Considerations When Buying a New Mattress

When shopping for a mattress, it is important to be aware of the quality and value of each potential purchase. The following are things a patient should consider when purchasing a new mattress:

1. Shop for the best value and quality of the mattress rather than for price. Mattresses with more coils and thicker padding tend to be higher quality and also more expensive; however, a higher price does not guarantee that the mattress is more comfortable or more supportive. Mattress stores often have sales and promotions, so it is a good idea to comparison-shop for the best price after finding the right mattress.
2. Be aware of mattress advertising gimmicks. Claims that a mattress is “orthopedic” or “medically-approved” should be viewed skeptically. There has not been extensive medical research or controlled clinical trials on the topic of mattresses and low back pain. The individual must determine whether or not extra features on a mattress make it more comfortable or supportive.
3. Give the mattress a test-run before buying. To sample mattresses, people can try sleeping on different makes and models in hotels or at other people’s homes before going to a mattress store. When shopping at the store, shoppers should lie on the mattress for several minutes to decide if it is a good fit. If two people will be sleeping on the mattress, both should test it at the same time to make sure they have enough space and are both comfortable on the same style of mattress. 
4. Purchase mattresses from stores and companies that are trustworthy. Consider the customer service offered by the mattress store, such as delivery options, warranty, and removal of old mattresses and the store’s return policy. Look for mattress stores where customers can return a mattress if they are not satisfied with the quality or comfort after sleeping on it for a significant amount of time (i.e. a couple of weeks to a month).
To help preserve the quality of a new mattress, it should be repositioned every six months to ensure that the mattress is evenly worn. This includes rotating 180 degrees and flipping the mattress lengthwise on a regular basis. The Better Sleep Council advises against putting a mattress on a box spring/foundation that is not made to go with the mattress, as this may decrease the life of the new mattress.

How to Evaluate a Mattress

Choosing a new mattress that is comfortable, supportive, and high quality is important to help people with low back pain get a sound night's sleep. And marketing messages, promotions and special features can make shopping for the right mattress a challenge.

By understanding the physical composition of a mattress and being prepared to ask questions about the interior of a mattress, individuals can accurately evaluate and compare mattresses. Some mattress stores will offer cutaway views of the interior; this is a good aid in understanding and gauging mattress quality.

Key Components of a Good Mattress

The following physical components are the important features of most high quality mattresses.

Mattress springs and coils provide back support. The wire in the coils comes in different thicknesses, where a lower gauge number denotes thicker, stiffer wire and a firmer mattress. A higher concentration of steel coils may indicate a higher quality mattress, but this does not mean that the highest number is best: patients should use their own judgment regarding which mattress is best suited to provide support and help alleviate their low back pain.
Mattress padding provides comfort. In addition to the spring coils in a mattress, the padding on top of the mattress can indicate quality. Mattress padding is usually made of materials such as polyurethane foam, puffed-up polyester or cotton batting. Extensive mattress padding is often more expensive, but many people find it more comfortable and worth the extra cost.
Middle padding in a mattress. This type of mattress padding is just below the quilted top layer and is usually made with foam. When looking at a cross-section of the mattress, softer foams feel almost moist to the touch while firmer foams won’t spring back as quickly. The next layer of mattress padding is made of cotton batting that may vary in thickness across different mattresses and even within one mattress. This causes the mattress to feel firmer in some areas rather than others, such as increased firmness in the middle of the mattress.
Insulation mattress padding. This padding lies on top of the coil springs so that they cannot be felt from the top of the mattress, and it also protects the coils from damaging the top layers of the mattress.
Mattress ticking and quilting. The outer layer of a mattress consists of ticking, which is usually a polyester or cotton-polyester blend in a good quality mattress. The mattress quilting attaches the ticking to the top layers of padding. It is a good idea to examine the quality of stitching on the mattress quilting, looking for consistent, unbroken stitches.
Mattress foundations. The mattress foundation or box spring adds another level of support to the mattress. Foundations usually consist of a wooden or metal frame with springs. A plain wooden frame may make mattresses feel harder than a frame with springs. A wood mattress foundation should only be purchased if the wood has no cracks and is straight. The Better Sleep Council recommends that purchasing a foundation and mattress as a set helps preserve the mattress.
Foam mattresses. As an alternative to traditional mattresses, some types of mattresses are constructed entirely or mostly from memory foam or latex foam. They can be purchased in different densities. Some foam mattresses are made of multiple layers of foam adhered together while others have a foam core in the center. Foam mattresses come in various degrees of firmness to give people greater selection for back support and comfort. Choosing between a foam mattress and a traditional mattress is based on personal preference.
Asking questions, requesting written product information and examining each mattress thoroughly will help patients become more educated consumers. By following the practical guidelines for selecting a new mattress, patients will be well equipped to find the best mattress for sleep comfort, back support and reducing low back pain.


