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Bursitis Causes and Treatment Options

Bursitis Causes and Treatment Options

Bodily movement is assisted by over 150 fluid-filled sacs called bursae. Bursae help to cushion your bones, ligaments, and tendons as they move against each other. When in good health these bursae ensure that your joins have a full range of motion. However, these sacs can become swollen and irritated, creating a condition known as bursitis.

The most common cause of bursitis is overuse of the joint. Repetitive movements can irritate the bursae, leading to pain, swelling, and tenderness. Common movements that may lead to bursitis are extensive kneeling (scrubbing the floor or laying carpet, for example), lifting heavy objects (lifting a bag of groceries into the car), and athletic injuries (an aggressive tennis swing). These movements cause the sac to fill with fluids. The resulting swelling puts pressure on the tissue around the sac, causing pain and tenderness.

Other less-common causes of bursitis include gout and infection. Gout crystals can form in the elbow, causing pain and inflammation. Bursae in the knee and elbow lie just below the skin. This leaves them vulnerable to puncture injuries, which can lead to infection.

People become more susceptible to bursitis as they age. Because the shoulder is the most used joint in the body, it is the place where it is most likely to be felt. People over the age of 65 should be especially cautious when carrying out activities that put stress on the shoulder joint.

Treating bursitis begins with conservative measures. Because bursitis due to injury and repetitive movement often goes away on its own, these treatments focus on relieving pain and making the sufferer more comfortable. Treatments for this situation include ice packs, rest, and over the counter anti-inflammatory pain relievers (such as Aleve or Advil).

In more severe cases, a physician may inject a corticosteroid into the inflamed sac. He or she may also use a needle to draw fluid out of the bursae, relieving pressure and quickly reducing pain. In very rare cases of persistent bursitis, surgical intervention may be necessary to remove the problematic bursa.

Part of bursitis treatment is giving the body enough rest to heal the inflamed bursae. Patients should be careful not to overuse the affected area. Immobilization is best, as is getting plenty of rest. After the swelling and pain have receded, patients should be careful in how they treat the problematic area to reduce the chances of the problem recurring.

Bursitis can be painful, but for most people the discomfort will fade with time and rest. If the pain lasts for more than a week or two, or if it becomes so intense that you cannot carry out your daily activities, consult with your doctor.

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Spinal Health at the Gym—Form Matters!

Spinal Health at the Gym—Form Matters!

Whether you are an athlete training for competition or someone who visits the gym regularly just to keep fit, protecting your back and spine from injuries during workouts is important. A large-scale University of Arkansas study found that after injuries to the hand, injuries to areas ranging from the neck to the lower back were the most common type of gym-related injuries.

Back injuries at the gym are more common today due to the large amounts of time we spend sitting at a desk or hunched over a computer. According to personal trainer Justin Price, a specialist in functional fitness and corrective exercise, “If someone is rounded throughout the day in their upper back, and then they go to the gym and do an overhead shoulder lift standing, their upper back cannot extend properly. They straighten and arch upward from their lower back, which has a nervous breakdown because it’s getting all the stress.”

Price suggests that in order to avoid injury you consider getting a personal trainer who can show you the proper way of performing exercises and using equipment. The most important way to maintain good spinal health is to strengthen your core muscles. These are the muscles that lend strength and support to the spine, and which tend to become weakened with long periods of sitting. Following are a few tips on how to use proper form when exercising or lifting weights in the gym.

Tighten your gluteus muscles – When performing a squat, deadlift, or during pushups, be sure to squeeze your glutes. This ensures that the muscles connecting your lumbar and sacral areas are locked so your hips and lower back move as a single unit. Otherwise there is a tendency for the lower back to curve, with the vertebral discs being exposed to more stress than they are designed to handle.

Tighten your abs – So as to keep your spine from arching too much in either direction, tighten your abdominal muscles like you are preparing to be punched in the stomach. This will provide stability to the spine as you bend and lift.

Pull your shoulders down and back – A rounded upper back is one of the leading causes of back injury. It increases pressure on the front side of the vertebral disks, increasing the risk of disc herniation.

Keep hips and shoulders aligned – Back injuries happen more often when twisting and bending. Ensure that your hips and shoulders move as one unit. If you need to change direction, lead with the hips and the shoulders will follow. If you lead first with the shoulders, the hips tend to fall behind, too late to keep from overstraining the low back muscles.

