Main Street Chiropractic

Hi I'm Dr. Carl Zaycosky, and this is my way of sharing the resources, insight, and experience I've gained in my years as a chiropractor. I hope they help you chart a course toward whole body health.

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Back Pain Guidelines Part 3

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One point of contention I have with the guidelines are the recommendations as to when to employ exercises for someone experiencing acute low back pain. Exercise is recommended as a treatment approach for chronic (lasting more than 12 weeks) pain. I don’t dispute that exercise alone may not have measurable benefit in the acute, early stage of injury; it has proven benefit when used in conjunction with spinal manipulation. There is a study which indicates spinal manipulation has better outcomes when used with exercise when compared with spinal manipulation as the sole treatment method.

I want to add my own opinion at this juncture. It’s important to remember each person’s back pain is a little different than someone else’s. Meaning what may not work for one individual may work for another. I often think what a savings our national healthcare budget would have if each person could be directed initially to the back pain treatment approach that would be the most effective for them. Since that isn’t possible. Recommendations from a reputable source (The American College of Physicians) that have made an extensive review of the medical literature is the best alternative currently available. This approach is called best practice methods and is a model that is being implemented throughout healthcare.

 

You local chiropractor,

Dr. Z.

Carl Zaycosky, DC
Main Street Chiropractic

For part 2: click here

For part 1: click here

 

 

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Back Pain Guidelines Part 2

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The American Academy of Physicians came up with these guidelines by reviewing over 150 studies covering the treatment of low back pain (LBP). To me the most surprising finding wasn’t what worked but what didn’t. The research does not show any benefit in using non-steroidal anti-inflammatory drugs (NSAIDS) in the treatment of LBP lasting less than 12 weeks. This time frame is considered by most to be the acute stage of an injury. NSAIDS are medicines like aspirin, Motrin, Advil and Aleve. You can also add acetaminophen (Tylenol) to this list of unhelpful approaches in treating acute LBP even though Tylenol is not an NSAID.
The first line in the treatment of LBP is spinal manipulation, CHIROPRACTIC CARE (emphasis added). Also in this group of first line choices are massage, acupuncture and heat. Though be careful of heat application in the first days of a back injury. I’ve blogged in the past about the wonders of ice therapy and still hold that opinion. http://drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/ice-vs-heat-how-to-properly-care-for-your-injury-part-1-inflammation-and-congestion-1.html
The study points out that there is a circumstance where NSAIDS use has proven to be reasonable. That is when the above mentioned treatment options don’t work. This is clear . Given the potential side effects and the minimal benefit in helping low back pain NSAIDS are not the first choice.
Low back pain is a common aliment and only a few years ago these recommendations may have seemed outrageous; not that people weren’t using chiropractic care for treatment of their back pain. But discouraging the use of medication as a first step in treatment is a big change in the American Academy of Phycisians guidelines.


There is still more to this so stay tuned.
Dr. Z.
Main Street Chiropractic

Back Pain Guidlines Part 1: click here

Back Pain Guidlines Part 3: click here

 

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Back Pain Guidelines Part 1

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“times they is a changin’” specifically in how back pain is treated by health professionals. The word came out earlier this year with the release of updated guidelines from The American Academy of Physicians regarding treatment of back pain. I’m going to cover these recommendations in the next few blogs, but before I get to that, SPOILER ALERT: chiropractic treatment comes out smelling like a rose in these guidelines.
Healthcare is consistently changing as new approaches are discovered and found to be effective, subsequently being employed with patients. Likewise treatment approaches that seemed to be helpful are discarded once the science has proven them to be ineffective or not as effective as they were once thought to be.
The treatment of back pain is a prime example of how treatment approaches change over time. When I started practice the medical model of care at least for severe low back pain, was two weeks of bed rest. Keep in mind too this rest often times occurred in a hospital, “times they is a changin’” image under today’s health care norms of same day surgery and home based care, spending two weeks in a hospital to rest.
My point is not to ridicule past practices. I’m sure the healthcare providers then were using methods they thought best for their patients. Believe me I was employing methods of chiropractic practice in 1984 I wouldn’t dream of using today. And, I bet 50 years from now the providers will look back and shake their about what was being done to patients in the teens.
I’ll get to the specifics next time.

