Osteoarthritis, the most common type of arthritis, is often considered to be a normal part of aging. Usually by the age of forty our joints, especially those which are weight bearing (lower spine, hips, knees, ankles, feet) begin to show signs of wear and tear. The cartilage begins to thin, joint surfaces are not as smooth, and fluid which lubricates the joint becomes diluted, dehydrated and less protective. Consequently, these aging joints become stiff, sore, weak, and sometimes swollen.
Most people with osteoarthritis report additional pain and stiffness in the winter and early spring due to cold, damp weather and NEPA has plenty of it! The cold, for example, restricts the flow of blood to the joints, leading to more pain and stiffness. While moving to a warmer and less humid climate is one solution, it is not practical for most. But all is not lost because there are other alternatives to protect and keep your joints healthier this winter and early spring.
A paraffin bath is one of the best methods to apply heat to your hands and feet to ease pain and stiffness associated with osteoarthritis. A special heating unit works like a crock pot to melt the wax to liquid form. The hands and/or feet are dipped into the wax several times to create a warm coating around the entire area. A 20 to 30 minute treatment while watching TV or listening to good music will provide pain relief, improve mobility in the joints and bring life back to winter damaged skin. $39.99 to $159.99 (www.bedbathandbeyond.com).
Hot packs, electric and microwavable, offer heat to bring blood flow and lessen joint pain and stiffness. They are great for neck and lower back pain, depending on the shape of the pad. Consider rectangle for lower back and cylinder/round to wrap around neck and joints of arms and legs. SourceMed.com offers an electric pad which creates moist heat for $59.95 and a microwave “bed buddy” (herbal or nonherbal) can be found for $9.99 to $43.95 at TheWarmingStore.
Hand and toe warmers are small packets placed in the gloves or boots of skiers, campers and hikers to keep the hands and feet warm. These throw away warmers can also be used by anyone with cold hands or feet whether you are shoveling snow, attending an outdoor event in the cold or sitting in a cold, drafty room watching TV. (Walmart, Dick’s, www.amazon.com)
Supportive sleeves for the joints can provide protection and warmth year round, but especially during the cold winter and early spring. Those made with neoprene material offer warmth and compression and can be valuable when participating in activities such as skiing, walking, running, basketball name a few. Additionally, it can be helpful for those having joint pain with daily activities such as grocery shopping or house work. These devices should not be used when sitting for prolonged periods of time or sleeping. There is no scientific evidence that supports the use of cooper or magnets weaved into the sleeves for additional pain relief. (available at most pharmacies and medical equipment stores)
Similar to neoprene sleeves, compression shorts, pants and shirts can be invaluable to those participating in outdoor activities in cold temps. UnderArmor, Reebok, Nike, and others make these products which can also be worn indoors for those working in cool, drafty environments.
It seems obvious how and why hot water and massaging water jets can soothe the sore joints and muscles. To ensure additional pain and stress relief, add a candle, soft music and a cocktail!
If you suffer from osteoarthritis to the joints of your lower body, you would be well-advised to limit impact activities such as running and basketball. Instead, walk, swim, use the elliptical and bike to protect your joints.
As above, if you have arthritis in the joints of the upper body, use low weights, avoid push-ups and dips, which transfer your body weight through the arms.
As many of you know, I love outdoor activities year round. However, with age I have become a little more sensitive to the cold…which can be a problem when you are skiing, skating, snowshoeing, or hiking. Fortunately, technology has made it possible to be “warm in the cold!” I love my heated vest because it not only keeps me warm, but I require less layers and less bulk to be toasty. These products come with a rechargeable battery. Heated gloves are also available. Vests and jackets range in price from $60.00 to $200.00 but you don’t have to by the most expensive to get a good result. Visit www.ororowwear.com; www.ihoodwarm.com; www.amazon.com
These over-the-counter, non prescription drugs include aspirin and ibuprofen (Advil, Motrin) which are very effective in the treatment of the pain and inflammation associated with arthritis. A topical NSAID, Voltaren, is also available over-the-counter. However, like all drugs, they are not without their risks so one must consult with their primary care physician and pharmacist before using them. For example, NSAIDs can thin the blood, irritate the stomach and may interact with other medications.
