Whiplash 101

The little brain that could

Life has been amazing and I wanted to update those who have wondered what happened to me.

I matriculated at Oxford October 15th. As the physician from Cambridge standing beside me so aptly stated, it was my ultimate screw you, I made it anyway statement to the world… from a person with a TBI… Others can make it too, the race does not always fall to the fastest and the brightest. The determined ones that persevere also have a place but they procure it at great cost, almost never without opposition and always with help from those that surround them with hope and compassion. The greater price in my eyes was to remain a dependent victim without respect or autonomy. I was spurred on to not accept the victim mentality but to reach higher just as I was until I could do better, with the help of God I shall continue… Really thankful to Oxford for accepting me, their kind ,helpful support is awesome…

I got here through some unusual circumstances which just goes to show that even when you think it is over destiny  is waiting to be claimed.

My first challenge  came when I was dumped without pay by a spinal organization who decided to focus on being a patient’s rights org to promote non FDA approved  stem cells paid for by vulnerable patients. There was ethical  disagreement and I was devastated. I was later to take neuroscience, genomics, bioethics  and some cell biology  courses where I learned how fortunate I was to escape. At the same time the university I applied to had funds cut and the department that welcomed me was phased out.

My sponsors and friends urged me to apply to Oxford. At first I was too discouraged to try but then  I saw the Center for Evidence Based Medicine. This was exactly what I was looking for  as I determined to find ways to put evidence into practice. I applied and was accepted.

It is interesting here at Oxford, they are gracious and incorporate an atmosphere of learning without disdain. It is a haven for curious outspoken people to share ideas and an Oasis for those of us who want to do science and medicine with ethics and excellence.

Aaron and Thomas, our classmates arranged for us to go to a lovely dinner at St Cross…my first. I ended up sitting next to the college Master,  Sir Mark Jones,  he was a great dinner companion and very charming. His friend was a medical professor who has also taken some EBM classes. We shared with them that EBHC was positioned to benefit and influence the world even to third world countries.

From this meeting I learned ways in which insulin could be kept cold in villages in Asia with no electricity. We can build solar refrigerators for very little money and the people can run them. It will save lives. In my life patients, principles and people matter.

Those of us from EBHC shared how we got there and some of our backgrounds it was beautiful to see how each of us will have the opportunity to be a change maker in our corners of the world.

I want to encourage you all to follow your dream and  remember there is a place for you!

 By Richard DonTigney

The lack of movement in the sacroiliac joint is a myth. When walking the pelvis moves obliquely to the line of travel, to increase the length of the stride. The sacrum moves on the asymmetric pelvis to drive counter rotation of the trunk to decrease loading forces. Pelvic dynamics has profound effects on normal gait.  

The joint is vulnerable to injury through minor trauma only in anterior rotation of the innominates on the sacrum.  Idiopathic low back pain is a commonly overlooked, reversible dysfunction in anterior rotation, usually bilateral.   A diagnosis of dysfunction can be made simply by identifying a single painful point at the posterior inferior iliac spine that is caused by a vertical shear on the conjoint origin of the piriformis muscle and tearing of the capsule at S3. See pain patterns here. The anterior rotation will loosen the iliolumbar ligaments, destabilize L4,5-S1 and increase shear and torsion shear to the disks.  Correction restores stability.

Full correction in posterior rotation will provide immediate relief of pain.  More than three treatments are seldom necessary.  Stabilization of the unstable SIJ can be obtained with five to six sessions of prolo specifically to the long posterior sacroiliac ligaments.  Prolo to the iliolumbar ligaments without correction of the SIJ first can tighten the joint in the uncorrected position and may prevent correction.

Anyone not properly treating dysfunction of the sacroiliac joint is perpetuating chronic low back pain.  X-rays of innominate movement on the sacrum are published on-line at www.thelowback.com/how.htm#movement

 By Amy Price PhD  

Regenerative and preventive medicine can have an impact on quality of life by reducing neurodegeneration, optimizing the genetics we are dealt and by giving us the best shot at deflecting the damage trama has created. It appears that balance provides keys to longevity. It is tempting to chase after the newest ‘super antioxidant’ , cell treatment, medical device  or pharmaceutical in hope of the cure. The most exciting concept is the power of the human body to heal from the inside out. I have noted  the mostly  mediocre results  of multitudes of  patients  who have tried to juice their way to health, get injections of souped up grown out stem cells, live life in altered oxygen environments and inject chemical concoctions in hopes of staving off destruction.    