Your Local Chiropractor
Dr. Z.
Main Street Chiropractic

For part 2: click here

For part 3: click here

 

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Diet Myths Part 3

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The third myth regarding weight loss is if you lose weight quickly it won’t stay off as long when compared to losing weight slowly. The evidence doesn’t show either approach better than the other. Though, let me say this. If your method of losing weight is simply to dehydrate yourself this should be avoided. I have had patients over the years that admit to sweating off the pounds to make weight for an athletic event or to fit into a gown for a big evening out. Eating disorders fall into this category, again to be avoided.
The final myth is one episode of sex is equivalent to walking a mile when it comes to calorie expenditure. Nope, if you thought having sex was good for your exercise of the day that’s not the case. The article pointed out that the average sexual encounter lasts about 6 minutes. During this time a man in his 30’s burns about 20 calories. This is only 14 calories more than sitting and watching TV.
A small study of 300 people was conducted at the University of Michigan’s family medicine clinic. The average age of the group was 37. The people were asked whether the previously mentioned myths were true or not, 85% thought Myth 1 was true, 94% Myth 2, 85% Myth 3, and 61% Myth 4. Weight loss is hard no doubt about it. But having the correct facts can make it easier.

Your Neighborhood Chiropractor,

Dr. Z

 

Part One: http://drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/diet-myths-1.html

Part Two:  http://www.drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/diet-myths-part-two.html

 

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Diet Myths Part 2

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My revelation about diet myths were sparked by an article in the New England Journal of Medicene published in 2013. 

http://www.nejm.org/doi/pdf/10.1056/NEJMsa1208051

The first myth is if a person makes a small change in diet or exercise this will create significant long term weight lose. Sorry, not the case. The physiology of your body is set to maintain a weight level. It’s going to take more than an extra 100 foot walk to the mail box or three less bites of food to establish measurable weight loss. With this said, a 1000 mile journey starts with the first step. So by all means take it. Just realize you’ll have to take a bunch more steps to achieve a worthwhile goal.


The second myth is setting initial big goals will lead to failure. What the study concludes is setting lofting goals does not lead to frustration and subsequent surrendering your weight loss goals. If anything a big goal may actually lead to better weight loss outcomes. Let me add this. The goals whether they be diet strategy or an exercise routine have to be safe and within in your current health situation. This is why I’m a believer in proven weight loss programs. I’m a big believer in Weight Watchers and the literature backs up this approach. I’m a firm believer in using a personal trainer to direct your exercise program. Using a personal trainer doesn’t always mean she needs to be at every exercise session. But at the very least getting started and providing periodic modification to a program is best attained by someone who is trained in this calling the shots.

Dr. Z.


at Main Street Chiropractic

 

Part One: http://www.drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/diet-myths-1.html

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Diet Myths Part 1

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With spring time right around the corner there is a noticeable emphasis within media circles, whatever your platform may be regarding weight loss. I get questioned on weight loss issues consistently. If they don’t I bring it up to a patient where excessive weight, a high BMI, is contributing to their joint pain. Over the years I hear/read things about weight loss I assume to be true if for no other reason I’ve heard them repeatedly.
A recent trend in healthcare is for providers to use “best practice methods” to treat their patients. One would assume this has been the case for eons. Not so. Best practice methods are those substantiated by science as being clinically and well as cost effective. A doctor may think what they are doing is best approach based on their past experience, and I’ve been guilty of this, but the scientific literature says there is a better, cheaper way. Such is the case with 4 weight loss myths I thought were fact when in reality that’s not the case.
Over the next two blogs I’m going to talk about these common misconceptions and in 3 of the 4 cases provide the link to the scientific article that substantiates the claim that calls into question the dieting myth. Warning, do not read scientific articles while driving or operating heavy machinery since they have been known to cause drowsiness.

Your local chiropractor,

Dr. Z

Main St. Chiropractic

 Part Two:  http://www.drzmainstchiro.com/dr-carl-zaycoskys-blog/entry/diet-myths-part-two.html

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Plain Ol' Water Part 1

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I want to talk with you about something boring, so bland and tasteless one may even forget about it, passing it by for a more lively choice. Water, more specifically plain old water !This stuff has big benefits for your health and well-being but too often you may be guilty of passing by the tap and substituting a high sugar high calorie alternatives when all you and your body needs is plain old water.

Over the next few blogs I want to focus on an article I ran across in the Journal of Nutritional Dietetics (December 2014) dealing with water consumption and maintaining a healthy weight. Though keep in mind weight control is only one of several good reasons to consume boring water.               

