Q: Do I have a pinched nerve?
A: Many patients consult a doctor of chiropractic because they think they have a pinched nerve. Commonly associated with the spine, a pinched nerve is actually rare. Research suggests that only 10 to 15 percent of spine related problems are caused by direct pressure of bone on a nerve. Typically, a pinched nerve will result in numbness, burning or a “pins and needles” feeling. When a bone pushes on a nerve, this is a serious condition that requires immediate attention – sometimes over the course of months – because even if the symptoms are gone, the pressure on the nerve is still there.
Several other factors can cause numbness and/or a burning sensation. Most commonly, nerves are stretched or irritated, which produces a numbness feeling. Many people are surprised to discover that many causes of their pain are actually due to chemical irritation to the nerve, which also responds beautifully to chiropractic care.
Robert Bigbie, DC, FASBE
Bigbie Chiropractic Office
Q: I’m suddenly seeing flashing lights. Is this something to be concerned about?
A: Flashing lights or photopsia is a common symptom of posterior vitreous detachment (PVD). A PVD is a painless separation of the vitreous from the retina and is often associated with floaters. A sign of maturity, it is most common after age 60. The floaters are condensations in the vitreous gel that can look like cobwebs or black specks floating in your vision. Prompt examination is important since a PVD can be a cause of retinal tears and the floaters may be blood from a torn retina and blood vessel. Retinal tears can develop into a retinal detachment, a more serious condition that can cause loss of vision or blindness. Fortunately retinal tears can be treated with an office based laser procedure to seal the edges of the tear and prevent a retinal detachment. A PVD without retinal tears requires no treatment. The flashing lights will eventually stop but some of the floaters may persist.
Jeffrey Gross, MD
Carolina Retina Center
Q: How can diabetes affect eyesight?
A: People with diabetes face many health problems, including eye disease. Diabetic retinopathy is the most common diabetic eye disease and the leading cause of blindness in American adults. It can develop without any symptoms. Diabetics also are twice as likely to develop glaucoma and cataracts. Diabetic retinopathy is caused by changes in the blood vessels of the retina. Blood vessels either swell and leak, or they can grow on the surface of the retina. The condition can be treated with a laser procedure. Severe cases are treated through a surgical procedure called a vitrectomy. Although both treatments have a high success rate, they do not cure diabetic retinopathy. New leaks and growth can still occur. It is important for both type 1 and type 2 diabetics to have a dilated eye exam every year. Almost half of all Americans with diabetes suffer from this disease.
Derek L. Barker, MD
Columbia Eye Clinic
Q: What is Integrative Medicine?
A: A better known name for integrative medicine is holistic medicine. An integrative physician considers the entirety of the patient – body, mind and spirit – as a treatment plan is derived. This comprehensive plan will involve lifestyle modifications, complimentary/alternative medical (CAM) therapies and conventional Western medical therapies to treat the patient as a whole.
Conventional medicine commonly approaches symptoms. Integrative medicine seeks the cause of the symptom and focuses treatment at the root of the problem. Evaluations include exploration of the health of the body, mind, emotions, environment, social structure and spiritual path, looking to achieve balance in all areas.
Lifestyle changes as well as evidence based natural and CAM therapies are initially recommended, only reaching for pharmaceuticals or surgery when all other treatments have been exhausted or those treatments are clearly indicated. It is true informed care, hearing all the options available when planning a treatment course.
Rachel E. Hall, MD, Integrative Physician
Q: Why do puppies need to be vaccinated multiple times?
A: Puppies are born with immature immune systems. Fortunately, nature developed a system of protection for the newborn with special milk (colostrum) provided by the mother. The colostrum is only produced for several days after birth and is rich with the mother’s antibodies, so her immune system passes to the newborn. The amount of protective antibodies that each puppy receives is different and typically last six to 12 weeks. We don’t know which puppies are still protected at six weeks of age and which ones will have protection for 12 weeks. Vaccinating multiple times ensures protection of the puppy as soon as the mother’s antibodies are gone, and it helps stimulate memory cells for even greater antibody production by the puppy. Vaccines are repeated every three weeks until the puppy reaches 15 to 16 weeks of age (the age maternal antibodies are known to be gone). This provides the puppy with the best protection against dangerous viruses.
Marcie Maloney, DVM
Four Paws Animal Clinic
Q: I have excess fat in one area of my body. Is it possible to transfer that fat to another area of my body?
A: Yes! Hutchinson Center for Aesthetic Medicine is one of the few offices in the Midlands that offers fat transfer. Many people have at least one area that has a little too much fatty tissue and other areas that they feel would benefit from enhancing. So many times men and women say, “If I could just take this fat away and move it here!” Now this is possible. Great results have been achieved by transferring fat to the face (instead of using filler), the buttocks, and filling depressed scars. Fat transfer requires little down time and most people are able to return to normal activities the next day. Fillers, such as Radiesse and Juvaderm, are a good alternative to fat transfer but will last anywhere from nine months to a year. Fat transfer will last indefinitely and, because it is a natural product of the body, it is completely safe.
Manly E. Hutchinson, Jr., MD
Hutchinson Center for Aesthetic Medicine
Q: What are the best ways to prevent sunburn and to treat fire ant and mosquito bites in the summer?
A: Babies and children should use sunscreen with an SPF of 30. And don’t trust that it is waterproof or sweatproof – be sure to reapply it throughout the day. One of the best home remedies for fire ant bites is in your kitchen – meat tenderizer. Mix a small amount of meat tenderizer with a few drops of water and rub it onto the bites. The mixture will help the fire ant bites go away faster. And a great first aid treatment for mosquito bites is roll-on deodorant that contains aluminum salt, which most kinds do. The deodorant can prevent a fresh mosquito bite from flaring up and becoming infected.