 

How Do Chiropractors Know If Your Spine is Out of Alignment?

How Do Chiropractors Know If Your Spine is Out of Alignment?

Views of the spine
Human Spine

Having a misaligned spine (also called a spinal subluxation) can negatively affect your daily life in a number of ways.  It can not only cause pain in the back and neck, but can also cause pain in the rest of the body because of the pressure that the misaligned vertebrae place on nerves in the spinal column.  For example, many people suffer from sciatica (a condition in which pain can be felt shooting down the leg as far as the foot) due to a misaligned vertebral disc putting pressure on the spinal nerve roots.  A chiropractor can diagnose if your pain is due to your spine being misaligned and can perform a spinal adjustment to restore proper alignment and range of movement, relieving pain.

Spinal subluxations are very common.  They occur when one or more of your 24 bony vertebrae (most people actually have 33 vertebrae counting the nine that are fused to form the sacrum and coccyx) are pulled out of alignment with one another.  This can happen for a variety of reasons.  Among the most frequent contributors to spinal misalignment are an injury, a sudden jar, fall or trauma, bad posture, stress, inactivity, obesity, repetitive motions and lifting something improperly.  When your spine becomes misaligned, your range of motion can become more restricted, with or without accompanying pain.  Although spinal misalignments can happen quickly (usually in the case of an accident or acute injury), they can also occur over time due to weak postural muscles. This is often the case with those who sit at a desk for hours each day.

A chiropractor may use a variety of different diagnostic techniques to determine if your spine is out of alignment.  Most chiropractors can easily spot a subluxation, as body posture reflects any misalignment.  For example, when lying down, one leg will appear shorter than the other.  When standing up, the body may lean to one side, or the head may tilt to the left or right.  Also, one shoulder or hip may appear higher than the other, and the distribution of body weight may favor one foot or the other.

Other things that your chiropractor may do to determine if your spine is out of alignment are to check your range of motion (reduced range of motion usually indicates a misalignment), press along your spine (called palpation) to evaluate joint function, perform strength testing and look for changes in muscle tone.  He or she may also order x-rays of the spine to be taken, so as to have a visual confirmation of your spinal subluxation.

Once the misalignment has been pinpointed, your chiropractor will perform a spinal adjustment that will move your vertebrae back into alignment, restoring correct posture and alleviating pain that may have been caused by the misalignment.

The Opioid Crisis’ Latest Victims: Addicted Babies

The Opioid Crisis’ Latest Victims: Addicted Babies

(NU) – And now the nation’s opioid crisis is putting newborn babies at risk.
The use of prescription painkillers like OxyContin by women during pregnancy has resulted in what’s being called “an explosion” of infants as addicted to the drugs as their mothers. Newly published data in JAMA Pediatrics shows the number of cases of neonatal abstinence syndrome (NAS) has risen five-fold in the U.S. from 2000 to 2012 – that’s nearly 22,000 affected inf ants in that last year alone – and the reality behind those stats is heart-wrenching. “The babies, they really suffer,
just like adults do when they withdraw from narcotics,” Dr. Terrie Inder, chair of pediatric new born medicine at Boston’s Brigham and Women’s Hospital, told CBS News. “The babies are very irritable and sometimes have high heart rates, sweating, flushing, diarrhea. They cry a lot.”

Heightening experts’ concern: The crucial early “bonding” between mother and child is disrupted, given the babies’ average hospital stay of 24 days. The mothers, often unaware of the potential collateral damage from the painkillers they’ve been taking, experience what Inder calls “anxiety and guilt.”

Back and neck discomfort is especially common during pregnancy since women’s postural changes can result in spine and pelvic pain.

The open question is whether this latest development, combined with the Centers for Disease Control and Prevention’s call last year for physicians to dramatically curtail prescribing opioids will encourage more women to seek alternatives like drug-free chiropractic care. “All chiropractors are trained to work with women who are pregnant,”, The American Pregnancy Association says, lauding their expertise in “establishing pelvic balance and alignment.”

If you are expecting a baby or know someone who is, Dr. Oblander is well-trained in taking care of women during their pregnancies. Be sure to take good care of yourself and give our office a call if you experience back or hip pain during your pregnancy!

