Dysbiosis and What to Do About It


You have literally trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract. Together they create a virtual ecosystem.  This is known as your microflora.  This “Garden Within,” under certain conditions, will shift out of balance. This mimics how a garden becomes overgrown with the wrong plants or weeds. When that happens, we say a person has dysbiosis.

Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have an upset stomach after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating,  think dysbiosis.  

Three Ways Dysbiosis Can Impact Your Gut

1. Microbial Overgrowth

An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast takes first place as cause for an intestinal overgrowth.  An unwelcome virus or parasite can also cause an overgrowth imbalance. 

To treat this type of dysbiosis Western practitioners prescribe medication (usually antibiotics) to kill unwanted bacteria, parasites, or yeast.  Dr. Smith prefers using gentler, broad-spectrum antimicrobial herbs to weed the internal garden.  Also, probiotics and fiber-rich foods encourage growth of the good while getting rid of the bad.

2. Microbial Undergrowth

This is less common than a microbial overgrowth, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise. An under-abundance indicates a need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. You do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.

3. Microbes Settling in the Wrong Place

Living microbes are wanted, but we need them to live where they belong.  Sometimes they take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well. Herbs and antibiotics are the go-to for treating SIBO.


Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, may also be tracked back to dysbiosis. We are becoming more and more aware of the impact our microbiome has on our whole being – our whole health – and our disease processes.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  Inflammatory processes in the body result in the deposition of scar tissue in the fascia.  Scar tissue in fascia often results in pain syndromes.  Dr. Smith treats the pain from scar tissue with a combination of chiropractic, massage and fascia-specific modalities.

How did you get dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as do any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

And then there’s stress

Probiotics in your diet


Probiotics are live microorganisms that have health benefits when consumed.  Probiotics — which are usually beneficial bacteria — provide all sorts of powerful benefits for your body and brain.  Studies suggest that they may improve digestive health, reduce depression and promote heart health.  Some evidence suggests they may even give you better-looking skin.

Getting probiotics from supplements is popular, but you can also get them from fermented foods.

Here is a list of 8 probiotic foods that will add these beneficial bacteria to your diet.

9 Nutritious Probiotic Rich Foods

1. Yogurt

Yogurt is one of the best sources of probiotics, which are friendly bacteria that can improve your health.  It is made from milk that has been fermented by friendly bacteria, mainly lactic acid bacteria and bifidobacteria.

Eating yogurt is associated with many health benefits, including improved bone health. It is also beneficial for people with high blood pressure.  In children, yogurt may help reduce the diarrhea caused by antibiotics. It can even help relieve the symptoms of irritable bowel syndrome.

Additionally, yogurt may be suitable for people with lactose intolerance. This is because the bacteria turn some of the lactose into lactic acid, which is also why yogurt tastes sour.  However, keep in mind that not all yogurt contains live probiotics. In some cases, the live bacteria have been killed during processing.  For this reason, make sure to choose yogurt with active or live cultures.

Also, make sure to always read the label on yogurt before you buy it. Even if it is labeled low-fat or fat-free, it may still be loaded with high amounts of added sugar.

2. Kefir

Kefir is a fermented probiotic milk drink. It is made by adding kefir grains to cow’s or goat’s milk.  Kefir grains are not cereal grains, but rather cultures of lactic acid bacteria and yeast that look a bit like cauliflower.

The word kefir allegedly comes from the Turkish word keyif, which means “feeling good” after eating.  Indeed, kefir has been linked to various health benefits.  It may improve bone health, help with some digestive problems and protect against infections.

While yogurt is probably the best known probiotic food in the Western diet, kefir is actually a better source. Kefir contains several major strains of friendly bacteria and yeast, making it a diverse and potent probiotic.  Like yogurt, kefir is generally well tolerated by people who are lactose intolerant.

3. Sauerkraut

Sauerkraut is finely shredded cabbage that has been fermented by lactic acid bacteria.  It is one of the oldest traditional foods and is popular in many countries, especially in Europe.  Sauerkraut is often used on top of sausages or as a side dish. It has a sour, salty taste and can be stored for months in an airtight container.

In addition to its probiotic qualities, sauerkraut is rich in fiber as well as vitamins C, B and K. It is also high in sodium and contains iron and manganese.  Sauerkraut also contains the antioxidants lutein and zeaxanthin, which are important for eye health.

