Boca Back Pain & Chiropractic Center :: 561-706-0466

October Newsletter

October Newsletter

Posted: October 3, 2011
By: Dr Derek Friedman


Volume 11 Issue 10

A Free Monthly Newsletter
For The Friends And Patients Of:

Derek Friedman, D.C.
7491 N Federal Hwy #C16
Boca Raton, FL 33487
(561) 353-1945


"When we are unable to find tranquility within ourselves,
it is useless to seek it elsewhere." ~ Francois de la Rochefoucauld


  • Health Update #1: Low Back Pain
  • Health Update #2: Carpal Tunnel
  • Health Update #3: Fibromyalgia
  • Health Update #4: Neck Pain
  • Health Update #5: Whiplash



  • Neck pain and headaches:  What you should know to start ending your pain and achieve lasting relief
  • Why hand sanitizers put you at risk for viruses
  • What 66% of mothers can do to strengthen their babies' immune systems
  • Tips to make going back to school healthier




Looking for a safe and effective back pain treatment?
Breaking Back Pain News:

Survey Says Chiropractic Outperforms Other
Back Pain Treatments - Even Medication

        SURVEY SAYS!!!!  If you have back pain... you are probably old enough to remember Richard Dawson first yelling that phrase on the popular 70s and 80s game show, The Family Feud. If not - it doesn't matter - you just learned something interesting about American pop culture and game show history. 

So, What Does The Survey Really Say?

        According to an August 9, 2011 article on, "In a new survey, chiropractic outperformed all other back pain treatments including prescription and over-the-counter medications, deep-tissue massage, yoga, and Pilates. According to the American Chiropractic Association (ACA), this news reinforces the use of conservative care options as a first line of defense against pain.

        The survey, released by a leading consumer product rating and survey publisher in late July, found that 65 percent of those surveyed using chiropractic care for back pain said it helped a lot. Only 53 percent of respondents using prescription medications found them as helpful.
        "Additionally, about half of those surveyed who are using deep-tissue massage, yoga or Pilates said those treatments helped a lot and only 28 percent of respondents using over-the-counter medications reported that they helped a lot.

        "Current evidence-based guidelines support the use of conservative care such as chiropractic for conditions such as chronic lower back pain."

        One serious eye-opener was that only 28% of respondents said over-the-counter medications helped a lot.

        It has been known for quite some time that common over-the-counter non-steroidal anti-inflammatory medications (NSAID) have serious side effects.  One of these side effects is that an estimated 16,500 people die every year.

        Natural, conservative options like Chiropractic, deep tissue massage, yoga, and Pilates are most likely better and safer choices when it comes to relieving back pain.

What About Neck Pain And Headaches?

        Neck pain is very common and it can make your life miserable. If you suffer from headaches... there is a very good chance you suffer from a common type of headache called "cervicogenic headache."  This type of headache is caused by a problem in your neck.

        One way to tell you might suffer from cervicogenic headaches is to identify if any neck motions cause the headaches or increase their severity.

        Also, take a good look at yourself in the mirror.  Does your head tilt to one side?  Is your head posture bad?  In other words, does your head stick out in front of you instead of sitting back over your torso?  You'll probably need a trained eye (like your Chiropractor's) to see that one.

What Helps This Type Of Headache?

        According to an "evidence report" published by Duke University researchers, "Cervical spinal manipulation was associated with improvement in headaches in two trials involving patients with neck pain and/or neck dysfunction and headache.  Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headaches when compared with an attention-placebo control.  Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity.  However, among patients without a neck pain/dysfunction component to their headache syndrome - that is, patients with episodic or chronic tension-type headaches - the effectiveness of cervical spinal manipulation was less clear."

What 66% Of Mothers Can Do
To Strengthen Their Baby's Immune System

        According to the Centers for Disease Control and Prevention, only 38 percent of Rhode Island mothers nurse their babies six months after birth.  The national average is 44 percent.

        State Health Director, Michael Fine, says the state hopes to raise the percentage of Rhode Island mothers nursing at six months to 60 percent by 2020.