Topical analgesics or pain relievers can be rubbed into or sprayed on the skin over the affected area. Some products are counterirritants using menthol, methylsalicylate and camphor which provide a sensation on the skin other than pain. Salicylate based products can work like aspirin to provide relieve from mild pain and inflammation. Capsaicin based products can also provide temporary relief due to the counter stimulation of warmth and tingling. A few things to keep in mind when using these products: one, discuss it with your physician or pharmacist. Two, topical agents are more effective in superficial joints such as the fingers, toes, wrist, elbow, knee and shoulder than in the deep tissues of the hip, buttocks, or lower back. Three, wash your skin thoroughly ater using these products and before using heat, cold or electric stimulation.
The therapeutic benefits of massage are well documented. However, like most treatments, it is important to find a qualified professional that meets your needs. Licensed physical therapists, physical therapist assistants and massage therapists are the best choice. Benefits include; relief from pain, headaches, muscle spasm, and stress, improved relaxation, posture, and breathing.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit our Health and Exercise Forum
New Year’s Resolutions are very predictable. While most are health oriented, I purport that a healthy mind, body and spirit requires a healthy lifestyle. Interestingly, the ten most popular resolutions listed below, all have an impact on a healthy life.
Polls repeatedly show that one of the most consistent resolutions for the New Year is to make more time to spend with family and friends. Moreover, research shows that the comfort and camaraderie of these people whom we love is important to our health and well-being.
The benefits of regular exercise is no longer anecdotal, it is factual. Daily exercise, even in small doses, has been associated with more health benefits than anything else known to man. Studies clearly demonstrate that it reduces cholesterol and coronary artery disease and the risk of some cancers. Also, it increases longevity, helps achieve and maintain weight loss, enhances mood, lowers blood pressure, and even improves arthritis. In short, exercise keeps you healthy and makes you look and feel better. If done properly, there is no down side. So, make this year the year to do it!
Recent studies report that more than 66 percent of adult Americans are considered overweight or obese. As a result, weight loss is one of the most popular New Year's resolutions. However, adhering to a weight loss program is not easy. It requires many things, including, setting reasonable goals and staying focused. Often, professional help is required. While this may be one of the most difficult goals to attain, the ultimate reward and value is well worth the effort.
Second only to losing weight, this resolution, while extremely difficult, is another life-saving goal that must be attempted. Studies report that smokers try and fail four times on average before they are successful. SO, KEEP TRYING! Get help. Talk to your physician about using over-the-counter or prescription nicotine replacement therapy and proven quit-smoking aids. Consider smoking cessation classes, support groups and hotlines in addition to the meds. This is one goal that is worth the effort.
Due in great part to our hectic and stressful work and family demands, the United States is home to millions of people requiring the use of mood elevators and antidepressants. As a result, it is important to learn what really makes you happy in order to FIND YOUR SMILE. It requires the balance of a healthy mind, body and spirit. It might be a walk in the snow, taking dance classes or a trip to the spa. One hint, it is often something simple and inexpensive.
This is one tip for a healthier New Year that I expect to receive plenty of flack about! But, I would be remise if I did not mention this potentially harmful habit. While many people use the New Year as an incentive to finally stop drinking, most are unable to adhere to such a rigid goal. Studies show that moderate drinking can offer many health benefits such as lowering cholesterol and coronary artery disease but that is defined as one or two 8 ounce drinks per day and red wine is preferred. However, many heavy drinkers would do well to taper off to a moderate level. For those with a problem and have decided that you want to stop drinking, there is a world of help and support available such as Alcoholics Anonymous. There are also a number of treatment-based programs, as well as support groups for families of alcoholics.
This is one tip that few consider being health related. However, serious stress from financial problems affects millions of Americans every day. This cumulative stress can be very harmful to your health and can be lessened by initiating a plan. Get professional help and learn how to downsize and reevaluate your real needs…less toys with less stress for a longer life!
There may be no one thing more important to gaining a new perspective on life that to have learned something new. It could be as drastic as returning to school to prepare for a career change or as simple as learning to play bridge. Have you vowed to make this year the year to learn something new? Take a course at local college or read a new book. Visit the Everhart Museum or take the free tour of the Scranton Cultural Center. It will enrich your life and make you a more interesting person. Most local colleges and universities offer distance and adult education programs.
Service to others is service to you! There may not be anything more gratifying than providing a service to others in need. Volunteerism makes you a better and healthier person. It fits into any schedule. Donate clothes, time or resources. Locally, we have many charitable causes in need of help: Be a “Friend of the Poor,” or serve lunch at St. Frances Soup Kitchen.
