Copyright 2011 Arizona Pain Specialists
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Arizona Pain Monthly | June 2011
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Welcome to Arizona Pain Monthly Magazine
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I will meditate on your precepts and fix my eyes on your ways. – Psalm 119.15
How do you define “relax?” For some, the word relax conjures images of a beach, a comfortable lounge chair, fruity drinks or children happily playing in the surf. For others, it may be a mountain retreat with a hammock and the sound of the wind whispering through the pines. Still yet, there are those that find the graceful moment of relaxation in every day moments – like sticking your hands in a warm sink of soapy water while washing the dinner dishes, raising your arms above your head for a stretch when getting out of bed, or listening to the birds sing as you get the morning paper. The one feeling of relaxation that ties all cultures together is that of good health. Living a pain free, healthy life is a blessing that makes us all breathe a bit easier. How do we at Arizona Pain Specialists keep this in mind for our patients, staff and selves? Finding a healthy work & life balance includes taking time to relax. This means visiting our excellent chiropractic team for adjustments and acupuncture; taking time to exercise and fill the spirit, eating a diet that gives us enough energy not only to get through the day, but to provide focus and stamina, and perhaps our most favorite – scheduling time for a massage.
This month, we hope you’ll take the time to join us in finding our inner balance and
relaxing. Check out our nutritious (and anti-inflammatory) summer recipes. Read an interview with a world renown massage therapist. Learn more about chiropractic techniques to relieve back pain during pregnancy. We thank you for being a part of Arizona Pain Specialists, and we wish you a warm, happy and relaxing June! Kind Regards,
Dr. Paul Lynch and Dr. Tory McJunkin Arizona Pain Monthly | June 2011
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Meet Daltrey T. Nurse Practitioner
Daltrey is a kindhearted nurse practitioner at Arizona Pain Specialists. She first began working as a nurse practitioner in 2005 and has been a part of our great workforce since June 2010.
Nurse practitioners are an integral part of our team at Arizona Pain Specialists, working in tandem with our physicians to create and implement individualized treatment plans for patients. All of our nurse practitioners are registered and certified, capable of performing medical tasks under physician supervision. These duties may include: writing prescriptions, providing medical care, and collecting necessary information from our patients to share and consult our physicians. Daltrey works at both the Scottsdale and Chandler clinics to best accommodate our patients and staff. She has a positive attitude and works hard to ensure all patients leave feeling comfortable with their treatment plan. Take a look at some of Daltrey’s favorites below and see what you may have in common! FAVORITE ACTIVITIES: Reading, hiking
FAVORITE TV SHOWS: The Middle, Modern Family FAVORITE FOOD: Bacon and chocolate
FAVORITE MOVIE: All superhero movies
FAVORITE LOCATION IN THE WORLD: The beach
FAVORITE LOCATION IN ARIZONA: Wherever my family is FAVORITE THING ABOUT ARIZONA: People are so sweet FAVORITE BANDS: Ginny Owens FAVORITE BOOK: Luke
FAMOUS PERSON YOU’D LIKE TO MEET, DEAD OR ALIVE AND WHY: Emily Dickinson, to learn about her and her poetry CRAZY FACT ABOUT YOU: I am very involved with church. I help in our homeless ministry, our women’s ministry, and teach English as a second language to those learning UNKNOWN TALENT: Writing
WHAT CELEBRITY DO PEOPLE SAY YOU LOOK LIKE: Marsha Brady
AS A CHILD, WHAT DID YOU WANT TO BE WHEN YOU GREW UP: A college math professor Page 4
WHERE ARE YOU FROM ORIGINALLY: Bowling Green, KY Relax
Arizona Pain Monthly | June 2011
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Arizona Pain Monthly | June 2011
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Research shows massage isn’t just a great way to relax and relieve muscle soreness, but also to improve blood pressure, reduce stress and improve quality of sleep. A peer review of recent medical articles shows 8 of 10 studies found massage also relieves anxiety and tension. Having dedicated his career to helping others through massage, John Hill isn’t surprised by this news; this massage “Massage is not a luxury,” he therapist has long known the says. “It is a necessity. A form of benefits of touch. self-love. We are human beings, Hill, the owner of Space Massage not human doings!” Studio in Phoenix, says while the immediate effects of massage are To find this space where the apparent – it feels good, you feel emotional and physical are able to be in harmony through relaxbetter – it’s the long-term benefits that make his clients return. ation, Hill pairs massage with both activity and stillness. “Massage reconnects your body “Do what you like and enjoy,” he and mind,” he says. “It allows says. “Some people say, ‘I have to your mind to wander, but your body to be still. Massage therapy go to the gym,’ or, ‘I need to ride my bike.’ I would rather hear ‘I activates the parasympathetic get to hike today,’ or ‘I’m meeting nervous system, counteracting a friend for a bike ride through the body’s negative response to the neighborhood.’ I also highly stress. This allows relaxed musrecommend yoga and meditacle tension and the heart rate, blood pressure and circulation to tion.” return to normal.” Before selecting a massage therapist, Hill says there are basic For Hill, massage is a part of a questions to ask, including; if the healthy lifesyle.
