You might ask, what does this headline have to do with chiropractic? It’s often said case management or patient care is much more than just what we do to our patients (such as in chiropractic, applying a spinal adjustment). The patient education portion of our care plan can frequently make or break a successful outcome in a case. It is the goal of this Health Update to potentially save your life by empowering you with the knowledge needed when it’s time to purchase your next car. This is about what specific automobile features contribute to crash survival – hence, saving lives!
Did you know the car you choose can improve the odds of crash survival by 400%? In the popular magazine Consumer Reports, they wrote, “Ultimately, safety is active and passive, balancing the ability to avoid an accident and to survive one.” Typically, the first thing we do as consumers when we consider safety in a particular car is to look at the crash-test results. While this is important, we must first consider the size and weight so we compare crash-test results between cars in the same weight class since statistics show there are two times as many occupant deaths annually in small vs. large cars. Keeping size and weight in the foreground, when evaluating crash-test results, the front and rear end “crumple zone” of the car should be designed to absorb crash forces by buckling and bending in a serious collision. If you’ve ever watched race cars crash, you usually see car parts bend and break off as they bounce off the guard rail or other cars, sometimes to the point where all that is left is the cage surrounding the driver. Amazingly, the race car driver often climbs out of the cage and walks away, seemingly unharmed.
The next important car feature to consider is a car with a structurally superior passenger compartment. Look for a high quality “restraint system” made up of 3 components: seat belts, airbags, and head restraints. These work together to keep us safe and in place during a crash while the outside of the car crumples, absorbing the energy of the crash.
So where do you look to get this information? There are several resources available:
1. The NHTSA (National Highway Traffic Safety Administration) tests front end impacts at 35 mph, and in 1997 added side impact tests at 38 mph. They also test for the rollover potential for SUVs and trucks and grade the results for each category from 1 to 5 stars representing the likelihood of suffering a life-threatening injury in a crash.
2. Since 1995, the IIHS (Insurance Institute for Highway Safety) has used a method reviewed by Consumer Reports as being more realistic by crashing only half of the vehicle at similar speeds into fixed barriers, since most crashes are not direct, whole car strikes.
3. Consumer Reports is a 3rd option. They integrate the data from both NHTSA and IIHS and gives us their “CR Safety Assessment,” and run 40 new cars each year through numerous individual tests.
Other important “accident avoiding” features often overlooked include: Tires - greatly impact braking and emergency handling so REPLACE them as needed; Braking-check for the distance required to stop the car at different speeds- the shorter, the better; Emergency Handling-data about accident avoidance and choosing a vehicle with electronic stability control (ESC), especially in SUVs is wise; Acceleration-the quicker a car can get to highway speeds, the better; Driver position and visibility-a good view of the surroundings, especially the “blind spots” is important.
We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you.
About 25 years ago it was said that small amounts of vitamins A, C, and vitamin P (bioflavonoids) could cut your risk of a stroke by 75%. This is better than aspirin, blood pressure drugs, and cholesterol drugs, all rolled into one. Some interesting lab research at that time from Cornell University showed this to be true with rats. But I suggested that my own research, and that of nutrition-conscious doctors, had also proved this with human patients.
That was a long time ago, and there were only a dozen or so like-minded doctors with whom I regularly conferred. Since then our Advisory Board has grown-to include real experts from every possible medical and health field. These advisors include physicians, surgeons, specialists, chiropractors, osteopaths, dentists, therapists, psychologists, nurses, and more. And more than 20,000 doctors of every kind get Health Alert monthly, rely upon our protocols, and report on their results with protocols such as vitamins A, C, and P to prevent strokes.
So if you are at risk for having a stroke, or if you have had a stroke and wish to prevent another, take the most powerful preventive measure possible. Use whole vitamins A, C, and P complexes made from phytochemicals, phytonutrients, and nutrient-dense concentrates and extracts. These are not what you will buy in a store. They are the real thing-made from a proprietary blend of carrots, Echinacea, yeast, alfalfa, mushrooms, raw bone, extract of kidney and adrenal, and more.
Perhaps the most critical of all is the vitamin P extracted from the juice of buckwheat seed and leaves. It is dehydrated without heat to maintain the life force of the vitamin P complex. And vitamin P complex, along with vitamins A and C, are critical to maintaining blood vessel integrity, and to prevent strokes. If you are trying to prevent a first or subsequent stroke, take Cataplex ACP (3-4 daily) along with Cyruta-Plus (3-4 daily) as part of your preventive routine. Both are produced by Standard Process, and they come with along list of positive secondary effects, such as anti-flu, anti-infection, anti-colds and bronchitis, and anti- cancer. In fact, Cyruta-Plus is part of almost every cancer protocol we make up.
If you already take Congaplex from Standard Process to help with colds, flu, and bronchitis, you do not need to take Cataplex ACP. Congaplex is one-third Cataplex ACP.
So research is great, and even drugs are some times helpful. But to gain a 75% reduction in your odds of getting a stroke, right now, simply use the protocol that has been successful for over 30 years.
Recognize and Treat a Stroke Immediately
Modern medicine does offer spectacular help when you can get to the hospital and get the right care within 3 hours of suffering a stroke. This is tough because most folks do not recognize a stroke. If you or one of your loved ones is prone to stroke, learn and know the simple signs of S-T-R. They mean smile, talk, and raise both arms.
If you suspect a sudden stroke, and the patient cannot smile, talk, or raise both arms properly, get them to a hospital immediately. A fourth test is to have them stick out their tongue. If it is crooked, get them to the hospital. If treated in time with immediate drug therapy, all symptoms can be eliminated for most common strokes.
And if you do not make it in time, and you suffer from the disastrous effects of a stroke affecting one arm or leg, remember Taub stroke therapy, also called Constraint-Induced Movement Therapy (CI Therapy). This is where a nonfunctioning arm or leg can be made to work again-in 14 days. Call toll free 1-866-554-8282 or visit www.taubtherapy.com to locate the nearest center to help you recover quickly.
Have you ever noticed how many people have terrible posture?
