With a nod to‪@healthsourceoffairlawn1001‬, Dr. Michael Scaperato and Nick Angelis, CRNA give practical tips on preventing and treating neck and back pain. Integrity Chiropractic is an excellent first line option, and Ascend Health Center is an excellent third option if your nerves keep politely sending pain messages. We give practical tips as well as medical ones: adjustments and exercises from the chiropractor, ketamine and lidocaine infusions and SPG blocks from the nurse anesthetist. Of course, we repeat the disclaimer that none of this should be tried without checking in with your own provider.

Transcript: [Music] Hello and welcome to the Ascend Health Show. I’m your host, Nick Angelis. I’m a CRNA and the owner of Ascend Health Show or Ascend Health Center. And I’m here with Dr. Scaparato from Integrity Chiropractic. Hello. Welcome. That was kind of fun how I said I’m the owner of the show as opposed to owner of the clinic–like it’ll just swallow up the clinic and then this will become the main thing and I’ll just see patients on the side at some point. Right.

Right. So, thanks for having me on again, Nick. Really appreciate it. Yeah, absolutely. So, we’re gonna talk about back pain and uh I have a confession to make. This is kind of awkward. So, a couple years ago, I talked to another chiropractor about back pain, Dr. Bob from Health Source at Fairlawn. So, I know all this time you thought you were the only chiropractor in my life, but it turns out that there’s there’s someone else.

Yeah. Well, the good news is I actually know Dr. Bob personally. He’s a great chiropractor. So, I’m happy to share the time with him on the show.

Well, uh I guess there’s not going to be any chairs thrown. So, this won’t be as interesting of a show as could have been. No sort of Waffle House fights or

Although that does that does have to do with back pain because sometimes you get into an altercation and afterwards you’re like, “Oh yeah, maybe I shouldn’t have done that.”

Right. Time to go see the chiropractor, right? Yeah. Yeah. Maybe I’m a little old to be getting in Waffle House bites. You never know. Do you even have any Waffle Houses around here?

So, actually, Ohio does have some Waffle Houses. There’s one right down the road in my parents house uh up north along the lake. So, Yep. They’re still up they’re still running, thriving. Yeah.

Yeah. So, if you take our advice and get your back all set, then you can go to that Waffle House at 2 a.m. and, you know, see what happens.

Yeah. Come in the chiropractor next morning. So, since we’ve Well, I think the previous show with Dr. Bob 2 was more on sciatica. So, we’ll just talk about all the other nerves and we’ll leave the sciatic nerve alone for this conversation. Sounds like a plan for today. Yeah. Do you want to start with neck pain? Because technically that’s your back, you know, your cervical spine. Sure. And I see a lot of patients for that and I treat it somewhat too although obviously not to the extent that you do. So right.

So when it comes to neck pain, neck pain is actually one of the most common symptoms and common complaints that come into my office. And a lot of people say you know the most common thing I hear of you know my neck pain is the same quote. I think I slept on it wrong as most common thing that I hear and while there is some truth to it there’s a deeper reason for it too. So if you remember or if you know at home our body and our nervous system is the master system. It controls everything in our body. For example, when you eat food, the most common the only thing you really have control over is chewing it and swallowing it. But once that’s done, you don’t say, “Okay, muscles, you need to take that food and have it travel all the way down the esophagus to the stomach. Hey stomach, I need you to start churning in, start digesting it. Hey pancreas, time to release those enzymes. Hey muscles, move that through.” You don’t think about all that stuff. Your nervous system does it for you. So, it’s a two-way street from your brain down the spinal cord out those nerve roots to the nerves to everything, whether it’s a muscle, a joint, or even your organs. And then it’s sending messages back up the spinal cord to the brain, letting them know, hey, here’s what’s going on, and here is how things are functioning. Right? So the nerves in the neck, those are the ones that go to the eyes, they go to the throat, they go to the thyroid gland, um they go to all the muscles and parts of the mouth. Even your teeth, your teeth have nerves. That’s why when you get a toothache, it’s nerve pain. So everybody has experienced most people have experienced some sort of neck pain, tooth pain or some of nerve pain to know that it’s more nerves and not just muscle or sleeping out wrong. So when you have misalignments in your neck, whether tilts or curvatures or even rotation of the bones puts pressure on those nerves. Now you can have pressure on those nerves all the time and not necessarily feel pain. It has to get so bad and be so much pressure before those signals are sent to the brain saying, “Hey, there’s something wrong here.” And that’s what tries to get your attention. So is that why sometimes you can look at an MRI or an X-ray or CT and it won’t match what the patient’s saying about their pain? There’s definitely some times that that has happened. Yes. But the vast majority of time then when patients come to my office their tilt there are tilts curvatures or other abnormalities with their with their alignment what we call vertebral subluxations not so much a full dislocation but out of alignment out of place of where it should be which pressure on those nerves. It puts pressure on those joint space in the neck which are very sensitive. They’re small joint spaces but have a lot of nerves there a lot of sensory nerves that can cause pain as well. And then of course when those get irritated, your body doesn’t like that. So the muscles will tighten up like an internal splint. Keep you from moving your neck or your head in a way and putting in a position to where it’s going to make things feel worse. Well, the muscles in your neck are just like the muscle in your hand. Maybe you walk around with your hand balled up in a fist all day long, right?

