Cracking, Adjusting and Arthritis

The question of whether it is safe to crack yourself is something I get asked almost every day as a chiropractor. Some amount of cracking in the body is completely normal and is just a tight muscle or tendon rubbing over the bone. On the other hand, there are some things that are not normal or even safe. Let’s look a little deeper into the joints and try to see what’s right and what’s not.
Although the question of whether cracking your knuckles leads to arthritis or not has been somewhat dispelled, this is what you need to know about arthritis. The word arthritis means inflammation of a joint. Inflammation occurs from a variety of means and could stem from some arduous activity done one day, chronic activities done over a lifetime or even chemically induced due to a poor diet or exposure to other environmental triggers.

If your joints are inflamed from an intense workout or helping a friend move furniture or some other unusual activity, some ice on the affected joint for 15 minutes every hour for a few hours should do the trick. Chemical or environmental triggers can sometimes be difficult to pinpoint, which is the reasoning behind avoiding inflammatory foods like gluten, soy, dairy and sugar whenever possible.

Now let’s look at the chronic arthritis brought on by repetitive actions and poor posture. When most people think about arthritis, they picture an elderly person with gnarled fingers, in seemingly constant pain as they knit a blanket to stay warm. Someone who has a physical job where they do the same thing day after day to parts of their bodies will most likely cause premature degeneration of those joints being used. Sitting at a desk and looking slightly downward at the screen or constant usage of a mobile phone or book reading (Who does that?) will cause arthritic degeneration of the neck. And if you’re wondering why you’ve never heard of arthritis in the neck before, it’s because most MD’s consider it to be a normal part of the aging process. When you place abnormal forces on a joint for long periods of time, those joints start to deform. This is known as Wolff’s Law. You lose bone in some places and begin to form extra bone in places where it shouldn’t be which can lead to joint fusion and therefore, substantial loss of mobility in those joints.

Let’s get back to the difference between cracking and adjusting. Cracking is the simple manipulation of a joint by any means and could happen intentionally or unintentionally. We could turn our heads to the side and hear a crack. So, what cracked? Your response to this question should be, “I don’t know!” because you don’t. I can feel something is not properly aligned in my back, but it’s difficult for me to determine exactly what the issue is because as soon as I reach behind me to feel my back, the simple act of twisting has already distorted the alignment. In order to objectively figure out where and what the misalignment actually is, your body must first be in a neutral position. This is why a chiropractor will evaluate a person while they are lying on their stomach or back or sitting straight. Once the chiropractor is able to determine the exact position of the bone/joint in question, then they can figure out how best they can make the correction properly and safely. This correction is called an adjustment. Anyone can crack something- intentionally or unintentionally. These “cracks” can be safe or harmful, but there is no way to tell quickly. Chiropractors deliver precise corrections to reduce subluxations or misalignments throughout the body. This is done in a safe and calculated manner to only the bones/joints that require it. The rest are left alone and not moved just for the heck of it. Find it, fix it, leave it alone.

Phone 212-883-8700
Email [email protected]
IG @lambchiro

Matresses, Pillows and Sleeping Positions

Sleep is one of the key components of health and adequate sleep is necessary for our bodies to repair themselves, so I just wanted to spend a few minutes talking about some recommendations to help everyone get better rest.  As one of the most commonly discussed topics in my office, having some resources here may be able to many of you. Some of the most common questions I get each day are:

-What is the best mattress to sleep on?

-What is the best position to sleep in?

-What is the best pillow to use?

Let’s try to address these questions.  First, a common line of thought is that peoples bodies sometimes hurt when they lie down, or when they wake up, so therefore, it must be their beds or mattresses.  For many, the damage was done long before they reach the bed.  Bodies are subjected to many different stresses during the day, whether you are engaging in heavy lifting on the job or at the gym, or sitting for long hours at a desk.  Muscles get strained, ligaments get stretched and massive forces are imposed upon the body in less than optimal positions.