Recently I was invited to  join the herd of hardcore calorie restriction regimes. I did a little study on this and the results were interesting. There may be a slight bias here since I possibly value dark chocolate above hard science and only wish it was included as a food group! The study of interest was not hard core starvation but simply allowed animals to eat without limits and then the maximum amounts were reduced by 30% over a lifetime. None of the animals were underweight, they were allowed what was optimal for survival nothing more. A team of miners trapped underground in Chile were fed the same way and when they were rescued they were in remarkably good shape.  The impact of diet restriction and not starvation is illustrated by the monkey study below:    

The longitudinal Rhesus monkey (RM) study is an adult-onset study from 1989+ which explored the effects of 30% Caloric restriction (CR) without malnutrition on RM (Colman, Anderson, Johnson, Kastman, & Kosmatka 2009). Metabolic disorders and rising obesity incidence rates are complicated by the drive to eat until satiation is reached. Sedentary lifestyles, stress and environmental are contributing factors (Mattson, & Magnus, 2006). Resistance to age related illness and mortality in RM was addressed. A 5 page journal submission necessitates sharing selectively when considering research spanning 20 year+. Earlier CR research used rodents, mice, worms, flies, and yeast, however small human studies name CR as a factor for cardiovascular benefits (Colman et al, 2009).   

The 30 mature male monkey study (1989) was expanded to include 30 females and an additional 16 males (1994) to increase statistical power and enable gender CR effects. RM matures at 7-14 years with mean lifespan of 27 years in captivity and 40 years in the wild. In 2009, 50% of controls and 80% of the CR group were still alive (Colman et al, 2009). CR was found to delay onset and reduce incidence of diabetes, cardiovascular disease, cancers and specific grey matter (GM) brain atrophy. Slowing or reversing the ageing process as evidenced by CD, metabolic disorders and neoplasms could benefit the economy. CR induced metabolic reorganization and regulation may reveal significant cross species metabolism regulatory factors and inform future research on life-span and quality life.    

Ageing effects in yeast, worms, flies or mice CR studies indicate molecules responsible for signalling including mTOR,PGC-1a and SIRT1 are sensitive to nutrient changes (Colman et al, 2009). These mechanisms were introduced but not addressed in the study. They are thought to optimize mitochondrial function by improving synaptic function. These findings will  be important if found to apply to primates and then  humans (Colman et al, 2009) CR animals (below) looked younger and healthier at 27.6 years than  controls as noted by thicker fur, elastic skin, posture, eye clarity, skin colour oxygenation, bone density seen through shoulders/hips/spine/jaw and less joint swelling in CR animals. See photo top left. 

Subjective evidence was augmented by decreased mortality rates and age related conditions in CR protocols for RM. Figure 2 shows glucose impairment was not present in CR animals,  cancer and CD were reduced. CR reduction correlating with lower glucose impairment/neoplasia/CD rates would be valuable to determine for later correlation in human studies. Diagram B (3) shows CR age related deaths 1:3 ratio. Figure C (4) shows all deaths. The higher non disease related deaths of CR animals to approximately age 20 is of concern and may be why CR effects on overall mortality failed to reach significance (p=0.16). The ratio of age related differences in mortality in contrast to this insignificance warrants further investigation.  

Age associated diseases in RM are consistent with human ageing processes specifically glucose impairment, cancers and heart disease. Assessments included nutrient intake, BMI, blood pressure, activity levels, endocrine, serum, glucose level profiles and necropsy. Animals were observed 2x daily. They had regular electrocardiograms, brain MRs, and x-rays (Colman et al, 2009). Inclusions of EEG, echocardiogram and MRI colonoscopy could yield improved preliminary disease results. Stress echo may yield early cardiac valve impairment and angiography stroke inducing blockages. EEG could measure temporal aspects of brain function and determine if impaired timing resulted in attention, coordination or processing deficits. Colonoscopy could explore whether early treatment or CR affected survival rates.    

