Back Clinic Sleep Hygiene Chiropractic Team. The ideal sleep environment is cool, quiet, and dark. However, research has shown that continuous sleep can be interrupted by uncomfortable room temperature, light, and noises. Proper sleep hygiene specialists may also recommend selecting a comfortable mattress, pillows, and bedding and moving or hiding a visible clock. This prevents the sleeper from focusing on time passing while trying to fall asleep. Dr. Alex Jimenez describes sleep hygiene as a variety of habits that are often necessary to achieve a proper quality of sleep to rise with full daytime alertness.
Sleep is essential for an individual’s mental and physical health and well-being because it is important in the body’s natural healing and repairing functions. Therefore, the most important sleeping measure is to maintain regular sleeping patterns. According to Dr. Jimenez, heavy meals before bed, caffeine or alcohol before bed, and even improper sleeping postures accompanied by pain and discomfort can be frequent poor sleep hygiene practices that can interfere with the sleep quality of many individuals. Sleep and hygiene articles can help provide useful insight towards improving sleep and overall health.
Most people know that a chiropractor can help with musculoskeletal problems, such as backaches and slipped discs, but many people do not realize that chiropractic can do much more. In fact, chiropractic can even improve your sleep.
Getting enough quality sleep each night is good for your health. Not getting enough sleep can increase your risk of developing obesity, diabetes, cardiovascular disease, and other serious conditions, according to Harvard Medical School.
But what if you allow yourself plenty of time but still have trouble falling asleep or staying asleep?
Chiropractic can help you sleep. In fact, one-third of people who undergo chiropractic adjustment report sleeping better immediately, according to the National Sleep Foundation. The benefits are not just for adults � 40 percent of infants slept better after just one chiropractic session. That is good news, considering one-fourth of babies experience sleep problems and when babies don�t sleep, nobody else in the house sleeps either!
3 Ways Chiropractic Can Improve Your Sleep
1. Pain relief
Pain can prevent you from getting a decent night�s sleep, especially if you have chronic pain that lasts for three or more months. In fact, one study shows that 20 percent of people with chronic pain experience at least one symptom of insomnia, compared with only 7.4 percent of people without chronic pain. Chiropractic can alleviate pain associated with backaches, headaches, whiplash, migraines and more to help you get the sleep you need.
Chiropractic can also help you sleep by providing a drug-free approach to pain relief. Many prescription pain relievers, such as those containing morphine, oxycodone, and opioids, can make you drowsy throughout the day. Daytime drowsiness might cause you to take naps throughout the day, which can interfere with your ability to sleep at night. The drug-free approach of chiropractic allows you to stay alert all day and sleep well at night.
Extensive research presented by the National Institutes of Health shows that chiropractic is as effective as other treatments, such as drugs, at relieving pain. Perhaps the best part of chiropractic is that the research shows that pain relief lasts up to 18 months of treatment � which means you can remain pain-free without using drugs for a year and a half.
2. Relieves muscle tension and stress
Stress can prevent you from falling asleep or sleeping well. Stress can also cause uncomfortable muscle tension that interferes with sleep. The National Sleep Foundation lists muscle tension as one of the three signs that you are under too much stress to sleep. Tension and poor sleep can be a vicious cycle, as tension can cause poor sleep and poor sleep can cause tension.
Chiropractic often includes massage to melt away painful muscle spasms. These therapeutic massages are relaxing, which helps you unwind enough to fall asleep. Chiropractic also stimulates blood flow, which helps bring oxygen to your brain and other parts of your body.
Your chiropractor may also be able to suggest gentle exercises, stretches and relaxation techniques to help you relax tense muscles and quiet your stressed-out mind.
3. Suggested sleeping positions
Your chiropractor may offer suggestions on sleeping positions and other ideas about how you can sleep better. Your chiropractor may discourage you from sleeping on your stomach if you are having back pain, for example, or be able to recommend a particular pillow or mattress to help you sleep better at night.
For more information on how chiropractic can improve your sleep, talk with your chiropractor. You may start sleeping better as soon as your first visit.
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Foot Orthotics
Foot Dysfunction�can very easily cause a domino effect that extends all the way to the back. The feet are the foundation of the body and when there is a problem with the way they function it can cause the entire body to shift out of alignment.