I’ve got some patients like that.

You can do it. It’s not recommended because what happens the longer you do it? It hurts. We don’t want body doesn’t want it to hurt. So it should be able to open and close like you open and close your hand. should be able to contract and relax your neck muscles as well. They’re tight like that. That’ll cause pain. But also, what are your muscles attached to? The bones. So, when they’re attached to the bones, they can pull things out of alignment over time as well, which then irritates the nerves and joint spaces even more, which then irritates, makes the muscles tighten up and irritates them, pulls things out of alignment. It’s just that repetitive cycle that goes on. So, sleeping in the wrong position, yes, that can cause neck pain. However, there’s a deeper root that things are likely out of alignment, sort of irritated, and your neck was put in a position to where it caused to have pain. Now, there’s things outside of sleeping on a pillow that also can cause it. Posture while sitting in chairs, you know, a lot of people have desk jobs and computer jobs. So, they are constantly putting themselves in positions that are compromising, irritating those nerves. um trauma. You know, most people think of trauma like car accidents, slips, falls, but also what if you were at a rock concert and you’re constantly banging your head back and forth. That concert repetitive motion of irritating those nerves and joint spaces with the neck being out of alignment, that can cause almost whiplash type of injuries. or you know um being on a playground as a kid slipping and falling that’s a can be a traumatic event that can throw things out of a line in the neck too.

So you’re kind of saying that we should have good neck health so that I can go to Cedar Point and ride roller coasters. Absolutely. One way of thinking of this is if I and I guess neck health is the right term.

If I have good neck health and I can do some of these fun things and if I can’t I need to stop riding top thrill 2, right?

