Chiropractic management of Cervicogenic headaches

It’s only been 3 months since we started providing an English speaking Chiropractic service in Tokyo but already we have seen a marked uptake in the amount of headache cases compared to our other locations. Perhaps it’s the stress of city life or maybe even it’s nightlife ! but whatever the reason headaches are one thing I think Chiropractic management has an edge on treating.

What is a tension type headache ?

Headaches have been classified by the The International Headache Society into a few main types with tension headaches being the most common.Lifetime prevalence in the general population ranging in different studies between 30% and 78% (1) so if you are suffering headaches you are not alone.

Essentially a tension headache is a headache characterised by peri-cranial tenderness ( pain around the skull ) in the base on the neck and around the muscles of the face. It’s important to figure out what’s not too so excluding headaches from a more serious cause and distinguishing them from Migraines can be quite a challenge.

The exact cause of tension headaches is unknown and likely to be to from many factors ( stress is always in there somewhere ) but one theory that makes sense to us is that long hours of strain cause irritation in the upper cervical joints of the spine which in turn can cause spasms of the upper cervical muscles which in turn sets of some sort of cascade that leads to an inflammatory response and increased sensitivity to pain.

Whatever the cause we find that all over all the many complaints we see on a daily basis, headaches are one of the conditions that seem to respond most favourably.

Chiropractic Treatment of Headaches

Manual therapy has been shown to improve the suffering from tension headaches ( 2) and the results seem better when a few different techniques are involved so the best approach is use a multi-model approach such as combining manipulation, soft tissue releases stretching rather than just using one modelatity.

Changing your work habits is also a great idea but don’t think reaching for that standing desk is going to solve all your problems. What’s more important that sitting or standing is frequent breaks and movement away from your workload.

Getting good hydration is also really important particularly when you are drinking a lot of caffeine which is going to cause even further problems. if you like me love your coffee, make sure you you learn to love your water too.

If you would like to book a Chiropractic appointment for an English speaking Chiropractor in Tokyo you can do so on the link below.

www.tokyointernationalchiropractic.com/appointments

References

How did Tokyo international Chiropractic come about ?

Like many things, completely but accident.

In 2018 my Japanese wife and I sold everything we owned and moved from Australia to Japan to try something exciting and create a new life in Japan after being in private Chiropractic practise for nearly 15 years in the hinternaland just behind Byron Bay. We had already visited Hokkaido several times with my wife’s family being from Sapporro and decided Niseko was an obvious choice.

We were lucky enough to be able to purchase some land there before the interest in Hokkaido real estate and built our first house in Niseko in 2020 looking up to the magic dormant volcano of Mount Yotei.

Working and living in Niseko was a life changing experience and it was a blessing to be able to meet people from all over the world keen to experience their own winter wonderland. Certainly living in Japan has had it’s challenges. I really miss my good Cheese, Aussie wines and my family ( probably in that order ) and underestimated the little things, like not being able to read anything but all the whole living in Japan has really opened so many exciting doors and cultural experiences that I would not swap it for the world.

In 2019 Niseko Chiropractic was established that provided Chiropractic consultations to injured skiers, snowboarders and tourists to Niseko.

Sadly this all came crashing down in 2020 when covid closed Japan’s international borders. Fortunately work was found remotely on the Island of Okinawa assisting SOFA personal based near Kadena and Camp foster. In a moment of panic in July 2022 it seemed like Japan’s borders where never going to open up so another remote operation in the heart of Tokyo commenced.

The start of our Tokyo operation

The Tokyo college of Chiropractic where kind enough to allow us some consulting space in their teaching clinic which over the last few months has allowed us to build a clientele large enough to justify a new premises. Again in another stroke of good luck Sato-san from Physic Chiropractic allowed us some space to consult from in Ebisu just walking distance from Shibuya station.

Working in Tokyo has been a really exciting and eye opening experience after growing up in the quite suburbs of Sydney Australia and living most of my life in the countryside. It’s amazing to see the scale of nightlife and options available for everything interest, even it it means not always making the healthiest of choices !

With your support we aim grow this business, hire some more internationally qualified experienced Chiropractors and provide an english speaking Chiropractic service full time in the crazy city of Tokyo.

