Tag: Neck pain

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5 Tips To Improve Ergonomics While Working From Home

A lot more people are working at home lately thanks to the global pandemic Covid-19. This new situation can lead to challenges in setting up a work station which will be both comfortable and reduce the chances for strain and injury. So in this article I will outline several tips to improve ergonomics. Ergonomics means fitting the job to the person, which is important to consider while you work from home.

A drawing of a person working at a laptop on an article about ergonomics while working from home on the blog of Meriden chiropractor Dr. Erik Reich
Working from home can be stressful. Your work space shouldn’t be.

1. Practice Good Posture

Many tasks you will likely be performing at home while working will be done with your arms and hands outstretched to the front of your body. For example, typing, checking your phone, writing, using a laptop, and reading are all activities which place your shoulders and arms in a forward position. This posture is chest and shoulder dominant. This means your chest and shoulder muscles are contracted more frequently to position your arms forward and closer to center. This can lead to shoulder irritation and poor breathing patterns.

In order to counteract this predominance of the chest muscles and forward rounding of the shoulders, you should be mindful of sitting and working with your chest forward. Think of someone tying a string to your breast bone and pulling you up. In this way your chest leads in front of your shoulders and places you in a more “open” posture.

Furthermore, if you are sitting at a desk, be sure to adjust your chair so that you are at a comfortable height and your thighs are parallel or slightly higher than parallel to the floor. Your keyboard and computer should be directly in front of you, not off to the side. Also, the computer screen should be at least 18″ from your face and the top 1/3 of the screen should be at eye level.

2. Don’t Forget to Move

Even while you are sitting or standing to work at home, movement is important. If your work requires you to spend long hours at a desk, small movements such as tapping your feet, rolling your neck and shoulders, and fidgeting with your hands and fingers, can help stimulate blood flow and decrease stiffness. Short breaks to stand, pace, performs some air squats, calf raises, or desk push-ups can also be very helpful.

3. Set a Timer

If you are like me, sitting to write or type, or finish computer work, you may be prone to stay put for long stretches of time to complete the task at hand. What can be helpful is to use your phone’s clock timer or another inexpensive timer to set micro-breaks for every 20 minutes. This way when the timer goes of you have an auditory cue to get up and move for a few minutes, without becoming overly distracted.

4. Your Breathing is Important

When working from home you may be sitting a lot. Sitting places the hips in flexion and can impede full expansion of the lungs while breathing. Naturally while sitting you will tend to take shallower breaths.

Take some time to focus on deep breathing and you may notice your posture improves, your back feels less tight, and you don’t fatigue as easily. Keeping your shoulders behind your chest as previously discussed can help.

Furthermore, placing one hand on your chest and one hand on your stomach and taking a deep breath, you should feel the hand over your belly move. Shallow chest breathing where your diaphragm doesn’t expand into your abdomen limits rib expansion and decreases circulation. So make sure both hands are moving well when you breath, get your diaphragm involved!

With improved rib expansion while breathing your blood will carry more oxygen, your joints will circulate their fluid to provide nutrition to the joint cartilage, and your stress levels will reduce. Good breathing has many health benefits.

5. Take Walking Meetings

Many meetings these days are being conducted remotely. There are many apps which make this possible, and when working from home it may seem convenient of comfy to sit on the couch at your chair for the duration. I would suggest if possible that you walk or pace comfortably around your house while on these calls. You may have already been sitting for some time before the meeting starts, and getting back to more work following the meeting. So if possible try and use this time to move around.

So there are 5 tips which I hope you will find helpful during these times when you are working from home, whether by choice or due to the recent coronavirus pandemic.

About the Author:

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

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc.  located at 303 South Broad Street. Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. Spending time with his wife and son, and their Boston terrier, is something Dr. Reich also enjoys.

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What is Chiropractic?

Chiropractic is a profession of health care providers. Chiropractors treat conditions of the muscles, joints, and nervous system. The most common and widely recognized chiropractic intervention is the adjustment or “joint manipulation.” Chiropractors also employ other treatments such as exercise, physiotherapy, nutrition counseling, and lifestyle modification advice.

A picture of a chiropractor setting a patient up to be adjusted.
Chiropractic adjustment or manipulation is the most widely recognized treatment performed by a chiropractor. An adjustment is delivered to a joint to affect the motion of the joint. Adjustments also can relax surrounding muscles, and release pain modulating chemicals to reduce symptoms.