You know having proper spinal hygiene does involve the health of the the nerves, the bones, muscles, joints, ligaments and tendons of the neck. Okay? And that’s where chiropractic comes in. So using typically my hands or even some instrument tools that are spring-loaded to simulate that that push on that bone very slightly to put in a better position, line things up better. Takes pressure off those nerves, takes pressure off those joint spaces, allows those muscles to function properly and even relax and not be in that that tight protective mode as often. That provides a lot of relief for my patients. Wow, that’s awesome. So, what kind of since I brought up neck health, are there some exercises that people can do for their neck? Sure, there are some things that could be done. Now, you got to be careful with stretches and exercise because you can go on Google and say, you know, best neck stretches or best neck exercises, but think of also your your neck like the the tires of a car. Let’s say you hit a pothole, knocks it out of alignment. Do you go and start tightening up the screws and bolts or changing the tires or the rims or the brakes? No. you go to a wheel alignment specialist and they align the wheels back up and then they tighten things and look things over, right? So, think about that in the terms of chiropractic, too. Stretch and exercises will help, but if there’s misalignments, if you’re doing a bunch of exercises for your neck to strengthen it, you’re strengthening that misaligned position, too. So, you want to make sure to also to incorporate that alignment from a chiropractor with your stretches and exercises. Sure. So, one of the most common stretches that I give for my patients after some realignments or adjustments as we call them, um, a good one for the for the neck is, you know, sitting in a chair upright and actually sitting on a hand. Whatever hand, good. I’m glad we have a little bit participation here. So, sitting on the hand, whatever hand you sit on, you’re going to have your head fall away from that hand. Then, you should feel a nice stretch going for along the side of the neck. It can even go down into the shoulders. You guys do this at home, too. Now, Nick, what number would you give how strong that stretch feels on a scale of one to 10? One’s a light stretch, 10’s a really strong one. Like two. Two. Good. I recommend for my patients to keep it at a four below. Reason is your body doesn’t know the difference between therapeutic stretching. You’re doing something dumb outside of here where the muscle’s getting pulled so far apart, it doesn’t know if it’s going to start to tear or not over time. Yeah. So, what does it do to protect it? Tightens it up. Well, if it’s trying to tighten it up or trying to pull it apart, you get in a little tug of war with it and may not happen after you’re done stretching, but shortly after when you try to use again, it can tighten up or what we call a muscle spasm. Most people know it as a Charlie horse. And if you ever had a Charlie horse, it could be painful. So, that’s why keeping at that four below helps to prevent that from happening. Doesn’t overstretch it. Um, one of the common things I heard when I played sports was get that deep burn into that stretch, right? That’s actually bad. That’s your body saying, “Whoa, whoa, whoa. This is getting pulled way too hard, way too quickly. We really need to tighten it up.” And that’s what it is. And I witnessed it firsthand in middle school while playing while running track. Um, this guy started to do the 8 meter relay, five steps in, grabbed his hamstring, fell to the ground, was out for the rest of the season due to a severely strained hamstring. So, you want to be careful with that stretch. none of that. But when you stretch, that stretch should feel the same all the way through. If towards the middle or at any point you feel it start to do that increase going from a two to a three to a four, five, six, seven, eight, getting higher. That’s your brain saying, “Hey, this is probably okay, but I’m not sure. So, I’m going to start to slowly tighten it up just in case.” So, that happens. You just bring that head more back to neutral, and that helps to relieve and get back into that range. So, a lot of times my patients ask me, “Well, why sit on my hand? Isn’t that bad for my back?” Well, you’re doing it temporarily. You know, I don’t recommend stretching for more than a minute to a minute and a half. Most my patients, honestly, it’s 30 to 40 seconds. Okay? So, the reason I have you sit on your hand is because if you have really tight neck muscles and those uh shoulder muscles close to the neck, when you bring your head to the side, it tends to bring your shoulder with it. So that just helps to anchor it down to get that nice clean stretch with all those muscles there because in a lot of cases you’re using accessory muscles and you might not realize what muscles are trying to help the muscle that isn’t doing its job anyways. You’re absolutely right. Isn’t the body’s very intricate and very well detailed and put together. So when one muscle or set of muscles either fail or dysfunctional because they’re not strong enough or too tight, other muscles will take over to make sure that the body still functions the way that is. It’s like a group project. Like there’s always that one lazy kid that’s not doing nothing. So everybody else has to help them out, right? It’s good for even the body to have checks and balances, right? So what should we do? Because you mentioned that a lot of times your body will you’ll feel that burn. So it’s I didn’t expect this to be more