There are many choices these days when it comes to selecting a mattress and it can be a bit confusing.  Firm, soft, plush, pillow top, foam, etc.  My recommendation for mattresses has traditionally been a firm mattress with a pillow top.  You can start the selection process online or in a store where you can actually test them out live(my preferred method). For many years, I slept on a foam mattress and loved it.  Last year, after years of recommending them to others, I decided to try a sleep number bed , a mattress which can be adjusted from firm to soft.  This bed is known as the “relationship saver”, as you can have each side a different firmness.  My only suggestion on this mattress is spring for a middle tier model as the lower end ones do not provide enough foam between the top of the bed and the air compartments.  Their sleep monitoring program is very glitchy and their customer service is poor.  Some of the mattress companies have cool questionnaires to help you determine your ideal match. As many people are concerned about what their bedding is made of, there are companies like Saatva (my personal favorite)  that are providing eco-friendly and organic materials, made in the USA.  Lastly here, I will mention that getting something with a good return policy is useful.  One of the best I’ve seen is from Bloomingdales.  I will provide a few links/resources here.

The Saatva link comes with a $50 coupon.

https://saatva.grsm.io/lambchiro50  

https://www.tempurpedic.com/pillows/

Tri-Core Cervical Pillow

Original Bones™ OrthoBone® Pillow in Velour

http://fashion.bloomingdales.com/fashion-tips/mattress-buying-guide/#comfort_guarantee

https://onpurple.com/

https://casper.com/

https://www.tempurpedic.com/

As far as sleeping position goes, this is a very difficult question, as people have developed their sometimes bad sleeping habits over their lifetimes and resistant to change.  The key is trying to get your body in as neutral position as possible.  If you’re a back sleeper, a small pillow or a neck roll under the curve of you neck is best while trying to keep a pillow behind your knees.  If you’re a side sleeper (most people), having enough pillow under your head and neck to support it and keep it in line with the rest of your spine while keeping a small pillow between the knees is our goal.  If you’re a stomach sleeper, I’ve got some bad news – it’s not good for you no matter how you spin it.  Some of the worst spines I’ve seen, riddled with arthritis and incredibly tight upper back and neck muscles stem from sleeping on your stomach with your head twisted in one direction or another.  Most sources will recommend that you sleep on your left side to relieve or minimize acid reflux as well as improve heart circulation for pregnant women.  Either side is fine in my book as long as you are well supported and comfortable.

The pillow question may be the most common one I get in the office.  I mentioned some suggestions along with sleeping positions, but as far as specific pillows go, there is a vast number of choices out there. For many years, I carried Tempurpedic pillows in the office.  They are somewhat expensive and there are many cheaper alternatives.  I do like the support of foam pillows, but there are others that do the job as well.  The most popular pillow recommended by chiropractors for years is the Tricore pillow, available on Amazon for about $40  Buckwheat, microbeads, beans, rice, water, air, down, etc.  Whatever feel you prefer is fine as long as it’s the right size.  Some pillow companies like tempurpedic make pillows of different sizes.  The pillows I’ve recently been recommending for the majority of my patients are adjustable pillows, meaning ones that we can add or remove material from in order to accommodate different body sizes.  These include the orthobone, mypillow and bamboo pillows readily found on Amazon.

Please contact the office for any further questions.
Phone 212-883-8700
Email [email protected]

Back Pain and Women

Everybody experiences back pain of one form or another at some point in their lives. There are some simple things we can do to help minimize those pains and hopefully prevent them from occurring in the first place. Some women, due to their inherent physical makeup and societal roles, may be especially susceptible to back pain and may have particular difficulty in addressing it. I am here today to address some of those female-specific issues.

The biggest cause of mostly preventable back pain, in my opinion, is posture. Sitting, standing and also sleeping properly are vital to living a healthy, mostly pain-free life. Sitting in a slouched position puts a lot of excess pressure on the joints, muscles and discs in the back and is a direct cause of pain. Sitting up straight is often easier said than done, but having your chair at the right height is definitely the first step. Standing up straight and looking straight or slightly upwards (not down at your phone) is another key. Sleeping in a neutral position without twisting or kinking up the body is also important.