Our style is more of a modern multi-modal approach utilising soft tissue work, rehabilitation exercises as well as some of the more traditional Chiropractic techniques.

If you are seeking an english speaking Chiropractor in Tokyo we hope you can may give our service a try 🙂

English speaking Chiropractor for

SOFA personal based in

Yokota air base and Yokosuka Navel base

After working with SOFA members based Okinawa for the last 2 years Brent Verco has now expanded to Tokyo and there has already been a pleasing level of interest from Yokota and Yokisuka.

Whilst we do appreciate Ebisu city is not exactly ” next door ” we do hope that perhaps if some SOFA members wish to let their hair down in Tokyo’s nightlife or combine it with some of the great activities and shopping there there may be some interest from US personal in visiting our Tokyo clinic.

Both our current Shimbashi clinic and our new permanent clinic in Ebisu are really close on the ” Tokyo line ” so it’s really easy to grab a train up.

Having worked with SOFA crew down near Kadena and Camp foster for the last 2 years we have learnt about about the unique stresses and challenges of a military career and we hope you may have give us a try whilst you complete your tour in Japan.

If you would like to book an appointment in Tokyo please go to

www.tokyointerntationalchiropractic.com/appointments

There is a really easy way to increase your health dramatically that does not cost any money, does not require any sit ups or resisting chocolate. Do I have your attention now ?

Its sleep. It’s likely you are not getting enough both in quantity and quality.

Tokyo international chiropractic recently made some simple changes by cutting out caffeine after 2pm, reducing alcohol in the evenings ( well most of the time ! ) and tying to be in bed by 9pm and I feel a whole better for it. The results were obvious within a week or 2.

So why does sleep matter ?

Here are Tokyo International Chiropractic’s top 5 reasons

1. Good Sleep will Help you loose weight

Yep this one is a good reason right here.

No dieting or heavy lifting required. Short sleep is significantly correlated with Obesity.

There are many theories as to why but recent research suggest that tired people eat more calories and that you develop poor regulation of your hormones due to poor sleep (1). Good sleep was also associated with the ability to maintain a healthy weight so once you have lose the flab getting some better sleep may be a helpful way to help maintain the new you.

2. Good sleep will increase your mental health and decrease your risk of depression

There is an important link between you mental health and depression. It has been estimated that 90% of patients with depression complain about sleep quality (5)

Sleep deprivation can cause increased levels of anxiety and cause you to find problems and distress in situations where you don’t really need to (3). If you already prone to depression or other mental health issues then getting better sleep should be an even more important goal of yours than it may to others (4).

3. Good sleep makes you a better nicer person and a better spouse

Poor sleep affects your irritability level and those tiny problems we all have to deal with in relationships can snowball into something far more serious just because are emotional brains are not being kept in check. Just imagine we all have a 2 year old living in our heads and its good sleep that keeps the angry little baba inside us all in check.

Poor sleep can also make us less able to succeed in social interactions. We are less likely to able to read the danger signs that we may be rubbing a person the wrong way or they are not interested in what we have to say ( 6). In short poor sleep may be making you a bit of an asshole.

4. Good sleep decreases your risk of alzheimer’s disease and even cancer

This is some really interesting research. Poor sleep means that your body is not ridding itself efficiently of the build of of amyloid beta (Aβ) plaques in the brain. (7). This over a long period can increase your risk of getting Alzheimer’s disease.

Essentially just as your muscles make lactic acid and other metabolic waste products your thinking also also produces waste that needs to be washed out and broken down. Sleeping is the time our bodies use to clean our brains more than we are awake.

Having your natural circadian rhythms has also shown to be slightly associated with an increased cancer risk not just for shift workers but even those living in more challenging time zones (7) so there is some link between poor sleep and cancer risk.

The Australian lifestyle medicine has some great information about caring for your brain better on the post below

5. Good sleep will increase your performance at work and ability to earn a better income

If you want that promotion or better income from your time at work then performing better is going to help you. There is a host of research to back up poor sleep and poor performance but your own experiences are probably the most valuable here.

So how much sleep is enough ?