Lean muscle mass and metabolic function was preserved in CR animals. Pre-diabetic conditions at baseline resolved in the CR condition. Neoplasm incidence and cardiovascular disease were reduced by 50% with CR. Human age related brain atrophy isn’t accurately replicated using small animals (Colman et al, 2009). Higher cognition, state/trait differences, working memory capacity and variances in somatosensory architecture complicate parallels between animal and human studies (Yankner& Loerch,2008). Common grey matter atrophy patterns exist so (GM) volume was measured. Age related cortical and temporal atrophy was resistant to CR.  Significantly less age related atrophy was found in areas of executive function and motor pathways (Colman et al, 2009).   

It is not known if genomics were applied to recruit genetically dissimilar animals to constitute a random population although animals were assigned to CR or control in a random manner. Diet was individualized in reference to volume consumed. We are not told if animals were allowed to graze or if food was given at specific times nor was there information given on sleep times and cycle differences (Froy & Miskin, 2010). This may influence insulin levels, circadian rhythms and preferred amount consumed per meal (Mattson, Chan, Duan, Aging, Joseph, Cole, G., et al. 2009). Nutritional needs over lifespan and personal variations in nutrient type were not identified (Mattson & Magnus, 2006). In animals requiring medical treatment, information was not forthcoming in relationship to drug/strategy interactions on factors measured (Heading, 2008). Libido/fertility levels with CR and CR effects on offspring DNA were not discussed.   

Identification of longevity factors for RM not in captivity and whether CR benefits are tied to lifetime commitment or are developmentally sensitive would be useful for future study. Specific restriction of foods/groups such as high fats and sugars may be as beneficial as CR (Molteni, Barnard, Ying, Roberts & Go, 2002). Linking CR application to specific phenotypes may increase CR effects (Prolla & Mattson, 2001). The higher incidence of premature deaths in CR animals could be investigated by comparing vestibular and motor function of CT animals with controls.   

Although this study may inform human ageing research, cross-species generalizations need cautious application. Human variations in genomics, phenotypes, complex cognition, stressors, diet, social responsibilities and exercise may mean successful RM studies do not transfer to humans (Carlson, 2007). It still may be reasonable to consider CR in order to enjoy the possible subjective and objective benefits described in the study.   

 References:   

 Carlson, N. R. (2007) Physiology of Behaviour, 9th edn, Pearson International, Allyn & Bacon, Boston.   

Colman  RJ,  Anderson  RM,  Johnson  SC,  Kastman  EK, Kosmatka  KJ,  Beasley  TM,  llison  DB,  Cruzen  C,  Simmons  HA, Kemnitz  JW,  Weindruch  R.  ‘Caloric  restriction  delays  disease onset and mortality  in rhesus monkeys’. Science. 2009; 325:201‐204   

Froy, O., & Miskin, R.(2010). Effect of feeding regimens on circadian rhythms : Implications for aging and longevity. Review Literature And Arts Of The Americas, 2(1), 7-27.   

Heading, C, (2008)  ‘Addiction potential of medicinal drugs’, GUIDE TO ADDICTION, 1-47.SD805 (eds) ,2009, Open University, UK, Milton Keynes   

Mattson, M. P., & Magnus, T. (2006). ‘Ageing and neuronal vulnerability’. Neuroscience, 7(April). doi: 10.1038/nrn1886.   

Mattson, M. P., Chan, S. L., Duan, W., Aging, B., Joseph, J., Cole, G., et al. (2009). Modification of Brain Aging and Neurodegenerative Disorders by Genes , Diet , and Behavior. Physiological Reviews, 637-672.   

Molteni, R., Barnard, R. J., Ying, Z., Roberts, C. K., & Go, F. (2002). A High-Fat , Refined Sugar Diet Reduces Hippocampal Brain-Derived Neurotrophic Factor , Neuronal Plasticity ,. Science, 112(4), 803-814.   

Prolla, T. A., Mattson, M. P., Prolla, T. A., & Mattson, M. P. (2001). Molecular mechanisms of brain aging and neurodegenerative disorders : lessons from dietary restriction. Review Literature And Arts Of The Americas, 24(11), 21-31.   

Yankner BA, Lu T, Loerch P. Annu Rev Pathol 2008;3:41.   

