Wednesday, July 13, 2016

Chiropractic Subluxations

I write to you today with these definitions above to help you, the lay person to have a better understanding what chiropractic means. To a chiropractor and the terms used to describe what we call subluxation, is the basis of what our practice was built upon. All joints in the body can have some type of subluxation and with that subluxation there is usually a loss of functional, structural and/or pathological changes that may compromise the neural integrity of that joint and my influence organ system function and general health.

I will give you an example of an axial subluxation and appendicular “extremity” subluxation.
The vertebral subluxation is the term applied to a vertebra which has lost its normal position and/or motion in relation to neighboring vertebrae. Vertebrae which do not function properly within the spinal framework generate mechanical stress. This accelerates the wear and tear on the surrounding spinal muscles, ligaments, discs, joint and other spinal tissues. Pain, palpatory tenderness, inflammation, decreased spinal mobility, and muscle spasm and hypertonicity will eventually follow.

Additionally, because of the direct mechanical and physiological relationship between the spinal column and the spinal nerve roots, vertebral subluxations, as well as other spinal abnormalities have the potential to impair proper nerve functioning. Once nerve functioning is compromised, communication within the body becomes less effective jeopardizing the overall health and wellness of the individual.

Vertebral Subuxations

Vertebral subluxations have a great number of different causes all of which the average individual is exposed to daily. These causes can be described in terms of physical, chemical, and emotional causes.
Physical causes include acute trauma to the body, repetitive motions affecting the spine, bad postural habits, improper workstation habits and design, and weak or imbalanced spinal musculature.

Chemical causes include poor dietary and nutritional practices, drug and alcohol use and abuse, and the ingestion of chemical toxins in the foods we eat, air we breathe, and water we drink. Chemicals which are harmful to the body decrease the body’s ability to function optimally and reduce the ability to successfully adapt to and withstand internal and external stresses – making us more susceptible to spinal subluxations and the consequences of these subluxations.

Emotional causes refer to stress. Excessive stress or inadequate stress management skills can deplete the body of the ability to sustain normal functions. The impact of emotional stress on physical health is well documented in the medical research and can have devastating effects on the immune system, making the body susceptible to injury and disease.

If you would like to learn more about subluxations, please visit my website at

Thursday, July 7, 2016

Migraines Signs, Symptoms and Treatments

There are several different types of headaches that thousands of people suffer from daily. The list can start with TMJ “Temporomandibular joint” headaches, sinus headaches, tension headaches, neck pain headaches “cervico-genic” headaches, migraines and cluster headaches. I would like to describe to you how these headaches can affect you, the signs, symptoms and treatment options that maybe best for you.

According to the Medical News Today there was an article written by Dr. Helen Webberly, who gives one of the best and well written explanations about migraine headaches, causes, symptoms and treatments. The link to this article is below.

A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound.
The excruciating pain that migraines bring can last for hours or even days. Migraine is a common problem affecting 36 million Americans, about 12% of the population.

Migraine Statistics

§ The cause of migraines is still largely unknown.
§ Migraines can be preceded by an aura of sensory disturbances followed by a severe one-sided headache.
§ Approximately 12% of Americans get migraine headaches.
§ Migraine tends to affect people between 15-55 years of age.
§ Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches such as allergies, light and stress.
§ Some people get a warning prodrome, preceding the onset of a migraine headache.
§ Many migraine sufferers can prevent a full-blown attack by recognizing and acting upon the warning signs.
§ Over-the-counter medications can eliminate or reduce pain.
§ Specific medications can help some sufferers.
§ People who suffer from severe attacks can take preventative medicines.

Migraines can be debilitating for those who suffer from them on an ongoing basis. If you are suffering from migraines, it is important to consult a physician. Doctors of chiropractic medicine are highly trained and can help their patients in many ways beyond just treatment of spinal pain. If you are suffering from migraines contact Dr. Salameh today. Dr. Salameh is a board-certified chiropractic physician who has always believed in natural healing. He takes a whole body approach to your care and offers the latest therapies to help you heal naturally through corrective chiropractic care, nutrition, and exercise.