This is going to vary on your stage of life, occupation and your own individual makeup and stresses you are under at the time. Here are some general guidelines below

The amount of sleep you need each day will change over the course of your life. Although sleep needs vary from person to person, the chart below shows general recommendations for different age groups. This table reflects recent American Academy of Sleep Medicine (AASM) recommendations.

Age	Recommended Amount of Sleep
Infants aged 4-12 months	12-16 hours a day (including naps)
Children aged 1-2 years	11-14 hours a day (including naps)
Children aged 3-5 years	10-13 hours a day (including naps)
Children aged 6-12 years	9-12 hours a day
Teens aged 13-18 years	8-10 hours a day
Adults aged 18 years or older	7–8 hours a day

If you routinely lose sleep or choose to sleep less than needed, the sleep loss adds up. The total sleep lost is called your sleep debt. For example, if you lose 2 hours of sleep each night, you’ll have a sleep debt of 14 hours after a week. So it’s not so much about how much per night it’s the amount over a few days and the week that really matters.

Sleeping when your body starts to tell you it’s time is also is very important.

Signs you are not getting enough sleep

If you’re getting less than eight hours of sleep each night, chances are you are going to be having some problems. Even worse being sleep deprived means you may be less likely to notice them !

Often people have been sleep deprived for so long that they forget what normal even feels like.

Here are a few signs to look for…

Need an alarm clock in order to wake up on time
Rely on the snooze button
Have a hard time getting out of bed in the morning
Feel sluggish in the afternoon
Get drowsy after heavy meals or when driving
Need to nap to get through the day
Fall asleep while watching TV or relaxing in the evening
Feel the need to sleep in on weekends
Fall asleep within five minutes of going to bed

How to get better sleep

The following article has some great advice but some take home things are to avoid caffeine in the afternoons, avoid too much alcohol in the evenings and try and get some daily exercise of at least 20 minutes to a half hour

https://www.healthline.com/nutrition/17-tips-to-sleep-better#section17

If you would like to make an appointment with an Australian trained English speaking Chiropractor in Tokyo please consider Tokyo international Chiropractic. You can book online here

References

Simple health tip

What if there was one simple thing you could do from tomorrow that would dramatically improve your health, drop your weight and even lighten your mood ? Well there is. All you need to is swap out soft drink for sparkling water.

Why ? Well read on

Imagine you are meet a good friend at your local cafe. You order coffees and then they reach for the sugar cubes and slide one into there latte. You would not care to notice.

Now imagine they put it 2. It might cross your mind to think, wow quite the sweet tooth, remember that if I ever make coffee for them at home. Now imagine they start to put 3 then 4 then 5 then 6… . by around cube 7 You might be thinking Wow, this person got a bit of a problem here. Once they got to cube 9 you might wonder if they have gone mad.

Well that’s how much sugar is in a 250ml can of coke. 39 grams to be precise which accounts for 9 teaspoons of sugar. (1) and that info is from Coca cola themselves. Nobody bats an eyelid if somebody orders a coke with their lunch.

Commercial soft drinks first appeared in the US with a drink called ” Moxie ” and by 2018 the world was producing 1 billion litres of soft drink per year with a value of 60 billion dollars. In 1776—at the time of the American Revolution—Americans consumed about 1.8 of sugar per person each year. By 1850, this had risen to 9kg , and by 1994, to 54kg (4) . Move aside big pharma and make way for ” Big sugar ” . The issue with soft drinks is they are simply packing an energy density we are not evolved to handle. Soft drinks alone are estimated to account for up to 47% of added sugars in a typical modern diet (3).

In the US alone 64% of the population is now considered overweight with 30% considered obese (3). Whilst Japan’s figures are not as alarming it’s clear we are headed in worsening direction.

If you are looking to drop a few kilo’s dropping soft drink is going to be easiest and simplest thing you can do for yourself to dramatically cut your sugar intake.

And it’s not just the weight. Drinking just 500ml of soft drink per day for 6 months induced features of the metabolic syndrome and fatty liver and type 2 diabetes (4). Drinking just one serve day is thought to raise your blood pressure by at least 2 mm of Mercury (5).

