Effects of Cortisone Injections

There are many different forms of pain relief for injuries and joint pain. One common method of pain relief used in medical offices includes Cortisone or Corticosteroid Injections. Cortisone is used to treat many conditions from allergies to joint pain. It is meant to target and reduce inflammation in the body, and is often used to treat arthritis, bursitis, acute or overuse injury, and many more.The advantage to cortisone injections is that it provides relief of localized inflammation. It generally works faster than NSAIDs and is more specific to the location of the pain. Another potential benefit is that it does not cause stomach irritation and gastrointestinal problems over the long run like Aspirin and other NSAIDs.While cortisone many times provides quick relief of pain, the list of potential side effects and disadvantages can be a major drawback. Short term effects of corticosteroid injection may include soreness, bruising, or increased pain and swelling at the site of inflammation. This is called “post injection flare” when the area of involvement becomes aggravated. It may also cause tendon weakness if the injection is done in or near tendons around the joint. Less common effects may include sweating, difficulty sleeping, and possible nerve damage.The more significant problems with cortisone come with long term use. Joint pain and arthritis which are continually being treated with injections to decrease pain. Some of the long term side effects can include:• Syringe2Thinning of the skin• Weight gain and puffiness in the face• Acne (from steroid use)• Increased blood pressure• Cataract formation in the eyes• Thinning of joint cartilage• Weakening of ligaments• Increased inflammation• Possible infection• Thinning of the bone or Osteoporosis• Less commonly, Avascular Necrosis or Osteonecrosis (death of bone tissue due to lack of blood supply)When it comes to joint pain, injury, and arthritis, it is important to remember that just because the pain is gone, does NOT mean that the problem has been fixed. Some of the long term side effects associated with steroid injections can be potentially dangerous. For example, thinning of cartilage may lead to further degeneration and arthritis in the joint. Weakening of tendons and ligaments can lead to tears and further damage within the joints. With osteoporosis, the bones become thin and brittle making them more fragile, which may lead to fractures, just to name a few.Corticosteroids are not exactly "pain relievers," however, pain is reduced because they decrease inflammation. Some people experience weeks to months of relief, while others notice little to no change in symptoms depending on the condition being treated. Inflammation can continue to come back if not treated appropriately.So are we saying inflammatory medications and injections should never be used? Not necessarily, there is a time and place for different types of treatment. However, injections should not be used to continuously treat the underlying problems which may exist. Many acute and chronic conditions take TIME to heal, and the longer you wait, the longer it may take to correct. Chiropractic care treats the root of the problem, focusing on proper function of the nervous and musculoskeletal systems to allow the body to heal.At Optimal Chiropractic, we understand that each patient is unique, and not all pain can be treated the same way. We customize our treatments for each patient based on their functional and lifestyle goals. We utilize a combination of chiropractic care, soft tissue therapies, and rehabilitation techniques to speed healing and address all tissues of the human body. Give our office a call today to see how Dr. Chris and Dr. Emily can help you, or someone you know with your health needs, (208) 777-4305.

What is an Anti-Inflammatory Diet?

After our blog earlier this week about the harmful side of non-steroidal anti-inflammatory drugs (NSAIDs), we wanted to follow up with a more natural and safe way to fight some of those long standing inflammatory conditions. While acute inflammation in response to injury is a necessary process, chronic inflammation can lead to many more serious conditions.The causes of pain and disease can be broken down into 3 simple categories. These categories include things which you are doing, thinking, or eating.A question we often get asked by patients, is what can they do at home to help with healing? Among stretches and exercises which may help with an injury or condition, nutritional changes can be a huge factor to aid in healing. And while NSAIDs may delay healing times, a proper diet ensures that the body is receiving vital nutrients to fight off chronic illness and injury.Inflammatory diagramAgain, it is important to remember, inflammation in itself is not a bad thing. Acute inflammation is part of the body’s natural response to injury or irritants which may be harmful. Take a look at the image on the left, chronic inflammation in the body can lead to any and all of these conditions.So what exactly is an anti-inflammatory diet? Basically, any diet that does not contain sugar, flour, omega-6 oils, and trans-fats can be considered anti-inflammatory. A diet rich in fresh fruits, vegetables, raw nuts, lean meats, chicken, and fish is ideal. It is important to minimize or eliminate gains including bread, pasta, crackers, and cereals. Dairy products are also important to minimize in the diet. Fried, processed or packaged foods, and many oils and salad dressings also contribute to inflammation in the body. It is generally recommended that each meal should contain about 25% protein, and 75% vegetables.Supplementation may often be recommended to combat the negative side effects of inflammation and chemical imbalances in the body. The correct supplements may actually normalize the production of various inflammatory chemicals in the body. A high quality multi-vitamin is important for nutritional deficiencies in the typical diet. Omega-3 fatty acids are also critical, which can be found in certain foods and fish oil supplements. High ratios of Omega-6 fatty acids (found in grains and processed foods) to Omega-3s may lead to uncontrolled/chronic inflammation.Fruit and Veggie HeartMaking the change to an anti-inflammatory diet may not be easy, however, the benefits are numerous. It is important to remember that these changes take time. Along with decreasing inflammation and preventing disease, you’ll likely sleep better, increase energy, and recover from pain faster. Before making any significant changes to your diet, it is a good idea to talk with a health care professional first.If you are interested in more information on this topic, go to, or contact Dr. Chris and Dr. Emily at Optimal Chiropractic in Post Falls, ID at (208) 777-4305.