The goal of organization, like the goal of financial order, has similar health implications because it eliminates tremendous stress. There are many books and websites that offer suggestions on how to organize just about anything in your life. For this reason, I love my iPhone – there’s an App for that!
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
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Happy Holidays! It is at this time of year that we celebrate life with great hope and faith. People of many faiths take time to reflect, respect, and resolve. Christians celebrate Christmas, the miraculous birth of Christ, the Son of God, and the Messiah. Jews celebrate Chanukah, the miraculous festival of lights, when one night’s oil provided enough light and safety for 8 nights. Both major faiths promote healthy lifestyles for the mind, body and spirit. These faiths are grounded in hope, faith, love and peace. It is no surprise that studies repeatedly demonstrate that people of faith outlive those without!
With this in mind, I purport, that to be truly healthy, one must have faith because complete health is multidimensional. Socrates preached this message to his students thousands of years before Christ. One must have a healthy mind, which requires intellectual stimulation with attainable goals related to education and intellect. One must have a healthy body by eating well, engaging in physical activity and have attainable goals related to his/her body. Likewise, one must have a healthy spirit with faith, hope, prayer and meditation, comrades and counsel, and set attainable spiritual goals.
How being religious or spiritual has been shown to benefit your mind, body and spirit…
High blood pressure (hypertension) can lead to heart disease and stroke, which are the leading causes of death in the United States, according to the Centers of Disease Control (CDC). It affects 1 in every 3 adults and only half of these people have their blood pressure under control. Well, religion and spiritually may help …
The health benefits of religion or spirituality are well documented. One study conducted at Duke University Medical Center on 4,000 subjects, older adults who described themselves as religiously active were 40% less likely to have high blood pressure when compared to those less active. Moreover, they were surprised to find that those who described themselves as spiritual rather than religious also were less likely to develop high blood pressure.
Research also indicates that religious people are more satisfied with their lives than those without faith. A sociology study determined that high satisfaction among church goers may be due to the strong social bonds that are developed within a religious congregation. Regular church attendees see the same people weekly and often more often, when participating in rewarding and gratifying church-related volunteer work.
In an impressive study published in the Journal of the American Medical Association, researchers interviewed 345 late-stage cancer patients to assess their spirituality as it related to their illness. 88% stated that they were religious as it related to their coping mechanisms. It was determined that those using religion for coping demonstrated a 7.4% rate of resuscitation as compared to 1.8% for those not using religion as a coping mechanism.
According to a Duke University study of 1,718 older adult participants, those described as “highly spiritual” were 50% less likely to have high levels of anti-inflammatory proteins that weaken the immune system and have been linked to some cancers, viral infections and autoimmune diseases. The outcome was similar for those who attend religious services at least once a week.
Those who attend religious services more than once per week are found to live and additional 7 years when compared to those who never attend services. Again, researchers feel that the social benefits of a belonging to a strong religious community may be a large part of the associated longevity. Additionally, the lifestyle of religious people is often healthier: members of these communities rarely engage in risky and unhealthy behaviors such as smoking, excessive drinking, indiscriminate, unprotected sex, etc.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles, visit our "Health Care Forum"
We all know someone who has been affected by a stroke. It can be a devastating and life-changing event. According to the National Stroke Association, (NSA) it is the 5th leading cause of death and number one cause of disability in the United States. Nearly 800,000 people in the USA have a stroke every year. Every 40 seconds someone has a stroke and every 4 minutes someone dies of a stroke in the USA. 897% of all strokes are ischemic from a clot or mass blocking a blood vessel in the brain.
According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. THE GOOD NEWS: According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. Improved smoking cessation, management of high blood pressure and cholesterol are believed to be significant contributing factors. THE BAD NEWS: Progress has slowed in recent years! THE MESSAGE: Continued vigilance and lifestyle changes are essential!
While the signs and symptoms vary, most people experiencing a stroke have several if not all of these symptoms in various parts of the body.
F – Face Drooping – ask for a smile to see if one side droops
A – Arm weakness or numbness
S – Speech – can the person repeat a simple sentence? Do they slur?