        Studies show breast-feeding improves child's health and is a low-cost alternative to formula.

        Many experts believe breast feeding is one of the most important things a mother can do to help her baby develop a strong, natural immune system.

Hand Sanitizers May Put You At Risk For Viruses

        According to Medical News Today, "New research has found that hand sanitizers are not as effective as soap and water in health care settings at preventing viral outbreaks. In fact, they may even be responsible for outbreaks of seriously contagious viruses. As a common alternative to using soap and water, hand sanitizers are often regarded as being the most efficient way to cleanse hands."

        In February, a survey was presented at an American College of Preventative Medicine meeting. "The survey focused on 161 long-term care facilities and found that the preferential use of hand sanitizers over hand soap was linked to a higher risk of outbreaks of the highly infectious norovirus, a virus responsible for the majority of acute gastroenteritis cases.

        "The study found that norovirus outbreaks were far more rampant in facilities where staff favored hand sanitizer use. In facilities where norovirus outbreaks occurred, members of staff were six times more likely to use hand sanitizers than soap and water for cleansing their hands."

        The misuse and improper use of antibiotics is known to create super bugs that are immune to antibiotics.

        It is unclear if hand sanitizers are doing the same damage.

        Best bet:  Wash your hands with soap and warm water.

        And don't forget, if you ever have any questions or concerns about your health talk to us. Contact us with your questions. We're here to help and don't enjoy anything more than participating in your lifelong good health.


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Inspirational Story Of The Month
(Names And Details Have Been Changed To Protect Privacy)

How 17 Days Buried Alive Can Change Your Life -
And Maybe Even Change The World...
This record-setting story has 33 heroes and a supporting cast of millions...
        It's been just over a year since the Chilean Mine tragedy.

        Most have forgotten all about it and have gone on with their lives.

        For the 33 people who were trapped in that mine for 33 brutal days... their lives will never be the same.

        One of the most amazing things about this story is how the miners handled themselves throughout the ordeal.

        Evidence points to the fact that instead of breaking down and fighting, the miners stuck together.

        They formed a "community" and helped one another.

        One account states the only thing the miners argued about was who was going to be taken out LAST when they were rescued.

        Each volunteered to let everyone else go first.

        One writer in the Digital Journey recently commented on this and contrasted the Chilean miners to the riots in Great Britain...

        "Inspirational though their story is, it is a sad indictment of British society that at this time, people, especially the young, have been rioting on the streets and even killing people because they have - we are told - given up hope. These men never gave up hope; would any denizen of Tottenham, Hackney or Birmingham's inner city willingly have changed places with one of them?"

        Clearly "hope" is something no one should ever lose.  No matter how bleak the situation or how dark the circumstances - things can always get better.

        The darkest hours are just before the dawn; and, when things change, they often change quickly.  Terrible times give way to joy... just about overnight.

        Everyone has hard times.  They are all different, but they are also relative.  Your hard times can be as painful as someone trapped in a mine... if you allow it.

        For example, let's look at the miners and how their lives turned out a year later.

        Some of the miners used their brief fame to launch businesses and speaking careers...  and they are doing well.

        Others are broke and are having serious mental problems.

        An article in the states, "They are taking uppers, downers, stabilizers, I think they are over prescribed ... They don't understand why they are taking them but they are fed up with pills... It is not pills they need, but the tools to deal with fame and the tools to renovate themselves."

        This is an extreme example.  Things are not always as easy as, "making the decision to succeed."

        But, if those miners could ban together and help each other survive in the toughest of times, then so can everyone else. If some of those miners could come through that tragedy and use the experience as a positive way to give them a great new life - I'm sure most of the people reading this can take steps to have a better and healthier life too.

        Most of the time, it is not the problems we face - or the solutions we come up with - it is the decisions we make about how we react to the outcomes.

        Take immediate steps to improve your life and make the decision to enjoy the positive instead of searching for the negative.

        We love helping our patients and their friends and relatives through their tough times and getting them feeling better! We are here to help you stay feeling better and looking younger! Don't be a stranger. :)

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Did You Know?