One of the most common faulty postures is called “forward head carriage” or “anterior based occiput.” Other terms are “hump back” or slouching. There are several reasons for this common postural fault. One is the weight of the head is, on average, approximately 10-13 pounds and if it’s positioned too far forwards, the muscles in the upper back and neck tighten up much more than normal, fatigue and become painful. Also, the muscles that attach to the skull have different degrees of strength. They also attach and pull at different angles, contributing to the common forward head carriage posture. The muscle of the chest are much stronger than those in the mid and upper back and tend to pull our shoulders forward. The following pictures offer a good view of both a faulty posture as well as a “good” posture. Notice the forward shift in the line in the pictures of poor posture and backwards shift in the good posture pictures.
As you can see, the weight of the head is back over the shoulders and the shoulder posture is appropriately positioned back in the image titled “Good Head Posture.”
It is important to understand correcting Forward Head Carriage takes time – in fact, it takes a minimum of 3 month before this becomes an automatic new “habit.” Of course, it could take longer or, completely fail IF you are not VERY conscientious about CONSTANTLY reminding yourself to position your posture as shown above in the “Good Head Posture” image (above). An exercise based on this posture correction technique is performed by retracting your chin / head as far back as you can and holding that position for 5-10 seconds. Doing this multiple times a day, between the time you maintain a partial chin tuck (“Good Head Posture”) position will further facilitate the posture retraining process.
If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service. We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.
“Doc, I try to do my exercises but I have to hit the ground running in the morning….to get the kids ready for the school bus….I have morning meetings….I’m not a morning person….I’m pulled in 100 directions during the day….I forget about them until I’m in bed….I exercise on my job and that’s enough…."
I’m sure we’ve all rationalized our inability to keep up with exercises, especially after our episode of low back pain (LBP) subsides. In fact, only about 4% of LBP patients continue doing their exercises after their pain subsides. That means 96% of us with chronic, recurring low back pain DO NOT exercise even though we know we should. We feel bad, even guilty for not exercising. So, what can we do to “trick” ourselves into being more compliant with our low back exercises?
First, let’s accept the fact that most of us cannot consistently “fit in” exercise into our busy schedules. With that said, the TIMING of when to do the exercise may be more important than even doing them at the same time every day. In other words, do a few exercises when you need them the most. For example, if you’re working at a computer for more than 1 hour, and you start to feel back pain from the prolonged sitting – especially if your work station set up is less than ideal – do one or two sitting exercises right at your work station, BEFORE your back pain gets any worse. If you wait too long, the exercises may not be of much benefit. Setting a timer next to your screen that beeps every hour is a good reminder to do one or two simple exercises and only takes a minute or two. Many inexpensive digital watches can be set to beep on the hour/every hour or, you can set a “timer” to beep after 60 minutes as a “gentle” reminder. Some cell phones also have a timer feature. Here are three sit down low back exercise options (try them all and decide which one(s) feel most productive/helpful):
1. “Crossed Knee Stretch”: Cross your legs; pull the crossed knee towards your opposite shoulder (feel the pull in your buttocks); arch your low back and at the same time, twist or rotate to the side of the crossed knee. Hold for 5-10 seconds and repeat up to 3 times. Repeat this on the opposite side.
2. “Sit Twists”: Reach across with your right hand and grasp your left leg at mid-thigh. Twist/rotate your back to the left and pull with your arm. Hold 5-10 seconds / repeat 3 times. Repeat this on the opposite side.
3. “Sit Floor Touches”: Bend over as if to touch the floor or tie a shoe. Hold 5-10 seconds.
If you do the math, it would take a minute for #1 and #2, 30 seconds for #3 (total 2.5 min.). If that’s too long, hold for 5 seconds. If that’s too long, do 1 rep, not 3. You get the idea…..MAKE IT WORK! Modify the dose to fit your schedule or ability to stretch. If you do this AT THE TIME you start to feel tight or sore, you can PREVENT a LBP episode!
We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
Fibromyalgia (FM) is a chronic condition affecting multiple body systems is not limited to any one aspect of health. Because of this, there is no ONE diet that works the same for all FM patients. Since most dietary guidelines that address FM are based on general healthy eating principles utilized for many conditions such as hypoglycemia, diabetes, food allergies, headaches, digestive disorders, and fatigue, let’s review some of the most popular and successful dietary approaches that have been reported regarding FM.
Basic Guidelines:
Carbohydrates: AVOID all refined carbs (white flour products). Eat whole grain bread, oatmeal, granola, nuts. Avoid artificial sweeteners and limit sugar intake to a max. of 40g/2000 calories. Eat roughly 14 grams / 1000 calories consumed of soluble dietary fiber such as apples, oats, and legumes vs. insoluble fiber such as bran. Your total carb intake from all sources should be between 30-55% of your total calories.
Fats: AVOID saturated fats (these clog up circulation, lead to inflammation and pain). That means <10% of total calories consumed, so limit or eliminate foods such as cheese, beef, milk, oils, ice cream, cakes, cookies, mayonnaise, margarine, chips and chicken skin. Eat mono- and poly-unsaturated fats and include regular amounts of omega 3-fats. Eat < 300mg/day of cholesterol; Try to avoid ALL trans fats such as cakes, cookies, crackers, pies, bread, margarine, fried potatoes, chips, shortening. Take omega 3 fatty acids like alpha-linolenic acid (ALA) as these help make other omega 3 fats like EPA and DHA, and are very helpful for the brain. ALA is found in flaxseed, linseed oil, or cod liver oil. Limit total fat intake to 20-35% of calories consumed.
Protein: Go easy on red meat as they are high in saturated fat. Instead, eat more fish and vegetable protein (legumes and soybeans are great). When eating meat or poultry, remove all visible fat and skin before eating. Maintain protein at 20-40% of total caloric intake. AVOID: processed meats, especially salt-cured, smoked or nitrate-cured.
Fruits & Vegetables: Whole fruits are superior to juices. Include blackberries, strawberries, raspberries, kiwis, peaches, mango, cantaloupe melon and apples. Some FM sufferers cannot tolerate citrus fruits but if you can, fruits like oranges and grapefruits are great. Vegetables are crucial. Good choices include carrots, squash, sweet potato, spinach, kale, collard greens, broccoli, cabbage, and Brussels sprouts. These foods reduce the risk of developing chronic diseases (diabetes, heart disease, stroke and cancers).
Dairy Products: Choose reduced or fat-free varieties of cow or soy milk. This also applies to yogurt and cheese.
