What to expect on your first visit

My staff will give you forms to fill out – symptom forms, health history forms, insurance forms, etc.
We meet and talk about what brought you into the office. We talk about your past history, and current goals. The most common reasons people come in to see me are for chronic pain relief, acute pain relief, sports medicine, to learn an exercise program, and weight loss startegies.
I start to perform a comprehensive postural evaluation; I’ll watch you walk; I’ll watch you perform range of motion and we will perform other assessments that will give us information about your muscles and joints. Some clients get the Functional Movement Screen (FMS) on the first session.
I might perform a Body Composition Analysis that will tell us your percentage of body fat, lean muscle mass, your water content, how many calories you burn a day along with many other important biomarkers.
I will use my skilled hands to perform the examination.
I might use the warm laser, Deep Muscle Stimulator, Scenar device, or other modalities if you are in pain.
I will most likely begin to talk to you about exercises, stretching, sleep improvement, and nutrition.
Sometimes cases are complex, each session is personal, customized and individual therefore it may take a session or two just to get through the comprehensive evaluation I perform.
Plan on being in the office about 90 minutes on that first session. Follow up sessions are half hour long.

In the office…

I am a chiropractor educated in ‘evidence-based’ acute care, chronic pain management, sports injuries and injury prevention. Cutting edge, patient friendly solutions and tools for restoration of musculoskeletal injuries, health and fitness, sports medicine, and long-term athletic participation, and life-long exercise are embraced. I utilize standard medical and chiropractic evaluations, functional movement assessments, skilled hands-on, modalities, body weight and sports performance training tools to improve musculoskeletal injuries and imbalances, and movement efficiency to decrease the risk of injury.

I use Deep Muscle Stimulation (DMS), warm laser, Graston like tools, fascial therapy, and other modalities. I am known for ‘figuring out’ the difficult cases, teaching patients self-care and supervised corrective exercise programs.

Most insurance companies cover my sessions.

For more information please call 310-473-2911.

Asthma nutrition

Using current nutritional research, here is what we know that can help asthma.

Fish oils (essential fatty acids) have a broad anti-inflammatory effect. It could take 9 months of supplementation to increase FEV (forced expiratory volume). FEV is a pulmonary function test used to diagnose asthma and other pulmonary diseases. I recommend 2-3 grams per day.

Pyrodoxine, vitamin B6 has been studied and found to be effective in the prevention of asthma attacks.

Vitamin B12 shots can improve tolerance to flare-ups, possibly by preventing reactions to sulfite exposure. B12, also known as cyanocobalin or hydroxycobalamin works by binding the sulfites to cobalamin, thereby blocking their allergic potential.

Rye grass extract can help to dampen bronchial hyper-reactivity.

Nettles can help prevent underlying allergic reactions to various inhalants.

Vitamin C is thought to be the major antioxidant in the linings of the lungs and bronchi. Asthmatic patients have been shown to have low vitamin C blood levels. Some studies show lessening of respiratory symptoms and improvement in respiratory function with C supplementation. It’s also postulated that vitamin C may help lower histamine levels. This effect, however, was only found to occur when supplementation continued over a six- week period.

Magnesium both orally and intravenously can help prevent flare-ups.

Antioxidants, such as quercetin, are thought to provide protection because free radicals can stimulate bronchial constriction.

DHEA can improve breathing capacity. It is typically low in-patients who have used steroids repeatedly. I like to know a persons blood levels before DHEA supplementation.

Accurate testing and treatment of both food and inhalant allergens is extremely important. Have you had a RAST panel? A blood test, to screen for allergens.

Addressing food and inhalant allergies and building a healthier immune system can go a long way in terms of prevention. Since air pollution is often cited as a cause of asthma, I can’t help but wonder if chemicals in the home or workplace are a major contributing factor. Chemicals aggravate the lungs – period!

You have to be concerned about household products, scents, wood preservatives, floor and wall treatments, carpets, rugs, drapes, and synthetic-impregnated furniture. Have any of these things changed recently? Also consider indoor natural gas from furnaces, water heaters, and stoves which generates irritating nitric oxide residues.

If you were my sister I would tell you to go to my website www.DrJeffreyTucker.com, click on Metagenics & order these products from them:

UltraInflam X (make shakes using 2 scoops per day). This has lots of natural anti-inflammatories.

Perimine (1 tablet BID)

EPA-DHA 720 (2 in the morning & 2 at night)

Include D3 (5,000 IU per day until your levels are 50-60), vitamin C (2-3 grams per day), & quercitin (dosage on the bottle). Stick to an anti-inflammatory diet using low carb – it is part of the puzzle.

Migraine Headache update

From the 64th Annual Meeting of the American Academy of Neurology: New treatment guidelines were presented and over-the-counter treatments and complementary treatments were discussed. They conclude that the herbal remedy butterbur, is effective in preventing migraine. Other treatments that were found to be probably effective are the nonsteroidal anti-inflammatory drugs fenoprofen, ibuprofen, ketoprofen, naproxen, and naproxen sodium; subcutaneous histamine; and complementary treatments such as magnesium, MIG-99 (feverfew), and riboflavin.

Posture Evaluations, Part 7: Thoracic Spine Analysis

Thoracic spine article I wrote in Dynamic Chiropractic magazine

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55231

Treatment Checklist for Plantar Fasciitis, Part 1

Here’s the link to a recent article I wrote on Plantar fasciitis in Dynamic Chiropractic magazine

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55758

Neuropathy Explained

Dr. Tucker: Will you explain what neuropathy is?

