Sugar In Your Joints, Not Your Stomach?

Prolotherapy is a relatively non-traditional procedure that can possibly help with a variety of musculoskeletal injuries, including, but not limited to osteoarthritis of the knees, low back pain and tennis elbow. Prolotherapy is also known as proliferation therapy and involves the injection of a sugar solution into the affected region, particularly the tendons and/or ligaments with the purposes of stimulating an immune response at the site and strengthening collagen fibers.

The reason this is in the news is due to a recent study that found prolotherapy beneficial for patients with diagnosed knee osteoarthritis. Osteoarthritis is commonly referred to as degenerative joint disease and affects a large segment of the population, especially the elderly. Typical treatments include steroid injections, physical therapy and even surgery. What's interesting about those treatments is that recent evidence has found that steroid injections increase bone fragility in the elderly, so prolotherapy should be viewed as a viable alternative.

The study found that patients who underwent the dextrose-based injection procedure had a 24% increase in a knee-specific quality of life survey one year after having the procedure performed. 

Epidural Injections For Low Back & Neck Pain May Increase Fracture Risk

A retrospective analysis recently performed, and published in the Journal of Bone and Joint Surgery, has found that, in older patients the risk of vertebral fracture is increased following epidural steroid injections.

The results were confirmed in a second analysis and the researchers used the records of more than 3000 patients who were 50 years or older and who had received at least one steroid injection for compressive neuropathic pain.

While this is a preliminary study and did not control for a number of other cofactors that influence bone stability and increase fracture risk such as smoking and higher BMIs, it is important to consider when referring patients for lumbar steroid injections.

11 Healthiest Foods

This is a pretty cool series on 11 healthy foods that has a few ones that are a little off the beaten path...

http://www.rodalenews.com/worlds-healthiest-foods?page=11

Statins & Musculoskeletal Pain

The incidence of adverse musculoskeletal and rheumatologic events in patients who are prescribed and medicated with cholesterol-lowering stating drugs is greater than in patients who are not medicated. The evidence is already established that myalgia (muscle pain) is a common effect when taking statins, due to the fact that mechanism by which the body produces CoQ10 is shut down when cholesterol synthesis is shut down. However, this new review further ties incidents such as sprains, strains and according to one review, joint disease or osteoarthritis with statin use.

The researchers stated, "this is the first study, using propensity score matching, to show that statin use is associated with an increased likelihood of diagnoses of musculoskeletal conditions, arthropathies, and injuries."

One of the lead researchers noted that the "wide array of clinical presentations" of musculoskeletal adverse events associated with statins includes myalgias, muscle weakness, muscle cramps, rhabdomyolysis, autoimmune muscle disease, and tendinous diseases.

When it comes to joint pain versus cardiovascular health, cardiovascular health rightfully takes precedence. The issue becomes the tendency among primary care providers to prescribe statin drugs such as simvastatin, atorvastatin, pravastatin, rosuvastatin, and fluvastatin or lovastatin as the first line therapy increases annually and the patients become younger. 

Primary care providers should always weigh the benefits and complications with prescribing statins to all patients, but specifically younger patients. The first line therapy should always be dietary and lifestyle modification widely reported and available in a number of reputable sources. 

Roberto Clemente: Baseball Player, Hall-of-Famer, Believer In Chiropractic, Chiropractor --- WAIT, WHAT?!?!?!

Who knew that baseball hall-of-famer Roberto Clemente was such an avid believer in chiropractic. Incidentally, he also seemed to function as a chiropractor himself according to teammates. This is certainly worth a look and listen to as he joins an illustrious list of athletes who utilize chiropractic services).

(Skip ahead to the 1:10 mark if you'd like).

A Pain In The Butt, Literally - A Series On Sciatica - Part 2

In the first part of this series on sciatica, the question, "what is sciatica?" was posed, and then answered. In this second part, the question, "how does it happen" will be answered? This is in an effort to educate the public as to why the term sciatica is used so often, specifically in chiropractic, orthopedic and primary care settings.

Sciatica, as answered in part 1, is an inflammation or irritation of the sciatic nerve. In order to understand how does it happen, one must first understand the anatomy of the region. The sciatic nerve is a large, tortuous nerve that is comprised of nerve roots at the L4 - S3 vertebrae. The nerve roots come together to form a "superhighway" nerve that supplies nearly the whole of the skin of the leg, the muscles of the back of the thigh, and those of the leg and foot (see picture to left).

Nerve roots joining to form the sciatic nerve

Once you understand how large a nerve it truly is, and how far ranging the distribution is, it becomes a little clearer as to how irritation of the nerve can lead to problems as far away as the foot. When an intervertebral disc is "bulging," or "herniated" it implies that the center portion of disc has been pushed out the back of the disc. When this occurs, the bulge or herniation (see below) pushes or compresses against the nerve root that will later join with other nerve roots to form the sciatic nerve.

Just as when you compress anything, transfer from one side to another becomes more difficult. Think of a plastic bag that is inflated. Then compress the middle and try to transfer air from one side to the other. Because of your compression, transfer is made increasingly difficult, even impossible. A nerve operates in the same fashion. When compression occurs, signals that travel back and forth, in addition to the blood flow within the nerve becomes more difficult. Compression can take many forms including pain, altered sensation such as pins and needles, tingling or shooting sensations, and weakness. Herniations and bulging discs are the primary mechanisms by which sciatica occurs, but there are other causes as well, including but not limited to muscle tightness within the hip, bone spurs on vertebrae, spinal stenosis, tumors and even pregnancy.

