LBP vs. Piriformis Syndrome
Q: I have low back pain and right leg pain. One person said it is a back problem and another said it was a piriformis syndrome. How can I tell the difference? I want to continue my walking without pain.

A: These two conditions can be similar except when it relates to activity level and pain timing. The pain with a low back injury will usually be much more intense when sitting or performing repetitive tasks that load the area of injury such as aggressive high-impact walking. If it is a low back injury, non-weight bearing exercise and traction/distraction that unloads the spine will help to alleviate the pain. It is prudent to be both gently active for circulation and rest, allowing time to heal. Stabilizing core muscles in the pelvis, low back, and abdomen region is important for long-term resolution.

Piriformis syndrome is a tight, strained muscle that becomes increasingly tight and constricted if allowed to rest. The pain level is generally increased initially by stretching the muscle with internal hip rotation, but with further activity it reduces pain. More aggressive stretching and light to medium ambulating helps to circulate fresh blood through the injured muscle resetting correct tone and promoting healing. Be sure to make time for stretching after exercise.
— Jacob May, DC

Black Cohosh
Q: My friend is taking black cohosh for hot flashes. Is this something I should be taking?

A: Hot flashes are most likely caused by fluctuations in estrogen levels. Some foods and herbs have compounds, known as phytoestrogens, that have a similar structure to estrogen and can be helpful for balancing estrogen levels. Black cohosh is the most studied herb for menopausal complaints. Numerous scientific studies have shown it to be helpful for hot flashes and other menopausal concerns. However, just because it works for your friend, doesn’t mean that it is right for you. Women who have hot flashes disrupting their sleep or daily routine may need actual estrogen, by prescription, to help them balance their estrogen levels and decrease the frequency and severity of hot flashes. Your doctor can prescribe bio-identical estrogen replacement. Women with mild to moderate hot flashes may find they can manage with diet, lifestyle, and herbal support. Eating a good balanced diet high in fruits and vegetables, exercising and taking supportive herbs, such as black cohosh, red clover, and ginseng may be helpful. Ask your doctor, pharmacist, or naturopathic physician what your options are, get educated and make informed decisions. Remember that menopause is a natural life transition, not an estrogen-deficiency disease.
— Arianna Staruch, ND

Foot Adjustments
Q: A friend has her feet adjusted by her chiropractor and says it makes a big difference. Is this common and something that you recommend?

A: Depending on the shape of your feet, history of conditioning and injuries adjusting the feet, knees and hips can make a great difference for your performance. High arch feet (pez cavus) benefit from adjustments to restricted joints within the foot allowing for smoother muscle contraction phase upon heel strike, midstance and toe off. Adjusting someone’s flat feet (pez planus) helps reposition joint stretch receptors that activate muscles in the foot and calf. When your feet feel good your body gets many neurologic signal messages stating “okay to keep going” allowing for more comfort and distance. If you have a chiropractor now be sure to have her check your feet and legs.
— Bryan Baisinger, DC

Springtime Allergies
Spring is such a magical time to walk. The plum blossoms rain down like snow at the slightest breeze — and then you start to sneeze! In the U.S. there are 36 million people who suffer with seasonal allergies. Up to 30% of adults and 40% of children suffer with allergic rhinitis. That’s sneezing, runny nose, and watery eyes common with allergy sufferers. Allergic rhinitis can lead to lack of energy and even behavior problems in children. Other conditions that can be linked to allergic rhinitis include asthma, sinusitis, ear infections, sleep disorders, and even depression and back pain

In the Pacific NW, our temperate rain forest supports a myriad of pollen sources, from trees and grasses, to flowers and weeds. One of the most notorious of allergy inducers here is Scotch broom, that yellow flower that lines the freeways from Seattle to Bandon. Allergists suggest avoiding outdoor activities during the high-pollen season or when pollen counts are highest — usually between the hours of 5am and 10am.

There are a number of over-the-counter and prescription drugs available for allergy symptoms, including antihistamines, and nasal sprays containing steroids. There are also some natural support options that may be helpful for mild to moderate complaints.

A placebo-controlled study published in 2004 showed that the herb Butterbur could improve nasal symptoms in allergic rhinitis. An open trial with Butterbur also helped some asthma sufferers to reduce the amount of asthma medication they needed to take.
The anti-inflammatory benefits of eating fish or taking fish oil (omega 3 fatty acid supplements) helpful in cardiovascular health may also be helpful for allergies and asthma.

Some of the other popular natural support options for allergies include freeze-dried stinging nettles, quercitin (both natural antihistamines), and N acetyl-cysteine (a mucus buster).

Vitamin E was shown to have some benefit with hay-fever, but recent studies questioning the safety of doses of vitamin E above the daily recommended intake, means that further studies are needed before taking vitamin E in high doses.

Herbs and supplements usually have a greater safety margin than drugs, but that does not mean that they are safe for you. Each individual is different, so be sure to check with your doctor, pharmacist or naturopathic physician before taking any over-the-counter medication, supplement, or herb. Don’t let your allergies keep you from enjoying spring walks. Get educated, get help.
— Arianna Staruch, ND

This issue’s experts:
Jacob May, DC, brings careful thought and analytical thinking blended with a holistic approach to medicine. To contact Jacob May, call 503-279-0205 or email jacob@clearh2o.org.

Arianna Staruch is a naturopathic physician focused on women’s health issues. To contact Dr. Staruch call 503-279-0205 or email arianna@clearh2o.org.

Bryan Baisinger, DC, is owner of Clearwater Chiropractic & Massage. To contact Dr. Baisinger call 503-279-0205 or email bryan@clearh2o.org.