T – Time = Brain Damage! Time to Call 911
If the above signs or symptoms have been identified than there is a medical emergency - Immediately Call 911
Strokes can happen at any age, even to babies in the womb. Still, the odds of a stroke climb quickly after middle age.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
When a patient comes to our physical therapy clinic with lower back pain it is standard protocol to take a thorough history and complete a neurological exam. This is especially important if the patient has leg pain, tingling or numbness in one or both legs referred from their lower back. During the history, the patient will often report an increase in symptoms in their legs at night in bed. They report pain, tingling, a need to constantly move their legs. While some of these symptoms are associated with lower back pain and “sciatica” others, such as the urge to constantly move the legs, is not. This may be a symptom associated with another problem such as restless legs syndrome or RLS.
Recently, more information has become available on restless legs syndrome (RLS). According to the RLS Foundation, RLS is a neurological condition suffered by approximately 10% of the population in the United States. It is considered a central nervous system disorder. There are many manifestations of this disease. Some people suffer only mild symptoms creating urges to move their legs in bed at night. Others suffer severe symptoms of uncontrollable urges to move their legs sitting or lying. The problem may lead to insomnia, disrupted sleep, distress and fatigue.
Genetic among first-degree relatives: This type develops earlier in life and the symptoms are more severe. There is also an iron deficiency associated with genetic RLS.
Non-inherited or idiopathic. This type is more associated with aging. There are several criteria to diagnose RLS. Also, there are medications and other treatment options available for RLS. Exercise, including stretching, walking and weight-training can be very effective.
Read Dr. Mackarey’s Health & Exercise Forum – every Monday
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's articles visit MackareyPhysicalTherapy.com
The “first Thanksgiving” was in 1621 between the Pilgrims of Plymouth Colony and the Wampanoag tribe in present day Massachusetts to celebrate the harvest and other blessings of the previous year. In 1789, President George Washington, at the request of Congress, proclaimed Thursday, November 26, as a day of national thanksgiving. In 1863, Abraham Lincoln proclaimed the national holiday of Thanksgiving to be the last Thursday of November.
Americans and Canadians continue to celebrate this holiday as a time for family and friends to gather, feast, and reflect upon their many blessings. Like most, I am very grateful for the simple things; family, good friends, food, shelter, and health. This year, I am also thankful for the dedicated scientists who developed the COVID 19 vaccination so we can safely enjoy Thanksgiving with our families. It turns out that being grateful is, not only reflective and cleansing; it is also good for your health!
Grateful people are more likely to behave in a prosocial manner, even when it is not reciprocated. A study by the University of Kentucky found those ranking higher on gratitude scales were less likely to retaliate against others, even when others were less kind. Emmons and McCullough conducted one of the most detailed studies on thankfulness. They monitored the happiness of a group of people after they performed the following exercise:
There are many things in our lives, both large and small, that we might be grateful about. Think back over the past week and write down on the lines below up to five things in your life that you are grateful or thankful for.” The study showed that people who are encouraged to think of things they’re grateful for are approximately 10% happier than those who are not.
Conclusion: Amy Morin, psychotherapist, mental health trainer and bestselling author offers this advice: “Developing an “attitude of gratitude” is one of the simplest ways to improve your satisfaction with life. We all have the ability and opportunity to cultivate gratitude. Simply take a few moments to focus on all that you have, rather than complain about all the things you think you deserve.” So…be grateful and have a happy Thanksgiving!
Source: NIH, Forbes, Amy Morin “13 Things Mentally Strong People Don’t Do.”
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
For all of Dr. Mackarey's
November is National Chronic Obstructive Pulmonary Disease (COPD) month. COPD is the fourth leading cause of death in the United States, according to the Centers for Disease Control and Prevention. This problem refers to a group of lung diseases that causes damage to the airways and air sacs in the lungs. People with COPD suffer from diminished airflow and difficulty breathing. Emphysema and chronic bronchitis are two of the most common types of COPD. The damage can't be reversed, so treatment includes medications and lifestyle changes designed to control symptoms and minimize further damage, according to the Mayo Clinic.
Exercise is an important part of life for those with COPD because it improves the overall strength and endurance of respiratory muscles. When you exercise, muscles adapt and use oxygen more efficiently so your lungs don't have to work so hard. Also, in addition to improvement in breathing, exercise boosts mental health, helps maintain a healthy weight and blood pressure, and improves circulation. Most importantly, exercise will improve your quality of life with COPD. Before you begin an exercise program, see your family physician or pulmonologist for approval. Then, see a physical therapist to design a program specific to you needs. Always begin slowly and rest if you get short of breath, have chest pain, feel dizzy or sick to your stomach.
