C5 Radiculopathy

C5 Radiculopathy

With radiculopathy involving C5, there typically is no pain distal to the elbow and no numbness or paresthesia in the hand. The patient generally reports cervical pain along with pain in the shoulder, medical border of the scapula, and upper arm. Paresthesia or numbness or both may be seen over the deltoid area and radial aspect of the upper arm. The biceps reflex may be decreased or absent, although this is less likely than with C6 radiculopathy. Motor loss involves shoulder abduction. 

Foods to Avoid

AVOID:

Ripened cheeses (Cheddar, Emmentaler, Stilton, Brie, Camembert)

                              (permissible cheeses: American, cottage, cream, Velveeta)

Herring, pickled or dried

Chocolate

Anything fermented, pickled, or marinated

Sour cream (no more than ½ cup daily)

Nuts, peanut butter

Sourdough bread, breads, and crackers containing cheese or chocolate

Broad beans, lima beans, fava beans, snow peas

Foods containing monosodium glutamate (MSG)-soy sauce, meat tenderizers, seasoned salt

Figs, raisins, papayas, avocados, red plums (no more than ½ cup daily)

Citrus fruits (no more than ½ cup daily)

Bananas (no more than ½ cup daily)

Pizza

Excessive amounts of tea, coffee, or cola beverages (no more than 2 cups daily)

Sausage, bologna, pepperoni, salami, summer sausage, hot dogs

Chicken livers, pate

Alcoholic beverages: (If you do drink, limit yourself to two normal size drinks selected from Haute Sauterne, Riesling, Seagram’s VO, Cutty Sark)

Diet and Headache

Diet and Headache

Below is a list of foods that may trigger headaches. Dietary triggers do not necessarily contribute to headaches in all patients. Certain foods may trigger attacks in certain individuals, but not on every occasion. Be your own expert by trying to log the foods you have eaten before a migraine attack and see whether their removal reduces or eliminates your headaches.

Dejerine’s Sign Clinical Pearl

Dejerine’s Sign

Clinical Pearl

Patients with radicular symptoms and pronounced Dejerine’s sign, especially if it is in the lumbar spine, should be told to bend the knees and lean into a wall during a cough or sneeze. This maneuver reduces intradiscal pressure and minimizes the effect of the cough or sneeze on the nerve root. A more worrisome situation is the sudden, unexpected absence of Dejerine’s sign when all other clinical findings indicate an active nerve root compression. The loss of the sign indicates fragmentation of the disc with momentary decompression of the nerve.

Distraction Test

The complaints of patients with chronic or degenerative conditions of the cervical disc are quite different from those of patients with acute conditions. Patients with chronic conditions experience intermittent episodes of pain, discomfort, and muscle spasm. Exacerbations come from exertion. Pain and stiffness may result from weather changes or unexplained causes. Radiculopathy is not always present. Hyporeflexia, motor weakness, and sensory disturbance (especially paresthesia) are common. 

Clinical Pearl

Brachial Plexus Tension Test

Clinical Pearl

Although the brachial plexus tension test involves shoulder joint movement, it also provides maximum stretch on the brachial plexus, which affects the lower branches of the cervical spine (C5) the most. If this test is positive, the early stages of a C5 nerve root disorder may be present along with the subtle signs of a positive doorbell sign (pain that occurs at the superior scapulovertebral border and radiates with the use of deep palpation of the C5 segment) and pain in the deltoid area. The deltoid pain is often misconstrued as an articular problem of the shoulder.

Functional Assessment

Functional Assessment

A complete functional assessment includes evaluation of the following:

1.      Self-care: ability to wash, bath, attend to toilet needs, dress, cook, and feed oneself

2.      Mobility: ability to stand, transfer, walk, negotiate stairs, drive, and use public transportation

3.      Lifestyle: nature of occupation, work capacity, and Social Security benefits

The Cervical Spine

The Cervical Spine

Axioms of Cervical Spine Assessment

1.      Cervical spine syndromes are extremely common and are probably the fourth most common cause of pain.

2.      At any given time, 9% of men and 12% of women have neck pain with or without arm and hand pain, and 35% of the population can remember having had neck pain at some time.

3.      The cervical spine is the origin of a large proportion of shoulder, elbow, hand, and wrist disorders.

4.      Most people who develop pain in the neck do not seek medical attention because they regard such pain as a part of life, so they simply wait for it to disappear.

