9712871Neck pain is a fairly common condition. Most people will experience it at some point in their lives with women reporting slightly higher instances of chronic pain. Pain medication often is the first line of defense against neck pain but it doesn’t solve the problem and many drugs carry the risk of harmful side effects. Chiropractic treatment for neck pain, including spinal adjustments is a non-invasive and drug-free therapy. The first thing a chiropractor will want to know during your visit is the intensity and duration of your pain. Sometimes, the pain is merely a mild nuisance but severe neck pain can cause serious impairment of your daily activities. While mild to moderate pain is typically the temporary result of poor posture or carelessness when performing daily activities, severe neck pain can be a sign of a congenital defect such as scoliosis, an injury from a recent accident, or progressive age-related deterioration. Although a doctor of chiropractic will use many of the same criteria as a medical doctor when diagnosing neck pain, a chiropractic medical history tends to place greater weight on the fact that the neck is merely one part of the integrated biomechanical system that is the human spine. Systems such as accompanying shoulder or arm pain are considered in context of the underlying issue of chiropractic neck pain. Spinal manipulation and spinal adjustments are an important part of the treatment program for chiropractic neck pain. This drug-free therapy simply involves the chiropractor using his or her hands to treat subluxations. A subluxation occurs when one or more spinal vertebrae move out of position, thus creating pressure and irritation near the spinal nerves. Spinal manipulation and spinal adjustments can fix the subluxation, relieve pain in the soft tissues, increase circulation, and stimulate the body’s nervous system. Contrary to popular belief, spinal manipulation and spinal adjustments are not painful. When you seek chiropractic treatment for neck pain, the treatment is precise and gentle. Chiropractors are trained as experts in the spine and how to manually return motion to restricted spinal joints. They do not merely “pop” or “crack” bones until something “snaps” back into place. After spinal manipulation, spinal adjustments, your chiropractor may recommend that you use an ice pack on your neck to further control inflammation. This cold therapy can be completed at home and is an excellent supplement to traditional chiropractic treatment for neck pain. Once your chiropractor has helped to get your neck pain under control, he or she may suggest exercise, diet, or lifestyle changes to improve your range of motion, strengthen muscles, and prevent a painful relapse. If your condition does not seem to be improving within a reasonable time frame, however, you may be referred to another specialist for further treatment. It is important to note that doctors of chiropractic do not utilize drugs or surgery in their practice. However, there are times when a chiropractic doctor will recommend that the patient consult another practitioner if these or other methods of treatment are indicated.


Prediction of Outcomes with Chiropractic Care and Cervical Pain Courtesy of: Dr. Frank Gomez – www.http://sayvillechiropractor.com  

Pain located in the neck is a very common condition. Neck pain can come from a number of activities, disorders and diseases in the neck, such as degenerative disc disease, neck strain, whiplash, a herniated disc, or a pinched nerve. It can also come from overuse, sports injuries, and everyday home and work related activities. Usually, there is an underlying instability or problem in the neck that is a precursor to the pain. Neck pain is also referred to as cervical pain. “Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and gland swelling” (MedicineNet.com, 2008, http://www.medicinenet. com/neck_pain/article.htm). “There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck” (MedicineNet.com, 2008, http://www.medicinenet.com/neck_pain/article.htm). “Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury” (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430). “The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear” (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).   Further detailed explanations of some of the causes of neck pain are: “Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting “rebound” in the opposite direction is known as whiplash. The sudden “whipping” motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash” (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430). “Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine. – Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion. – Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally. – Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Over time, a disc may bulge or herniate, causing tingling, numbness, and pain that runs into the arm” (American Chiropractic Association, n.d., http://www.acatoday.or/content_css.cfm?CID=2430). “Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms” (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430). When considering solutions for neck pain, you must look at what will help you and how long it will take to get better. Like with any malady, the progression of treatment should be drugless first, involve drugs second and have surgery as a final option. A significant factor must be the scientific evidence that predicts the outcome of any treatment. A cancer patient or a heart disease patient, prior to undergoing chemotherapy or open heart surgery, will ask the doctor what the percentage of success is for the treatment. The same question should be asked of every doctor for every treatment and chiropractic is no different. In 2008, Thiel and Bolton studied 19,722 patients that were treated for a variety of symptoms, most of which were pain or stiffness in the neck, shoulder or arm region. The purpose of the study was to determine the outcome of chiropractic care in patients with nonspecific musculoskeletal disorders, including mechanical neck disorders. The results revealed that 71.6% of females and 67.9 % of males had immediate improvement. This shouldn’t be confused with the overall satisfaction rate of 94% of patients treated with acute neck pain as reported by Haneline (2006), asThiel and Bolton (2008) examined immediate improvement, not improvement over time as Haneline did. Since statistics can be manipulated in many different ways, let’s examine those patients who experienced immediate worsening. The Thiel and Bolton (2008) study revealed that 95.2% of females and 96.2% of males reported no immediate worsening, rendering an overwhelming predictor of a successful outcome. Predictable outcomes are critical in guiding both the public and the doctor in realizing a successful treatment plan. These studies, along with many others, conclude that a drug-free approach of chiropractic care is one of the best solutions to treat neck pain. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state. We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. Thank you for reading my article. More on back pain can be found on my website http://www.http://sayvillechiropractor.com/. Any questions please contact us. 631 991-3492 –   The Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s.   No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans   Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about.   Serving the areas of Sayville, Oakdale, Bohemia, Bayport.   YOU MAYBE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492   Not ready yet…No Problem.   To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up.   Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com   By Mark Studin DC, FASBE (C), DAAPM, DAAMLP William J. Owens DC, DAAMLP References: 1. MedicineNet.com. (2008, January). Neck pain. Retrieved from http://www.medicinenet.com/neck_pain/article.htm 2.  American Chiropractic Association. (n.d.). Chiropractic and neck pain: Conservative care of cervical pain, injury. Retrieved from http://www.acatoday.org/content_css.cfm?CID=2430 3.  Thiel, H. W., & Bolton, J. E. (2008). Predictors for immediate and global responses to chiropractic manipulation of the cervical spine. Journal of Manipulative and Physicological Therapeutics, 31(3), 172-183.  

Surgery for Neck and Arm Pain? Courtesy of: Dr. Frank Gomez, Sayville Immediate Chiropractic care            

We in the healthcare management world are all biased. If a patient with neck and arm pain presents to chiropractic clinic, the doctor of chiropractic will usually recommend a non-surgical trial of care as long as “red flags” don’t exist (that is, “bad” things like bowel/bladder weakness, rapidly worsening symptoms, and a few others). Frequently, the patient asks, “…should I just have the surgery…am I just postponing the inevitable?” Here’s what we know…             In a 2015 study addressing this very question, the authors compared a non-surgical physical therapy approach using neck-specific general exercises, pain relief, coping strategies, and improving self-management strategies against surgical treatment (ACDF – anterior cervical decompression and fusion) with post-surgical physical therapy. Twelve months following the conclusion of treatment, they found 87% of the 31 patients in the surgical group reported a “better/much better” result compared with 62% of the 32 patients in the non-surgical group. However, at the two-year point, the satisfaction numbers were 81% (surgical) and 69% (non-surgical). The study’s “conclusion” states that a structured NON-SURGICAL treatment approach “…should be tried before surgery is chosen.”             More importantly, at the one year point, 62% of those treated WITHOUT surgery reported a “better/much better” result, which improved to 69% by year two while those receiving surgery DROPPED from 87% to 81% after two years. It would be interesting to see this split at three, four, and five-year time-points, as it is well known that degeneration occurs more rapidly above and below a fusion due to the increased biomechanical load. This can lead to the need for further treatment.             A very similar 2013 study followed 50 patients with herniated cervical disks and arm pain who received chiropractic treatment. After two weeks of care, 55.3% reported they were “better” or “much better.” After one month, 68.9% reported improvement and the percentage increased to 85.7% after three months.             The good news is that guidelines for treating neck pain that radiates into an arm recommend that patients undergo a course of “conservative” (non-surgical) care FIRST before progressing to surgical care. In fact, many guidelines DON’T even recommend MRI or EMG/NCV initially unless the result from the non-surgical care is not satisfactory, usually by the four-to-six week point into treatment.             These studies show that patients with neck and arm pain (most commonly caused by herniated disks) are frequently successfully managed WITHOUT SURGERY and hence, this approach should be tried FIRST and surgery be reserved ONLY to the non-responders.             We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services. To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ, CHIROPRACTIC PHYSICIAN at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

What’s Better for Neck Pain, Medication or Chiropractic? Courtesy of Dr. Frank Gomez & Sayville Immediate Chiropractic Care

Although both medication and chiropractic are utilized by neck pain sufferers, not everyone wants to or can take certain medications due to unwanted side effects. For those who aren’t sure what to do, wouldn’t it be nice if research was available that could answer the question posted above? Let’s take a look!             When people have neck pain, they have options as to where they can go for care. Many seek treatment from their primary care physician (PCP). The PCP’s approach to neck pain management usually results in a prescription that may include an anti-inflammatory drug (like ibuprofen or Naproxen), a muscle relaxant (like Flexeril / cyclobenzaprine), and/or a pain pill (like hydrocodone / Vicodin). The choice of which medication a PCP recommends hinges on the patient’s presentation, patient preference (driven from advertisements or prior experiences), and/or the PCP’s own preference.             Although it’s becoming increasingly common to have a PCP refer a neck pain patient for chiropractic care, this still does not happen for all neck pain patients in spite of strong research supporting the significant benefits of spinal manipulation to treat neck pain. One such study compared spinal manipulation, acupuncture, and anti-inflammatory medication with the objective of assessing the long-term benefits (at one year) of these three approaches in patients with chronic (>13 weeks) neck pain. The study randomly divided 115 patients into one of three groups that were all treated for nine weeks. Comparison at the one-year point showed that ONLY those who received spinal manipulation had maintained long-term benefits based on a review of seven main outcome measures. The study concludes that for patients with chronic neck pain, spinal manipulation was the ONLY treatment that maintained a significant long-term (one-year) benefit after nine weeks of treatment!             In a 2012 study published in medical journal The Annals of Internal Medicine, 272 acute or sub-acute neck pain patients received one of three treatment approaches: medication, exercise with advice from a health care practitioner, or chiropractic care. Participants were treated for twelve weeks, with outcomes assessed at 2, 4, 8, 12, 26, and 52 weeks. The patients in the chiropractic care and exercise groups significantly outperformed the medication group at the 26-week point AND had more than DOUBLE the likelihood of complete neck pain relief. However, at the one-year point, ONLY the chiropractic group continued to demonstrate long-term benefits! The significant benefits achieved from both exercise and chiropractic treatments when compared with medication make sense as both address the cause of neck pain as opposed to only masking the symptoms.             With results of these studies showing acute, subacute, as well as chronic neck pain responding BEST to chiropractic care, it only makes sense to TRY THIS FIRST!             We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services. To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ, CHIROPRACTIC PHYSICIAN at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

Neck Pain, Headache, and the Jaw Joint Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com