Thursday, June 30, 2016

Sinus Headaches Symptoms and Treatment

The third topic of my headache series are sinus headaches. Living here in Jacksonville, Florida, we experience allergy season what seems like all year around, but realistically twice a year. Whether it be from the pollen from pine trees or ragweed, I always have patients coming into the office with a sinus infection asking if I can help. This is pretty much what I explain to them.
Your sinuses are air-filled spaces inside your forehead, cheekbones, and behind the bridge of your nose. When they get inflamed -- usually because of an allergic reaction or an infection -- they swell, make more mucus, and the channels that drain them can get blocked.
The build-up of pressure in your sinuses causes pain that feels like a headache.


You’ll feel a deep and constant pain in your cheekbones, forehead, or the bridge of your nose. The pain usually gets stronger when you move your head suddenly or strain. At the same time, you might have other sinus symptoms, such as:
  • A runny nose
  • Feeling of fullness in your ears
  • Fever
  • Swelling in your face

Other kinds of recurring headaches, like migraines or tension headaches, are often mistaken for sinus headaches. Because the treatment you need depends on what kind of headache you have, it’s important to figure out if your symptoms are caused by your sinuses. If a sinus blockage, such as an infection, really is the cause, you'll likely have a fever.
Usually your doctor can tell if your sinuses are blocked based on the symptoms you describe and a physical exam, but in some cases, you may need CT or MRI scans.
The goal is usually to relieve your symptoms and treat an infection if you have one. You might take antibiotics, as well as antihistamines or decongestants for a short time. You can also use inhaled nasal decongestants, but only for up to 3 days. Longer use can make your symptoms worse.
You can also take pain relievers, or if they don't help, your doctor can prescribe corticosteroids to ease the inflammation in your sinuses. If an allergic reaction causes your sinus flare-ups, you might need a preventive allergy treatment.
You can also feel better with simple at-home tricks, such as drinking more fluids, using a humidifier, or saltwater nasal spray.
If you take decongestant and pain-relieving medicines too often, you might get medication overuse headaches. It's important to touch base with your doctor if you’re using any medication for a long time to relieve your headaches. Decongestants also can raise your blood pressure, so if you have high blood pressure, talk to your doctor before you take one.
In rare cases, he may recommend sinus surgery to remove polyps or open up small or constantly swollen sinuses.
Ever heard that allergies cause sinus headaches? It’s not quite that simple.
Allergies can cause sinus congestion, which can make your head hurt. Treatment for your allergies can ease that congestion, but it won’t relieve your headache pain. You usually have to treat the two conditions separately. See your doctor to make sure you get the right help.
Webmd doesn’t mention anything about chiropractic care for sinus infection and I understand why. Not to many people know that chiropractic care can help relieve the pressure of a sinus infection if only for a short period of time within the sinus cavity. I say short period, because keep in mind your sinuses are infected and creating more mucus and probably blocking the pathways in which they need to drain, therefore causing more pressure in the head in face. If you are interested in learning more about how chiropractic can help call my office.

WebMD Medical Reference
View Article Sources 
SOURCES: American Academy of Otolaryngology-Head and Neck Surgery. Mayo Clinic.
Reviewed by Neil Lava, MD on May 13, 2016
© 2016 WebMD, LLC. All rights reserved.

Monday, June 27, 2016

The Causes of Cervicogenic Headaches and How to Treat Them

This is part 2 of my headache series and today’s discussion is all about Cervicogenic headaches. A headache that is caused by a dysfunction within the cervical region; this is what we call as chiropractors, a cervicogenic headache. As you may already know, most headaches come from a number of sources, Jaw pain, Hypertension, Dehydration and so on.  What I will be discussing with you today, are some the causes, diagnoses, and treatments of a cervicogenic headache.

Cervicogenic headache usually starts in what we call the suboccipital area, which is that muscular area that is just under the occiput of the head. That pain starts there - it can be on one or both sides - and it tends to radiate up into the head and around the head. The easiest way to visualize it is to actually take the palm of your hand and place it on the back of the head and that really is where the pain spreads. More rarely, the pain can travel to the front of the head and behind the eye. Once again, that's not common and it is even less common for it to just appear in the front of the head or behind the eye, but it does happen.