Recipe Ingredient Substitutions
Here is a guide to give your kitchen a healthy makeover! Here are tips to help you create a healthy environment for your home, and these substitutions will help you make delicious allergy-friendly�dishes.
NCBI Resources
We live in an extremely sleep-deprived society. According to the�Centers for Disease Control�(CDC), 1 in 3 people in the United States does not get enough sleep on a regular basis. Additionally, the�National Sleep Foundation�reports that 45 percent of adults in the US admit that insufficient or poor sleep has had an impact on their daily activities at least once in the previous week. What�s more, about a third of the people who said they slept the number of hours that doctors recommend reported experiencing poor sleep quality.
We live in an extremely sleep-deprived society. According to the Centers for Disease Control (CDC), 1 in 3 people in the United States does not get enough sleep on a regular basis. Additionally, the National Sleep Foundation reports that 45 percent of adults in the US admit that insufficient or poor sleep has had an impact on their daily activities at least once in the previous week. What�s more, about a third of the people who said they slept the number of hours that doctors recommend reported experiencing poor sleep quality.
How Lack of Sleep Affects the Body
Insufficient or poor sleep has been linked to numerous health issues. People who don�t get enough sleep or their sleep quality is poor, have a higher risk of developing dangerous health conditions such as heart disease, diabetes, and obesity.
Over the long term, it has been linked to a shortened lifespan. It may be tempting to forego sleep to have a few extra hours of awake time, but the price is far too high. Your body and mind need sleep and when you deny that need you set in motion the potential for some severe impacts on your health.
Sleep is when your body and brain rest and rejuvenate. When you have adequate sleep, you will find that you are more focused and you have better mental clarity.
You will also notice increased energy and a better mood. When you don�t give your body the rest, it needs you will begin to feel drained and irritable.
You may also notice that you get sick more often as sleep is directly tied to immune function. One study even found that people who got eight hours of sleep a night were less likely to catch a cold or develop cold symptoms that those who got less than seven hours a night.
Those who got less than seven hours were three times more likely to get sick. There is no denying, sleep is essential.
Amazing Benefits of Sleep
There is no denying that sleep is vital for a healthier mind and body. This includes quality of sleep. Poor quality of sleep can be just as detrimental as not getting enough hours of sleep and can still lead to sleep deprivation. A great deal of research has been done on the effects of sleep and has shown that getting good sleep provides excellent benefits including:
Longer life
Increased production at work
Enhanced athletic performance
Less anxiety and depression
A better outlook on life
Decreased inflammation
Healthier spine
Better pain management
Improved grades
Lowered risk of certain health conditions
Better memory
Increased creativity
Reduced chance of auto accidents
Lower stress level
Better decision making
Enhanced attention or focus
Portrait of a Good Night�s Sleep
Adults should get between seven and nine hours of sleep a night, preferably uninterrupted, within 24 hours on a regular basis. There is more to a good night�s sleep than just quantity though. You should be able to fall asleep within about 20 minutes after you lie down and stay asleep.
When you wake, you should feel refreshed and alert, productive throughout most of the day � although it is normal for a person to notice a temporary decrease in energy and alertness later in the afternoon.
If your family members, friend, or spouse notice any unusual or troubling sleep behaviors such as snoring, restlessness, pauses in breathing, or nightmares it could indicate a more significant problem other than the interrupted sleep. It is well worth visiting your doctor to get help and remedy the situation because sleep is one of the essential needs your body has � and you can�t survive without it.
Sleeping. New parents chase it, Type A personalities fight it, but everyone needs it. The thing is, most people don�t get enough of it. According to the National Sleep Foundation, 45 percent of adults in the United States report that in a seven day period lack of sleep affected their daily activities.
Sleep quantity is not as much of a problem as sleep quality. Around 35 percent of people who said they slept for 7 or 8 hours a night still reported that their sleep quality was �only fair� or �poor� and 20 percent said that they did not feel refreshed upon waking. When a person is dealing with pain, such as lower back pain, it can make it even more difficult to get a good night�s sleep.
The Importance of Sleeping
Sleep is vital for good health. The Centers for Disease Control (CDC) cites insufficient sleep as a contributing factor to a variety of conditions including obesity, diabetes, depression, and cardiovascular disease. It is also a significant contributing factor in many machine related crashed, worksite accidents, and automobile accidents, leading to injury, disability, and even death.