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person is licensed, what he/she enjoys about the work, and why they are in the practice. For Hill, the answer mirrors his belief in living a balanced life:
“I became a licensed massage therapist so I could travel, keep my hands strong for rock climbing and to help people feel better,” he says. “I also really liked the idea of only using my hands to create something that isn’t tangible and seeing the change in a person from the beginning of a session to then the end. Bliss!”
For more information about the relaxation benefits of massage, visit: www.spacephx.com.
Arizona Pain Monthly | June 2011
Anti-inflammatory recipes
Anti-inflammatory foods have been known to reduce inflammation in the body relating to pain. By eating and maintaining a healthy diet, similar to the recipes found below, it is possible to see a reduction in pain. This month we have featured three simple and healthy anti-inflammatory recipes that will help you relax.
Blueberry and Yogurt Smoothie Recipe
Serves 3-5 • 1/4 cup of wild blueberries (whole) • 1/4 cup of wild blueberries (chopped) • 1 tbsp. honey • 1/2 of a banana • 1/2 cup of ice • 1/2 cup of yogurt
Blend the banana, ice and yogurt together until the banana is well blended. Add the blueberries (hole) and blend on low speed for 30 seconds. Add the chopped blueberries as needed for enjoyment.
Arizona Pain Monthly | June 2011
Watermelon Summer Salad Serves 4 • 2 large avocados - peeled, pitted and diced • 4 cups cubed watermelon • 4 cups fresh spinach leaves • 1 cup golden raisins • 1 large grapefruit
In a salad bowl, toss together the avocado, watermelon cubes, raisins and spinach. Cut the grapefruit in 1/4 slices and squeeze on of top salad, as needed, for a flavorful dressing!
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Summer Salmon Saute Serves 4 • 4 salmon steaks • pepper, to taste • 2 tbsp. unsalted butter • 1/4 cup chopped scallions • 1/4 tbsp. dried thyme • 1 1/2 cup sliced zucchini • 5-7 asparagus • 1/4 cup water • 1 tsp. grated lemon peel • 4 lemon slices
In a skillet, heat 1 tbsp. butter. Add scallions & thyme and sauté 30 seconds. Stir in zucchini & mushrooms, water & lemon peel. Simmer over low heat & cover until the vegetables are tender. Season the salmon with pepper. In a separate skillet, sauté salmon in 1 tablespoon of butter over medium heat until browned on both sides (about 10 minutes). Cover salmon with vegetables, garnish with lemon slices & serve.