(Article shared from News USA)

I Trust Chiropractic Care

I Trust Chiropractic Care

Clinton Romesha

“When I first consulted a doctor of chiropractic for back pain, it was discovered that my pelvis was imbalanced – little surprise after many years of carrying military gear in all kinds of terrain. Aligning my hips and lower back, along with stretching and healthy living advice, made all the difference for me. Chiropractic is a natural alternative, and I am grateful for this car that has kept me away from having to mask my pain with addictive painkillers and their harmful side-effects. I encourage my brother and sister Veterans to consider chiropractic for healthier living.”   –  Clinton Romesha

 

In a 2013 ceremony, U.S.Army Staff sergeant Clinton Romesha received the Medal of Honor for acts of gallantry on 10/3/2009, during Operation Enduring Freedom in Afghanistan.

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Neck Pain Causes

Neck Pain Causes

By John H. Shim, MD, FACS

In order to effectively treat neck pain, it’s important to understand the underlying medical condition that’s causing the pain. This is especially true if the pain has lasted 4 or more weeks.

Cervical spine disorders.
Most Common Neck Pain Causes: Strains and Sprains

The most common causes of neck pain—strains and sprains—heal within a few days or weeks. A strain is when a muscle or tendon has been irritated by overuse or overextension. Similarly, a sprain is when a ligament has been irritated by overuse or overextension.

Common causes of neck strains and sprains include:

    • Sleeping in wrong position. Often referred to as a “crick” in the neck, a person might wake up in the morning with neck pain due to sleeping in an awkward or atypical position that overextended the neck.
    • Sports injury. A person could move the neck suddenly and/or in an unusual way in a new sport, or a player could have a collision or fall. A common sports collision injury is a stinger, which happens when nerves in the neck/shoulder are impacted and pain, numbness, and weakness can radiate down the shoulder, arm, and hand.
    • Poor posture. Whether it’s at work, home, and/or commuting, poor posture can lead to neck problems. If a person’s head is often tilted forward for long periods of time, then the neck’s muscles, tendons, and ligaments need to work harder. Poor posture can be problematic during any number of activities, including working at a computer, watching TV, riding the train, reading a book, gardening, and more. Text neck, for example, is an increasingly common problem that develops in anyone who spends hours looking down at the phone while texting.
    • Repetitive motions. Turning the head in a repetitive manner, such as side to side while dancing or swimming, may lead to overuse of the neck’s muscles, tendons, and ligaments.
    • Holding the head in unusual position. Anything that requires holding the head in an unusual way for long periods of time could cause neck strains and sprains. Some examples include having a long conversation while cradling a phone between the head and shoulder, or spending an afternoon looking up at an air show.
    • Whiplash. In a whiplash injury, the head and neck are forced suddenly backward and immediately forward with a great deal of force. The soft tissues along and near the cervical spine can be torn or ruptured as a result. This type of injury commonly occurs in an auto accident that involves a rear-end collision.

Causes of Chronic Neck Pain

Neck pain is considered chronic when it persists for more than 3 months. These conditions tend to stem from problems in the cervical spine either with a facet joint or disc. Common causes include:

  • Cervical degenerative disc disease.
    Everyone experiences wear and tear on the cervical spine over time. It’s natural for the discs to gradually lose hydration and the ability to cushion the spine’s vertebrae. If a disc degenerates enough, it can lead to painful irritation of a cervical nerve in various ways, such as a herniated disc, pinched nerve, or changes in the facet joints that can cause arthritis.
  • Cervical herniated disc A cervical disc is herniated when its jelly-like inner layer, the nucleus pulposus, leaks out through a tear in the disc’s protective outer layer. This could result from an injury or aging. A herniated disc may press against or pinch a cervical nerve, or the inflammatory proteins of the nucleus pulposus may come close enough to a nerve to cause irritation.
  • Cervical osteoarthritis
    When the cartilage in a cervical facet joint wears down enough, it can lead to cervical osteoarthritis, also known as cervical spondylosis. Rather than having the facet joints move smoothly along cartilage as intended, they might grind bone on bone. The joint could become enlarged from inflammation and bone spur growth, causing a nearby nerve to become pinched or pressed
  • Cervical spinal stenosis with myelopathy Spinal stenosis occurs when the spine’s degeneration leads to a narrowing of the spinal canal, such as from a herniated disc that pushes into the spinal canal or bone spurs that grow into the canal. When the spinal canal narrows enough to compress the spinal cord—a large bundle of nerves that runs inside the spinal canal—myelopathy can result. Myelopathy is when compression of the spinal cord starts causing symptoms, such as weakness or problems with coordination in the arms, hands, legs, or feet.
  • Cervical foraminal stenosis This condition occurs when the foramina—the holes in the vertebral construct through which nerve roots that branch off from the spinal cord can exit the spinal canal—become narrowed. This narrowing of the hole can cause irritation for the nerve root that runs through it. Foraminal stenosis is associated with radiating pains in a pattern specific to the nerve that is pinched by the narrowing. In some situations, there is a combination of the cervical stenosis causing myelopathy, as well as the specific nerve pattern associated with a cervical foramen being narrowed.

