Ask The Chiropractor

ask the chiropractor bookBelow you can find a list of articles that were written by Dr. Pollack to answer some of his most common questions. The full book can be purchased at Amazon.com


What exactly is sciatica, and what is the best treatment for it?

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Sciatica is the inflammation of the sciatic nerve, the largest and longest nerve in the body. Burning, sharp, piercing pain is the most common symptom felt in the low back extending to any part of the leg calf or foot. The sciatic nerve branches out and controls the organs in the pelvis including the reproductive system, bladder, kidneys and prostate. Abnormal symptoms caused by irritation from this large nerve may originally be in one of these organs or tissues, arise in the low back, legs or even the toes. You don't have to have pain running down your leg to have sciatica. Once irritated, coughing, sneezing sitting, standing or any basic movement can re-initiate symptoms.

Sciatica can frequently be caused by the misalignment of the joints of the spinal bones in the low back or pelvis, called vertebral subluxations. These misaligned spinal bones create pressure, choking on the nerves. This obviously interferes with the sciatic nerve's function. If the joint misalignment is left uncorrected, degeneration can begin to occur.

In the past, long periods of bed rest were commonly prescribed for sciatic pain and malfunction. Recent studies have confirmed that lengthy bed rest is a waste of time and may interfere with healing.

Another common prescription, epidural injections, does not help patients suffering from sciatica, either. Researchers in Germany did a six- month study published this year in Clinical Orthopaedics and Related Research. These researchers found that spinal cortico steroid injections do not help patients with sciatica improve any faster than those not given such injections.

What does seem to be the correct prescription is conservative chiropractic adjustments to realign the misaligned vertebrae. According to the recently released united states agency for Health Care Policy and Research (AHCPR) guidelines, "relief or discomfort can be accomplished most safely" with chiropractic adjustments.

Sciatica is a horrible experience and it doesn't just go away, even if the symptoms are dormant. Chiropractic care (sometimes coupled with simple exercises) normalizes the joint mobility, corrects the vertebral subluxation and takes pressure off the sciatic nerve. Correction of your sciatica could be as close as a call to your nearest Chiropractor.

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The many "myths" about low-back pain

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Question: Is it true that once you get low-back problems you always have them? Is it also true that when you have a low-back history when you are younger, you can't walk very long periods when you get old?

Answer: The questions you are asking are commonly asked and part of a barrage of "myths" surrounding the generalized condition of low-back pain. When any type of physician is studying for his/her particular specialty there is a small percentage of students that develop a condition called "medical student syndrome," which is developing the condition you are studying. An example of this would be studying diabetes and then feeling numbness in your extremities even though there is no cause for the condition other than that the mind was convinced it had the condition. I bring this to light because I believe there is a similar condition with patients when they read or hear information, gossip, or stories about other patients with similar conditions and then believe or create the same condition for themselves.

Low-back pain is so unique to each individual that I suggest that no two people have the same condition. The definition of sciatica from Dorland's Medical Dictionary states, "A syndrome characterized by pain radiating from the back into the buttock and into the lower extremity or pain anywhere along the course of the sciatic nerve."

This common diagnosis is so vague that it can be misconstrued to mean almost any possible condition in the lower back or lower extremities. When patients claim they have the same low-back pain as their friend or neighbor, or low-back pain is in their family, I am very skeptical to agree. The "myth" that once you have low back, you will have it forever, is a premature illusion. You can definitely choose to have it forever or you can choose to correct it. Yes, there are a small percentage of patients that have unresolving low-back pain for years or their entire life, even after doing everything possible to relieve it. Most of our chiropractic patients get low-back pain relief and more importantly low-back pain resolution and correction. Low-back pain that occurs in your youth has a greater chance of being corrected than long-established patterned low-back pain conditions. The earlier the cause of your pain is detected and corrected, the less likely you will have problems in the future or have difficulty with mobility.

My advice is to not wait for low-back pain and have your spine checked by a Chiropractor as part of your regular preventative maintenance. The integrity of your nervous system is essential to the vitality of your life. I am sure you get your teeth checked regularly, so it makes sense to get your spine checked regularly.

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How to use proper mechanics in golf swing to prevent low-back pain?

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Question: Could my golf swing be the cause of my low-back pain? When I am not playing golf my low back is mildly achy, but after 18 holes I am hurting for weeks.

Answer: There aren't any golfers that are immune to low-back pain at some time. Every professional golfer, including Tiger Woods, has had a period of low- back problems. The PGA provides Chiropractors and/or massage therapists at almost all events and many professionals have their own Chiropractors attend the events.

