The Zen Corner

Science, Art, and Philosophy of Chiropractic


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Stressed? How do we know?

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Stress is a reaction to a stimulus that disturbs our physical or mental equilibrium. This stimulus comes from various sources. How do we measure this reaction? By symptoms? Blood pressure? Pulse? Blood tests? All of which can be expensive after a while. Heart Rate Variability used to be one of the expensive tests that needed heavy electronic machines but with newer technology, this made the test more accessible. We know from research that there is all kinds of stress and states that we go through on a daily basis. By using Heart Rate Variability we can find out more about our stress and states of our physical and mental conditioning.

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In the world of wellness and longevity healthcare, the topic of heart rate variability is a focus for optimal function. Many physical fitness trainers, psychologists, acupuncturists, osteopaths, chiropractors, and more are utilizing this by analyzing stress and ability to adapt. Heart rate variability is not just monitoring the heart rate but the rhythm and intervals between each heartbeat. Each individual has a specific heart rate variability and for an assessing that norm and comparing it to daily activity and lifestyle is the best indicator of how we are adapting to our environment.

Eustress vs Distress

Eustress is a stress when an individual perceived the event or incident as beneficial to them. Motivates and focuses energy on tasks and goals. Individuals feel excited, performances improve and are within their coping abilities. Eustress is often short-term stress.

Distress is too much stress that can cause anxiety, sorrow, pain, trouble falling asleep. When you had too much eustress and overload yourself with too much can cause distress.

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Homeostasis and Allostasis

Homeostasis as a definition:

“….the tendency toward a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes.”

Homeostasis sounds like a complicated word in the medical word but it is simply putting it as all body chemical process is in balance and harmony to regulate and adapt to the environment.  Homeostasis is a situation where we have established during our healthy and vibrant time in our body. To establish homeostasis can be difficult or simple depending on your health condition. To measure homeostasis has been typically by measuring several parameters of blood laboratory tests, neurological examinations, and cardiovascular measurements.

Allostasis as a definition:

“…the process by which the body responds to stressors in order to regain homeostasis.”

When there is a environmental stress is introduced to a human, the body responds by regaining homeostasis. This is the adaptive component of our body to self-regulate and adapt to the stimulant. The signs of allostasis in our body are when stress hormones, cytokines, and catecholamines are present. When these stressors are constantly stimulating us for a long time, then our ability to adapt starts to fail. This is called allostatic load.

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Stressors are anything that challenges homeostasis and constantly disrupt the process of homeostasis will indicate a stress load. Maintaining homeostasis efficiently will help us have better health, better performances, and better resilience to our environment. Our goal is to maintain this stable environment for the body. Usually, unfamiliar stress causes greater stress response because this process requires greater resources to overcome stress and more recovery time.

When stress is accumulated over time, this becomes the allostatic load. When the allostatic load is too much, the ability to tolerate the load decreases. The wear and tear of the body experience repeated cycles of inefficient regulation of the stress response. Poor performance and increased recovery time will eventually lead to chronic diseases, a higher rate of injury, and higher susceptibility to illness.

Heart Rate Variability

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It is not just a heart rate but it is the inner-beat variability between successive heart contractions. In each heartbeat, there is an electronic signal that is produced and measured by the ECG/EKG representing the ventricular depolarization during a heart contraction. It is called the QRS complex. With the Heart Rate Variability, we are measuring the interval between RR. This is called the RR intervals or inter-beat intervals (IBI). By measuring Heart Rate Variability, we are measuring the change in time or variability between successive heartbeats.

Why is there a variability?

The variability in the heart rate is the result of the allostatic (adaptive) processes of the bodies response to stimulus and other regulatory processes within the body. Having variability is beneficial for the biological system that is complex like our body. There are many regulatory systems that regulate and affect the heart. In the short-term, there is the respiratory system, cardiovascular system, and autonomic nervous system. For long-term, there is circadian rhythm, body temperature, hormonal patterns, cumulative stressors.

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Clinical Indicators of Health!