Other Causes of Neck Pain

While not the most common causes of acute or chronic neck pain, other causes of neck pain could include:

    • Emotional stress. Sometimes muscles in the neck can tighten up and ache in response to stress, anxiety, or depression.
    • Infection. If part of the cervical spine becomes infected, then inflammation could cause neck pain. One example would be meningitis.
    • Myofascial pain. This chronic condition has trigger points, which result from achy muscles and surrounding connective tissues, typically in the upper back or neck. Trigger points can be chronically painful or only painful to the touch. The pain might stay in one spot or it can be referred pain that spreads to/from another area in the body.
    • Fibromyalgia. Fibromyalgia is hard to diagnose, but it typically involves pain in the muscles, tendons, and ligaments in several areas of the body, including in the neck.
    • Spinal tumor. A tumor, such as from cancer, could develop in the cervical spine and press against a nerve. These types of tumors more commonly occur as cancer that has started in another part of the body metastasizes.
    • Spondylolisthesis. This condition occurs when one vertebra slips over the one below it. It can be due to a tiny fracture in the vertebra, or possibly from advanced disc degeneration, or ligament laxity.
    • Ankylosing spondylitis. This progressive arthritis of the spine and pelvis can cause widespread inflammation, pain and stiffness throughout the spine, including the neck.

Risk Factors for Developing Neck Pain

Some research indicates that getting unhealthy amounts of sleep, being inactive, and smoking can all raise the risk of developing neck pain.2 In addition, working longer hours or being in a labor-intensive occupation, such as the military, health care support, or installation and maintenance, may increase the risk for neck pain.3

References

  1. Croft PR, Lewis M, Papageorgiou AC, et al. Risk factors for neck pain: a longitudinal study in the general population. Pain. 2001; 93(3):317-25.
  2. Yang, Haiou PhD; Haldeman, Scott DC, MD, PhD; Nakata, Akinori PhD; Choi, BongKyoo ScD, MPH; Delp, Linda PhD, MPH; Baker, Dean MD, MPH. Work-related risk factors for neck pain in the US working population. Spine. 2015. 40(3):184-192.
Can You Really “Bank” Sleep?

Can You Really “Bank” Sleep?

striped-cat-sleeping-on-chair

Banking sleep to save energy for later? To most people, this idea probably sounds too good to be true. At the very least, it probably seems to defy common sense and or runs counter to the way we think our bodies work. However, it actually turns out that banking sleep is possible—within limits.

A great deal of research has been conducted on this subject.  In one particular study, American scientists invited a number of volunteers to adjust their sleep patterns so that researchers could observe the effects. For a week, half of the volunteers were permitted to sleep more than usual, and the remaining volunteers were made to sleep according to their usual pattern.

“After this week of either extended or habitual sleep per night, all the volunteers came to the lab and they were given three hours of sleep, per night, for a week,” says Tracy Rupp of the Walter Reed Army Institute of Research. The volunteers were then assigned tasks of varying difficulty, and those who had banked their sleep were more unaffected throughout the sleep restriction.

Rupp elaborates: “They showed less performance deterioration with regards to reaction time and alertness than the group that had been given the habitual prior sleep.”

The study also revealed that a week after the experiment, the banked sleepers were recuperating faster from deficiency of sleep than the others were. Rupp again: “What we’re basically saying is if you fill up your reserves and pay back your sleep debt ahead of time, you’re better equipped to deal with the sleep loss challenge.”