of a it sounds fufu but it’s not the whole listen to your body see what your body is saying but it sounds like it really is. Absolutely. So when do we because there are also cases where you should I would say ignore your body but there are often cases of back pain where if you stop doing things because your back hurts then you’re actually in worse shape because then those muscles atrophy because there’s no activity. So, what’s the best way to listen to your body when we’re talking about stretches and neck and back and that sort of thing? Great question. So, we talked about, you know, making sure that the the stretch level on your own scale, because everybody feels it differently, is at a four or below. Okay? You want to make sure to not go over, you know, a minute and a half, two minutes. So, because then your body’s like, “Okay, this has been it prevents you from getting to that point where body says, this has been going on for too long. We really need to tighten this up.” And it kind of starts to defeat the purpose of it. you know, when it when it comes to when it comes to pain, you know, your body doesn’t want you to be in pain all the time. And pain actually does serve a purpose, believe it or not. It is there to let you know that something is wrong. Now, if I were to get up and bang my knee on this table, yeah, I’m going to feel some pain, but that pain should go away. If it lingers and lingers for, you know, for days, typically between five and seven days, I recommend that if you’re still feeling pain from something that was done or you don’t know it was done, it doesn’t go away, it’s time to go see your chiropractor or other appropriate physician for whatever you may have going on too. Because that’s also the thing, some of that pain may be due from other chronic issues that you’re already seeing another physician for. So, but if it’s something that involves the neuromuscular skeletal system, the nerves, the joints, the bones, the muscles, that is a time to give your chiropractor a call to make an appointment and just get things checked out. It may be a simple misalignment, fixated joint that a chiropractor can help with that’s caused irritation, is causing that pain. Sure. No, that makes sense. So, I treat a lot of neck pain, headaches, migraines. A lot of times I’ll do a ketamine treatment and it works a lot better if they come to me fairly quickly. And now obviously migraines are something where if it’s not that bad then don’t come see me, not the first line. And if it’s really bad then you won’t be able to come into your car to see me. So I realize it’s a little bit challenging but sometimes I’ve seen that where okay you spent six days in the hospital and it couldn’t help you and then you came to see me and I may be able to do it with you know the skills I have as a nurse and nest or whatever but it does help to get these things early and start treating it right away. Right. You know, one of my chiropractors told me that an ounce of prevention is worth its weight in gold. So, and believe that gold is pretty up there. So, the little bit that you It’s gone up lately. So, yeah. Yeah. The little bit that you do for your body for the prevention or maintenance or wellness portion of it really does help in the long term, not only with overall body function, but also it’s a little easier in your wallet, too. Yeah, absolutely. And that is a big reason for this show is we try to find ways that patients can help themselves. So if you do have a Charlie horse or sore muscles, what’s your go-to? Is it Epsom salt baths or what kind of treatment or supplement or whatever? Which by the way, we do have our own show on supplements that we did a couple months ago. So you can go through these 60 odd shows I’ve done and one of them is us talking about supplements. Yep. And I believe we talked about, you know, magnesium, the role with tight muscles or [  ] muscles, too. So magnesium is definitely something you can take. Epsom salt baths are great, too. Um, you know, I recommend more of a lukewarm water bath rather than a hot bath like most people like to take because whether you’re immersing yourself in water in a hot tub, a bathtub, a jacuzzi, or putting heat on your body with an electric blanket or a heating pad, it opens up your blood vessels and has blood rush in, right? That’s just a dilating effect of heat. When you remove that heat source, that blood is still pulled in that area or systemically, meaning throughout the whole body. Well, that’s technically an increase in swelling. So, when you increase swelling, it increases pressure onto those already irritated nerves, joints, and even muscles, which then can increase the inflammation, which then tends to increase pain levels as well. We want to decrease it all. So, using more lukewarm water can help with those muscle spasms. Now, if you keep getting them, there may be a dietary issue. There may be um they could be even autoimmune or a compromised nerve issue because remember those nerves that’s a transmission of signals to the body including those muscles. So imagine if you had a four-lane highway and you take away one lane well now you got three right messages aka cars can still go travel but say you get it down to two. Well now you cut off transmission of the nerves 50%. Let’s take it down to one. Due to a really compromised nerve, there’s going to be a lot of backup. Things aren’t going to function properly. It’s not going to know when to contract, when to relax, when it needs to move, when it’s at rest, and things get kind of backed up and bundled up. And that can cause the muscle to improperly tighten up and