Sleep allows your body to heal and the spine to rejuvenate. It helps you handle stress better and manage pain more effectively. It is an essential part of good health so making sure that you get good quality sleep should be a priority � and it is possible. These are the best sleep positions to get your best sleep when you have lower back pain.
Stomach Position
Sleeping on your stomach is usually the least back friendly sleep position, but some people can�t sleep any other way. Take the strain off of your back by supporting it with a pillow under your lower abdomen and pelvis. Using a pillow may put too much stress on your back, so you might need to try to sleep without one. Another alternative is to use a flatter, less fluffy pillow. Try different positions, such as drawing one leg up or splaying your legs more until you find on that is right for you.
Back Position
If you sleep on your back, you likely won�t be comfortable just lying flat. Try different positions such as placing a rolled towel under your knees or the small of your back to provide added support. Use a good pillow to support your neck. Some pillows are made specifically for people who sleep on their backs; you may want to give it a try.
Side Position
Many people with lower back pain find sleeping on their side to be the most comfortable sleep position. If you sleep on your side, pull your knees up slightly so that they are almost perpendicular from your body. You may have to make some adjustments to how bent your legs are before you find a position that takes the pressure off of your back. Place a pillow between your thighs and knees. You may want to use a body pillow to provide even more support all along your legs.
A Word about Your Pillow and Your Bed
The position that you sleep in can help relieve your back pain, but getting good quality sleep will help you manage your pain much better so it should be your goal to get a�good, restful sleep every night. You should change out your pillow on a regular basis.
Pillows can get worn and no longer deliver the support they once did. If you are waking up with neck or back pain or headaches, it could be your pillow. Additionally, studies show that making your bed every day improves your quality of sleep. Make sure that the temperature is comfortable and avoid electronic devices for about an hour before bedtime. Be kind to your body; make sleep a priority.
Envision yourself waking up entirely rested, prepared to deal with any obstacle and adopt all the joys of the world with gratitude. The majority of us know what a good night’s sleep resembles, but are we really getting the proper rest we should be getting? Within this stressful universe, it’s tough to achieve the sleep schedule that our brains and bodies require to operate to its fullest potential.
Proper sleep hygiene and the application of organic herbs and botanicals can help promote a healthy amount of sleep. The outcome could result in a wide array of benefits, including an improvement in problem solving and work performance, weight management, and even promote the prevention of chronic health issues, such as diabetes, cardiovascular disease and mood disorders like depression. You may find numerous products and information regarding how to manage proper sleep. A research study from 2016 indicated that individuals in the United States alone spent over $41 billion on sleeping treatments, where it is expected to rise up to $52 billion by the year 2020.
What Natural Remedies or Botanicals Can Help Promote Sleep?
The�German Commission E, globally recognized for its understanding information on the role of medicinal herbs, additionally recommends the frequent utilization of certain botanicals, such as valerian, lavender, lemon balm, and hops, to promote the right level of relaxation and support proper sleep. There are several other well-known options which have sedative qualities, such as passion flower, chamomile, and kava kava. Nearly all of those relaxant natural remedies and botanicals are available commonly in teas, but they are also found in supplement form. Nearly always found in specialized mixes, these herbs have various mechanisms of action, and, therefore, behave synergistically when mixed together.
Lavender (Lavandula angustifolia) is a very popular floral herb utilized in fundamental oil form, teas, extracts and in other botanical combinations to promote relaxation as well as to relieve stress and anxiety. Recent research studies have identified that lavender works by antagonizing NMDA-receptors and serotonin transporters. Doses of about 80 milligrams every day of lavender from gel cap type for up to ten weeks were utilized in a research study where participants had previously been diagnosed with an unspecified type anxiety disorder. Both quality and length of sleep seemed to have been enhanced in those subjects without them experiencing the sedative side-effects as demonstrated in pharmaceutical sleep treatments. Other uses of lavender include 1 to 2 tsp in hot water as a tea every day, or its key oil diluted in a carrier oil used for massage or in a hot bath. Lavender is generally considered safe, however it’s also believed to be toxic if ingested orally in large quantities.