Researchers from the University of Illinois examined data from over 18,000 adults who had recorded their drinking habits over a 7 year period ending in 2012. The sheer size of this study group makes the findings of the researchers very credible.

The people who participated in the study were asked to record the intake of their diet for 2 days. One of the items tracked was the intake of plain water. They were also asked to record their intake of other fluids, fruit drinks, energy drinks, pop even sweetened water.  Finally, they were asked to record how much “energy-dense, nutrient poor” foods they ate. Folks these are your chips, ice cream, cookies, etc.

I bet you can figure out what the results were already. I’ll talk about them next time.

Your local chiropractor,

Dr. Z

Main St. Chiropractic

Your local chiropractor,

Part two click here

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Sleeping Posture Part 1

We spend 1/3 of our lives or at least we should sleeping. You may have heard various people in your life comment about your posture. Don’t slouch. Sit up straight. A well intentioned local chiropractor devoted a blog series to proper posture. So, why do we simply plop down in any old manner when we go to sleep and neglect our sleeping posture? Over the next few blogs I’m going to talk about sleeping posture that may earn you some extra zzzz’s.

Let’s talk first of all discuss how not to sleep. Don’t sleep on your stomach. I know this is going to be tough for some of you. I’m a recovering stomach sleeper. Yes, the habit can be broken. First of all here is why it is bad. You may recall from my Perfecting Posture blog the concave (inward) and convex (outward) curve of your spine. The low back and neck are concave and mid back is convex. When you sleep on your stomach the inward curve of both the neck and low back is made larger. This is a problem because the surfaces of the joints in the spine are on the back part of the bone. Increasing the curve puts more pressure on the pain sensitive surface of the joint causing the back or neck to hurt.

A good way to break this habit and this is what I did; start out sleeping on your back put a small pillow next to both your hips. This hinders the ability to roll over and after a week or two you’ll be comfortable sleeping on your back.

Stay tuned! I will have more sleeping posture tips for you in the next installment.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For Part 2: click here

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The SI Joint: Part 1

I’m going to get a little technical on these next few blogs. But I think you’ll find this to be good stuff. I’m going to address a cause of low back pain that is at times overlooked by health care providers (including me). That is the sacroiliac joint commonly referred to as the SI joint.

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Here’s a brief anatomy lesson. Your pelvis is made up of three bones, starting at your side with the illium going to the center where the sacrum sits and another ilium on the far side. Or, as I tell people a hip bone, the tailbone and another hip bone. Where the tailbone meets the hip bone is called the sacroiliac joint. I find it curious that patients consistently refer to their SI joint as their hip joint. The hip joint is by definition the ball and socket type joint that the top of your leg fits into which lies at the lower part of the ilium.

The movement of the SI is important to understand in knowing why it can cause back pain. Slightly cup your hands. Place the palm of one hand on the back surface of the other cupped hand. Now glide the surface of your hands back and forth toward the wrists in a smooth movement over the top of each other. This is the type of efficient movement that takes place at your SI joint when everything is working correctly. When it’s not this can cause problems. More on that next time. 

Your local chiropractor,

Dr. Z

Main St. Chiropractic

For part 2, click here.

For part 3, click here.

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What Pillow is Best For Me? Part 1

I get this question a lot. My canned answer goes something like this, “pillows are not one size fits all. An NFL linebacker will not use the same pillow as a 120 lb. soccer mom.” The question is a good one. Practicing over the years, I’ve seen many occasions where an improperly sized pillow created a whole bunch of neck problems. For this reason I suggest patients with neck problems bring their pillow in for me to evaluate. Because, sometimes the pillow is a perfect fit and is not the cause of the neck issue, or a slight modification of the current pillow is all that’s needed as opposed to buying a new one.

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Even without a hands on evaluation there are some helpful things you can look for when making your next pillow purchase. I’ll be covering these points in the next few blogs.

To evaluate a pillow properly you have to mimic your sleeping position whether you sleep on your side or back. You need to assume that postion to do a proper assessment. Notice I did not include sleeping on your stomach. That is bad for both your neck and low back. Remember the concave (lordotic) curves I wrote about several blogs ago (Perfecting Your Posture: Part 1)? Sleeping on your stomach increases that curve resulting in jamming together the joints which are at the back of the bones in both the neck and low back. This isn’t good.

Next time, I’ll talk about proper neck support you should have from the pillow.