How Do Painkillers Impact Healing?

The use of painkillers and over-the-counter medications are very common for pain relief among many Americans. However, most are unaware that these medications may in fact be slowing the process of healing in many of the conditions they are attempting to treat. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be very helpful to decrease minor aches and pains, and help us continue with our daily activities, but at what point do they actually become harmful to our health?IbuprofenInflammation is not always a bad thing. It is the body’s way of protecting itself and removing harmful factors so that healing can begin. After an injury, the body activates specific cells which attack the injured area. These cells will increase blood flow allowing more nutrients to flow to the area. It can also produce swelling which may also stimulate nerve fibers which cause pain.Knowing the importance of inflammation in the body, it becomes easier to appreciate how anti-inflammatory medications may inhibit tissue repair. There are 2 enzymes in the body which regulate different functions, COX-1 and COX-2. The second is responsible for signaling pain and beginning the process of inflammation, as well as stimulating part of the immune response. The delay in healing is due to the inhibition of prostaglandin production from the COX-2 enzyme. These prostaglandins control processes such as muscle and blood vessel constriction.Without inflammation, the healing process would be much slower as it would be difficult to initiate this healing process. Many practitioners even discourage the use of ice, as it may cause vasoconstriction (or narrowing of the blood vessels) and decrease the amount of nutrients brought to the injured area.Even with exercise, the harder you train, small micro-tears are occurring in the muscle. The more forcefully the muscles contract, the more damage may occur. Without inflammation to initiate healing, more and more injury may occur over time with repetitious activity. This is also one reason why taking NSAIDs before a work out could be harmful.Soft tissues such as muscle, ligaments, and tendons are not the only structures in the body affected by NSAID use. Injuries to bone, particularly fractures, are also affected when it comes to the remodeling phase. With fracture healing, the area undergoes the inflammatory process, new blood vessel formation, a callus forms, and new bone is laid down to the area of injury. Prostaglandins also play an important role in the formation of different types of bone cells. Therefore, long term use of NSAID pain relievers can delay the process of healing fractures, and may actually accelerate other conditions such as osteoporosis and joint deterioration.The effects of NSAIDs are not only harmful to the musculoskeletal system, but to other bodily systems such as the digestive tract as well. Over-the-counter medications such as Aspirin can cause excessive stomach acid production. Stomach acid is very acidic, as it is needed to break down food and nutrients we take in on a daily basis. The stomach has a protective coating so as to not become degraded from the acid. However, with constant higher levels of acidity than normal, this acidic environment can lead to a breakdown of the lining causing ulceration and bleeding in other areas of the gastrointestinal tract.So are we saying NSAIDs are all bad, all the time, in every situation? Of course not. However, there are consequences with repeated, long term use. Many athletes, for example, who are constantly training need to be aware of the effects which over-the-counter medications may carry. Injuries take time to heal, and it is important to take the time to allow the body to its job.

