Archive for September 2014

What Is a “Charley Horse”?

September 24, 2014

“Charley horse” is a North American slang term for a painful muscle spasm. These muscle spasms are very common and may occur while exercising or when falling asleep. A charley horse occurs when the muscles of the calf or foot (and less often, the thigh, arms, hands, abdomen and rib cage) suddenly tighten up and “seize” or become hard to the touch. The condition can be very painful and may last anywhere from several seconds to over a day.

These muscle spasms may be caused by many things, including:
• Exercising without stretching first or while dehydrated.
• Hormonal imbalances, such as those that occur during pregnancy.
• Dietary deficiencies of potassium, calcium, or magnesium.
• Poor blood circulation in the legs or other extremities.
• Nerve malfunction caused by spinal injuries or pinched nerves.
• Reactions to medications such as diuretics and others used to treat conditions such as Alzheimer’s disease, high blood pressure, osteoporosis, and Parkinson’s disease.


Almost everyone experiences charley horses from time to time, and in most cases they can be treated at home without professional medical attention. Massaging the affected muscle area often relieves the tightness and allows the spasm to subside. Applying heat (in the early stages of the spasm) or ice (after the pain has begun to subside) can be useful, as can taking a warm bath with Epsom salts.
Stretching exercises can also help. For example, for a charley horse in the calf or back of the thigh, you can lunge forward, putting your weight on the affected leg and bending your knee slightly. For cramps or spasms in the front of the leg, use a chair to aid your balance and pull your foot up behind you, toward your buttock. You can also elevate the affected area to increase blood circulation.


If you experience charley horses frequently, consider some of the following strategies to prevent their reoccurrence:
• Consult your chiropractor to make sure that there are no physical causes for the recurring spasms, such as a pinched nerve. Chiropractic adjustments often relieve this cause of charley horses.
• Always drink lots of water before exercising to keep your muscles hydrated and lower the levels of sodium in your blood.
• Increase your consumption of foods high in potassium (avocadoes, oranges, and bananas), magnesium (halibut, mackerel, and almonds), and calcium (spinach, kale, and dairy products), or consider taking vitamin supplements.
• Avoid diuretics such as caffeine or drugs that cause you to urinate more often, thus depleting the levels of water and electrolytes in your body.

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

How Do Chiropractors Measure Range of Motion?

September 16, 2014

Limited range of motion is usually caused by an injury in a specific joint or by a chronic condition such as osteoarthritis, and is often accompanied by stiffness, pain, and swelling. At some point, limited range of motion can interfere with a patient’s ability to perform day-to-day activities. When this happens, range of motion testing becomes a very important diagnostic and treatment tool for chiropractic physicians.

From a clinical point of view, chiropractors must measure a patient’s range of motion to set a baseline, design an appropriate treatment plan and monitor progress over time. Range of motion testing is also commonly used during a broad-based physical therapy evaluation, along with tests to evaluate a patient’s balance, coordination, flexibility, strength and stamina. Range of motion testing also has other administrative uses, including for insurance reimbursement purposes (that is, proof that the patient requires treatment because it is “medically necessary”) and as a way to document improvement.

Range of motion—the movement of a joint from full flexion (flexed) to full extension, usually measured in degrees—is a very important concept in diagnosing and treating musculoskeletal problems that affect joint function, and chiropractors can measure it in several different ways depending on the part of the body in question. Each joint has a different range of motion, and the parameters of a “normal” range of motion are arrived at by observation and general consensus within the chiropractic community.

Chiropractors often use a device such as a goniometer or an inclinometer to measure an axis and range of motion of a patient’s joints. They will also look for signs of discomfort, resistance and compensation as the patients’ joints are moved. Range of motion testing is painless for the most part—sometimes, post-operation and post-injury range of motion testing may be painful, but the pain lasts only as long as the testing does.