While not all of these endurance exercises may be appropriate for you, one or two of these may offer a good starting point.
Walk Around the House – Start walking around the house for 1-2 minutes nonstop. Every 1-2 hours. Then, add 1-2 minutes every week.
Static Marching – hold onto the countertop or back of chair and march in place for 30 seconds. Rest 1-2 minutes and repeat. Do 5 cycles. Add 5-10 seconds every week.
Climb the Steps – If you can do so safely, use the steps for exercise 1-2 times per day. Then, add 1-2 times per day.
Walk the Mall/Treadmill – If you are able to get out of the house and can tolerate more extensive endurance exercises, get out and walk the malls or use a treadmill.
Recumbent Bike – If balance is a problem, but you can tolerate more extensive. Endurance exercise, use a recumbent bike (a bike with a backrest)
Walking is free exercise and can be done in some form by almost everyone…even with an assistive device such as a cane or walker. For those with COPD who are active and fit – walk 4-5 days per week for 30 to 45 minutes. Less fit individuals can walk for 15 to 20 minutes. For those with COPD who are in poor condition and have significant SOB – walk for 2-3 minutes (to the bathroom or around the house) every 30 to 45 minutes. Try not to sit for 60 minutes without getting up and walking around.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck. More erect posture promotes better breathing. Perform 5 repetitions each 3 -5 times per day
Row-The-Boat - Pinch shoulder blades together as if you are rowing a boat.
I-Don’t-Know – Shrug shoulders up toward the ears as you do when you say “I don’t know.”
Chin Tucks – Bring your head back over your shoulders and tuck your chin in
Bicep Curls – sit in chair and bend your elbows up and down with a can of peas in your hands
Wrist Curls – as above but bend your wrists up and down
Chair Push-ups – Push up with your arms to get out of a chair
Saw Wood – pull a light resistance band (yellow) back from a door knob as if you were sawing wood.
Hip Hikes – Sit in chair and march by hiking your hip and lifting up your heel 4-6 inches off the floor
Leg Kicks – Sit in chair and kick your knee out straight – then bend it down to the floor
Hips Out and In – Sit in chair and bring your knees in and out against a resistance band
Toe Raise/Heel Raise – Sit in chair and raise your toes up – then raise your heels up
Diaphragmatic Breathing - The diaphragm muscle is essential for breathing. While sitting or lying down, put one hand on your abdomen and the other on your chest. Slowly inhale through your nose and try to separate the hand your stomach from the hand on your chest. Then, slowly exhale through pursed lips.
Pursed Lipped Breathing - breathe in through your nose slowly for 3- 5 seconds. Then, purse your lips as though you're going to whistle. Lastly, exhale slowing through the pursed lips over 5 to 10 seconds.
“Better Breathers Club,” in conjunction with the American Lung Association, offers a free local support group to help patients and their families suffering from COPD and chronic lung disease. For more information contact the American Lung Association at www.lung.org
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
World COPD Day 2022 is Wednesday November 16th! The purpose of this two part series on lung disease is to raise the level of awareness for the prevention and treatment of this disease.
Chronic obstructive pulmonary disease (COPD) has become the fourth leading cause of death and is one of the only major chronic diseases which has seen an increase in mortality rates. COPD includes emphysema, chronic bronchitis and asthma.
Patients with COPD suffer from progressive shortness of breath, cough, wheeze, and sputum production. Most patients with emphysema have been cigarette smokers.
Patients with emphysema develop obstruction to airflow as a result of narrowing of bronchial tubes due to excess mucous, smooth muscle constriction, and destruction of lung tissue. Eventually, the lungs become over distended, which leads to overexpansion of the chest itself. This process leads to the so-called ''barrel chest'' appearance of patients with advanced COPD.
The most common symptom of COPD is shortness of breath. Initially the patient complains of shortness of breath only with exertion, but symptoms progress over time to include difficulty breathing, even at rest. Eventually the disease worsens to the point that oxygen is required and the patient may become severely disabled.