Your Top 10 Superfoods


When it comes to ditching unwanted pounds, these key ingredients are as powerful as they are tasty. Add them to your plate to lose weight!

 

Wild Salmon

Slimming superpowers: The fish's omega-3 fatty acids could help you fight flab more effectively. They alter the expression of certain genes, shifting your body to burn fat rather than store it.
The amazing proof: In a study analyzing the diets of 35,000 women, published in Public Health Nutrition, those subjects who ate oily fish such as salmon two to four times per week had the lowest basal metabolic indexes, a common measure of body fat.

Apples

Slimming superpowers: This fruit's 4 to 5 grams of fiber not only are filling but also help ferry out some of the fat and calories you take in from other foods.
The amazing proof: People who ate an apple 15 minutes before lunching on cheese tortellini consumed 187 fewer calories in total than those who snacked on nothing beforehand, a study from Penn State University in University Park determines. How about them apples?

Quinoa

Slimming superpowers: A complete protein, quinoa has all the essential amino acids needed to build metabolism-revving muscle.
The amazing proof: Reduced-calorie dieters eating about 115 g of protein daily lost 22 percent more fat after four months than those who ate 70 g per day, The Journal of Nutrition reports.

Lentils

Slimming superpowers: These legumes are rich in resistant starch (RS), a carbohydrate that may encourage fat burning and shrink fat cells.
The amazing proof: When study participants enjoyed a meal with 5 g of RS—about what you get from 3/4 cup cooked lentils—they burned 23 percent more fat over 24 hours than when they had a meal without the starch, researchers at the University of Colorado in Denver say.

Olive Oil

Slimming superpowers: Healthful monounsaturated fats found in olive oil could potentially switch on genes related to fat burning and storage.
The amazing proof: Dieters on a low-cal plan emphasizing monounsaturated fats, protein and complex carbs lost almost double the weight that dieters who ate the same calories but less total fat and protein and more carbs lost, a study in the Archives of Internal Medicine reveals.

Eggs

Slimming superpowers: The breakfast staple is loaded with choline, a compound known to help block fat absorption.
The amazing proof: After eight weeks, dieters who ate two eggs, toast and jelly for breakfast five days a week lost 65 percent more weight than those who had a same-calorie bagel breakfast without eggs, according to a study in the International Journal of Obesity.

Yogurt

Slimming superpowers: Lowfat and nonfat Greek and regular yogurts contain 20 percent or more of your daily calcium needs. The mineral slows production of cortisol, a hormone that encourages belly-flab buildup.
The amazing proof: People on a low-cal diet that included yogurt lost 81 percent more belly fat than those on a similar but no-yogurt plan, a study from the University of Tennessee at Knoxville concludes. This dairy is a must-do.

Sweet Potatoes

Slimming superpowers: These spuds have RS, the same carbs found in lentils that may turn up the body's fat-scorching furnace. RS may also increase production of peptide hormone compounds that signal the brain to stop eating.
The amazing proof: After a breakfast and a lunch containing RS, subjects ate about 10 percent fewer calories over the next 24 hours compared with when they had similar meals with a placebo, research from the University of Surrey indicates.

Kiwifruit

Slimming superpowers: A large kiwi has 84 milligrams of vitamin C—more than a day's quota. C helps form carnitine, a compound that transports fat into cell mitochondria, where it's burned for energy during exercise.
The amazing proof: People with low blood levels of C burned 10 percent less fat per pound of body weight while walking than did those with normal levels of C, a study at Arizona State University in Mesa shows. But when subjects got a dose of C, their fat burning increased fourfold.

Edamame

Slimming superpowers: The green soybeans supply 17 g of protein per cup, and your body torches more calories digesting protein than it does processing carbs and fat.
The amazing proof: Researchers from the Federal University of Vicosa found that people burned about 70 more calories per day when their A.M. meal contained soy protein versus other types of protein. Cool beans!

