Archive for April, 2008

Sleep and Your Health

John-David Kato, DC, MSc, ACSM-RCEP, CSEP-CEP. April 18th 2008.

I attended the Living-With-Living-Well education session “Wake Up: Sleep has an impact on your health!” put on by Toronto Rehab. This session covered a number of topics including obstructive sleep apnea (OSA), narcolepsy, insomnia and how these conditions can affect your health. People with conditions such as these have disturbed sleep and often have excessive daytime sleepiness as well as other health concerns. For example OSA can cause elevated blood pressure. The repetitive periods of waking at night are related to an increase in adrenaline levels in the body, which raises the blood pressure throughout the day. Many people with OSA are often not aware that they wake up at night, and they might not even feel tired during the day. High blood pressure itself usually has no symptoms, but can lead to many health problems over time such as heart disease or stroke.

The physical signs and symptoms associated with obstructive sleep apnea (OSA) include restless sleep, high blood pressure, night time chest pain, large neck (>17” circumference for men, >16” for women), excess weight, morning headaches and having to go to the bathroom several times during the night.

Another interesting aspect of sleep disturbances that was mentioned was the link between sleep and pain. Though the mechanism is still not fully understood, some studies have shown that individuals with disturbed sleep, particularly those with chronic pain (e.g.: fibromyalgia), may experience an enhanced perception of pain. Of course, in some cases it may be the pain that causes the sleep disturbance in the first place, thus potentially leading to increased daytime pain and a vicious cycle. This can make teasing out what is causing what more challenging. In addition to affecting pain sensation, poor sleep can have an impact on a number of other areas of our lives: mood, personality, concentration, memory, thinking, and even libido to name a few.

Identifying the presence of a sleep disorder is the first step in tackling it. If you do have excessive daytime sleepiness, the first thing to ask yourself is whether you are getting enough sleep. Keep in mind that “enough sleep” for one person may not be the same for another. You might also find that your sleep needs change, as you grow older. An easy test to see if you are getting enough sleep is trying to sleep longer and seeing if you feel more rested. If you still feel tired talk to your doctor: he/she will be able to assess whether you might benefit from a thorough sleep assessment to rule out a more serious cause such as OSA. You could see a complementary health care professional, like a naturopath, to see what non-medical strategies there are to help sleep. Seeing a chiropractor is of course another option. Although treatment of a sleep disorder is not in a chiropractor’s scope of practice in Ontario, they treat injuries, relieve pain and tension, and give some recommendations (for exercise, sleep hygiene, weight loss, and other lifestyle advice), all of which may help improve the quality of your sleep.

JD Kato is a chiropractor and clinical exercise physiologist practicing at the Rosedale Natural Health Clinic. If you would like to contact him, to schedule an appointment or to learn what other services we offer, please call 416-926-0084 or visit www.rosedalenaturalhealth.com

Office Work and Related Physical Pain

By Rowena Gallardo, Registered Massage Therapist

Pain due to poor posture is experienced by many Torontonians that have a sedentary occupation and lack physical activity. These are individuals whose work requires them to maintain a static posture for more than 6 hours a day and those who do repetitive activities. Eventually, poor posture slowly becomes the new “normal” for the body.

Lack of movement can diminish the ability of your body to distribute nutrients to the affected areas resulting in diminished tissue health. The most common symptoms are tension headaches, neck and shoulder stiffness and pain, difficulty breathing and decreased range of motion usually in the cervical spine. Others experience carpal tunnel syndrome and numbness and tingling down the arms. We often ignore the pain and tolerate it as much as we can and wait until it gets debilitating before we get help. At this point, corrective action must be taken to restore the body’s natural alignment and function.

Massage therapy treatment for postural dysfunction aims to be progressive, not aggressive. The therapist works on the patient’s main complaint while addressing compensatory structures at the same time.

The treatment goal is to relieve pain, improve tissue health, eliminate trigger points, decrease muscle tension, improve muscle length, strength and flexibility, and restore normal range of motion. In addition to this, patients improve breathing, build up confidence, stamina and exhibit a healthier posture.

First the short and tight muscles of the affected areas are slowly stretched back to normal length, to allow more room and less resistance. Examples of tight muscles are the pectorals, scalenes, sternocleidomastoid, suboccipitals, upper traps, hip flexors and hamstrings. The treatment includes progressive passive stretches on the upper chest, neck and shoulders combined with joint mobilizations in these areas and also on the elbows, wrists and the small joints in the hands. The therapist may also use friction technique on areas with adhesions and muscle stripping on the intercostals and rhythmic mobilization from the cervical spine down to the sacrum.

Then the therapist works on the lengthened and weak muscles, stimulating the muscle fibers to rebuild its strength and tone. Some of these muscles are rhomboids, levator scapula, erector spinae and gluteus maximus. The therapist uses fast and heavy tapotement to wake up the tired muscles of back and shoulders. Hydrotherapy may also be incorporated using heat to improve blood flow in tight muscles, and cold hydrotherapy to reduce swelling. The therapist encourages strength training exercises for the back and shoulder muscles to slowly build normal strength and function.

Maintaining a proper posture during work is a constant effort. It has become a very difficult task especially with the lack of proper ergonomics in the work space. It is highly advised to stay conscious of your posture at all times. Take short breaks occasionally, stand up take a deep breath and stretch your entire body by reaching up with your arms and then bending forward touching your feet with your hands. And when you get home at the end of the day, have a warm bath with Epsom salts and immerse yourself in rest and relaxation.

If you have any questions about how massage therapy can help with work related pain or postural dysfunctions, please give us a call at 416-926-0084.