        Nuts and seeds just might boost your brainpower and balance your moods. Everything from the most common nuts -- such as walnuts, hazelnuts, cashews and almonds -- to the more exotic seeds and nuts can clear up that "brain fog" and enable you to think clearer and be happier than you ever imagined.  

        Walnuts are "brain food."  Walnuts are made up of 15 to 20 percent protein and contain linoleic (omega-6 fatty acids) and alpha-linoleic acids (omega-3 fatty acids), vitamin E and vitamin B6, making them an excellent source of nourishment for your nervous system.  A healthy nervous system means both clearer and happier thinking.  Under-consumption of omega-3-rich foods may actually lead to depression. The same walnuts that you can find in the baking aisle of just about any grocery store may also boost your mood.  

        Walnuts aren't the only nut with mood-boosting omega-3s, either. Flax seeds are an excellent source for omega-3s, making them a viable source for those who don't like to eat fish, the most common source of omega-3s.  

        Cashews are high in magnesium, which can "open up" the blood vessels in your body, including those in your brain. When more oxygen-rich blood nourishes your brain, like any organ, it operates better. By providing your body with phenylalanine, adding almonds to your diet can do wonders for your mental and neurological health. Additionally, almonds are high in riboflavin, which may boost your memory. Peanuts and pecans provide another important nutrient for optimal brain function, choline.  Choline aids in both memory and brain development.  Seeds and nuts are essential to a healthy, well-functioning brain. 

Tip Of The Month

Tips To Make Going Back To School Healthier...


        By the time you read this, if you have children, they are already back in school. If they are, then you know what it's like to try to pack a healthy and safe lunch every day. Not too long ago officials from the Oklahoma State Department of Health offered some great tips to help parents out:

  • Keep everything clean when packing the lunch. Use hot, soapy water to clean hands, clean preparation surfaces, and clean utensils. Wash your hands before you prepare or eat food. Wash insulated lunch bags with warm soapy water after each use. 
  • Use an insulated lunch box to help keep foods cold. Insulated, soft-sided lunch totes are best for keeping perishable foods chilled. You can also use a thermos to keep milk or juice cold until lunchtime. Perishable foods should not be out of refrigeration for more than two hours. 
  • Use freezer gel packs that are widely available in stores. If you cannot get freezer gel packs, freeze a juice box or plastic water bottle overnight and put that into the lunch box next to the sandwich. 
  • Keep your lunch in the coolest place possible! If there is a refrigerator at school, put your lunch in there. If not, keep it out of the sun and away from the heat.
  • Pack shelf-stable foods, especially if you have a brown paper bag lunch. These food items include fresh fruits and vegetables, crackers, peanut butter sandwiches, canned meats, shelf-stable cheeses, packaged pudding, and canned fruits and juices. 
  • Rinse fresh fruits and vegetables under running tap water, including those with skins and rinds that are not eaten. Blot dry with a paper towel before packing them in your child's lunch. 
  • Use a thermos to keep soup, chili and stew hot. Use an insulated bottle stored in an insulated lunch box. Fill the bottle with boiling water, let stand for a few minutes, empty, and then put in the piping hot food. Keep the insulated bottle closed until lunch to keep the food hot. 
  • Make sure kids wash their hands before eating lunch. Encourage at least 20 seconds - about the time it takes to sing two choruses of the "Happy Birthday" song - of hand washing in warm soapy water. 
  • Discard perishable leftovers after lunch.  Discard all used food packaging since bacteria can grow on plastic bags, aluminum foil, and paper. If you're packing your child's lunch with reusable bags, be sure to wash them daily with soap and hot water.

Remember, we're always here to help your body heal
and maintain the health you deserve.


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Health Update: Low Back Pain


 Low Back Pain: Where Is My Pain Coming From?