Figure 1 A&B are control animals C&D are CR all at 27.5 years (Colman et al 2009)Figure 1 A&B are control animals C&D are CR all at 27.5 years (Colman et al 2009)

 

Brain and Body Repair Together

By Amy Price PhD

 

 

 Brains can be empowered and grow with healthy lifestyles and targeted training. The stemcells of the body are mobilized into action by creating favorable conditions and a climate for growth. Like wise pain, social rejection and inflammation can slow improvement in healing factors and getting a head start by cultivating health brain and body lifestyles has been shown to stave off the onset of certain dementias

Research on cognition that shows transfer of training and increase in quality of life  can be very successful when individual differences are professionally assessed and programs targeted to individuals.  This is why one size fits all ‘brain training’ shows limited success. The brain requires novelty and positively graded accomplishment to reach full potential. [1-4].  

Brain age related deficits are noticed primarily in the prefrontal and parietal cortical regions  which tend to shrink as individuals age with men exhibiting more extensive shrinkage than women [5]. These areas are crucial for planning and for connecting input from other brain areas. The areas of shrinkage initially demonstrate increased regional activation. This may be a time sensitive window where neuroplasticity growth factors can be leveraged to best advantage. Combining several strands of behavioral and neuro-imaging evidence, the argument can be made that functional plasticity has the capacity to alter the course of cognitive aging. Losses in regional brain integrity may drive functional reorganization through changes in processing strategies and domain specific cognitive training.

These same deficits can be present in brain injured persons but the route to successful training would take a different though just as effective path.

Factors such as cognitive training, regular exercise, nutrition enrichment and  positive relationships can increase Cortical thickness . These findings were first published on animal studies but are also noted in human studies [5-10].  A combination targeted personalized brain and physical training produces specific volume changes in white and grey matter [9]

Physical exercise boosts the brain’s rate of neurogenesis throughout life, while mental exercise increases the rate at which those new brain cells survive and make functional connections into existing neural networks.[7-10] Both physical exercise and the challenge from mental exercise increase the secretion of nerve growth factor, which helps neurons grow and stay healthy.[8-10] This makes sense if we think of how exercise helps to clean out the sludge and provide oxygen so the body can make more effective use of tissues needed for regeneration and repair.  In fact scientists are now finding compounds that can increase our stem cells within the body and even then are finding that targeted solutions are needed for optimum stem cell growth health and production [14]

Nyberg found that although older brains exhibit less plasticity than do young brains overall, the benefits of training—particularly domain-specific training—can be substantial and durable [13]. Studies are showing these gains to be of 5 years + More- over, the training benefits were found to be similar to the amount of decline anticipated over 7–14 years [3, 12, and 13].

References

1.            Posner, M., & Rothbart M. Educating the human brain. Washington, DC US: American Psychological Association.; 2007:189-208. doi:10.1037/11519-009

2.            Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(19):6829-33. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18443283

3.            Willis SL, Tennstedt SL, Marsiske M, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA : the journal of the American Medical Association. 2006;296(23):2805-14. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17179457

4.            Gordon E, Arns M, Paul RH. Research Report THE INTEGRATE MODEL OF EMOTION, THINKING AND SELF REGULATION: AN APPLICATION TO THE “PARADOX OF AGING”. Thinking. 2008;7(3):367-404.

5.         Greenwood PM. Functional plasticity in cognitive aging: review and hypothesis. Neuropsychology. 2007;21(6):657-73. http://www.ncbi.nlm.nih.gov/pubmed/17983277

6.            Joseph J, Cole G, Head E, Ingram D. Mark P. Mattson, Sic L. Chan and Wenzhen Duan. Physiological Reviews. 2009:637-672.

7.            Kramer AF, Bherer L, Colcombe SJ, Dong W, Greenough WT. Environmental influences on cognitive and brain plasticity during aging. The journals of gerontology. Series A, Biological sciences and medical sciences. 2004;59(9):M940-57.: http://www.ncbi.nlm.nih.gov/pubmed/15472160.

8.            Kramer, AF; Erickson KI, Colcombe SJ (2006). “Exercise, cognition, and the aging brain”. J Appl Physiol 101 (4): 1237–42. doi:10.1152/japplphysiol.00500.2006.