Images of herniated & bulging discs

If you experience any of these symptoms, make sure you schedule an appointment with Dr. Donohue at Rehabilitation & Spinal Care of Rockford. The office is accepting new patients and can provide relief of this condition and these symptoms. Call (815) 394 0309.

...And The Vitamin D Train Rolls Onward....

In the seemingly endless well of positive news arising from research into Vitamin D supplementation, the latest comes from Dublin, Ireland and details how "patients in remission with Crohn's Disease who took vitamin D supplements had clinically meaningful improvements in quality of life."

In patients who fell into the aforementioned criteria (Crohn's Remission), those who were taking a supplement and had blood levels of Vitamin D (25-dihydroxyvitamin D) greater than 30 ng/mL. had higher quality of life scores than those not taking the vitamin and whose blood levels were less than 30 ng/mL.

For patients who have been diagnosed with Crohn's Disease, often times a poor quality of life is present and fatigue and loss of muscle strength are chief complaints. For the patients taking the supplement, they reported increases in strength and decreased levels of fatigue. 

Vitamin D supplementation is quickly becoming an essential component of not only musculoskeletal health, but overall health. The wealth of information being compiled by researchers, doctors and scientists continually demonstrates that not only are Americans, generally speaking, deficient in the vitamin, but that being deficient has serious adverse effects. 

At Rehabilitation & Spinal Care of Rockford, we utilize two forms of Vitamin D, one oral solution from Biotics, and a pill form from USANA. Both supplements contain 2000 IU/dose. Vitamin D is a fat-soluble vitamin so there are some small risks if you have active Tuberculosis, kidney disease or have elevated serum calcium levels. Otherwise, it is a safe and effective supplement and should be taken by the majority of Americans. Included below is an image of common food sources of Vitamin D, however, often times people need to be supplemented to achieve effective levels of between 40-80 ng/mL.

If you need a supplement, call RASC Rockford today to obtain the highest quality daily supplements on the market. 

A Pain In The Butt, Literally - A Series On Sciatica

The refrain is familiar, so much so that the question has become standard in the orthopedic health care setting. "Doctor, the pain travels down my leg when I......sit, stand, drive, golf.....what can you do?"

We've all heard the term Sciatica in some form or fashion. Whether it's an important player on your favorite team, your parent, you or somewhere in the news, the word is increasing in usage. But what exactly is sciatica? How does it happen? Why does it happen? Most importantly, what can be done about it?

Those answers, and trust me, there are answers, can be found in a variety of places including the internet, anecdotally or through medical research. But really, the best wealth of information will come from your doctor, a specifically a specialist in spinal or orthopedic disorders.

Sciatica, as people who have suffered from this condition, is an irritation of the sciatic nerve itself or the nerve roots that eventually join together to form the nerve. The sciatic nerve is the largest nerve that supplies sensation and motor function to the posterior gluteal region, back of the thigh, back of the calf muscle and into the foot. Irritation anywhere along the pathway can cause pain up and down the leg, leading to loss of sensation or even the ability to move the leg. It is important to note that sciatica is not a diagnosis, but rather a specific symptom that leads to a diagnosis. Fortunately, sciatica tends to occur on only one side of the body.

If you are experiencing any altered sensation, tingling, numbness, pain or pins and needles in either of your legs, do not hesitate to call Rehabilitation & Spinal Care of Rockford and schedule an appointment to be seen by Dr. Mike Donohue.

How Nutrition Can Protect Your Skin This Summer

Ouch!

If and when the sun ever decides to show it's face this summer, it is important to remember that the UV rays can affect your skin cells. The best way to protect yourself this summer is to cover up if you are going to be in the sun for a long time, wear sunscreen and eat properly. Wait, eat properly? How can I do that? Well, I'm glad that you asked, here are 10 specific foods to remember to pack while you're at the beach, eat after doing yard work or buy on vacation...

Almonds

Flax Seed 

Carrots

Sweet Potatoes

Spinach

Safflower Oil

Tuna

Green Tea

Dark Chocolate

Tomatoes

Probiotics - The Hype Is Real

The Gupta Guide is a webpage on the MedpageToday.com website that provides summarizations of public health concerns and interesting medical news. A recent update detailed the results of a review performed by the Cochrane Collaboration which found that prophylactic probiotic usage is a "cheap, safe and effective way to prevent Clostridium difficile [C. Diff] associated diarrhea."

In fact, C. Diff was prevented in 64% of cases compared with patients given a placebo or no treatment. This represents a wonderful step forward in the fight against this deadly pathogen which causes untold hundreds of millions of dollars in treatment costs. In truth, "the cost [for probiotic prophylaxis] is generally low, about $15 to $40 for a month supply online. In contrast, the estimated cost of treating primary C. difficile infections ranges from $2,871 to $4,846 per case in the U.S. Recurrent cases run $13,655 to $18,067."

Clostridium difficile is an intestinal bacteria that is normal in the human gut, but only normal in certain ratios to other bacteria. In patients who need to be treated with antibiotics while in the hospital, this intestinal balance can be affected negatively, resulting of a mass killing of the beneficial bacteria. The death of "good bacteria" leads to increased colonization of the C. Diff. bacteria. When this occurs, treatment becomes extremely difficult and in cases can lead to the death of the affected patient.