Tag: cheshire

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Stenosis Treatment in Meriden

Have you heard the term “lumbar stenosis” regarding back pain or leg pain you are experiencing? If you or a loved one suffer from lower back and leg pain, and have been told you have stenosis, you may have some questions. So, where can you find stenosis treatment in Meriden, CT? My name is Dr. Erik Reich and I am a chiropractor in Meriden, CT. As a chiropractic physician I have treated many people suffering from lumbar stenosis over the past 8 years of clinical practice. Many cases of stenosis respond incredibly well to conservative chiropractic treatment, which is both non-invasive and drug free.

Picture of a badly inflamed lumbar spine illustration, demonstrating lumbar stenosis. Dr. Erik Reich treats lumbar stenosis patients in Meriden.
Dr. Erik Reich is a chiropractor in Meriden who treats neuromusculoskeletal conditions including pain and disability arising from spinal stenosis.

What is Lumbar Stenosis?

Lumbar spinal stenosis is a condition where the spinal canal narrows. Then, the narrowing can cause pressure on the nerves resulting in pain or other symptoms travelling into the legs. Lumbar stenosis can have several causes. For example, it can be caused by bony changes such as osteoarthritis, or congenital narrowing of the spinal canal, and spinal ligament thickening. Also, disc derangement such as herniation can also lead to narrowing and stenosis symptoms.

Do I Need Surgery?

Recent studies comparing surgery for lumbar stenosis versus conservative treatment such as physical therapy show similar outcomes. However, surgery carries added risks. Granted, for certain people surgery is an absolute necessity. To rule out surgery, a thorough history and examination should always be performed.

The risks associated with surgery typically do not arise in non-invasive treatment options such as chiropractic care. Therefore, while outcomes may be similar, many patients opt for a conservative non-invasive approach before considering surgery.

How Can Chiropractic Treatment Help?

There are several key components to an effective chiropractic treatment plan for addressing lumbar stenosis symptoms.

First, patient education is a key component of any successful treatment plan. High quality, evidence informed education about the condition, expected outcomes, goals of treatment, and possible side effects should be relayed. With better information, the patient often experiences better results.

Second, pain needs to be addressed. However, pain is only one symptom of stenosis which must be dealt with. It is hard to accomplish the goals of treatment if you are in pain. So passive care such as heat, massage, joint manipulation or adjustments, flexion-distraction, and other interventions are warranted to reduce painful symptoms to the point where active treatment, like an exercise program, can commence.

Third, active treatment moves to the forefront. Once pain has been reduced or eliminated, active treatment should begin in earnest. You should expect guided exercises, home stretching, and nutrition counseling. Symptoms from lumbar stenosis typically respond well to active care. Positive changes can usually be felt within the first week or two of treatment. Although every patient is unique and “it depends.”

Dr. Erik Reich is a Chiropractor Providing Lumbar Stenosis Treatment in Meriden

photo of Dr. Erik Reich with his son on his shoulders
Dr. Reich, Meriden chiropractor, and his son.

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, and traumatic injuries such as work and car accidents. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

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5 Questions to Ask Your Chiropractor in Meriden

So what 5 questions to ask your chiropractor in Meriden? Below are some common questions, but this list is by no means exhaustive.

1. How Often Do You Treat This Type Of Condition?

Most chiropractors have a lot of experience treating lower back pain and neck pain, as well as headaches and other body aches and pains. It is a good idea to ask the doctor how often they see the types of symptoms you are feeling. Also ask how comfortable the doctor is with managing your symptoms. If the doctor states that 30% of their practice is treating people experiencing symptoms similar to yours, it’s probably a sign they are comfortable managing that condition.

Like other doctors, some chiropractors specialize or have a preference to treating certain conditions or groups of symptoms versus other types of pain. For example, I feel very competent and knowledgeable about lower back, neck, and shoulder pain. I do not feel as knowledgeable about some types of knee pain. So it doesn’t hurt to ask. Because every provider is different and some prefer to focus their time and practice on certain conditions or regions of the human body. Be wary of a doctor who states they only treat one area of the body and claims to be able to effect distant symptoms. While not unheard of, a chiropractor who only treats the first three joints of your neck, even if you are calling about elbow pain, should be approached with caution.