9.             Valenzuela MJ, Sachdev P, Wen W, Chen X, Brodaty H. Lifespan mental activity predicts diminished rate of hippocampal atrophy. PloS one. 2008;3(7):e2598. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18612379.

10.          Ernst C, Olson AK, Pinel JP, Lam RW, Christie BR. Antidepressant effects of exercise: evidence for an adult-neurogenesis hypothesis? Journal of psychiatry & neuroscience : JPN. 2006;31(2):84-92. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16575423

11.          Ball K, Edwards JD, Ross La. The impact of speed of processing training on cognitive and everyday functions. The journals of gerontology. Series B, Psychological sciences and social sciences. 2007;62 Spec No(I):19-31.  http://www.ncbi.nlm.nih.gov/pubmed/17565162.

12.          Willis, SL; SL Tennstedt, M Marsiske, et al. (2006). “Long-term effects of cognitive training on everyday functional outcomes in older adults”. JAMA 296: 2805–14. doi:10.1001/jama.296.23.2805.

13.          Nyberg, L. (2005). Cognitive training in healthy aging: A cognitive neuroscience perspective. In R. Cabeza, L. Nyberg, & D. Park (Eds.), Cognitive neuroscience of aging: Linking cognitive and cerebral aging. New York: Oxford University Press.

 14.         New Scientist http://www.newscientist.com/article/dn16383-drugs-unlock-the-bodys-own-stem-cell-cabinet.html}

Retrain Your brain and Increase Joy and Thinking Skills!

By Amy Price PhD

  Do you need to get your life back and restore relationships after trauma? Extensive research indicates our brain needs to overcome the negativity bias ingrained through the fight/flight response produced by trauma or social rejection to operate at maximum potential. It is more than positive thinking as the mind has a specific ratio of positive to negative input it accepts plus the input must be genuine to release the feel good chemicals that promote brain learning and healing.  Many people involved in an auto crash must fight for insurance rights and social acceptance during an era of limited capacity and chronic pain. All these aspects take a critical toll on the brain and promote inflammation cascades that lead to long term functional loss. The great news is that with targeted brain training in small manageable steps you can get back the edge taken from you though trauma, bad relationships, or serious illness. Your brain wants to work for you!

Clicking on Train Your Brain , Save Your Mind here will take you to a fascinating short video on the power of personal brain optimization and contains a clinically validated assessment tool. This video is presented by Dr Evian Gordon of Brain Resource Company  and speaks about the highly acclaimed wellness program My Brain Solutions. It is well worth investigating, in less than 15 days I showed improvement on several measures of cognition. If you would like to sign-up for MyBrainSolutions please email me ….read on for why training your brain matters…Our minds and brains become so starved for approval and acceptance that we accept input and relationships that are harmful and not genuine.

 Your own brain even when it is damaged can pick up emotional cues in 1/20 of a second  which will determine how we respond to others.  How can you tell the difference between a forced and genuine smile? For a smile ask your self if the eyes crinkle slightly and the pupils enlarge, smiling with only the mouth is not genuine expression. Interestingly this insight has been validated by multiple behavioral, FMRI, GSR and QEEG studies, yet like many insights it is rooted in wisdom passed down from successful individuals who are at peace with themselves. Dr David Whitehouse, an eminent Harvard trained Psychiatrist put is this way  ”PEOPLE NOT ONLY SEEK AN EMPOWERING MIND, BUT ONE THAT IS AT PEACE WITH ITSELF”.  My Brain Solutions can help you learn to discern emotion and train your brain from a negative to a positive bias and offers a clinically validated personal assessment with a presonalized prescription to increase your brain function. Dr Evian Gordon states in his book ‘The Brain Revolution’ that  “THE DIFFERENCE BETWEEN AND EXPERT AND A NOVICE LEARNER IS A MODEL” One critical component of cognitive skill is one’s ability to speedily reframe or re-appraise the circumstances that surround you. People that successfully reframe have better life satisfaction and long term survival rates than those who are fixated on negative events, this ability can be trained.