Make sure to choose unpasteurized sauerkraut, as pasteurization kills the live and active bacteria.

4. Tempeh

Tempeh is a fermented soybean product. It forms a firm patty whose flavor is described as nutty, earthy or similar to a mushroom.  Tempeh is originally from Indonesia but has become popular worldwide as a high-protein meat substitute.  The fermentation process actually has some surprising effects on its nutritional profile.

Soybeans are typically high in phytic acid, a plant compound that impairs the absorption of minerals like iron and zinc.  However, fermentation lowers the amount of phytic acid, which may increase the amount of minerals your body is able to absorb from tempeh.  Fermentation also produces some vitamin B12, a nutrient that soybeans do not contain.

Vitamin B12 is mainly found in animal foods, such as meat, fish, dairy and eggs.  This makes tempeh a great choice for vegetarians as well as anyone looking to add a nutritious probiotic to their diet.

5. Kimchi

Kimchi is a fermented, spicy Korean side dish.  Cabbage is usually the main ingredient, but it can also be made from other vegetables.  Kimchi is flavored with a mix of seasonings, such as red chili pepper flakes, garlic, ginger, scallion and salt.

It contains the lactic acid bacteria Lactobacillus kimchii, as well as other lactic acid bacteria that may benefit digestive health.  Kimchi made from cabbage is high in some vitamins and minerals, including vitamin K, riboflavin (vitamin B2) and iron.

6. Miso

Miso is a Japanese seasoning.  It is traditionally made by fermenting soybeans with salt and a type of fungus called koji.  Miso can also be made by mixing soybeans with other ingredients, such as barley, rice and rye.

This paste is most often used in miso soup, a popular breakfast food in Japan. Miso is typically salty. You can buy it in many varieties, such as white, yellow, red and brown. Miso is a good source of protein and fiber. It is also high in various vitamins, minerals and plant compounds, including vitamin K, manganese and copper.

Miso has been linked to some health benefits.  One study reported that frequent miso soup consumption was associated with a lower risk of breast cancer in middle-aged Japanese women.  Another study found that women who ate a lot of miso soup had a reduced risk of stroke.

7. Kombucha

Kombucha is a fermented black or green tea drink.  This popular tea is fermented by a symbiotic colony of bacteria and yeast or SCOBY. It is consumed in many parts of the world, especially Asia.  The internet abounds with claims about the potential health effects of kombucha.

However, high-quality evidence on kombucha is lacking.  The studies that exist are animal and test-tube studies, and the results may not apply to humans.

However, because kombucha is fermented with bacteria and yeast, it does probably have health benefits related to its probiotic properties.

8. Pickles

Pickles (also known as gherkins) are cucumbers that have been pickled in a solution of salt and water.  They are left to ferment for some time, using their own naturally present lactic acid bacteria. This process makes them sour.

Pickled cucumbers are a great source of healthy probiotic bacteria which may improve digestive health.  They are low in calories and a good source of vitamin K, an essential nutrient for blood clotting.

Keep in mind that pickles also tend to be high in sodium.  It is important to note that pickles made with vinegar do not contain live probiotics.

9. Traditional Buttermilk

The term buttermilk actually refers to a range of fermented dairy drinks.  However, there are two main types of buttermilk: traditional and cultured.

Traditional buttermilk is simply the leftover liquid from making butter. Only this version contains probiotics, and it is sometimes called “grandma’s probiotic.”

Traditional buttermilk is mainly consumed in India, Nepal and Pakistan.  Cultured buttermilk, commonly found in American supermarkets, generally does not have any probiotic benefits.

Buttermilk is low in fat and calories but contains several important vitamins and minerals, such as vitamin B12, riboflavin, calcium and phosphorus.

The Anti-Inflammatory Diet


An anti-inflammatory diet is an eating plan designed to prevent or reduce low-grade chronic inflammation, a key risk factor in a host of health problems and several major diseases. The typical anti-inflammatory diet emphasizes fruits, vegetables, lean protein, nuts, seeds, and healthy fats.

Often resulting from lifestyle factors like stress and a lack of exercise, chronic inflammation results when the immune system releases chemicals meant to combat injury and bacterial and virus infections, even when there are no foreign invaders to fight off.

