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Bursitis

Posted in common conditions, remedies, tagged , , , , on November 12, 2009| 6 Comments »

imagesA bursa is fluid-filled sac that acts as a cushion; and lies between a tendon (or muscle) and bone, which allows for virtually “frictionless” movement between these structures. When a bursa gets inflamed, it can lose it’s ability to create a smooth gliding surface and become irritated. The result will be pain (sharp or dull) and decreased range of motion. The pain can occur with or without movement. Bursitis (inflammation of a bursa) is a relatively common condition that I see in patients.

There are several ways a bursitis can occur. The most common would be due to structural imbalances and faulty calcium metabolism. Typically I see these two occur together. An infected bursa will also get inflamed, but that is much more rare, though still usually treatable with conservative, non-invasive methods. There are bursa all over the body, so to speak, but the common ones that get inflamed are in the shoulder, “hip” (outside of the upper thigh), and spine.

Treatment directed towards balancing the muscles, tendons, ligaments, joints, and sometimes even skin will resolve the structural imbalances. Because “everything is connected”, it’s not uncommon for muscle and joint dysfunction in one part of the body to result in a bursitis in another. For example, the most common structural reason for “hip”, or trochanteric bursitis is excessive foot pronation (or “flat feet”). [the (greater) trochanter is bony eminence on the upper, outer part of the femur, or thigh bone] A bursitis of the shoulder can be caused by neck, TMJ, or pelvic dysfunction, and sometimes even foot dysfunction. Bursitis in the spine can occur for any number of reasons including postural distortions (due to muscle dysfunction) and spinal, pelvic or extremity structural imbalances.

When a bursitis is the result of faulty calcium metabolism, nutritional supplements are almost always indicated. Keep in mind that structural imbalances will almost always accompany a calcific bursitis. Therefore, treatment should be directed towards correcting both issues. The reason a bursa gets calcified may be two-fold. First, anything that is chronically inflamed will usually begin to calcify. Second, calcium won’t be directed properly if there is a nutrient imbalance. I’ll discuss calcium metabolism in relation to bursitis in this article. Click here if you are interested in reading my article about inflammation.

Typically the person with a calcific bursitis will have stiffness upon waking and feel better after movement. This type of pain pattern will usually be the case with any type of “calcific pain”. As far as nutrients go, the main ones to consider are vitamin D and essential fatty acids or EFA’s (usually omega-3’s). This is because the problem usually begins with an excess amount of blood calcium that gets deposited in the bursa instead of the bone. Vitamin D raises blood calcium levels by absorbing it from food (or supplements) in the digestive tract, or by extracting it from bone. [Having calcium taken up from the bones is never a good idea as it can lead to osteoporosis.] Omega-3 fatty acids (or oils) will take calcium out of the blood and deposit it in the bones. The problem arises when there is an excess amount of vitamin D, or a lack of EFA’s; either of which can cause excess levels of calcium in the blood. The former is less likely, unless you’ve spent a fair amount of time in the sun or supplement excessively.

The next factor that plays a role is when the body is overly alkaline. This will cause any excess blood calcium, assuming there is an insufficient amount of EFA’s to drive it into the bone, to precipitate into the tissues, bursae in this case. So the solution is two-fold. Adequate amounts of EFA’s and an environment that is NOT overly alkaline. The remedy would be to make sure you get adequate amounts of EFA’s and possibly supplement with an acidic type of calcium. I often use both with great success.

Keep in mind that you will not always have a calcific bursitis show up on an x-ray for there to be a calcium metabolism problem. If it does show on an x-ray, the problem is quite chronic. Fortunately, in my experience with patients, bursitis (calcific or not) is usually something that resolves completely with conservative care.

There are many other potential calcium metabolizing nutrients that may be necessary, with the most common being magnesium and vitamin B6. Lastly, if these don’t work, one needs to consider further complicating factors including: infections, digestion, general pH balance, and chemicals that may be affecting calcium metabolism.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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3 tips to consider when taking essential fatty acid supplements

Posted in remedies, tagged , , on November 5, 2009| 5 Comments »

Over the years there has been a lot of hype about the health benefits of taking omega-3 fatty acids (particularly flax seed and fish oil). And rightfully so, as they are essential and can be difficult to get in adequate amounts from diet alone. Additionally, they can often directly address certain health conditions.

