Dr. Richard Schwartz /215-283-2844/ Ambler Chiropractic / Can Poor Posture Predict Mortality?

Dr. Richard Schwartz / 215-283-2844/ Ambler Chiropractic

Can poor posture

predict mortality?

Maybe so according to a recent study and that ain’t all! Turns out that posture (in this case thoracic HYPER kyphosis) is getting some attention in the literature and appears related to a wide range of ailments, of which increased risk of death is only one. Only problem is that chiropractors aren’t doing the research. OH NOOO!!!

Because while half of our profession has relegated spinal structure to the dustbin of chiropractic history in pursuit of more “sophisticated” theories, our MD and PT colleagues are more than happy to lay the scientific ground work relating spinal structure to a wide range of ailments. End Of Rant…promise.

First off…thanks to Dr. Roger Coleman at ScienceInBrief.com for making me aware of this research. For those of you who aren’t familiar with the ScienceInBrief.com
project, we review scientific articles on a wide range of subject which are of interest to chiropractors. Unlike this newsletter, very little of what we do at SIB is directly related to posture based chiropractic. But occasionally, I run across articles which are relevant for readers here at Postural Rehab. Here’s a recap of the article along with some thoughts on managing thoracic HYPERkyphosis.

Hyperkyphotic Posture Predicts Mortality in Older

Community-Dwelling Men and Women: a prospective study 1

The Facts:

a. The authors studied the association between thoracic hyperkyphosis and mortality in over 1300 individuals with a mean age of 73.

b. If the individual laid on their back and was unable to rest the head on the table without putting the neck into hyperextension they were considered to have thoracic hyperkyphosis.

c. Patients were followed for an average of 4.2 years.

d. Those “with hyperkyphotic posture had greater mortality rates. Increased severity of “kyphotic posture” appeared to be associated with a higher risk of mortality.

Discussion: Obviously, the inability to bring the head back to neutral resting position COULD be also caused by factors other than thoracic hyperkyphosis, but what’s important here is that POSTURE appears to be associated with early mortality. Interestingly, thoracic kyphosis was found to be twice as common in men (44%) as women(22%) in this study, which seems to be at odds with conventional thought that thoracic hyperkyphosis is commonly caused by osteoporosis, a condition much more common in women.

The “NORMAL” Thoracic Kyphosis

Obviously, a radiographic evaluation of the T spine gives us a much more accurate idea of the sagittal curvature.

Harrison defined the thoracic kyphosis as ELLIPTICAL in shape, having a Jackson’s (Cobb) angle of 44.2 degrees from T1-T-12. Realizing the difficulty of visualizing both T1 and T12 on the radiograph, Harrison recalculated the model to reflect a thoracic kyphosis of 33.3 degrees between T 3 and T10. 2

Vaz et al, define the average thoracic kyphosis as 47 degrees in healthy young adults. 3

Boseker et al, defined a range of “normalcy” between 20-50 degrees in healthy children. 4

So you can see that opinions vary as to what is actually normal. I encourage interested readers to come to do some reading and establish in their mind what they consider to be the appropriate upper limits of thoracic kyphosis. Personally, I generally tend to view curves in excess of 40 degrees (as measured from T3-T10) as suspect. That’s just my opinion based on my reading of the literature, but 40 degrees is an upper limit you will find frequently cited. Regardless of which value you consider appropriate, it is important to have some sort of firm upper limit, above which you will start considering clinical intervention.

Clinical Management:

A number of tools have been looked at for treating thoracic hyperkyphosis but definitive research is still sorely lacking. Some options you may want to consider are exercise, bracing, and spinal remodeling. Here are two simple, inexpensive tools I have found to be helpful.



Thoracic Rolls

One method of actively addressing the thoracic kyphosis is to simply place the patient over a large foam roll ( our Multipurpose Rolls in the 10-13″ range work well for this), have them raise their hips up, and then “roll” themselves up and down over the roll by alternately flexing and extending the knees. This does two things. First, it introduces a fulcrum effect into the mid T spine to help reduce the kyphosis. Secondly the rolling motion helps mobilize the spine and costovertebral articulations to promote a reduction of kyphosis.