The Anti-Inflammatory Diet

Since our food choices influence the level of inflammation in our bodies, the anti-inflammatory diet is thought to curb chronic inflammation and help prevent or treat chronic illnesses.  The following conditions are thought to benefit from this type of diet: allergies, Alzheimer’s disease, arthritis, asthma, cancer, depression, diabetes, gout, heart disease, inflammatory bowel disease (such as ulcerative colitis and Crohn’s disease), irritable bowel syndrome (IBS), and stroke.

1. Foods to Eat on the Anti-Inflammatory Diet

Research suggests that people with a high intake of vegetables, fruits, nuts, seeds, healthy oils, and fish may have a reduced risk for inflammation-related diseases. In addition, substances found in some foods (especially antioxidants and omega-3 fatty acids) appear to possess anti-inflammatory effects.

Foods high in antioxidants include:

  • Berries (such as blueberries, raspberries, and blackberries)
  • Cherries
  • Apples
  • Artichokes
  • Avocados
  • Dark green leafy vegetables (such as kale, spinach, and collard greens)
  • Sweet potatoes
  • Broccoli
  • Nuts (such as walnuts, almonds, pecans, and hazelnuts)
  • Beans (such as red beans, pinto beans, and black beans)
  • Whole grains (such as oats and brown rice)
  • Dark chocolate (at least 70 percent cocoa)

Foods high in omega-3 fatty acids include:

  • Oily fish (such as salmon, herring, mackerel, sardines, and anchovies)
  • Flaxseed
  • Walnuts
  • Omega-3-fortified foods (including eggs and milk)

There’s also some evidence that certain culinary herbs and spices, such as ginger, turmeric, and garlic, can help alleviate inflammation.

2. Foods to Avoid

Omega-6 fatty acids (a type of essential fatty acid found in a wide range of foods) are known to increase the body’s production of inflammatory chemicals. Since omega-6 fatty acids help maintain bone health, regulate metabolism and promote brain function, you shouldn’t cut them out of your diet altogether. However, it’s important to balance your intake of omega-6 fatty acids with your intake of omega-3 fatty acids in order to keep inflammation in check.

Foods high in omega-6 fatty acids include:

  • Meat
  • Dairy products (such as milk, cheese, butter, and ice cream)
  • Margarine
  • Vegetable oils (such as corn, safflower, soybean, peanut, and cottonseed oil)

Instead of vegetable oils, opt for oils like olive oil and avocado oil.

Additionally, studies show that a high intake of high-glycemic index foods like sugar and refined grains, such as those found in white bread and many processed foods, may rev up inflammation. Avoid sugary drinks, refined carbohydrates, desserts, and processed snack foods.


3. The Benefits of an Anti-Inflammatory Diet

More and more research suggests that an anti-inflammatory diet may play a key role in scores of health conditions. A study published in the British Journal of Nutrition in 2017, for instance, assessed the association between dietary inflammation (measured by a dietary inflammatory index) and atherosclerosis (the buildup of plaque in the arteries) in women over the age of 70. Researchers found that dietary inflammatory index scores were associated with subclinical atherosclerosis and heart-disease-related death.

Adhering to an anti-inflammatory diet may help reduce levels of certain inflammatory markers (such as a substance called C-reactive protein) in people with type 2 diabetes, according to a study published in Endocrine in 2016. For the study, people with newly diagnosed type 2 diabetes followed the Mediterranean diet or a low-fat diet. After one year, C-reactive protein levels fell by 37 percent in people on the Mediterranean diet but remained unchanged in those on the low-fat diet.

4. Meal Ideas

Breakfast foods: breakfast smoothie, chia bowl, oatmeal.

Lunch: salad with quinoa and vegetables, soup, grilled salmon.

Snacks: fresh blueberry fruit salad, apples, and nut butter, walnuts, chia seed pudding, guacamole.

Beverages: ginger turmeric tea, golden milk, green juice, green smoothie, herbal tea, turmeric tea, green tea.

5. Tips on Following an Anti-Inflammatory Diet

  • Eat five to nine servings of antioxidant-rich fruits and vegetables each day.
  • Limit your intake of foods high in omega-6 fatty acids while increasing your consumption of foods rich in omega-3 fatty acids (such as flaxseed, walnuts, and oily fish like salmon, tuna, mackerel, and herring).
  • Replace red meat with healthier protein sources, such as lean poultry, fish, soy, beans, and lentils.
  • Swap out margarine and vegetable oils for the healthier fats found in olive oil, nuts, and seeds.
  • Instead of choosing refined grains, opt for fiber-rich whole grains like oats, quinoa, brown rice, bread, and pasta that list a whole grain as the first ingredient.
  • Rather than seasoning your meals with salt, enhance flavor with anti-inflammatory herbs like garlic, ginger, and turmeric.

