Archive for May 2014

Get on the Fast Track to Relief! Chiropractic Care Can Provide Back Pain Relief More Quickly Than Many People Realize

May 21, 2014

Chronic back pain is one of the most prevalent health care problems in the world. In America, over a third of the population – more people than are affected by cancer, heart disease, and diabetes combined – suffer from it. Worldwide, it is the single leading cause of disability. Americans spend over $50 billion each year to treat their back pain. As a nation, we also bear other costs in the form of lost productivity and lost wages, not to mention a reduced quality of life.

So if you’re one of the 600 million people around the world with back pain, what should you do about it? If you visit most medical doctors, they are likely to recommend rest and prescribe some type of medication to manage the pain. The trouble with these treatments is that they do little to address the underlying problem. Worse still, some drugs are highly addictive and have negative side effects. For more severe cases, surgery is typically the only other options offered.

Man With Back Pain

There is another alternative—chiropractic care. Over the years, many studies have demonstrated chiropractic’s ability to successfully relieve back pain. For example, a study published in the Journal of Pain in February 2014 compared chiropractic spinal manipulation therapy (SMT) to no treatment, and (unsurprisingly) found chiropractic superior. What was more interesting about this study, however, is that it also compared chiropractic SMT to “fake” or placebo SMT, presented to the patients either without any accompanying description, or with a talk that specifically told the patients that it could significantly reduce their back pain. This second group “expected” relief as much as the real SMT group did, so researchers could test whether any relief they experienced was due only to the placebo effect. The group of patients receiving real chiropractic SMT reported significantly more reduction of pain than any of the other groups involved in the study, including the two placebo groups. So the effect of SMT is very real, not imagined.

Woman With Back Pain

Even more fascinating are the results of a study published in the November 2013 issue of Spine. In this study, 183 adults with chronic spinal pain were divided into two groups. One of the groups received placebo adjustments meant to simulate chiropractic care. The other group received real chiropractic adjustments—but only two sessions.
Patients were assessed for the intensity of their pain on a scale of 0 to 10, and their physical range of motion was assessed using a standard Functional Rating Index. At the end of the two-week study, the patients who had received only two chiropractic treatments reported significantly more reduced pain than the placebo group, more improvements in physical function, more global improvement (48% vs. 24%), and more satisfaction with their treatment (78% vs. 56%). The primary finding of the researchers was that chiropractic was far superior to the placebo care, but they also noted how quickly these results occurred—after only two treatments!

So if you are looking for relief for your back pain—and fast relief—these studies seem to indicate that chiropractic care is the way to go. The comparison of patient satisfaction is particularly interesting, since it supports the conclusions of many other studies and surveys conducted by experts inside and outside the healthcare community. These findings echoed the results of a recent survey conducted by Consumer Reports. The survey asked 45,601 participating subscribers with back pain to rate their satisfaction with various treatment options, including both alternative therapies and conventional therapies offered by medical doctors. The results were conclusive. In the treatment of back pain, “Chiropractic outperformed all other back-pain treatments.” Chiropractic care was also rated by the Consumer Reports subscribers as helping a lot with their neck pain, osteoarthritis, and several of the other 12 conditions the pollsters and editors examined. In fact, it was often rated more highly than relief obtained from prescription medications.

The vast majority of chiropractic patients suffering from back pain are very satisfied with the care they receive from their chiropractors and with the results of their treatment. So don’t just “live with” your back pain—do something to eliminate it. Call your chiropractor today, and see for yourself the difference that safe, effective chiropractic care can make!

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

What is “Cervical Myelopathy”?

May 19, 2014

Cervical myelopathy, or more accurately called “cervical spondylotic myelopathy” (CSM), is the most common spinal cord disorder in those over age 55. The natural degenerative processes that happen as we age, in combination with normal wear and tear, can cause a narrowing of the space through which the spinal cord passes, compressing the nerves. This can cause pain and disability.

cervical myelopathy1

Cervical disc degeneration, common in those over age 40, creates a narrowing of the space between the vertebrae when the disc either shrinks or bulges. Unfortunately, this degeneration also has a tendency to accelerate if not properly addressed. This is because more pressure is put on the spinal joints as the disc degenerates, which in turn tends to cause further degeneration. Inflammatory diseases such as rheumatoid arthritis also can cause degeneration in the joints of the neck, causing pain and stiffness. Injury or trauma to the cervical spine—typically related to auto accidents or rough contact sports—can also cause CSM. In rare cases, tumors and congenital abnormalities of the spine may trigger or contribute to this condition.