While these results may sound great, there are limits to what banking sleep can do for you. “It’s a strategy that’s only partially successful,” explains Michael J. Breus, Ph.D., in the November 2013 issue of Psychology Today. “New research indicates that although some of the negative effects of a week of insufficient sleep can be remedied with extra sleep on the weekend, others cannot. Researchers at Penn State University College of Medicine studied the effects of weekend recovery sleep after a week of mild sleep deprivation. They found that make-up sleep on the weekends erased only some of the deficits associated with not sleeping enough the previous week.”

Banking sleep isn’t limited to sleeping longer nights. Naps can be extremely effective as well—within limits, of course. According to Science Focus, “A 1991 study at Wright State University in Dayton, Ohio found that after an ordinary night’s sleep, subjects could take an extra nap in the afternoon and then work through the night with greater alertness that a control group who didn’t nap. The study also found that performance is proportional to the length of the nap—but the effect doesn’t last.

After a second consecutive night without sleep, all of the subjects performed equally badly, regardless of how much sleep they had initially. It may be that all of us are normally slightly sleep-deprived and one really good night’s sleep will bring us back up to 100%, but that the ‘tank’ isn’t big enough to buffer us against more than one all-nighter.”

The practical uses of banking sleep go beyond needing to pull an all-nighter before finals or a big presentation at work. Dr. Winter, a member of the American Academy of Sleep Medicine, puts it thusly: “If you knew you were going to give birth on a particular day, for example, you could sleep for 10 hours a day for multiple days before the event, and be fine.”

Lastly, it is important to consider the host of negative effects of sleep deprivation. Memory loss, obesity, and even early death comprise some of these consequences. The moral of the story here is that banking sleep in advance may actually be a reasonable short-term strategy for coping with an isolated event (like giving birth). However, the best long-term strategy for staying healthy and performing well is to get a good night’s sleep as consistently as possible.

 

The Positive Effects of Chiropractic Care!

The Positive Effects of Chiropractic Care!

We know that our patients who get adjusted regularly see the wonderful side effects! Their backs are not the only beneficiary of their adjustments! Here is a study that confirms that keeping the spine adjusted has more positive effects than just your back or neck feeling better!:

A retrospective study conducted in Sweden [1] has determined that about one in four chiropractic patients experiences some form of “positive nonmusculoskeletal side effect” after spinal manipulative therapy (SMT).

In addition, the percentage of patients who experience positive side effects increases with the number of spinal regions adjusted. The Swedish researchers asked all members of the Swedish Chiropractors Association (SCA) to participate in the study. Eighty-one percent of the SCA membership complied. Each doctor of chiropractic gathered data from 20 patients over a three-week period for a total of 1,504 valid patient questionnaires. Patients were included if they had been previously adjusted within the last two weeks for musculoskeletal complaints. The patients were asked if after their previous visit they ìexperienced any positive changes that do not seem to have anything to do with your back problem?

At least one positive side effect or reaction was reported by 23 percent of the respondents. The more spinal areas that were adjusted, the better their chances of experiencing at least one positive reaction:

The positive, nonmusculoskeletal reactions appear to cluster into a number of system/organ-related classifications. Of those patients who experienced them, here is the breakdown by percentage:

 

  • Respiratory System: 26%

  • Digestive System: 25%

  • Circulatory System/Heart: 14%

 

  • Eyes/Vision: 14%

The benefits experienced can also be broken down into subcategories:

 

  • Easier to Breathe: 21%

  • Improved Digestive Function: 20%

  • Clearer/Better/Sharper Vision: 11%

  • Better Circulation: 7%

  • Changes in Heart Rhythm/Blood Pressure: 5%

 

  • Less Ringing in the Ears/Improved Hearing: 4%


The authors, as is typical in research papers, are careful to point out the limitations of extrapolating the findings. They note that the study does not demonstrate whether the statistical link between treatment and reaction is causal. They assert that ìthe absence of an untreated control group makes it impossible to say whether these reactions are treatment-specific, or if they simply represent normal fluctuations of common symptoms of physiologic function. While these results are very exciting, it is clear that additional research is needed.