What is Adrenal Fatigue Syndrome?


We all get run-down now and then due to the stresses of everyday life and the demands of our busy schedules. Over extended periods of time this can overburden our bodies, creating a situation that’s not so easy to bounce back from. In particular the adrenal glands, being in charge of the release of various stress hormones, can become exhausted and unable to effectively do their job. This is referred to as “adrenal fatigue.” When this happens, our fatigue can become chronic and be joined by other symptoms such as pain and inflammation.

The underlying signs of adrenal fatigue as seen through diurnal cortisol testing.  

Understanding and Treating Adrenal Fatigue

1. About Adrenal Fatigue

The adrenal glands have many functions, including the secretion of cortisol and other hormones in response to stress. Stress comes in many forms: physical, psychological, emotional, mechanical, chemical, environmental, etc. It can come from an emotional trigger like a fight with a loved one or trouble at work. It can also come from a physical trigger like an injury or motor vehicle accident. 

When prompted by pain or inflammation cortisol is released from the adrenal glands into the blood. Cortisol modifies the inflammatory pathways resulting in a decrease in inflammation and pain. When a drop in blood sugar occurs cortisol is secreted to help balance the levels of sugar in the blood. Cortisol is also released from the adrenal glands in a 24-hour daily rhythm with a burst in the morning to help us awake and a decrease in the evening to help us sleep. 

When adrenal glands are required to secrete at high levels for extended periods of time due to prolonged stress, pain, or blood sugar imbalances, they can become fatigued or begin to secrete cortisol at lower levels. When this occurs it is common to see an increase in fatigue, pain and/or inflammation.

2. Symptoms of Adrenal Fatigue

The list of possible symptoms is quite long (75+). Below are a few of the more common that you may find relatable.

  • Insomnia
  • Low Blood Pressure
  • Low libido and lack of sex drive
  • Feeling hypoglycemic despite normal lab values (getting hangry a lot)
  • Depression
  • Anxiety, often accompanied by panic attacks
  • Brittle hair and thinning skin/fingernails
  • Not feeling rested despite a full night of sleep
  • Feeling “wired” and unable to relax
  • Feeling tired in the afternoon between 3 and 5.
  • Needing coffee to get going in the morning.
  • Feeling tired between 9 and 10 pm.
  •  Craving for salty food such as potato chips
  • Cold hands and feet; general sensitivity to cold.
  • Abdominal fat accumulation.
  • Generalized pain and inflammation.
  • Weight loss with more advanced cases

3. The Adrenal Fatigue Controversy

Adrenal Fatigue is increasingly common, yet there still remains an unwillingness among medical doctors to diagnose it. There are essentially three reasons for this:

1. Lab Tests are Inconclusive.
2. It is not yet formally recognized as a diagnosis.
3. There is no pharmacological solution.

“Adrenal fatigue is not a real medical condition. There are no scientific facts to support the theory that long-term mental, emotional, or physical stress drains the adrenal glands and causes many common symptoms.” 

– Hormone Foundation

“Any doctor worth his/her salt understands that the term “adrenal fatigue” means mild adrenal insufficiency. The Hormone Foundation statement readily admits that adrenal insufficiency IS a real diagnosis. To me, they seem to be denying the possibility that some people might have a mild form of a real diagnosis. That’s short-sighted and excessively arbitrary.” – Richard Shames, MD

In time this will change, but what does that mean for you in the meantime?
If you suspect that you are suffering from adrenal fatigue, taking an adrenal fatigue assessment quiz is a good first step. If you answer yes to more than 10 questions may indicate that you have been under sustained stress. In the case that you have been experiencing a number of physical and/or psychological symptoms a deeper assessment of your Diurnal Cortisol levels may be appropriate.

4. Recovering From Adrenal Fatigue

The Approach to Adrenal Fatigue in short:

Diet Modification: Eating a diet rich in fruits, vegetables, whole grains and legumes that provides antioxidants and nutrients is essential for adrenal health (i.e. an anti-inflammatory diet).  The adrenal glands need a good diet rich in B vitamins, vitamin C, zinc and magnesium. Eating quality protein at each meal allows the body to maintain healthy levels of blood sugar without taxing the adrenals. Eliminating caffeine and alcohol is also crucial.
Lifestyle Modification: In a word, Stress Management. With adrenal issues stress management is vital to any treatment. Proper sleep, stress reduction techniques such as deep breathing or meditation and exercise can all increase the body’s ability to handle stress.
Supplementation: providing extra nutrition through a multivitamin, increasing minerals available to our system through the use of raw sea salt, and using adaptogens to help balance your hormones and manage your stress response.

