills, and wake up with a huge path to a pot of gold at the top of a bean stock. That is what the FDA should be teaching. Because we live in the “is” world, if the FDA was truly concerned with protecting the general public, then they would be teaching us the rules of the “is” world. Proper nutrition education, proper lifestyle management, proper exercise recommendation and prevention in general are the fundamentals of what the FDA should be pushing. Instead, they push other pharmaceuticals for an array of conditions that are much better helped through lifestyle modification and habits (i.e., weight bearing exercise and exercise in general for “pre” osteoporotic patients, let alone osteoporotic patients). What is the heck is “pre ____” anyways???

So what does this have to do with neck pain?

Well, that’s easy. When I have a consultation with many of my patients, they have what I call “selective amnesia”. When we go over their case, and determine how bad their neck pain problem is, how much they suffer, how they are unable to do the things they love to do, how severe it is actually impacting their life. When it comes time to take responsibility for their situation, they tend to be looking for the magic pill solution. Take a pill, go to bed, and all that postural stress you put on your body, your job, your day to day activities, your sleeping habits, all disappear with that magic pill. Forget about putting the time in to learn what it is that you are doing on a daily basis to continue the downward spiral into continued neck and upper back pain. Forget about the time and energy to strengthen deconditioned musculature, posture, core strength, and flexibility that is needed. The selective amnesia kicks in when we discuss the time, energy, and money that is going to have to go in to changing their life. If you happen to agree with me, if you happen to understand the sacrifices that must go into changing your life, to help with your aches and pains, then you realize it doesn’t happen overnight. Safety and effectiveness should always be a concern, but living your life with accountability, living your life doing the things you love to do, were meant to do, is your job either way. Not the FDA’s job.

Till next time, watching your back, and neck.

Doctor Joel Rosen

An injury occurs typically because the muscles of the neck are unable to tighten quick enough to the sudden or unexpected movement. When it is from a motor vehicle accident, especially from an impact from behind, it easy to envision the resultant injury to the neck.

The impact is surely forceful enough, and in most cases sudden and unexpected, to cause an injury to the neck. But even if the impending collision is expected, the muscle of the neck are overpowered to result in trauma as well.

That said, there are very basic pieces of advice to reduce the chances of being in a car accident in the first place. This may seem like basic suggestions, but prevention is always the best medicine, and when a neck injury and life long pain and suffering are common consequences of car accident, being reminded of these suggestions are helpful.

1) Consuming Alcohol and Driving: I know, simple, common sense advice, but you would be surprised how often this happens, and really neck pain and suffering is but one of many evils that happen with drinking and driving.

2) Using your Cell phone and driving: Again, seems like common sense, but having one hand on the wheel, and one hand on the phone, decreases reaction time, decreases concentration, and decreases physical ability to maneuver your vehicle.

3) Do not text on your phone and drive: How often do you see someone doing this? Scary is it not?

For the reasons above, and mostly not paying attention, will significantly increase your chances in causing a car accident.

University of Utah actually determined that being intoxicated was less of a problem for causing motor vehicle accidents, when compared with distractions from cell phone use.

Amazing!

Not paying attention while driving is hypothesized to be involved in 20-50% of motor vehicle accident, reported by police in which up to 13% resulted from the driver not paying attention.

Another reported study found that using the speaker component of your phone vs using the cell phone with your hands were alike. Both decrease the drivers ability to respond in time, when measured against a driver not using a phone at all.

It would seem that hands free would be less likely to result in an accident vs hand held. However, it is believed that the energy it takes our brain to concentrate or, the “thinking” part during the conversation causes the primary distraction, not the use of hands.

South Carolina University also found that when compared to talking with a passenger, planning to speak put far more demands on the brain than listening. Thus, we become “distracted”, and it is these “distractions” that increase the probability of an accident.

4) “Rubbernecking”:

Another form of “distraction”, the obvious concern are the eyes of the road, while the vehicle is still moving. We have a fascination with other accidents, and we rubberneck when an accident is ahead.

As we focus on the other accident, not only are our eyes off the road, more then likely, traffic ahead is slowed, if not stopped. Wham, another accident.

5) Changing Stations/CD Player: another distraction in which we are not focused on the road.

Of all the factors listed above, texting seems to be the most worrisome. The University of Utah study found a factor of 6x times more likely to be in a car accident due to being distracted because of texting.

It seems that texting while driving is more common with the young. Half the drivers asked between the ages of 16-24 admitted to texting while driving, whereas with drivers between the ages of 35 years old and 44 years, 22% admitted to texting.