Treatment of COPD starts with smoking cessation, and, when symptomatic, patients are started on inhaled bronchodilator medications. Some of these medications include albuterol, ipratropium, titotropium, and inhaled steroids. Long-acting bronchodilators such as formoterol or salmeterol and theophylline medications may be added. Oxygen is added when the patient's own oxygen level falls to a certain point. In fact, oxygen is the only therapy that has been shown to prolong the life of patients with COPD.
Over time, patients with COPD decrease their level of activity due to the sensation of shortness of breath. This downhill slide eventually leads to a very sedentary existence. Recent studies have shown that COPD not only affects the lungs, but is a condition which affects the diaphragm and the peripheral muscles. Patients with COPD have been shown to have abnormal limb muscles as a result of deconditioning and systemic inflammation.
Pulmonary rehabilitation has been shown in numerous studies to decrease the shortness of breath associated with COPD. Exercises to strengthen the arms are helpful to assist patients in performing activities of daily living such as combing hair, cooking, and reaching objects above their heads. Walking and riding a stationary bike are helpful to exercise the leg muscles, especially the large thigh muscles. Despite the fact that exercise programs may not improve lung function, the patients overall level of function are almost always improved.
Patients who participate in rehab programs have less shortness of breath, are less likely to be hospitalized, and have improved functional capacity. These patients have lower rates of healthcare utilization, and improved overall health status and quality of life scores. The ideal pulmonary rehabilitation program includes smoking cessation training, breathing and relaxation exercises, nutritional information, and training in proper use of medications. The most important feature of a pulmonary rehab program, however, is aerobic exercise involving the arms and legs.
Pulmonary rehabilitation is an integral part of the treatment of a patient with
COPD, and should be considered in any patient who can tolerate exercise. A cardiac stress test should be done to ensure that there are no occult coronary artery blockages or cardiac rhythm abnormalities.
In summary, COPD is a growing cause of disability, morbidity, and mortality. Medications, oxygen, and pulmonary rehabilitation can help to improve symptoms and quality of life. The combination of bronchodilator medications with pulmonary rehabilitation is the most effective approach when treating patients with COPD. Next week, in Lung Disease - Part II, learn more about pulmonary rehab for patients with COPD to improve their functional status.
Guest Columnist: Dr. Gregory Cali, DO – is a pulmonologist (lung doctor) in Dunmore, PA.
Visit your doctor regularly and listen to your body.
Keep moving, eat healthy foods, and exercise regularly
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” COPD Part II – Exercise with COPD.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.
See all of Dr. Mackarey's articles at www.mackareyphysicaltherapy.com/forum
According to the World Health Organization about half of the world’s adult population has had a headache at least once in the past year. Prolonged use of electronic devices has greatly contributed to this problem. For many people, these headaches are infrequent and do not often affect daily life. But what about when your headache occurs frequently or is so severe it prevents you from going about your day to day activities? Some types of headaches are more easily treated and managed than others.
There are two types of headaches: primary and secondary. Primary headaches occur without an underlying disease and include migraines and tension-type headaches. Secondary headaches can be associated with serious disease, requiring emergency care, or can be referred from other structures of the body such as the cervical spine (neck).
Headaches symptoms that may constitute a medical emergency are: vomiting, seizures, fever, muscle pain, night sweat, weight loss, and neurologic symptoms such as blurred vision. If you are experiencing any of these symptoms, if your headache worsens, or your symptoms change it is recommended that you seek medical attention. Any headache that is unusual for you and does not resolve itself in a reasonable time should be brought to your primary care physician’s attention.
Migraines: Migraines are a primary form of headache that typically lasts from four to seventy two hours, can range from moderate to severe pain, and typically are located on only one side of the head. Often they can be accompanied by an aura, nausea or vomiting, sensitivity to sound, or light sensitivity. Migraines can be aggravated by routine physical activity such as going up stairs. This type of headache is thought to occur in the central nervous system and is related to blood vessels.
Tension-type: Tension-type headaches are the most common primary headache disorder and can last anywhere from thirty minutes to seven days. These can often have a pressing or tightening quality that occurs on both sides of the head. Here there is no nausea, vomiting, light sensitivity, or aggravation with physical activity. This type of headache is thought to occur in the central nervous system but can have a hereditary component and is usually associated with muscle tender points. Tension – type headaches can be treated with relaxation techniques such as Progressive Muscle Relaxation (PMR), medications, and physical therapy.