Neck pain and headaches can be very disabling and can significantly alter a person’s normal pattern of living.  Simple things like reading the newspaper, cooking, driving a car, and/or looking down when feeding a baby, can become almost intolerable.  Canceling plans for the day or saying “no” to vacations can be very disheartening and often occurs because of severe neck pain and/or headache making these activities simply, “no fun.”  The cause of the headaches associated with neck pain and dysfunction is usually due to the compression caused by the tight neck muscles squeezing the upper three nerve roots in the neck region, resulting in radiating pain into the head.  Frequently, light and noise sensitivity, as well as nausea, can accompany a severe headache, which only adds to the activity limitations associated with neck pain. In fact, there are many experts who feel most headaches, even migraines, stem from the neck or are at least are very closely related.  Since neck pain affects approximately two thirds of the population at some point during their lifetime, it becomes clear that headaches, in the absence of neck pain, are quite uncommon.  Another interesting and lesser-known relationship is the jaw (frequently referred to as the TMJ) and its association with neck function, especially the upper cervical vertebrae, as well as headaches.  The muscles that move the jaw/TMJ are largely innervated by the 5th cranial nerve, also called the trigeminal nerve.  Several studies have found that when stimulating structures innervated by the trigeminal nerve, neck and/or jaw pain was created and vise versa.  Similarly, patients with jaw problems (called temporomandibular dysfunction or, TMD) often report neck pain.  When we open our mouth wide, head-neck extension always occurs followed by head-flexion when we close the jaw.  Hence, the neck is always moving when we chew, yawn, talk, and clench our teeth.  In fact, all of these every day activities result in jaw, head, neck motion extending from the base of the skull and first cervical vertebra (occiput-C1) and continues down through the entire cervical spine.  This was investigated in a study where the relationship between neck symptoms, jaw function – specifically active mouth opening, and pressure pain sensitivity in a trigeminal nerve innervated region after a spinal manipulation was applied to the upper neck vertebrae.  Here, 37 female patients with neck pain were randomly assigned to 1 of 2 groups (control and experimental) and, before and after treatment, exams of mouth opening and pressure pain levels were measured.  The group receiving the upper neck manipulation showed a significant increase in active mouth opening motion as well as improved pressure pain tolerance compared to the control/non-manipulation group in a sample of woman with neck pain.  This study is very important as many people suffer from neck pain, headaches and TMD.  In order to properly treat these patients, one must focus on multiple regions, not just the neck area.  It has been demonstrated when we bite down, there is a corresponding tightening of two important muscles in the neck and upper back region.  Similarly, studies show relaxation of muscles in the neck, upper back and TMJ after spinal manipulation to the neck is applied.  Injuries to the TMJ are common but often not pursued by patients as often they’ll say, “my jaw clicks and snaps but I don’t think about it.” If you, a friend, or a loved one are struggling with neck pain, headaches, or TMD/jaw pain, we will properly assess your condition and administer the appropriate care that is required.  We also coordinate services with other health care providers when necessary.  This recommendation may represent one of most significant acts of kindness you can give to those that you truly care about. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up.

The Great Challenge: Chiropractic Adjustments vs. Acupuncture vs. NSAIDs! Courtesy of: Dr. Frank Gomez & Sayville Immediate Chiropractic Care                      

Wouldn’t it be nice if we could assess three common types of treatment for neck and back pain to determine which is the most effective? Here is a look at three studies that compared three popular forms of care for chronic spinal pain to determine the short-term and more importantly, the LONG-TERM benefits of chiropractic manipulation, acupuncture, and non-steroid anti-inflammatory drugs (NSAIDs, like Advil). The FIRST published study included a pilot group of 77 patients complaining of chronic spinal pain (neck, mid-back, or low-back pain). These patients were separated into one of the three treatment groups and received either NSAIDs, acupuncture, or chiropractic manipulation. Patients received care for four weeks with outcome measures (questionnaires) used to assess changes in pain and disability. After a 30-day time frame, only patients who received chiropractic manipulation (CM) reached a level of statistically significant improvement, supporting CM to offer the best SHORT-TERM BENEFITS for those with chronic back/neck pain. The SECOND study included 115 patients, again randomized, to receive either one of the same three treatments, but this time the outcome data was gathered two, five, and nine weeks after the start of treatment. Again, those who received chiropractic manipulation (CM) experienced the best overall improvement at nine weeks. The THIRD study involved follow-up from the same patient group from the SECOND study two years later. Once again, participants completed outcome assessments that measure pain and disability. This time, the results showed that only patients in the chiropractic manipulation group maintained long-term improvements in pain and disability. There have been other studies looking at the efficacy and benefits of SMT (spinal manipulative therapy) both in comparison with other forms of care (as presented here) as well as with different conditions or diagnoses. Perhaps the most exciting results were published in 2008 by the International Bone and Joint Decade 2000-2010 Task Force on Neck Pain. They divided patients into four groups (Group 1: Neck pain with little to no interference with activities of daily living – ADLs; Group 2: Neck pain that limits ADLs; Group 3: Neck pain with radiculopathy or radiating arm pain from a pinched nerve; Group 4: Neck pain with serious pathology such as cancer, fracture, infection, and/or systemic disease.) The researchers concluded that chiropractic care was highly recommended especially in Grades 1 and 2 (which includes the majority of neck pain sufferers). Interestingly, many multidisciplinary physician groups now incorporate chiropractic care as part of their “team” approach, which also offer pain management in the form of medications, injections, PT, and when necessary, surgery. They have seen the value of spinal manipulation for neck pain and often seek out chiropractic because it’s safe, beneficial, and cost effective! We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

Neck PainThe MOST Important Exercises (Part 2) Courtesy of: Dr. Frank Gomez at Sayville Immediate Chiropractic Care

As stated last month, exercises that focus on improving posture, flexibility, strength, and coordination are important for creating a well-rounded cervical rehabilitation program. Our discussion continues this month with stretching and strengthening exercises.             STRETCHING: Since our neck muscles have to hold up our 12 pound (~5.5 kg) head, it’s no wonder why our neck muscles seem to be tight almost all the time. Here are two ways to stretch the neck: 1) You can simply drop the chin to the chest, look at the ceiling, try to touch your ear to your shoulder (without shoulder shrugging) on both sides, and rotate the head left to right and vice versa (six directions). 2) You can use gentle pressure with your hand and assist in the active stretch by gently pulling into the six directions described in #1 by applying “over-pressure” at the end-range of motion (staying within “reasonable pain boundaries”).             STRENGTHENING: Most people have a forward head carriage, meaning their head normally rests in front of their shoulders. The further forward the head sits, the greater the load on the muscles in the back of the neck and upper back to hold it up. This position promotes a negative spiral or “vicious cycle” that can lead to many complaints including (but not limited to) neck pain, headaches, balance disturbances, and in the long-term, osteoarthritis. There are two important groups of muscles that require strengthening: the deep neck flexors and deep neck extensors. 1)      The deep neck flexors are muscles located directly on the front of the cervical spine and are described as being “involuntary” or unable to be voluntarily contracted. Hence, we have to “trick” the voluntary outer “extrinsic” (stronger) muscles into NOT WORKING so the deep, intrinsic ones will contract. You can do this by flexing your chin to the chest and pushing your neck (not head) back over your shoulders into resistance caused a towel wrapped around the back of the neck. If you feel your chin raise towards the ceiling, you’re doing it WRONG! Keep the chin tucked as close to the chest as possible as you push your neck (not your head) backwards. If you’re doing it correctly, your chest should raise towards the ceiling as you push your chin down and neck back. Try it! 2)      The deep neck extensors are strengthened in a very similar way EXCEPT here you DO push the back of HEAD back into your towel while keeping your chin tucked tightly into your chest. Do three reps, holding each for three to five seconds and switch between the two for two to three sets. We will finish this discussion next month with important coordination exercises! To Receive Daily Health Updates,  go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

Neck Pain… The MOST Important Exercises (Part 1) Courtesy of Dr. Frank Gomez, Sayville Immediate Chiropractic care – 631-991-3491

Neck pain can occur for many different reasons, but what can you do about it? That’s the BIG question! As discussed last month, exercise training is an important part of the chiropractic management process. Let’s take a close look at which exercises are MOST important with respect to self-management strategies. There are several goals or reasons to perform neck exercises. We will break these down into four main categories: Posture, stretch, strengthening, and coordination. POSTURE: The biggest culprit in this category is the forward head carriage. If you look around a crowded airport, bus stop, train station, or mall, you can see MANY examples of this. If fact, this faulty posture is estimated to occur in 66-90% of the population! Also, forward head posture is STRONGLY associated with decreased respiratory muscle strength, which can reduce lung capacity and our ability to breath by as much as 30%! It’s also linked to tension headaches, altered eye and ear function, high blood pressure, and over time it can lead to arthritis, herniated disks, pinched nerves, and more. The “classic” appearance is the position of the head is too far forward, the shoulders roll forwards and the upper back sticks out. Did you know that for every inch the head glides forwards from the proper position, there is a 10 lbs (~4.5 kg) increase of weight that the neck and upper back muscles have to hold up? Using an average 12 lbs (~5.4 kg) head, a 5 inch (~12.7 cm) forward head carriage places an extra 50 lbs (~23 kg) of weight on the upper back/neck muscles for a 62 lbs (~28 kg) total! So, LET’S FIX IT! Here is one exercise that may help your posture: Look straight ahead and 1) Tighten your core by performing an abdominal brace. This is done by contracting your belly muscles so that when you poke your thumbs into your sides and front, you feel a firm abdominal muscle wall. You don’t have to “brace” at a 100% of maximum, shoot for 25-50% or just enough to feel the muscles contract. Relax and contract several times so you’re sure you can feel the muscles tighten up. Keep a curve in your lower back when you do this (don’t slouch). 2) Lift your chest – don’t just tuck you head back! This will improve the rounded shoulders and slouched upper back posture. Think of lifting your chest towards the ceiling more than just sticking it out. Notice in a mirror how much improvement occurs already! 3) Perform chin retractions – do 10 retractions every hour (set the timer on your cell phone to remind you)! Do this gently, slowly, and to a firm end-point of movement. If you feel like you are creating a “double or triple chin,” you are doing it right! If you do the ten reps every hour, then in an eight hour work day, you’ll have done 80 posture corrections! This a GREAT way to “re-program” your nervous system and when you find yourself doing this WITHOUT THINKING, it will have become a new (and good) habit! Stay tuned next several months for more neck exercises focused on STRETCH, STRENGTHEN, and COORDINATION training! We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care for neck pain or headaches, we would be honored to render our services. To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492

Neck Function and Balance Courtesy of: Dr. Frank Gomez and Sayville Immediate Chiropractic