Call ABChiropractic Family & Wellness in St. Charles MO at 636-916-0660 to schedule your no risk appointment.  Our chiropractors can help address your pain complaints and mattress concerns.  We offer a full range of different chiropractic adjustments, as well as decompression, traction, and massage therapy.

7 Sleeping Tips for Patients with Chronic Pain

Patients dealing with back and neck pain will often have trouble sleeping.

Consider these points:

• Various studies detail how chronic pain can make it difficult to sleep and how sleeping problems can exacerbate one's symptoms.

• A past Spine-health poll of nearly 1600 people found that 63.7 percent of people get less than or equal to 6 hours of sleep while only 29.9 percent of responders get the recommended 7-8 hours of sleep.

We've compiled some sleep tricks that seem to help many of our forum members:

1. Only go to bed when you are tired

Do not allow yourself to toss and turn in bed. This only makes things worse, and usually you'll end up stressing about everything you have to do the next day.

If you are not sleeping within 20 or 30 minutes, get out of bed and engage in something that makes you tired. One person suggested the iPhone app, "Words with Friends."

Once you figure out your optimum bed time, do your best to keep a regular sleep schedule.

2. Cool the room

Simply cracking the window in cold weather or cranking the air conditioner a little more in hot weather is a great way to make the room temperature colder and to have deeper and more restorative sleep.

3. Drink herbal tea

Make a conscious decision to avoid coffee after dinner and expand this to exclude/limit pop and even other stimulants like alcohol and nicotine.

Chamomile tea is an excellent choice to help you relax.

4. Work up a sweat

While many chronic back pain and neck pain sufferers worry that exercising will only exacerbate their pain, the opposite is actually true: remaining inactive is often worse for pain.

Engaging in regular exercise, stretching, and strengthening programs can promote the body's natural healing process and make you feel better both physically and mentally. And, as a bonus, it will make it easier to fall asleep at night.

5. Write down your worries

Why is it that when your head hits the pillow, all your worries become so intense? Try "forced worrying." Before you go to bed, take 15 minutes or so to write down your worries on a blank sheet of paper.

Remind yourself that you will have plenty of time to address these concerns the following day. If you find yourself in bed worrying about other things, keep a notebook and pen nearby and write these down as well.

6. Visualize something peaceful

With your mind free of worry, gently close your eyes and think of something tranquil and relaxing.

Consider incorporating a sound relaxation machine or even aromatherapy.

7. Check your "equipment"

Ask yourself these questions:

• Does my mattress provide me with enough lumbar support? Check out these mattress guidelines.
• How does my pillow support my neck? Is it too high or too firm? Remember these suggestions for pillow support and comfort.
• What position is most comfortable when sleeping? Am I relaxed on my back, side, or am I curled up? How do I feel when I wake up in the morning after having slept in these positions?

Certain sleeping positions are recommended for different types of pain.

For example, patients with pain from osteoarthritis are advised to sleep in the fetal position (on their sides, with knees curled up), while patients with degenerative disc disease may prefer to sleep on their stomach. Those with hip pain may achieve relief by placing a pillow between the knees.