Reference:

The Types of Improved Nonmusculoskeletal Symptoms Reported After Chiropractic Spinal Manipulative Therapy
J Manipulative Physiol Ther 1999 (Nov);   22 (9):   559–564

The Abstract

OBJECTIVE:   To investigate the frequency and types of improved nonmusculoskeletal symptoms reported after chiropractic spinal manipulative therapy.

DESIGN:   Retrospective information obtained by chiropractors through standardized interview of patients on return visit within 2 weeks of previous treatment.

SETTING:   The private practice of 87 Swedish chiropractors (response rate 81%).

SUBJECTS:   Twenty consecutive (presumably naive) patients per chiropractor (1504 valid questionnaires returned, 86% of optimal number of replies).

INTERVENTION:   Spinal manipulation with or without additional therapy provided by chiropractors.

MAIN OUTCOME MEASURES:   Self-reported improved nonmusculoskeletal symptoms (reactions).

RESULTS:   At least I reaction was reported after the previous treatment in 21% to 25% of cases. Of these responses, 26% were related to the airway passages (usually reported as “easier to breathe”), 25% were related to the digestive system (mostly reported as “improved function”), 14% were classified under eyes/vision (usually reported as “improved vision”), and 14% under heart/ circulation (about half of these reported as “improved circulation”). The number of spinal areas treated was positively associated with the number of reactions.

CONCLUSION:   A minority of chiropractic patients report having positive nonmusculoskeletal reactions after spinal manipulative therapy but such reports cluster predominantly around specific symptoms. It would be interesting to find out if these can be verified objectively and, if so, to investigate if they are caused by the treatment or if they are signs of natural variations in human physiology.

 

Fear or Phobia: What’s the Difference?

Fear or Phobia: What’s the Difference?

frightened-woman

It’s normal to have fears. Fear is a useful emotion that keeps us from doing things that may be harmful or dangerous. Our species continues to exist today because our earlier ancestors had a healthy fear of certain types of predators, environments and situations. In the modern world, many of those primal fears have become much less relevant. Nevertheless, quite a few of us still have a lingering apprehension of spiders, snakes, darkness, heights or other things that we perceive to be dangerous. For most people, this instinctive fear is just quirky or uncomfortable—something we can usually avoid or overcome without too much effort. But what if this apprehension becomes all-encompassing and interferes with daily life? When this happens, you may be dealing with a phobia.

Psychologists define a fear as being “an emotional response to a real or perceived threat,” whereas, according to the Oxford English Dictionary, a phobia is “an extreme or irrational fear of or aversion to something.” Note the words extreme and irrational. A phobia keeps you from living your life as you normally would if the feared situation were not present. For example, you may become nervous or agitated in small or confined spaces and generally avoid taking the elevator. But if that fear is severe enough that it keeps you from taking your dream job because you’d need to use an elevator every day to get to your office, then you likely have a phobia (“claustrophobia”).

Symptoms of a phobia can be both mental and physical. In some cases, just thinking about the thing you fear can bring on the fight-or-flight response. Phobia symptoms often include general anxiety, trembling and feelings of nausea. Your heart may begin pounding and you may start sweating, feeling lightheaded, and breathing so quickly that you begin to hyperventilate. You may also feel an intense need to escape, feel like you are going to die, or fear losing control. Even though you may understand that your phobia is irrational, you still have no ability to stop it.

Not all phobias interfere with the everyday lives of people who have them. A phobia of snakes (called “ophidiophobia”), for example, probably won’t matter much to a city dweller unless he or she visits the reptile house at the zoo. However, a phobia of crowds (“enochlophobia,” “demophobia” or “ochlophobia”) could be a big problem on city streets or in the subway.  Other phobias can have a significant impact on anyone who has them. For about 3% of the population, their fear of doctors (“iatrophobia”) is so great that they avoid any form of healthcare whatsoever, including preventive care. Obviously, this can put their health and even their lives at risk.

If a phobia is affecting your day-to-day activities, then it may be time to seek professional help. Therapy for phobias has been shown to be remarkably effective, and you may also be able to use some self-help strategies on your own to combat the problem.