Your mood is also affected by increased soft drink intake. It might give you that ” buzz ” whilst you are consuming it but just like any recreational drug when abused in can affect your mood. When controlled for other factors soft drink intake correlates with an in increase in depression and anxiety scores. ( 7).

And if all that is not enough consider your teeth. Coca cola tops the list with an acidic PH of 2.3 (6) which puts has a pretty nasty effect on the quality of your tooth enamel (6). It’s crazy to think teenage kids are needing regular trips to the dentist for fillings.

So if there is just one easy thing you are willing to try to get healthier, give up the soft drink.

References

Tokyo International Chiropractic research review

There has been a been a lot of talk about the risks of sitting lately. Some commentators have coined the term ” Sitting is the new smoking ” and certainly the research does support the large health risk of sitting too much correlates with poorer health outcomes (1).

But the plot thickens when we start to look further.

How much of the health risk is due to the sitting itself and how much is just because people that sit more tend to exercise less ? What about to standing workstations ? Do they actually help reduce our risk or are they just a fad ? Once again we need to turn to the research to cut the wheat from the chaff.

The dangers of sitting too much

In 1953 Morris (2) published a paper in the prestigious medical journal ” The lancet “.

Morris noted that bus drivers in the 1950’s had far more heart disease than bus conductors. This was interesting. They both worked identical hours and shared almost identical work environments and backgrounds. The main difference seem to be that one group was sitting and one group was standing. Was sitting causing their heart disease ?

Fast forward to 2016 and several papers did some large meta analysis and it seems yes that too much sitting was associated with a range of problems from Heart disease, to type 2 diabetics and obesity (3).

But the interesting question still remained. Is it the sitting itself that causes the problem or is it the lack of physical activity associated with the sitting that causes that leads to poor health ?

Maybe both ?

Well the research at this point is divided with some experts claiming that doing exercises does not offset the dangers of sitting whilst others claiming daily exercise can mitigate a lot of the the dangers of sitting.

Dr. Alter and colleagues conducted a meta-analysis ( where they study other studies ) of 47 studies that tracked groups of people who reported data on how often they spent sitting and on how much exercise they took.

They found that people who were the most sedentary were more likely to be diagnosed with type 2 diabetes, cardiovascular disease and various cancers, including breast, colon and ovarian cancers. The most sedentary people were also 24% more likely to die during the studies than participants who spent the least amount of time sitting.

Although this association was much stronger among people who spent little time exercising, the study also found that too much sitting time was associated with poor health outcomes, regardless of physical activity (4)

Alter was of the opinion that exercise alone does not reduce the health risks of sitting. He believes we actually need to sit less.

In 2016 a much larger study was published by Owen et al (5) in the reputable journal The Lancet that found that moderate activity ( about 60 to 75 minutes a day ) does seem to offset the health risk of sitting in regards to death rates. They did find however that if you watched more than 3 hours of TV a day then even moderate to heavy exercise did not offset the health risks of the sitting.

So they researchers are still a little divided about whether sitting itself is the issue or if is sitting is a co-founding variable associated with the real culprit, lack of enough activity.

I think it’s safe to say that we should all be aiming to try to get an hours walking in more days than not and also minimizing or at least having breaks with the amount of sitting we need to do over the day. A short walk to the water fountain to bitch about a c0-worker may be healthy.

What about standing workstations

It seems like an obvious solution. If sitting is causing the problem then why not just stand ? The sitting/ standing workstation became an overnight sensation in the corporate world with some pretty hefty price tags too.

The interesting thing here is the jury is still out on weather standing workstations make much of a difference. Surprisingly little research has been done to date on whether a standing workstation is really a viable alternative to combat the risks of sitting.

A Harvard study found that when you sit you burn about 80 calories an hour and when you use a standing workstation you use about 88. Over a 3 hour period this relates to about the same energy difference from eating a carrot ( 6). The authors concluded you would be far better off doing a short walk in your lunch break.

And just to make things even more spicy…….

Maybe standing still all day at a workstation is not that good for your either ! One study find that finding that occupations involving predominantly standing were associated with an approximately 2-fold risk of heart disease compared with occupations involving predominantly sitting (7). With all the media attention on the dangers of sitting some authors noted a gap in the research knowledge on looking at the risks of standing.