Research on cognition that shows transfer of training and increase in quality of life is dependent on carefully assessing individual differences with  clinically accepted tools which provide personalized training to meet these perimeters[1,2,3,4,]

Learning and novelty are partners yet many brain fitness programs offer rote repetition of weak areas without variation in task or content in a bid to target learning, However research shows us this is not the way meaningful learning occurs. Tasks must be individually challenging to hold engagement and yet structured enough to be doable. Ideally tasks will adapt to changing learning curves to build neuroplasticity. The best learning capitalizes on emotional and intellectual strengths already present while strengthening areas of weakness in a positive atmosphere. For example, teaching a university student mnemonics and concept mapping may make the memory more efficient however teaching an individual with organic damage or early dementia how to remember names and faces with a mnemonic is an exercise in futility.

Specific training alone can lead to plastic changes in the brain as demonstrated by expert Braille readers who show an enlarged hand area and smearing of finger representations in the somatosensory cortex. This result was observed in expert, but not in novice Braille readers suggesting that the training and not the blindness which leads to the changes in cortical representation [5]Similar domain specific results were noted in London taxi drivers and expert violinists. Kramer et al [6] states recruitment of additional brain regions helps performance only if the recruited area complements processing of the task in question. This is likely why rote memorization fails to increase working memory whereas training that targets attentional networks and processing speed increases working memory limits. We are incapable of processing in depth what we have not attended to and our capacity for material attended to is limited by the speed at which we process stimuli.

My Brain Solutions has an inviting Dashboard where you can  Empower Your Own Life….See you at the Dashboard!

References:
1. Posner, M., & Rothbart M. Educating the human brain. Washington, DC US: American Psychological Association.; 2007:189-208. doi:10.1037/11519-009

2. Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(19):6829-33. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18443283

3. Willis SL, Tennstedt SL, Marsiske M, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA : the journal of the American Medical Association. 2006;296(23):2805-14. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17179457

4. Gordon E, Arns M, Paul RH. Research Report THE INTEGRATE MODEL OF EMOTION, THINKING AND SELF REGULATION: AN APPLICATION TO THE “PARADOX OF AGING”. Thinking. 2008;7(3):367-404.

5. Greenwood PM. Functional plasticity in cognitive aging: review and hypothesis. Neuropsychology. 2007;21(6):657-73. http://www.ncbi.nlm.nih.gov/pubmed/17983277

6. Kramer AF, Bherer L, Colcombe SJ, Dong W, Greenough WT. Environmental influences on cognitive and brain plasticity during aging. The journals of gerontology. Series A, Biological sciences and medical sciences. 2004;59(9):M940-57.: http://www.ncbi.nlm.nih.gov/pubmed/15472160

cold light laser

 By Amy Price PhD

Laser  therapy has been reported helpful in wound healing and chronic pain. It is a fast, painless modality which can be administered by a medical professional or self administered in some localities by a patient trained and licensed in laser protocol. The light that the laser uses is not visible to the naked eye and special laser light spectrum goggles are needed. They are sensitive to the spectrum of the laser used. According to the Cochrane report results for wound healing and chronic pain relief are evident however more study is needed to determine protocols for effectual wave lengths and time exposure 

What is a cold light laser?

Low-level laser light is compressed light of a wavelength from the cold, red part of the spectrum of electromagnetic radiation. It is different from natural light in that it is one precise color; it is coherent (it travels in a straight line), monochromatic (a single wavelength) and polarized (it concentrates its beam in a defined location or spot). These properties allow laser light to penetrate the surface of the skin with no heating effect, no damage to the skin and no known side effects. Rather, laser light directs biostimulative light energy to the body’s cells which the cells then convert into chemical energy to promote natural healing and pain relief. 

These are ways laser treatment has been found to help

Speeds Up Tissue Repair:   Increased energy to the cells means increased cellular activity for all of the cell’s components that rely on this energy including collagen formation. Speeding up tissue repair  means less scar tissue formation. 

Increases Endorphins: Endorphins can  produce analgesia (pain relief) and feelings of well-being. They are known as the bodies natural  pain killers. 

Increased Lymphatic Drainage:  Studies have shown that cold laser therapy can increase the size of the lymphatic ducts thus facilitating protein waste removal. 

Increased Blood Flow: to the tissues because of increased capillary formation. This helps healing. The laser affects deeper tissues as well including  muscles and tendons. 