Symptoms of cervical myelopathy include pain and stiffness in the neck, tingling or numbness (particularly in the arms and legs), weakness (such as having trouble lifting things or frequently dropping objects), difficulty walking, and problems with coordination. For example, patients suffering from CSM may have trouble buttoning their clothing or feeding themselves.

cervical myelopathy2

A diagnosis of CSM can be confirmed by x-ray, MRI and/or use of a special kind of CT scan, called a myelogram, which can show the spinal canal in greater detail, including any bone spurs, and the size of the opening through which the spinal cord passes.

If CSM is not treated, it will cause a steady degeneration about 40% of the time. Approximately 20% of cases resolve spontaneously, and the remaining 40% stabilize. There is currently no way to determine which outcome will result.

Conservative treatment of CSM includes the following:
• Anti-inflammatory drugs such as ibuprofen to reduce swelling and pain
• Soft collars to support the neck and reduce movement so that the soft tissues supporting the neck are allowed to rest (though this should only be used in the short term, as long-term use can cause a weakening of the neck muscles)
• Exercise to strengthen the muscles supporting the neck
• Steroid injections to decrease pain and swelling (although these only result in temporary relief)
More severe cases of spinal myelopathy can require surgical treatment, which may include laminectomy (removing part of the vertebra), discectomy (removing part of the intervertebral disc) or spinal fusion. If you have CSM, your chiropractor can help you understand your condition, the range of options available and the course of treatment that may be best for you.

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

A Note to Parents About Physical Rehabilitation and Young Athletes

May 16, 2014

The Wall Street Journal recently published an article noting that “More than 3.5 million children a year receive treatment for a sports injury.” Given this statistic, it’s important for parents to understand that young athletes require a different approach to rehabilitation than adults do.

Why is this? Primarily because children are still growing and their bones, cartilage and connective tissues are not fully developed. Youngsters whose bones, muscles, tendons and ligaments are still changing can be more prone to suffer musculoskeletal injuries from overuse or acute trauma. When it comes to treating sports injuries in young athletes, physical therapy needs to take these facts into account.


Injuries from overuse continue to rise. Baseball and softball injuries to the shoulder and elbow have jumped by 500% since the year 2000. Very young baseball and softball pitchers (ages 9–14) have greater risk of overuse damage because their elbow joint is not fully developed. Ignoring pitch count limits and incorrect biomechanics can increase the risk.

Middle School vs. High School Athletes
As you example above suggests, children in different age groups have differing risks. This applies to all physical activities. This is why middle school children should restrict their repetitive activities to prevent any overuse injuries. Their age alone puts these younger children at greater risk from such harm.

The Short Story on Rehabilitation
The objective of all therapy is to return the young athlete to health as soon as possible and to determine when it will be safe to resume athletic activities. Because of the differences between middle school and high school children, rehabilitation for younger athletes should de-emphasize certain repetitive aspects of physical therapy to prevent additional injuries from overuse. In addition, the focus for these children should not be on returning the young athlete to their sport, but on thorough healing.

Whatever the sport, the role of a well-trained physical therapist or sports chiropractor can go beyond simply helping with recovery. He or she can also help prevent future injuries and improve a young athlete’s performance. The rehabilitation process itself can teach the young athlete some very important lessons about how to care for his or her body and develop training habits that will improve performance and reduce risk. A well-rounded therapeutic approach will expose a patient to concepts in several areas, including the following:
• Good nutrition and hydration
• Good sleep habits
• Strength
• Endurance
• Balance
• Flexibility and range of motion
• Speed
• Coordination
• Correct biomechanics

Of course, an ounce of prevention is always worth a pound of cure. It’s a good idea for parents, coaches and healthcare professionals to expose young athletes to these concepts BEFORE they’re injured. That said, no amount of teaching and preparation can guarantee that a child won’t suffer some type of sports-related injury. If and when this happens, it’s important to work closely with your physical therapist or sports chiropractor so that your child gets the maximum benefit from his or her time in rehab

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

What is a “Bone Bruise”?