Causes of Spinal Degeneration

Arthritis in the spine is referred to as Degenerative Disc Disease (DDD) or Degenerative Joint Disease (DJD). It occurs from biomechanical changes in the bony structures and soft tissues of the body. Physical, chemical, and psychological stressors to the body can both lead to these changes. Degeneration should not be thought of as a "normal wear and tear" condition, it is a response to something that has gone wrong in the body.Normal vs DegeneratedBiomechanics is the study of the structure and function of the body and systems. Trauma or postural abnormalities can alter the body’s biomechanics in many ways. A car accident, for example, may cause a whiplash injury in the neck. This is going to cause overstretching and inflammation of the ligaments and soft tissues of the cervical spine. If left untreated, these joints can become unstable. As the injury heals, some areas can have too much motion and some may develop too little motion or fixation.This lack of motion, or hypomobility, can progress and cause muscle hypertonicity and spasm, fibrosis, and eventually calcification of soft tissues and bone spurring. It is important for soft tissue injuries to heal with motion so that the tissues are not able to become fixed and degenerated. If tissues heal incorrectly, it can lead to compensation and improper movement of the joints and the body as a whole.Stress is one psychological factor that can also effect the body in a negative way. Click HERE to read our previous blog about stress and its effect on the nervous system. Constant activation of our sympathetic nervous system (controlling “fight or flight” response) from stress causes our body to continually remain in a heightened state. Irritation of the sympathetic system prevents our parasympathetic system (“rest and digest”) from allowing the body to heal correctly.Chemical stressors include things such as nutrition or medications. Dietary factors may lead to chronic inflammation in the body. Nutritional deficiencies may also rob the body of essential vitamins and minerals needed for proper healing. Often times certain medications are designed to mask symptoms of an injury. Those which provide relief of pain may lead to a delay in healing if proper measures are not taken to correct the problem simultaneously.Chiropractic care can have a significant effect on the body when it comes to healing. At Optimal Chiropractic, we focus not only on mobility of the spine and extremities, but stabilizing and strengthening for the greatest healing outcomes. We develop treatments individual to each patient based on their specific presentation and possible dysfunctions. Our goal is to not only get you out of pain, but to correct the problem and educate each patient to improve their overall quality of life and prevent future problems.Interested in seeing how we can help you or someone you know? Give our office a call at (208) 777-4305. Get on the right track to your optimal health today.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, inflammatory disorder affecting many joints in the body, most commonly in the smaller joints such as the hands and feet. While both rheumatoid and osteoarthritis both affect joints of the body, they differ in the fact that rheumatoid arthritis is not a “wear and tear” type of condition. This type of arthritis causes a painful swelling affecting the lining of the joints. It can eventually lead to erosion of bone and eventually joint deformity.Women are generally 2-3x more commonly affected by rheumatoid arthritis, it usually starts to show up around the mid-30s to 40 years of age. Rheumatoid is an autoimmune disorder in which the body mistakenly attacks its own tissues. The immune system is designed to protect the body from disease and infection. With an autoimmune disease, the immune system attacks normal and healthy cells of the body. Autoimmune conditions tend to run in families.Symptoms of the condition may vary in severity and often come and go, which is typical of an autoimmune condition. Swelling and pain are common in the extremities, and may increase with flare ups of the condition. During periods of remission, symptoms may fade or even disappear completely. Since it is a systemic disorder, it can have an effect on other body systems including the eyes, mouth, skin, lungs, blood, and blood vessels.Rheumatoid handsRheumatoid arthritis is usually bilaterally symmetrical, meaning when it is present in the hands, for example, then both are usually affected to the same degree. In the hands, we typically see enlarged joints of the knuckles and middle of the fingers. In advanced cases, the fingers may become deformed and deviate away from the thumbs. Swelling of the hands, feet, and elbows are also common with this condition.Diagnostic imaging can show many characteristics of this condition in different areas of the body. Bony erosion or a localized osteoporosis are some common findings on X-ray views of the condition. Lab testing is the best way to confirm the condition.Treatment of rheumatoid arthritis usually includes rest, anti-inflammatory medication, and some sort of an exercise or therapy program such as what may be offered in a physical therapy or chiropractic office. The goal is to detect and treat the condition early on to reduce or stop the inflammatory process as quickly as possible. Prevention of joint and organ damage, as well as improvement in physical function is important to reduce long-term complications. Consultation with a rheumatologist is also important in early stages to control progression of the condition.Degenerative or osteoarthritis is more commonly seen in the chiropractic office, however, it is important to remember that both types of arthritis are manageable with proper care. At Optimal Chiropractic, Drs. Chris and Emily treat patients with a wide range of conditions. Our focus is not only on treatment of a disease or condition, but prevention and education for all those who seek to improve their overall health.If you or someone you know is suffering with pain or muscle weakness caused by arthritis, we would love to help. Give our office a call at (208) 777-4305, we are located across from the Kootenai Urgent Care Clinic in Post Falls, Idaho.