The reason there is such a high abundance of low-back symptoms with golfers is because the basic swing requires the combination of bending, lifting and twisting at the same time. Our low backs are not designed for this type of repetitive movement. The lateral joints attached to the vertebra, called facets, are supposed to only move in one direction at a time. The lumbar muscles that attach and support the facets help assist or compensate for the additional motions placed upon them. A perfectly performed swing can minimize the stress on the facets, discs and muscles of the low back. I have been golfing for 25 years as a part-time or weekend warrior, which accounts for about 90-percent of the golfers out there, and the majority of golfers I have observed have atrocious swings, including myself. When our body mechanics are distorted or imbalanced we overtax the low-back joints and muscles surrounding them. Add a bad shot that pounds the earth or a follow through into a branch or rock that jolts the spine and you will suffer for it.

The solution to preventing low-back pain as a golfer is preparation. A series of full-body stretching and pre-swinging is essential. The upper body as well as the low back and legs should be warmed up. Special attention should be given to the hamstrings muscles, which when irritated, can lead to sciatica and other problems. Have a professional instructor observe your golf swing to determine if there are adjustments you can make to reduce stress on your spine and any other body structures. Have yourself video taped in slow motion as you move through all phases of your golf swing. Self-observation is a very powerful tool. Should your back pain or symptoms persist, absolutely see your Chiropractor immediately. The best policy to prevent low-back pain while golfing is to visit your Chiropractor before injuries occur to maintain the healthiest posture possible.

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Can chronic whiplash pain can result in psychological distress?

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Question: I have had consistent neck and head pain for almost 6 months since my whiplash injury from an auto accident. I now feel depressed and anxious. Could my psychological distress be related to my pain?

Answer: Chronic pain or consistent pain over an extended period of a few weeks to even months or years can create psychological stress. Constant pain, whether mild or severe, interferes with our quality of life. Happy positive people with great dispositions are no match for chronic pain. The pain wears us down physically and emotionally.

Whiplash symptoms are especially irritating to our psyche because of their close proximity to the brain. The higher up in the body our pain and the closer the injured tissue is to the brain the greater the degree of pain and interference. Our neurons (nerve cells) are highly concentrated near the brain, upper spine, face and jaw. As we move distal (away from the skull) the concentration of nerve cells dissipates. A whiplash injury is very serious concern even in a mild fender bender. Considering the origin of the nerve supply originates in the brain and spine, any trauma to these regions can directly or indirectly affect the rest of the body. Typically the posterior and/or anterior neck muscles and ligaments are sprained or strained in a whiplash accident. The jaw muscles are usually triggered in most of these conditions because when the neck muscles are weak or irritated the jaw muscles compensate by contracting to maintain the head upright. Undue weight bearing on the jaw muscles can lead to headaches and facial pain. This syndrome of pain associated with whiplash results in a very distressing scenario for the whiplash sufferer. Distal pain in the extremities is obviously not fun either but pain in the face neck and head are riveting due to the high concentration of nerves and the residual affects on all our senses we depend on a moment-to-moment day-to-day basis.

Chiropractors are specially trained in dealing with whiplash syndromes and their associated pain and psychological effects. There are natural solutions in most cases so seek the advice of a Chiropractor.

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Can Smoking Cigarettes increase low-back pain?

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Question: Can smoking cigarettes increase low-back pain?

Answer: For many years research could not identify all the adverse effects cigarette smoking has on our health. Research out of the journal Medical Hypotheses,

2001, evaluated the relationship between low-back pain and cigarette smoking. The results of the study indicate cigarette smokers have an increased risk of low-back pain, which may be caused by disc degeneration and spinal instability. There is evidence that disc degeneration of cigarette smokers is of more severe degree than non-smokers.

Cigarette smoking increases the release of specific proteolytic enzymes from the tiny capillaries in the lungs, which inhibits the protective proteins (protease). The high level of proteolytic (enzyme) activity of cigarette smokers speeds up the degenerative process. The study also implies that this activity also weakens the spinal ligaments resulting in spinal instability.

Cigarette smoking is absolutely dangerous to your health and can cause low-back pain..

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A good workout is not as good as an adjustment

Question: Is a good workout as good as an adjustment?

Answer: A program of good physical exercise can have a positive influence on your health. But it is not a substitute for chiropractic care. A healthy diet rich in vegetables fruits and fresh water can have a positive influence on your health but they are no substitute for chiropractic care. A healthy mental attitude with meditation and peace has a positive influence on our health but they are no matches for the importance of a chiropractic adjustment.

Some people incorrectly believe that they can solve their spinal problems with good workouts. If that were true, bodybuilders and weight lifters would have perfect spines. However, these and other athletes have found chiropractic care to be a valuable part of their training program.

The chiropractic adjustment specifically is geared towards balancing the nervous system, which controls every cell, tissue and organ in the body. Every system in the body is dependant on the nervous system. Proper nutrition, exercise and mental attitude play essential roles in our holistic health model but without a healthy nervous system they will fail every time.