When we have reduced health, we have decreased adaptability. Which means heart rate variability can significantly decline with decreased health. Changes in Heart Rate Variability have been correlated to 9 out of 10 leading causes of death in the United States.

  • Heart Diseases
  • Cancer
  • Chronic lower respiratory diseases
  • Stroke (Cerebrovascular diseases)
  • Alzheimer’s diseases
  • Diabetes
  • Influenza and Pneumonia
  • Nephritis, nephrotic syndrome & nephrosis
  • Intentional self-harm (suicide)

Heart Rate Variability is also linked to many of the risk factors associated with these diseases such as hypertension, obesity, glucose intolerance, insulin sensitivity, and stress. It is also known for an accurate and objective monitor for progression or regression of the disease and health.

Presnological Assessments

Heart Rate Variability is not a diagnosis of diseases listed above.  It is a prenosological assessment that determines that direction of our health is going towards. Prenosological is the determination of potentiality for the failure of the adaptive state. This determination is before the advent of the disease states or symptoms will occur. There are levels of adaptive states in the prenosological assessments.

  1. Proper Adaptive Function
    1. Optimal adaptability of the stressor, and therefore health exists-Not Diagnosable
  2. Prenosological State
    1. Tension on the ability for adaptive response via stressors-Not Diagnosable
  3. Premorbid State
    1. Subpar adaptation begins to occur, possible symptoms-Not Diagnosable
  4. Pathological State
    1. Adaptive failure-Improving diagnostic certainty

There was a large study that assessed the prenosological state of various individuals. With the first proper adaptive functional state was 30% of the public. People with tension on the adaptive system and subpar adaptation together were 40-70% of the population. For the final state of adaptive failure and pathological state were 10-30%. This means there are between 70-90% of individuals that have undiagnosable states of adaptability. (Baevskii, R.M. et al. “Use of principles of prenosological diagnosis for assessing the functional state of the body under stress conditions as exemplified by bus drivers.” Human Physiology 35.1 (2009):34-42. These researchers concluded that people that are in the tension or subpar adaptive states need assessment of the level of health rather than the diagnosis of diseases.

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Conclusion:

Many conditions may need a medical diagnosis because the person may have progressed their condition beyond adaptive capabilities. Stress is something elusive and people may think they need a medical assessment with blood tests and MRI taken to confirm local or physical manifestation of ill health. Sometimes it is a condition where we need to boost the persons’ adaptive capability and they will do fine. Having an HRV analysis helps us to find out what is our pre-medical condition. HRV is one of them and there are many others that are known. Stay tuned for more presnological assessment for functional and adaptive capabilities!

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Cancer, Alzheimer’s and Cardiovascular Disease has a Link!

This is a research article review research paper from Clinical Science issue 2012 titled, “You may need the vagus nerve to understand the pathophysiology and to treat disease.” The research article writes about treating the vagus nerve, located in the upper neck, reduces the health risk of major diseases which are inflammatory reactions, increased oxidative stress, and excess stress responses. The vagus nerve activity can be measured by a non-invasive evaluation by Heart Rate Variability.

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High-Risk Diseases

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Frequent causes of death that are worldwide have been attributed to cardiovascular diseases, cancer, and Alzheimer’s disease. Another category that has been on the rise has been the Metabolic Syndrome. This syndrome includes risk factors of obesity, elevated blood lipids, elevated glucose, and blood pressure. All of these diseases and risk factors are manifested differently in clinical science and the screening process, complex treatments, prevention measures are expensive! This paper is attempting to suggest a screening process of pre-medical conditions before they start to have morbid diseases and health risks.

The hypothesis of this research paper is linking all the high-risk health factors have a common problem with the vagus nerve. The vagus nerve is a nerve that is extending from the brain stem down and front of the neck and travels down in most of the vital internal organs. (https://emedicine.medscape.com/article/1875813-overview#a1) This vagus nerve can be evaluated by Heart Rate Variability which is an in invasive and non-expensive assessment.

 

Hypothesis

The article proposes three hypothesis on how the vagus nerve is involved.