More Than the Adjustment

What is chiropractic? Well, most visits to the chiropractor involve getting an adjustment, or several adjustments. However, there are other important benefits to receiving chiropractic care. A skilled chiropractic physician will be able to identify and diagnose the cause of pain or other symptoms. Also, if the underlying problem(s) is amenable to chiropractic treatment, a trial of care will be recommended which may include patient education, adjustments, physical therapy modalities, stretches and exercises, and lifestyle advice all tailored to you as an individual.

If you present to the chiropractor and treatment is not recommended for you, an appropriate referral to a specialist should be made. Some conditions may not seem likely to respond to chiropractic treatment but many patients decide to go forward with a short trial of care, especially if they have already tried many other doctors or treatments without success.

Safe and Effective Treatment

Chiropractic treatment is non-invasive. It is also conservative in nature, and without drugs or surgery. Furthermore, there are typically few side-effects beyond soreness following some treatments. Therefore, many medical journals and societies are recognizing chiropractic treatment as a first line intervention. Especially for treatment of lower back pain, neck pain, and headaches. Also, chiropractic has shown itself to be efficacious in the treatment of joint pain. As well as tendon injuries, ligament sprains, disc herniation, and other insults to the human frame.

From the American Chiropractic Association’s website some key points:

  • DCs are licensed to practice in all 50 states and the District of Columbia–and in many nations around the world–and undergo a rigorous education in the healing sciences at institutions accredited by the U.S. Department of Education. 
  • A growing list of research studies and reviews demonstrate that the services provided by chiropractors are both safe and effective. The evidence strongly supports the natural, whole-body, and cost-effective approach of chiropractic services for a variety of conditions.
  • Chiropractor’s services are included in most health insurance plans, including major medical plans, workers’ compensation, Medicare, some Medicaid plans, and Blue Cross Blue Shield plans for federal employees, among others. 
  • Chiropractors are used extensively by amateur and professional athletes, professional dancers, and others to prevent and treat injuries as well as achieve optimal health and functioning.

About the Author:

Dr. Reich and son riding on his shoulders pictured in a blog post for What is chiropractic?
Dr. Erik Reich is a practicing chiropractor in Meriden, CT.

Dr. Erik Reich is a chiropractor in Meriden, CT. He practices at Omni Physical & Aquatic Therapy Center, Inc. . Where he treats all types of patients from high school athletes, seniors, victims of trauma such as auto accidents, laborers, and desk jockeys. 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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Choosing a Chiropractor

What should you be looking for when choosing a chiropractor?

The chiropractic profession is varied, and there are many different styles of chiropractic treatment and practices out there. So how do you pick a chiropractor? I will list and discuss some key considerations when you are in search of a new chiropractor.

First, ask your family and friends for a recommendation, or even your primary doctor which chiropractors in the area they would see if they needed care. Friends, family, and your health care team will likely not recommend to you someone they don’t like and trust themselves.

Second, check online. You can do a quick internet search for the chiropractor’s name and the town or city they practice in and get an idea of their practice by looking at their website, checking reviews online, and even looking up their license to practice and check for irregularities. When you are choosing a chiropractor in your area, don’t neglect performing an online search.

Next, give their office a call. Did someone pick up right away or did you have to leave a message? If a receptionist, or even the doctor, answered, were they pleasant, easily understood, and helpful? Did you get a good first impression? These are important windows into the “feel” of the office.

Exterior photo of Omni Physical & Aquatic Therapy Center, Inc. in Meriden, CT where Dr. Erik Reich Chiropractor sees patients
Dr. Erik Reich practices in Meriden, CT at Omni Physical and Aquatic Therapy Center, Inc.

Things to consider when starting treatment.

Chiropractic treatment is varied, but there are certain considerations that you should be aware of when starting a treatment program. Many chiropractors utilize spinal adjustment or “manipulation” of the spine to alleviate neck or back pain. Adjustment of the extremities such as ankle or wrist may also be performed based on the presenting health issue.

As a patient, be extremely wary of any chiropractor who says they have a unique technique or treatment that only they can use or a new treatment which they discovered. Joint manipulation is practiced more frequently by chiropractors than other manual healthcare providers, but it is not exclusive or proprietary to chiropractors as a profession, and there are many different named adjusting techniques and styles but no one has a monopoly on getting someone better with an adjustment.