Thoracic Arch

Another method is to simply allow the patient to passively rest over a foam roll or fulcrum for 20-30 minutes. This time frame allows for stretching of the paraspinal tissues to occur and for the spine to “remodel” into a reduced kyphosis. I use our Thoracic Archfor this purpose and we now have lots of doctors using these arches on a regular basis to remodel the T spine.

I generally start with the patient over the arch with the fulcrum at the apex of the kyphosis as shown above. Once they can comfortably relax for the full 20-30 minutes without any problems or soreness, I place a 1″ spacer beneath the arch to raise it up and increase the leverage effect into the mid thoracics. Occasionally, I may end up placing an additional spacer or two as needed to effectively introduce extension into the thoracics.

References:

1.Kado DM, Huang MH, Karlamangla AS, Barett-Connor E, Greeendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. JAGS 2004;52:1662-7

2. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF. Can the thoracic kyphosis be modeled with a simple geometric shape? The results of circular and elliptical modeling in 80 asymptomatic patients. J. Spiinal Disord Tech. 2002 Jun;15(3):213-20.

3. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine.Eur Spine J. 2002 Feb;11(1):80-7.

4. Boseker EH, Moe JH, Winter RB, Koop SE. Determination of “normal” thoracic kyphosis: a roentgenographic study of 121 “normal” children. J Pediatr Orthop. 2000 Nov-Dec;20(6):796-8.

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When a Headache is Not Just a Headache

When a Headache is Not Just a Headache

Chiropractor in Horsham, Pa Blog

In most cases, headaches are minor nuisances that resolve within a short time. However, a headache can on rare occasions be the warning sign of a potentially serious disorder that requires immediate medical attention.

Potentially serious disorders that can produce headache pain include brain tumors, stroke (particularly stroke related to brain hemorrhage or an arterial tear in the neck) and inflammation of the temporal arteries. There are often subtle signs that accompany headaches associated with these conditions that can help people recognize that something more serious is causing their pain.

The American Chiropractic Association suggests people be aware of the signs that a headache is more than just a headache. If you experience any of the following symptoms with your headache, seek immediate medical attention:

— The sudden onset of severe headache that is more intense than any headache you have ever had in the past — Headache that is accompanied by blurred vision, double vision, trouble swallowing or speaking, or severe dizziness — Headache that is accompanied by numbness, tingling, weakness or clumsiness in the arms or legs — Headache that is worsened with lying down — In older adults, headache in the temple area that is accompanied by a feeling of pulsations in that area — Headache that is accompanied by confusion, disorientation or loss of consciousness — Headache that is accompanied by fever — Headache that is accompanied by a severe stiff neck — Headache that is accompanied by persistent or unexplained vomiting — Severe headache in someone over age 50 who does not normally suffer from headaches

“Many people find relief from their headache pain through natural, drug-free chiropractic care and massage therapy,” says Dr. Richard A. Schwartz of Horsham, Pa, a doctor of chiropractic with postgraduate training in neurology. “But in cases where a more serious condition is the root of the pain, it’s vital to identify the warning signs early and to seek immediate medical attention.”

Massage Therapy Horsham, Pa

What can Massage Therapy Really do for your Back Pain? Horsham, Pa /Montgomery County Chiropractor Discusses

If done correctly, massage therapy can work wonders for people with back pain. It may not always be the best choice, and it may not work for everyone. But most people will get great results if the massage therapist has a good understanding of the human body, muscle imbalances, and how to work with them. A word of caution: Massage therapy should never be considered a substitute for proper medical attention. At our Horsham, Pa chiropractic and wellness center we have well trained and certified doctors and massage therapist

As a massage therapist for the past 10 years, I have watched massage therapy grow in popularity and credibility to the point where the practice is now commonplace for those who suffer from back pain. There is no denying the positive effects massage can have on the body. Most massage therapists use a variety of techniques during a session, such as energy techniques and stretching, along with traditional massage. The Touch Research Institute at the University of Miami has coordinated over 100 studies that document the therapeutic effects of massage. One study on massage and back pain found that massage decreased back pain and depression while also improving sleep and range of motion for most joints.

What to look for in a massage therapist

As in many other professions, there are varying degrees of training and qualifications a massage therapist can have. It is up to you to find one who is trained in techniques that actually address issues of back pain. Some of the more popular styles of massage for back pain are: orthopedic massage, medical massage, and something called St. John’s Technique. It would also be a good idea to look for a massage therapist who has comprehensive knowledge of muscle imbalances relating to back pain. Good luck finding one, because they are rare.

