Wednesday, March 29, 2017

Cervicogenic Headache

By Dr. John A. Papa, DC, FCCPOR(C)
Cervicogenic headache is defined as a headache which has its origin in the area of the neck.  The source of pain arises from biological tissues such as muscles, ligaments, joints, and nerves that have become injured and/or irritated.  When these structures become stimulated, their nerve endings send pain signals from nerves in the neck to the head.

Cervicogenic headache is a relatively common cause of chronic headache and has symptoms similar to those seen in other well known headache disorders such as migraine and tension type headaches.  For example, both migraine and cervicogenic headaches affect females more than males, with headache symptoms generally located unilaterally (on one side of the head).  These headache sufferers may complain of severe pain, head throbbing, sensitivity to light and sound, and nausea.  Neck pain and muscular tension are also common symptoms in tension headaches, migraine attacks, and cervicogenic headaches.  The problem of symptomatic overlap in these common and frequent headache types makes the accuracy of precise diagnosis difficult.  Furthermore, the fact that an individual may have two or more headache types co-existing at any one time further elevates the diagnostic challenge.
Cervicogenic headaches are usually unilateral (occasionally bilateral), and can be experienced in several different regions of the head including the base of the skull, the forehead, or behind the eyes.  The intensity of pain may fluctuate from mild to moderate to severe on a daily basis.  Individuals with cervicogenic headache may also exhibit physical signs of altered neck posture and restricted range of motion of the neck.  Headache symptoms can be triggered or reproduced by active neck movements or passive positioning.  Tenderness can also be palpated in the neck and upper shoulder region with muscular trigger points spreading pain upwards into the head.
The cause of cervicogenic headache may be singular or multi-factorial.  This may include a whiplash injury, sports injury, arthritic changes, chronic postural strain, stress, and fatigue.  The evaluation and assessment of headaches should include a proper medical history and physical examination.  Serious causes of headache symptoms must be ruled out before appropriate treatment can be administered.
After a diagnosis of cervicogenic headache is made, the goal of therapy is to minimize headache frequency and diminish levels of pain associated with each episode.  Treatment and management options that have demonstrated effectiveness include: postural correction, joint mobilization and manipulation, acupuncture, soft tissue therapy, and rehabilitative exercises.  Trying a variety of therapies or combination of therapies may be required to find relief.  It should be remembered that many patients who are diagnosed with migraine and tension headaches may also respond to these treatment strategies.
For those suffering from headache symptoms that may be interfering with their activities of daily living, a qualified health professional can prescribe appropriate therapy, rehabilitation, and self-management strategies specifically for your circumstance.  For more information, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Thursday, March 23, 2017

5 Tips To Improve The Quality Of Your Child’s Sleep

Canadian Chiropractic Association

We often take great care to ensure our children build good personal hygiene habits such as brushing their teeth and bathing. But do we pay as much attention to our children’s sleep hygiene? As adults, we easily recognize the benefits of a good night’s sleep for ourselves, and certainly we want the same for our children. Sleep has an important restorative role to play and it is critical for healthy growth and development. Proper sleep can also help prevent health problems now and in the future.
It is important to understand your child’s sleep needs and identify potential sleep problems early. Children need an ample amount of sleep to ensure that they are energized and have the ability to excel at the activities they enjoy.
If you are concerned about your children’s quality of sleep, you may notice the following signs1:
• Falling grades in school
• Poor self esteem
• Either low or excessive appetite
• Headaches or migraines
• Hyperactive behaviour
• Difficulties with attention
As a family, there are ways to build in good habits into your nightly routine to help your children get better sleep.
The Encyclopedia on Early Child Development recommends the following tips for good sleep hygiene in children2:
Tip 1: A child’s bedroom should be a safe, secure, and quiet sleeping environment: Consider distancing electronics and devices away from the bed or keeping them out of the bedroom entirely.
Tip 2: Establish a bedtime routine: It is important to provide a short and consistent routine for children before bed. A good routine will relax the child and encourage sleep. The routine should be carried out in the child’s bedroom and should take place 15 to 30 minutes before bedtime. It is recommended that the routine is predictable and consistent. Also be sure that there is a set bedtime.
Tip 3: Keep a regular schedule: The bedtime routine and schedule should be followed every day,
with the routine continued on weekends.
Tip 4: Teaching a child to fall asleep alone: When a child is older (over six months) the parent can slowly remove themselves from their bedside, allowing the child to grow accustomed to sleeping on their own.
Tip 5: Encouraging daytime activities that help a child sleep at night: Exercise can help or hinder sleep depending on the time of the day that activity took place. Exercise during the day will help the child fall asleep at night, whereas exercise close to bedtime may cause sleep onset insomnia. Ideally, exercise should stop two to three hours before bedtime.
Getting a good night’s sleep is important for everyone. But, like many good habits, it’s important to start at an early age. With the new school year approaching, creating a routine now is one of the easiest ways to make good sleep hygiene a long-lasting practice for your children.
For more tips on maintaining sleep hygiene, visit your chiropractor.