Dwight Reynolds, MD
Lexington Pediatric Practice, Lexington Medical Center
Q: What can be done about my shoulder pain?
A: The shoulder joint is one of the most complex joints in the body. Many of the problems seen in the shoulder are the result of overuse syndromes. Frequently, the rotator cuff muscles become inflamed. Part of the cause is muscle imbalance, but arthritic spurs in the bony arch and injury can be factors as well. Rehabilitation involves both rotator cuff and scapulothoracic muscles.
Another problem often seen is adhesive capsulitis. Both tendinitis and capsulitis initially present the same way, though the predominant problem in adhesive capsulitis is a scarring of the inferior joint capsule. Though the cause is unknown, this problem is seen more often in women and involves three stages: pain, stiffness and recovery. Physical therapy is largely successful at restoring shoulder function with this problem, although some cases require surgical repair.
Richard McCain, MD
McCain Orthopaedic Center
Q: What is hip resurfacing?
A: Hip resurfacing is an alternative to traditional hip replacement that is particularly suited to younger, highly active patients. This procedure replaces a thin layer of bone from both sides of the hip joint with metal surfaces, which is biomechanically more similar to the natural hip than a traditional hip replacement. Resurfacing preserves more of the natural bone, which is an important consideration for the younger patient who may need additional surgery later in life. Resurfacing facilitates natural movement of the hip joint without fear of dislocation. As a result, these patients are able to achieve a much higher activity level after surgery to include running and full athletic participation, which is not typically possible after a traditional hip replacement. Less bone loss, increased stability of the hip joint and avoidance of thigh pain are key benefits of hip resurfacing.
Thomas P. Gross, MD
Midlands Orthopaedics, P.A.
A: What are bunions? Why do they hurt, and should I “fix” them?
Q: The answer is complicated because the problem is multi-faceted. First, a bunion is not a growth on the toe. It is a prominence of normal bone that becomes exposed as the big toe moves toward the lesser toes. This can be an inherited trait or traumatic in etiology but most commonly is acquired from ill-fitting narrow toe-box shoes … yes, high-heels. Pain is usually from frictional irritation of the bump in the shoe. Occasionally, pain can be from instability of adjacent joints, arthritis or stress transfer. Fixing the bunion is generally accomplished through a variety of surgical procedures, depending on the kind of bunion. Non-surgical options exist for palliation of symptoms. The best advice is to seek an evaluation from a board-certified fellowship-trained orthopedic foot and ankle surgeon to provide you with options for treatment.
Ryan Putnam, MD
Moore Foot and Ankle Center
Q: Is snoring in children dangerous?
A: Maybe. Snoring can be a sign of pediatric sleep apnea, which is associated with numerous behavioral abnormalities and health risks in children. It was previously thought that primary snoring (snoring not associated with pediatric sleep apnea) was normal. Research now shows, however, that even children with primary snoring are more likely to perform below their peers in school, particularly in language, spelling and IQ tests. They are also more likely to have behavioral problems. In the absence of obesity, enlarged tonsils and adenoids are usually the main cause of snoring and apnea in children since tonsils are quite large in comparison to the size of the throat, especially between the ages of about five and seven years. Removing the tonsils and adenoids often stops the snoring and apnea. In fact, some medical studies have shown that taking out the tonsils and adenoids improves academic performance and behavior.
Children with allergies are more likely to have blocked nasal passages, and this can explain why some children only snore during allergy season or when they have a cold. In these cases taking allergy medication can help stop the snoring. If you notice your child snoring regularly, mention it to your child’s primary care doctor. They will help you determine if further investigation is warranted.
Robert Puchalski, MD
South Carolina ENT
Q: What is the difference between traditional veneers and “prep-less” or “no-prep” veneers?
A: Traditional veneers provide the cosmetic dentist with the most flexibility in smile rehabilitation. If there is severe crowding, midline discrepancies, the need for drastic color enhancements, etc., then traditional veneers may be the only option. If cosmetic issues are mild to moderate, then you may be a candidate for prep-less or no-prep veneers.
Cosmetic dental practices with advanced training may offer minimally invasive dentistry including products like Lumineers, Durathins or Vivaneers. These are three of several popular veneer products that improve smiles with little to no tooth preparation. These products can offer beautiful and natural looking porcelain veneers with minimal or no destruction of your existing tooth structure. Wafer-thin porcelain veneers are individually crafted to perfectly fit and bond to the shape and structure of your existing teeth, correcting for staining, chipping or spacing. This means a brilliant new smile without extensive preparation of the existing tooth structure. Say goodbye to worrying about long and painful dental visits with minimally invasive porcelain veneers placed by a trained cosmetic dentist. Your only worry will be who will get to see your new smile first!
Justin W. Griffin, DMD
WildeWood Aesthetic Dentistry
Q: Can I delay or prevent spinal surgery with spinal injections?
A: Epidural steroid injections and other spinal pain interventions are used primarily to relieve pain. The underlying process that causes the pain ultimately determines the need for surgery or other interventions. Not all disc herniations or other causes of back and radiating pain require surgery. Disc herniations may resorb or dry up on their own and pain injections are performed to give pain relief in the interim. Back pain may have more than one cause even in the presence of disc herniation, spinal stenosis or nerve root impingement. Other tests, including nerve conduction velocity and EMG, may be necessary to determine cause. Additional causes for back pain may include muscle spasm and muscle imbalance or fatigue and ligament strain. These will contribute to or exacerbate pain caused by nerve impingement, spinal stenosis or disc herniation. Often, the relief of pain may lead to improvement in muscle spasm or fatigue. Patients should talk with their physicians or other health specialists to see if spine injections can help with their back pain syndrome.
Timothy P. Close, MD
Women’s Care @ ImageCare