The most common secondary headache that is not related to a serious medical condition is a cervicogenic headache (originating from the neck).
Cervicogenic Headache: The length of time a cervicogenic headache can last varies. Here the pain is on one side and usually starts in the neck. This type of headache is aggravated or preceded by head postures or movements of the neck. Due to the nerves of the neck and face sharing common connections, pain signals sent from one region can lead to discomfort in the other. Physical therapy can be an effective treatment to help relieve symptoms. For example: posture, exercise, ergonomics, massage, manual techniques, traction, trigger point, and acupressure.
A cervicogenic headache can be caused by an accident or trauma or can stem from neck movement or sustained postures. Sustained postures could mean sitting in front of a computer at work or looking down at your phone. Changing these postures throughout the day could help reduce symptoms. Changing postures could mean bringing your phone closer to you using pillows or another supportive surface when reading or checking social media. If you are someone who works at a desk, it could involve taking breaks or getting a standing desk. However your life requires you to move, there are some simple and effective exercises you can perform throughout the day to help cervicogenic headache symptoms.
5 TIPS FOR TENSION HEADACHES
Progressive Muscle Relaxation: PMR is an effective method for reducing tension throughout the body. With this method you first tense a muscle group, such as at the neck or shoulder, and then relax the muscles noting the difference between the two. This helps reduce both stress and tension. For more information or to learn how to do PMR, refer to podcast at: https://www.psychologies.co.uk/try-progressive-muscle-relaxation
Manage your stress level: While stressors vary from person to person, one method for managing stress is with exercise. Any form of exercise can help reduce stress, but a cost free method is aerobic exercise such as walking or running. A less time consuming method could be to perform deep breathing exercises throughout the day.
Heat or cold: When feeling sore or stiff, applying a hot or cold pack or taking a hot shower can help ease a tension headache.
Posture: Some tips for posture are to make sure your head is over your shoulders rather than sitting forward and making sure you are sitting or standing up straight with your shoulders back.
Over the counter medications: Talk to your doctor or pharmacist for additional information.
5 TIPS FOR CERVICAL HEADACHES
Posture: See tips listed under tension headaches.
Ergonomics: If your job or hobbies require you to sit for extended periods it may be beneficial to change positions throughout the day or consider getting a standing desk. Also, limit time on electronic devices. When sitting make sure the monitor is at eye level, your legs are able to fit under your desk, and you are close to the keyboard and monitor. If you are working with a laptop or phone, avoid putting it on your lap. Instead, bring your laptop closer to you by putting pillows on your lap.
Exercise: Some exercises to help relieve symptoms are chin tucks, shoulder blade pinches, and back extension. These exercises can be performed multiple times throughout the day in sitting or standing.
Physical Therapy: Physical therapy may include massage, manual techniques, stretching, traction/ decompression and exercise. A physical therapist can assess your posture and provide strategies specific to you.
Over the counter medications: While medication may not cure cervicogenic headaches, they may help relieve pain. Talk to your doctor or pharmacist for additional information.
Contibutor: Alexa Rzucidlo, PT, DPT
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
As more of us become more comfortable living with COVID 19, travel plans have exploded. For 2 ½ years many have put air travel for family vacations on hold and we are eager to get back to air travel. As you may have gathered from my previous columns, travel is one of my passions. My family and I have been fortunate to have visited many spiritual places of natural wonder and beauty that we call our National Parks. Many of the parks are on the west coast and require some preparation to endure the many hours of travel by airplane through different time zones. Moreover, travel to other countries and continents, often requiring 8, 10, 16 or more non-stop hours on a plane can really take a toll on your mind and body and gave new meaning to the term “jet lag.”
According to the Mayo Clinic, jet lag, also known as jet lag disorder, is a sleep disorder that can occur in people who travel through different time zones in a short period of time, such as a flight from New York City to Los Angeles. Obviously, the further the distance traveled and the more time zones entered, the more significant and drastic the symptoms, as found, for example, in those traveling from the United States to Asia.
Sunlight has a direct impact on our internal clock by regulating melatonin, a hormone that regulates sleep and wake cycles in the body. Travel through different time zones can affect the amount and duration of sunlight and therefore, impact the regulation of these cycles. The inability to regulate the cycles results in many symptoms.
Posture exercises are designed to keep your body more upright and prevent rounded shoulders and forward head/neck.
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This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at GCSOM.