It appears Laser can generate  relief for chronic pain treatment

Relieve nerve pain and trigger points without surgery or chemicals

By Amy Price PhD

IMS is similar to acupuncture except that the treatment does not rely totally on meridians but is based on a physicians training in anatomy. trigger points and the central nervous system. It can be treatment orientated as well as a useful minimally invasive diagnostic tool for neuropathic muscle pain.

Trauma and chronic pain often produces muscle shortening. These shortened muscles can press on and irritate the nerve. Even though this pressure may seem slight and be difficult to measure it can be the source of excruciating pain. This pressure builds up over time causing all kinds of problems like making the nervous system super sensitive. This can cause sensitivity to pain in other areas of the body. To get an idea of how this works think about wearing a pair of slightly snug shoes. At first you feel nothing but as the day goes on that slight pressure becomes something that can not be ignored. With the shoes you can rip them off and toss them into the trash, but when pressure mounts inside the muscle pushing on the nerve there is nowhere for it to go.

IMS works on the premise that supersensitive area can be desensitized. IMS releases muscle shortening by dry needling the sensitive areas with tiny acupuncture needles. Penetration of a normal muscle is relatively painless however an afflicted muscle responds to the needle with a slight cramping sensation. This stimulates a ‘stretch receptor’ which produces a reflex relaxation response resulting in a lengthening of that muscle fiber. The needle also causes an electric potential which travels to the nerve and potentially resets it to normal function. The other thing that happens is the needle produces a minute wound which causes increased blood flow to the area to enhance circulation and initiate healing. For FAQs about IMS or research links click here Does it work? The answer seems to be that for some people it does. For research links  New treatments with prolotherapy and adult stem cell treatment may produce results. Diet can help with pain Specific supplements can help ligaments and tendons heal to take the stress off overworked muscles

Ligament injury refers pain see chart

 By Amy Price PhD

The ligaments act like duct tape to hold our bones and joints together.  When ligaments lose their elasticity the bones and joints move too much and irritate the structures around them. Ligaments provide boundaries for movement.  For example when we bend our fingers backwards the ligaments will stop us from pushing them too far back and breaking the bones. It is this way with most of the joints in our bodies. The ligaments cause them to work within a safe range of motion. When one of the ligaments is torn or stretched, the excess movement will cause pain and swelling. In an injured joint and you may notice more popping, cracking or even a grinding feeling.  The joint may have become unstable.

 In the neck and spine, ligaments are crucial for holding vertebrae together. Spinal ligaments are especially vulnerable to overstretching or tears in a car wreck.  If you experience these symptoms after a wreck you may want to be examined for a ligament injury:

•             popping, cracking, or grinding in the neck with movement

•             pain or spasms that get much worse with activity

•             Numbness or tingling into the hand(s) or feet that gets worse with activity or accompanied by popping, cracking, or grinding.

 Flexion-extension x-rays, or digital motion x-rays can be a good way to help diagnose ligament instability.  A good physician will want to test the spine segment by segment to test for stability and this is  an essential step for enabling accurate treatment. The diagram above shows some of the ways ligament pain is referred in the neck area. For referred pain in other body areas look at our dermatome pages

Treatment usually proceeds as follows:

•             Specially trained medical practitioners such as Chiropractors or Osteopaths can mobilize any stiff segments that may be overloading the unstable segment

•             Posture Training can improve stability, injury can increase tightening of muscle structures which can cause guarding of the painful area. This throws posture off balance and  can aggravate instability.

•             Strengthen any weak, deep supporting muscles (like multifidus) that may be allowing too much movement. Core strength exercise like modified Pilates with the guidance of a trained physiotherapist can be helpful

•             Don’t be talked into mobilizing or manipulating an unstable segment as this can bring a temporary improvement but over time can make things worse. Sometimes bracing is used and while this may seem like a good solution to reduce pain initially prolonged bracing can cause further weakening of the surrounding muscles and later slow recovery.

•             Prolotherapy may prove helpful, adult stem cell therapy using your own cells has been reasonably successful in initial trials.

•             Surgical stabilization is sometimes used when no other treatment brings improvement.