stay tightened. So, it could be a compromised nerve issue. I just had a patient come in earlier this week was being along the sciatica that nerve with that sciatic nerve going down the leg. Her hamstrings were constantly tight and her glutial muscles and purformis muscles were just super [  ] Not because of what was going on with those muscles, but because of the control to those muscles. So by giving adjustments in that lower back top of the pelvis area there it allowed that transmission of those muscles to reach them saying hey you don’t have to stay tight like this and they relaxed and of course she felt better right take that Dr. Bob there thank you actually Dr. Bob for the great setup for that question. I appreciate it. But it’s also true. So when you first started, you talked about how nerve conduction goes down. You know, we don’t have to say like get your get get in the game, Colon. You got this. And then those nerve conductions come back up. But then our brain interprets the what the nerves are telling it, which is more my line of work with uh Ascend Health Center where sometimes it is just simply your brain is taking information and then telling you something that isn’t quite true or it becomes more of a psychogenic thing as opposed to a structural thing. So it becomes very interesting when sometimes you’re like, “No, I don’t really see what’s wrong. I’m not really sure why, you know, this pain is here where you have this discomfort or whatever. And that’s why I feel when it gets really complicated, too, because it’s well, you said sometimes it’s a structural thing where the lanes are going from four to three to two. Sometimes it’s a nerve conduction problem outside of having a structural thing, and sometimes we just don’t know. So, uh, in my line of work, it is usually I send the patients to you or Dr. Bob since we mentioned him too. Uh, if it’s no, I’m not really sure what’s going on here. you know, this ketamine infusion didn’t work, this medication didn’t work. I don’t think this is a chemical problem. I think this is a structural issue where someone just has to manipulate it. Um, and then other cases, you’ll send patients to me for the opposite where, okay, we’ve aligned everything. You shouldn’t have this pain anymore, but it’s still there. So, yeah, very good point. You know there was a very famous Greek philosopher that said look well to the spine for the cause of disease because the most common places that you could have joint and both misalignments are actually in the spine and that is the that is the main communicator between the brain and the body. So having that proper alignment, that proper structure and being solid in the foundation that actually makes a big difference with overall health and how your body not only you know acts and behaves and functions on a day-to-day basis but also when things get out of alignment, it becomes just this stepping stone going up of ways that it can affect other areas and other body systems too, right? Absolutely. Probably at some point in the show we should have some sort of disclaimer about this not being medical advice. Although I usually say, well, no, it’s not that you shouldn’t listen to our advice, otherwise you just wasted 20 minutes of your life. It’s just that you should compare this advice with what your physician or chiropractor says about you personally because even when patients Google search something like, yeah, that’s really great general information, but how does that relate to you personally? And partly as what you were saying, if you’re paying attention to, okay, this is a deep burn that I don’t need or this is a pain I’m not sure where it’s coming from, then you have more information to share with a professional. So together you can figure out what to do about it, right? You know, we all come from different walks of life. You know, I have some patients that have been in multiple car accidents. I have patients that have been in no car accidents. And of course, their spines are going to be vast vastly different. You know, I have patients that have had multiple kids and their, you know, pelvis and spot, low back are out of alignment. And I’ve had patients that have had no kids and they have, you know, less issues with theirs. But I’ve also seen the opposite. Patients that have had no kids with terrible backs than patients with multiple kids and their low back and pelvis looks better than that one. So it it’s all depends on just what you’ve encountered in your life you know and it it dives really really deep when you get into all those different details which can be done but you know chiropractors and also nurse anesthetists and also um you know you yourself they we we get a lot of training to be able to dissect and find out what’s going to be best for your body based on your own walk of life right and to be clear uh at Ascend Health Center we’re not your first line for neck or back problems like third fourth Absolutely. I’ll come fix you up. But something like a ketamine infusion, which works on glutamate to reprogram your nervous system, send new neurons in places, like it works great. Not at all. First line option. Didn’t want uh someone to come here cuz like, well, you know, I think I slept wrong. Maybe I’ll go see Nick and uh get an infusion about it. Yeah, cuz you know mostly we do mental health, so anxiety, depression, but then more and more over the last six years, we’ve seen that blend into fibromyalgia, all sorts of different disorders. And a lot of times, too, when you don’t know what’s going on, it can be extremely expensive, which is our next show, so stay tuned for