Be gentle with yourself.  Give your body the permission and time that it needs to heal. 

What is Rotator Cuff Syndrome?


 The rotator cuff is a group of muscles and tendons that surround the shoulder joint.  It keeps the head of the humerus firmly within the shallow socket of the shoulder. A rotator cuff injury often causes a dull ache in the shoulder.  This often worsens when you try to sleep on the involved side.

A wide variety of techniques can be used to address Rotator Cuff Syndrome. These include sports massage, myofascial release, assisted stretching, extremity adjustments, and appropriate home care.

Understanding Rotator Cuff Syndrome

1. Common Causes of Rotator Cuff Injuries

Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury increases with age.

Many people recover from rotator cuff injuries with physical therapy exercises.  These attempt to improve the flexibility and strength of the muscles surrounding the shoulder joint.

Sometimes, rotator cuff tears occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons, or eventual joint replacement.

2. Symptoms of Rotator Cuff Syndrome

The pain associated with a rotator cuff injury may:

  • Be described as a dull ache deep in the shoulder.
  • Disturb sleep, particularly if you lie on the affected shoulder.
  • Make it difficult to comb your hair or reach behind your back.
  • Be accompanied by arm weakness.
Many types of Shoulder Pain begin with a rotator cuff imbalance.  Frozen shoulder, impingement syndrome, and rotator cuff syndrome all often harken back to a rotator cuff muscular imbalance.  

3. Risk Factors for Rotator Cuff Syndrome

  • Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears most often affect people older than 40.
  • Certain sports. Athletes who regularly use repetitive arm motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
  • Construction jobs. Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that damage the rotator cuff over time.
  • Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.

4. Complications & Prevention

Without treatment, rotator cuff problems have the potential to cause permanent loss of motion or weakness.  They may also result in progressive degeneration of the shoulder joint. Although resting your shoulder is necessary for your recovery, keeping your shoulder immobilized for a prolonged time can cause the connective tissue enclosing the joint to become thickened and tight (frozen shoulder).

If you are at risk of rotator cuff injuries or if you’ve had a rotator cuff injury in the past, daily shoulder stretches and strengthening exercises can help prevent future injury.

What is Runner’s Knee?


Runner’s knee hurts, limits your mobility, makes it hard to get comfortable, and takes forever to heal.  The term runner’s knee is sometimes used a bit loosely.  It may be used to describe either tendinitis of the Ilio-tibial Band (ITB) tendon where it attaches on the lateral side of the knee.  More often it is used to describe patello-femoral syndrome which describes tendinitis and pain related to the patella and its surrounding/supportive structures.  Both are caused by repetitive overuse and what may be described as inappropriate stress on the knee.  

A wide variety of techniques can be used to address Runner’s Knee including: sports massage, myofascial release technique, assisted stretching, extremity adjustments, orthotics, and  appropriate home care.

What Do you Do about Runner's Knee?

1. Running Surface Matters

As we run there is a fair amount of force generated by the impact of our feet striking the ground.  Depending of the firmness of the ground, more or less of that force is transmitted up through and absorbed into our bodies.  That force is absorbed into our ligaments, tendons, muscles, and ultimately the discs in our backs.

You can think of there being a hierarchy of stress.  

  • Concrete:  Concrete is the worst.  It does not have any give.  If you are trying to aggravate your back or give yourself shin-splints, go run on concrete. 
  • Asphalt:  Asphalt is better than concrete.  There is some space between the particulates and there is a bit of give under your weight, especially when it is warm outside.
  • Track:  It was made for running.
  • Turf/Trail:  These are ideal as long as you have good balance & coordination.  The natural springiness of the earth is what we were made to run on, and it will absorb a fair amount of force.  If your balance is questionable, you may sprain an ankle.
  • Sand:  This is heaven if you can stand it.  It absorbs force, provides resistance, and the shifting surface is great for proprioceptive stimulation (improving balance).