These postural guidelines are important for everyone, but now let’s get into some of the female-specific points. One thing many women do more than men is carry a purse/bag on one shoulder. In order to keep the bag on the shoulder, one must raise the shoulder a bit and that causes an imbalance. Scoliosis is a sideways curvature of the spine and is seen early on in both males and females, but becomes more pronounced in females more after adolescence. In my opinion, one of the biggest factors contributing to the cause of scoliosis is uneven arches developed from walking on hard, flat surfaces with poor support in our shoes. As women tend to wear shoes with less/no support, this is another area that I think could be easily addressed.

The task of childbearing rests on females and their anatomy differs dramatically from males in this sense. Carrying a child puts excess pressure on the spine as well as the rest of the body and it makes it much more difficult to stand upright and sleep in a neutral position. Breasts add to the situation, putting more weight in the front and therefore, even more pressure on the upper and middle back musculature. There are a variety of support belts and posture correctors to help with this and women with larger breasts also have a hard time finding properly fitting bras to support them. Some of my patients have had a lot of success in getting custom made bras and have reported this helping tremendously in their chronic back issues.

Regardless the reason and the duration, chiropractic can help people by restoring the natural order of things in the body and allowing people to better deal with the stresses caused by postural distortion. It is not a quick fix and this is something that everyone has a tough time digesting. The longer your body is in a misaligned state, the longer it will take to change that, and in some cases, the damage done is nearly irreparable. Chiropractic adjustments will help put your body in a place to allow for healing to occur. Weekly checkups for life is, in my opinion, key to a healthy life.

The Health Insurance industry in the United States is seriously flawed. Premiums are sky-high and deductibles are ridiculous. Still, if you are paying for insurance, you expect to be able to go to any doctor you choose and have your services covered. Most people expect to have a copay of $10-20 and that is all. Another thing many do not understand is the difference between In- Network and Out-of-Network doctors. Insurance companies want you to see In-Network doctors because they usually have contracted rates with the companies. This means the doctor legally can not set their own prices (remember that next time you get hit with a bill after seeing a doctor).  Most chiropractors in NYC are Out-of-Network, which means they can set their own prices and if an insurance company only pays a portion of that, then legally, the patient owes the remainder. This too can get confusing for the patient.

Still, the most confusing thing for most people seems to be the concept of deductibles. If you are seeing a chiropractor that bills your insurance $300/visit and the insurance company only pays $150 of that charge, then theoretically you owe the doctor the remainder of that, which is $150/visit. Most offices whose billing is like this will usually write off the patients balance for hardship or other reasons. Here’s where it gets confusing (I don’t enjoy this math).

If you have a $1,000 deductible and your insurance is paying $150/visit, then it will take 7 visits before the doctor receives any money at all from the insurance company. Deductibles in the $100’s of dollars were the norm 10 years ago and earlier, but now, thanks to Obamacare, most individual deductibles seem to be around $5,000. In that scenario, it would take 33 visits with the insurance company paying $150/visit before the doctor gets anything. Most insurance companies will also not allow patients to see a doctor 33 visits or more and so that becomes even more of a problem.

So, you can probably see why more and more doctors are turning to cash only practices. Instead of charging $300 or even $150 for a visit, they are offering more manageable fees so that people can save on their out-of-pocket expenses. It’s still difficult for most people to see that by offering a visit at $75 cash is saving the person from having to pay the $150 or more per visit. Utilizing insurance also incurs the fees associated with the extra time to fill out paperwork, process claims and in many offices, the usage of an outside billing company to process such claims.

Most chiropractors are trying to offer their services at the lowest possible rates to make it easy for the patient. Most patients don’t really understand the value of chiropractic past their aches and pains. When you realize that the real point of chiropractic is to enable your brain and body to work together and allow your body to function and heal despite what life throws at you, then that $75 will seem like the greatest bargain in the world.

Benefits of Chiropractic Care During Pregnancy

Pregnancy is one of the most life changing experiences for a woman, but it also comes with a slew of physical and emotional challenges. From morning sickness and fatigue to back pain, pelvic dysfunction, and postural changes, expectant mothers often struggle with a variety of issues throughout their pregnancy journey. Fortunately, chiropractic care offers a natural and effective way to provide relief and support during this special time.