Call Dr. Awwad, ABChiropractic Family & Wellness, your Pain Relief Center in St. Charles MO 63303 to schedule your new patient exam and consultation to see how we can help you with your pain complaints.  Call 636-916-0660 and speak to Karen or Rachel to schedule your life changing appointment.  Chiropractic is safe and effective for the detection and correction of pain symptoms.

Upper Back Pain from a Thoracic Herniated Disc

A herniated disc in the upper back can occur when the inner gelatinous material of an intervertebral disc leaks out of the inside of the disc. A thoracic herniated disc can cause upper back pain and other symptoms, such as radiating pain or numbness.

Specific symptoms of a thoracic herniated disc are usually different depending on where the disc herniates, as the herniated disc material in the upper back can either impinge on an exiting nerve root or on the spinal cord itself.

Thoracic Degenerative Disc Disease

Thoracic disc disease is conceptually similar to disc disorders in the cervical and lumbar spine, but symptomatic lesions (anatomical problems related to the symptoms) are far less common.

The most common location for thoracic disc disorders is at the thoracolumbar (the thoracic and lumbar parts of the spinal column) junction (T8-T12) in the mid back. The true incidence is unknown because many thoracic disc disorders do not cause thoracic back pain or other symptoms, and they comprise only a very small percent of all herniated disc treatment surgeries.

In one study, 90 asymptomatic patients (with no pain or other symptoms) were evaluated with thoracic MRI scans. These were the findings:

• 73% of patients were found to have disc abnormalities in the upper back, such as a thoracic herniated disc or thoracic degenerative disc disease
• 37% specifically had a thoracic herniated disc
• 29% had radiographic evidence of spinal cord impingement identified on the MRI.

These patients were followed for 26 months and none of them developed thoracic back pain from their thoracic disc disorders.1

The fact that so many people had thoracic herniated discs but no pain or symptoms is important to mention, as it shows that people may have both upper back pain and a thoracic herniated disc, but that the disc disorder may not be the cause of the thoracic back pain – it may just be an incidental finding.

In fact, there are many causes of upper back pain that are much more common than a herniated disc, and a correct diagnosis of the cause of the patient’s pain is more important than whether or not an MRI scan shows a thoracic disc herniation.

References:

1. Wood KB, Garvey TA, Gundry C, Heithoff KB: Magnetic resonance imaging of the thoracic spine. J Bone Joint Surg Am. 77:1631-1638, 1995.

CALL ABChiropractic Family and Wellness at 636-916-0660 to see how chiropractic can help.  We are located in St. Charles MO, 63303.  We are your St. Charles Pain Relief Center.

Chiropractic Adjustment

A chiropractic adjustment, also known as chiropractic manipulation, manual manipulation, or spinal manipulation, is a common therapeutic treatment for lower back pain.18

A chiropractic adjustment refers to a chiropractor applying manipulation to the vertebrae that have abnormal movement patterns or fail to function normally.

The objective of this chiropractic treatment is to reduce the subluxation, with the goals of increasing range of motion, reducing nerve irritability and improving function.

Chiropractic Adjustment Description

A chiropractic adjustment typically involves:

• A high velocity, short lever arm thrust applied to a vertebra
• An accompanying, audible release of gas (joint cavitation) that is caused by the release of oxygen, nitrogen, and carbon dioxide, which releases joint pressure (cavitation)19
• A relieving sensation most of the time, although minor discomfort has been reported (that usually lasts for a short time duration) if the surrounding muscles are in spasm or the patient tenses up during this chiropractic care.

It should be known that joint cavitation or cracking does not occur at times, typically as a result of significant muscle splinting or the patient not being adequately relaxed during the chiropractic manipulation. At times like this, it is sometimes best for the chiropractor to apply ice, have the patient rest, or do electrical stimulation and massage prior to attempting the chiropractic adjustment.

Chiropractic Adjustment Techniques

There are many different manipulative techniques that can be utilized in chiropractic, and there is a certain skill level and "art" involved with high velocity, low amplitude adjustment or manipulation. It is perhaps more important for the chiropractor to determine when not to apply the adjustment.