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Why Should I Consider Chiropractic Care During Pregnancy? During pregnancy there are many physiological and hormonal changes that occur as the fetus develops. The mother’s body will show an increase in the hormone Relaxin. Relaxin levels can increase up to the 14th week in the first trimester, and again increase near delivery. As the female body prepares for vaginal birth, the ligaments of the pelvis lose their rigidity and the pelvis can become unstable. As the growing uterus expands, it pulls the sacral base forward, causing an anterior tilt of the pelvis and flexion of the hips. This position of the sacrum and pelvis causes an increase in lumbar lordosis (increases curvature in the low back). This position puts stress on very important muscles for low back stability; such as the piriformis muscles and iliopsoas muscle (both major contributors to back and radiating leg pain). Establishing and maintaining pelvic balance and alignment is an important reason to obtain chiropractic care during pregnancy.
during her pregnancy, and chiropractic physicians will generally utilize methods that avoid unnecessary pressure on the abdomen. One of the most successful and safe chiropractic treatments for pregnant women with back pain and/or radiating leg pain is “Cox flexion-distraction decompression.” In a randomized clinical trial comparing chiropractic
treatment to physical therapy, patients with radiating leg pain did significantly better with flexion-distraction treatment than with physical theraIs chiropractic care safe py. This method of adjustment during pregnancy? and stretching is successful because it increases the posteThere are no known contrarior disc height, thereby openindications to chiropractic ing the vertebral canal and care throughout a pregnancy. facet joints, reducing posterior Chiropractors are extensively disc stress and increasing the trained to treat pregnant wom- intervertebral foramen (where en with back pain. Specific the nerves to the legs exit the techniques and tables can be spine) by up to 28%. used to adjust a woman’s body
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It has also been identified that there is a relationship between untreated back pain during pregnancy and a longer duration of labor and delivery. Women who have been treated with chiropractic care during their first pregnancy have, on average, a 25% shorter labor time. The results are even better on subsequent pregnancies, with the amount of time spent in labor decreasing by a significant 31%, on average. What about chiropractic care and breech deliveries?
adjustA specific chiropractic adjust ment, known as the “Webster Technique,” is used to correct musculoskeletal causes of intrauterine contracture. Intrauterine contracture is defined as any force external to the developing fetus that obstructs the normal movement of the fetus. This technique is primarily used on women near the end of their eighth month of pregnancy who experience breech presentation of the fetus. Dr. Larry Webster, founder of the International Chiropractic Pediatric Association (ICPA), developed a specific chiropractic evaluation that adjusts the balance of a pregnant woman’s pelvis. This reduces stress on her uterus and supporting ligaments. Arizona Pain Monthly | June 2011
The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issued an 82% success rate of babies turning vertex when doctors of chiropractic use the Webster Technique. Talk to your health care provider.
Pregnant females are given some of the most conservative treatment recommendations of any patient population. Most medications and injections are contraindicated. Women seek-
Arizona Pain Monthly | June 2011
“Chiropractors are extensively trained to treat pregnant women with back pain.�
ing pain relief are frequently referred for chiropractic care by their OBGYN. If you are pregnant and currently experiencing any of the symptoms referenced above, know that there are many options available for you at Arizona Pain Specialists. If you would like more information on chiropractic care and pregnancy, please speak with your health care provider.
Arizona Pain Specialists Chiropractor, Tiffany Moat, D.C.
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For millions of Americans suffering from chronic pain, the concepts of pain and lack of sleep are synonymous with one another. In fact, about 2/3 of all people experiencing some form of chronic pain also report poor sleep. Most often, chronic pain conditions lead to the onset of sleeping problems. The two can quickly become intermingled, making it difficult to discern which causes the other. Studies have shown that lack of sleep actually makes people more sensitive to pain; this can create a vicious cycle in which pain can lead to sleeplessness, that sleeplessness can increase pain sensitivity, which leads to greater pain and that, in turn, leads to more restless nights.
