Many people are exposed to dangerously loud sounds at work and at play, and most of them don’t wear ear plugs or take other steps to prevent hearing loss, a recent U.S. study suggests.
Almost 49 million adults work in very noisy conditions, and more than one-third of them never use hearing protection, the study found. Among leisure pursuits, firearms pose a particular risk and just 59 percent of the 35 million U.S. gun users represented in the study wear hearing protection all the time.
“The problem here is both the number of people using firearms and the potential noise-inducing hearing loss from the repeated gunfire,” said senior study author Dr. Neil Bhattacharyya of Harvard Medical School and Brigham and Women’s Hospital in Boston.
“A rifle has an extremely loud single burst of sound and if you are firing hundreds of rounds, that can be very damaging, particularly without hearing protection,” Bhattacharyya said by email.
To assess how often U.S. adults are exposed to loud noise and how regularly they take steps to protect against hearing loss, researchers examined 2014 survey data representing 240 million people.
Overall, 22 percent were exposed to “very loud” sounds at work requiring them to shout to be heard at arm’s length. The exposures were for at least four hours a day, several days a week.
Roughly one in five people were exposed to loud sounds outside of work, and 62 percent of them didn’t use hearing protection, researchers report in The Laryngoscope.
With firearms, researchers found that one in five people who shot more than 10,000 rounds of ammunition in the past year never used hearing protection. Most of the firearm-related noise exposure came during recreational shooting.
Lawn mowers were the most common source of non-occupational noise exposure.
Almost two-thirds of people around loud noises during recreational activities never used any hearing protection.
One limitation of the study is that it only included one year of survey data, the authors note. It also didn’t have medical records to document specific hearing or health problems associated with noise.
“Untreated hearing loss is associated with increased stress, depression and social withdrawal, and may exacerbate problems for those with cognitive changes such as dementia,” said Dr. Jennifer Derebery of the House Ear Clinic and Institute and the University of California Los Angeles David Geffen School of Medicine.
If people aren’t sure whether the noise around them is loud enough to damage their ears, they can get a sound meter app for their phone and use ear plugs or other protection whenever the app shows the sound is too loud, Derebery, who wasn’t involved in the study, said by email.
And there are good options for people to wear when they still need to hear the sounds around them, a concern for many hunters and concert goers.
“There are outstanding electronic ear muff and ear plug options that solve many of the complaints that recreational shooters and hunters have related to conventional hearing protection,” said Colleen Le Prell, an audiology researcher at the University of Texas at Dallas who wasn’t involved in the study.
“They allow quiet sounds, such as speech and sounds the hunter might be making as they walk, to be not only delivered but amplified, which can be very useful with someone who already has some hearing loss,” Le Prell said by email. “Hearing loss can be prevented, with the consistent and correct use of hearing protection devices.”
Modern chiropractic started in the late 1800s when Daniel David Palmer, a self-educated teacher and healer, performed the very first spinal manipulation on a patient. Chiropractic is the third largest area of medicine today. The word chiropractic comes from Greek words meaning “treatment by hand”, which is exactly what chiropractors do�they use their hands to manipulate the body and promote healing and wellness.
The chiropractic philosophy is dependant on the following belief statements:
All bodily functions are connected as well as the healing process requires the entire body.
A healthy nervous system, especially the spine, is the important thing to your healthier body. The spinal cord carries advice throughout the body and is accountable for many bodily functions including voluntary movements (such as walking) and involuntary functions (like respiration). When the systems of the body have been in equilibrium, it is called homeostasis. Disorders of the bones, muscles, and nerves increase the risk of disorder along with other health problems and can disrupt homeostasis.
When body systems are in harmony, the human anatomy gets the extraordinary ability to keep well-being and treat itself.
Chiropractors
They use traditional diagnostic testing strategies (like x-rays, MRI, and laboratory work) along with specific chiropractic techniques that involve hands-on manipulation of the articulations (joints) of the body. Nutrition and healthful lifestyle counseling is also offered by chiropractors. Chiropractors elect to not prescribe drugs, plus they do not perform operation; however, many chiropractors work with medical doctors and certainly will refer a patient when needed.
Chiropractors believe among the chief reasons for pain and disease is the misalignment of the vertebrae in the spinal column (this is known as a chiropractic subluxation). Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors are able to alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis.