Your local chiropractor,

Dr. Z

Main St. Chiropractic

For Part 2: click here

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Choosing a Good Chiropractor: Part 1

In my practice I get questioned on a fairly regular basis about how to find a good chiropractor. My immediate response is “you’re lookin’ at ‘im” (shameless self promotion). But, a patient often asks because he or she will be moving out of town or has a friend or family member living out of the area who wants to try chiropractic.

The first myth to bust is that although chiropractors hold what I consider a special bond (forged through the challenges we’ve faced from more powerful, well-funded organizations), we don’t all know each other on a personal basis. I don’t know a chiropractor in Omaha, Nebraska. 

The largest or slickest ad in either print or online does not make one a good chiropractor nor does it make one a bad one. So advertising isn’t of much help. 

Being a member of the American Chiropractic Association (ACA) or the state association does not make one a good chiropractor. It only means you pay your yearly trade association dues. Though, in my opinion the ACA is a great organization and every chiropractor practicing in the USA should be a member. The same holds true with the Ohio State Chiropractic Association (OSCA) for those docs practicing in Ohio. There is some value to the consumer in knowing your chiropractor is a member of his national and state association. A lot of clinical as well as insurance info is disseminated through the associations and at the very least the chiropractor you’re choosing is in this information pipe line.

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Next time, two tried and true methods for finding a good chiro.

Your local chiropractor,

Dr. Z.

at Main St. Chiropractic

For Part 2: click here

For Part 3: click here

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Fighting Fatigue: Part 1

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Are you feeling more and more like your “get up and go” has got up and went? By mid afternoon do you feel like you don’t have what it takes to keep on going? It’s fatigue. We all get tired from time to time. Fatigue, though, lasts, slowing you down physically and dulling you mentally, sucking the energy right out of you. Keep in mind that chronic fatigue can be a symptom of a more serious underlying problem that should be investigated by a healthcare professional. If in doubt, seek care. However, if this has been ruled out, I have some tips for fighting fatigue that I’ll cover in the next few blogs. These are proven to help recharge your batteries (as well as some that say they do, but have been proven otherwise.

Pacing yourself throughout the day is an important part of staying energized for what lies ahead during the day (without being exhausted by your daily tasks). Spread out your tasks into three sections: morning work, afternoon work and evening activity. A quick scan at the start of the day can help you compartmentalize or prioritize these chores to their proper location in the day, allowing you to break the day in thirds and pace yourself more easily throughout the day. Keep in mind that it is equally important to eat, drink water, and rest between these periods.

I’ll have more energy boosting ideas for you on the next installment.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For Part 2: click here

For Part 3: click here

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Is Sitting the New Smoking? Part 1

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Recently I’ve run across several articles in the popular media about the dangers of sitting. The Mayo Clinic and Harvard’s medical school have made mention of this news, also.

It appears to me that this interest in the negative health aspects of sitting stems from a 2012 article in The British Journal of Sports Medicine. The article compares smoking and sitting. The piece stated each cigarette smoked takes 11 minutes off your life, while sitting watching TV takes 22 minutes off of your life. Let’s assume these numbers are correct. If you compare people who don’t watch any TV to those who watch 6 hours a day the TV watchers live 4 ½ years less than the non-watchers.

It’s important to keep in mind that what the authors of the article are really saying is a sedentary life style is bad for you, and being a couch potato is an integral part of this lifestyle. Considering the amount of time most people sit in the course of a normal day—the drive home, eating, and sitting at your desk. Let’s face it: we sit a lot. Sometimes because we have to, other times because we want to. However, there are ways we can make sitting and watching TV less sedentary.

Stay tuned for the next installment to see how you can become a more active couch potato.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For part 2: click here

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Perfecting Your Posture: Part 1

One of, if not the, most effective ways to prevent neck and back pain is to maintain good (or at least adequate) posture. And there’s more to it than just, “sit up straight!” Over the next few blogs I want to go over some posture basics and give you 4 simple tips that will make maintaining good posture easier.

Posture is the way you hold your body when you’re performing various tasks, like standing, sitting or lifting. If your posture is good, then the bones of your spine are in the best position for that task. The bones in your spine, vertebrae, are in three groups: neck (cervical), mid-back (thoracic) and low back (lumbar). The curves, or the direction the vertebrae face, determine posture.