That said, when taking flax seed or fish oil from supplements, there are several things that need to be taken into consideration.

1) Freshness: Both flax seed and fish oil are quite volatile and can go rancid (or oxidize) very easily. Consuming rancid fats is equivalent to directly consuming harmful free radicals that can wreak havoc on the cells in your body. Free radicals have been implicated as contributing to many degenerative diseases. To understand more on free radicals and oxidation, read my article on the aging process. As a result of this, it’s important to make sure that the oil you are consuming has not been sitting on a shelf for very long. Many times the label will say when the product was manufactured. You should be fine if it was manufactured within three months from when you purchase it. Keep in mind that flax seed oil is more unstable and likely to go rancid much quicker than fish oil. Also, some manufacturers will add antioxidants to the product to help keep it from oxidizing and extend the shelf life – whether that shelf is in the store or your home. By the way, it’s best to keep any oil refrigerated at home.
P.S.: Never heat or cook with flax oil. And generally, the only oils I recommend people cook with are olive and coconut, as they have high “smoke points” and will likely remain stable when heated to reasonable cooking temperatures.

2) Antioxidant levels in your body: You can consume the freshest of any essential fatty acid, but if you don’t have enough antioxidants in your bloodstream, the fat can actually go rancid inside your body. Again, this will create an excessive amount of free radicals and cause more harm than good. Living in today’s industrialized world contributes plenty to our free radical burden, so make sure you have enough antioxidants anyway; but especially if you are supplementing with essential fatty acids. You can obtain these through your diet from foods such as: berries, pomegranates, curcumin (the spice curry is made from), rosemary, 100% raw cacao (or chocolate), green tea and most fruits and vegetables in smaller amounts, among other sources. Additionally, you can take a broad-spectrum anti-oxidant supplement.

3) Source: If you are (or plan on) taking fish oil, be sure it comes from a reputable manufacturer. Otherwise, it’s quite likely that you’ll be consuming harmful chemicals (known as PCB’s) and the toxic metal mercury which unfortunately have made their way into the oceans and rivers, and ultimately fish.

I have found many over-the-counter brands that were more harmful than helpful to my patients. I’m not saying that all brands bought in stores are contaminated or rancid; just be careful. I determine how good an oil is for my patients based on specialized muscle testing techniques, palpatory pain thresholds and range of motion testing.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Omega-3 fatty acids: flaxseed oil or fish oil?

Posted in food, remedies, tagged , , , on November 4, 2009| 3 Comments »

Essential fatty acids, or omega-3’s and omega 6’s as they are also known, are necessary for a number of different functions in the body. They are labeled “essential” because the body cannot synthesize them from other substances, and therefore must be obtained from the diet. Omega-3 fatty acids, found in large quantities in fish oil, flax seed oil, chia seeds, and walnuts (and others less so) are well-known for their health-promoting properties. On the other hand, omega-6’s, found in corn, soybean, safflower, sunflower oil, etc. are seen to hinder health (when eaten large quantities), despite being necessary. The key is to have a proper balance between the two; and research supports the best intake to be anywhere from a 3:1 to a 5:1 ratio of omega-6’s to omega 3’s. Unfortunately, the average American consumes a 25:1 ratio of 6’s to 3’s. [As an aside, the omega-6 fat known as gamma-linolenic acid (GLA) found in black currant seed, evening primrose, and borage seed oil can be quite beneficial to one’s health.]

Some of the health-giving attributes of omega-3’s include the following: regulation of inflammation, alleviation of pain, prevention of excessive blood clotting, maintenance of the integrity of cell membranes, reduction in elevated cholesterol and triglycerides, optimal fetal development, reduced cardiovascular risk factors, anti-cancer properties, better cognitive function, reduced incidence of depression, among many others.

The way that omega-3’s produce their health-giving effects is through the conversion of a substance called eicosapentaenioc acid (EPA) into eicosanoids. Specific eicosanoids, known as prostaglandins and leukotrienes are ultimately responsible for the beneficial effects.