6) Drowsiness: another significant distraction responsible for an increased risk for a motor vehicle accident is being drowsy, which increased the drivers risk of a crash or near crash by 4 times, according to a July 2009 Virginia Tech report.

They studies analysis of videos of 200 truck drivers, Combined, the drivers studied logged over 3 million miles.

Results indicated that texting while driving had the greatest safety risk at 23 times more likely to have their eyes being off the road.

Other variables for increase in safety risk was reaching for a moving object, with a 9 fold increase, while rubbernecking increased the risk 3.7 times, reading increased it 3 times, dialing a cell phone increased risk 3 times, and talking or listening on a hand held device increased the risk 1.3 times.

The bottom line: Neck injuries from motor vehicle accident, let alone fatalities, are a very real concern. Concentrating on the function of “driving” is paramount, but avoiding the above distractions can not only save your neck in the future, it may even safe your life.

Till next time, watching your back and neck.

Doctor Joel Rosen

This article will explain how they are related, why neck pain and dizziness often occur together, and better yet, what you can do about it.

Vertigo is defined as: ” a condition in which somebody feels a sensation of whirling or tilting that causes a loss of balance”

If you have ever felt dizziness, then you understand that eerie sensation of tilting or spinning! I should know I often experience vertigo myself. I especially get dizzy going on roller coasters, Ferris wheels, and other things too. Like trying to read in a moving car, going out on a boat in choppy waters, or watching a bumpy home video, when the camera is shacking constantly.

As a chiropractic physician and rehab specialist, I often hear my patients say when describing vertigo are: unsteadiness, dizziness, lightheadedness, or even giddiness.

Why do we get vertigo? Does vertigo have any relationship to neck pain or neck problems? If so, what?

Great questions to ask because if they are related the answers may explain why we get dizzy in the first place.

Secondly, if neck pain, dizziness and vertigo are related, then if we focus on fixing your neck pain, then you can fix the vertigo problem as well.

Understanding the anatomy will really help you understand how they are related.

The part of our brain that is responsible for vertigo is called the vestibular nucleus, which is located in the brainstem. Stimuli, or information from the body travels up the spinal cord into the brainstem, and then into the brain.

Whatever information that enters into the vestibular nucleus that causes the nucleus to be excited, creates the sensation of vertigo. The information that enters the nucleus can be normal or abnormal.

As a normal signal for example think about a spinning body on a roller coaster, a normal signal of information being sent the brain is the sensation of spinning. Consequently, a sensation of vertigo may develop. The vertigo is a normal response of the spinning. If you stop spinning, you stop sending the information to the nucleus, and the vertigo sensation stops.

The information that enters the nucleus and initiates the vertigo sensations can arise from a number of sources as well. Let’s talk about four of them.

Firstly, labyrinthine (inner ear): inner ear problems may be sent to the vestibular nucleus, and cause vertigo. This is what I have personally. Having several inner ear infections as a child, I had repeated tube procedures into my ears, which unfortunately created a large amount of scar tissue in my inner ear.

Something called Canalithiasis produces vertigo a pathological diagnosis for the sensation of vertigo as a result of dislodged particles in the canals of the inner ear.

This is also known as BPPV:

B stands for benign, because it is not a serious cause of vertigo like infection or malignancy

P stands for paroxysmal, which suggests the bout last for short episodes, typically 20-60 seconds, and a sensation of lightheadedness may persist for several hours.

P stands for positional, because the vertigo is dependent on the positions of your head and neck.

V stands for Vertigo.

Whenever a bout of benign paroxysmal positional vertigo (BPPV) occurs, an incredibly basic, but hugely successful technique for treating and elimination vertigo should be performed.

Pioneered by physician John Epley, MD, the procedure is aptly called, the “Epley” procedure. This procedure to treat BPPV involves precise positioning and turning of the head through a series of positions with intention to move the problematic particle along the inner ear to a location that no longer sends information to the brainstem.

Another source of information that enters the nucleus and initiates the vertigo sensations can arise from the cerebellum.

The cerebellum is linked neurologically to the vestibular nucleus. Also known as the “little brain”, one of the cerebellum’s functions is to provides a major source of input to the vestibular nucleus, or the vestibular centers.

A third source of stimuli to theses vestibular center is the Temporomandibular Joint (TMJ): It was been shown that the TMJ sends information to the vestibular nucleus as well.

So if you have ever had jaw problems, as well as neck pain (which are also closely related as well) in the past or currently, then you’ve have probably experienced vertigo as well. Thus, proper evaluation of the TMJ, determining how well the jaw is opening and closing, also called “tracking”, understanding if this is a sensitive area, grinding the teeth in the evening are all sure signs that you may have TMJ issues.