Again it seems like gentle daily exercise may be worth implementing first before you worry about rushing out to purchase a standing workstation.

In conclusion it’s probably safe to say that an doing a job where you sit all day is a risk to your health and this becomes far more serious when you are not doing enough exercises.

So get out there and move more !

References

https://www.diabetesresearchclinicalpractice.com/article/S0168-8227(12)00208-2/fulltext
Morris JN, Heady JA, Raffl e PA, Roberts CG, Parks JW. Coronary heart
disease and physical activity of work. Lancet 1953; 265: 1053–57.
Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., … Lee, I.-M. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302–1310.doi:10.1016/s0140-6736(16)30370-1
https://annals.org/aim/article-abstract/2091327/sedentary-time-its-association-risk-disease-incidence-mortality-hospitalization-adults
https://sci-hub.se/https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2816%2930370-1.pdf
https://www.health.harvard.edu/blog/the-truth-behind-standing-desks-2016092310264
https://academic.oup.com/aje/article/187/1/27/4081581

We did it !

Some exciting news to share for our Tokyo clients.

Tokyo international Chiropractic ( TIC ) is very grateful to the Tokyo College of Chiropractic for allowing us to consulting space to test the market over the last few months. We were very heartened by the level of demand.

Tokyo international Chiropractic is proud to announce that we have now secured a permanent location in Eibusu just a short walk from the station and only a 10 minute walk from the Shibuya station.

Many thanks to Sata-san who has invited TIC to share his beautiful clinic ” Physic Chiropractic ” and we look forward to being able to continue to offer Chiropractic services to the english speaking expatriate community of Tokyo.

If you are seaking an English Speaking Chiropractor in the heart of Tokyo we hope you can consider our services. For the direct link to our online calender and booking service please go to

https://niseko-chiropractic.cliniko.com/bookings?business_id=884386216470906756

[Please purchase a license if

Google maps link of new location ( after 3rd October 2022 )

So what exercises work ?

A very interesting article was recently published in the British Medical Jounal.

They examined the important question of which type of exercises work best for chronic lower back pain ?

Should we be doing yoga, pilates strength training or Mckenzie extension exercises to help our lower back pain. We don’t have time for everything so what works the best ?

Lower back pain that last more than 12 weeks ( Chronic lower back pain ) is a huge burden to society. Although chronic lower back pain only makes up 20% of cases that present to us practitioners it makes up over 80% of the costs for the direct costs of low back pain and if you have chronic lower pain you know you would be happy to try anything for meaningful result.

Each week there seems to be a new ” miracle cure ” or celebrity exercise program that is going to cure all and make all our flabby bits go way. Should we be doing kettle bells squats or swiss ball situps ? what is really going to help ?

And The Answer ?

Well according to authors the good news is that almost all exercise programs that you can choose from tend to make a significant improvement but not 1 thing seems to be so much better than anything else (1) .

So if you already drawn to pilates and yoga and enjoy the social aspect of these programs then pick one of those and stick to it.

Stretching by itself seemed to have very little improvement so if you are trying to treat your back pain just with stretches you watched from youtube you may have work cut out trying to get a good result.

The Mckenzie method which seemed to be darling child of rehab for few years got poo pooed in the study (1) My thoughts on this is that the Mckenzie method really seems to shine when you are dealing with a disc issue and much of non specific lower back does not really have a firm diagnosis so perhaps we may be making the sample size a little to general here. (1)

And The Winner ?

This study seemed to indicate that the pilates method seemed to yield the highest results but only by small margain against the others. The authors also sound significant improvements for mental health so if we can get off just looking at pain for a moment there are far higher reaching benefits to choosing an exercise activity that works for you.

Just my hunch but one reason I think the mat classes do so well is the social interaction and support you get from them. There is a big plus to exercising where you have friends waiting your attendance and have somebody to share a coffee with afterwards.

Even simple old arerobics seemed to get some positive results so even joining a fitness class or taking up light jogging my useful.

Us manual therapists also received a kick up the bum. It’s hard when research does not always agree with your clinical experience but if you are going to have some faith in the science then we are going to have to eat humble pie sometimes. As therapists we must try harder to incorporate exercise therapy into our treatments and also help hold the patients accountable for commitment to their chosen exercise program.