In the nervous system, there are three primary areas that regulate our balance: the cerebellum (located in the back of the brain), the dorsal columns (located in the back of the spinal cord), and the inner ear (the “vestibular” part of our cranial nerve VIII). There are also small, microscopic “proprioceptors” or mechanical receptors located in our joint capsules, muscles, and tendons that relay information to the brain and work hard to keep us upright when we walk, run, and play!             Conditions that can result in balance problems include, but are not limited to, BPPV (Benign Paroxysmal Positional Vertigo), spinal stenosis (narrowing of the spinal canal where our spinal cord is located), dorsal column disease, cerebellar lesions, and/or circulation loss into the back of the brain. Other conditions associated with light headedness include low or high blood pressure, hydration, medications, postural or orthostatic hypotension, diabetes, endocrine disorders, hyperventilation, heart conditions, and vasovagal syncope. However, issues with BPPV/inner ear are the most common reported cause of dizziness. Emergency actions should be exercised when dizziness is associated with chest pain, shortness of breath, or palpitations. If eating helps resolve the dizziness, blood testing for hypoglycemia is appropriate. If confusion, memory lapses, changes in speech, facial droop, weakness on one side of the body, or acute headache occur, these could be signs of a stroke or a brain bleed or tumor and should be quickly evaluated. If ANY of these signs or symptoms is present, we will refer you to the appropriate specialty for further evaluation.             The upper cervical spine has also been found to affect balance, and it’s a primary area of treatment that we as chiropractors focus on when patients complain about balance dysfunction. Unique to this upper cervical region is the fact that the nucleus of cranial nerve V (the trigeminal nerve) extends down the spinal canal to the C2 level and adjustments in this region can have significant benefits for several other conditions, including trigeminal nerve problems as well as BPPV (inner ear dysfunction such as dizziness) where small crystals dislodge from the ampulla of the semicircular canal and interfere with the flow of fluid inside the canal with resulting dizziness. Adjustments and the BPPV exercises (Epley’s and / or Brandt-Daroff) significantly benefit this cause of dizziness. You can depend on our evaluation to determine if chiropractic is the right choice in managing your balance disturbance!             To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

Neck Pain, Headaches, and Low Back Stability? Courtesy of: Sayville Immediate Chiropractic & Dr. Frank Gomez

Neck pain and stiffness are very common complaints, and these problems can come and go chronically for years, even decades. Numerous studies point to exercises and chiropractic care as two of the best approaches for gaining control over this common, potentially long-lasting, and sometimes disabling condition. However, focusing only on the neck may NOT be the best approach, but rather, the management of weak pelvic / low back stabilizing muscles can have significant benefits for those suffering from neck pain. Let’s take a closer look… A group of physical therapists in Brazil and Australia performed a systematic literature review of the benefits of specific stabilization exercises for spinal and pelvic pain and looked at disability, return to work, number of episodes, global perceived benefit, and quality of life factors. They not only searched for the beneficial effects for low back and pelvic pain and dysfunction, but also the benefits for headache with or without neck pain and any related disability. Not only did they find significant research support for improving pelvic pain and for preventing recurrence after an acute episode of low back pain but they also found that cervicogenic headache and neck pain improved from the use of low back / pelvic stabilization exercises! Furthermore, researchers have found that patients achieve more significant improvement when stabilization exercises focus on the individual patient vs. the use of a generic “…one size fits all” stabilization program. Additionally, spinal manipulative therapy (SMT) has been reported as the most effective treatment for cervicogenic headache and neck pain patients. Other studies have found that the combination of exercise AND SMT is more effective than exercise alone. The bottom line is that stabilizing the lower quarter (low back and pelvis) helps, as it offers the neck and head a better foundation on which to rest. An analogy would be a house with a weak foundation resulting in the whole house being in jeopardy, especially the attic or the area farthest away from the ground. Like the attic, the head is perhaps more dramatically affected by the weak pelvic stability than areas closer to the pelvis / low back. Researchers have found that doctors of chiropractic can significantly improve neck pain, balance, and headaches in chronic neck pain patients by strengthening the deep neck flexors, or the muscles that attach directly to the front of the cervical spine. We also know that treatments that promote movement such as spinal manipulation, when rendered early-on, can results in better outcomes for the whiplash patient. Therefore, the “key” to the greatest success is chiropractic adjustments + cervical range of motion exercises + cervical stabilization exercises + lumbar/pelvis stabilization exercises! Traditionally, “rest and heat” are commonly prescribed for neck pain patients, or worse, they are placed in a cervical collar and taken off work and told to rest. The evidence published, especially since 2008, STRONGLY disagrees with this approach favoring a treatment plan that incorporates motion, “usual” activity (including work), manipulation, and exercise as soon as possible. Chiropractic embraces not only spinal manipulation but also patient specific range-of-motion and strengthening/stabilization forms of exercises as “main ingredients” to care when patients present for neck pain and headaches. To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up.

What’s Causing My Back Pain? Courtesy Of: Sayville Immediate Chiropractic & Dr. Frank Gomez            

Low back pain (LBP) is one of the most common reasons patients seek out Chiropractic care, and they appreciate being told what is causing their back pain. This is why doctors gather a careful and complete history from new patients and perform a physical examination.  Once the “pain generator” is determined, a doctor can discuss various treatment options and develop a plan for managing the patient. Let’s review some causes of LBP!             If we divide the various conditions into three categories, it significantly improves diagnostic accuracy. These include: 1) Mechanical LBP; 2) Nerve root pain; and 3) “Red Flags” (serious conditions). The most common conditions are those belonging to the first group. The following is a partial list of conditions that belong to each category: 1)      Mechanical LBP: Causes of mechanical LBP include Lumbar and sacroiliac (SI) sprains, lumbar muscle strains, facet syndrome, degenerative disk disease (DDD) and/or injury to the disk without nerve pinch, osteoarthritis (this can affect different parts of the spine), spinal instability, spondylolysis and/or spondylolisthesis, and more. The pain pattern is usually localized to the low back and may spread into the buttocks, hips, thighs, but rarely extends past the knee. Usually, there is NO numbness or weakness in the leg or foot because that symptom suggests a spinal nerve pinch. 2)      Nerve root pain can result from herniated disk (from either direct nerve pinching and/or chemical irritation inflaming the nerve), central or lateral spinal stenosis (usually caused by a combination of things including DDD), arthritis, and/or calcification of ligaments near the nerve. These can be managed very successfully without surgery but the careful monitoring of numbness, muscle weakness, and treatment satisfaction is important! 3)      Red Flags: These are the potentially dangerous conditions such as cancer, fracture, infections, cauda equina syndrome (spinal cord pinch creating bowel and/or bladder weakness). Referred pain from organs may be included here as well. As you can see, these carry potentially lethal consequences and require immediate referral and specialty management.             The majority of patients suffering from LBP fall into the first two categories, and the HISTORY can tell us a lot! If the patient complains of pain that stays mostly in the low back but may spread into the buttocks or thigh without numbness/weakness in the leg and feels better with leaning forwards or curling up in a ball, it probably is a Group 1 (mechanical) diagnosis. If there is numbness, tingling, and/or weakness in the leg to the foot and bending over hurts, it’s most likely disk derangement (bulge, herniated, etc.) with a nerve pinch. If there is unexplained weight loss, a past history of cancer, non-responding LBP to treatment, sleep interruptions, and age >50 years old, we may now be in category three and further tests are needed!             The IMPORTANT point is that spinal manipulation (chiropractic) can manage the most common causes of LBP as a non-surgical, low-risk form of care.                 To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http://www.SayvilleChiropractor.com http://www.DrFrankGomezBlog.com http://www.Chiro-Trust.org http://www.SayvillePainRelief.com

Neck Pain – When Should I Come In? Courtesy of: Sayville Immediate Chiropractic and Dr. Frank Gomez

Neck pain is one of the most common complaints patients have when they come to a chiropractic office for the first time, second only to low back pain. Neck pain affects all of us at some point in life, and for some, it can become a chronic, permanent problem that can interfere with many desired activities and lower their quality of life. There are many different causes, and prompt evaluation and treatment is important is some cases.             Neck pain and stiffness are the two most common symptoms that present for evaluation and treatment. This can be located in the middle of the neck and/or on either side and can extend down to the shoulders and / or chest. It can contribute to or causetension headaches that can travel up the back of the head and sometimes behind the eyes. Pain often increases with neck movement, such as when turning the head to check traffic while driving and/or it can hurt at rest while held in static positions, such as when reading a book. Neck pain can come on gradually or quickly and often cannot be traced to a specific injury or cause making it a challenge to figure out. While neck pain is often not serious or life-threatening, there are causes that should be evaluated promptly. If you wake up with acute neck pain associated with very limited range of motion, this may be due totorticollis, or wry neck, and prompt treatment helps it resolve more quickly than “waiting it out.” Torticollis can be caused by exposure to a draft, changes in weather, trauma, or after a cold or flu. When in doubt, come in for an evaluation and treatment, as anxiety associated with the “fear of the unknown” only adds to the stress associated with neck pain and it’s ALWAYS best to be “…safe than sorry!”             Numbness or tingling may accompany neck pain and can be located in the face, arms, hands, and/or fingers. This is one of those times to come in promptly, as these symptoms may indicate the pinching of a nerve root in the neck. There are MANY chiropractic treatment approaches that effectively treat nerve root pinching, and treatment should NOT be delayed. Other common symptoms may include clicking, crunching, or grinding noises, technically called crepitus, which may or may not be benign. If the noise is accompanied by pain, especially if it radiates down to the shoulder blades or arms (either side or both), it’s time to promptly come in. Any time symptoms occur acutely or come on fast, it’s best to get evaluated as soon as possible.             Dizziness is another common symptom that can result from neck problems and is often associated with movement such as rising from laying or sitting. Certain positions of the neck can also bring on dizziness. This is sometimes caused by the “stones” in the inner ear shifting out of position and is technically called BPPV or “benign paroxysmal positional vertigo.” When this occurs, we can usually manage it very well with treatment and specific BPPV exercises. Other times, dizziness may be due to a restriction in blood flow reaching the brain. In which case, a prompt evaluation is VERY appropriate, especially if blackouts occur.             Sleep interruption or difficulty falling asleep are other good reasons to seek prompt evaluation and treatment. Sleep loss can lead to many problems such as excessive fatigue, tiredness, irritability, and just generally feeling poor! Remember, prompt care usually results in prompt resolution!             To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http://www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http://www.Chiro-Trust.org http://www.SayvilleChiropractor.com http://www.DrFrankGomezBlog.com http://www.SayvillePainRelief.