Dr. Fedoryk: Neuropathy is a term for a collection of disorders that occurs when nerves of the peripheral nervous system are damaged. The condition is generally referred to as peripheral neuropathy, and it is most commonly due to damage to nerve axons. It is characterized by a numbness or painful tingling in the feet, legs, hands and arms. Neuropathy can affect nerves that control muscle movement and those that detect sensations such as coldness or pain. It can also contribute to dementia. And while neuropathy is a common side effect of diabetes, it’s sometimes caused by other factors, such as thyroid problems, chemotherapy, traumatic injuries, infections and exposure to toxins.

Dr. Tucker: Do most Chiropractors treat neuropathy?

Dr. Fedoryk: Most Chiropractors treat the symptoms of neuropathy. Some of the common treatments include manipulation, mobilization, physical therapy modalities like ultrasound, gentle traction and laser. As a specialist in exercise therapy I like to teach my patients things that they can do at home that include specific exercises to improve muscle and joint function(flexibility and mobility). We can also recommend nutritional supplements and discuss diet. It is especially important for these patients to strictly manage blood sugar levels. Once the blood sugar is under control, supplementation with alpha-lipoic acid may offer considerable support. Alpha-lipoic acid (ALA) can rapidly and significantly reduce sensory symptoms and pain of diabetic neuropathy. It is a potent antioxidant that prevents or improves nerve conduction attributes, endoneurial blood flow and nerve Na+ K+ ATPase activity.

Dr. Tucker: How much alpha-lipoic acid do you recommend?

Dr. Fedoryk: Oral supplements of 600 mg per day is a good dose to start with.

Dr. Tucker: Any other comments for readers?

Dr. Fedoryk: Neuropathy is a serious condition that can lead to grave health problems. Don’t try to go it alone. Look for a health care professional or chiropractor who understands the causes of neuropathy along with the possible treatment options for your condition and uses a holistic approach to your condition.

Knee Osteoarthritis & BMI: What are the treatment options.

2007-2009. For men and women, the prevalence of age-adjusted arthritis increased significantly with increasing BMI (P <.001 for trend). The age-adjusted prevalence of OA among people who were obese (25.2% for men and 33.8% for women) was nearly double that of people who are underweight/normal weight (13.8% for men and 18.9% for women). Source: CDC. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation— United States, 2007-2009. MMWR. 2010;59(39):1261-1265.

Treatment options for OA

In patients with knee OA, my approach tends include shoe inserts. These  are good adjuncts to supplements, laser, Deep Muscle Stimulation (DMS), injectables, taping, and exercise therapy. I recommend swimming, recumbent bicycles, rowing machines and elliptical trainers. I teacgh my clients a lot of low load, easy to do stretches and strenghtening exercises. Weight loss is really important here. 

On laser therapy for treating patients with knee OA:  It depends on the patient and the severity of his or her OA. For example, if the patient is older and has a severely arthritic knee, a total knee replacement will probably be necessary. If a patient has OA and joint effusion, I might recommend laser, aspiration and corticosteroid injection.

If I have a patient with symptoms of OA who may have incurred an injury such as an ACL tear, I will use warm laser and DMS. 

If you have undergone an arthroscopic procedure, but not yet fully out of pain, I will use laser. 

I often use glucosamine and chondroitin sulfate with high dose omega 3′s.

I like topical menthol products such as BioFreeze. These have evidence of efficacy.

There are dangers of using cortisone, which has been administered for years as an injection in the joints. If any of my patients ask for cortisone because it worked when administered to them 10 years ago, I would educate them on safer long-term options. The most common recommendation I have for most of my patients is to eat less carbs and exercise more. I love the anti-inflammatory diet coupled with UltraInflamX by Metyagenics and high dose omega 3 fish oils. Through weight reduction and a low-impact exercise program, many patients will achieve dramatic improvements in their arthritis pain.

My goal for patients is to decrease pain and inflammation, maintain or improve function and retard disease progression if possible. In this regard, preventing damage to subchondral bone, cartilage, joint space narrowing and osteophyte formation is the goal. 

The contraindications for NSAIDs include gastrointestinal (GI) bleeding or adverse effects to the kidneys or liver. Some patients worry about taking a glucosamine product because they have diabetes, but I inform them no data support this concern. 

I might recommend UltraInflamX by Metagenics alot. I like garlic, ginseng and gingko — but these affect bleeding time. If used in conjunction with NSAIDs, the risk of GI problems increases.

Functional Movement Screen (FMS) Website

Functional Movement Screen is Part of Your Treatments

Muscle imbalance is a common problem for all of my patients. Most patients don’t even realise that muscle imbalance is what got them in trouble.

Muscle imbalance can be attributed to two changes in muscle function:

• A tightening of the muscles which provide movement e.g. hamstring
• The weakening the muscles that control movement/joint position e.g. the gluteals are the key stabiliser muscles around the hip joint

Changes in the function of these muscles cause muscle imbalance.

Normal movement is the key!

• The limited range of motion can affect movement and place greater stress on the joints- this can also lead to injury!
• The tightness in the muscle may inhibit the opposing muscle group through a process called reciprocal innervation.
• Weakening the muscles that control movement significantly affect their endurance. This means they may not be able to function for as long a period as you require.

My job is to pin point the factors affecting your pain and/or performance. I use the Functional Movement Screen and provide corrective exercise to reduce the chance of injury.