As a chiropractor experienced in prenatal and pediatric techniques based in Midtown Manhattan, I’ve seen the amazing benefits that chiropractic adjustments can offer pregnant women. I will now try to explain why chiropractic care is not only safe but highly beneficial for expecting mothers, and how it can help create an environment for a healthier pregnancy and smoother delivery.

1. Alleviating Pain

The most common reason people seek chiropractic care is for pain relief. With pregnancy, the body must adapt to the growing baby, the center of gravity shifts, and hormonal changes can cause loose ligaments and joints. When ligaments aren’t doing their job of holding things together, muscles have to go into spasm to take up the slack.

Chiropractic adjustments help realign the spine and pelvis, reducing strain on the muscles and ligaments. This can alleviate many pregnancy-related pains, such as:

• Lower back pain: As the pregnancy progresses, postural changes and additional weight can strain the lower back. The lumbar discs can start to bulge, which can cause irritation of spinal nerves which can cause pain in the back and down the legs. Chiropractic care can help by realigning the spine and reducing nerve irritation.
• Pelvic pain: Pelvic misalignments can cause significant discomfort during pregnancy. Chiropractors use gentle techniques to restore balance and reduce pressure.
• Sciatica: The growing uterus can cause the piriformis muscle to spasm and put pressure on the sciatic nerve, causing pain down the back of the legs. Chiropractic adjustments and stretching can help.

2. Fetal Positioning and Intrauterine Constraint

Being properly aligned helps create an environment so that the fetus can assume an optimal position for birth. In the case of a breech presentation, the Webster Technique, a gentle and specific protocol is performed to level the pelvis and reduce intrauterine tension. This can help the baby move into a more favorable position for delivery, which is especially important for women hoping for a natural birth.

3. Posture and Spinal Alignment

As pregnancy progresses, there is weight gain and changes in posture and alignment of the spine. Poor posture can contribute to a variety of issues such as neck pain, back pain, and headaches.  Chiropractic adjustments aim to correct these misalignments, improving overall posture and spinal alignment. This not only helps reduce pain but also supports the body’s ability to adapt to the physical demands of pregnancy. Better posture can also contribute to improved energy levels, reduced fatigue, and facilitate proper nerve and blood flow.

4. Common Complaints

Pregnancy usually is accompanied by other uncomfortable symptoms including nausea, headache, heartburn, and fatigue. While these symptoms are a normal part of pregnancy, chiropractic care can help alleviate them.

• Morning sickness: Chiropractic adjustments can help improve posture and reduce the tension that contributes to nausea. Many find relief from morning sickness after just a few chiropractic visits.
• Headaches: Hormonal changes, increased blood volume, and changes in posture can all trigger headaches during pregnancy. Chiropractic can help to relieve muscular tension in the neck and upper back, allowing for better blood flow and oxygen delivery to the head, leading to fewer and less intense headaches.
• Heartburn: As organs get pushed around during pregnancy, pressure on the digestive tract can lead to heartburn or acid reflux. Improving alignment and posture can help.

5. Improving Labor and Delivery

A common report from women getting chiropractic care throughout their pregnancy is that they often have smoother and shorter labors and deliveries. Proper spinal alignment, pelvic positioning and reduced muscular tension can help make things go much more easily.  Chiropractic adjustments can:

• Increased pelvic flexibility: A properly aligned pelvis allows for better movement and flexibility during labor and delivery.
• Reduced labor pain: Well adjusted women report being more relaxed and prepared for delivery and experience less pain.
• Improved contractions: A well-aligned spine that the nerves can function properly leading to more effective contractions and faster deliveries
• Posture and positioning: Chiropractors can help discuss better strategies for delivery like using gravity to your advantage.

6. Safety and Considerations for Pregnant Women

Chiropractic care is generally considered safe during pregnancy when provided by a trained and experienced chiropractor who specializes in prenatal care. It is so safe, that it is often recommended by midwives, doulas and obstetricians.  Chiropractors use gentle, non-invasive techniques to ensure the safety and comfort of both mother and baby.  They often use tables and pillows specifically designed to work with expecting moms.