Sleep Tips Part 7

How to sleep better tip 7: Know when to see a sleep doctor

If you’ve tried the tips above, but are still struggling with sleep problems, you may have a sleep disorder that requires professional treatment. Consider scheduling a visit with a sleep doctor if, despite your best efforts at self–help, you are still troubled by any of the following symptoms:

§  Persistent daytime sleepiness or fatigue

§  Loud snoring accompanied by pauses in breathing

§  Difficulty falling asleep or staying asleep

§  Unrefreshing sleep

§  Frequent morning headaches

§  Crawling sensations in your legs or arms at night

§  Inability to move while falling asleep or waking up

§  Physically acting out dreams during sleep

§  Falling asleep at inappropriate times

10 Ways to Protect Your Eyes

10 Ways to Protect Your Eyes

Your eyes can process 36,000 bits of information every hour. That's why it's so important to protect your vision with good eye-health habits. If you want to see clearly for years to come, follow these 10 steps to prevent vision problems.

How are your peepers doing? Take this eye health quiz to find out.

1. Know Your Family's Eye Health History

Does glaucoma run in your family? Does anyone have cataracts? Many eye problems are hereditary. If you know you have a high risk for developing an eye disease or eye condition, you can take steps to prevent it.

2. Schedule an Eye Exam

It's important to have an eye exam to make sure your eyes are healthy and seeing their best. A visual acuity test will help your optometrist determine if you need eyeglasses or contact lenses for vision correction. A dilated-eye exam should also be done to check your eyes for any damage or signs of disease, such as glaucoma, cataracts, or age-related macular degeneration (AMD).

Are you at risk for these 3 common eye problems?

3. Eat Right to Nourish Your Eyes
It's true that beta carotene in carrots is good for your eyes, but so are ample amounts of vitamin C, vitamin E, zinc, and omega-3 fatty acids. They all help reduce your risk of AMD, a common eye disease that can lead to blindness. Fill up on oranges, strawberries, and leafy greens for vitamin C. Add turkey and chicken for zinc. Eat almonds and peanut butter for vitamin E, and salmon, tuna, or halibut for omega-3s.

12 recipes for healthy eyes

4. Wear Your Sunglasses
Sunglasses help prevent cataracts and crow's feet. Ultraviolet (UV) rays can damage your eyes in any season, and in morning and late afternoon, too -- not just midday. Choose sunglasses with large lenses -- or even wraparound lenses -- that offer 99% to 100% UVA and UVB radiation protection.

5. Exercise for Better Vision
Vigorous exercise, such as running, can protect your eyes from cataracts and AMD. Not a runner? Any workout that pumps up your cardio fitness, such as biking, roller skating, swimming, or lifting weights, can protect your eyesight by reducing inflammation in your body that can negatively impact your eyes.

6. Take Care of Contact Lenses to Prevent Eye Infections
Always wash your hands thoroughly before handling contacts, and follow the instructions for cleaning, disinfecting, and storing them to reduce your risk of eye infections. Also, wear and replace contact lenses as recommended by your eye doctor.

7. Treat Dry, Irritated Eyes
Are your eyes itchy, scratchy, burning, or dry? As you age, normal tear production decreases, which can lead to dry eyes. To prevent dry eyes, eat more foods with vitamin A (like cantaloupe, carrots, and mangoes), use a humidifier to moisten dry air, and wear sunglasses to protect your eyes on bright or windy days. Some prescription and over-the-counter meds, such as antihistamines and pain relievers, can reduce your eyes' ability to create natural tears, so ask your doc for alternatives.

8. Prevent Computer Eyestrain
Most of us forget to blink and take breaks as often as we should while working on the computer or watching TV, which can make eyes tired and dry. It might even give you a headache. Follow the 20-20-20 rule to reduce eyestrain: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.

9. Check Your Eyes for Signs of Other Health Problems
If your optometrist notices that blood vessels in your eyes look stiff, form kinks or loops, or look bronze or gray instead of red, it could be a sign of high blood pressure or diabetes, which can harm your eyesight. Blocked blood vessels or inflammation in your eyes may signal autoimmune disease that can cause vision problems, pain, sensitivity to light, and red, itchy eyes.

10. Use Protection to Prevent Eye Injuries
Whether playing sports or doing chores around the house, protect your eyes to reduce your chance of eye injury. If you normally wear eyeglasses while playing tennis or baseball, be sure your frames are made of polycarbonate -- a super-strong plastic. When using household cleaning products, wear safety goggles to shield your eyes from chemical splashes, turn the spray nozzle away from you, and wash your hands thoroughly after using cleaning chemicals.