Some chiropractors dedicate their practices exclusively to finding and removing subluxations. But in addition to using manual adaptations, most chiropractors offer other treatment modalities such as the following:
Physiotherapy
Herbal therapy
Heat/cold therapy
Ultrasound
Electric muscle stimulation
Acupuncture
Manipulation under anesthesia
Traction
Massage
Exercise programs and teaching
Lifestyle and nutrition counselling
Physical rehabilitation
Additionally, many chiropractors have considerable postgraduate training and become board certified in some specific regions of interest such as for instance:
Neurology
Orthopaedics
Sports medicine
Physical rehabilitation
Nourishment
Diagnostic radiology
In Overview
Chiropractic has come a long way since its beginnings. Due to its success in treating back and neck problems and as a consequence of changing approaches and recent research, chiropractic has become more accepted and is currently considered by many to be a piece of mainstream Western medicine. Actually, many hospitals finally have chiropractors on staff. Chiropractors will also be recognized by the court system as expert witnesses inside their field.
The understanding the spine is somehow involved in health and wellness, in addition to the practice of utilizing manual manipulation as a way to obtain healing, dates back to the time of the ancient Greek philosophers. In fact, Hippocrates once said, “Get understanding of the back, for this is the requisite for several ailments.”
The First�Chiropractic Adjustment
Modern chiropractic, however, indicates its beginnings in the late 1800s, �when a Canadian living in the US, Daniel David Palmer, a self educated teacher and healer, performed the very first spinal manipulation on a patient.
That patient was Harvey Lillard, a janitor who worked in Palmer’s building. Lillard was almost totally deaf and mentioned to Palmer that he lost his hearing many years before when he was bending over and felt a “pop” in his upper back.
Palmer, who had been a practitioner of magnet therapy (a common therapy of the time) was fairly learned in physiology and incredibly interested in how a spine interacts with all the remainder of the entire body’s systems.
He found a difficulty with one of his vertebra and examined Lillard’s back. Palmer manipulated Lillard’s vertebra and an amazing event occurred�Lillard’s hearing was restored. Today, this process is referred to as a chiropractic adjustment.
Palmer soon found that alterations could alleviate patients’ pain as well as other symptoms. These problems with vertebrae are called chiropractic subluxations.
He started to use these “hand treatments” to treat many different ailments, including sciatica, migraine headaches, stomach complaints, epilepsy, and heart trouble. In 1898, he started the Palmer School & Infirmary in Davenport, Iowa, and began teaching his chiropractic techniques.
Initial Resistance In The Medical Community
The medical community failed to immediately embrace techniques and Palmer’s chiropractic theories. The called him a “quack” and refused to recognize his achievements. At one point, Palmer spent time in jail because of his violation and was indicted for practicing medicine with no license.
Research has shown that Palmer was not the fish monger that was unlearned that some in the health care profession claim. An investigation of this library, which he quoted in his letters, showed that he was up to date in his knowledge at the turn of the 20th century. Obviously, his theories, in the light of 21st century knowledge, seem uneducated.
Chiropractic Today
Today, chiropractors are licensed in most European countries, Canadian provinces, all the US states, Australia and New Zealand. There tend to be more than 50,000 practicing chiropractors in the US alone . Despite its North American roots, there are more chiropractic educational programs beyond North America.
The concept that light energy from a laser can reduce inflammation and pain, hasten healing in damaged tissues, relax muscles, and stimulate nerve regeneration appears far fetched. Science, however, tells us these effects do happen.
“Power and wavelength ascertain the capability of the laser to penetrate into the body. Once you are in the infrared spectrum and above 800 nanometers in wavelength, laser energy penetrates like X-rays, but to attain depth you need substantial electricity or energy,� Dr. Bruce Coren told Spine Universe.
Two Categories Utilized in Physical Therapeutics
You can find just two groups of lasers being used in physical therapy; group 3 and 4. �Category 3 lasers are much less than 500 milliwatts, mw, in power while class 4 lasers are greater than 500 mw,� Dr. Coren said. Class 3 lasers are occasionally known as cold lasers, while the treatment may be called LLLT for low-level laser therapy. In contrast, class 4 laser treatment might be called HPLT for high power laser therapy.
�The majority of neuro-musculoskeletal conditions respond better to a higher power and a greater dosage, which will be a function of power output and time,� Dr. Coren commented. The best results are going to be obtained with a laser that’s 30 watts of power or more. A 10-minute treatment using a 30-watt laser will generate 18,000 joules, which gives a critical pain relieving, anti inflammatory and healing effect.�
Although 5 or more sessions may be required to solve the problem, patients usually begin to feel better after 1 or 2 treatments. � The more extensive the injury and the more chronic, the more treatments are usually needed,� he included.