Furthermore, other treatment modalities practiced by any good chiropractic physician are not unique to the chiropractic profession. Education about your condition, an exercise program, stretching and other treatments of the muscles and tendons, and nutrition advise may be helpful and offered at a chiropractic visit, but none of these interventions are exclusive to the chiropractor. Be skeptical of any chiropractor who wants to sell you their own vitamins or supplements because they are the “best” or the only ones that work.

You should beware of excessive imaging. Years ago it was common for chiropractors to over-utilize x-rays for a variety of reasons. Be aware that current understanding and imaging guidelines do demonstrate their usefulness in ruling out fractures, dislocations, and other red flags. X-rays should not be taken in the absence of recent trauma or suspected disease, and x-rays are not indicated to monitor your progress as treatment progresses. If you are not in pain and the chiropractor wants to take x-rays, you should get a second opinion.

Avoid long term contracts, payment plans, and care which does not have a reasonable start and end point. When you see a chiropractor, you should start feeling better. Depending on the severity of the original injury or health issue, this may take 1 visit, 6 visits, or a month of visits, or even longer…but avoid any doctor who claims to know that you will need 3, 6, or 12 months of visits when they’ve only met you once or twice and want you to pre-pay for 6 months of care. Everyone responds and heals differently, but this can not be known that far in advance and especially not to the degree where you should pay up front.

What Makes a Good Chiropractor?

Choosing a chiropractor shouldn’t be difficult. However, because the market is so fractured with many different types of practices, and in America the healthcare system is so focused on profit and efficiency, patients need to be keenly aware of outdated and potentially harmful practices that are more focused on serving the doctor or benefiting the practice than providing benefit to you, the patient.

You need to look for a chiropractor who takes a patient centered approach, which uses best practices and current evidence to come up with an active treatment plan focusing on return to regular activity and eliminate or reduce pain.

A good chiropractor is therefore one who avoids gimmicky marketing tricks, reduces or eliminates unnecessary or wasteful imaging or other expensive tests, and works well with other members of your healthcare team including primary doctors, APRNs, orthopedists, neurologists, and specialists.

A good chiropractor takes a thorough health history and performs a detailed physical examination before working with you on a treatment plan that is individualized to your goals and preferences. Also, a good chiropractor will offer education, support, exercises, and lifestyle modification advice, to encourage active participation in the process of getting you well, and not rely solely on passive interventions such as heat, adjustments, ultrasound, etc.

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Degenerative Disc Disease as Diagnosis = Rubbish

American Academy of Orthopaedic Manual Physical Therapists Releases Position Statement Opposing Use of ‘Degenerative Disc Disease’ as Diagnostic Term

A series of spinal models is displayed in order purposing to demonstrate various stages of spinal degeneration. Dr. Erik Reich states this terminology of degeneration and disease does more harm than good.
“Degenerative disc disease is a term which is neither accurate or helpful, it should be abandoned.” states Dr. Erik Reich, Meriden Chiropractor.

The position statement released recently by AAOMPT is spot on. Few things are as upsetting to me as a clinician as when a patient presents to my office having been scared by this garbage terminology. Degenerative disc disease (DDD) is not degenerative or a disease.

As Professor Stu McGill, a world renowned spine researcher is oft quoted as having said, “A degenerative disc disease diagnosis is the equivalent of telling your wrinkled mother-in-law that she has degenerative face disease.”

AAOMPT says patients often react to the label ‘degenerative disc disease’ by losing hope and seeking more invasive and higher-risk treatments. They avoid beneficial physical activity for fear that exercise and movement will worsen their condition, possibly leading to chronic pain. The majority of spinal pain is self-limiting and can be managed appropriately without the need for medications or risky procedures such as injections or surgery. For those individuals who do need care, AAOMPT supports and encourages early physical therapy instead of high-risk procedures and medication. AAOMPT strongly recommends that clinicians avoid using the diagnosis of degenerative disc disease.

One of the key interventions a clinician can provide to a back pained patient is education about their condition. Telling someone who has had a diagnostic scan or imaging that they are suffering from a disease such as DDD, when in fact this process is a normal part of aging and not a disease at all, causes harm and creates a nocebo effect.

A nocebo in this case arises from a patient being told they have a disease where in fact no disease is present. This can lead to negative expectations of recovery, fear or avoidance of beneficial activities, and seeking more aggressive and invasive treatments when they are not indicated or necessary.

Unfortunately, use of this terminology is still prevalent. Hopefully that changes as more practitioners are made aware of the negative consequences to patients of using this type of poor diagnostic language.

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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.