May 14, 2014

Although the term “bone bruise” seems to indicate a relatively mild injury, in actuality it is no less severe than a broken bone. Also referred to as a bone contusion or bone swelling, bone bruises result from an acute trauma or a repetitive stress injury, and should be treated professionally.

A bone bruise occurs when the inner structure of your bones becomes fractured. Bone is made up of two different types of tissue: compact “cortical” bone on the outside and “cancellous” or “spongy” bone on the inside. Cortical bone is strong and solid, whereas spongy bone, as its name suggests, is a more delicate meshwork of bone tissue that can more easily suffer many small fractures, resulting in a bone bruise.

bone bruise1

An acute trauma or stress to a bone may not be sufficient to fracture the outer bone, but there may be enough force to cause the spongy inner bone to fracture, leading to bleeding in the injured area. Sports injuries may be one of the most common causes of bone bruises, when an athlete falls or bumps into another person with considerable force. Auto accidents, falls and twists, particularly to the knees and ankles, also frequently result in a bone bruise. Other areas likely to sustain a bone bruise are the wrist, foot and hip.

Symptoms of a bone bruise (which include pain, stiffness and swelling) can sometimes be mistaken for tendon or ligament damage, or even a muscle bruise. Intense pain that lasts more than a couple of days (and often for weeks or months) may be a sign of a bone bruise. Stiffness may occur if the bone bruise is located near a joint or is in part of the joint. However, swelling is the leading symptom of a bone bruise, and there will usually be no sign of bruising on the skin, as the bleeding occurs within the bone itself. If you think you may have a bone bruise, an MRI can determine whether it’s that or something else. X-rays and CT scans can only indicate a fracture of the outer bone.

bone bruise2

A bone bruise usually takes several months to heal because the inner spongy bone takes longer to repair than the outer layer. Treatments typically involve rest to take any pressure off the bone, elevating the affected area to help reduce swelling, taking an anti-inflammatory pain reliever and using ice packs to relieve pain soon after the injury. A brace can be worn to provide support to the injured area and reduce healing time. Experts also recommend that people quit smoking if they want the bone to heal more quickly, since smoking constricts blood vessels, reducing the circulation necessary to bring healing.

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

Chiropractic Care Offers Relief for Patients with Neck Arthritis

May 13, 2014

According to the Centers for Disease Control and Prevention (CDC), arthritis affects an estimated 50 million Americans. The most common form of arthritis is osteoarthritis, in which the cartilage surrounding joints becomes brittle and wears away, causing the tendons and ligaments supporting them to become stretched and painful. Eventually, the bones may even rub directly against each other, triggering even more pain. The result is that the arthritis sufferer loses mobility in the affected joints, and may develop chronic pain whenever they use them.

The joints most commonly affected by osteoarthritis are the knees and two areas of the spine – the lower back (lumbar spine) and the neck (cervical spine). Medical treatments for cervical or neck arthritis—the form of osteoarthritis we are focusing on in this article—are primarily pharmacological, using NSAIDs (non-steroidal anti-inflammatory drugs such as diclofenac, ibuprofen, and naproxen) to reduce swelling and treat minor pain, codeine to treat more serious pain, and muscle relaxants. More serious cases are sometimes treated with amitriptyline, which reduces nerve pain in some cases, but which also has undesirable and uncomfortable side effects.

Neck arthritis has been treated by chiropractors for many years with a great deal of success. While much of the clinical evidence has been anecdotal, a new study published in the February 2014 issue of the Journal of Manipulative and Physiological Therapeutics validates the use of spinal adjustments to manage the pain of neck arthritis and improve function.