As mentioned above, omega-3 fatty acids can be obtained from both vegetarian and non-vegetarian sources. Despite the obvious differences, there’s more you need to know to determine which one will be effective for you. So even though both sources are technically omega-3 oils, there is still a difference.

Again, the health-promoting biochemicals that are produced from omega 3’s originate directly from EPA. Omega-3 fats from fish oil actually contain EPA in them naturally. On the other hand, vegetarian sources of omega-3 fats do not actually contain EPA. Instead the body must convert the components contained in those (vegetarian) sources into EPA. Here is an example of how it works. Flax oil contains something called alpha-linolenic acid (ALA) which then needs to be converted to stearidonic acid. Stearidonic acid then gets converted to eicosatetraenioc acid, which then finally gets converted into EPA. Then of course, the EPA gets converted into the beneficial eicosanoids. Remember, these eicosanoids (certain prostaglandins and leukotrienes) are the biochemicals that exert the anti-inflammatory, etc. responses that we hope to achieve from ingesting the omega-3’s in the first place.

The problem that can result with having to make all these conversions (ALA to EPA to prostaglandins) is that those processes can be impeded by various things. Essentially the main issue arises in the initial conversion of ALA. This step will be impeded or blocked in the presence of alcohol, trans fats (partially hydrogenated oils), and/or deficiencies in vitamin B6, magnesium, and/or zinc. Considering that magnesium and zinc tend to be the most deficient minerals in people, it’s quite probable that many people are not reaping the full benefits of omega 3’s from vegetarian sources. Recall fish oil on the other hand already contains EPA, and therefore does not require the conversions that vegetarian sources do. As a result, one is much more likely to benefit from taking fish oil. It is certainly possible to attain all the benefits from flax seed oil (and other vegetarian sources) as you would fish oil, assuming the “impeding factors” are a non-issue.

When determining which oil is best for my patients, I use in-office procedures that include specific types of muscle testing, palpatory pain threshold levels, and range of motion tests.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Natural remedies for inflammation

Posted in common conditions, food, remedies, tagged , , , , , , , , on September 7, 2009| 4 Comments »

The word inflammation comes from the Latin word inflamatio, which translates into: “to set on fire”. It is a term that describes the biological response to an injury or protection from a microbe. Essentially, this “injury” can only come from about 5 things: 1) physical trauma (e.g.: ankle sprain, etc.); 2) allergic reactions; 3) infections; 4) chemical toxins (e.g.: toxic metals, environmental chemicals. etc.) and 5) ionizing and UV radiation (e.g.: x-ray, sunlight, etc.). The”hallmarks” of inflammation are a change to the micro-circulation and build-up of inflammatory cells in the damaged area. The five key signs of inflammation are pain, redness, edema (or swelling), heat, and loss of use. You may not have all five, but in the most extreme case they all exist. These five signs are generated by the biochemicals which respond to any sort of tissue damage.

The biochemicals released are designed to help heal the damage that has taken place. They help clean up the debris from the damaged cells, bring more blood to the area to restore new growth, and improve the drainage. There is much controversy over when to “artificially” (through ice, nutrients, or medication) reduce inflammation. However, it’s generally accepted that acute (24-72 hours) inflammation is necessary to begin the healing process. Inflammation (that is one or all of the five key signs) that persists for longer than this time (that is sub-acute or chronic) may indicate an inability to repair properly; appropriately coined a “cumulative repair deficit” by Dr. Stuart White. Therefore, intervention in the sub-acute or chronic stages is usually necessary and certainly desired by the patient.

Let’s now discuss some natural ways to deal with chronic inflammation, considering that it is normal to have inflammation in the acute (and sometimes sub-acute) time-frames. First and foremost, the source(s) of inflammation needs to be avoided. For example, exposure to food allergies/sensitivities, chemicals, toxic metals, radiation, etc.. Additionally, if the inflammation is the result of a structural impediment, you may need muscle and joint re-balancing done by a doctor. If the source is not avoided or addressed, you are simply “painting over the rust” and dealing with symptoms as opposed to the cause.