One of the best ways to begin conquering a phobia is to expose yourself to the thing you fear in a gradual, controlled manner. For example, if you have a phobia of spiders (“arachnophobia”), first look at a few pictures of spiders. Then watch a short video featuring spiders. When you are comfortable with that, perhaps visit a zoo and look at them through the glass. Relaxation techniques such as slow, deep breathing and meditation can help when you are confronting your fears. The more frequently you are exposed to the thing you fear without actually being harmed, the more quickly your phobia is likely to disappear. This doesn’t necessarily mean that you are going to become a fan of spiders, but at least you will have conquered the irrational part of your fear that gets in the way of you living your life.

 

What Is Immunotherapy and How Can It Help with Food Allergies?

What Is Immunotherapy and How Can It Help with Food Allergies?

young-parents-feeding-child

Food allergies affect over 15 million Americans, including 1 in every 13 children under the age of 18. The symptoms of these allergic reactions can range from minor (e.g., itching, swelling of the lips, intestinal cramps, diarrhea, and vomiting) to major or even life-threatening (e.g., development of hives and rashes, tightening of the throat to the point of being unable to breathe, significant drops in blood pressure).

Having such an allergy—or being the parent of a child with such an allergy—can impose unwelcome lifestyle limitations and cause a great deal of anxiety. At present, there is no known cure for serious food allergies that works for everyone. This means that the best approach for the time being is to completely avoid the food product to which you or your child has an allergic reaction. However, this is not always practical or possible to do. That’s why the majority of “treatments” currently available focus on managing the symptoms after an attack has taken place. For instance, individuals with serious food allergies may carry an auto-injector filled with epinephrine (adrenaline) with them at all times, just in case.

Naturally, because of the seriousness and the prevalence of food allergies, a great deal of research is being conducted on treatments to desensitize individuals to the foods they are allergic to. This may effectively “cure” the allergy for some sufferers. One of the fields that shows promise is the study of immunotherapy (more precisely, low-dose immunotherapy), in which extremely small amounts of the allergen are administered to allergy sufferers over time. The basic idea behind the experimental treatment is that the body will develop a tolerance to these low doses and that the allergic reaction will gradually cease.

The first work in immunotherapy was undertaken in the 1960s in England by Dr. S. Popper, who was trying to cure allergic reactions to pollen by injecting patients with low doses of the allergen in combination with the enzyme beta-glucuronidase in an approach called “enzyme potentiated desensitization” (EPD). While the then-experimental treatment showed early success, its use in the U.S. was suspended by the FDA for administrative reasons in 2001. However, follow-up work continued and an enhanced American version of the EPD injection called Low Dose Allergens (LDA) was later introduced.

The obvious drawback of this type of therapy is that the doses have to be injected by a physician. It is also necessary for patients to avoid outside exposure to larger doses of the allergens and to many medications while the treatment is underway. However, other researchers have continued to study desensitization via immunotherapy with the goal of finding other mechanisms of administering the low-dose allergens, such as oral medications, sublingual (under the tongue) medications, and others.

Some of the most promising work in this field is being performed at Stanford University School of Medicine by Kari Nadeau, Associate Professor of Allergies and Immunology. Nadeau is working with children afflicted with peanut allergies. Her approach is to give them minute doses of the peanut allergen and gradually escalate the doses over a period of months in the hope of them eventually developing immunity. Up to this point, Nadeau’s technique has produced positive results for many patients, but it does appear to have limitations. First, the therapy doesn’t seem to offer a permanent “cure”. Patients must continue to take low doses of the peanut allergens or risk losing their immunity. If they stop for more than a few days, the allergies can come back. Second, the treatment itself is time-consuming and often expensive.

While the jury is still out on immunotherapy, the concept shows promise. However, progressing from concept to proven treatment is clearly going to take much more work. As it stands today, some immunotherapy approaches work for some patients but don’t work for others. Plus, there are questions about how long immunity actually lasts and whether it must be maintained or periodically boosted. This is clearly a very important consideration since patients could run the risk of unknowingly losing immunity and coming into contact with the allergen, allowing it to trigger an unexpected—and potentially serious—attack.

So if you suffer from food allergies and are looking for a way to diminish them, the best advice we can offer at this time is to continue following the research and to consult with your own healthcare providers about the potential benefits and risks in your own case. If you do decide to pursue immunotherapy, be sure that it is being administered and overseen by well-trained medical professionals who can monitor progress and watch for side effects.