How does massage therapy provide relief?

You probably have heard that massage improves circulation, right? But exactly what does that mean? Well, throughout our bodies we have a clear fluid that circulates around the body tissues called “lymph.” At the same time, we may have inflammation, which is an immune response to injury or infection that causes pain, redness, heat, and swelling in the affected area – in our muscles, around our muscles, even in our joints. When lymph and inflammation start to accumulate in the body, the excess fluid will put pressure on blood vessels and our circulation will decrease, limiting blood flow to that area. As the pressure increases, it irritates the nerves, which will cause you to have pain. By helping the body remove excess lymph and inflammation, massage therapy can make your blood flow better, which will reduce the pressure that is irritating the nerves and get rid of your pain.

And as if that were not enough, massage provides a number of other benefits: relaxing the muscles, improved range of motion, improved sleep, and increased production of endorphins, which will improve your mood. Is it any wonder you feel like a million bucks after a massage?

Is massage all you need to get relief?

As helpful as it is, massage has a very limited scope and cannot fully address your condition. It’s great for removing inflammation and providing relaxation, but back pain is a physical condition that requires a physical solution. Sure, a massage therapist may stretch your body a little. But that’s not a substitute for identifying muscle imbalances and postural dysfunctions and then developing a very specific and very targeted action plan to correct them and restore the body’s harmony.

If massage is part of an overall plan that includes working with a trained expert in muscle imbalances and postural dysfunctions, then you may be on to something. Unfortunately, most people don’t go this route. In my opinion, the ones who do will get the best and fastest results.

Is massage right for everyone?

Of course not. There are a number reasons why massage might not be right for you. Please review this list as you consider massage as an option.

1 Fever
2 Infectious Disease
3 Recent Operation
4 Skin Diseases
5 Varicose Veins
6 Cancer
7 Pregnancy
8 Cuts or Abrasions
9 Thrombosis

10 Heart conditions
11 Hypertension
12 Edema
13 Angina
14 Epilepsy

All massage sessions are one-on-one, which gives you the opportunity to converse with the therapist as well as get the personal attention you need to get results. You can ask questions about how you compare with other people. Feel free to ask the therapist what approach he or she will be taking so you know what to expect. The massage therapist has many different techniques to use to deal with your back pain, and some are better than others.

Be aware that sometimes a massage therapist can get distracted with other problem areas. It is in your best interest to keep the therapist focused on your back and associated ailments. You may need to try several different therapists before finding the one that works best for you – and with you.

Top Chiropractors In Horsham,Pa

A Chiropractor Dr. Richard Schwartz located in Horsham, Pa put together a group of Local Respected Chiropractors . The list of these local doctors to horsham, pa are for you “the potential patient”  to make an informed decision  on picking an ethical well respected doctor in your area.

Dr. Richard Schwartz a local horsham chiropractor: Auto and Work Accident Specialist, with advanced training in rehabilitation of injury disabilities. Dr. Schwartz is also certified in Graston technique great for rehabilitation of soft tissue injuries like tennis elbow.

Dr. Marc Schwartz located at the Pavilion in jenkintown, pa is one of the TOP Chiropractors to make this list of chiropractors local to horsham, pa  he has is masters in  Nutritional Therapy.
Dr. Marc Schwartz and staff welcomes you to our practice. As a leading wellness practitioner for over 20 years, we want to make it as easy as possible to help you achieve your optimal health. That’s why we’ve developed this information-rich website – to prepare you for visiting our practice and to keep you informed about the best health practices available. On these pages, you’ll find information about our operations, such as hours, payment policies and a link to request an appointment along with a complete library of information ranging from kinesiology to nutrition as well as treatments and technologies related to your health.

Dr. Keith Miller Auto and Work Accident Specialist, with advanced training in rehabilitation of injury disabilities.He currently serves as the Co-Captain of the Sports Medical Team for the Susan Komen Breast Cancer 3-Day Philly. Dr. Miller spoke before the Philadelphia Dental Association Convention in both 2008 & 2009 on common injuries in a dental practice.

Dr. Spine.net