There is no substitute for regular chiropractic care. If you have never had your spine and nervous system checked by a Chiropractor it is time to do so. If you have not seen your Chiropractor in a while it is time to make the call for an appointment today.

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Healthy home environment prevents winter colds

Question: Is it possible that I am getting sick due to the heater in my house? Since I turned on the system my nose runs and I feel terrible. Can your home environment cause illness?

Answer: Your home environment absolutely can contribute to a weakened immune system leading to illness. The winter season has an extreme influence on our internal home environments. Closed windows trap airborne viruses, bacteria and mold. When improper circulation of air is present these germs can become static and multiply. Repetitive cleaning of potential sources of the germs is helpful but it may only scratch the surface of a serious exposure to the cause of the problem. Some tips for winter household health maintenance include:

1. Clean all vents, ductwork, chimneys and baseboard elements.
2. Remove dust and pollen accumulated on windows, paddle fans, ceilings, walls and floors.
3. Have your house checked for mold if there has been a history of water leaks prior in the year. If you smell a mold odor or suspect mold in your vents call a professional to analyze your heating, air and ventilation systems.
4. Air purifiers are an exceptional way to collect airborne germs and allergens on a daily basis.
5. Check to maintain proper humidity levels in your home. A dry environment may create dry mucous membranes in the sinuses and throat contributing to potential irritation or infection.
6. Be aware of the materials used to build your home and make sure toxic materials, such as asbestos, are removed.

Persistent conditions and illness should not be left untreated. Chiropractors are trained professionals in the health field that may help your immune system recover by balancing your nervous system

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What Causes Migraine Headaches and Can Chiropractic Care Help?

Migraines affect a significant amount of people, however, the triggering processes for these splitting headaches are not yet fully understood.
Developments in the function of the blood or nervous systems in particular areas of the cerebrum and changes in chemical balances inside the body have been connected to the cause of migraine headaches. In this way, it is intriguing that chiropractic treatment has been shown to be effective and, in many cases, successful for migraine sufferers.
Migraines are typically divided up into two various types although many more subdivisions exist. These two main categories are ‘common‘ and ‘classic‘ migraine.
The pain of the headache is normally one sided encompassing half of the forehead and one eye however pain can also spread from the back of the head over to the eye or in some cases be located over both eyes.
Sensations described also include, throbbing, stabbing and pulsing pains.

Common Migraine

This is the most frequent kind of migraine accounting for 80-85 % of migraines. Research indicates that a change in cerebral blood circulation could be responsible for the symptoms of this headache.

It normally involves:

  • a pulsing unilateral headache
  • more commonly in females
  • is typically found to have begun in young adulthood
  • headaches are usually severe although sufferers are able to carry on with their daily tasks
  • often, there is associated nausea and vomiting.

Classic Migraine

This type of migraine accounts for up to 15 % of attacks with the typical throbbing one-sided headache as in a common migraine, but is prefaced by what is known as ‘prodrome’ or ‘aura’. This describes symptoms experienced just before the inception of the throbbing headache such as:

  • visual symptoms such as scintillation (flashing lights).
  • the presence of scotoma (a blind spot).
    • That usually lasts approximately 30 minutes after which it is replaced by a disabling headache that can go on for a few hours up to 3 days.
  • Vomiting and nausea may occur.
  • Photophobia (sensitivity to very bright lights) is typical, and bright lights can also prompt the pain.
  • Rest in a cool quiet and dark room is quite often reported to be the only relieving factor.

Again, the root cause of these headaches are not fully understood but are thought to be associated with the changes in blood flow, the existence of certain chemicals and the way in which nerves send signals.

Contributing Factors

Many factors have been linked with the onset of a migraine attack some of the more common are here:

  • after periods of anxiety (oftentimes occurs on over the weekend or holidays)
  • Foods (routinely; chocolate, caffeine, nitrates, cheese, nuts, wine and many more )
  • A number of medications (including vasodilators)
  • Changes in sleeping habits
  • Hormonal changes (associated with menstruation)
  • Tension in the neck (particularly the upper part of the neck)

However, it is essential to know that in reality, for many people, the symptoms are a combination of more than just one variety of headache. Many specialists, including Chiropractors, now talk about a headache continuum, where the, severely disabling, classical migraine is at one end ranging to the, less disabling, light tension headache at the other end.