Saturday, March 18, 2017

Air Travel Comfort Tips

By Dr. John A. Papa, DC, FCCPOR(C)

Comfort is not usually the first word that comes to mind when someone mentions flying.  Sitting cramped in a small space for a long plane ride can also lead to muscle and joint pain.  Here are some helpful tips for a more enjoyable voyage.
Choose the Correct Seat - Some airlines fill the plane from front to back, so ask for a seat in the back row to increase your chances of having an empty seat next to you.  If the arm rests lift up, you might even be able to lie down.  Aisle and emergency exit seats maximize leg room and are less claustrophobic.  If you are susceptible to motion sickness, request a seat over the wings and try to schedule flights on larger airplanes.
Keep Moving - Moving around is good for your circulation and helps to prevent swollen feet and ankles.  Wear loose clothing and walk about the cabin periodically every 60 to 90 minutes.  Wear shoes you can slip off easily.  Every so often, draw circles with your toes and contract your calves to help prevent blood from pooling in your legs.  Tapping your feet can also help increase circulation and reduce the chance of muscle cramping.
Stretch it out - Try not to place anything under the seat in front of you so you can stretch your legs out.  Quick and easy stretches also include standing up and raising your arms above your head, rotating your shoulders back and forth, and moving your head side to side.
Keep Good Posture While Seated - Position your lower back against the back of the chair to obtain the greatest amount of support for your spine.  A rolled sweater or blanket can also be used for added support.  Make sure that your weight is evenly distributed on your seat, your shoulders are not rounding forward, and you are not slouching.  Support your neck and head with a pillow if necessary and avoid awkward positions if trying to rest or sleep.  Try not to stay in one position for a long period of time.
Additional Tips
·        Eat Right - Eat a light, non-fatty meal just before you leave for the airport.  This can make handling turbulence a little easier.
·        Handling Pressure - Chewing gum, yawning or sucking on hard candies can help to relieve the pressure that builds up in your ears as the airplane ascends and descends.  This is not recommended for toddlers.  For young children, sipping a drink may help.
·        Prevent Dehydration - The air in most airplanes can dry out your skin and cause eye and nasal dryness.  Take a moisturizer with you for your skin and wear glasses instead of contact lenses to prevent eye dryness.  Drink enough water and steer clear of caffeine and alcohol as they further dehydrate you.  Alcohol can also interfere with your ability to sleep.
In the event that you suffer from ongoing muscle and joint pain following your trip, you should contact a licensed health professional.  For more information, visit  The author credits the CCA in the preparation of this educational information for use by its members and the public. 
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, March 13, 2017