Pain & Sleep Say goodnight to pain
This cycle of pain and sleep can be extremely distressing, not just physically, but also mentally and emotionally. Often times, lack of sleep can lead to increased health problems, irritability and mood disturbances, as well as anxiety and depression. Because of the emotional toll that insomnia can take, people often resort to taking over-the-counter sleeping pills. While sleeping pills may provide a short-term solution, they can actually cause increased insomnia over the long-term. Many types of overthe-counter sleeping pills can lead to physical dependency, increased tolerance, and addiction due to long-term usage. Additionally, self-medication through the form of alcohol is not advised as a means to achieve quality sleep. While alcohol may numb chronic pain conditions for a brief period and help induce sleep, it is likely to be short-lived and will cause you to wake during the night. Poor quality of sleep is also likely to lead to irritability, crankiness, and increased pain in the morning. Sleeping pills and alcohol should be avoided when trying to get a good night of sleep. Chronic pain sufferers need to take into account their particular pain condition, sleep surface, and sleep position. For instance, those who suffer from back and hip pain find that sleeping in the fetal position (on one’s side with legs bent) with a pillow nestled between their knees, provides the most relief for their condition. Others have found sleeping on their back with a pillow under their ankles or knees is most comfortable, as it helps maintain the
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normal curve of the spine. The key to prevent back pain is to sleep in a position that allows the natural curves of the spine to be supported. Sleeping on one’s stomach should probably be avoided, as the curvature of the lower back gets overextended, placing stress on the neck muscles. If you insist on sleeping on your abdomen, consider placing a pillow under your pelvis and lower abdomen to increase support of the spine. As far as sleep surfaces go, there is a prevailing
Arizona Pain Monthly | June 2011
“Pain and sleep can be extremely distressing, not just physically, but also mentally and emotionally”
notion that “the harder the better.” However, this is not always true. In fact, studies have shown that medium-firm mattresses reduce pain and lead to a decrease in pain medication usage among those suffering from chronic low-back pain. These mattresses have an advantage over harder mattresses in that they allow the shoulders and hips to sink gently into the mattress. The key to a good mattress is ultimately one that provides back support and allows for the natural curvature of the spine. Ultimately, the selec-
Arizona Pain Monthly | June 2011
tion of a mattress comes down to personal preference. A mattress that allows for comfortable sleep and provides a respite from pain and stiffness is ideal – just make sure it provides back support. Perhaps a happy-medium is to select a firmer mattress for support, and pair it with memory foam for softness and comfortability.
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In addition to these, there are some general, lifestyle tips that can increase the chances of obtaining a good night’s sleep. The following is a list of items that can help improve quality of sleep: • Limit alcohol intake - With no alcohol in the evening
• Avoid stimulants – Coffee and other forms of caffeine, as well as chocolate, should be avoided after 6 p.m. In fact, limiting caffeine consumption throughout the day will help improve sleep quality
• Eat a balanced diet – Eating a diet consisting of whole foods, fruits and vegetables, drinking purified water, and minimizing the amount of refined foods and sugars you intake (especially late at night) will lead to better sleep, and overall, greater health • Avoid big, heavy meals at night and eat only light snacks – Pairing tryptophan-containing foods with carbohydrates can help calm the brain and improve sleep. Some examples include a small bowl of whole-grain or reduced sugar granola with low-fat milk
• Consider melatonin – Instead of relying on sleeping pills, consider taking melatonin which acts as a mild sedative but is a healthier choice than sleeping pills • Exercise regularly – Even if you’re only able to do some light walking, any form of exercise will improve your health as well as improve your sleep
• Practice relaxation techniques – Including meditation, deep abdominal breathing, progressive muscle relaxation, visualizing a peaceful, restful place, or listening to soft, soothing music
• Write it down – If you find your mind racing while laying in bed, write down your worries, stresses, and anxieties so that you get them out of your head – this can help allow you to release your worries and begin to relax • Reserve your bed for sleeping – We learn through association, so don’t associate your bed with activities such as work or errands; this only makes it harder to wind down and relax. When you get into bed you want your body to get cued that it’s time to sleep.
• Develop a sleep routine – Set a regular bedtime, and follow the same routine each night leading up to that bedtime (i.e., eating a light snack, reading a book, taking a bath)
• Create a proper sleep environment - Make your bedroom a comfortable temperature and sleep in a dark room. Limiting exposure to light at night can help keep your body’s internal cycles intact. Avoid sleeping with the TV and/or computer on. The backlights can be disruptive to sleep and are not good habits to develop.