Chiropractic Adjustment Side Effects

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The most common reaction to a chiropractic adjustment is aching or soreness in the spinal joints or muscles. If this aching or soreness occurs, it is usually within the first few hours post-treatment and does not last longer than 24 hours after the chiropractic adjustment. Application of an ice pack often reduces the symptoms relatively quickly.

Call our St. Charles, Missouri office at 636-916-0660 to schedule your new patient appointment for you and your family to see if Chiropractic treatments can help you.  ABChiropractic Family & Wellness in St. Charles MO offers a variety of chiropractic adjustments as well as decompression and massage therapy.  

Mario H Awwad D.C

Exercise and Chiropractic

Cardiovascular and strengthening exercises combined with chiropractic care are important in the management of low back pain.

If a patient has a history of heart problems, it is important for the patient to consult with not only the doctor of chiropractic but their primary care physician to be certain that they can tolerate cardiovascular fitness-promoting activities. Specific instructions are given by the chiropractor with respect to proper exercise for the patient's condition before beginning any exercise program.

In general, a reasonable amount of exercise performed daily and utilizing enjoyable activities is recommended for patients undergoing chiropractic treatment.

Exercise Benefits

Many studies have reported the importance of exercises in managing acute and chronic low back pain, strengthening the low back, preventing and keeping back patients working, and to improve quality of life. The strength of the abdominal muscles was also found to be able to differentiate between those with vs. without chronic LBP.

Overall and when combined with chiropractic care, aerobic exercise helps promote proper digestion, keeps the muscles in proper tone and promotes better circulation. Walking briskly around the block at least once or twice is a convenient and popular activity.
Also, many forms of work and/or household tasks can function as an exercise program. The important point is to exercise!

Types of Exercises

There are many applicable back exercises that are available for patients also undergoing chiropractic care for lower back pain. One can classify the chiropractic patient into a flexion or extension biased category to determine the variety that is best for that patient. For example:

- If a patient feels best when bending over (flexion biased), exercises that promote low back flexion such as pulling the knees to the chest, posterior pelvic tilts, bending forward from a sitting position and others are usually helpful.

- If a patient is least symptomatic in extension, especially if leg pain centralizes or diminishes (extension biased), prone press- up type exercises usually yield the best results.

Other exercises that can help reduce lower back pain include:

-Strengthening of the pelvic (trunk) stabilizing muscles

-Stretching of the hamstrings, adductors, and other overly short or tight postural muscles

-Proprioceptive or balance promoting.

Benefits of Back and Abdominal Exercise

Weak and/or overly tight supporting muscles can have painful spasms and suffer injuries themselves,
which then prevent them from supporting the spine as needed. Compromised muscles can also lead to problems with bone structure of the spine due to poor posture from the weak muscles, thereby creating an increased risk of back pain/ injury.

Consequently, developing combined strength in stomach muscles and back muscles can:

- Reduce the likelihood of back pain episodes

- Reduce the severity of back pain

- Protect against injury by responding efficiently to stresses

- Help avoid back surgery in some cases

- Facilitate healing from a back problem or after spine surgery

- Improve posture.

Reported Efficacy of Exercise in
Chiropractic Care

According to the Scientific Commission of the Council on Chiropractic Guidelines and Practice Parameters (CCGPP):

- Strong evidence supports exercise as being at least as effective as other non-surgical treatments for chronic low back pain

- Moderate evidence supports use of a graded-activity exercise program in occupational settings for subacute lower back pain

- Some evidence shows that exercises are no more effective than other nonsurgical treatments for acute lower back pain.

As with any chiropractic treatment, it is important for chiropractors to perform a focused reevaluation of an exercise program following its initial therapeutic trial to determine its effectiveness. Using spinal range of motion as a measurement of the effectiveness of exercise is just one way in which chiropractors can make such determinations.