Chiropractic Management of Neck Pain (Part 2) Courtesy of: Sayville Immediate Chiropractic and Dr. Frank Gomez            

Last month, we covered the first two of four primary goals when it comes to the chiropractic management of neck pain (#1 – Pain Management and #2 – Structural realignment). This month, we will conclude this discussion with #3 – Functional Restoration and #4 – Prevention.             3) FUNCTIONAL RESTORATION: Restoring function basically allows the patient to return to their pre-injury activities of daily living, which is the ultimate goal when managing all conditions! In order for this to happen, it is necessary to have the first two goals accomplished, and the primary “tool” that we use to accomplish this goal is exercise training. There are several options to determine which exercise is most needed. A physical performance test can be done, which consists of a series of exercise-like maneuvers that we measure with an instrument that measures degrees (for range of motion), count repetitions (when testing for strength), or count time – usually in seconds (when testing for endurance, balance, and aerobic capacity). We then can compare you to the “norms” that have been published to see if you need help in a particular area. This also establishes a “baseline” or starting point to compare a month later after you’ve performed the proper exercises designed to improve that “failed test.” The three primary goals of exercises include stretching, strengthening, and restoring coordination.             STRETCH: A very effective exercise is performed by bending the head to the right, reaching over with the right hand, and gently pulling on the head until a good stretch is felt on the left side of the neck. Reaching down with the opposite (left) arm (as if there’s a dollar bill on the ground and you just can’t quite reach it) enhances the stretch. While stretching, tuck in your chin, drop your head forwards and backwards, and turn your head a little from side to side to feel for different tight muscle fibers. Continue this stretch for 10-20 seconds or long enough to feel that you’ve accomplished a good stretch. Then, repeat this on the opposite side. This can be done sitting or standing, and most importantly, do this multiple times a day, especially when you feel tight – like at work, for example. There are other stretches but this actually combines four different exercises into one, so it’s often enough!             STRENGTHENING: Place your hand against the side of your head and push your head into your hand using about 10-20% maximum effort (not much pressure!). First, allow your head “to win” by moving your head further until a tight stretch is felt. Second, let your hand “win” by moving the head to the opposite direction while maintaining pressure against your hand. Allow the head to bend ALL THE WAY to the end-range and repeat three times in each direction.             COORDINATION: Motor control, balance, and coordination are further enhanced by balancing on one foot with eyes open AND closed. Stand near a wall to avoid falling!             4. PREVENTION: Keep exercising and eat right! Consider joining a health club, working out with a friend, riding a bike, walking, and/or swimming. You choose!             To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Chiropractic Management of Neck Pain (Part 1) Courtesy of: Sayville Immediate Chiropractic and Dr. Frank Gomez            

Neck pain is a very common condition that drives many patients to seek chiropractic care. Treatment planning typically includes four primary goals: 1) Pain Management; 2) Structural Realignment; 3) Functional Restoration; and 4) Maintenance / Prevention.             1) PAIN MANAGEMENT: Getting rid of pain is the primary focus of ALL patients in the early stages of a neck injury. If we use the acronym “PRICE” (Protect, Rest, Ice, Compress, and Elevate), the first three apply when it comes to neck pain. We“protect” our neck by avoiding or changing the way we go about doing things such as our sleep position (this often prompts a “proper pillow discussion”), adjusting the outside rearview mirrors of our car (if you flair the outside mirrors outwards, it opens up the “blind spots” and may prevent a collision, especially if you cannot rotate your neck very far), and modifying other ADLs (activities of daily living). The bottom line is: if an activity creates a sharp pain sensation, it is a “warning sign” to modify or stop WHATEVER it is that you’re doing. Wearing a cervical collar for a SHORT duration of time can qualify for both “Protect” and“Rest.” Try resting your neck on a pillow when reading or watching TV, as it allows the neck muscles to rest. A cervical traction device can help reduce muscle spasm, improves flexibility (range of motion), and reduce pain. Alternating “Ice” and heat can be even more effective, as it “PUMPS” out inflammation or swelling. Heat is also a good natural muscle relaxant and ice reduces swelling (inflammation), both of which can help reduce pain. There really is no hard and fast rule as to how long you should continue using ice (days, weeks, or months) – if it helps, use it (unless you are hypersensitive and frostbite easily, in which case limit the ice time). However, heat can worsen a condition if it’s applied too soon or too long. Anti-inflammatory herbs like ginger, turmeric, boswellia, and others are very effective and actually may be BETTER than ibuprofen, Aleve, or aspirin. Recent studies indicate that there may be a delay in healing when over-the-counter pain medications are used, and the recommendation is to AVOID these drugs so healing won’t be delayed!             2) STRUCTURAL REALIGNMENT: The goal here is to improve (to the best of our ability) faulty bony misalignments that frequently exist in the neck, upper, middle back as well as the low back, as all can contribute to neck pain. This is also a great long-term goal, as it may help PREVENT future episodes of neck pain. There is a natural process of aging called osteoarthritis that none of us can avoid, but allowing faulty curves and bony misalignments to persist may actually accelerate this degenerative process! Your Chiropractor may have you lie on a tightly rolled up towel (a frozen water bottle often feels even better) placed behind the neck and when it’s comfortable, performing this on the edge of the bed is a great way to re-educate a reversed cervical curve (and, it feels GREAT!). Even a heel lift in the shoe of a short leg can help the neck! Spinal manipulation, manual mobilization techniques, and trained exercises all address this treatment goal quite effectively!             We will continue this conversation next month discussing the third and fourth topics: 3) Functional Restoration; and 4) Maintenance / Prevention, so STAY TUNED!             To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign up We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up.

“My Neck Is Killing Me!” Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com

When patients present with neck pain, they always ask, “where is the pain coming from?” Of course, this can only be answered after a careful history and thorough evaluation is completed, which is what we do in this office.  Let’s take a closer look at what this involves. The History: This includes a careful description of how the injury occurred, if there was an injury.  For example, in a slip and fall injury, it makes a difference if the patient fell forwards, sideways, or backwards; if they landed on their knees, hips, buttocks, back or if they hit their head on the ground.  Also, if there was a dazed feeling or loss of consciousness in the process.  If there was a head strike, were there any signs of concussion: fatigue, mental “fog,” headache, difficulty communicating or forming words or sentences.  When there is no specific injury, we will ask if there were perhaps one or more, “mini-“ or “micro-“ injuries that may have occurred sometime within 2-3 days prior to the onset of the neck pain.  The cumulative effect of several small “micro-injuries” can result in a rather significant onset of symptoms several days later.  The next batch of information gathered includes factors that increase and decrease the pain, the type of pain quality (sharp, dull, throb, burn, itch, etc.), pain location – “…put your finger on where it hurts and “does it radiate into the arms or legs, severity (pain level 0-10), and timing such as, “it’s worse for the 1st 30 min. in the morning and then loosens up.” Information regarding past history, family history, medical history (surgeries, medications), social history, habits (caffeine, tobacco, alcohol, etc.), and a systems review (heart, lungs, stomach, nervous system, etc.). The Physical Exam: This includes vital signs (blood pressure, etc), observation – the way the head is positioned (forwards, to the side, rotated, etc.); palpation – touch/feel for muscle spasm, trigger points, spinal vertebra position and motion; range of motion, orthopedic and neurological tests. The exam procedure may also include x-ray, depending on each case. The Diagnosis:  This is determined after taking all your information and “…putting the puzzle pieces together” to determine what is causing your pain. The Treatment:  Chiropractic spinal manipulation (often referred to as “adjustments”) is performed by applying energy or force to the misaligned or fixed vertebra structures by one of many methods depending on the patient’s size, pain level, tolerance, and so on. Other “manual” treatment approaches include soft tissue therapy such as trigger point therapy, active release, massage, vibration, and others. The use of physical therapy modalities such as ice, heat, electrical stimulation, ultrasound, light – laser therapy, and/or others, again, depending on your specific situation and needs can also be very helpful.  Similarly, exercises to teach you how to hold your proper posture, to improve flexibility or range of motion, and to strengthen the muscles that are weak really help to make the adjustments “hold” and the beneficial effects last longer. A work station/job assessment may also be needed if that appears to be irritating your condition.             We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up.

Neck Pain, Chiropractic and the Older Patient Courtesy of Dr. Frank Gomez of Sayville Immediate Chiropractic

People of all ages suffer from neck pain, and many frequently turn to chiropractors for care because it’s been found to be one of the most effective and efficient forms of treatment available, and it carries minimal side effects!  It has been projected that by 2030, nearly one in five US residents will be 65 or older. Currently, approximately 14% of the patients treated by chiropractors are 65 or older, making it one of the most frequently utilized forms of complementary and alternative care used by older adults. What kind of care can a senior citizen expect when seeking treatment from a chiropractor? Let’s take a look!             Musculoskeletal pain, or pain in the neck, back, arms, and/or legs, drives the majority of elderly patients to chiropractors. While low back and neck pain are the most common complaints, it’s not unusual for patients to also have one or two other conditions (or more) that they did NOT know chiropractic care could help. In fact, common “goals” for managing every patient (not just the elderly) include services related to patient assessment, maintenance of health, and prevention of illness, in addition to treatment of illness or injury. Common chiropractic treatment approaches include spinal manipulation and/or mobilization, nutritional counseling, physical activity/exercise, and (especially important for the elderly population) fall prevention.             We will now focus on neck pain as it relates to the elderly population and the various chiropractic management strategies that might be encountered by an elderly patient. Common reasons patients present regarding the neck include limited movement, stiffness, and pain. Neck pain can also interfere with sleep, as finding a comfortable position in bed can be quite challenging! Lifting, carrying, and playing with grandchildren is a very common issue for either causing a new complaint or irritating an existing one. Neck pain may also interfere with reaching and lifting. Thus, activities like yard or garden work may become more difficult and less enjoyable. Neck pain is often associated with headaches, which can make daily tasks even more challenging.             When an elderly patient visits a chiropractor for the first time or for a new complaint, he/she can expect to fill out some initial paperwork, as well as provide a history of the main complaint and any lesser complaints. This may also include providing a family and medical history. The examination usually includes general observations, palpating or feeling for muscle tightness, tenderness, warm/cool, range of spinal motion (neck, back, extremities), orthopedic tests, neurological tests, and possibly x-rays. Treatment of the neck may include massage or mobilization to loosen up the neck, manipulation to free up restricted joint motion, and even exercise training. The goal of treatment is to improve neck motion, activity tolerance, and quality of life (less pain, improved sleep, etc.). So, whether you are 10, 20, 50, 70, or 90 years old, give chiropractic a chance to help you manage your neck pain!             We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Neck Pain – Drugs or Chiropractic? Courtesy of: Sayville Immediate Chiropractic Care