2. Arch Support for Runner’s Knee

Poor arch support is the root of many of the problems that we suffer in the legs, knees, ankles, and feet.  You can think of the entire lower extremity as being one big sheet of connective tissue.  Inadequate medial arch support causes most people to pronate (feet roll in when walking/running) which rotates the hips and knees putting excess stress on many soft-tissues including the ITB.  Excess stress leads to inflammation.  Tendinitis literally means inflammation of the tendons.

3. Stretching for ITB Syndrome

The IT Band is the great human design flaw.  It crosses too many joints for us to stretch it effectively, and it gets tight from just about everything that you do.  The list of activities that aggravate the IT Band is extensive:  sitting, standing, walking, running, crouching, you get the idea.  If you are breathing and not in a half-fetal position, your IT Band is probably getting tight.

The ITB is very hard to stretch (but here’s a good one), but the combination of foam rolling and using a lacrosse ball on the TFL and Glut Minimus is quite effective.  If your tendon is already inflamed ice, rest, and kinesio tape go a long way.  For chronic ITB issues, you might consider arch support and an ITB strap.

How Chiropractors Treat Hip Pain


Your hips support your whole upper body providing stability, strength, and mobility. It stands out as one of the most common types of joint pain potentially occurring both early and later in life.  The hip joint specifically refers to where the rounded edge of the upper thigh bone (femur) connects with the socket of the pelvis, known as the acetabulum. This joint also contains connective tissue and is protected by several fluid-filled sacs called bursa. A long list of muscles connect to the hip providing it with support and producing a wide range of movement patterns.  This ball and socket joint can hurt for a wide variety of reasons.

We develop hip pain for a wide variety of reasons.  Overuse and improper biomechanics often lead to Bursitis or Tendinitis.  Later in life we often experience degeneration in the hips also known as Arthritis.

Common Causes

  • Osteoarthritis –Osteoarthritis is caused by natural wear and tear and usually presents after 50 years of age. Cardinal signs of arthritis are pain and stiffness in the morning as well as reduced range of motion.
  • Low Back Pain – It is inevitable that your low back can affect the hip. Both of these areas are closely connected and if you have any kind of lower back problems it can also lead to pain in your hips. Some low back issues are spinal stenosis, misaligned joints and  herniated discs.
  • Bursitis/Tendinitis – These condition occurs when there is inflammation or irritation to the bursa or surrounding tendons. Both Bursitis & Tendinitis can limit motion and cause pain due to inflamed soft tissues.

Chiropractic Treatment

Chiropractors treat hip pain by mobilizing the surrounding muscles and joints to help reduce inflammation in the area as well as increase flexibility.  They also employ a number of physical therapy modalities, such as e-stim & ultrasound to help reduce inflammation.  Reduction of inflammation and restoration of normal movement are key when it comes to treating hip pain.

Outside of your treatments try a few exercises to help stretch your hip and get some pain relief. The pigeon yoga pose (pic above), is helpful to open your hips and keep them loose. Tight hips can limit mobility and often contribute to low back pain as well. You can also use tools at home such as a yoga strap or foam roller to help lengthen and mobilize the soft tissues. 

Nerve Pain


Neuritis,  neuralgia, Sciatica, Thoracic Outlet Syndrome, & Carpal Tunnel all refer to nerve pain conditions.  The underlying control system for your body is the brain. The brain communicates to the rest of the body through the many nerves that make up your nervous system. Some nerves go straight to their destination, but others combine to form complicated nerve networks called a ‘plexus.’ The brachial plexus is made up of nerves that come out of the middle and lower neck that supply information to the shoulders, arm, elbows, wrists, hands and fingers.  The Lumbar Plexus is a similar arrangement of nerves originating in the Lumbar Spine and innervating the low back, pelvis, legs.

Dr. Smith uses a wide variety of techniques to treat nerve pain, including: sports massage, myofascial release technique, chiropractic, an anti-inflammatory diet, and physical therapy modalities.

Causes of nerve pain in the arm and hand

1. Brachial Plexus Nerve Pain

The nerves that make up the brachial plexus sometimes become irritated as they leave the spinal column. This occurs when the spinal bones in the neck and upper back are misaligned or do not have the range of motion they typically should.  This potentially damages the very nerves they are supposed to protect. Any injury or trauma can cause the bones to become misaligned or  decrease the local range of motion. Serious accidents or more minor irritations such as sleeping incorrectly can cause the vertebrae to become misaligned.