Hops (Humulus lupulus), aside from its frequently enjoyable pronunciation and serving as the main ingredient in a variety of beers, this is one of the herbs which is most commonly mixed in teas or supplements to achieve as well as maintain an overall calming effect. Researchers haven’t completely discovered how hops causes this effect, however, it’s been demonstrated to bind to serotonin and melatonin receptors. Valerian-hops blend products have also become the most widely researched in placebo-controlled, double-blind randomized controlled trials comparing them to benzodiazepine-class sleep drugs and/or medications with varying results. Like lemon balm, signs for its use as a herbal treatment for relaxation or insomnia includes an extended background in history.
Passionflower (Passiflora incarnata) is basically another botanical utilized to remedy stress, anxiety and insomnia. Researchers have discovered that passionflower works by increasing levels of GABA, achieving a comforting effect. In a Japanese research study from 2017, scientists discovered that passionflower extract modulates the amounts of the receptors as well as the genetic expression of the related enzymes in vivo and in vitro. This ultimately resulted in favorable effects on circadian rhythms.
Dr. Alex Jimenez’s Insight
Natural remedies and botanicals are a natural option for promoting sleep. While various herbs taken in numerous forms can help provide a good night’s rest, other alternative treatment options can also be considered to get you through a full night of rest. Chiropractic care can help promote sleep by carefully correcting spinal misalignments, or subluxations, through spinal adjustments and manual manipulations, among other techniques. Spinal misalignments, or subluxations, can cause tension and stress along the back, causing pain and discomfort which can contribute to poor sleep. Regular chiropractic care can solve a variety of health issues which may be causing you sleepless nights, thus helping you sleep better and improving quality of life.
Proper Sleep Hygiene Advice
Dr. Michael Polsky, a board-certified sleep physician, recommends contemplating proper sleep hygiene for improving sleep. Sleep hygiene is a phrase utilized to refer to how we prepare our bodies and minds for sleep, beginning hours before we actually have to sleep. In fact, the window of 2 to 3 hours before sleeping proves to be significantly the most essential when attempting to get a good night’s rest. Below, are several notes of advice for achieving and maintaining proper sleep hygiene:
At least 2-3 hours before bedtime, have a light, balanced meal and also reduce fluids
Make a strategy to avoid the use of electronic devices 1 to 2 hours before bed
Do a little mild activity, like walking or yoga; avoid a hard workout or some other action which is too stimulating
Reduce or eliminate caffeine, commonly from coffee, tea, or chocolate, drink no more than 1 to 2 cups of coffee or tea before lunch
Keep a regular sleep schedule, even on weekends
A Simple Tea Recipe
Blend a batch of 2 parts peppermint leaf, 1 piece lemon balm, 1 part passionflower, and 1 part lavender. Steep one heaping teaspoon in a teacup of hot water for 5 minutes and enjoy only as a relaxing drink.
Sleep deprivation is one of the most common behaviors which can lead to a variety of health issues. While the natural remedies and botanicals mentioned above can be utilized to help promote sleep, other alternative treatment options, such as chiropractic care, have been reported to help provide a better good night’s rest. Chiropractic care focuses on the diagnosis, treatment and prevention of a variety of musculoskeletal and nervous system injuries and/or conditions, through the use of spinal adjustments and manual manipulations. A spinal misalignment, or subluxation, can cause pain and discomfort when trying to get proper sleep. Through chiropractic care, a chiropractor can help promote sleep by carefully correcting any spinal misalignment which may be causing painful symptoms. By treating symptoms of pain and discomfort, chiropractic care can help promote sleep, naturally, without the need for drugs and/or medications as well as surgical interventions.
In conclusion, proper sleep and rest are essential elements towards achieving and maintaining overall health and wellness. Through the use of natural remedies and botanicals, by practicing good sleep hygiene tips, and by receiving chiropractic care, the average American can begin to experience the benefits of proper sleep. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at�915-850-0900�.
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
Back pain is one of the most prevalent causes for disability and missed days at work worldwide. As a matter of fact, back pain has been attributed as the second most common reason for doctor office visits, outnumbered only by upper-respiratory infections. Approximately 80 percent of the population will experience some type of back pain at least once throughout their life. The spine is a complex structure made up of bones, joints, ligaments and muscles, among other soft tissues. Because of this, injuries and/or aggravated conditions, such as herniated discs, can eventually lead to symptoms of back pain. Sports injuries or automobile accident injuries are often the most frequent cause of back pain, however, sometimes the simplest of movements can have painful results. Fortunately, alternative treatment options, such as chiropractic care, can help ease back pain through the use of spinal adjustments and manual manipulations, ultimately improving pain relief.