Healthy drinks: Drink 8 glasses of water a day or diluted fruit juices, or herbal teas. Drinking water helps flush out toxins. Avoid coffee, tea, and alcohol as these increase fatigue, increase muscle pain and interfere with normal sleeping patterns. Limit or eliminate alcohol.
Healthy Snacks: Chopped vegetables, unsalted nuts and/or seeds; AVOID ALL commercial snack foods (except salt-free air-popped popcorn) as these are high in trans fats & salt. Avoid chocolate and candy.
Junk Food: Regular consumption of this is BAD for FM patients due to the high levels of fat, sodium, calories and general lack of nutrition.
Artificial Sweeteners: AVOID them! Examples: aspartame, NutraSweet, & saccharine.
MSG: (monosodium glutamate (MSG) and Sodium (Salt) can aggravate FM!
QUANTITY: Eat smaller light meals, especially in the evenings.
We recognize the importance of including chiropractic in your treatment planning and realize you have a choice of providers. If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
More safe, easy and effictive fibromyalgia management solutions!
N Engl J Med 2010; 363:743-754 August 19, 2010
Previous research has suggested that tai chi offers a therapeutic benefit in patients with fibromyalgia.
We conducted a single-blind, randomized trial of classic Yang-style tai chi as compared with a control intervention consisting of wellness education and stretching for the treatment of fibromyalgia (defined by American College of Rheumatology 1990 criteria). Sessions lasted 60 minutes each and took place twice a week for 12 weeks for each of the study groups. The primary end point was a change in the Fibromyalgia Impact Questionnaire (FIQ) score (ranging from 0 to 100, with higher scores indicating more severe symptoms) at the end of 12 weeks. Secondary end points included summary scores on the physical and mental components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). All assessments were repeated at 24 weeks to test the durability of the response.
Of the 66 randomly assigned patients, the 33 in the tai chi group had clinically important improvements in the FIQ total score and quality of life. Mean (±SD) baseline and 12-week FIQ scores for the tai chi group were 62.9±15.5 and 35.1±18.8, respectively, versus 68.0±11 and 58.6±17.6, respectively, for the control group (change from baseline in the tai chi group vs. change from baseline in the control group, −18.4 points; P<0.001). The corresponding SF-36 physical-component scores were 28.5±8.4 and 37.0±10.5 for the tai chi group versus 28.0±7.8 and 29.4±7.4 for the control group (between-group difference, 7.1 points; P=0.001), and the mental-component scores were 42.6±12.2 and 50.3±10.2 for the tai chi group versus 37.8±10.5 and 39.4±11.9 for the control group (between-group difference, 6.1 points; P=0.03). Improvements were maintained at 24 weeks (between-group difference in the FIQ score, −18.3 points; P<0.001). No adverse events were observed.
Tai chi may be a useful treatment for fibromyalgia and merits long-term study in larger study populations.
(Funded by the National Center for Complementary and Alternative Medicine and others; ClinicalTrials.gov number, NCT00515008.)
Low back pain is a very common problem affecting 80-90% of all of us at some point in our lifetime. Why is that you ask? There are many reasons. One of the biggest reasons is that we are 2-legged animals carrying 2/3rds of our weight above our waist. Studies have shown deterioration or arthritis occurs much sooner in us vs. our 4-legged animal counterparts. A 180 lbs man carries roughly 120 lbs above the waist. This means, every time he bends over, in order to stand upright, he needs to lift 120 lbs PLUS whatever he is lifting. Hence, the argument of, “…but I only bent over to lift a pencil and my back went out,” seems on the surface as impossible but in reality, the man in our example is lifting the pencil plus 120 lbs. Now, let’s add to that the point that a 5 pound weight equals 50 pounds when held out in front with the arms stretched out straight. Now, if that’s not bad enough, now, let’s assume all of this is happening from a bent forward position, with a twist at the waist, with out stretched arms, while lifting a 20 pound object. Get the idea? It’s amazing our back doesn’t get injured every day as we lift 2 bags of groceries into the far end of a car trunk, or, when lifting our 30 pound child in and out of a car seat, height chair, or when they are screaming and pushing away from us as we try to lift them!
In order to further appreciate why the low back is so vulnerable to injury, some basic understanding of anatomy is needed. When we’re born, the back is made up of 33 segments of which 5 fuse by the time we’re about 18 years old to make up the sacrum (bottom of the spine) and 4 fuse to make up the coccyx (tail bone), leaving 5 lumbar (low back), 12 thoracic (mid-back) and 7 cervical (neck) vertebra. These are stacked up on top of each other like building blocks and are connected to each other by a shock absorbing disk in the front and two smaller facet joints in the back, acting like a tripod. In the low back, we’re supposed to bear about 80% of our weight in the front and 20% in the back but, if our abdominal muscles are a bit out of shape and the pelvis rotates forwards, the curve in the low back increases and overloads the back of the vertebra (facets) making them vulnerable to injury. The disk becomes injured when we bend/lift/twist. This can tear the outer tough fibers of the disk, allowing the central more liquid-like material to leak out. If this happens, the leaking or “herniated” disk can put pressure on the nerve that exits the spine and travels down our leg. If the pain pattern includes the back of the leg, it’s commonly referred to as “sciatica.”
OK, enough about anatomy. What can we do to reduce the chances of having periodic low back pain? Obviously, staying in shape is very important. Certain muscles of the body must be tight to keep us upright or standing. These muscles need to be stretched on a regular basis. For example: the hamstring muscle. We’ve all had to perform hurdler types of exercises and remember how tight they feel!
We realize that you have a choice in where you choose for your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR LOW BACK PAIN! FOR A FREE NO-OBLIGATION CONSULTATION CALL 796-0098
Traction is a common form of treatment for patients with low back pain. By definition, traction is the “act of pulling a body part.” That basically means traction can be applied to an arm, leg, finger, toe…..virtually any body part that one can get a hold of. Here, the focus of traction is being applied to the lower part of the spine and the primary objective is for pain relief and restoring function. Traction “works” by applying a force that separates and increases the space between joints. It also stretches the surrounding soft tissues, including ligaments, joint capsules, muscles and tendons. Spinal traction can be applied manually (with the hands) or by a device with either the use of complicated computerized equipment or, by a gravity assisted means such as using the body’s weight and gravity as the traction force.