When you have neck pain, do you instinctively reach for that bottle of ibuprofen or Tylenol? If so, is that the best option? Who can we trust for the answer? Since between 10-20% of the population suffer from chronic or persistent neck pain, this is a VERY IMPORTANT question!             If we look at the literature published in peer reviewed journals by authors who have no financial incentives in the outcome of the study, we can find accurate, non-biased information to answer this question. So, let’s start with a landmark study published inSPINE, a leading medical journal that reviewed ALL the publications printed between 2000 and 2010 on neck pain – a total of 32,000 articles with over 25,000 hours of review. (Haldeman S, Carroll L, Cassidy JD, et. al. The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: Executive Summary. Spine 2008,33(4S):S5-S7). This resulted in a 220 page comprehensive report from a multidisciplinary International Task Force involving seven years of work from 50+ researchers from 19 different clinical scientific disciplines worldwide looking at the MOST EFFECTIVE approaches available (both surgical and non-surgical) for patients suffering from neck pain.             Highlights from the study include the following: 1) Manipulation/mobilization are safe, effective, and appropriate treatment approaches for most patients with disabling neck pain (both traumatic and non-traumatic); 2) Neck pain patients should be informed of ALL effective treatment options so they can choose effectively; 3) The very rare risk of vertebrobasilar artery (VBI) stroke is NO DIFFERENT when comparing patients consulting a doctor of chiropractic verses a primary care medical physician as the stroke event, in most cases, has occurred prior to the visit; 4) The treatment option(s) available should consider the potential side effects and personal preferences of the patient; 5) For most neck pain patients, treatments that were found to be safe and effective include manipulation, mobilization, exercise, education, acupuncture, analgesics, massage, and low-level laser therapy; 6) For non-neurological neck pain, ineffective treatments (poor choices) include surgery, collars, TENS (transcutaneous electrical nerve stimulation), most injection therapies (including corticosteroid injections and rhizotomy); 7) For neck pain WITH nerve compression, there is very little research published on non-surgical care. Here, in the absence of serious pathology or progressive neurological loss, start with the most conservative (like chiropractic!) followed by more invasive treatments like epidural steroid injections (ESI’s) and surgery; 8) Whiplash patients should follow similar guidelines as described above; 9) Some benefit from the chosen treatment should be seen within the first two to four weeks of care; and, 10) Be realistic about treatment goals – neck pain is often recurrent (comes and goes) as most people (50-80%) will NOT experience complete resolution of symptoms and will have neck pain again one to five years later.             Another study published in The Annals of Internal Medicine (“Spinal Manipulation, Medication, or Home Exercise with Advice for Acute and Subacute Neck Pain: A Randomized Trial. 3 January 2012, Vol.156, No. 1, Part 1) reports similar information favoring spinal manipulation and exercise, as these were found to be SUPERIOR to medication use. Another study reported excellent results for 27 patients utilizing chiropractic care who had herniated cervical disks WITH spinal cord compression verified on MRI (70% improved after an average of 12 visits)! TRY CHIROPRACTIC FIRST!!!             We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Carpal Tunnel Syndrome – What Can I Do to Help? (Part 2) Courtesy of: Sayville Immediate Chiropractic Care

Carpal Tunnel Syndrome (CTS) management strategies were introduced last month, which we will conclude this month with Part 2. In part one, we cited three primary goals of CTS management that include the following: 1) Physical management strategies; 2) Chemical management strategies; and 3) Self-management strategies. All three goals include a component that we as doctors of chiropractic control AND (most important), a component that you the patient controls. We will continue this discussion this month with chemical management strategies. 2. Chemical management strategies: Here, MY JOB includes guiding you in methods to reduce swelling or inflammation. The first method involves the use of ice. Different cooling approaches include the use of ice cup/massage (applied directly on the skin until numb, which takes about five minutes) and/or ice packs (takes about 10-15 minutes). We can also offer assistance in choosing various anti-inflammatory herbs (such as ginger, tumeric, boswellia) and  vitamins (such as vitamin B6 or pyridoxine; magnesium, fish oil / omega 3 fatty acids, vitamin D) with anti-inflammatory properties. Recently, probiotics have also been demonstrated to reduce inflammation! YOUR JOB is to follow these recommendations that you and I agree upon to help reduce the inflammatory effects of CTS. Other “chemical strategies” may include adding the primary care physician to “the team,” as prescriptions for various conditions such as diabetes, hypothyroidism, rheumatoid arthritis, and others may be appropriate in certain CTS cases. 3) Self-management strategies: Though we have already looked at “MY JOB” and “YOUR JOB” as it pertains to 1) Physical management and 2) Chemical management strategies, overlap exists between all three CTS management goals. In other words, as the name implies, “self-management strategies” includes the need for you to comply with the recommendations. For example, wearing the cock-up wrist splint primarily at night (when sleeping and less commonly at times during the day), following instructions regarding job modifications, nutritional strategies and, when applicable, pharmaceutical intervention are things you can do to alleviate symptoms. One of the MOST IMPORTANT self-help strategies is the training of carpal tunnel specific exercises, as well as exercise in general. Maintaining a proper weight (a BMI between 20-25) is also a goal that will help CTS, as obesity is a risk factor for this condition and a host of other conditions, including diabetes! EXERCISE #1: Stand near a wall. Place your palm on the wall at shoulder height pointing the fingers down towards the floor, keeping the elbow straight. Reach across with the opposite hand and pull your thumb back as you stretch the palm-side forearm muscles. Hold 5-10 seconds until you feel the muscle “melt.” Repeat three times per side, five times a day. You can use the edge of a counter top rather than a wall, if you like. EXERCISE #2: Bend the elbow 90 degrees. “Dig” your thumb DEEP into the palm-side forearm muscles close to the elbow. Slowly straighten the elbow and maintain the deep pressure into the muscle until the elbow is completely straight. REPEAT this multiple times moving your thumb one inch closer to your wrist from the last pressure point until you are one to two inches from the wrist (or, until you don’t feel much tenderness). You can vary the speed at which you straighten the elbow but generally, slower is better than fast movement, and the deeper the pressure, the better.             Repeat these two exercises on BOTH sides so you can feel the difference between the two, regardless if you have problems on both sides. Since the neck and shoulder can be involved, we will also show you how to stretch these areas, as keeping the whole “kinetic chain” stretched is very important for long-term benefits.             We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Carpal Tunnel Syndrome – What Can I Do to Help? (Part 1) Courtesy of: Sayville Immediate Chiropractic

Carpal Tunnel Syndrome (CTS) can arise as a result of a number of different causes and as such, treatment is guided by the specific needs of the individual and tailored to each individual case. With that said, there are specific treatment strategies that chiropractors provide that address three primary goals: 1) Physical management strategies; 2) Chemical management strategies; and 3) Self-management strategies. All three goals include a component that we, the doctor, control AND a component that you, the patient, can control or manage. This combined effort or “team approach” ALWAYS works best, especially over the long-term. So, let’s break these three management strategies down along with the two components: my job (as your chiropractor) and your job (as my patient)! 1) Physical management strategies: This category addresses the mechanical nature of CTS. That is, compression of the median nerve at ALL of the possible sites, not JUST the wrist/carpal tunnel area. Since the median nerve arises initially from the neck or cervical spine, nerve root compression of C6-T1 (and a little of C5) can give rise to CTS signs and symptoms. As discussed last month, this area can be one of the “great imposters” of CTS and/or it may contribute as a co-conspirator and combine with CTS, which magnifies or increases the CTS signs and symptoms, the so-called “double-crush syndrome.” Other “mechanical” sites of compression can be reviewed in last month’s Health Update, but in brief, these may include the thoracic outlet (shoulder area), Struther’s ligament (just above the elbow), the pronator tunnel (just below the elbow), the anterior interosseous membrane (forearm), as well as at the carpal tunnel itself. MY JOB (as your chiropractor) is to reduce the pressure on the nerve at any and/or ALL these locations (remember, each case is unique). This can be done by using manual therapies including (but not limited to) manipulation of joints in the neck, shoulder, arm, elbow, forearm, wrist, hand, and fingers. Mobilization of muscles and other soft tissues may include active release techniques, friction massage, trigger point therapy, stretching with and without resistance, traction, and more. Various modalities might be used to reduce muscle tightness, swelling, or inflammation. A nighttime wrist splint keeps the wrist in a neutral position, as the carpal tunnel’s pressure goes up A LOT when the wrist is bent. Since you cannot control the position of your wrist while you sleep, the brace can REALLY HELP! A BIG part of my job includes teaching YOU about CTS so that you understand the underlying causes, thus allowing you to identify jobs, hobbies, or situations where you may be inadvertently harming yourself. If you can, PROMPTLY identify offending wrist positions and STOP the repetitive injurious movement and then MODIFY your approach to the task, whether it means taking “mini-breaks,” changing the work station set up, or some other approach. Along with this “teaching concept” is exercise training. It is also VERY IMPORTANT for you to properly perform the carpal tunnel stretches and other exercises (see Part 2 next month) on a regimented/regular basis. YOUR JOB includes wearing the brace (don’t forget or procrastinate), most importantly at night. You can wear it during the day while driving or doing something where you are not “fighting” the brace. In some cases, the brace can bruise you if you are moving your wrist against it repetitively or too hard, and it can actually do more harm than good in those situations. Your job is also to identify ways to do your job and/or hobbies with less torque or twisting of your wrist. Next month’s discussion will start chemical strategies (#2 on the list above), which includes several very effective and safe approaches in the CTS management process. We will then address #3, “Self-management strategies,” which will include various CTS-specific exercises. We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Great Imposters of Carpal Tunnel Syndrome Courtesy of: Sayville Immediate Chiropractic Care

Carpal Tunnel Syndrome (CTS) is caused by compression and subsequent irritation of the median nerve as it travels through the carpal tunnel and into the hand where it innervates the palm side of the second to fourth digits. As stated last month, the median nerve is sometimes referred to as, “…the eye of the hand” since we rely so heavily on activities of daily living (ADLs) that require its health and function. Some of these ADLs include buttoning a shirt, picking up small objects, tying a shoe or neck tie, writing, holding a book or coffee cup, gripping items such as a phone or steering wheel, opening jars, household chores, and carrying objects, especially with the finger tips.             When patients present with CTS signs and symptoms, one would think that the examination and treatment would be fairly straightforward and “routine.” The problem is, no two cases of CTS are identical because of all the possible mitigating factors, or the presence of OTHER issues that may be contributing or may be the REAL cause for CTS in that particular person. This may explain the reason surgical release of the transverse carpal ligament doesn’t always work!             The “Great Imposters” of CTS include both physical and chemical factors. Physical factors include (but are not limited to): 1) Cervical nerve root compression: Since the median nerve originates from the C6-T1 (and a little from C5) nerve roots exiting the spine, it only makes sense that a pinched nerve in the neck can mimic a pinched nerve at the wrist. The difference here is “usually” that the whole arm is involved, which is less likely in CTS only. Moving down from the neck, the next most common location for a mechanical pinch is at the 2) Thoracic outlet: Here, the nerve roots coming from C5 to T2, like merging lanes of a highway, come together to make the three main nerves that enter the arm and along with the blood vessels, this “neurovascular bundle” leaves the upper chest region and travels through the thoracic outlet to enter into the arm. The thoracic outlet can become narrowed if there is an extra rib, a shift in the collar bone or shoulder blade, from muscles that are too tight (especially the anterior scalene and/or pectoralis minor), or from anything that occupies space within the thoracic outlet. 3) Struther’s ligament: In a few of us (only about 2%), there is a ligament just above the elbow that can entrap the median (as well as the ulnar) nerve, creating a pinch and subsequent numbness below that point, mimicking CTS. 4) Pronator tunnel: The median nerve is more commonly entrapped by the pronator teres muscle just below the elbow, and treating this location can be highly rewarding when managing stubborn CTS cases. Less common is entrapment in the mid-forearm, though it’s possible by either the interosseous membrane that connects the ulna and radius or from fracture of the ulna and/or radius. The most distal point of median nerve compression is at the carpal tunnel. Entrapments can be singular or multiple and when more than one “tunnel” compresses the median nerve, the term double or multiple crush is utilized. Management MUST address ALL points of compression to obtain long-term satisfying results. Other “imposters” of CTS include a host of conditions including (but not limited to) thyroid disease, diabetes, arthritis, pregnancy, birth control pill use, obesity, and MANY others! Chiropractic makes the most sense when it comes to managing CTS from mechanical causes. If response is slow or not satisfying, we will order tests and/or consults to get to the bottom of what “imposters” may be contributing to your CTS symptoms!              We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com

Chiropractic & Exercise vs. OTC Medication for Neck Pain?