Hypothesis 1: Better Vagal Nerve Activity, Reduced Risk

Hypothesis 2: Vagus Nerve Keeps the Stress response and inflammation in check

Hypothesis 3: Poor Vagus Nerve Function means higher risk for a disease.

Solution: Heart Rate Variability Assessments:

Heart Rate Variability is an assessment that measures the beat-to-beat variation in heart rate. This natural rise and fall of heart rate are caused by several physiologic phenomena, including breathing and autonomic nervous system activity. Healthcare professionals utilize HRV for a wide variety of clinical applications. Previous blog (https://zenchiropractic.wordpress.com/2013/04/) has mentioned how this is a way to measure the performance of the vagus nerve.

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Health Risk Factors

There are health risk factors that lead to major diseases like the cardiovascular disease, cancer, and Alzheimer’s diseases. The following three are the major steps that lead to major diseases:

  • Oxidative Stress
  • Inflammation
  • Excessive Stress Response

For more information about these steps, scroll further down for a more detailed summary of the article.

 

Oxidative Stress

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Oxidative stress is a condition where free radicals are flowing through your bloodstream. It is an unstable molecule that can damage cells by damaging the molecular structure of the cell. A free radical is a single person showing up to couples only dance party and stealing a partner from one of the couples thus creating a chain reaction. Simple a molecule needs even-electron ions to stabilize and a free radical is uneven and desperately wants to be even. To counter this situation it always adds antioxidants which neutralize the free radical.

Oxidative stress occurs when the free radicals are overwhelming the antioxidants and leading to damaging cellular structures such as DNA. Damaging the DNA of the cell can lead to transforming them into malignant cells. Also, oxidative stress can damage LDL, which carry cholesterol and create promotion of inflammation for plaques in the arteries in the heart and lead to cardiovascular diseases. This same process can happen in the artery of the brain and that leads to stroke and damaging nerve cells in the brain.

Inflammation

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Inflammation isn’t an evil, it is a necessary process for the body to heal. It is the amount of inflammation that causes more risks. Normally inflammation is like construction or house remodeling. Your house or building is the body and all the construction and remodeling will cause an increase of dust, extra equipment in the hallways, plastics taped on the walls and carpets, and more people in the area! This will clog up the hallway or room and often involves destruction or construction of walls. Inflammation is similar to this while the immune cells are repairing damaged artery lining, kill infected or malignant cells. Inflammation serves to prevent tumor cells to grow, infected cells to take over our body, repair damaged tissue.

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Inflammation becomes a problem when there is too much inflammation or the process goes out of control.  When the inflammation process in the artery increases too much it will start to clog up and cause elevated blood pressure and a blood clot to form which leads to cardiovascular disease. When inflammation process goes out of control and the immune cells start to attack good cells; this we call auto-immune diseases and can result in degeneration of the brain called neurodegeneration.

Excessive Stress Responses

Stress responses involve the sympathetic nervous system activity to increase fight or flight response. When this stressful state stays long term, this will fatigue and exhaust your body. This stressful state involves increased blood pressure, arteries to constrict, increased blood sugar, decrease digestive and many more! (https://www.diffen.com/difference/Parasympathetic_nervous_system_vs_Sympathetic_nervous_system) This can easily explain how increased stress response can contribute to cardiovascular diseases with increased blood pressure. During an emergency stressful state, the blood is mainly flowing toward muscles for survival. Increased adrenaline and noradrenaline, increases the opportunity for the tumor cells to grow since all the immune cells activity are slowed down to emphasize the survival state.

Conclusion:

To summarize this article, the authors were pointing out that the vagus nerve activity is vital in finding out the precursors for most common diseases that cause death worldwide. To analyze the vagus nerve, Heart Rate Variability is highly recommended due to good data from other research articles.

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Chiropractic causes stroke?

Can a chiropractor cause a stroke?

This question has been a long and tortuous battle between the medical profession and chiropractic for many years. The result was that the chiropractic profession was put through the judicial court systems by the medical profession claiming chiropractors to be an unscientific cult. The result was chiropractic did not lose in court and the profession itself is much more accepted today than it was 100 years ago.