Common conditions of the spine for which traction is often utilized include low back sprains and strains, disk herniations (“slipped disks”), and spinal stenosis. Spinal stenosis occurs when there is a narrowing of the hole or canal through which a nerve root exits the spine or where the spinal cord travels, often caused by arthritic spurs. Hence, it is most common after the age of 60 years old. Traction has been shown to improve circulation, reduce inflammation, and by movement of the joints, it may also reduce the nerve’s excitability, resulting in pain reduction.
The “dose” of traction from a clinical experience standpoint, is determined by patient comfort. It must “feel good” to be safe. Remember, too much of anything changes it from being beneficial to being potentially harmful. Therefore, when determining the dose of traction for the first time, we advise the patient to pay careful attention to the way they feel during the time traction is being applied. Often, it feels good at first but may become uncomfortable as time passes. If there is sharp pain, radiating pain (such as down a leg), or, if it is just not comfortable, traction should be discontinued and the recovery time should be reported.
A “typical” dose is 10-15 minutes of time, and the traction force can be continuous or intermittent, kind of like turning on a water faucet and leaving it running vs. turning it on and off. With intermittent traction, we can vary the time that the force is applied such as 30 seconds on and 10 seconds off. Generally, the total treatment time can be longer with intermittent traction (such as 15 minutes) compared to continuous traction, where 10 minutes may be utilized. The traction weight or force can be gradually increased, depending on tolerance and individual patient response to the prior weight.
The Cochrane Report found traction is most effective for cases of sciatica or nerve root pressure creating leg pain. Also, it’s best when used in conjunction with other treatment approaches. In a chiropractic setting, manual traction (where the doctor uses their hands to apply the force) is often utilized along with side to side or figure-8 movements to achieve better results. Spinal manipulation, muscles massage, myofascial release techniques, exercise training for both stretch and strengthening purposes and patient education such as teaching proper bend/lift/pull/push techniques are often utilized to achieve the most satisfying results when managing patients with low back pain.
Low back pain (LBP) can have many causes such as genetics, acquired abuses, body type (especially obesity – body mass index or BMI >30), gender, as well as cultural aspects that predispose one to acquire low back trouble. So, the question remains, “what can I do to reduce my risk for developing low back pain?”
The answer, like the cause is – you guessed it – multifactorial. Since we can’t change our genetics, we’ll have to accept that one. But, we can change our BMI by keeping our weight to a reasonable amount. In an April 2010 study from Norway, 60,000 men and women provided BMI information and 20.9% of the men and 26.3% of the women indicated they had chronic low back pain. The authors found a direct relationship to a high BMI and an increased prevalence of LBP. Similar results attributing obesity to LBP were also reported in a meta-analysis published in January 2010 in the American Journal of Epidemiology (2010; 171(2):135-154).
So, what is, “…a reasonable amount of weight?” When using the BMI, a BMI of 18.5 to 25 is considered “normal,” while 25-30 is described as overweight and >30 represents obesity. We should also mention anything LESS than 18.5 is considered underweight and that’s not good either as many nutritional needs of the body are compromised and too little weight can negatively affect bone health leading to osteoporosis and a myriad of other problematic health issues.
You may be wondering what a body mass index or BMI is, as its quite important and is quickly gaining respect in the medical world. In fact, it has been suggested to include the BMI along with the other “vital signs” pairing it up with blood pressure (BP), pulse, breathing rate, height, weight, and temperature. The BMI is a formula of height and weight and it’s a rough calculation of our total body fat, which is related to the risk of disease and death. However, according to the National Heart, Lung and Blood Institute (NHLBI) it’s a little more complicated than that as people with greater muscle mass (such as a body builder) will have a higher BMI, suggesting they are overweight. At the other end of the spectrum, older individuals who have lost muscle mass may be still be overweight but their BMI will not reflect that.
The NHLBI reports 3 factors of importance when defining obesity and its many negative health effects, including the increased prevalence of LBP. The 3 factors are: 1) The BMI; 2) The waist measurement; 3) The presence of other negative health factors including: high BP, high LDL-cholesterol, low HDL-cholesterol, high triglycerides, high blood sugar, a family history of heart disease, physical inactivity and smoking cigarettes. If you have a waist size >35” for woman, >40” for men, AND 2 or more risk factors, simply put, you MUST lose weight! Even a small weight loss of 10% (such as 30# if you’re 300#), will help lower your risk of developing diseases associated with obesity such as heart disease, high cholesterol related diseases, stroke, certain types of cancers and type 2 diabetes.
We also realize you have a choice in who you choose for your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.
Fibromyalgia (FM) is a condition that usually affects different organ systems in the body, causing a number of symptoms. Some of these include:
1) The muscles (the musculoskeletal system): tender, achy, stiff, tight muscles, trigger or tender points all over the body;
2) The nerves (the nervous system): headaches, light headedness, sleep disruption, depression, anxiety, numbness/tingling (overlaps with the cardiovascular system);
3) The stomach and intestines (the gastrointestinal system): diarrhea, constipation, irritable bowel, leaky gut, heart burn, lack of appetite, abdominal cramping;
4) Breathing (the respiratory system): hyperventilation, rapid / shallow breathing patterns;
5) The heart (the cardiovascular system): racing heart rate – palpitations, feeling cold all the time, numbness/tingling (overlaps with the nervous system);
Because of the multiple systems involved, there are many challenges to managing Fibromyalgia. Studies suggest a balance between several approaches works best. Some of these approaches include biomedical treatments, organ-specific treatments, and cognitive interpersonal treatments. Within these categories, the following can be broken down further:
1) General – those treatments directed at the whole body such as anti-inflammatory measures. These include (but are not limited to) medications (corticosteroids, NSAID’s – such as Advil, Aleve) and nutrients (ginger, turmeric, boswellia, Vitamin D, and others). Other anti-inflammatory measures include diet, such as the Paleo Diet or “caveman diet.” This diet eliminates grains or flour-based products from the diet. That means no more breads, pastas, crackers, cookies – anything made with flour. This approach emphasizes consuming fruits, vegetables, grass-fed lean meats and fish. The main ingredients in grains that are of concern in the Paleo Diet are gluten and lectins
2) Central – those treatments directed at the chemical factors in the brain that control mood, depression, anxiety and so on. These include (but are not limited to) medications (tricyclic antidepressants, muscle relaxers like Cyclobenzaprine, SSRI, SNRI and Trmadol) and certain nutrients (neurotransmitter support such as 5-HTP – tryptophan, DHEA, phenylalanine, and others).