Courtesy of: Sayville Immediate Chiropractic Care “Boy, my neck is killing me! Honey, where is the ibuprofen?” Isn’t this the FIRST thing people think of when they have an ache or pain? The general public does NOT usually think, “….boy, do I need to see my chiropractor – my neck is killing me!” So, the question of the month is, which one is better, chiropractic or over-the-counter (OTC) medication? Let’s take a look. Though this question has been discussed for years (just search: “chiropractic vs. NSAIDs”), a recent study looked specifically at this question, which will be the main focus of this Health Update. The study points out that it has been estimated that 75% of Americans will experience neck pain at some point in their life. For years, spinal manipulation has been criticized as being ineffective or providing limited benefits. Meanwhile, ads on TV, in magazines, and almost everywhere you look, show someone reaching for aspirin, ibuprofen, or even narcotics to manage their pain. However, this new research clearly supports that seeing a chiropractor and/or engaging in light exercise can bring neck pain relief more effectively than relying on pain medications! Researchers even found that the benefits of chiropractic adjustments were still favored A YEAR LATER when comparing the differences between the spinal manipulation and medication treated groups! Moderate acute neck pain is one of the most frequent complaints prompting appointments at primary care/medical clinics and is estimated to account for millions of doctor visits per year. In some cases, pain and stiffness occurs without a known cause and there is no “standard” medical treatment. Though physical therapy, pain medication, and chiropractic have all been utilized for neck pain, until now no one had compared the benefits of each in a single study. The study consisted of 272 neck pain subjects split up into three groups: 1) Chiropractic group (approximately 20-minute treatments an average of 15 times); 2) Pain medication group (meds included acetaminophen, and in some cases stronger prescription meds including narcotics and muscle relaxants); 3) Physical Therapy group (consisting of meeting twice and receiving advice and exercise instruction at 5-10 repetitions up to eight times a day). At the end of three months, the chiropractic and exercise group did significantly better than those who took drugs. Approximately 57% of those receiving chiropractic management and 48% of those who did the exercises reported at least 75% reduction in pain vs. 33% of people in the medication group. A year after the treatment period ended, the numbers decreased to 53% in the chiropractic and exercise groups, compared to 38% in pain medication group. The chiropractic group received the highest scores in patient satisfaction at all time points. An interesting downside noted in the medication study group was that the subjects had to use a progressively greater amount of medication at a progressively increased frequency to manage their pain. Stomach trouble is the most common side effect of NSAIDs (leading to ulcers) as well as liver and kidney problems. Another interesting finding was that the subjects in the medication treated group felt less empowered, less active, and less in control over their own condition compared with those in the other two groups. This study points out the benefits of two treatment approaches that chiropractors commonly utilize: spinal manipulation and exercise training/advice! We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to http/:www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. http/:www.Chiro-Trust.org http/:www.SayvilleChiropractor.com http/:www.DrFrankGomezBlog.com http/:www.SayvillePainRelief.com http/:www.USchirodirectory.com Chiropractic and Neck Pain in Children Courtesy of: Sayville Immediate Chiropractic Care www.http://sayvillechiropractor.com Children have been treated by chiropractors for spinal problems ever since chiropractic was founded in 1895, and neck pain is no exception. Neck pain is surprisingly common in kids, though not quite as common as it is in adults, reaching a similar occurrence rate by age 18. Studies conducted in the United States and in other countries report similar findings, leaving one to conclude there is a high prevalence of neck pain in kids all over the world. There are many causes of neck pain with a few being unique to children and some that could be a warning sign of something dangerous, such as meningitis. But far more commonly, neck pain in kids is NOT dangerous. Let’s take a look!             Looking at neck and shoulder pain in high-school-aged students, 931 males between 16 and 19 years of age were surveyed. More than two out of five students (44.3%) had recurrent neck and shoulder pain more than once a week with an overall prevalence of 79.1%. THAT’S A LOT! The study reported the student’s average sitting time was 10.2 hours a day, 59% did NOT sit up straight, and 11.9% reported that they stretched their neck and shoulders regularly throughout the day. Students with recurrent neck and shoulder pain also reported frequent fatigue and depressed moods. Looking specifically at 1,122 backpack-using adolescents, 74.4% were classified as having back or neck pain. When compared to non- or low use backpackers, there was nearly a two times greater likelihood of having back/neck pain! Also, females and those with a large body mass index (overweight) were also significantly associated with back/neck pain. Lastly, they found when compared to adolescents with no back/neck pain, those with pain carried significantly heavier backpacks.             Another common cause of neck pain in adolescents is a condition called torticollis or, “wry neck.” This is basically a muscle spasm of certain neck muscles that rotate and extend the head from the neutral / normal position, often described as being “stuck” in this position. Though there are several types of torticollis, it can be triggered by almost anything including a change in weather, sleeping in a draft, following an infection like a cold or flu, maintaining a faulty prolonged posture, certain types of medications, and many others. Some studies describe torticollis as usually improving within one to four weeks, but in the hands of a chiropractor, it usually takes two to three days for the acute pain to subside and one week to completely finish the job! Of course, this varies depending on the case. Infants can be born with “congenital torticollis,” which occurs in 0.3 to 2.0% of newborns. Here too, chiropractic is VERY effective.              We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.Chiro-Trust.org www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Neck Pain and Sleep Courtesy of: Sayville Chiropractic, Dr. Frank Gomez www.http://sayvillechiropractor.com I’m hoping this “HEALTH UPDATE” will not PUT you to sleep but rather WAKE YOU UP to the important information presented here about how to sleep in the presence of neck pain.             If you’ve ever had neck pain, then you already know how challenging it is to find a comfortable position in bed and how difficult it can be to fall asleep and stay asleep!  In fact, sometimes neck pain can get so bad, that lying down is not even an option.              Sleep, especially deep sleep, is a VERY important part of healing so it’s important to learn as much as possible so you can get some good quality sleep!  In fact, a Harvard based report states 75% of us get less than 6 sleep hours at least a few nights per week, which over the short haul, is not a problem, but NOT so in the long haul! They go on to list “Six reasons not to scrimp on sleep:” 1) Learning and memory – “memory consolidation” occurs better after we sleep when learning new tasks (and tests scores reflect the difference); 2) Weight and metabolism – chronic sleep problems can cause weight gain by altering the way our body processes and stores carbohydrates and by altering the hormones that affect appetite;  3) Safety – increased fatigue = a greater tendency to fall asleep during the day, which can be catastrophic (car accidents, industrial accidents, etc.); 4) Mood – the lack of sleep can increase irritability, impatience, concentration loss and moodiness; 5) Heart health – serious sleep loss has been linked to hypertension, increased stress hormone levels, and irregular heartbeat;  6) Disease – alters immune function and may help fight cancer.             Let’s get back to sleeping best with neck pain!  As a start, avoid caffeine at least 2-3 hours before bedtime – that’s a “no brainer!”  For some, exercising too close to bedtime is not helpful.              Regarding neck posture while sleeping, the proper pillow is VERY IMPORTANT!  Try lying on your back and both sides but preferably not your stomach due to the need to rotate the neck. The “ideal pillow” is one that allows the neck to remain “neutral” or, maintain its normal curve that is present when standing. The pillow should not be too thick or too thin.  Since the neck is generally skinnier than our head, a “neck-friendly” pillow should be thicker on the edge so that it fills in the space between the neck and bed and thinner under the head. This is true whether we lay on our sides or back but the amount of space varies with age, gender, and phenotype – that is, thin, medium or heavy-set body types. There are many contoured or “shaped” pillows available that are thicker on the outside edges and thinner in the middle.  Some of these include foam pillows of different densities, air pillows, water pillows, memory foam pillows, feather pillows, and others.  Some companies make a pillow based on the measurement between the neck and the point of the shoulder.  This allows the person to pick the pillow size best suited for their neck size.  It’s important to note that it can take about a week to get used to the “new shaped” pillow so, “BE PATIENT!”  Since we spend 6-8 hours of time in bed sleeping (that’s 25-30% of our life is spent sleeping!), neck pain may be PREVENTED by using a contoured pillow and, it’s easier to get used to the new shape when you don’t hurt so take advantage of getting a contoured pillow when you are feeling good – talk to us as we can measure you and help you get set up right away!             If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.  We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.Chiro-Trust.org www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Neck Pain:  Manipulation vs. Mobilization –  What’s Better? Courtesy of: Dr. Frank Gomez, Chiropractic Physician www.http://sayvillechiropractor.com Does mobilization (MOB) get less, the same, or better results when compared to spinal manipulative therapy (SMT)? To answer this question, let’s first discuss the difference between the two treatment approaches. Mobilization (MOB) of the spine can be “technically” defined as a “low velocity, low amplitude” force applied to the tissues of the cervical spine (or any joint of the body, but we’ll focus on the cervical region). This means a slow, rhythmic movement is applied to a joint using various methods such as figure 8, side to side, front to back and /or combinations of any of these movements. In the neck, gentle to firm manual traction or pulling, when applied to the cervical spine, stretches the joint and disk spaces and can be included during MOB. Spinal Manipulative Therapy (SMT) can be defined as a “high velocity, low amplitude” type of force applied to joint which is often accompanied by a audible release or “crack,” which is the release of gas (nitrogen, oxygen, and carbon dioxide). Some joints “cavitate” or “crack” while others are less likely to release the gas. Studies that date back to the 1940s report an immediate improvement in a joint’s range of motion occurs when the joint cavitates. Many people instinctively stretch their own neck to the point of gas release, which typically, “…feels good.” This can become a habit and usually is not a big problem. However, in some cases, it can lead to joint hypermobility and ligament laxity.  As a rule, if only a gentle stretch is required to produce the cavitation/crack, it’s typically “safe” verses the person who uses higher levels of force by grabbing their own head and twisting it beyond the normal tissue stretch boundaries. The later is more likely to result in damage to the ligaments (tissue that strongly holds bone to bone) and therefore, should be avoided.  