• Visit your healthcare provider – If you continue to experience sleep disturbances, pain and discomfort, or insomnia, visit your doctor to develop a treatment plan
Arizona Pain Specialists Research Director, Ryan Tapscott
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Arizona Pain Monthly | June 2011
heal his injuries. He was sure to contact a pain physician during his journey, who used minimally invasive treatment modalities to get his legs back into running condition. By properly stretching and Our staff has kept in contact icing, he was also with him throughout his rigorable to keep his legs ous run, and he continually sent in better form, continuing with updates on how he had managed prayer to reach the finish line. his pain. In the beginning of May, During his time on the road, he continued to feel the effects of his lengthy days on foot as he Jeff had the opportunity to visit family and friends, some of who entered into Washingtion D.C. have joined him to run along his Battling a new leg injury, Jeff posts on his blog how he had to side. In addition, he shares in his take a five day break because he blog that he had conversations with many passerbies that was physically unable to helped him get through continue his run toward each day. With his New York. “I could incredible journey barely walk and had to literally crawl up the steps”, Jeff states, while discussing his wearisome struggle with pain. Jeff was sure to take the proper steps to overcome his pain and Jeff Grabosky has run America! Kicking off in California, Jeff has run cross-country, traveling nearly 3,700 miles. He began his journey in late January 2011, running an average of 30-35 miles per day. During the time of print, Jeff was scheduled to cross the New York finish line on May 20, 2011.
Arizona Pain Monthly | June 2011
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coming to an end, Jeff will be able to embrace our theme for this month, he can finally relax. With his run across America complete, he has hopes of working and assisting at his friend’s running shop. Jeff has been an inspiration to many and is a great example of how to fulfill your dreams, even if you suffer from chronic pain. If you like to read more about Jeff’s run across America, visit www.arizonapain.com and check out his blog.
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Relax and enjoy a game of Sudoku
There are 9 rows in a traditional Sudoku puzzle. Every row must contain the numbers 1, 2, 3, 4, 5, 6, 7, 8, and 9. There may not be any duplicate numbers in any row. In other words, there can not be any rows that are identical. There are 9 columns in a traditional Sudoku puzzle. Like the Sudoku rule for rows, every column must also contain the numbers 1, 2, 3, 4, 5, 6, 7, 8, and 9. Again, there may not be any duplicate numbers in any column. Each column will be unique as a result.
There are 9 regions in a traditional Sudoku puzzle. Like the Sudoku rule for rows & columns, every region must also contain the numbers 1, 2, 3, 4, 5, 6, 7, 8, and 9. Again, there may not be any duplicate numbers in that region.
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Arizona Pain Monthly | June 2011
We wouldn’t be able to see more than 7,000 patients each month without the dedication of our employees. We are so very thankful for those who work with us. This month’s selections for Employee of the Month are a great reflection of the wonderful group of people who make Arizona Pain Specialists successful!
Brian DeMartino - PCG Manager
As the patient concierge manager, Brian DeMartino has exemplified APS’ core values – honesty, integrity and work ethic. Brian has worked for APS for more than one year and his professionalism has set a new standard for the department. Always willing to greet staff with a sincere smile, Brian was a obvious selection for employee of the month. “His dedication, substantial output and results all commend him to this award. Brian represents the excellence APS aspires to,” says Mark Egge, COO.
Lance Jones - IT
Lance Jones is known for being a quiet and diligent worker. As a member of the IT team, he is always available to help coworkers with technological needs. APS’ IT team has been critical to growth; Lance has been willing to put in extra time on weekends and after hours to see that the company’s infrastructure can handle the fantastic increase in locations, patients and employees.
“Lance has worked very hard during the last month to develop and streamline systems. He has saved other employees countless hours with his attention to detail and performs at the highest level of customer service,” says Randy Braunm, Director of IT.
Many thanks to Brian and Lance for their hard work! APS is exceptionally thankful for all of our employees!
Arizona Pain Monthly | June 2011
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