Call your St. Charles chiropractor, Dr. Mario Awwad, to schedule your New Patient Special.  At ABChiropractic Family & Wellness, we specialize in chiropractic adjustments, decompression, massage therapy and most importantly, RESULTS!  Call 636-916-0660 and speak with Karen or Rachel to schedule your life changing appointment today.

Mattress Guidelines for Sleep Comfort

The right mattress can really help one have a good night's sleep and wake up feeling rested and refreshed. Sleeping on the wrong mattress can cause sleeplessness, back pain, and overall aches and pains. For people with a back problem, a mattress that isn't a good fit can make the pain worse.

When searching for the best mattress, remember that mattresses are largely a matter of personal preference. There is no single type of mattress or bed that works well for all people, and there is no best mattress for back problems. Likewise, there
is no single sleep position known to be best for all people. This is due to several factors:

- There are many causes of back problems, and different back conditions may respond better to specific types of beds, mattresses and sleep positions.

- There is a high degree of personal preference for mattresses, and what works well for one person may not work well for another.

- There is very limited scientific study published on mattresses and back pain, and findings from the studies that have been completed are inconclusive.

- Overall, the causes of back pain can be quite complex, and it’s difficult to isolate whether or not a person's mattress has played a significant role in improving the pain or making it worse.

The bottom line is that the type of mattress that is best for any particular person is really a matter of personal preference.

The type of mattress one uses is not the only factor for patients with pain and sleep difficulty. Many other factors need to be considered that may affect sleep, including:

- Medication side effects

- Irregular sleep patterns

- Caffeine/alcohol/tobacco use

- Sleep apnea

- Anxiety/stress

If comfort is not the only thing making sleep difficult, it is advisable for the patient to consult his or her family physician to discuss other possible causes and treatments for sleeplessness.

Experiencing significant or persistent back pain may indicate an underlying back condition that has nothing to do with the mattress. It is always advisable for people with back pain to consult with a health care provider for a thorough exam, diagnosis, and treatment program.

As a reminder, sleep comfort is first and foremost a matter of personal preference. No one should expect that switching mattresses or beds will cure their lower back pain, and changes in the type of bed or mattress used should be made solely for the sake of comfort.

Sleep Positions for Back Conditions

An important factor that can influence individual preferences for mattresses, beds and sleeping positions is the specific back condition a person has. For example:

- Osteoarthritis. Patients with pain from osteoarthritis of the facet joints may prefer to sleep on their sides with their knees curled up (in the fetal position). This helps open up the facet joints in the spine and can relieve any corresponding pressure. Alternatively, sleeping in a reclining chair or an adjustable bed that allows the head and knees to be elevated can also relieve pressure on the facet joints.

- Degenerative Disc Disease. Patients with pain from degenerative disc disease may prefer to sleep on their stomach as this can relieve pressure on the disc space. Patients may feel most comfortable using a relatively firm mattress and placing a flat pillow under the stomach and hips, which can further reduce stress on the lower back.

- Spinal Stenosis. People with pain from spinal stenosis may prefer to sleep on their sides with their knees curled up (in the fetal position). This helps relieve pressure on the nerve root. Sleeping in a reclining chair or an adjustable bed that allows the head and knees to be elevated can also relieve pressure on the nerve.

- Bursitis. Patients who have inflammation of the bursa over their hips (greater trochanteric bursitis) can be especially susceptible to pain from a mattress that is too firm. If the mattress is too hard, a new mattress with thick padding on top, or placing an egg crate foam
mattress cover over the old mattress, can help provide some relief from the firmness.

- Hip Pain. Patients with hip pain who sleep on their sides can usually find some pain relief by placing a pillow between their knees. This decreases stress across the hip.

- Herniated Lumbar Disc. The most comfortable sleep position depends on the position of the disc. For a paracentral disc herniation (most common), patients will tend to do better lying on their stomach. For a foraminal herniated disc, sleeping on the side in a fetal position is usually better tolerated.

In general, elevating the knees slightly by placing a pillow under them while lying on the back can help many general forms of low back pain. Many patients also find that this is the most comfortable way to sleep after spine surgery.