Properties of High Power Laser Treatment
Pain Relief: Laser decreases nerve sensitivity by decreasing bradykinin; a pain generating compound. It normalizes ion channels, gatekeepers that are mobile, and releases endorphins, body�s natural pain reliever, and enkephalins, that is related to endorphins, that generate an analgesic effect. Additionally, it has a pain-blocking effect on specific nerve fibers. This increased energy accelerates the repair processes of the cell. Laser additionally causes a widening of the arteries and veins around the damage which really helps to remove damaged cellular debris and increase nutrients and oxygen. White blood cell activity is improved leading to a more fast repair process.
Gifted Tissue Repair and Cell Growth:�Photons of light from lasers penetrate deeply into tissue and accelerate cellular reproduction and growth. As a result of exposure to laser light, the cells of nerves, ligaments, tendons and muscles are repaired quicker.
Improved Vascular Action:�Laser light raises the formation of new capillaries in damaged tissue, which closes wounds quickly, and speeds up the healing process.
Cause and Acupuncture Points:�Laser is very effective in extinguishing painful trigger points. It’s likewise a highly effective method of stimulating acupuncture points with no distress related to needling.
Reduced Fibrous Tissue Formation:�Laser therapy reduces the formation of scar tissue following tissue damage from burns, cuts, scratches, repetitive motion injuries or surgery.
Faster Wound Healing: Collagen is the essential protein necessary to repair injuries or to replace old tissue. Because of this, the laser is effective on burns and open wounds. Laser raises the number of stem cells, which enhances healing.
Conditions Treated Where Laser Therapy is Administered
High power lasers are typically present in physical therapy clinics and chiropractic offices. Neck, back or joint pain generally responds immediately to laser therapy.
�Lasers are also rather powerful for inflammatory conditions, including peripheral neuropathy, tendonitis, bursitis, and capsulitis. Sprains, strains, and repetitive motion injuries all have an inflammatory component and may be successfully treated with laser,� he remarked. �There is no specific state that reacts more quickly to laser. Nonetheless, some patients will respond faster than others for precisely the same condition as individual healing rates can change.�
Laser therapy can be used as a stand-alone treatment, or with rehabilitative exercise therapy. �Rehabilitative exercises and laser therapy complement each other nicely,� explained Dr. Coren.
Precautions of Laser Therapy
There are a few precautions with laser treatment. Eye protection is required for both therapist and the patient, and laser must not be performed over malignancies, pacemakers, spinal stimulators or within the midsection of pregnant women.
Further Recommendations
High power laser treatment is just one of the quickest, most powerful modalities therapists now need to treat inflammation and pain. �Sadly, laser just isn’t covered by insurance, and high-power lasers could be difficult since they are high-priced to locate. Most importantly, results are reached by the quantity of energy produced, 18,000-30,000 joules per treatment being the sweet spot,� Dr. Coren reasoned.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 . �
By Dr. Alex Jimenez
Additional Topics: Chiropractic and Sciatica
Sciatica is identified as a group of symptoms rather than a single injury or condition. Low back pain is common among a variety of individuals, but when symptoms of numbness and tingling sensations are accompanied with pain and discomfort, there may be unnecessary pressure being placed against the sciatic nerve. Sciatic nerve pain or sciatica can occur due to a variety of factors and chiropractic treatment can help relieve the symptoms. Chiropractic care is a safe and effective treatment option available for restoring the health of the spine and reducing sciatica symptoms.
Chiropractors think that good health is decided by way of a healthy nervous system, particularly a healthy spinal column. Sometimes, vertebrae become misaligned and put pressure on the nerves exiting the spinal cord. The misalignment of a vertebra is called a chiropractic subluxation.
Chiropractors use specific methods to return the vertebrae in their proper locations or muster them to allow them to go freely when subluxations happen. These techniques are called spinal manipulations or adjustments. During an adjustment, the vertebra is freed in the misaligned location and returned to the right place in the spinal column. The adjustment permits the entire body to cure and preserve homeostasis once performed.
Chiropractors Are Trained In Many Different Adjustment Techniques
Some are done by hand; some necessitate using specialized instruments. Since each patient is different, your chiropractor will pick the best technique for the state. Nevertheless, don’t hesitate to ask the chiropractor which technique she or he will be doing and the way that it will be achieved.
Common Adjustment Techniques Employed By Chiropractors Are The Following:
Toggle Drop – this is when the chiropractor presses down firmly on a specific part of the back. Subsequently, using a drive that is precise and rapid, the chiropractor aligns the spine. This really is accomplished to enhance mobility in the vertebral joints.
Motion Palpation – this hand-on procedure is performed to determine in case your vertebrae are moving freely inside their normal planes of motion.
Lumbar Spin -the chiropractor positions the patient on her or his side, then implements a thrust that is quick and precise returning it to its proper place.