What causes a Cervicogenic Headache?
In order to discuss the causes of cervicogenic headache, I need to take a step back for a second and talk about the anatomy cervical spine “neck”.  What we're looking at here is the back of the head, the neck or cervical spine, and specifically what we're looking at is these little joints. Now these are facet joints - or zygapophysial joints – the hinge-like joints in the spine. Now, these joints are true joints - in other words, they have the synovial fluid, synovial capsule, cartilage - and they can react like any other joint; in other words, they can get irritated, inflamed, and can become painful. Now, what's important in this context is that the innervations for these joints comes from a very small branch - called medial branch - that comes around here and goes into the joint. At times, that branch continues on and becomes another nerve. The nerve we're concerned about specifically is called the third occipital nerve. This nerve crosses the C2-3 facet joints and the facet joints are named for the different vertebral bodies that are interfacing and forming that joint, so this is a C2 and C3. So a C2-3 is crossed by the third occipital nerve, then continues onto the occiput and around the scalp. If there is irritation at this joint, this nerve tends to transmit pain and cause the pain that we're discussing - the pain that actually encompasses the occiput and the back of the head.

Now, the causes of this, there are many to discuss. If we are to group them together, the most common cause is really similar to a whiplash injury. If you think about the joint itself as a hinge-like joint that provides the sliding motion. Whiplash is essentially an acceleration-deceleration injury grinding that joint. That usually is the first step to precipitating this cervicogenic headache because it irritates the joint, then the irritation drives the whole process.

Now, whiplash or acceleration-deceleration injury through that joint can mean motor vehicle accidents, can mean just falls - commonly falls on ice - that cause this motion of the head and that's usually more common in the younger population. When we talk about the older population and when arthritis becomes more of a problem, that arthritis in that same joint can also cause irritation, inflammation, and irritation to that nerve, causing that cervicogenic headaches. Of course, anything that would cause irritation to that nerve would cause the headaches and muscle spasms, grinding that joints, irritation to the joint from other causes, from the laxity of the joint, in different conditions that really predispose the hypermobility or increased mobility of that joint can also predispose to inflammation and irritation of that nerve, once again predisposing one to cervicogenic headaches.

How is a Cervicogenic Headache Diagnosed?
Diagnosing cervicogenic headache can be somewhat tricky because the headaches resemble a number of different headaches and to complicate the matter, they can trigger other headaches. So, for instance, patients can have cervicogenic headaches as another trigger for a migraine. Cervicogenic headache in itself can cause tension types of headache. But if there is suspicion for cervicogenic headache, the studies have shown that a very precise diagnostic procedure can be very accurate in diagnosing it.

The way this procedure is done is under controlled conditions and the guidance of an x-ray or fluoroscopy. A needle is actually placed at the joint at three separate spots - at the most likely places of this nerve - and anesthetic is placed very precisely at the location of the nerve. If this eliminates the pain, then that's a very positive indication that that's the source of the pain.

How is a Cervicogenic Headache Treated?
In discussing treatments for cervicogenic headaches, it's important to remember that we have to look at it as constellation of symptoms, even though we know that there is a third occipital nerve that gets irritated and that's what we have to treat, that resolves a part of the problem - a very important part of the problem - but from literature we know that we see the best outcomes by approaching it from several different directions. What I mean by that is: one of the main treatments for cervicogenic headaches is addressing the pain generator. So, reducing the inflammation at the joint and reducing the inflammation at that third occipital nerve is one of the first things to do. That can be done by placing medication right at the source of the inflammation and irritation. Another way to do this - and this is a very well-studied approach - is to use radiofrequency rhizotomy. Radiofrequency rhizotomy essentially eliminates those feeding nerve fibers and the way this is approached is a probe is placed along the path of this nerve and then radiofrequency energy is used in order to treat this area to eliminate those nerve fibers.

Besides using these techniques, what's important to remember is that chiropractic care and theruapeutic modalities such as Ice and Interferntial units to decrease inflammation and reduce pain, along with PNF stretching, or proprioceptive neuromuscular facilitation stretching, is a set of stretching techniques commonly used in clinical environments to enhance both active and passive range of motion in order to improve motor performance and aid rehabilitation. So, it is important to address this from a point of controlling the pain because, as we know, pain really drives a lot of the muscle spasms and prevents one from doing the exercises and manipulations that are necessary in order to get better. Once everything comes together and all of the components of the biomechanical chain are treated, the myofascial component is treated, the irritation and inflammation is eliminated, most patients tend to recover very well. 