Call ABChiropractic Family & Wellness, your St. Charles Missouri Pain Relief Center at 636-916-0660.  We offer chiropractic adjustments, decompression and massage therapy.  Sports physicals and work physicals are also offered.

Leg Pain & Numbness: What Might These Symptoms Mean?

Leg pain can range from a mild nuisance that comes and goes, to debilitating pain that makes it difficult to sleep, walk, or engage in simple everyday activities. The pain can take many different forms ‐ aching, searing, throbbing, or burning, and it can be accompanied by other symptoms, such as a pins‐and‐needles sensation, and/or leg or foot numbness or weakness.

Leg Pain Symptoms and Descriptions

Leg pain may be caused by a problem in the leg, but often starts with a problem in the lower back, where the sciatic nerve originates, and then travels along the path of the nerve (called sciatica).

For this reason, diagnosis of anyone with leg/foot pain, and/or leg/ankle/foot weakness or numbness should include an exam of the lower back.

Not all leg pain derived from low back problems presents the same way. Leg pain caused by a low
back problem is often accompanied by additional symptoms, such as leg numbness or weakness, or foot pain, and the type of pain may vary widely from patient to patient.

Typical descriptions of leg pain and accompanying symptoms include:

Burning pain.

Some experience a searing pain that at times radiates from the low back or buttocks down the leg, while others complain of intermittent pain that shoots from the lower back down the leg and occasionally into the foot. Words used to describe this type of burning leg pain include radiating, electric or shooting pain that literally feels like a jolt. Unlike many forms of low back pain that can often be a dull ache, for many, leg pain can be excruciating and nearly intolerable. This type of burning pain is fairly typical when a nerve root in the lower spine is irritated, and it is often referred to as sciatica.

Leg numbness or tingling.

Anyone who has had a leg or foot "fall asleep" and then gradually return to normal can imagine what numbness in a leg would feel like. Not being able to feel pressure, or hot or cold, is unnerving. Unlike the short-lived numbness of an asleep limb, numbness coming from a low back problem can be nearly continuous and can severely affect a person’s quality of life. For example, it can be difficult or almost impossible to walk or drive a car if one’s leg or foot is numb. Typical symptoms can range from a slight tingling sensation to complete numbness down the leg and into the foot.

Weakness (foot drop) or heaviness.

Here, the predominant complaint is that leg weakness or heaviness interferes significantly with movement. People have described a feeling of having to drag their lower leg and foot or being unable to move their leg as quickly and easily as needed while walking or climbing stairs, for example, because of perceived weakness or slow reaction. Patients with foot drop are unable to walk on their heels, flex their ankle, or walk with the usual heel-toe pattern.

Constant pain. 

This type of pain is normally felt in the buttock area, so it is not technically leg pain but it may accompany some form of pain felt in the legs. It may also be pain that occasionally radiates past the buttock into the leg. This type of pain is usually described as "nerve pain," versus an aching or throbbing pain. It is typically present only on one side, and is commonly called sciatica or lumbar radiculopathy. It may often be relieved by stretching, walking or other gentle movement.

Positional leg pain.  

If leg pain dramatically worsens in intensity when sitting, standing or walking, this can indicate a problem with a specific part of the anatomy in the ow back. Finding more comfortable positions is usually possible to alleviate the pain. For example, bending over may relieve pain from spinal stenosis, while twisting (as in a golf swing) can increase facet joint related groin, hip and leg ache.

There are many spinal conditions that may cause leg pain, foot pain, and other lower extremity symptoms. Most successful treatments are based upon having an accurate anatomic diagnosis for the basis of a specific pain syndrome. Chiropractors are well suited to oversee the diagnosis and treatment of these situations.

Call 636-916-0660 and schedule your new patient exam at ABChiropractic Family & Wellness.  Our office is conveniently located in St. Charles, Missouri.  Our office is easily accessible from either highly 70 or 94.  Dr. Mario Awwad specializes in fast pain relief of leg pain.