3) Psychotherapy and active behavioral therapy – treatments that are supportive of nervous system such as cognitive behavior therapy, aerobic exercise, patient education, multidisciplinary therapy, hypnotherapy, biofeedback, and strength training.
4) Passive physical intervention – chiropractic therapy, massage therapy and other forms of manual therapy, and acupuncture.
The goal of this article is to look at fibromyalgia from a holistic perspective so that those struggling with FM and similar conditions can better appreciate the concept of multidisciplinary treatment, of which chiropractic care plays a significant role. Coordination of care and finding the “right” health care providers cannot be over-emphasized.
Few conditions leave their victims as miserable and agitated as headaches. There are many causes of headaches including stress, odors, bright lights, noise, fatigue, certain foods, hormonal shifts, allergies, as well as genetic predisposition. With all the possible causes of headaches, it’s not surprising many people seek help from many different approaches such as conventional medical therapies like pharmaceuticals and injections. Others prefer a non-drug treatment approach such as chiropractic, massage therapy, acupuncture, and nutritional counseling.
Usually, there is not one specific cause of headaches so treatment can focus on various areas. For example, muscles that attach to the base of the skull in the neck and upper back are often very short and tight, resulting in pressure or a squeezing effect on the surrounding nerves and blood vessels -- resulting in headaches. Chiropractic treatment includes methods aimed at reducing the tightness found in the joints and muscles. One of these approaches is called spinal manipulation or “adjustments” where the joints in the neck are moved to restore motion and reduce joint fixations. By relaxing the muscles and tension between the joints, the nerves in the neck are less pressured which, in turn, can reduce headaches. The top three nerves that exit the upper neck travel into the head and are often the culprit behind the onset of headaches. The second nerve from the top is the one responsible for causing radiating pain over the top of the skull which communicates with other nerves sometimes causing the pain behind the eye.
Another chiropractic approach in the management of headaches includes soft tissue therapy where trigger points found in tight muscles are addressed through various forms of massage and mobilization methods. Manual traction of the head and neck can also be highly effective in reducing the tension found in headache sufferers. Exercises are often taught to the headache patient with significant benefits reported. Some of these, such as range of motion exercises with and without resistance (example: pushing your head into your hand during neck movements) and posture re-training (chin tucks – reducing the forward head position), help address the limited motion problems of the neck. Cervical (neck) traction performed by placing a rolled up towel placed behind the neck while lying on the back so that the head can hang off the side of the bed can also be very helpful. Another neck traction approach is the use of a unit that hangs off a door where water is placed in a plastic bag calibrated for weight for 15 minutes at a maximum tolerated weight. This can be of great benefit as it can be performed at home at your convenience multiple times a day or, as needed.
Other treatment approaches that chiropractic utilizes include stress management (such as biofeedback, relaxation instructions, meditation, visualization and others), diet modifications (as certain foods can trigger headaches), nutritional supplementation (such as fish oil, Vit. D, feverfew and others), and sleep restoration.
You may have wondered, “If I get hurt in a car accident, who should I go to for treatment of my whiplash problem?” This can be quite a challenge as you have many choices available in the healthcare system ranging from drug-related approaches from anti-inflammatory over-the-counter types all the way to potentially addicting narcotic medications. On the other side of the fence, there are nutritional based products such as vitamins and herbs as well as “alternative” or “complementary” forms of treatment such as chiropractic, exercise, and meditation, with many others in between. Trying to figure out which approach or perhaps combined approaches would best serve your needs is truly challenging. To help answer this question, one study reported the superiority of chiropractic management for patients with chronic whiplash, as well as which type of chronic whiplash patients responded best to the care. The research paper begins with the comment from a leading orthopedic medical journal stating, “Conventional [meaning medical] treatment of patients with whiplash symptoms is disappointing.” In the study, 93 patients were divided into three groups consisting of:
Group 1: Patients with a “coat-hanger” pain distribution (neck and upper shoulders) and loss of neck range of motion (ROM), but no neurological deficits;
Group 2: Patients with neurological problems (arm/hand numbness and/or weakness) plus neck pain and ROM loss); and,
Group 3: Patients who reported severe neck pain but had normal neck ROM and no neurological losses.
The average time from injury to first treatment was 12 months and an average of 19 treatments over a 4 month time frame was utilized. The patients were graded on a 4-point scale that described their symptoms before and after treatment.
Grade A patients were pain free;
Grade B patients reported their pain as a “nuisance;”
Grade C patients had partial activity limitations due to pain; and
Grade D patients were disabled.
Here are the results:
Group 1: 72% reported improvement as follows: 24% were asymptomatic, 24% improved by 2 grades, 24% by 1 grade, and 28% reported no improvement.
Group 2: 94% reported improvement as follows: 38% were asymptomatic, 43% improved by 2 grades, 13% by 1 grade, and 6% had no improvement.
Group 3: 27% reported improvement as follows: 0% were asymptomatic, 9% improved by 2 grades, 18% by 1 grade, 64% showed no improvement, and 9% got worse.
This study is very important as it illustrates how effective chiropractic care is for patients who have sustained a motor vehicle crash with a resulting whiplash injury. It’s important to note the type of patient presentation that responded best to care had neurological complaints and associated abnormal neck range of motion. This differs from other non-chiropractic studies where it is reported that patients with neurological dysfunction responded poorly when compared to a group similar to the Group A patient here (neck/shoulder pain, reduced neck ROM, and with normal neurological function). We realize you have a choice in where you go for your health care needs and we truly appreciate your consideration in allowing us to help you through this potentially difficult process.
Osteoporosis and diabetes often go hand-in-hand for people who are chronically inactive. The reason is intricate but simple. Weight bearing exercise (such as weight lifting) builds strong bones by increasing osteoblasts, cells that create bone-the cure for osteoporosis. The increasing number of osteoblast cells also secretes a hormone called osteocalcin. Osteocalcin improves insulin production and insulin sensitivity, the cure for type 2 diabetes! So if you are inactive and develop osteoporosis, and instead of exercise you opt for the ineffective, poorly tested, and extremely dangerous osteoporosis drugs, you will lose out on the osteoblasts that build strong, new bone, as well as the hormones that are part of the cure for type 2 diabetes!