Treating Your Migraine

Identification of a unique trigger is essential in the management of the problem in a regular sufferer, with lifestyle or behavioral changes playing an important part in the treatment (e.g. avoidance of specific foods or maintenance of a regular sleep patterns).
Nutritional and herbal studies have indicated that the use of supplements including omega-3 fatty acids, magnesium, calcium, vitamin D among others useful in the treatment of migraine. However, it is important that you always speak with your Chiropractor or physician before beginning any supplements.
Medicines can possibly be useful in some circumstances but are primarily prophylactic. Initially nonprescription medications can be taken but if migraines are chronic your Family Doctor may recommend the use of prescribed medications.
Acupuncture treatment has additionally been shown to assist in some cases amongst other alternative methods.
Chiropractic has been shown to help diminish the severity and frequency of migraine headaches and symptoms in most cases, especially cases of common migraines, and we therefore recommend that you undergo a trial treatment.
Chiropractic care also deals with many contributing factors or after effects including relief of restriction in movement of the neck, muscle tension in the neck, shoulders and upper back and helping correct any postural issues that may influence the occurrence of both migraine and tension headaches.

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What is TMJ (Temporal Mandibular Joint Dysfunction), and Can a Chiropractor Correct The Condition?

The jaw is a hinge joint attaching the mandible (jaw) to the skull and is surrounded by 68 pairs of muscles immediately in front of the ear on both sides of the head. They allow you to chew, yawn, speak, and swallow and are in continual use. This joint is among the most frequently used in the body. You can locate it by positioning a finger in your ear and pushing forward while opening and closing your mouth. The articular disc divides the condylar head of the mandible and the skull. When this disc is misplaced it will cause Temporal Mandibular Joint Dysfunction (TMJ). Studies show about 35 % of the American population has TMJ disorders.

A common symptom might be having a restricted range of motion within the joint. If you suffer from TMJ, each time you open and close your mouth you put wear and tear on the tissues of the joint. This can cause severe problems unless treated properly, so it is definitely recommended that you look for a Chiropractor that offers TMJ treatment options.

To find out if you may be suffering from TMJ dysfunction, you can test the range of mobility in your jaw; hold your palm up and down with your thumb facing the ceiling. Flex your index finger so it is not in the way. Open your mouth as broad as you can without strain or pain and place the three remaining fingers (middle, ring, and pinky) between your upper and lower teeth. (I should have prefaced this by advising you to wash your hands first.) If you can not fit all 3 fingers and you have pain, it is possible you have TMJ. Don't be worried if only 2, or maybe four fingers fit. If there is no discomfort and it doesn't affect how or what you eat then, the diagnosis is probably negative.

Commonly, TMJ is accompanied by sounds such as clicking, grinding, or crunching when you close or open your mouth. The articular disc is fitted so that the condylar head of the mandible can move smoothly up and down. The clicking noise will occur when the condylar head is not in the proper fitted position and passes over the ridge of the disc. As the bone passes over the ridge it will induce a pop or click that can lock the jaw in either the open or closed state and typically needs a manual adjustment to dislodge it back into normal functioning order. The grinding or crunching noises occur when there is bone on bone contact inside the joint. If the articular disc is totally out of place or has worn through, the jawbone will move on its hinge, but in direct contact with the skull. This could be caused by arthritis wearing away the cartilage of the bones. If you are experiencing noises when you move your jaw consult a Chiropractor to help determine the severity.

TMJ disorders have numerous causes. Crooked or missing teeth can force the bone out of its proper position. Injury from a fall or auto accident can lead to the same thing. Whiplash is a very frequent cause of TMJ. On numerous occasions stress leads to a grinding of the teeth or clenching of the jaw. This can over tax the muscles and cause severe pain. That pain can flow throughout your face, neck, and head causing various symptoms and discomfort. Similar to a kidney infection, that may cause vomiting, diarrhea, nausea, loss of appetite, or a bladder infection; TMJ may present as various symptoms (headaches and earaches) that wouldn't usually be considered in conjunction with it. Consult with your Chiropractor for an exam of these symptoms.

You may wonder, "Why have I been referred to a Chiropractor to fix a problem with my mouth?" The response is simple; an experienced Chiropractor is trained to correct ailments, due to bone misalignments, by examining all facets of your lifestyle. The initial step is a complete medical examination consisting of your medical and family history, as well as, life style practices and daily routines. He will perform x-rays that can locate a condylar head that is incorrectly positioned. A posture assessment is performed in addition to palpation test to determine the severity of the disorder and the amount of mobility.

Dr. Pollack will develop a TMJ treatment plan that excludes surgery and medication. An intra-oral orthotic, or splint, can be fitted into the lower or upper jaw, and is designed to reposition the condylar head back in to its normal position. If your TMJ is related to stress, a number of muscle-relieving exercises or stress-relieving therapies may be diagnosed. Some of these treatments would consist of, biofeedback, meditation, counseling, or massage. Treatments including heat, ice, electrical stimulation, and ultrasound are used when needed. The emphasis is on rehabilitation and return of motion through individually adapted programs.

For information on how Dr. Pollack can treat these conditions, please click to request a Free Chiropractic Exam. Dr. Steven J. Pollack has more than 30 years experience as a Chiropractor and Applied Kinesiologist in correcting TMJ dysfunctions.
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