By Simon Roulstone

 This page is offered by Simon who became a quadriplegic after a car crash. He has a phenomenal site that helps people understand the complexity of spinal damage and shows how you can choose to do what you want to do in life anyway. Some people let life happen others make things happen. Simon makes things happen! Please visit his site by clicking on the banner on the bottom of this page

This page describes the role of dermatome and myotome locations and how you can have pain at one area when the damage is really somewhere else. We urge people to take a dermatome map into your doctor  and show them the pain patterns

 Spinal nerves have motor fibers and sensory fibers. The motor fibers innervate certain muscles, while the sensory fibers innervate certain areas of skin. A skin area innervated by the sensory fibers of a single nerve root is known as a dermatome. A group of muscles primarily innervated by the motor fibers of a single nerve root is known as a myotome. Although slight variations do exist, dermatome and myotome patterns of distribution are relatively consistent from person to person.

myotomes-dermatomes by permission Apparelyzed.com

Myotomes

Each muscle in the body is supplied by a particular level or segment of the spinal cord and by its corresponding spinal nerve. The muscle, and its nerve make up a myotome. This is approximately the same for every person and are as follows:

C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).

C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .

C6 is for bending the wrist back.

C7 is for straightening the elbow.

C8 bends the fingers.

T1 spreads the fingers.

T1 –T12 supplies the chest wall & abdominal muscles.

L2 bends the hip.

L3 straightens the knee.

L4 pulls the foot up.

L5 wiggles the toes.

S1 pulls the foot down.

S3,4 and 5 supply the bladder. bowel and sex organs and the anal and other pelvic muscles.

Dermatomes

Dermatome Apparelyzed.com used by permission Click to enlarge (2009) C

Dermatome is a Greek word which literally means “skin cutting”. A dermatome is an area of the skin supplied by nerve fibers originating from a single dorsal nerve root.  The dermatomes are named according to the spinal nerve which supplies them. The dermatomes form into bands around the trunk but in the limbs their organisation is more complex as a result of the dermatomes being “pulled out” as the limb buds form and develop into the limbs during embryological development.

In diagrams or maps, the boundaries of dermatomes are usually sharply defined. However, in life there is considerable overlap of innervation between adjacent dermatomes. Thus, if there is a loss of afferent nerve function by one spinal nerve sensation from the region of skin which it supplies is not usually completely lost as overlap from adjacent spinal nerves occurs: however, there will be a reduction in sensitivity.

Cervical spine showing nerve compression from Wikipedia 2009

Anterior cervical diskectomy is an operation performed on the upper spine (neck) to relieve pressure on one or more nerve roots, or on the spinal cord. The procedure is explained by the words anterior (front), cervical (neck), and diskectomy (cutting out the disc).

ACD is  a surgery used  as neck and arm pain, among other symptoms, may occur when an intervertebral disc herniates. This happens, either suddenly with injury or slowly over time, when some of the disc’s jelly-like center (the nucleus pulposus) bulges or ruptures through its tough, fibrous outer ring (the annulus fibrosus) and presses on a nerve. When a disc ruptures in the cervical spine, it puts pressure on one or more nerve roots (often called nerve root compression) or on the spinal cord. This pressure causes symptoms in the neck, arms, and even legs. Further pressure may be caused by rough edges of bone, called bone spurs, that naturally build up around some herniated discs. If at all possible it is best to not have this done unless it is pressing on a nerve or the spinal cord, if it is a surgeon will often advise the surgery to avoid further damage to the nerve or spinal cord.

In this operation, the cervical spine is reached through a small incision in the front of your neck. After the soft tissues of the neck are separated, the intervertebral disc and bone spurs are removed. The space left between the vertebrae may be left open or filled with a small piece of bone. In time the vertebrae may fuse, or join together.

If used, the pre-formed bone graft may be obtained from a bone bank. It will not be rejected by your body, because it is avascular (contains no blood cells) or artificial bone protien can be used. In some circumstances, or if your surgeon prefers, the bone graft might instead be removed from your own hip through a second incision.

Anterior cervical diskectomy is not the only solution. A minimally invasive surgery can be done which leaves almost no scar. This link will lead to where you can see a four minute movie of the procedureThe results are best with single level sugery. There are also procedures which are used to patch tears. Autologous stem cell therapy (using your own stem cells) and platelet rich plasma or PRP can  be used to fix tears which can be a major source of pain because of the leakage of fluid which irritates the surrounding tissue.

Some people have artificial disks inserted , rather than  a diskectomy or fusion. A great place to get information on this option is the ADR support community