Getting a good night�s sleep is absolutely integral to good spinal health. Sometimes, though that isn�t possible. According to the National Sleep Foundation, 92 percent of people believe that a�comfortable mattress is important for good, restful sleep. A bad mattress, or one that is old, or one that is simply wrong for your body can contribute to sleep deprivation, lower back pain, headaches, stiff neck, and anxiety and depression. With so much at stake, it�s easy to see just how important it is to select a good mattress.
Ask About How The Mattress Is Made
Learn about the construction� and what the different components mean for your comfort. Different mattresses have different coils and they are arranged differently. The padding can vary in thickness. The depth can range from 7 inches to 18 inches on the average. Understanding the various components can make it easier for you to find the one that is right for you.
Look For Comfort, As Well As, Support
A good mattress is comfortable and has good support. Support is good but if you don�t have comfort then it won�t be effective.
If it is too firm (too much support) it will cause pain on your body�s pressure points. You want your hips and shoulders to slightly sink into the mattress. However, if you prefer a mattress that is firmer to support your back, you can get one with padding on top.
Don�t Let Price Be The Determining Factor
You naturally want to get the most for your dollar, but remember that you get what you pay for. A cheap mattress can translate to a poor quality one.
Look for quality and value rather than price. If money is an issue, do some comparison shopping to find the mattress you want for the best price.
Sales are another way to save money on a purchase, but look out for advertising gimmicks. Know the meaning of the terms that are used and know what you are looking for before you go for that so-called great deal.
Educate Yourself On The Different Mattress Types
Do you want a memory foam or would latex work better for you? What exactly is an innerspring mattress? Are adjustable beds really all they are cracked up to be? Do some research and brush up on the different�types of mattresses�so that you can approach your shopping trip with confidence and as an educated consumer. It will definitely work in your favor.
In The End, It�s All About Personal Preference
There is no mattress that is a one size (or type) fits all. Different people will respond differently to mattresses. The best thing to do is try them out. Spend at least 20 minutes laying down before you make the decision to purchase or not.
Finally, if you find that your�quality of sleep�has recently gotten worse, that you are tossing and turning or wake up with pain in your back, neck, or head, it could be time to change your mattress � or pillow. If you can see your mattress sagging, that could be another indication that it is time to get a new one.
Mattresses are designed to withstand a certain degree of wear and tear, but they don�t last forever. The quality, the weight and other factors contribute to how quickly it wears out. So if you notice any of the warning signs it may be time to get a new mattress so that you can get back to peaceful, restful sleep.
Injury Medical Clinic: Back Pain Care & Treatments
You try to do all the right things when it comes to taking care of your spine. You lift the right way, exercise, practice good posture, stretch, drink plenty of water, and take frequent breaks to walk around if you are seated for an extended period of time. Those are all excellent habits to keep, but there is something else that you should be doing � and it is one of the most overlooked and undervalued health practices. Rest!
Running On Empty: The Silent Epidemic
Stress can do severe damage to your emotional and mental health, but it can also hurt your body as well. Many people carry stress in their lower backs which means that when stress goes up it can result in lower back pain. It can also make you more sensitive to pain.
It is estimated that 66 percent of all doctor visits have a stress related component. What�s more, 50 percent of people who suffer from stress rate it as moderate to high. We live in a culture that makes it commonplace to run on empty. The problem with that is sooner or later you are going to crash and your body will bear the brunt.
Rest is important for helping you alleviate and manage stress, but recent studies show that 1 in 3 adults don�t get enough sleep. There is another reason to get your seven to nine hours in, though, that is directly related to spinal health.
What Rest Can Do For Your Spinal Health
When you rest you give your body time to replenish depleted stores of energy. Adequate sleep improves your immune function, memory, metabolism, learning, and healing. You will be more alert, happier, and have more energy. It is also very beneficial is you are trying to lose weight.
Excess weight can put pressure on your spine and cause it to curve, causing back pain. This is especially true if you carry your weight in your abdomen. That extra weight in the front pulls your spine into a sway back curve making it painful to stand for long periods of time.