Tuesday, June 21, 2016

TMJ “Temporomandibular Joint” Headaches

TMJ Symptoms: Tension Headache and Jaw Pain

Temporomandibular joint disorder, or TMD, causes jaw pain that may be mistaken for recurring tension headaches according to a recent study of TMJ symptoms. Jaw pain due to TMJ symptoms will not respond to tension headache treatment. Instead, such pain must be treated in the same way traditional TMJ symptoms.

The Temporomandibular Joint:
The TMJ, or temporomandibular joint, is the joint that connects the lower jaw to the skull. Actually, two temporomandibular joints are located just in front of the ears, one on each side of the jaw. The TMJ joint allows you to move your lower jaw so you can talk and chew. Disorders of this joint may be referred to simply as TMJ or as TMD (temporomandibular joint disorder).

In healthy people, the lower jaw that forms the TMJ joint are rounded and called condyles. When we open and close our mouths, the condyles glide along the TMJ joint sockets. To prevent wear and tear, a small disc acts as a shock absorber between the condyles and the socket.

TMJ Symptoms:
Damage to the temporomandibular joint, either through trauma or daily wear and tear, can result in TMJ symptoms, including jaw pain and tension headaches. Additional TMJ symptoms can include:

  • clicking sounds when moving the jaw
  • difficulty chewing or biting
  • ear ache
  • facial pain
  • fibromyalgia
  • “grating” feeling while chewing
  • less range when closing / opening the mouth
  • tender jaw

Between five to ten percent of the American population suffers from TMJ symptoms that require some form of treatment.

TMJ Symptoms and Fibromyalgia:The jaw pain associated with TMJ symptoms is similar to the joint pain associated with fibromyalgia, a condition often seen in women with sudden hormone changes (including menopause). Because TMJ and fibromyalgia often occur simultaneously in woman, doctors think a connection exists between the two.

Other conditions often seen with jaw pain and TMJ symptoms include:

  • atypical facial pain
  • cardiovascular diseases
  • chronic fatigue syndrome
  • equilibrium (balancing) disorder
  • irritable bowel syndrome
  • migraine headache
  • multiple chemical sensitivity
  • smell and taste disorders
  • speech and hearing disorders
  • trigeminal neuralgia (a painful facial nerve condition).

Tension Headache and TMJ
A recent study conducted by the University of Buffalo’s School of Dental Medicine researched the possibility that TMJ symptoms were being mistaken for tension headache symptoms. The study was led by Richard Ohrbach, an associate professor in the Department of Oral Diagnostic Sciences.

The study’s intent was to examine the difference between TMJ joint pain versus tension headaches in clinical examinations. However, the focus of the study wasn’t limited to tension headaches. It also examined migraines, mixed migraines and sub-clinical headaches.

All 583 participants in the study displayed TMJ symptoms. Because women are nearly twice as likely as men to display TMJ symptoms, women comprised 82.3 percent of the participants.
Ohrbach and his research team discovered that, in 82 percent of cases, they could reproduce tension headache symptoms by performing standard clinical examinations of the temporomandibular joint. Consequently, the process of diagnosing TMJ symptoms, as set forth by the Research Diagnostic Criteria for Temporomandibular Disorders, was compared to tension headache diagnosis process.

The study found that both patients and examining physicians may mistake tension headache caused by TMJ symptoms and jaw pain for classic tension headaches. Ohrbach notes that this is unfortunate, as “TMJ is very treatable, but if a jaw disorder is ignored, then treatment for the headache may not address all of the factors contributing to the headache.” Although TMJ symptoms were present in all participants, 152 were diagnosed with tension headaches, based on standard International Headache Society guidelines for tension headache diagnosis.

As a Doctor of Chiropractic I would like to note that Chiropractors do have some training in diagnosing and adjusting the Temporomandibular Joint, but I would always caution any patient to thoroughly interview and ask how much experience your Chiropractor may have with this disease. 

Medical News Today. (16 May 2006). Study suggests tension headache may actually be TMJD.

Thursday, June 16, 2016

Chiropractic Care for Wellness

A number of people are benefiting from the approach of chiropractic care for overall wellness. People no longer wait to get sick to get themselves examined by the medical experts. They no longer believe in the notion that health is absence of symptoms or pain. Rather they look for ways to enhance their health and to function at the optimal level in all sense- physically, socially, spiritually, and mentally. Since Chiropractors focus on the nervous system, which controls all the other aspect of our body, its maintenance is essential.