Preventing Falls

By Dr. John A. Papa, DC, FCCPOR(C)
A fall causing serious injury can occur to anyone at any time.  Since most trips, slips and falls happen in and around the home, it is a good idea to fall-proof your home with the following measures:
In the Halls and on the Stairs
·        Install non-slip strips on the edge of each step.
·        Secure loose carpet.  Make sure hallways and stairs are cleared of anything that you can trip over (i.e.books, shoes, bags).
·        Replace burnt-out light bulbs so that you always see where you are going.  Night-lights in halls and stairways can also be helpful.
·        Install handrails on both sides of staircases inside and outside the home.
In the Bathroom
·         Use non-slip mats inside and outside the bathtub and shower.
·         Install grab bars next to your toilet and in the tub or shower.
In the Kitchen
·         Put commonly used items on lower shelves and cabinets so a step-stool is not needed.
·         Replace loose scatter mats with rugs that have a rubber backing.
·        Keep a shovel and covered bucket of sand or salt near the doorway in winter to safely handle slippery conditions.
·         Keep steps and pathways clear of clutter such as yard tools, snow shovels, newspapers and wet leaves.
·        Don’t juggle parcels while trying to enter the house.  Never carry more than is reasonable.  Instead, make a few trips from the car with smaller packages.
More tips
·        Quickly dry up any wet areas on the floor to prevent slipping.
·        Wear shoes with good support and non-slip soles.
·        Always sit down to put on or take off shoes and clothes.
·        Employ extra caution when using ladders and step-stools.
·        Regular exercise can help improve your strength, balance and coordination.  Making your body stronger is one of the best ways to prevent falls.  Exercises such as yoga, Tai Chi, resistance training, bicycle riding, and power walking are great examples.
The following may be especially important for older individuals:
·        Maintaining a healthy diet and not skipping meals can increase your energy and strength.  Missing meals can lead to weakness, irritability and dizziness.
·        Have your MD or pharmacist review your medications.  Some medications can cause dizziness and weakness, which can affect your balance and perception.  Make sure that your MD or pharmacist explains all of the possible side effects of your medications.
Although the risk of falling increases as you get older, there are some simple things people of all ages can do to prevent falls.  In the event that you fall and suffer a muscle or joint injury that does not subside, you should contact a licensed health professional.  For more information, visit  The author credits the Canadian Chiropractic Association (CCA) in the preparation of this educational information for use by its members and the public.
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, March 6, 2017

What Smoking Does To Your Musculoskeletal Health

By Dr. John A. Papa, DC, FCCPOR(C)
The musculoskeletal (MSK) system includes the muscles, tendons, joints, and bones of the body.  Cigarettes contain many harmful chemicals, including nicotine and carbon monoxide which negatively affect the physical health and integrity of the MSK system.  Included below is a summary of those affects:
1.   Smoking decreases bone mineral density (BMD) and increases the risk of osteoporosis and future fractures.  Studies have shown that nicotine reduces the blood supply to bones, slows the production of bone forming cells, and decreases the absorption of calcium.  Post-menopausal women who smoke have greater spinal osteoporosis than non-smoking counterparts.  Among men, a consistently lower BMD at all bony sites is observed regardless of when in their life they smoked.  In addition, a relationship between cigarette smoking and low BMD in adolescence and early adulthood has been identified.
2.    Smoking delays healing times for bony fractures and soft tissue injuries such as rotator cuff tears.  Nicotine has been shown to decrease the production of fibroblasts (the main cells responsible for tissue repair).  In addition, the carbon monoxide found in tobacco smoke reduces oxygen levels in the body which is critical for all tissue healing.
3.   Smoking contributes to an increase in spinal problems.  The reduced blood circulation found in smokers deprives spinal discs of vital nutrients which can lead to premature degeneration.  Smoking may also provoke disc herniation through coughing.  Studies demonstrate a definite link between smoking and low back pain that increases with the duration and frequency of the smoking.  Exposure to secondhand smoke during childhood may also increase the risk of developing neck and back problems later in life.
4.    Smoking increases pain levels.  Smokers complain more often of MSK pain than non-smokers.  Studies indicate that smoking makes individuals more susceptible to sensing pain at lower thresholds.  In addition, smoking causes general damage to the MSK system through direct chemical irritation, chronic inflammation, and restricting blood and nutrient flow.
5.    Smoking causes stress and de-conditioning in the body.  For optimal functioning, your muscles and joints need a steady supply of oxygen-rich blood.  Smoking not only stiffens your arteries, it also decreases the rate at which oxygen and carbon dioxide are exchanged in the blood.  Other side effects of smoking include fatigue, lung disorders, impaired healing, and chronic pain.  Impaired healing means that injuries affect you for longer than usual, and healing from surgeries or infections can be problematic.  These side effects can lead to inactivity, which causes deconditioning.
Scientific evidence has established links between cigarette smoking and its detrimental impact on the MSK system.  However, it is never too late to try and quit smoking.  Some of the negative health aspects of smoking start to reverse after a smoker quits.  Those looking for help in trying to quit should speak to a medical professional.  Valuable resources can also be found on the Health Canada and Canadian Lung Association websites.  For additional information on health and wellness, visit
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.