A picture of a doctor holding a stethoscope with a question mark.
Meriden Chiropractor Dr. Erik Reich answers common questions new patients often ask when seeing a chiropractor.

2. Do You Take X-Rays?

In some cases x-rays are invaluable. However, routine x-rays for uncomplicated back pain are not recommended. With mounting evidence and guidelines being published regularly which advise doctors away from the over-utilization of imaging for most types of back pain.

Therefore, regular use of x-rays, especially for non-traumatic neck or back pain, should be avoided according to most researchers. Part of the reason for this change is the number of false positives which are seen in otherwise healthy individuals. X-ray imaging reports with scary sounding terms like degeneration, bone spurring, and spondylolisthesis can imply that something is very wrong with your spine, when in fact these are often found in healthy people with no history of pain or disability. What’s more, when a patient gets a scan and sees these findings, they are more likely to undergo more expensive tests, begin medications such as opioids, and have worse health outcomes overall due to the stigmatization of otherwise non-contributory imaging findings.

This is not to discount the legitimate usage of imaging, but in America, patients by and large are over imaged, over medicated, and have worse outcomes because of it. You can read more about the use of imaging in modern chiropractic practice here.

3. How Long Do Treatments Take?

Treatment plans should be tailored to the individual. Cookie cutter plans where every patient gets the exact same treatment are not your best interest. When asking how long a treatment will take be sure to exclude any time for history taking and examination. As these will make your visit longer, typically at your first appointment and any re-exams. Typically a treatment session can last anywhere from 10 minutes up to 30 minutes. However, a complicated case can take longer to evaluate and treat. Most patients in my office get a combination of hands on treatment and other modalities. Which may include adjustment to the spine or other soft tissue therapy. As well as guided exercise, and some passive modality such as a cold pack or electric muscle stimulation if warranted. A treatment session of this type would run around thirty minutes.

4. Will You Respect My Treatment Preferences?

The answer better be a loud “Yes”. Because patients are individuals with their own biological, social, and psychological make-up, treatment should be tailored to the individual. If a patient presents with a strong preference not to be adjusted, the chiropractor should respect this and not try to sell or trick the patient into accepting an adjustment, even if it is the doctor’s strong opinion that an adjustment is what is best for the patient. The pillars of evidence based practice are relevant clinical research, patient values, and clinical expertise. If my expertise and research backs a treatment, but that treatment violates the patients values, then a competent clinician should be able to come up with an alternative. This is important to honor the patient’s values, while making the best effort to make a positive change to the patient’s presenting health concern.

5. Do I Need A Referral?

In general you do not need to be referred to see a chiropractor. However, there are rare instances where insurance plans do require a referral for chiropractic services. If you are unsure about whether or not a referral is required by your insurance, check with your plan. If you do not have insurance, no referral is necessary.

ABOUT THE AUTHOR

A picture of Dr. Erik Reich, Meriden Chiropractor, with his son Leif sitting on his shoulders.
Dr. Erik Reich with his son Leif.

Dr. Erik Reich is a Chiropractic Physician in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, to seniors, and traumatic injuries such as work and car accidents. He also enjoys spending time with his wife and son, and their Boston terrier Jarvis.

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New Year’s Resolutions for the Back Pain Sufferer

Happy New Year!

2019 is coming to an end. As we embrace the new year, and you are making your New Year’s Resolutions to finally kick back pain to the curb, keep these points in mind. Because as a society approximately 80% of us have or will experience back pain, this is the perfect season to resolve to beat the odds. At an annual health care burden in the billions of dollars, lower back pain is a scourge felt worldwide. But these New Year’s Resolutions can help you overcome one of the leading causes of disability worldwide.