Popular media has taken up this on this drama between the professions and pulled out the story of chiropractic adjustment can cause a stroke. As this was inflammatory to the social media decades ago, it is the same today. Many writers and journalists misused scientific study that is published in a peer-reviewed journal as a rigorous research when sometimes it is just merely editorials expressing opinions.

Barber’s Haircut caused a Heart Attack?

Another common misuse of information is equating correlation with cause and effect. There is a logical fallacy where one event follows another, the first event caused the second event. This can be a basis for logical errors and superstitions. One can have myocardial infarction right after visiting the barber shop, then the barber cutting the hair caused the myocardial infarction. If we really wanted to force this argument, we can compile undisputed medical evidence of heart attack within weeks after visiting the barbershop. Now if we apply this to the issue of chiropractic adjustment and strokes it is another consideration.

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This research from Neurology describes this logical fallacy with some of the research materials that were written in a published journal.

There was a survey when neurologists were asked the number of patients evaluated over the preceding of two years who suffered a neurologic complication within 24 hours of receiving a “chiropractic manipulation.” Fifty-five strokes were reported. The author stated, “Patients, physicians, and chiropractors should be aware of the risk of neurological complications associated with chiropractic manipulation.” (Lee K: “Neurologic complications following chiropractic manipulation: a survey  of California neurologist.” Neurology 1995; 45:1213)

From a research standpoint, establishing a chiropractic manipulation causes stroke as a statement is very difficult. As Chesnut states: “A review of the literature regarding the relationship between chiropractic and stroke provides very little useful information. The vast majority of the published literature is comprised of case studies, case series, or case-control studies, none of which are capable of providing valid information regarding causation or risk. These type of studies can, of course, provide useful information with regard to suggesting a direction of future research, but they should never be interpreted as a valid means of determining causality. The only valid conclusion that can be reached from review of the available literature is that due to methodological shortcomings, there are literally no scientifically valid data that establish chiropractic adjustment as either a cause of stroke or as being associated with and increased risk of stroke.” (Chestnut J: The stroke issue: Paucity of valid data, plethora of unsubstantiated conjecture. J. Manipulative Physiol Ther 2004; 27; 368-72. )

There is no research article that has proven the relationship between chiropractic manipulation and stroke. We don’t have a method that proves this relationship regardless of opinion. There is more research on how chiropractic is not related to stroke. Jaskoviak reported that not a single case of vertebral artery stroke occurred in approximately five million cervical “manipulations” at the National College of Chiropractic Clinic from 1965 to 1980. (Jaskoviac P Complications arising from manipulation of the cervical spine. J Manipulative Physio Ther 1980;3:213.)

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There are some research studies that include “manipulations” administered by Kung Fu practitioner, osteopaths, physiotherapists, a wife, a blind masseur, and an Indian barber were all incorrectly associated with chiropractors. Terrett stated that the words of chiropractic and chiropractor have been incorrectly used in numerous publications with injuries by medical authors from respected medical journals and organizations. (Terett AGJ: Misuse of the literature by medical authors in discussing spinal manipulative therapy injury. J Manipuative Physiol Ther 1995; 18:203.)

9780312374808This is what we call junk science being put up as legitimate science. Poor correlations from a biased scientific method in a published research do not produce a conclusion of chiropractic will cause a stroke. Every chiropractic adjustment does not correlate with a risk of a stroke. It is time to replace yellow journalism with scientific investigation. In fact, Cassidy’s studies suggest that people with a stroke in progress may visit a chiropractor complaining of a headache and/or neck pain. Neither a physician or chiropractor caused the stroke. (Cassidy JD, Boyle E, Cote P. et al : Risk of Vertebrobasilar stroke and Chiropractic Care. Results of a Population-Based Case-Control and Case-Crossover Study. Spine 2008;33(4S)S176-S183. )

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Chiropractic has been associated with stroke from reports of medical literature for decades. The recent popular media seem to have led some gullible audience to accept this false and junk science at face value. Let’s be careful and examine that it will reveal the poor correlation between chiropractic and stroke. Stroke can happen anywhere at anytime and impossible to predict. Strokes can happen equally anyplace even at a coffee shop. So are you going to blame the coffee or maybe the chiropractor you saw a couple of days ago?