Muscles and joints  throughout the chest and shoulders also contribute to tightness around the brachial plexus, causing similar symptoms. This can be caused be structural deformities such as previous shoulder injuries or anatomic variation such as cervical ribs.  It can also be caused by one’s lifestyle, such as sitting at a desk or looking at a phone for too long. The pressure placed on the nerves and blood vessels can create numbness, tingling and pain down the arm collectively known as “thoracic outlet syndrome”.

2. Symptoms of Brachial Plexus Irritation

Symptoms from damage to or pressure on the brachial plexus can differ depending on location of the trauma.

Common symptoms to the shoulder, arm, wrist or hand are:

  • Muscle weakness
  • Muscle numbness
  • Neck pain
  • Neck stiffness
  • Decreased range of motion in the neck, shoulder, elbow or wrist

In addition to pain and symptoms in your arm or neck, it is not uncommon to experience headaches, facial pain, dizziness, or nasal problems as a result of brachial plexus nerve irritation.

3. Other Symptoms of Neck, Arm, Hand, and Shoulder Pain

Carpal Tunnel symptoms include tingling and numbness in the hand.  The pain is described as incredibly intense and has been reported to awaken sufferers at night. This pain is often caused by the swelling in the wrist. People often confuse nerves that are disrupted by the spine, muscles or joints as carpal tunnel syndrome.  However, the treatment in this case is completely different.  Misdiagnosed conditions can sometimes lead to unnecessary injections or surgery which could have otherwise been treated with conservative chiropractic care and soft tissue therapies such as Myofascial Release Technique.

4. Chiropractic for Shoulder, Arm, Neck, & Hand Pain.

The number of people suffering from pain and neurologic symptoms in their shoulders, arms and hands is on the rise.  Many of them seek help from a chiropractor or sports massage therapist. The chiropractic approach analyzes the body’s underlying structure to locate and reduce stress on the nervous system. Sports chiropractors with additional training can further help through the use of functional training, rehab exercises and soft tissue approaches such as myofascial release techniques and Therapeutic Massage. Such an approach often eliminates the pain and correct the underlying structural problem that refers pain to the arm, wrist, and hand.

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Abnormal Spinal Curves


The main purpose of the spine is to support the body’s weight.  However, it also provides stability to the torso, allows for flexibility & movement, and protects the spinal cord. Abnormal spinal curves may hinder or result in the inability of the spine to carry out any these functions.  

The  spinal column is composed of 24 vertebrae. There are 7 cervical vertebrae starting at the base of the skull and spanning the neck, 12 thoracic vertebrae located in the upper trunk of the body, and 5 lumbar vertebrae in the lower back. 

A “normal” spine consists of both concave and convex curvatures front to back.  However, when the curves become too extreme or the spine begins to curve laterally, painful spinal conditions may evolve.  Common abnormal curvatures of the spine include kyphosis, lordosis, and scoliosis.

We all have a natural curvature to our spines. However, excess or abnormal spinal curves can cause pain and a host of other issues.

Understanding Abnormal Spinal Curves

1. Kyphosis

Kyphosis is identified by an abnormal outward curvature of the thoracic spine. This type of spinal abnormality is most prevalent among the elderly population. People with this specific spinal abnormality may experience difficulty with balance because it tends to lead to an abnormal flexion of the spine. This can also increase compression and shear forces applied to the thoracic vertebrae, resulting in constant discomfort and inhibition of comfortable range of motion. Causes  of Kyphosis  can be years of poor posture such as anterior head carriage, or underlying inflammatory conditions such as  AS (Ankylosing Spondylitis), Scheuermann disease or DISH (Diffuse Idiopathic Skeletal Hyperostosis).

2. Lordosis

Lordosis, sometimes called swayback, refers to and abnormally deep curvature of the lumbar spine. When this occurs, the person typically experiences low back pain and muscle spasms. While it is common in dancers and in individuals who do not lift weight properly, it is also prominent among those who have a muscular imbalance between the muscles of the abdomen and lower back. A combination of weak hamstrings and tight hip flexors has also been known to cause lordosis.

3. Scoliosis

Scoliosis is a condition in which the spine curves laterally in the frontal plane.  It typically occurs during puberty and is most common in females.  The physical signs of scoliosis are uneven muscles on either side of the spine, uneven hips, arm, or legs, or an abnormal rib cage rotation. Secondary scoliosis can arise from neuromuscular conditions and uneven forces applied to the hips and back. To diagnose scoliosis, a doctor identifies curvatures of the spine greater than 10 degrees. The most reliable way to identify a scoliosis is by means of x-ray.