Since SMT is usually applied in a very specific location (where the joint is fixated or “stuck”, or, partially displaced), it’s obviously BEST to utilize chiropractic, as we chiropractors do this many times a day (for years or even decades) and we know where to apply it and can judge the amount of force to utilize, especially the neck where there are many delicate structures. Back to the question: Which is better, MOB or SMT? Or, are they equals in the quest of rid of neck pain? A recent study of over 100 patients with “mechanical neck pain” (strain/sprain)  showed that those who received SMT had a significantly better response than the MOB group as measured by a pain scale, a disability scale and 2 tests that measure function! So, the next time you ask the question, “….do you have to crack my neck?,” the answer should be “yes, if you want to achieve the quickest response.” However, if there is sharp pain during the “set-up” of the manipulation or adjustment, modifications in the technique are appropriate or, a different method should be considered. We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Cervical Traction – The Many Options and How To Use It! Courtesy of Dr. Frank Gomez www.http://sayvillechiropractor.com Last month, we looked at the published evidence that overwhelmingly supports the use of cervical traction. As promised, this month’s focus is the proper methods of applying it. The type of traction that this discussion will address will be limited to the kind that can be purchased and then used in the home, usually multiple times a day, giving it a clear advantage over in-office traction treatments which can only be applied a few times a week during office visits. In some cases however, it may be appropriate to use the in-office type for a few sessions to determine dosage and/or tolerance prior to administering a home unit, but this varies from case to case, and each type of traction unit is different. In the neck or cervical spine, there are many varieties including: sitting over-the-door types, cervical collar types, as well as supine (lying on the back) types. Each variety has its pros and cons and prices vary considerably from $10 to $600.             CONDITIONS: Probably the most common condition treated with cervical traction is “cervical radiculopathy,” or a pinched nerve. When a nerve root in the neck is pinched, pain, numbness, tingling, and/or muscle weakness occurs in the area the particular nerve innervates. For example, if a patient presents with pain and numbness radiating down the arm to the thumb and index finger and/or have weakness in bending their elbow and extending their wrist, then we know that the C6 nerve is pinched. When pulling or stretching the neck relieves the arm pain, traction is usually helpful. If pain worsens, the person is probably not ready for traction yet. PROTOCOL (DOSAGE): The key to a successful outcome using cervical traction is finding the right dosage. If you start with too much weight, it may leave you feeling sore, or worse, making you reluctant to try it a second time. Therefore, rather than relying on using a certain percentage of body weight, it’s safest to start with less weight and then gradually increase it, such as 5# (# = pounds or .45 kg) for 15-20 minutes. If that dose feels fine, try 7#/15-20 min., then 9#, 11#, 13#, etc., until you find it just isn’t quite as comfortable at the last weight. You have now found your current threshold and should drop down to the last most comfortable weight and use that for a few days and then MAYBE try increasing it again. Studies show a maximum stretch is usually achieved within 15-20 minutes, so extending the time longer may be less productive. Facing the over-the-door unit may be better tolerated than facing away. Try it both ways and you decide which feels best. The next most important issue is frequency. How often to repeat the traction sessions depends on: 1. The condition’s severity and your response; 2. Your time availability. If there is a severe nerve pinch with muscle twitching, weakness and dense numbness/tingling, then the traction be repeated MANY times a day, gradually increasing the weight to find the optimum amount. We’ve had people repeat the traction 10x/day! With the option of wearing a cervical collar traction unit, you can actually travel and/or do certain activities during traction. We’ve had people travel to and from work while performing traction! Since each case is unique, we’ll discuss that individually. The bottom line, IT WORKS GREAT with proper chiropractic management and in many cases, surgery CAN be avoided! We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Neck and Arm Pain – The Herniated Disk? Courtesy of Dr. Frank Gomez www.SayvilleChiropractor.com Patients that present with neck pain along with arm numbness, pain, and/or weakness, often ask, “…what’s causing this pain down my arm?”  The condition is often caused from a bulging or herniated disk pinching a nerve in the neck.  The cause of this complaint can include both trauma as well as non-traumatic events.  In fact, sometimes, the patient has no idea what started their condition, as they cannot tie any specific event to the onset.  The classic presentation includes neck pain that radiates into the arm in a specific area as each nerve affects different parts of the arm and hand.  Describing the exact location of the arm complaint such as, “I have numbness in the arm and hand that makes my 4th and pinky fingers feel half asleep,” tells us that you have a pinched C8 nerve.  This nerve can also be pinched at the elbow and make the same two fingers numb.  The difference between the two different conditions is when the nerve is pinched in the neck, the pain is located from the neck down the entire arm and into digits 4 & 5 of the hand.  When the nerve is pinched at the elbow, the pain/numbness is located from the elbow down to the 4th & 5th digits, but no neck or upper arm pain exists.  Examination findings usually include limitations in certain cervical (neck) ranges of motion (ROMs) – usually in the direction that increases the pinch on the nerve. Another common finding is the arm is often held over the head because there is more stretching on the nerve when the arm is hanging down and pain in the neck and arm increases.  Hence, raising the arm over the head reduces the neck/arm pain.  To determine where the nerve is pinched, there are a number of different compression tests that can recreate or increase the symptoms.  Some compression tests include placing downward pressure on the head with the head pointing straight ahead, bent or rotated to each side.  Other compression tests are performed by pressing in areas where the nerve travels such as in the lower front aspect of the neck, in the front of the shoulder where the arm connects to the chest/trunk, at the elbow and at the wrist.  If there is a pinched nerve, numbness, tingling and/or pain will be reproduced when pressure is applied to these regions.  Other tests include testing reflexes and muscle strength in the arm.  When a nerve is pinched, the reflexes will be sluggish or absent and certain movements in the arm are weak when compared to the opposite side.  Another very practical test is called the cervical (neck) distraction test where a traction force is applied to the neck.  When neck and/or arm pain is reduced, this means there is a pinched nerve.  This test is particularly useful because when pain is reduced, the test supports the need for a treatment approach called cervical traction.  It has been reported that the use of cervical traction when applied 3x/day for 15 minutes each, at 8-12 pounds, 78% of 81 patients reported a significant improvement in symptoms, which is very effective.  Other forms of care that can be highly effective include spinal manipulation, spinal mobilization, certain exercises, physical therapy modalities, and certain medications. If you, a friend, or a loved one are struggling with a herniated disk in the neck with associated arm complaints, we will properly assess your condition, run the appropriate tests, and administer the appropriate care that is needed.  We also coordinate services with other health care providers when necessary.  This recommendation may represent one of most significant acts of kindness you can give to those that you care about. We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com “My Neck Is Killing Me!” Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com When patients present with neck pain, they always ask, “where is the pain coming from?” Of course, this can only be answered after a careful history and thorough evaluation is completed, which is what we do in this office.  Let’s take a closer look at what this involves. The History: This includes a careful description of how the injury occurred, if there was an injury.  For example, in a slip and fall injury, it makes a difference if the patient fell forwards, sideways, or backwards; if they landed on their knees, hips, buttocks, back or if they hit their head on the ground.  Also, if there was a dazed feeling or loss of consciousness in the process.  If there was a head strike, were there any signs of concussion: fatigue, mental “fog,” headache, difficulty communicating or forming words or sentences.  When there is no specific injury, we will ask if there were perhaps one or more, “mini-“ or “micro-“ injuries that may have occurred sometime within 2-3 days prior to the onset of the neck pain.  The cumulative effect of several small “micro-injuries” can result in a rather significant onset of symptoms several days later.  The next batch of information gathered includes factors that increase and decrease the pain, the type of pain quality (sharp, dull, throb, burn, itch, etc.), pain location – “…put your finger on where it hurts and “does it radiate into the arms or legs, severity (pain level 0-10), and timing such as, “it’s worse for the 1st 30 min. in the morning and then loosens up.” Information regarding past history, family history, medical history (surgeries, medications), social history, habits (caffeine, tobacco, alcohol, etc.), and a systems review (heart, lungs, stomach, nervous system, etc.). The Physical Exam: This includes vital signs (blood pressure, etc), observation – the way the head is positioned (forwards, to the side, rotated, etc.); palpation – touch/feel for muscle spasm, trigger points, spinal vertebra position and motion; range of motion, orthopedic and neurological tests. The exam procedure may also include x-ray, depending on each case. The Diagnosis:  This is determined after taking all your information and “…putting the puzzle pieces together” to determine what is causing your pain. The Treatment:  Chiropractic spinal manipulation (often referred to as “adjustments”) is performed by applying energy or force to the misaligned or fixed vertebra structures by one of many methods depending on the patient’s size, pain level, tolerance, and so on. Other “manual” treatment approaches include soft tissue therapy such as trigger point therapy, active release, massage, vibration, and others. The use of physical therapy modalities such as ice, heat, electrical stimulation, ultrasound, light – laser therapy, and/or others, again, depending on your specific situation and needs can also be very helpful.  Similarly, exercises to teach you how to hold your proper posture, to improve flexibility or range of motion, and to strengthen the muscles that are weak really help to make the adjustments “hold” and the beneficial effects last longer. A work station/job assessment may also be needed if that appears to be irritating your condition. We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com NECK PAIN Common Questions about Cervical Disk Herniations Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com Last month, we discussed the topic of neck pain arising from cervical disk herniations. The focus of this month’s Health Update is common questions that arise from patients suffering from cervical disk derangement. 1. “What can I do to help myself for my herniated disk in my neck?” The mnemonic device “PRICE” stands for Protect, Rest, IceCompress, and Elevate is a good tool to use in the acute stage of many musculoskeletal conditions.