Most likely people blame chiropractors for stroke is because they are avoiding or spreading the liability when it happens in their clinic/hospital.

 


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Good, Bad, and the Ugly. Crack My Neck for Relieving Pain.

There are many situations where your spine will crack on its own or intentionally cracking them. The cracking of the spine in any different situations has an effect that can be good, bad, or ugly.

Good:

After a certain time period of a Chiropractic adjustment, the spine tends to realign the other vertebra on their own. Most likely the other vertebra was not in the right position are starting to go in the right position by themselves. When your body introduces any kind of force, such as when you are doing light stretching, turning, bending the spine realign. There is nothing to fear but to let your Chiropractor know what happened. Check out the former blog about this topic: https://zenchiropractic.wordpress.com/2012/11/29/what-happens-when-my-spine-goes-pop/

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When your spine pops and pain follows immediately then the joint became unstable and causing inflammation and muscle spasm. Even if you didn’t put much stress or any motion on the spine something pops and then the muscles around are creating spasms and sharp pain. Often times these situations are the vertebra was already starting to fall out of place and it was a matter of time when it went out of position. In this case, put ice on the area and get to a Chiropractor that will use x-ray, neurological exams, and education on what has happened and properly adjust that vertebra.

Ugly:

The unprofessional person intentionally twisting of the neck or low back of themselves or to others may create the cracking noise but then they will cause tendon and ligament to tear and create more instability. Over twisting the neck without proper examinations and professional skill then people are at risk possibly damaging artery integrity that is already weakened and may cause cardiovascular problems in the brain. The mistake is to think that by over twisting the joint the crack is more intense and the better you feel.

26real_450That cracking noise is not what Chiropractic is defined by but that is a very big misunderstanding. Cracking in your joints creates an endorphin response that gives you a euphoria for a moment but does not solve the actual joint problem. Properly correcting your spine takes a long training from a graduate level school and getting a state license. A grand total of 4485 hours of clinic hours with health science education. Many people attempt cracking their neck and low back themselves or ask others that are not professionals to crack their spine.

There are many other professional and non-professionals that try to say that they do chiropractic. Professionals such as massage therapists, physical therapists, sports therapists, and even some medical doctors to copy chiropractic because they know how effective Chiropractic care is. Non-professionals such as your friends, families, people you meet at the bar or parties, or any individual that offer to crack your spine or neck on the street. This is why people have an incidence of having a very bad experience with cracking their neck or back because they think it is just cracking is what helps the person. People could get damage to their muscles and ligaments, and damage to the artery structure in the neck.

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Dr. Gonstead’s Story:

Dr. Gonstead once had a farmer couple come to his office. The wife of this farmer was in a lot of back pain. Dr. Gonstead found the problem after careful analysis and adjusted the spine and told them to come back next week. The former couple did not come back. In fact, they didn’t come back for months. Then the farmer couple came back and the wife of the farmer was in a lot worse back pain. Dr. Gonstead analyzed again and it was much worse condition than before, so he asked the wife what happened. The farmer’s wife confessed that her husband tried to copy Dr. Gonstead after watching him adjust his wife after they went back home. They thought they could do the adjustment themselves not knowing how much science and careful skill that Chiropractic adjustment involved.

Summary:

There are many occasions were your spine will crack on its own. Some are fine because it is the process of our body to correct and heal itself. Some are bad because the spine got very unstable and finally went out of place. The worse is just because you want to feel the euphoria and cracking your neck or low back and causing a major set back of unstable joints does not help yourselves or the person you are trying to help. You could even cause serious damage to yourself or to others. It is not about cracking your neck and it is not about being a crack dealer for people. If it is about helping people, you should become a Chiropractor or go seek one to help your friend. They will find the cause and stabilize the situation.