4. Treatment

If the kyphosis or lordosis hasn’t progressed too far, chiropractic and physical therapy are both recommend to treat weakness and misalignments of the spine. However, if the spine is 50 degrees or greater outside the normal range of curvature, surgery may be required.  A thorough exam, including range of motion, postural check and orthopedic tests can be administered to identify the condition of the spine. Chiropractic therapy can slow down, stop, or even reverse the signs of abnormal spinal curvature.  Part of the treatment process includes custom exercises and stretches that will help strengthen weaker muscles to alleviate the unevenness.

Prevent Muscle Knots


We all spend too much time at our computers and looking down at our phones.  At this point it is almost inevitable.  Growing horns on the back of your skull yet?

Sitting in the same position for hours often results in becoming dehydrated and stiff.   That is usually when we start feeling tension in our necks, pain in our shoulders, and tightness in our low backs. Have you ever wondered why?

From extended use, our muscles get overworked, tight, and are unable to relax.  As a result, the muscle fibers become bunched and deficient in oxygen and nutrients.  Our muscles form knots.  This is sometimes described as building up lactic acid in the muscle fibers.  If you have ever experienced the joy of a muscle knot, you know that they can be extremely painful and stubborn.  Occasionally, muscle knots go away on their own, but they often need help. 

Proper steps should be taken to loosen the tense muscles fibers and relieve the pain. Let’s consider a few steps that you might take to prevent muscle knots from developing in the first place. 

Dr. Smith uses a wide variety of massage techniques and other services to address painful knots that develop in the muscles.  An ounce of prevention is worth a pound of cure right? 

Below we get into some of the things that you can do to keep these knots from coming back.

How do you prevent muscle knots

1. Eating right for muscle knots

Being dehydrated is likely a major cause of the muscle knots that you are experiencing. Are you drinking enough water?  Probably none of us are.  You should be drinking 7-9 glasses of water each day.  How many of us actually do that?  One way to help fulfill your body’s water requirements is by carrying a water bottle with you, or by setting a reminder on your phone that will notify you to refill that glass of water every hour.  

Certain things in our diets can also contribute to dehydration, such as coffee and alcohol.  If you are frequently experiencing knots, you might try to either cut back on your coffee/alcohol consumption or to include an additional glass of water every time you partake.

Further, it is highly recommended that you include calcium, magnesium, and potassium in your diet. These minerals are essential for muscle health and relaxation.  Deficiency of any of these can cause painful muscle cramps, knots, and stiffness. Intake of fresh, organic fruits and vegetables can help with these deficiencies and is just a good idea in general.  You might also try mineral supplementation or working more raw sea salt into your diet.

2. Keep moving to prevent muscle knots

Try to avoid sitting in the same position for too long.  Whether it is while you are reading, playing games on your phone, or writing that next great blog post take occasional breaks to get up and move.  It is important to get up and walk around every hour or so while at work. Even while seated at your desk, make small movements like turning your neck from side to side, straightening out your back, or uncrossing your legs. This simple movement strategy can go a long way in preventing muscle knots.

3. Exercise regularly for muscle knots

Our bodies are built to move. Many of the structures in our bodies are nourished through movement.  Movement also helps to reduce inflammation and push fluids back into circulation.  Stretching and exercising regularly helps release tension from the muscles and maintain that ever important flexibility. It is highly recommended to get at least 30 minutes of light exercises and/or stretching every day.  It not only helps the muscles, but it also has a positive impact on the heart and mind.

4. Improve your posture to address muscle knots

Just like sitting in one position for too long is not good, slouching at a desk or in front of the television is bad for your muscles too. Keep your posture upright.  Make your mom proud and sit up straight. 

Sit in a way that the muscles are not strained and blood flow is not blocked. Try to keep your head neutral and your back straight. Slouching or hunching your back puts stress on the postural muscles of the back and leads to pain. Keeping a good neutral posture will go a long way in preventing muscle knots and cramps.  If you feel like your workstation makes it hard to have good posture, consider getting an ergonomic evaluation.  Often the smallest shift in the arrangement of your gear can reduce stress on your body tremendously.

If you already have knots and pain, call your favorite local chiropractor, or massage therapist.  You’ll be glad that you did.