The tests themselves are actually very simple movements, many of which resemble basic stretches or exercises. They may measure so-called “passive” range of motion, “active assistance” range of motion, or “active” range of motion, depending on the patient’s needs. The passive range of motion exercises involve no effort at all from the patient—the movement is controlled by either a therapist or some type of equipment. Active assistance range of motion exercises require some outside help, but the patient is also responsible for moving the muscles around the affected joint. Active range of motion exercise is performed by the patient alone, moving the joint without any outside assistance.

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The specific process a chiropractor uses to test a joint’s range of motion may vary a bit from physician to physician, but there are a few general principles that most will follow:
• The chiropractor will test the unaffected or uninjured side first for a frame of reference.
• The chiropractor will warn the patient before testing the injured or affected joint, mentioning that there may be some discomfort or pain.
• The chiropractor will use active tests before passive tests, giving instructions and explanations along the way.
• The chiropractor will thoroughly assess painful movements last in order to minimize discomfort and will never stress the joint beyond the point of pain.
Range of motion testing allows your chiropractor to gauge your flexibility and make ongoing treatment decisions. Whether you’re receiving spinal adjustments, extremity adjustments, massage therapy or some other form of in-office manual therapy, or you’ve been prescribed at-home exercise or stretching programs, your chiropractor will work closely with you to relieve your pain and to improve your joint function. But range of motion testing also gives you—the patient—an easy way to see the difference your treatment is making.

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

Chiropractic Care for Herniated Disks in the Lower Back: The Latest Research

September 2, 2014

One of the most common causes of lower back pain occurs when the spinal disks in the lumbar area become herniated. A herniated disk happens when the bone of the disk itself has crumbled or fractured and the soft inner core bulges out through the outer portion of the disk. This places pressure on the spinal nerve root that runs through the disks, and the result can be pain in the lower back as well as numbness, tingling, or weakness in the legs and buttocks. Medical doctors tend to treat acutely herniated disks with oral steroids and epidural injections of cortisone, both of which have limited success rates and adverse side effects.

Recently, however, a major study published in the Journal of Manipulative and Physiologic Therapeutics has found that both chronic and acute herniated disks can be effectively treated by chiropractic adjustments. This year-long study followed 148 patients whose lumbar disk herniation had been confirmed by MRI scans. All patients suffered from back pain, sciatica, and radiating leg symptoms, and 79 of them had experienced these symptoms without noticeable relief for over three months.


The patients in the study were treated with chiropractic adjustments appropriate for their individual cases, characterized by the researchers as “high-velocity, low-amplitude spinal manipulation.” Throughout the study, the patients were examined by doctors at two weeks, one month, three months, six months, and one year. They were also asked to self-assess the success of the treatments at those points, rating their condition on a scale of “much worse, worse, slightly worse, no change, slightly better, better, and much better.”

The results were surprising, especially because the typical clinical expectation is that only 36% of lumbar herniated disk patients will show improvement after two weeks of treatment. However, among the patients who received chiropractic adjustments in this study, 69% reported significant improvement in both mobility and pain reduction after only two weeks. At one month, that number increased, with 79.6% reporting conditions of better or much better. At three months, 90.5% had reported significant improvements. Interestingly, the chiropractic care in the study ended at the three-month mark, but assessments at the six-month and 12-month points found that 88% reported that their condition was still improved.

The authors of the study reported no adverse side-effects and concluded that a large percentage of patients with acute and chronic lumbar disk herniation could be improved by chiropractic care. This likely comes as no surprise to the many chiropractors who have been treating herniated disks and the resulting lower back pain for years—or to their patients who have benefited from that care—but it is heartening to see scientific research catching up to what we’ve known all along: A drug- and surgery-free approach that treats the whole patient and helps their bodies to heal themselves is superior to masking the symptoms with painkillers or relying on dangerous steroids or epidural injections.

So if you have been diagnosed as suffering from one or more herniated disks, see your chiropractor. You have only your chronic pain to lose, and so much to gain.

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

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