Release Work – the chiropractor applies gentle pressure using her or his fingertips to separate the vertebrae.
The chiropractor applies a quick thrust at once the table drops. The dropping of the table allows for a lighter adjustment without the twisting postures that can accompany the manual adaptation.
Instrument adjustments – of correcting the spinal column frequently the gentlest ways. The patient lies on the table while a string is used by the chiropractor face down – filled activator instrument to do the adjustment. This technique is frequently used to perform adjustments on creatures too.
Manipulation done under anesthesia (or twilight sedation) – this is performed by a chiropractor certified in this technique in a hospital outpatient setting when you’re unresponsive to traditional adjustments
Keep in mind that before you experience complete relief out of your symptoms you may really need to go back to the chiropractor’s office for additional adjustments.
I have been travelling through Athens and now Istanbul. My 11 year old is a Percy Jackson nut and has been filling me in with the who’s who of Greek mythology and I am learning Latin words every day. Quite an education!
I looked up the word syndesmosis and the Latin translation is “(New Latin, from Greek sundesmos) bond, ligament, from sundein, meaning to bind together”. As sports injury professionals, we know syndesmosis to be the joint articulation between the tibia and the fibula bones around the ankle. These two bones are �bound’ together with very firm and strong ligaments.
Syndesmosis comes to mind after I saw a girl sprain a syndesmosis at the Archaeological Museum in Istanbul today. This poor girl was preoccupied by the hundreds of cats and kittens running all over the place and did not see the uneven cobblestones on which she placed her foot. At the same time, she turned to change direction. This is a common mechanism of injury for a syndesmosis – a forced dorsiflexion and rotation on a fixed foot.
Rehab Masterclass Issue 140 Of Sports Injury Bulletin
Of all the ankle injuries, injury to the syndesmosis is the biggest pest to sports physios and the like. And unlike simple garden variety ankle sprains that heal quickly, the syndesmosis takes a LONG time to heal properly. If you deal with athletes that are susceptible to syndesmosis sprains, I’m sure you will agree that these are harder injuries to manage because of the severe consequences if done badly.
I go into a fair bit of detail in my Sports Injury Bulletin piece about syndesmosis injuries, detailing how they happen, how to identify them and then manage them. What I would like to highlight here are the implications of mismanaging a syndesmosis sprain.
In the current issue of The Journal of Sports and Physical Therapy, a group of Japanese researchers discovered that individuals who had chronic ankle instability (CAI) had a distal fibula that was positioned more lateral compared with healthy individuals with no CAI. In effect, those who had suffered serious syndesmosis injuries in the past and ended up with a wider distance between the fibula and the tibia, suffered more ongoing ankle pain than those without a tibfib separation.
Research shows that even a 1mm displacement of the talus within the mortise (due to a wider placed fibula) can reduce the contact area in the talocrural joint by 42% (Ramsey and Hamilton 1976). Mismanaged syndesmosis injuries, resulting in an excessive amount of opening, can lead to early onset arthritic changes and chronic ankle instability. The talus bone bounces around in the now wider tibfib articulation.
A Widening Of The Fibula Is Due To One Of The Following:
Poor initial management, whereby the athlete is allowed to weight bear too early and this weight bearing forces the fibula away from the tibia as the syndesmosis ligaments are trying to heal.
The degree of damage is so severe that proper tightening of these ligaments is not possible without surgical intervention such as a screw or similar being placed between the two bones to �force’ them together.
The key for a sports injury practitioner, is to properly identify a regular ankle sprain from a more serious syndesmosis injury. If you get this part wrong and allow the athlete to get back to weight bearing too early, then expect some complaints about a chronically painful ankle some time down the track.
Call Today!
Kobayashi et al (2014). �Fibular malalignment in individuals with chronic ankle instability.’ JOPST. 44(11); pp 841-910.
Ramsey and Hamilton (1976). J Bone and J Surgery Am. 58(3); 356-357.
Sciatica is commonly characterized as mild to severe pain which radiates along a single or both legs, caused by the impingement or compression of the nerve roots in the lower back. Various types of injuries or conditions affecting the lumbar spine can result in symptoms of sciatica.
Sciatica is often referred to as radiculopathy, a medical term utilized to describe symptoms of pain, tingling sensations, numbness and weakness in the arms or legs as a result of nerve complications. If the nerve issues occur along the neck, it’s called a cervical radiculopathy. Because sciatica affects the lower back, however, it is called a lumbar radiculopathy.