        Low back pain can emanate from many anatomical locations (as well as a combination of locations), which always makes it interesting when a patient asks, "...doc, where in my back is my pain coming from?"  In context of an office visit, we take an accurate history and perform our physical exam to try to reproduce symptoms to give us clues as to what tissue(s) may be the primary pain generators. In spite of our strong intent to be accurate, did you know, regardless of the doctor type, there is only about a 45% accuracy rate when making a low back pain diagnosis?  This is partially because there are many tissues that can be damaged or injured that are innervated by the same nerve fibers and hence, clinically they look very similar to each other. In order to improve this rather sad statistic, in 1995 the Quebec Task Force published research reporting that accuracy could be improved to over 90% if we utilize a classification ap proach where low back conditions are divided into 1 of 3 broad categories:
  1. Red flags - These include dangerous conditions such as cancer, infection, fracture, cauda equina syndrome (which is a severe neurological condition where bowel and bladder function is impaired). These conditions generally require emergency care due to the life threatening and/or surgical potential.
  2. Mechanical back pain - These diagnoses include facet syndromes, ligament and joint capsule sprains, muscle strains, degenerative joint disease (also called osteoarthritis), and spondylolisthesis.
  3. Nerve Root compression - These conditions include pinching of the nerve roots, most frequently from herniated disks. This category can include spinal stenosis (SS) or, combinations of both, but if severe enough where the spinal cord is compromised (more commonly in the neck), SS might then be placed in the 1st of the 3 categories described above.

        The most common category is mechanical back pain of which "facet syndrome" is the most common condition. This is the classic patient who over did it ("The Weekend Warrior") and can hardly get out of bed the next day. These conditions can include tearing or stretching of the capsule surrounding the facet joint due to performing too many bending, lifting, or twisting related activities. The back pain is usually localized to the area of injury but can radiate down into the buttocks or back of the thigh and can be mild to very severe.

        We realize you have a choice in who you choose to provide your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

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Health Update: Carpal Tunnel


Carpal Tunnel Syndrome - What Can You Do For It?


        Carpal tunnel syndrome or, CTS, is a common condition that drives many patients to chiropractic clinics asking, "...what can chiropractic do for CTS?" 

        As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:
  1. A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work - especially if it's fast and repetitive.  Your doctor will also need to learn about your "co-morbidities" or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.
  2. A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.
  3. Treatment can include manipulation, soft tissue release, PT modalities (eg., electric stim., ultrasound).
  4. Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

        Here are some of the things that you, the CTS sufferer can self-manage:

  • A Carpal tunnel splint  is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.
  • Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times / day) such as: A. The "Bear claw" (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand) B. Tight Fist / open hand (fully open - spread and extend the fingers and then make a fist, with the hand). C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm - hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch! D. Wrist range of motion (dorsiflexion/palmar flexion) - Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times. E. Wrist range of motion (pronation/supination) - Place forearm and whole hand on table-- elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times. F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed. G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down. H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.
  • Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

        We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

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Health Update: Fibromyalgia


Fibromyalgia: Why Water Exercises?


        Fibromyalgia (FM) is a condition associated with tight, sore muscles but no one REALLY knows where FM comes from or why it picks on certain people and not others.  Some feel it's caused by lack of sleep, specifically deep sleep, eventually resulting in chronically tight muscles. Others theorize it's the underlying stress of a person's lifestyle that leads to the tight muscles. Either way, tight muscles lead to poor blood flow through the muscle and just like pumping up a blood pressure cuff too high and not releasing the tourniquet effect quick enough, pain results when the muscle is starved from lack of oxygen.  Dr. Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical Center, wrote that many people (especially FM patients) tense their muscles and probably don't even realize it, which reduces blood flow to the muscles, resulting in pain. So, the question is raised, how can the FM patient get their muscles t o relax so blood can flow through, bringing it the necessary amount of oxygen to the muscle so it doesn't hurt?