The main natural remedy to alleviate inflammation would be Omega-3 fatty acids. I’ve often used Omega-6 fatty acids also; particularly gamma linoleic acid or GLA (found in black currant seed, evening primrose oil, and borage oil) with great success in patients that have chronic musculoskeletal inflammation. Generally speaking though, most people have too many Omega-6 fats compared to 3’s in their diet; so Omega 3’s are generally recommended more often. Omega 3’s are best found in fish and krill oil. Flax oil does contain Omega 3’s, however, many biochemical steps need to occur before they are converted into to EPA (the anti-inflammatory substance). And very often, these steps can be disrupted through faulty sugar metabolism, alcohol, and trans-fats. As a result, it’s quite possible that you’ll never achieve the potential anti-inflammatory effects you are looking for. Fish and krill oil on the other hand need no conversion, as they actually contain EPA. I do not recommend that you eat fish unless you absolutely know it’s “clean”, click here to read why.

Other natural anti-inflammatory compounds include turmeric, resveratrol, ginger, quercetin, garlic, onion, boswellia, rosemary, vitamins C + E, and should also be considered. However, keep in mind that no one ever has an “herb-deficiency”. Therefore, make sure you’ve covered your nutritional bases first; that is essential Omega-3 fatty acids and vitamins C +E at a minimum. There may be other natural anti-inflammatory compounds as well, but the ones I mentioned should be more than enough.

Additionally, don’t forget that you need certain nutrients to rebuild the damage that has occurred from the inflammation. For this, think about rebuilding collagen, the most abundant connective tissue in the body. Therefore make to sure you have a sufficient amount of protein and vitamin C (the most basic nutrients) to build collagen. Some other nutrients for collagen formation would include: zinc, manganese, iron, vitamin A, sulphur, copper, and perhaps others indirectly.

In conclusion, it’s usually not apparent when you have chronic inflammation. The 5 key signs more often accompany acute inflammation and often are not observed with chronic inflammation if you don’t have pain or some sort of loss of function. This is especially true when there is inflammation in the arteries, which can lead to hardening of the arteries and ultimately cardiovascular disease. I most commonly see chronic inflammation as a result of poor dietary choices, environmental chemicals (and metals), and sub-clinical infections. Inflammation was the topic of a front-page article in Time Magazine titled “Inflammation: The Secret Killer”. It mentions the links between chronic inflammation and heart attacks, cancer, Alzheimer’s, and other diseases. So make sure you are getting anti-inflammatory compounds on a daily basis, through diet and/or supplements.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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Dr. Rob’s Top 5 Supplements for Overall Health

Posted in remedies, tagged , , , , , , , , on July 28, 2009| 4 Comments »

If you are a patient of mine, you know that I don’t “shotgun” any supplements.  That is, I don’t ever just give out supplements because they’re “good for you” or because the “the book” or “experts” say they are the best for a particular condition.  You know that I am extremely specific to my patient’s needs.  I’m able to be extremely specific because I use muscle testing.  Muscle testing allows me to have a “window” into the nervous system.  Therefore, I can find out what nutrients my patients will respond to best, based on the outcome of the test.

That said – I’m still willing to talk about what I feel are the top 5 supplements for overall well-being.  Please keep in mind that the order of importance for any given person will vary, even if they are just being used for general health.  That’s because everyone lives a different lifestyle and is exposed to different stressors.  Let’s begin:

#1 – Probiotics – These are more specifically known as acidophilus and bifidus, or “good” bacteria.  There are in fact many different names for probiotics, as there are many different strains of good bacteria.  The term probiotic means: pro- “for”  biotic- “life”.  Sounds like it should be in the top 5, doesn’t it?  Essentially, we have hundreds of strains of bacteria in our intestines.  Some of them are helpful, some are harmful.  For optimal health, we need to strive for a balance between the helpful and harmful.  Unfortunately, most people have too many harmful ones.  The function of these good bacteria helps all of the following: the immune system; proper digestion and absorption; food allergy/sensitivity reduction; production of certain vitamins and nutrients- such as vitamin K, choline, fatty acids, and more; and prevention of bad bacteria/pathogens from overpopulating the gut.