Why Chiropractors?

Chiropractors know about the nervous system, and which part of the body is connected to which nerve. They know the negative impact of spine on the functioning of the nervous system, and vertebral subluxations.

Professionals trained in this particular field carry out the spinal subluxations the right way, and can locate it as well. They help patients achieve their wellness goals, recover from injury, and boost their health.

Traditional or Modern Medical Model?

Before chiropractic, people used to follow the standardized medical model, which was based on symptoms. People only used to go to the doctor when they were sick or had some injury. But now, a lot has changed. Individuals are focusing on improving the psychological state, so that physical state remains intact.

People are seeking therapy for the pain that is being caused because of the stress, rather than finding the way to remove just the pain. Now, the connection between mind-body is being addressed. A number of studies have proven the effective role of chiropractic care for neck pain, spinal pain syndrome, headaches, and other conditions.


According to a poll by Palmer College of Chiropractic on the perception of Americans on chiropractic in 2015, the results portrayed that chiropractic doctors are seen in the positive light by 50% of the adults and they don’t mind getting this treatment for their back and neck pain. Moreover, 22% want to consult chiropractors about their wellness and health problems, and 31% of the people already following the program want to have appointment with a chiropractor on a regular basis.

Another 4-year study published in the Journal of Manipulative and Physiological Therapeutics found greater wellness among patients of chiropractic than non-users. The results of chiropractic users are; 51.8% reduction in pharmaceutical costs, 58.4% lesser hospital days, 43% lower admissions in the hospital, and 43.3% decrease in outpatient procedures and surgeries.

Just as your car needs timely maintenance, same is the case with your nervous system. You cannot just get it fixed once and ignore it later on. With chiropractic investment, you make sure your back muscles, neck, spinal cord, and nervous system are properly taken care of.

By adding Chiropractic Care for Wellness in your routine, you will be including exercises, chiropractic care, and good nutrition to it as well. This will provide the highest level of health known as wellness.

Monday, June 13, 2016

Chiropractic Care for Motor Vehicle Accident

Every year, up to 1.3 million people die because of road accidents. Anyone who has ever been in an auto accident only knows how traumatic it can be. Many individuals who are in auto accidents who are lucky enough to survive, live with physical, as well as emotional pain. It is important that the aftermath of the accident is handled properly, and the person gets proper care and treatment in order to recover from their injuries.

People go for surgeries and medications to get relief from the pain after the accident. One of the treatments a person may opt for includes Chiropractic Care. From neck injuries, to back injuries, soft tissue pain, and whiplash injuries –Chiropractors can treat them all.

Injuries of Motor Vehicle Accident

For some people, the pain kicks in when an individual get over the initial shock, while others feel the pain almost instantly. No matter whether the accident occurred from the back or the front, the neck region is the most susceptible part of the body to get injured during an accident. The seat belt can hold the body still, but the neck and head of the person can still move violently due to impact.
The sudden pressure because of the movement on the neck region can cause injuries in the soft tissues present in the neck, joint capsules, hyperflexion-hyperextension, and intervertebral discs. One of the most common injuries of the neck in the car accidents is called Whiplash.

Whiplash Symptoms

The sudden and harsh movement of the head in the backward, forward, or in the side directions is called Whiplash. It has the potential to dislocate the spine, and cause severe pain. Below are a few of the symptoms of whiplash that require medical attention as soon as possible.
1.       Pain in the lower back
2.       Pain in the arm
3.       Pain in the shoulder
4.       Headaches
5.       Blurred vision
6.       Stiffness in the neck region
7.       Reduced range of motion in the neck
8.       Dizziness
9.       Pain in the neck

Treatment with Chiropractic Care

A person who has endured whiplash should seek proper medical treatment and should not let it go untreated, as it can lead to pain in the future. With chiropractic care, the person will be able to sustain the health of their spine, even if no major symptoms show up. This way the spine and the bones, nerves, connective tissues, and muscles will stay in the right alignment and the body will function to its optimal level.

Initially, the chiropractor will carry out a physical assessment and look for the major muscles that are causing trouble. Once that is discovered, they will proceed with the treatment accordingly. When the treatment for the injury is not delayed, the recovery and healing does not take long to start.

Chiropractors also offer physical therapy, nutritional advice, and exercises to boost the restoration of your health.