  1. Exercise at least 20 minutes a day, 7 days a week.
  2. Stop smoking.
  3. Eat at least 6 servings of fruits and vegetables a day.
  4. Get more and better sleep.
  5. Seek help if your symptoms are not resolving.
Picture of a man holding his lower back in pain arched into extension with a caption stating that Dr. Erik Reich in Meriden, CT treats back pain in the blog for New year's Resolutions for back pain sufferers.
Dr. Erik Reich is a chiropractor in Meriden, CT who treats all types of musculoskeletal back pain.

Exercise for Your Back Pain

It may seem counter intuitive to exercise a part of your body that may be injured or in pain but science regularly backs this up. Therefore, one of the best interventions for both acute (new) and chronic (old) pain is graded exposure to exercise. If you are unsure of where or how to begin an exercise program while in pain, see resolution #5 – Seek Help!

Stop Smoking

Needless to say this is old news for a variety of health reasons, but in terms of back pain, smoking is very bad for both pain intensity experienced, healing time, and outcomes overall. I recently wrote a blog on this very subject here.

Eat Your Fruits and Veggies

Fruits and veggies pictured on the blog of Dr. Erik Reich Meriden Chiropractor for New Year's Resolutions for back pain sufferers.
Increased fruit and vegetable intake is associated with better healing and pain reduction.

When you consume more fruits and vegetables your body heals better, this is well documented in the scientific literature. Vitamin A is required for cell and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen and connective tissue formation and as a tissue antioxidant. Fruits and vegetables also contain fiber which is filling and satiety will reduce cravings for more inflammatory foods (processed foods, sweets, chips, etc.) which should be avoided when healing.

Better Sleep, Better health

Two recent studies in just the past month or two have shed more light on the important role sleep plays in your health outcomes. In one study which was discussed in this article, lack of and poor quality sleep was shown to increase pain felt by up to 30%. Furthermore, in another recent example, a study showed how sleep helps to clean the brain and allow your body to remove toxins.

Ask for Help

The human body is resilient. You are highly adaptable and given the right inputs the body will take care of the output. But garbage in = garbage out. So if you are experiencing back pain, make some simple (but not easy) lifestyle changes to give yourself the greatest chance to recover. Or if you are unsure of how to make these changes, don’t hesitate to reach out and get some help.

Dr. Erik Reich is available for appointments Monday – Friday and can be reached by phone at (203)235-0171.

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Why is Smoking Bad for Healing After Disc Injury?

If you want to get better faster and with less pain after a disc injury, don’t smoke.

Picture of an anatomical model of a lumbar disc herniation on the website of Meriden CT chiropractor Dr. Erik Reich
Scientific studies routinely demonstrate that smokers have more pain, decreased healing ability, and longer recuperation times”, states Dr. Erik Reich, a chiropractor in Meriden, CT.

It’s no surprise that smoking is bad for you. If you are a smoker, you’ve most likely been told by friends, family members, and your doctor to quit the habit already a million times. However, as a chiropractor, let me be perhaps the first to state it this way: smoking is terrible for your health after a disc injury.

In this study by Tsarouhas A et al. the authors state, ” Smoking habits were found to have a negative dose-dependent effect on the transcript levels of MMP-3 and MMP-13 and a positive correlation with pain intensity, suggesting an unfavorable role for smoking in the regression process of herniated disc fragments. “

In other words, smokers take longer to heal after a disc injury. Smokers also experience more pain with disc injury than non-smokers. Anyone who has had a cervical or lumbar disc herniation can tell you, they can be extremely painful and debilitating. Therefore, you should give yourself every advantage when you are trying to heal after such an injury to your spine. If you are a smoker, be aware that continuing to smoke during the healing process has been demonstrated to slow recovery, increase pain intensity, and result in poor outcomes. So stop smoking for disc health!

In sharing this study and the information in it, it is my hope that if you are a smoker experiencing back pain, but especially back pain due to trauma or disc injury, you seriously consider quitting immediately. I know you’ve heard it before about the negative health consequences of smoking cigarettes, but this study makes the connection between smoking and back pain in a way most people are still unaware.