that. It can get extremely expensive. Multiple specialists, multiple diagnosis, and then sometimes at the end of the day, you’re like, “Well, that’s great. Thanks for all the checkups and all the MRIs and all the CT scans, but my neck still hurts.” Something you could also do for neck pain, you know, to help kind of wrap this up is going back to that initial thing, I feel like I slept wrong. Sleeping on the right pillow is crucial for your spinal health, especially with the neck. There are so many people that come in that sleep with pillows that are either not supportive enough or even too supportive. If you’re somebody at home that when you sleep either without a pillow or if you do and you find yourself putting your hand or your neck or your arm up in any direction or any orientation on your under your head, that is a red flag for a chiropractor that your pillow is not supportive enough. So, what’s the best sleeping position? Best position if you’re able to is on your back. Now, me personally, I can’t sleep on my back. Actually irritates my neck. I don’t sleep very well. It’s not even comfortable, which is typically the most common thing that makes people not want to sleep on their back. So, there is an alternative. The alternative is laying on your side with a pillow to support the head and the neck, not to be under the shoulders. And you want to take a pillow about the width of your own fist. You’re actually put it in between your knees. That helps to stabilize the low back and the pelvis while you’re sleeping. So, it’s not rocking back and forth. You’re not crossing one leg over. Now, if you’re what we call a starfish sleeper and you just kind of sprawl out in bed, well, guess what I mean? That pillow in between your legs may or may not help. But it’s better to at least try and put your spine into a better position while sleeping than not. Which means sleeping on your stomach, that’s a no-go. That’s a habit that you should have tried breaking yesterday because you don’t have a cutout or anything in your bed. So, what do you have to do with your head and neck? gota turned to the side. Now imagine if you laid down like this, your head in this position like I’m looking at Nick for two hours, three hours, six, the full eight. Some people don’t move at all. Can you imagine what it’s going to feel like when you try to bring your head back to center and get up and all about your day? That will irritate those nerves and joint spaces and tighten up those muscles faster than you can say the longest word in the dictionary. So, it is recommended to sleep with a pillow. And when you do, you want to make sure that it’s not too high or too much support. So, it’s pushing the neck up either because now you’re sleeping in this position all night long. But if it’s not supportive enough, you could be in this position. So, being able to have a friend, family member, or even ask your chiropractor bring in your pillow to us. We’ll look at it and say, “Hey, this pillow is good. This pillow is bad.” And if it is not the best pillow for you, some offices like mine have actual pillows that we recommend and you can get so you can get a better night’s sleep. Wow, that’s awesome. I was just thinking about how starfish are invertebraas and so they probably won’t need chiropractic care. But sorry, haven’t adjusted a starfish yet. You never know. You just maybe some are watching this right now. You know, the ones that were hoping for a Jerry Springer type beatd down. Although you you’d probably win cuz your neck and spine are probably in better shape than mine. So, you know what? You’d be surprised because remember those those rock concerts I was talking about? True. Yeah, I could see that. Dr. Scaparo like going to those as a kid. So, but I was also getting adjusted in the process. So, that can actually help to decrease the rate of deterioration or lessen the chances of those whiplash type muscle type of That’s what we’re really saying that the a very active lifestyle is very healthy for you, but just make sure that you’re getting the care that you need to maintain that. Absolutely. So none of that. Like I did run this morning, which is not usual for me. But usually I would play basketball for two hours at church every Saturday morning and then nothing for the next week and then do that again. And as I turned 43 in the next few weeks, I’m like, you know what? Maybe I need to adjust that a little bit. Might be getting too old for that kind of sedentary lifestyle and then very active. So, yep. And if you’re looking to adjust it, per place to go is a chiropractor. That’s what we do. And speaking of places to go, uh, how can people contact you if they’re interested in some of this? Great. So, I am actually in Fair Lawn. So, um on West Market Street, right near Summit Mall. Um you can give my um office a call. Um the number has popped up periodically on the screen. You can go to my website. Um the website is integchiro.com and you can click on book an appointment and you can send an email that way.

Great. And for Ascent Health Center, uh, it’s 330-754-44844.

We take insurance as you take some insurance, too. Uh, we do counseling, psychiatry, some pain management. Like I said, we’re not your first line for that. Um, as well as a ketamine, Spravato, Transcranial magnetic stimulation for depression because I mean, neither of us are really into pills that much. There’s a lot of other things you can do as well depending on the person. But, uh, no fight today and, uh, thanks for coming.

Yeah, thank you, Nick. Appreciate having me on again. You are watching WCTV Wadsworth Community Television.