When you lay down and rest you allow your entire spine, associated muscles, and other parts of your body to rejuvenate and relax. You probably don�t realize it, but your muscles in your back and abdomen work all day to keep your body properly supported. Even when sitting there are muscles engaged. Laying down allows all of those muscles to finally relax.
Rest also allows your spinal discs to rehydrate. The spine is made up of fluid filled discs that sit between the vertebrae, acting as a cushion. As you go about your day, thanks to gravity, your discs become compressed. This compression causes the disc to lose fluid (which is about 88 percent water). This can cause pain if the discs are not properly rehydrated � and that is a two-step process of drinking adequate water and getting enough rest.
Drinking water will put the fluids into your body, but as long as you are upright, the compression will continue. Laying down to go to sleep takes that pressure off of your spine so there is no compression and the body can naturally rehydrate the discs. A few hours here and there is not really effective because it does not give the body enough time to do its job. This means that you need to get the recommended seven to nine hours of sleep each night.
Along with all the other great, healthy reasons to get a good night�s sleep, you not have one more to add to the list. A healthy spine will keep you standing tall and help keep you mobile, It is important to do all you can to take care of it.
Injury Medical Clinic: Neck Pain Care & Treatments
Sleeping: Lower back pain makes it hard to fall asleep, and the pain can awake anyone any hour of the night.
To help reclaim your sleep schedule, here are some simple guidelines to sleeping with lower back pain:
Sleeping With Lower Back Pain Guidelines
Sleep On Your Side To Relieve Pain
One of the most common causes of lower back pain is a pulled back muscle. This occurs when a muscle in the lower back is strained or torn as a result of being over stretched. Symptoms typically resolve within a few days, but the intense pain can make it difficult to fall asleep. The longer you lie in bed, the more unconditioned the body becomes, the worse the symptoms become.
No single sleeping position works for everybody with a pulled back muscle. But a good place to start is to test sleeping on your side. When sleeping on your side, try the following:
Avoid a tight curled-up fetal position (knees pulled in toward the body), and instead sleep with your body slightly elongated.
Slip a slim pillow between your knees to support the natural curvature of your spine.
Find a head pillow that holds your head midway between each shoulder. If your pillow is too thin or too thick it can bend your neck at an uncomfortable angle.
There is benefit from wearing a disposable heat wrap to bed, which can help alleviate the pain from a pulled back muscle. These wraps deliver muscle relaxing, low-level heat over the course of several hours. They may help to fall asleep and stay asleep.
Soothing Audio Relaxes The Mind & Body
When the lights go out, almost all of the stimuli that held your attention during the day dissipates. People tend to focus more on their back pain, and as one pays more attention to the pain, the anxiety can rise, which, makes it harder to fall asleep.
Listening to various soothing audio can relieve anxiety and the experience of back pain by redirecting the focus away from symptoms. Nighttime audio options include:
Audio Books For Children
Classical Music
Relaxation Podcasts
Regardless of what kind of audio chosen, make sure it is free of harsh sounds or intense plots. Otherwise there won’t be any sleep.
Mattress Quality Matters
On the internet one can discover all sorts of suggestions for extending the life of a sagging mattress. These methods include
Sliding Plywood Under The Mattress
Ditching The Box Spring
These tricks can work for some, but the best approach is to replace a worn out mattress.
It is important not to neglect the mattress because a sagging mattress can exacerbate lower back pain by placing additional stress on the spinal structures. This can make it harder to fall asleep.
When sleeping with lower back pain, the most expensive mattress is not always the best. Instead, the best mattress is ultimately one that provides the best sleep.
Here are a few tips to help get you started for a proper mattress:
The mattress needs to support the natural curvature of the spine. This means the spine should look similar when lying on you’re back or side as when you�re standing with good posture.
Visit the local mattress store and try out various mattresses. After 15 minutes on a mattress, one can tell if it is a good fit.
Don�t be afraid to take your time.
Sleeping with a partner, consider a larger-sized mattress. This will allow both room to sleep without startling the other.
Hopefully, the aforementioned advice will help you find relief from lower back pain and enjoy more restful sleep.
Chiropractic Clinic Extra: Back Pain Care & Treatments
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