Graphs of MMP levels from a study on disc herniations and the effects of smoking on the website of Meriden, CT chiropractor Dr. Erik Reich
Significantly lower MMP-3 (c) and MMP-13 (d) mRNA levels were observed in discs removed from patients smoking more than 20 cigarettes per day compared to non-smoking patients 

I have no doubt that studies coming out in the future will build on the negative relationship between smoking and back pain, but in the meantime if you want my clinical advice: stop smoking for disc health now to improve your outcomes from suffering a spine related injury. Of course this is in addition to eating a healthy diet and exercising regularly, and if you need help doing that call (203)2350171 today.

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Concussion Advice for Adolescents

New Guidelines Following Recent Studies on Earlier Return to Activity Following Concussion

Girl having bike helmet put on for safety and to avoid concussion or head trauma in case of a fall. Dr. Erik Reich Meriden Chiropractor.
Healthy children depend on play and sport as vital parts of their day.

You may have heard the advice in the past that if a child suffers a concussion they should avoid all activity, sit in a dark quiet room, and not use any electronics. This view was popular because it was thought the brain needed total rest to recover following a traumatic injury. But these concussion guidelines for adolescents have recently been updated following the release of some important studies on the effect of return to activity after a mild traumatic brain injury or concussion.

Each concussion is unique, and the cookie-cutter approach of total rest goes against current understanding and recent studies. Following a concussion it remains true that the child should be taken out of play immediately. However, while rest may be appropriate for one or two days, many days of inactivity can lead to feelings of isolation, depression, and anxiety.

Furthermore, while electronic device and TV use following concussion may worsen symptoms, there are no good studies showing their use is detrimental. Like other potential triggers for post-traumatic headache, electronics and TV use should be monitored and limited if symptoms worsen.

As a chiropractor in Meriden, CT I have seen many cases of concussion in my office, both adults and children. Head injuries and mild traumatic brain injury like concussion can be difficult to treat in young people because they may not be as communicative about what they are feeling. Children may also be more concerned about returning to play, getting back to a favorite activity or sport, or disappointing friends or teammates. It is important for parents to ask kids how they are feeling, and pay attention to behavior that seems abnormal for your child. Children are resilient and heal quickly, with proper guidance and avoidance of aggravating factors or advice known to prolong recovery following injury.

Does My Child Need Imaging?

The older guidelines as well as the newer guidelines do not recommend routine imaging in all cases of concussion, as most cases of concussion will not show up on CT scan or MR imaging. If red flags such as uncontrolled vomiting, or potential hemorrhage or skull fracture is suspected, then the appropriate imaging is necessary. But there are harms with unnecessary imaging such as exposure to radiation which is associated with heightened risks of developing cancer. Children are believed to be more at risk for cancer because they are still developing and growing. Advanced imaging is also expensive when it has been estimated that up to 2/3 of CT scans following head injury are not necessary.

Child walking with an adult. Walking at a comfortable pace without increase in symptoms is a good way to manage return to activity following concussion. Dr. Erik Reich Meriden Chiropractor.
Walking can be a great way to return to activity following a head injury

So What do the New Guidelines Recommend?

Treatment should be tailored to each individual. It is no longer recommended that a person be symptom free before resuming activity. In fact, patients who rested for five days of strict rest, had symptoms that persisted longer than those study participants who resumed light activity within 48 hours following their injuries.

Light aerobic activity such as walking, as long as symptoms do not worsen, has been shown to benefit recovery times. Again, prolonged rest can lead to anxiety, social isolation, and feelings of depression, so earlier return to a child’s normal routine, even if activity duration is reduced at first, is going to benefit recovery better than complete rest. Maybe the child can return to school on a half day basis for several days or a week. It might be the case that these half days do not worsen headaches or other symptoms, and full resumption of school can be attained quickly.

Parents, teachers, coaches, health care teams, and children should be included to make a plan for faster return to activity, school, play, and sport, with careful monitoring and observation that activities do not worsen symptoms. But complete rest is to be avoided in the absence of red flags, triggering activities, or other exacerbating factors. Routine imaging following concussion should also be limited to cases where fracture, hemorrhage, or severe injury is suspected.