X Ray Neck-arthritis

The study is a retrospective case review of older patients who were diagnosed with cervical arthritis and treated in a multidisciplinary clinic that provided both chiropractic and orthopedic services. All patients were thus treated by a chiropractor with a combination of upper cervical manipulation and mechanical mobilization device therapy. Their progress was measured by physical examination and X-rays, and their pain levels were determined by self-assessment, using a numeric pain scale (NPS).

The patients’ perceptions of their pain levels before spinal manipulation averaged 8.6 on the NPS, with a range of 7 to 10. After manipulation, the average NPS rating was 2.6, with a range of 0 to 7. However, the patients’ improvement wasn’t limited to their subjective assessment of pain relief (though this is important, of course). They also experienced substantial improvement in mobility. The patients’ ability to freely rotate their C1-C2 vertebrae increased from an average of 28 degrees at the start of the study to an average of 52 degrees. Clinical improvements in pain were seen in 80% of patients, and clinical improvements in range of motion were seen in 90% of patients.

The researchers therefore concluded that chiropractic treatment of neck arthritis was definitely effective, and provided both physical and psychological benefits to the patients in the study. These findings confirm that chiropractic care can provide safe, effective, drug-free relief to older adults suffering from neck arthritis. The findings supplement earlier research that has found that chiropractic manipulation can reduce arthritis symptoms in the knees, hips, and hands.

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

What Is “Crepitus”?

May 6, 2014

If your first thought when you saw the title of this article was, “Well, that word sounds a lot like “decrepit,” you’re actually (sort of) on the right track. Crepitus is a medical term that is used to describe the popping, cracking, grating, or “creaky” sounds that sometimes occur when you move joints such as your knees, elbows, wrists, or ankles.

The sounds are most often caused by the presence of air in the closed subcutaneous tissues surrounding the joints. They can also be caused by the rubbing together of two rough surfaces, as in the case of osteoarthritis or rheumatoid arthritis, in which the cartilage surrounding the joints has eroded, causing surfaces to grind against each other. But in most cases, the popping or snapping sounds are the result of these buildups of air being released quickly due to movement of the joint. (As an aside, the term “crepitus” associated with this sudden release of gas is related to the Latin term “decreptitus”’ meaning aged and infirm, but it probably wasn’t inspired by the myth of the alleged Roman god of flatulence named Crepitus.)

As a medical condition, crepitus is not usually considered a problem. It often appears in the mornings or after a period of inactivity, and goes away when your body “warms up.” However, if the popping and creaking sounds of crepitus last for long periods of time, or are accompanied by pain, signs of inflammation around the affected joint (swelling, redness, and increased temperature), or actual limitation of physical movement due to pain or stiffness, it is worth consulting your physician or chiropractor. In these cases, the popping and cracking sounds may actually be related to damage to the cartilage of the knees or other joints, or may be an early indication of damage to the articulating surfaces of the joints.


Crepitus and its associated pain and stiffness may be treated in many ways, including the application of ice packs, wearing elastic supports to allow sensitive subcutaneous tissue to heal, and exercises to strengthen the surrounding muscles. Swelling, stiffness, and pain surrounding the affected joint can usually be treated with over-the-counter analgesics such as aspirin or ibuprofen. Depending on the situation, your chiropractor may also recommend lifestyle changes such as losing weight, exercising more (or differently) and avoiding stress, or suggest nutritional supplements that can help you preserve or rebuild cartilage. If the condition is related to misalignment, chiropractic care of the spine or joints can help to reduce crepitus, as can the application of deep tissue massage or cross friction massage.

In any case, don’t worry too much about the occasional snap, crackle, and pop in your knees and other joints. Such sounds may, in fact, be associated with aging, but their presence doesn’t necessarily mean that you’re getting old and “decrepit.” It’s usually only if the crepitus is accompanied by pain and a noticeable restriction in your ability to move and flex the joints normally that you need to seek medical attention.

Contact Dr. Nicholas Carlisle – Atlanta Chiropractor at (404) 316-1190 (Buckhead) or (404) 781-2800 (Southwest Atlanta) for your appointment.

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