        One method of muscle relaxation is exercise. When the pulse rate increases, more blood reaches the muscle, which reduces pain. The studies are clear that walking, stretching and strength training all help reduce fibromyalgia pain. Exercise also relieves fatigue, helps sleep quality and reduces depression - WHAT A GREAT ANSWER for the FM patient! The key is finding the right combination of exercises and how much should one do. Our advice is to START SLOW and gradually increase the dose once you've proven good tolerance to the last workout session. Consider flexibility exercises (stretching) such as Yoga classes, walking around the block, or even playing golf (initially a few holes, then 9 and eventually a full round). 

        Many FM patients have found water exercises are uniquely helpful because of the weight reduction or buoyancy effect.  This is especially true for the overweight FM patient as land-based exercises may be too traumatic on the feet/ankles, knees, hips, or low back. Also, warm water can be quite comforting. Another nice advantage of water exercises is that you can do these anywhere, as long as there is a pool! The exercises can be taught in a formal water exercise class, which is a good place to start if one is available locally or through a health care service. Studies from Spain report that water exercises improve the FM patient's quality of life not just for the moment, but also over the long term! Over a 12-week timeframe, they discovered women who exercised in warm water for 60 minutes, 3 times per week improved both mentally and physically, had less FM related pain, and more energy ("vitality"). They reported less depression and found an im proved desire to be sociable.  The KEY for exercise to be successful is to increase the pulse rate. As Dr. Cope pointed out, a 20 minute, four times per week workout can make a big difference!

        If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!


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Health Update: Neck Pain

Neck Pain: What Can I Do About It?

        Neck pain is one of those conditions that affect most people at some point during their lifetime. All you have to do is ask just about anyone, "...have you ever had neck pain?" Then again, maybe you shouldn't since you'll probably get overloaded with way too much information from several people willing to share every little detail with you. Because of the way we are anatomically built, the neck is particularly vulnerable to injury (it has to hold up an average head weight of 15 pounds which can be quite a job, especially when we slump or slouch and that 15 pound weight falls forwards). Injury to the neck can result in minimal symptoms all the way to complete disability, making it one of the most common reasons people see doctors of all varieties for help.  Couple neck pain with headaches and now you have a real potential for disrupting lifestyles. With simple causes like poor posture, stress, work station problems or long hours at a computer, not to mention anxiety, depression and more, it's no wonder ost of us have needed help for neck pain at some point in time.  So, the question remains, "...what can I do about it?"

        From a chiropractic standpoint, manipulation, massage and other soft tissue techniques, and several forms of physiological therapeutics (such as ultrasound, electric stimulation, light - low level laser therapies), all work great!  But, instead of (or, in addition to) things that WE do to you, let's discuss things we can teach YOU to do on your own. There is a long list of aids that help neck pain that you can self-manage, of which some include: a home traction device, cervical pillows, exercises, posture retraining, stress management, work station modifications, work / job analysis and subsequent modifications, and more. Most important is that YOU are in control of your own management program. All you need is a little motivation (your job) and proper training (our job). Many of these "self-help approaches" include an apparatus or device of some sort, which are technically coined, "hard durable medical supplies." More specifically:

  1. Cervical traction units include (but are not limited to) inflatable collars, seated over-the-door traction units, laying on the back varieties, as well as towel traction. The concept here is that you are stretching the neck vertebra apart and if it's done proper, it should feel good! Don't do it if it doesn't or, reduce the weight until it does feel good. Another type of traction is placing a fulcrum (dense foam triangle) behind the neck while lying allowing the head to hang off the edge of the bed.
  2. Cervical pillows share the common concept of being contoured to fit the neck and head.  These are thicker on the edge so the gap between the neck and shoulder point is filled in so the head is pointed straight ahead. There are many types of contoured pillows including water pillows, foam, inflatable, buckwheat, rice, and other types. However, a word of caution is in order: you may not like it at first as it can take 3-4 nights to get used to it. But, once you do, you'll miss your pillow when you're not able to travel with it.
  3. Exercises. Place your hand against your head and push into the hand, allowing the head to "win" as you move through the full range of motion (forwards, backwards, sideways and rotation). Don't forget stretching, other strengthening exercises, and fine motor control exercises are important as well. We'll have to pick this topic up again in the near future.

        We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

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Health Update: Whiplash