Before beginning chiropractic care, it’s important to consult with your obstetrician or midwife to ensure there are no contraindications. A skilled prenatal chiropractor will be trained to adjust techniques based on the unique needs of each trimester, ensuring that care is tailored to your specific stage of pregnancy.

7. Choosing a Chiropractor in NYC

If you’re pregnant and considering chiropractic care in the New York City area, it’s important to choose a chiropractor who has training with the International Chiropractic Pediatric Association. Look for a chiropractor with extensive experience working with expectant mothers and one who utilizes gentle, safe techniques like the Webster Technique. We offer a holistic approach to care, incorporating lifestyle counseling, stretching, and nutritional guidance to support a healthy pregnancy.  He also works with pelvic floor specialists and physical therapists who may be of additional help.

Chiropractic care offers a wide range of benefits for pregnant women, from alleviating pain and improving posture to supporting fetal positioning and promoting a smoother labor. With its natural, drug-free approach, chiropractic care can be an essential part of a healthy pregnancy journey.  If you’re in the NYC area and looking for expert prenatal chiropractic care, don’t hesitate to reach out to our office. We specialize in providing gentle and effective chiropractic adjustments tailored specifically to the needs of pregnant women. Schedule a visit today and take the next step toward a healthier, more comfortable pregnancy.

Dr. Adam Lamb
ICPA Trained
Webster Certified
Phone 212-883-8700
Email [email protected]
IG @lambchiro

Osteoarthritis(OA) is the loss of cartilage in your joints as a result of wear and tear/chronic
repetitive activities and can be found in any one particular joint. Rheumatoid arthritis(RA) is an
autoimmune disorder where your body attacks your joint cartilage and is usually found on both sides of
the body in a symmetrical pattern (both wrists, etc.). Although there is no proven treatment/cure for
arthritis in the medical community, OA pain is usually managed with NSAIDS and RA with steroids.
Keeping active and maintaining a healthy weight is helpful, but for many it’s a catch 22- you
need to lose weight to be able to exercise and you need to exercise in order to lose weight. There are
many different herbs and supplements that can help manage pain, inflammation and possibly provide
some more joint mobility. I’m going to focus on a couple of those today.

For inflammation, turmeric , ginger, fish oil, pineapple, papaya, resveratrol, boswelia and long
list of other, more obscure herbs can help. I recommend taking a good turmeric supplement such as
APEX energetics “Turmero” ( a liquid variety emulsified with some healthy fat to aid absorbtion), as well
as trying to include it in your food as much as possible along with ginger and the fruits I mentioned. Fish
oil should be a part of your daily regimen as well.

Glucosamine and Chondroitin have been shown to be helpful in increasing joint mobility in many
people. These substances are part of normal cartilage and although have not been definitely proven to
help in studies, have helped millions and have no side effects as they are very safe things to consume (as
long as there is no allergy to shellfish as this is the most common source). To see if Glucosamine and
Chondroitin are right for you, I would recommend a trial period. If you’re taking pills, you’re going to
need to take one pill, 3 times a day for 3 months to give it adequate time to make a difference. I use a
liquid formulation that works a lot faster. You take ½ an ounce 2 times a day for a month and you
should see a difference by then. If you see a benefit, you continue as directed. If not, it may not be the
key for you.

Most quality glucosamine and chondroitin supplements will also contain some addition joint
mobility aids. MSM and vitamin C are crucial for collagen repair. The liquid glucosamine that I use also
contains MSM. SAMe is another compound found naturally in the body that helps with joint mobility
and chronic pain. As an added bonus, SAMe also helps with depression and anxiety. I’ve always thought
that if you have chronic pain, you will probably be depressed as a result and this connection makes
sense to me.

I really wanted to find Glucosamine that I could give to all my patients with joint issues. The Glucosamine that I would recommend to my patients should be easily absorbed and safe. After countless hours of research on existing products and their ingredients, I found a great liquid formula that would work quickly to improve joint mobility. This inexpensive and effective solution is safe for humans and even pets too. Give it a try!

Dr Lamb’s Glucosamine