I always like to remind people that bone is living, breathing tissue. Thanks to some of the latest research, we can now add that your skeleton is not only living, breathing tissue, it is also an endocrine gland that secretes hormones that build strong bone, help you lose weight, and prevent and treat type 2 diabetes. (Cell 07; 130;456). This is a perfect example of just why symptom treatment is so ineffective, expensive, and dangerous.
Medicine would opt to use biophosphonate drugs, such as Fosamax®, Actonel®, Boniva®, and Reckast®, rather than address the underlying cause of osteoporosis. The real cause is a deficiency of the nutrients I like to call the osteofactors, as well as a lack of weight-bearing exercise. The gold standard medical treatment of biophosphonate drugs stops your body from its natural process of removing dead and diseased bone. This does lead to more bone density but the increased bone density is made up of fragile, dead, weak, and often diseased bone. Even as bone density "improves," the drugs can cause severe problems, from muscle pains to permanent rot of the jawbone to traumatic hip fracture!
It is bone strength you are after. And only treating the underlying cause will bring about the change you need in your skeleton. Once this begins, you get the added benefits of increased strength and independence, weight loss if needed, protection against type 2 diabetes, and, of course, eliminating traumatic and life-changing side effects. Treating the underlying cause is such a bargain!
If you want to know about osteofactor nutrients, just send me a self-addressed, stamped (with two stamps) envelope and write END MY JOINT PAIN.
When it comes to exercise, nothing is more effective, easier, and the least time-consuming as lifting weights via The Slow Burn Fitness Revolution. You can get a copy of this book by Frederick Hahn, Michael Eades, MD, and Mary Eades, MD, at bookstores and online.
Osteoporosis and type 2 diabetes are connected. Bone is a living, breathing tissue, and there simply is no alternative to treating the underlying cause. The old song we sang as kids about "the ankle bone is connected to the knee bone, the knee bone is connected to the thigh bone, ..." is as true as ever. We just need to add that all the bones are connected to your hormone-producing endocrine system. Or to make it intricately simple, everything is connected to everything.
For over 15 years, Cindy and I have never been without a bottle of Gastrex capsules in our cupboard. We even take Gastrex on trips to exotic places. The reason is simple: Gastrex acts like a sponge to mop up poisons and toxins that cause food poisoning, severe gastritis, over-acid stomach, diarrhea, and more. You know the feeling when you get food poisoning, like you are going to die. And eating clay in the form of Gastrex quickly adsorbs the toxins for elimination and fast relief.
To adsorb means to gather together toxins or other substances onto a surface for elimination. This is similar to charcoal. Gastrex is made from bentonite (montmorillonite clay) as well as a host of other gut-healing substances. It has a huge surface area, and can adsorb hundreds of times its weight in toxins and poisons. And indeed, indigenous peoples have been eating clay for thousands of years (a little at a time) to eliminate poisons and toxins.
Today there are a host of "clay" products on the market, each making ridiculous healing claims. On just a few labels, the products claim to: cure diarrhea; absorb toxins, poisons, pesticides, viruses, and more; cure constipation, indigestion, and ulcers; provide more energy; and give you a clear complexion, whiter eyes, enhanced alertness, an emotional uplift, better gum repair, and an allergy cure. These products claim that clay works on your entire body, leaving no part left untouched by clay's "healing energies."
Whew! These claims are totally overblown, but there is a degree of truth to all of them. The truth is that montmorillonite clay (Gastrex) is a volcanic clay that adsorbs toxins, poisons, heavy metals, some viruses, molds, and even pesticides (such as Roundup®) and eliminates them from the body. I like to use Gastrex for food poisoning cases that cause diarrhea, cramps, and misery. Take 9-20 capsules (about 2 tablespoons in volume) on an empty stomach with water and just go to bed. If your problems are still there hours later, take another 6-15 capsules. That generally does it just about every time.
If you suffer from chronic gastritis or an ulcer, take 2-4 capsules about 15 minutes before meals on a temporary basis for relief and to start the healing. Aside from providing immediate relief, Gastrex contains several powerful healing agents in addition to the clay. These are chlorophyll, okra, duodenal tissue extract, and silica. Gastrex stimulates the production of bile, and it is naturally anti-ulcer.
If your problems are primarily in your intestines (like malabsorption syndrome and diverticulitis) add 2-3 Okra Pepsin E3 capsules taken 15 minutes before meals. This product is for healing, and the okra portion of it actually sticks pepsin (a natural enzyme) to the intestinal walls where it can gently erode away stale mucus. As the surface of your stomach and intestines are gently cleansed, the healing agents - allantoin and extract of the Tillandsia usneoides plant - can work to heal the surfaces of your gut. While Gastrex is best used as a temporary miracle aid-like a fire extinguisher, Okra Pepsin E3 can be used long term until your gut is improved or cured.
Use Gastrex as first aid for a sour stomach, food poisoning, toxic poisoning, and to heal up gastritis, colitis, diarrhea, and ulcers. For these conditions, healing clay in the form of Gastrex is indeed a miracle treatment of the month. I am never without a bottle.
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“I’ve been having this pain in my neck for a long time and it just won’t go away! It’s getting to a point where I have to do something and I’m not sure which route to go. Some of my friends have suggested chiropractic but I’m just not sure. Can you give me any advice?”
Neck pain is a very common complaint that chiropractors treat on a regular basis. Most people will experience neck pain during their lifetime requiring professional care and the choice between chiropractic or some other form of health care certainly exists. Chiropractic is a non-drug, non-surgical option many find appealing because of the many side effects of medications and no one wants to consider surgery unless it’s absolutely necessary and everything else has been tried first.
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders published some good, sound statements about neck pain of which a few include:
First, trying to identify the “cause” of your neck pain is often tricky and sometimes impossible to trace. Don’t worry, that’s “normal” as most patients cannot trace it to one specific cause because it’s multifactorial or, caused by more than one event, often over a period of time.