#2 –  Antioxidants – You’ve probably heard of these compounds.  They essentially “quench” free radicals that are formed inside the body.  Free radicals are unstable molecules (because of an unpaired electron in the outer shell) that can cause a domino-effect of damage to the cells.  Free radicals will damage your DNA – the blueprint your genes use to express themselves healthfully.  They are formed naturally through normal metabolic processes; however more sources of free radicals include poor food choices, certain prescription medications, environmental pollution, tobacco smoking (including second-hand), stress, ultraviolet light, oxygen and radiation.  Also, don’t forget that a lack of sufficient antioxidant levels will perpetuate the damage from existing free radicals by failing to neutralize them.  There are dozens of antioxidants.  Some are even essential vitamins and minerals like vitamins A,C,E, and the minerals selenium and zinc to name a few.  Some of my favorite antioxidants are grape seed extract, turmeric, rosemary, green tea extract, and alpha-lipoic acid.

#3 – Omega 3 (or 6) Fatty Acids – By now, everyone is talking about Omega 3’s, usually referring to fish oils. Keep in mind that there are plant-based sources also. Fish (and krill) is more easily used by the body, and we’ll discuss why that is another time.  Your medical doctor may even be talking about fish oils.  Why?  Well, one reason is that they are essential fatty acids.  “Essential” refers to the fact that they are essential to human health, but your body cannot make them with other nutrients you’ve eaten.  They MUST be consumed in the diet, unlike certain other fatty acids which can be manufactured inside the body.  Essential fatty acids have been found to be important for proper functioning of the immune, cardiovascular, nervous, and musculoskeletal systems.  Also, did you realize that our brains are made up of roughly 60% fat – another great reason to make sure you’re not deficient in this vital nutrient.  Most people consume enough (really too many) carbohydrates.  Many people consume enough essential amino acids (protein).  Very few people consume enough essential fatty acids, without supplementing. By the way, some people may need Omega 6 essential fatty acids more so than 3’s – don’t ever “shotgun” it, remember. Get checked!

4 – Vitamin D – This is another one of those supplements that is causing a lot of M.D.’s to jump on the band wagon.  Well frankly, good for them, and more so for their patients.  Relatively recently, this has been found to be an almost pandemic deficiency – especially in areas where people are not exposed to the sun for much of the year.  Research on vitamin D seems to be growing at a rapid pace these days.  So far it has been shown to treat or prevent osteoporosis (it’s necessary in absorbing calcium), infections (including colds and flu), diabetes, tuberculosis, inflammation, depression, and neurological disorders.  That list barely gives vitamin D the credit it deserves.  Get your blood levels checked!  And get out in the sun, before summer is over.

5) – A Multi-mineral supplement – You must have noticed how I didn’t say a multi-vitamin supplement, although that would be fine to add as well.   In my practice, I find that minerals are a much more common deficiency than vitamins.  Minerals act as catalysts in the body.  Essentially that means they drive chemical reactions.  They do this partly by activating enzymes.  So they are responsible for converting one chemical into another, which is really what makes all biochemical processes go around.  If there were no minerals to drive reactions, our bodies would essentially stop in their tracks.  In fact, they are even necessary for vitamins to work effectively because they help convert them from their inactive to their active form; so those vitamins can actually perform their proper biochemical role.  I find deficiencies of all different types of minerals, daily.  But if I had to choose only two, they would definitely be zinc and magnesium.

The 5 supplements above have been reviewed for general health.  However, they can obviously address specific ailments for certain people.  Again, if you have a specific health concern, it is most important to figure out exactly what you are deficient in, instead of throwing the whole kitchen sink at the problem.  I do this through highly specific muscle tests, along with blood, urine, and saliva tests for all my patients.  When people simply look things up in books (and “shotgun” their supplements), they often don’t work.  Then, unfortnately, people lose faith and decide that supplements or alternatives are ineffective across the board.  Figure out what your body needs, and you’ll see amazing results. Check back for more specific information on all of the above!
Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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