  • Protect your health by NOT placing yourself in an environment that is likely to harm you, such as playing sports or doing heavy yard work. That is, think about what you do BEFORE you do it and if sharp, radiating pain occurs, STOP and assess the importance of what you are doing. Use the concept, “…don’t pick at your cut.” This means if you want the injury to heal, don’t keep irritating it!
  • Rest is similar. Limit your activities to those that can be done without increasing symptoms, especially radiating pain.
  • Ice – The use of ice reduces swelling/inflammation, which reduces pain and promotes healing. Alternate it every 15-20 minutes (on/off/on/off/on) several times a day. You can also use contrast therapy (Ice/heat/ice/heat/ice) at 10/5/10/5/10 minute intervals to “pump” out the swelling.
  • Compress – The use of a collar worn backwards, if it’s more comfortable that way, can literally “take the load off.” the neck and disks. There are even inflatable collars which are pumped up with air to traction the neck. Other forms of traction will be discussed further.
  • Elevate – The concept of raising the ankle to the height of the heart so swelling can drain out of the ankle is the classic example of “elevation.” In the neck, the traction concept may apply once again.

2. “I don’t want to have surgery if I can help it. What can you do as a chiropractor to help me?” This is one of our primary goals, and in fact, the goal of ALL health care providers, even surgeons! Chiropractic offers anti-inflammatory measures: ice, herbal anti-inflammatory agents (ginger, turmeric, bioflavonoid, curcumin, bromelain, Rosemary extract, Boswellia Extract, and more), digestive enzymes taken between meals, muscle relaxant nutrients (valerian root, vitamin D, a B complex, chamomile, magnesium, and others) as well as other non-pharmaceutical options. Treatments consist of manual manipulation, mobilization, traction (for home and office), modalities such as laser and low-level laser, electrical stimulation, magnetic field, ultrasound, and others. Most important is having a “coach” guide you through the stages of healing by first addressing the acute inflammatory stage (first 72 hrs), the proliferative or reparative phase (up to 6-8 weeks), followed by the remodeling phase (8 weeks to 1 or 2 years) and finally, the contraction phase (lifetime – includes the natural shortening of scar tissue). If manual traction reduces neck and arm pain, the use of home traction is very effective. Options include sitting over-the-door traction, laying down versions, and mobile traction collars (discussed previously). Exercises to stretch and strengthen the neck are also very important in reducing neck pain as well as preventing recurrences. If in spite of all the best efforts of this non-surgical care approach should ongoing neurological loss and relentless symptoms continue, we will coordinate care with physiatrists for possible injection therapy and pharmaceuticals, with neurology for further testing (such as EMG/NCV – a nerve test), and/or neuro- or orthopedic surgery – THE LAST RESORT! We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Neck and Headache Pain and Posture Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com Neck pain is one of the most common complaints for which patients present to chiropractic offices. Headaches are also another very common problem and often go hand-in-hand with the presence of neck pain. So, the question that is frequently asked is, “…why do headaches and neck pain often travel together?”             There are many types of headaches, some of which we have discussed previously with migraine and tension-type headaches being the most common. This month, the focus is on how headaches and the neck are related to each other and what YOU can do about it.             The relationship between neck pain and headaches is strong! In fact, in some cases, headaches will occur ONLY when the neck hurts. One reason is because the first three nerves that exit out from the top of the cervical spine (C1, 2 and 3) have to travel through the thick group of muscles that insert onto the back/base of the skull along the occipital rim. Because we carry a lot of stress in the neck muscles, when they tighten up, they squeeze or pinch those 3 nerves and pain then radiates into the back of the head and sometimes up and over the vertex to the eyes or behind the eyes. If you take your fingers or thumb and push firmly into those muscles at the very top of the neck or base of the skull, it often feels, “…like a good hurt.” This is because they are usually tight since most of us carry our head too far forwards and the muscles have to contract and constantly work to keep the head from gliding even further.             So, what can YOU do about it? Let’s talk about a few GREAT posture retraining exercises. Tuck in your chin to the point where the voice changes pitch (your voice will start to sound “funny”). At that point, release the chin slightly so the voice clears and stay in position! That is the posture or head position of choice. Initially, it will be very difficult to remember to hold that position very long because your muscles (and brain) aren’t used to it and, you’ll slip back into the old forward head carriage habit or chin poke position. So, be patient with yourself because it takes about 3 months of constant self-reminding to, “…keep that chin tucked,” before this new “habit pattern” is formed in the brain.             Another great exercise is an “offshoot” of this, where you tuck the chin in as far as you can (making a double or triple chin) holding that position for 3 seconds, and then tip the head back as far as you can without releasing the chin tuck and hold for another 3 seconds. Repeat this 2-3x / “set” and perform this multiple times per day.             A 3rd great exercise for improving the forward head carriage posture is performed by lying on your back on a bed so that the edge of the bed is at the middle of the neck and head is dangling off the bed. Take a tightly rolled up towel (a hand size towel works well) and place it under the neck so that is resting on the edge of the bed so that your head can fall back towards the floor. Take some deep breaths and concentrate on relaxing all your neck muscles. Periodically, slowly rotate your head left to right, right to left, and “feel” the different muscles stretch as you do this. If you can afford 15 minutes, that’s PERFECT! But, if you only have a few minutes it’s still GREAT!             Between maintaining a chin tuck upright posture and retraining the curve in your neck with the head hang off the bed exercise, you’ll feel (and look) much better!              We at Sayville Immediate Chiropractic Care realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com To Receive Daily Health Updates, go to www.DrFrankGomezBlog.com and sign u Neck Pain, Headache, and the Jaw Joint Courtesy of: Dr. Frank Gomez www.http://sayvillechiropractor.com Neck pain and headaches can be very disabling and can significantly alter a person’s normal pattern of living.  Simple things like reading the newspaper, cooking, driving a car, and/or looking down when feeding a baby, can become almost intolerable.  Canceling plans for the day or saying “no” to vacations can be very disheartening and often occurs because of severe neck pain and/or headache making these activities simply, “no fun.”  The cause of the headaches associated with neck pain and dysfunction is usually due to the compression caused by the tight neck muscles squeezing the upper three nerve roots in the neck region, resulting in radiating pain into the head.  Frequently, light and noise sensitivity, as well as nausea, can accompany a severe headache, which only adds to the activity limitations associated with neck pain. In fact, there are many experts who feel most headaches, even migraines, stem from the neck or are at least are very closely related.  Since neck pain affects approximately two thirds of the population at some point during their lifetime, it becomes clear that headaches, in the absence of neck pain, are quite uncommon.  Another interesting and lesser-known relationship is the jaw (frequently referred to as the TMJ) and its association with neck function, especially the upper cervical vertebrae, as well as headaches.  The muscles that move the jaw/TMJ are largely innervated by the 5th cranial nerve, also called the trigeminal nerve.  Several studies have found that when stimulating structures innervated by the trigeminal nerve, neck and/or jaw pain was created and vise versa.  Similarly, patients with jaw problems (called temporomandibular dysfunction or, TMD) often report neck pain.  When we open our mouth wide, head-neck extension always occurs followed by head-flexion when we close the jaw.  Hence, the neck is always moving when we chew, yawn, talk, and clench our teeth.  In fact, all of these every day activities result in jaw, head, neck motion extending from the base of the skull and first cervical vertebra (occiput-C1) and continues down through the entire cervical spine.  This was investigated in a study where the relationship between neck symptoms, jaw function – specifically active mouth opening, and pressure pain sensitivity in a trigeminal nerve innervated region after a spinal manipulation was applied to the upper neck vertebrae.  Here, 37 female patients with neck pain were randomly assigned to 1 of 2 groups (control and experimental) and, before and after treatment, exams of mouth opening and pressure pain levels were measured.  The group receiving the upper neck manipulation showed a significant increase in active mouth opening motion as well as improved pressure pain tolerance compared to the control/non-manipulation group in a sample of woman with neck pain.  This study is very important as many people suffer from neck pain, headaches and TMD.  In order to properly treat these patients, one must focus on multiple regions, not just the neck area.  It has been demonstrated when we bite down, there is a corresponding tightening of two important muscles in the neck and upper back region.  Similarly, studies show relaxation of muscles in the neck, upper back and TMJ after spinal manipulation to the neck is applied.  Injuries to the TMJ are common but often not pursued by patients as often they’ll say, “my jaw clicks and snaps but I don’t think about it much.”  If you, a friend, or a loved one are struggling with neck pain, headaches, or TMD/jaw pain, we will properly assess your condition and administer the appropriate care that is required.  We also coordinate services with other health care providers when necessary.  This recommendation may represent one of most significant acts of kindness you can give to those that you truly care about. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article.  Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com Neck Pain and the Deep Neck Flexors Courtesy of Dr. Frank Gomez www.http://sayvillechiropractor.com It’s safe to say that if you haven’t had neck and/or shoulder pain, you probably will. Like low back pain, there is a statistical increase in probability that once you’ve had neck pain, the chances of having another episode are significantly increased. A recent study reported that over a 12-month period, 16-18% of the population studied complained of neck and shoulder pain and each year, medical care was obtained by 21-38% of that same group. Moreover, 13-21% lost work time because of their neck and/or shoulder pain. The study reported there was a “…strong episodic nature…” as this condition was found to frequently come and go. Neck pain can arise from a number of structures including muscles, ligaments, bone, joint capsules, and more. Typically, a patient presenting with neck pain is treated for a few weeks and is then quite satisfied with their result… until the next time. Unfortunately, there is usually, “…a next time.” So, the question is, what can we do to prevent neck pain or its reoccurrence? When considering the many causes of neck pain and the high rate of recurrence, one common finding in those with this popular “come and go” neck/shoulder pain pattern is weakness of the deep flexors muscles located in the front of the neck. One reason for this common finding is that it is very difficult to strengthen the deep, intrinsic muscles of the neck as they are “involuntary.” That means, we cannot consciously “flex” or purposely contract our deep neck flexor muscles. Also, the larger extrinsic muscles tend to be too tight and by reflex, “turn off” or, inhibit the deep neck flexor muscles, compounding the problem. Therefore, in order to exercise them, we must “trick” the deep muscles into contracting without contracting the larger, extrinsic muscles. This can be accomplished by doing a very specific, controlled exercise with our neck by laying on the back with a partially inflated blood pressure cuff (or, by using a special device purposely made for this test and exercise) placed behind the neck. The inflatable bag is pumped up partially to about 20mmHg and then in a VERY controlled manner, we tuck in our chin and flatten our neck pressing into the bag raising the pressure by 2mmHg and holding that steady for 3-5 seconds. This is repeated in increments by pushing down a little harder until the gauge reads 24mmHg and again, holding that for 3-5 seconds. This pattern is repeated 5x or, until you reach 30mmHg and the process is then reversed releasing the pressure in 2mmHg increments at 3-5 second holds until you reach 20mmHg again. Sound easy? Not quite!!! This exercise requires “fine motor control” to accomplish the task and most of us haven’t specifically addressed these fine moving muscles and end up only exercising the larger extrinsic muscles by doing traditional neck strengthening exercises, which further inhibits the deep neck flexors. The first time you try this, you’ll be amazed at how challenging and tiring it is. But, after a few days of performing the exercise, you may find you feel much better!  Of course, this depends on the degree of injury one has, but often, once cervical spine stability is improved by strengthening these deep neck flexors, symptoms usually improve. So, the question is, can we achieve good deep neck flexor strength by doing a more practical, upright position exercise rather than requiring a costly apparatus that requires a laying down position?  In a recent study, a standing exercise where a similar movement called, a “neck-lengthening maneuver” was performed producing similar results as the laying down exercise (relaxation of the strong, extrinsic – outside – muscles and strengthening of the deep neck flexors). Simply tuck in the chin and stand tall, “lengthening” your neck! We at Sayville Immediate Chiropractic Care realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future. The Sayville Chiropractic office that makes it convenient for you to get the care you want in today’s busy society! Our practice has a strong working relationship with many local allied health care professionals and primary care MD’s. No Appointment Necessary, Walk-in Chiropractic Care: New patients welcome. No Long Term Care Plans Since Back Pain, Neck Pain and Headaches are one of the most common complaints presenting to the chiropractic physician, please ask for more information about this if you or a loved one is suffering.  It’s one of most significant acts of kindness you can give to those you care about. Serving the areas of Sayville, Oakdale, Bohemia, Bayport. YOU MAY BE A CANDIDATE FOR DRUG FREE RELIEF! FOR A FREE NO-OBLIGATION CONSULTATION CALL DR. FRANK GOMEZ at 631 991-3492 Not ready yet…No Problem. To Receive These “Daily Health Updates” Via E mail go to www.DrFrankGomezBlog.com and sign up. Thank you for your time in reading my article. Please check out the links below for further reading on other health related material. www.SayvilleChiropractor.com www.DrFrankGomezBlog.com www.SayvillePainRelief.com www.USchirodirectory.com