Interesting challenges of the day1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side;
luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest. 4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift. 6. I too have had serious lower back issues, luckily fixed by my own chiropractor;
so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too. 8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.
10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks. 11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well. 12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder. 13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90? And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.
Achy and sore joints are the hallmarks of osteoarthritis. And one of the most frustrating aspects of the joint pain related to arthritis is when it occurs in the morning. Often, the pain can make it hard just to get out of bed.On the positive side, morning joint pain related to osteoarthritis doesn’t last long. “The good news is that the amount of morning stiffness with osteoarthritis is less than 5 to 10 minutes as a rule,” says Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland. And, he adds, the more you move around, the more quickly you'll loosen up.Of course, just moving around is easier said than done if you have osteoarthritis. Here are simple strategies that can make your mornings with arthritic joint pain more manageable:1. Do more the night before. One easy way to simplify your morning routine is to do the heavy lifting before you go to sleep — like packing your briefcase, laying out clothes, setting the coffeemaker, and setting the table for breakfast.“
I recommend that all of my patients ready things the night before. I do that myself,” says Robin K. Dore, MD, a rheumatologist and clinical professor of medicine at UCLA. “That way, if they are too stiff in the morning or need to sleep in a little if they had a bad night, there is very little that needs to be done before they can start their activities of daily living.”2. Try supportive sleep accessories. Lumbar and cervical pillows are the two main supportive devices our experts recommend to banish morning joint pain.“Sleep aids can definitely be helpful by cushioning tender areas and supporting areas that are painful to move if unsupported,” says Dr. Dore. “Be certain to try different cervical pillows before purchasing one, as individual preferences vary.”3. Perfect your posture. You can avoid a lot of arthritic joint pain in the morning by simply sleeping in the correct position. “The best sleeping posture for an arthritic spine will vary based on the unique aspects of the individual,” says Kirt Kimball, MD, an orthopedic surgeon in Orem and Provo, Utah.
“As a rule, lying on your side with cervical and slight lumbar support allows one to flex or extend as needed to find that ‘best’ position.”4. Stretch away the pain. Stretching away arthritic joint pain before you even get out of bed can minimize the pain you experience once you get on your feet. “When doing stretches, it is important to gradually apply stretch rather than bounce against the end point of a particular muscle group,” says Dr. Kimball.“As you attempt to stretch each muscle group, whether it be back, hip, thigh, knee, ankle region, or upper extremity regions, first consider the normal range of motion of that joint. Try to isolate the affected joint such that you are only working one joint at a time, and then take it to the extreme, gradually, and then gently push against that extreme to slowly improve the range of motion. All stretches should be done decisively yet gently and avoiding impact or bounce.”5. Take your time. With osteoarthritis, it’s often best to work your way up to getting out of bed rather than bounding out of bed immediately in the morning.“
Roll to your side; sit up in bed using your arms for support; put your feet on the ground; gently apply force to your feet as you push up on the edge of the bed with your hands,” says Kimball.6. Try a hot shower. “A hot shower is a pleasant way to apply heat energy to your body all at once,” Kimball says. “It can be focused on sore muscles, such as directing the flow of water to a particularly sore muscle group. It can reduce spasm and thus reduce pain by not only the therapeutic effect of heat but also the massage effect of the water pressure.”7. Make your mornings easy. When it comes to osteoarthritis-related joint pain in the morning, good posture applies not only to sleeping but also to getting up and moving around.“The human body was designed for upright functioning,” says Kimball. Working or standing in an upright posture with shoulders back and belly in is the right structural base to move from. “You can’t use your arms well unless they are attached to a stable foundation, including the shoulder and spine,” Kimball explains.
“This applies to the lower extremities as well. We weren’t designed to function at our best bent over or stooped over.”8. Try a new mattress. In some cases, a new mattress can improve your morning joint pain, but make sure to test carefully before you buy.RELATED: 7 Factors That Raise a Man's Risk for Osteoporosis“I advise my patients to get a firm but not an extra-firm mattress,” says Dore. “Some patients prefer a pillow-top to place on top of their mattress." She adds that some patients also like the flexibility of a mattress with memory foam, like the Tempur-Pedic brand, but others find these uncomfortably warm.9. Adjust your medication schedule. If your morning pain is severe, your doctor may advise you to take your arthritis medication at the end of the day.“While most patients take their arthritis medicines in the morning with breakfast, some people might find that taking it in the evening — with food, of course — can lessen the amount of stiffness they have in the morning,” says Dr. Wei.If morning pain gets in the way of starting your day, do as much as you can the night before — your mornings will be less frantic