More importantly though, rehabbing the TMJ by restoring and rehabbing faulty motion patterns, as well as easing muscle tension, being aware of grinding your teeth, and maybe even wearing a mouth guard, can all really help the vertigo problem as well.

A final source of stimulation to the vestibular nucleus in the brainstem is the cervical neck bones at the level of C1, C2, and C3.

It’s true, and in a study performed over 33 years ago in 1977 found that by injecting a saline irritant into the deep tissues of the upper cervical spine will create the sensation of vertigo?

When this occurs, when the tissue of the upper neck, including the neck bones, discs, and joints send faulty signals to the vestibular centers in the brain, vertigo obviously develops.

This cause of vertigo is classically termed CERVICAL VERTIGO.

Cervical vertigo, or vertigo caused from neck problems can easily be addressed by focusing on restoring proper neck function, neck posture, and neck ranges of motion.

In part 2 of Neck Pain and Dizziness I will discuss how Cervical Vertigo creates dizziness, and better yet, what you can do on your own to address your own cervical vertigo. What you can do on your own to restore proper neck function, posture and ranges of motion.

Learn that, and get rid of your dizziness, and neck pain. Perfect.

Till next time, watching your back and neck.

Doctor Joel Rosen

• Weight gain:

Women usually gain between 25 to 35 pounds during the course of their pregnancy. Also the added weight of the growing fetus can put extra pressure on the nerves of the pelvis and back.

• Changes in posture:

As the baby grows larger, your natural center of gravity changes. Often times, completely subconsiously, you may change your movement patterns resulting in back pain or strain.

• Hormone changes:

A hormone called Relaxin, which is produced during pregnancy, can cause the ligaments of the spine to loosen and cause instability and pain. Relaxin is essential to the birth process because of it’s effects on ligaments, unfortunately it can also be a cause of low back pain.

• Loss of Abdominal Strength:

As the uterus grows larger, a muscle known as the Rectus Abdominis may seperate at the seam, weakening the abdominal muscles which may worsen back pain.

• Stress:

Stressful times during your pregnancy can make your back ache, the bodies reaction to stress is to release adrenalyn and other chemicals, which can make back pain worse.

Safe Natural Pain Management

During pregnancy natural pain management is a must, chiropractic care and massage therapy are 2 essential treatments that shouldn’t be overlooked. Chiropractic Care helps to alleviate the pain caused by the conditions described above. Chiropractic works by helping to keep the spine in alignment, which keeps pressure off the nerves. It’s 100% safe when practiced by a qualified Chiropractic Physician and is a gentle and safe treatment. Because of all the controversy with pain medications and the fact that pregnant women are extremely limited to what they are allowed to ingest, Chiropractic Care is the best remedy for low back pain.

Massage Therapy is also a great choice for pain management, it’s a safe gentle technique, with no side effects. Massage helps with muscle and skeletal pain, and is also extremely relaxing, which makes it great for stress management. When applied in conjuction with Chiropractic Care the results can be terrific.

These two treatments, Chiropractic care and Massage Therapy can be utilized to effectively treat most causes of back pain in pregnant women and should not be ignored. Pregnancy can be a difficult time in womans life, and it may be comforting to know that there are treatments to make it a more comfortable experience. Even just visiting a Chiropractor once a week can be enough to stay feeling well.

If you live in the Boca Raton area than your in luck, because we’re just a phone call away. Our office is situated just off of Marina Blvd and 441 in the Sandelfoot Plaza. We accept walkins, same day appointments, or just give us a call at 561-255-0535 to schedule an appointment. You can also request an appointment using our online scheduler We have over 8 years of experience helping pregnant women alleviate back pain and look forward to helping you through this wonderful but stressful time

Our goal is simple, to get the patient out of pain and back to life in the shortest amount of time possible. To do this we use every tool available to us, Chiropractic Care, Massage Therapy, and even Acupuncture. Because every one is different some people will feel better after just one or two visits whereas others may need to come a little bit longer. But once the patient is feeling better they come in as often or as little as needed.

We take pride in being a very friendly and competent office. Our patients become part of our extended family and everyone gets the same exceptional care in a personalized way. We treat you the way we want to be treated when we go to our Doctors.

We do offer free consultations for anyone who has never been to a Chiropractor or wants to know more about our Drx 9000 machine. This is just an informal meeting where we can chat one on one. Please read the disclosure at the bottom about the free consultation. (it’s just a legality)

So, if you live in the area and are having some painful issues you want to resolve, you can give us a call 561-883-0090. We can get you into the office the same day, the last thing you want to do when your in pain is wait to be seen by your Doctor.

Stay posted for more information.