Beginning at the back of the pelvis, or sacrum, the sciatic nerve is paired with five sets of nerve roots which then runs from the lower back, under the buttocks and down through the area of the hips and into each leg. Nerve roots are a great part of the body’s entire nervous system, functioning by transmitting pain and sensation to the different parts of the body. Radiculopathy can frequently develop when pressure is applied to the nerve roots as a result of an injury or condition, such as a herniated disc or a bone spur in the lumbar spine.
Causes of Sciatic Nerve Pain
An array of spinal injuries or conditions can cause sciatic nerve pain or sciatica. The 6 most common include:
a bulging or herniated disc
lumbar spinal stenosis
spondylolisthesis
trauma or injury
piriformis syndrome
spinal tumors
Lumbar Bulging Disc or Herniated Disc
A bulging disc along the lumbar region of the spine is identified as a contained disc disorder. This occurs when the gel-like center of an intervertebral disc, known as the nucleus pulposus, remains contained within the tire-like outer wall of the disc, known as the annulus fibrosus.
A herniated disc occurs when the nucleus pulposus ruptures through the annulus fibrosus and it is identified as a non-contained disc disorder. Regardless if an intervertebral disc bulges or herniates, the structures of the disc can add pressure against the adjacent nerve roots, compressing nerve tissue which can lead to symptoms of sciatica.
However, the complications associated with a herniated or ruptured disc can be worse. While a herniated disc can cause the impingement or compression of the sciatic nerve and its nerve roots, the substance released by the disc itself is made up of hyaluronic acid, a chemical irritant which can also cause inflammation along the structures surrounding the disorder. Nerve compression or impingement, followed by pain and inflammation can often lead to tingling sensations, numbness and muscle weakness along the extremities.
Lumbar Spinal Stenosis
Spinal stenosis is a nerve compression disorder which most commonly affects older adults. When spinal stenosis develops along the region of the lumbar spine, it could cause symptoms similar to sciatica. Generally, the pain associated with the disorder will manifest due to physical activities, such as standing or walking, and it can be relieved by sitting down or resting.
Nerve roots found along the spine branch out from the spinal cord through passageways consisting of bone and ligaments known as the neural foramina. Located on the left and right sides and between each set of vertebrae, is the foramen. The nerve roots pass through these openings and extend outward beyond the spine and through to other parts of the body. However, when these passageways become narrow or clogged, leading to the impingement or compression of the nerves, it’s referred to as foraminal stenosis.
Spondylolisthesis
Spondylolisthesis is a disorder characterized when a single vertebra in the spine slips forward over an adjacent vertebra. When a vertebra is displaced, it could ultimately lead to the compression of the spinal nerve roots, causing symptoms of sciatica. Spondylolisthesis is considered a developmental disorder, meaning it is found at birth and may develop during childhood, although it can also occur due to the degeneration of the structures of the spine, due to trauma from and injury or as a result of physical stress from lifting weights.
Trauma or Injury
Sciatica can also be caused as a result of direct compression or impingement of the nerves due to direct trauma or injury to the tissues and other structures surrounding the lumbar or sacral region of the spine. These circumstances include: automobile accident injuries, slip and falls, and/or sports injuries from contact sports such as football. The force of a direct impact can damage or injure the nerves and, occasionally, fragments of broken bones may also add pressure to the complex network of nerve roots along the spine.
Piriformis Syndrome
Piriformis syndrome is identified by the painful symptoms which manifest when the piriformis muscle irritates the sciatic nerve. The piriformis muscle is located along the lower region of the spine, where it connects to the thighbone and provides the function of rotation to the hip. The sciatic nerve runs beneath the piriformis muscle. Piriformis syndrome occurs when the piriformis muscle spasms, adding pressure against the sciatic nerve. This syndrome can often be difficult to both diagnose and treat due to the lack of X-ray or MRI findings.
Spinal Tumors
Although rare, spinal tumors are abnormal growths which can be either benign or malignant, cancerous. When a spinal tumor develops along the lumbar region of the spine, there’s a risk that it could potentially cause the impingement or compression of the nerve roots, leading to symptoms of sciatica. If you believe you may have sciatica, contact your healthcare specialist. The first step toward relieving pain is a proper diagnosis.
The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss options on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .�
By Dr. Alex Jimenez
Additional Topics: Chiropractic and Sciatica
Sciatica is identified as a group of symptoms rather than a single injury or condition. Low back pain is common among a variety of individuals, but when symptoms of numbness and tingling sensations are accompanied with pain and discomfort, there may be unnecessary pressure being placed against the sciatic nerve. Sciatic nerve pain or sciatica can occur due to a variety of factors and chiropractic treatment can help relieve the symptoms. Chiropractic care is a safe and effective treatment option available for restoring the health of the spine and reducing sciatica symptoms.
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