Second, staying active and performing exercises can greatly help to reduce and sometimes prevent neck pain. One particular exercise that can be done multiple times per day and even in public places, as it’s not too conspicuous, is called chin tucks. Let’s try it together! While sitting, look straight ahead and tuck your chin towards your chest or, glide your head backwards. Hold the tucked position until you feel fatigue, which usually takes 5-15 seconds, and then slowly release the head poking your chin forwards in the opposite direction. Looking at this from the side, it sort of looks like a chicken when they walk! Repeat this exercise and emphasize the slow release, as if you’re in “slow motion,” gliding forwards and backwards holding the endpoints for 5-15 seconds per repetition. Start with 5 reps and over time, gradually increase the reps to 10 and repeat this several times each day. As a postural retraining process, when you’re sitting in your car, at your desk, watching TV, or in meetings, partially tuck in your chin so that the weight of your head (which is approximately 15 pounds) is centered back over your upper back and not poking forwards. This will GREATLY reduce the amount of muscle tension that commonly builds up during the day due to the increased muscle activity that is required to hold the weight of the head when it’s too far forward and away from the center of the body. Constantly remind yourself by maintaining a partial “chin tuck” during the day and perform the gliding exercises periodically, at least 3 times a day. Be patient as it takes about 3 months for this “new” posture to become automatic and your new “normal” habit.
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Fibromyalgia (FM) is a chronic condition where there is widespread / whole body pain that is often difficult to diagnose. Some patients may spend years of going to different doctors, undergoing many tests (of which most, if not all, are “negative”), and they may be diagnosed with different conditions such as rheumatoid arthritis, hypothyroidism, or mononucleosis before a diagnosis of FM is finally given. Needless to say, this process can be very frustrating!
The reason for this dilemma is that there is no single diagnostic test (blood test, x-ray/image finding, etc.) that verifies the diagnosis of FM, leaving doctors in a position to “rule out” all other possible “diagnose-able” conditions first, before considering FM as “the” diagnosis. Another challenge is the fact that FM symptoms vary widely from one person to the next and even vary within the same person at different times of the year. There are a few “guidelines” doctors can use to help secure the diagnosis of FM.
One such guideline is from The American College of Rheumatology (ACR) which requires that “widespread” pain be present throughout the body for at least 3 months (“widespread” is defined as pain on both sides of the body, above and below the waist). The ACR also has identified 18 points on the body of which at least 11 of the 18 “tender points” must be present to secure the diagnosis of FM. There is debate as to the accuracy of this rather stringent criteria as FM symptoms can come and go and vary, making the 11 of 18 tender point findings sometimes change between visits. Hence, widespread pain above/below the waist on both left/right sides of the body for at 3 months has become a more accepted indicator for diagnosing FM.
Yet another challenge in pinning down the diagnosis is that the FM sufferer may experience signs and symptoms seemingly unrelated to FM, such as stomach ache/digestive problems or headaches. This can lead the doctor down other paths before considering FM as a diagnosis.
Fibromyalgia can be primary (no other condition caused it) or secondary (other condition(s) lead to the development of FM). Hence, the diagnosis process focuses on identifying conditions which can be identified through standard diagnostic tests, often overshadowing the diagnosis of FM. Testing for conditions such as lupus, multiple sclerosis, sleep apnea, diabetes, Crohn’s Disease, and/or others, often makes sense to both you and your doctor, but adds to the delay in diagnosing FM. Here are some suggestions to help your doctor through this diagnostic maze:
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“For the last few months, I’ve been waking up at night with numbness and tingling in my hand. Lately, I’ve been waking up more often, 3-4 times a night and I’m having a hard time falling back to sleep. When I drive, my hands fall asleep within a few minutes and I have to shake my hand and fingers to wake them up. This has gotten to the point where I have to do something but I really don’t want surgery. What are my non-surgical options?”
CTS or, carpal tunnel syndrome is a condition where a nerve (called the median nerve) that travels down from the neck into the arm and through the wrist becomes pinched and inflamed. Common symptoms include numbness, tingling, dexterity problems (such as difficulty buttoning shirts), and opening jars due to weakness in grip and pinch strength. Sleep interruptions and loss of many daily activities, including work, occur because of CTS.
There are many non-surgical approaches to the treatment of CTS that should be utilized before surgery is considered, according to the American Academy of Neurology. In one study, 40% of neurologist polled recommended non-surgical care due to the potential side effects of surgery, some of which being severe, resulting in lengthy work loss post-surgically. A partial list of non-surgical care options include:
1. Rest – Giving the inflamed CTS time to heal is therapeutic but not always an option.
2. Activity/job modifications – Avoiding certain activities or modifying them by taking breaks during the work day, slowing down the pace of the job, altering the position of the job task, such as propping up a part so that the wrists do not have to bend to the extremes, or when necessary, complete avoidance of the job task.
3. Wrist Splint – This is a brace that maintains the wrist in a neutral position so it cannot easily bend. When the wrist flexes or extends, the pressure inside the carpal tunnel (on the palm side of the wrist) increases significantly, placing additional pressure on the already pinched median nerve. Wrist splints are especially useful at night.
4. Nerve Gliding Exercises – These are exercises that stretch the wrist joint and muscle tendons (as well as the median nerve inside the carpal tunnel), with the objective of breaking adhesions that limit the normal glide or movement of the nerve in the forearm and wrist.
5. Manual therapy techniques – These include manipulation of the arm including the forearm, wrist, and hand and sometimes the neck and shoulder, when needed. The objective is to improve the range of motion of the joints and soft tissues that may be participating in the process of median nerve pinching.
6. Anti-inflammatory medication / nutrients – Medications include aspirin, ibuprofen, naproxen and similar prescription drugs. Nutritional options including herbs (such as ginger, turmeric, boswellia), digestive enzymes, and Vitamin B6 may also help. Ice is also anti-inflammatory and direct, on-the-skin ice massage is quite effective.
Chiropractic is a perfect choice when considering a health care provider for the treatment of CTS as many of the above non-surgical techniques are utilized by our office. We realize that you have a choice in who you are considering for your health care provision and we sincerely appreciate your trust in choosing our service for those needs. If you, a friend or family member require care for CTS, we would be honored to render our services.
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“When I woke up this morning, I couldn’t move my neck! Every time I try to move it, I feel sharp pain on the left side of the neck shooting down into the shoulder blade. It just came out of nowhere!”