We must be a little cautious here. the beauty of the meta-analysis is that it allows a bit more power in finding what really works but the downside is that by throwing so many studies everything can get so generic that it can loose relevance to the actually condition.

This study only looked at ” non specific lower back “. If your therapist is confident of a structural diagnosis for your symptoms then some of the conclusions here may not be relevant for you. I’m thinking disc herniation or chronic SI ligament problems etc.

So the take home message for those in Niseko experiencing chronic lower back is that what is important is to pick an exercises intervention that works for you and stick to it.

In conjunction with a trial of manual therapy you will be well positioned to give yourself every chance of an active and enjoyable recovery.

If you would like to make an appointment with an English in speaking chiropractor in Tokyo Japan you can do so on the link below

Tokyo Chiropractor Appointments

References

https://bjsm.bmj.com/content/early/2019/10/28/bjsports-2019-100886

How important is training to failure ?

I have a confession to make first.

I have not been back to the gym since the Corona Virus shutdown my favourite little weights room at the Kutchan gym. You can see updated status on the Kutchan public gymnasium on the link below

https://www.town.kutchan.hokkaido.jp/culture-sports/sports-shisetsu/kucchan-taiikukan/

When I was training last summer season there was a school of thought going round the gym and probably every gym that you really need to keep pushing your reps until you fail, until you are not able to squeeze out even one more press. That was the point that you had a short rest, then repeated the movement. It was based on the idea that by pushing to failure you are more likely to cause the micro-damages necessary to cause muscle hypertrophy and also help train your nervous system to better at muscle recruitment.

Here is the interesting thing. that theory has not been tested by science as much as you think it would have by now. A brilliant study was just published by Lacerda et al ( 2020) that looked at the effect of weight training to failure verses just doing an equal amount of reps overall but not pushing up to the point that you simply can’t perform one more press.

And what did they find ?

The good news is they both work.

If you start training regularly you will get stronger. This is also suits the findings or other research looking at number of reps verses amount of weight etc. Whatever you end up doing. If you do resistance training regularly you will stronger and the difference between various methods may not be as much as we think.

What Lacerda’s study did was divide the group of 10 untrained me in to 2 groups. Over 35 training sessions one group pushed right to failure the other just did the same amount of reps but with a little more rest. Interesting for about 50% there was no difference whilst some individuals found a small difference with some getting better results with going to failure, others getting better results just doing the volume.

But the take of the home message of this study has to be that it’s really the volume and number of training sessions that seems to be more important that if you go to failure or not. This is certainly new news to some gym folk law that is still passed around. The caveat here is still need to be putting in a hard effort however, please don’t misinterpret this message as ” working hard doesn’t matter ” it’s just we are trying to tease out just how important it is if go right to point that we simply can’t perform the last rep.

The findings of this study may be particularly interesting to you if you rehabing an injury. Obviously by pushing to failure there is much high chance of loosing good form in our lifts and also becoming unstable and risking further injury.

So if you are comfortable training to failure and can maintain your good lift form even at failure you are probably just fine to keep on going the way you are, but if you are new to weights, nursing through an injury or worried you may slip and fall then you can pull back from this brink and know you are still getting a great workout.

For an appointment with an english speaking chiropractor in Tokyo please go our appointments page

References

Lacerda LT, Marra-Lopes RO, Diniz RCR, et al. Is Performing Repetitions to Failure Less Important Than Volume for Muscle Hypertrophy and Strength?. J Strength Cond Res. 2020;34(5):1237-1248. doi:10.1519/JSC.0000000000003438

Pubmed link: https://pubmed.ncbi.nlm.nih.gov/31809457/

English Speaking Chiropractic now in Tokyo

We are very proud to announce the launch of Tokyo International Chiropractic from the 15th of August 2022.

After 4 years in Japan Niseko Chiropractic is now proud to expand to the busiest city in the world and we feel there is an exciting space in the market for a native english speaking chiropractic service in Tokyo.

We are currently operating from our office in Shimbashi but will have some exciting announcements on a more permanent location soon.

Here is a pic of the U-max building in Shimbashi.

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