The neck and low back vertebrae should be in a concave, curved shape when viewed from the side. Think of concave being like a “cave.” The inner part of the C-shaped curve should face in for both the cervical and lumbar spine. The mid-back curve should face out in a convex manner, rounded like the surface of a magnifying glass.

As a side note, babies are born with a convex spine. As they crawl, they lift their head and push their pelvis forward and develop the secondary, or concave, curves of their neck and low back.  

Now that we’ve got the basics down, the next blog will deal with taking the necessary steps toward good posture.

Your local chiropractor,

Dr. Z

at Main St. Chiropractic

For part 2: click here

For part 3: click here

For part 4: click here

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Chiropractor Concerns: Choosing the Right Handbag, Part 1

One of the constants in my life as a chiropractor is picking up a patient’s handbag and giving it to them as they exit the treatment room at the conclusion of their visit. I pick the bag up and think, this thing weighs a ton; no wonder your back and neck hurt. So, for the next few blogs I’ll discuss handbags.

There are three things to consider when you purchase a handbag. The first is how heavy is it when it’s empty. Hardware, chains, buckles, etc. add weight. Leather is heavier than synthetic material. Remember, you’re going to be carrying this handbag every day.

If you are going to use a shoulder strap, wider is better. The more surface area to distribute the weight of the bag over the better. Thin straps may dig into the muscles across the top of your shoulder. As you shop for the perfect bag you may want to consider doing away with the strap completely and going with a model that has a handle.

Finally, your size and the size of the bag matters. There is a correct fit for the perfect handbag. The sweet spot for a shoulder bag is at, to slightly above your waist. If it’s too short your arms swing into the bag causing it to repeatedly pull on your neck and shoulder muscles, and if it’s too long it can interfere with proper leg and hip movement.

Now that you have the perfect mechanical look at your handbag, we’ll talk next about what you put in this thing.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For part 2: click here

 

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Ice vs. Heat: How to Properly Care for Your Injury Part 1

Washington Court House

Do I put ice or heat on it? This is definitely one of the top three questions I’ve gotten in my years of practice. Someone hurts their back lifting, say stacking fire wood, and though the body part and/or mechanism of injury may be different, the reaction is the same. They are aware that they should do something, but there is this ongoing cold/heat debate and, rightfully, confusion.  The following couple blogs will help you better understand the body’s response to injury and help clear up this debate.

It’s important to ask yourself: what is actually going on inside of me that cold or heat may or may not help? The body responds to a muscle injury by producing an inflammatory response. Inflammation is a term mentioned frequently in regards to health. The inflammation I’m discussing has to do with the reaction by the muscle to injury and the body’s automatic response to try to heal/correct itself. There is a well-studied process to how inflammation works in its response to a recent muscle injury. Basically, the body is responding by directing cells to the injured area that help in the healing process. One of the phases of this process is called congestion. Whether it’s traffic congestion on a crowded city street or an injured neck muscle, too much “stuff” is trying to get into an area that isn’t big enough. On the street if there isn’t some control of the vehicles there are obvious problems. The same for your muscles and the problem is called swelling.

We’ll talk about the control mechanism for your body’s congestion next time.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

For part 2: click here

For part 3: click here

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Walking: An Excellent and Underrated Exercise Part 1

You may want to become physically active, but feel like one thing may be missing from your life and presenting a major hurdle in attaining this goal—time. It’s tough to carve out additional time from a 24 hour day that involves an hour of commuting time to a nine hour job commitment (you do have an hour for lunch), family responsibilities and all those other things we’re told we need to do to be happy and fulfilled.

The first thing you need to do before you take that first step—or do the first exercise—is to make attainment of physical fitness a priority. Making it a priority doesn’t always mean you have to give up or replace one thing with another. The context of priority I’m talking about is being aware of the opportunities for physical activity during the course of your day and taking advantage of these opportunities opportunity.

Wilmington Chiropractic

As our first example let’s use what I consider the most underrated physical fitness activity when it comes to cost and access: walking. A good pair of walking/running shoes and a sidewalk and you’re off.  Keep in mind the CDC recommendations from the last blog, a pace quick enough where you can talk but not sing. This is not sauntering. It’s walking at a moderate consistent pace for at least 10 minutes.  That’s the key to it. Think of it as 30 minute walks over the course of a day and within a week’s time you have your recommended 150 minutes for the week.

There’s more to come on this next time.

Your local Chiropractor,

Dr. Z

at Main St. Chiropractic

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