Chances are, you are suffering from a common condition called torticollis, which literally means, “twisted neck” after the Latin terms of “torti” (twisted) and “collis” (neck). The common name for this is “wry neck,” and it’s basically a painful muscle spasm, like a “Charlie-horse” but located in the neck muscles. Usually, a person wakes up in the morning with this and the cause is often related to sleeping with the window being open or a fan or air conditioner blowing on you. It can also relate to a “cold settling in the muscle” after a cold or flu virus. Trauma such as falling or a car accident can also cause torticollis. However, most of the time, patients with torticollis are not sure what caused the abrupt onset of symptoms.
Usually, torticollis will gradually improve over a 2 week time frame. However, it only takes a few days to a week (at the most) if you receive chiropractic adjustments. Most importantly, without treatments, the sharp pain can last a week and can severely limit your activity, often prohibiting work as well as your desired “fun” activities. Hence, most people prefer having this treated as opposed to “waiting it out.” In some cases, it can last longer than a month and in rare cases even longer, so getting this treated is highly recommended. Also, try to get in for a treatment immediately before the muscle spasm really sets up. We find this to be the most effective approach. Here are a list of symptoms and treatment suggestions for torticollis:
Acute Torticollis Symptoms
Pain Relief Treatments for Acute Torticollis
If this history sounds familiar, you may be suffering from carpal tunnel syndrome or CTS. It’s a very common disorder affecting millions each year. Its also one of the biggest problems for certain types of industries such as meat packaging plants, textile manufacturers, and virtually any job that requires fast, repetitive movements commonly used on assembly lines in many lines of work.
CTS is the result of pinching of the Median Nerve as it travels from the neck into the arm, through muscles in the forearm and into the hand through the carpal tunnel. Pressure on the nerve at any of these locations can create the symptoms of CTS. This tunnel is quite small in size and included inside the tunnel are 9 tendons, blood vessels, and the median nerve. When the muscles of the forearms and hands are overworked, they inflame and swell. Because the carpal tunnel is normally so tight, the increased swelling inside the tunnel pushes and pinches the median nerve creating the classic pain, numbness, tingling, and sometimes burning sensations often described by people suffering with CTS.
Certain situations make people more vulnerable or prone to develop CTS. CTS is more common in woman than men by 3 or 4:1. This is partially because women’s bone structure is smaller and therefore their Carpal Tunnel is smaller too.
Women also experience fluid retention or build up during menstruation leading to symptoms like swollen fingers and swollen and painful breasts. Swelling in the already tight, confined space of the carpal tunnel will increase their susceptibility for developing CTS. Another hormone related cause or contributing factor is the use of birth control pills (BCPs). Since there are many different types of BCPs and each woman is unique and different, finding the BCP with the “right balance” of hormones where the swelling side effect is minimized is very important and should be discussed with the doctor who prescribed the BCPs.
Age (>50 years) is also a risk factor and with our aging work force, this is becoming a big issue. Other conditions like hypothyroid, diabetes, certain types of arthritis, and hypertension / congestive heart failure where an increase in fluid retention occurs can also increase the chance of developing CTS. Obviously, occupation type plays an important role as previously mentioned. Many jobs today require the use of computers and we’re finding the position of the monitor, the keyboard and mouse, are very important.
Chiropractic management of CTS includes wrist, forearm/elbow, shoulder and neck adjustments, corrective exercises, the use of night splints, and an anti-inflammatory diet. Also, correcting the “ergonomic factors” or, job-related causes is of utmost importance. This is why a chiropractor who treats all of these areas and has the specialized knowledge about CTS is the perfect choice of health care providers. If you, a friend or family member require care for CTS, we would be honored to render our services.
I heard Sally Field on the radio the other day telling all women who may suffer from loss of bone mass or osteoporosis, that it runs in the family, and that she cured her osteoporosis with once-a-month drug, Boniva®. The truth is that drug treatment of osteoporosis is not a cure, does not build strong bone, cannot be continued for more than 4 to 5 years, and is a dead end.
Your bones are living, breathing tissue. Half the time your body is building new bone via bone-building mechanisms that involve osteoblasts, and half the time your body is removing old, diseased, and brittle bone to make room for the new. This involves osteoclasts. Osteoporosis is a disease where not enough new, strong bone is developed- usually due to nutritional deficiencies and lack of exercise. It is not a disease where not enough old, diseased, and brittle bone is being removed.
Osteoporosis (biophosphonate) drugs, whether taken daily, weekly, or monthly stop the removal of old, diseased, and brittle bone. Over time, this increases bone mass because all the old bone that needs to be removed so new, strong bone can take its place, remains. This leaves fewer places or receptors for new healthy bone. However, at the same time, bone density is higher with old diseased and brittle bone-making everyone happy with your latest bone scan.
Naturally, the problem is that your new bone density is made up of more and more old, diseased, and brittle bone. So you are building anew skeleton out of glass. The end result, usually after 4 to 5 years, is failure, sometimes with traumatic hip fractures occurring while simply standing. And a rare result is osteonecrosis of the jaw. This is permanent and incurable jaw rot because the drugs have interfered with the body's ability to clear out old, diseased, and brittle bone.
There is simply no way out of osteoporosis except to supply the needed nutrients and to exercise. Once again, drugs are a dead end. The advertisements to the contrary are misleading at best and an insult to women everywhere. Osteoporosis is a dreadful disease when it progresses. Do not let this happen to you. If you need to really overcome your osteoporosis, then increase your osteoblast activity, and do not stymie your osteoclast activity.
The nutrients needed include raw bone, cod liver oil, and more. And while we are on the subject, building strong bones requires a matrix of nutrients. Those folks who would sell you their product because "you only need one missing nutrient" are as bad as the drug sellers. They say that you only need phosphorus, or you only need magnesium, or you only need calcium, or vitamin D, or boron, strontium, and on and on. This is ridiculous. Bones need all the osteofactors, that is, all the nutrients involved in the osteoblast or osteogenesis (bone and joint building) process.
If you need help, you can find it in my "End Your Joint Pain" article. Just drop me a self-addressed, stamped (with two stamps) envelope and write END MY JOINT PAIN. I will rush you my free flyer with a precise outline of what is really needed to beat osteoporosis. And as for side effects, you will be able to improve or end your arthritis, get stronger and more independent, and get relief from all your joint pains, all from the same treatment.